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| |    Understanding Sickle Cell Disease: Instructions for Teachers by Laura Jana, M.D., F.A.A.P. reviewed by Lewis Hsu, M.D., Ph.D. For the most part, children with sickle cell disease should be able to actively participate in the regular school setting. There are, however, some ways to make participation in day-to-day activities less likely to trigger complications of the disease. It is important to keep in mind that for children with sickle cell disease, any severe or untreated complication can be life threatening. If you observe any sign or symptom that concerns you, you shouldn't hesitate to get the child into the care of medical professionals or evaluated at a hospital or treatment center. Basic classroom guidelines Anticipate more missed school days. A child with sickle cell disease often misses more school days than normal because of episodes of pain, routine medical treatments, and trips to the hospital. It's helpful, therefore, to have a game plan for providing make-up work so that she will be able to continue her studies during the absence whenever possible. Aside from any materials or extra help that you can offer, if you anticipate a prolonged absence or see a child starting to lag behind, you might suggest that her parents arrange for a tutor at home or at the hospital. Allow extra water and bathroom breaks. In busy classrooms, it is not uncommon to limit water and bathroom breaks. For children with sickle cell disease, however, these rules need to be relaxed a little. The simple act of staying well hydrated can help prevent pain episodes and avoid organ damage. Children with sickle cell disease also need to take bathroom breaks more frequently, not only because of increased water intake but because their kidneys produce more urine, even when they're dehydrated. Pay attention to temperature control. Simply becoming overheated or too cold is enough to trigger a pain episode in a child with sickle cell disease. Keeping the temperature in the classroom comfortable is important, as is reminding the child to wear a jacket outside during cold weather or to take off a layer of clothing if she gets hot. Be aware of the need to rest. Because of the anemia characteristic of sickle cell disease, children can become tired sooner than their peers. For many children, admitting to this fatigue and taking a break from sports and gym activities can be embarrassing and draw unwanted attention. While participation should be encouraged, make it easy (and as inconspicuous as possible) for the child with sickle cell disease to take regular breaks. Don't assume lesser intelligence. While sickle cell disease can affect many aspects of everyday life, it does not inherently play a role in a child's intelligence. The academic abilities of a child with sickle cell disease may be affected by missed school and the impact of having a lifelong illness, not generally from a learning disability. For this reason, it is especially important to promote continued learning even in the face of absences, and identify learning problems as you would for any other child. In this day and age, children with sickle cell disease can lead long and productive lives, and a good education is key to making this a reality. Be vigilant. Sickle cell disease is one of the few conditions that can cause stroke (brain injury) in children. An uncharacteristic slip in academic importance may be a subtle sign. Please notify the child's family at once if any of the following symptoms appear without another explanation:
Be informed. The best thing you can do is to be informed about sickle cell disease and then create a plan to help a child stay involved, free of complications, and engaged in learning. Children with this disease are in most ways just like other children, but they do face particular challenges because of their lifelong disease. You can play an important role in offering them the chance to lead relatively normal and productive lives. If you'd like to learn more, the Georgia Comprehensive Sickle Cell Center offers a website for teachers.
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