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Classroom Accommodations

Childhood cancer treatment may have long-lasting side effects that can affect learning.

Sometimes children and teens may struggle in school in ways they didn’t before treatment. Some students may have problems focusing and paying attention.

But there are ways to help children adapt to changes. The key to getting the most out of these options is for your family, school, and hospital to work together. A school liaison can help you with putting this team together.

Some treatments can affect:

  • Memory
  • Learning
  • Focus
  • Attention
  • Processing
  • Organization

Federal law provides for supports and services through Individualized Educational Programs (IEP) and 504 Plans. The goal of both is help students with challenges learn better.

  1. What is an IEP?

    An IEP is a plan for special education services. It is part of the federal law called Individuals with Disabilities Education Improvement Act (IDEA). Schools must offer IEPs if they receive federal funds.

    Pediatric cancer patient sits in desk with text book open in conversation with unseen teacher.

    Students can qualify for an IEP if they have both a disability and a need for help with school to deal with the disability.

    Who can get an IEP?

    Students can qualify for an IEP if they have both a disability and a need for help at school to deal with the disability. Disabilities may include:

    • Learning
    • Behavior
    • Physical
    • Social
    • Emotional

    Your child must have a disability in at least one (1) of these areas.

    • Autism
    • Deafness
    • Deaf-blindness
    • Emotional problems
    • Hearing impairment
    • Cognitive (mental, thinking) disability
    • Multiple disabilities
    • Orthopedic (bone and joint) impairment (problem)
    • Other health impairment (problem)
    • Specific learning disability
    • Speech or language impairment
    • Traumatic brain injury
    • Visual problems

    Possible IEP Services

    Examples of IEP-related services include:

    • Teaching or tutoring, such as specialized reading or math help
    • Counseling, including rehabilitation counseling (independent living and job training)
    • Occupational therapy, physical therapy, and speech/ language/ hearing support
    • Parent counseling and training
    • Psychological services
    • School health services
    • Social work services
    • Transportation services
    • Accommodations such as extra time for tests, reduced workload, and other accommodations as listed below:
      • Seating at the front of the classroom
      • Locker located near classrooms
      • Second set of textbooks for home
      • A “scribe” for long written work
      • Copies of teacher’s notes
      • Use of a study guide
      • Extended time on tests, classroom assignments, and homework
      • Shortened or modified assignments
      • Use of elevator
      • Verbal testing
      • Memory, technology, verbal, or visual aids
      • Permission to leave class early to walk in uncrowded hallways
      • Buddy system for visits to the school nurse’s office
      • Permission to wear a hat at school
      • Prompt phone contact with parent when another student in the classroom has a contagious illness
      • Rest breaks

    Children and teens may receive these services in a number of settings. For example, teachers may present lessons in a special education classroom or area. Or, students may be pulled out of a general classroom for part of the day. They may receive small group instruction in reading and math or services such as speech or occupational therapy.

    How Can my Child Get an IEP?

    Students may go through an evaluation process. Contact the special education coordinator at the school about getting an IEP evaluation. If the school does not have a special education coordinator, you may talk to the school administrators, counselors, or teachers. Parents must sign an informed consent to give permission for the evaluation.

    It’s a good idea to meet with educators before the evaluation to discuss the process and ask questions. Make sure to write down any questions you want to ask and to take notes during the meeting.

    If the school elects not to do an evaluation and the parents believe an evaluation is needed, an outside psychologist can conduct an evaluation. The report from that outside evaluation can be submitted to the school system for review.

    The students’ evaluation team could include an:

    • Audiologist
    • Psychologist
    • Speech-language pathologist
    • Social worker
    • Occupational or physical therapist
    • Vision specialist
    • Classroom teacher
    • Special education teacher
    • Education diagnostician

    The team may collect data through observations, interviews, tests, report card grades and classroom performance. The process may involve parents, teachers, specialists, and students.

    The final report will paint a thorough picture of your child’s strengths and weaknesses. The IEP committee will meet and review the results and recommendations. 

    If your child qualifies for an IEP, educators will create one and review it with parents. The IEP committee will meet each school year to talk about how the plan is working. Students will have a new IEP evaluation at least every 3 years.

    If your child doesn’t qualify for an IEP, you can talk with the school about other types of academic support.

  2. What Is a 504 Plan?

    A 504 Plan is for students with medical concerns. It provides for modifications in their classrooms to help them learn better. It is part of a federal civil rights law, Section 504 of the Rehabilitation Act of 1973. It applies to public school and other programs that get funds from the U.S. Department of Education. The qualification for a 504 plan is different from an IEP.

    To be protected under Section 504, a student must be determined to: have a physical or mental impairment that substantially limits one or more major life activities; or. have a record of such an impairment; or. be regarded as having such an impairment.

    The purpose of a 504 Plan is to give students with learning problems the same access to instruction, activities, and school buildings as children without learning problems.

    A 504 plan documents your child’s needs and may be useful in case your child requires more support in the future.

    The law requires the 504 team meet at least once a year to review your child’s progress. You may request changes at any time.

    Young pediatric cancer patients sits with classmates in cap, gown, and face mask.

    For pediatric cancer survivors, creating a 504 plan with your child's school may result in additional support in the classroom.

    How is a 504 Plan different from an IEP?

    The main difference is that a 504 Plan modifies a student's education program in a general classroom setting. The classroom teacher delivers instruction.

    A student with an IEP may receive services in a special or general educational setting. A special education teacher usually oversees instruction.

    How may I request a 504 Plan?

    Ask for a meeting with the school to discuss creating a 504 plan.

    Usually the school will have a Section 504 coordinator. If not, you may talk to the school administrators, counselors, or teachers.

    What could my child receive with a 504 Plan?

    Examples of common supports include:

    • Seating at the front of the classroom
    • Locker located near classrooms
    • Second set of textbooks for home
    • A “scribe” for long written work
    • Copies of teacher’s notes
    • Use of a study guide
    • Extended time on tests, classroom assignments, and homework
    • Shortened or modified assignments
    • Use of elevator
    • Verbal testing
    • Memory, technology, verbal, or visual aids
    • Permission to leave class early to walk in uncrowded hallways
    • Buddy system for visits to the school nurse’s office
    • Permission to wear a hat at school
    • Prompt phone contact with parent when another student in the classroom has a contagious illness
    • Rest breaks

IEP or 504 Plan Meeting

What Will Happen during the Meeting?

The 504 Plan or IEP meeting may include:

  • School administrators
  • Counselor
  • Teachers from school
  • Parents
  • Hospital school program teacher or liaison (may be done by conference call if needed)

The group will discuss the specific accommodations or support services your child might need in school. Members will identify the problems your child is having and propose solutions.

What Information Should I Bring to my Meeting?

You know your child better than anyone.

Suggest approaches that have worked in the past.

Bring information about your child’s cancer and the side effects of treatment to share with educators.

What are Tips for an Effective IEP or 504 Plan?

It’s important that the IEP or 504 Plan be specific in the wording of accommodations or support services your child needs. This wording can eliminate confusion. For example, if your child is to receive memory aids, name the exact memory aids.

Make sure to document who is responsible for carrying out the different parts of the IEP or 504 Plan. Discuss all school settings that might require supports – each classroom your child spends time in, outdoor recess and physical education, and field trips.

You know your child better than anyone. Be your child’s advocate in planning and monitoring your child’s progress. If you believe your child’s needs aren’t being met, request a meeting to discuss needed changes.

For more information, talk to your hospital’s school liaison or teacher or administrator at your child’s school.


Reviewed: July 2019