A large number of children diagnosed with leukemia are preschoolers. Parents face the dilemma of continuing preschool through treatment, risking exposure to all the usual childhood viruses and diseases, or holding their child out, which denies them the opportunity for social growth and development. The decision is a purely personal one made after considering the following issues:
• Has the child already had chicken pox or received the chicken pox vaccine?
• Is the child already enrolled and comfortable in a preschool program?
• Are social needs being met by siblings and/or neighbors?
• Is preschool an option, given medical considerations?
Elizabeth was in preschool at the time of her diagnosis. The manager did a wonderful job of integrating her back into the fold. All of the other children at the school were taught what was happening to Elizabeth and what would be happening (such as hair loss). They learned that they had to be gentle with her when playing. The manager was a former home health nurse, so I was very confident that she would be able to take care of my daughter in the event of an emergency. She was already familiar with central lines and side effects from chemotherapy. She was a gem!
• Does the child need special services, such as early childhood intervention, including physical, occupational, and speech therapy, that are available through the school system?
US federal law mandates early intervention services for disabled infants and toddlers and, in some cases, children at risk of having developmental delays. Infants, toddlers, or preschoolers with leukemia may be eligible for these services in order to avoid developmental delays caused by the cancer or treatments. These services are administered either by the school system or the state health department. You can find out which agency to contact by asking the hospital social worker or by calling the special education director for your school district.
The law requires services not only for the infant or preschooler, but for the family as well. Therefore, an Individualized Family Service Plan (IFSP) is developed. This plan includes:
• A description of the childs physical, cognitive, language, speech, psychosocial, and other developmental levels.
• Goals and objectives for family and child.
• The description, frequency, and delivery of services needed, such as:
- Speech, vision, occupational, and physical therapy.
- Health and medical services.
- Family training and counseling.
• A caseworker who locates and coordinates all necessary services.
• Steps to support transition to other programs and services.
We have had an excellent experience with the school district throughout preschool and now in kindergarten. We went to them with the first neuropsychological results, which were dismal. They retested him, and suggested a special developmental preschool and occupational therapy. Both helped him enormously. He had an evaluation for special education services done, and now has a full-time aide in kindergarten. He is getting the help he needs.
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