Starting a new school or nursery can be a difficult transition period for any child. For children affected by retinoblastoma (Rb) there could be many other issues which may influence your choice of where you would like your child to be educated.
Visiting nurseries and schools and talking with the staff will allow you to assess how confident you feel about their ability to meet your child's needs. The needs of your child will vary according to the degree to which retinoblastoma has affected their vision. If your child is still having treatment you may have other considerations. See our section on time out for treatment.
Our section on special educational needs and visual impairment provides further information for children with severe vision loss as a result of retinoblastoma.
The move from a familiar and small school or nursery to a new environment may be very worrying for a child with sight problems - and also for the school. Changes can be very unsettling, and other children may ask difficult questions.
But in many unilateral cases where sight in one eye is impaired or the eye has been removed and the remaining eye is not impaired the child will hopefully be adapting well and getting on with life. But there are still some important points you need to consider and make school staff aware of. See our section on artificial eyes and monocular vision for more information.
At nursery learning activity is quite fluid and the other senses of touch and hearing can play a more important role in learning at this age. The reassurance and confidence of a voice is important in ensuring the child has followed what is going on and is taking part.
It is important to prepare the nursery and/or school and give them the background to your child's condition as to what to expect in certain situations.
For your own peace of mind and the confidence of your child, try and make arrangements to meet the class teacher and chat to him/her about your child's needs prior to them starting. For advice on what to tell them see what shall I tell my child's school.
The school or nursery will need to have a simple background to retinoblastoma and knowledge about the degree to which it has affected your child's vision and well being. A factsheet can be printed off from our about retinoblastoma section and there is more detailed information on specific treatments relevant to your child which you may find helpful.
Managing an artificial eye
Our dedicated section on artificial eyes provides information for parents and teachers on caring for your child's eye during school. It also looks at the considerations which need to be made for children with monocular vision.
Inclusion in sport can be even more valuable than usual in restoring a child's confidence, social ability and sense of belonging brought about through teamwork. There is more information on what school staff should be aware of regarding sports in our section on what shall I tell my child's school. See also our section on sports goggles and protective glasses.
Interest from other children
If you child has an artificial eye then, when the time is right, you may need to address the curiosity of other children in the class. There are some tips on how best to approach this under our artificial eyes section.
Research in the USA suggests some children treated with chemotherapy or radiotherapy could be affected in other ways. The research does not relate to retinoblastoma treatment specifically and of course many children who have not been treated also display these symptoms so this should be born in mind. Some of the issues covered are:
- understanding, remembering and processing mathematical concepts and facts
- memory and information retrieval skills
- attention deficits
If you are interested in reading more, you may find the publications (from the USA) listed at the end of this page useful.
Further academic concerns
If the teacher suggests that your child is simply not attentive in class, or needs to work harder, it is possible that other learning difficulties are being missed. Many learning disabilities are invisible, especially when the child concerned has a high level of intellect (such as is common in survivors of retinoblastoma). Paying attention to your child's comments about his/her ability to keep up in class, or lack of enthusiasm for school could also alert you to other unidentified learning difficulties.
If you are concerned, ask to speak to the school's SENCO, and request a psychological assessment to be undertaken and/or begin the statementing process if it is thought that additional support would be helpful.
Taking the first steps in the process is often hard for parents and teachers because children affected by retinoblastoma treatments usually have excellent reasoning skills and often display above average intellect. However, it has been suggested that some may perform less well in subjects such as maths and science, which require good vision, rapid processing skills, short-term memory and sequential operations.
Many difficulties are frequently eliminated or vastly improved by using large print or audio resources, employing memory enhancement tasks, eliminating or increasing the length of timed tests, improving organisational skills, allowing the child to use a computer or typewriter in class, and acquiring a classroom assistant for the child in subjects such as maths and science.
Janes-Hodder H, Keene N, (2002, 2nd Ed), Childhood Cancer: A parent's guide to solid tumor cancers, O'Rielly, Sebastopol, CA. USA.
Keene N, Hobbie W, Ruccione K, (2000), Childhood Cancer Survivors: A practical guide to your future. O'Rielly, Sebastopol, CA. USA.
Visit www.childhoodcancerguides.org for more information.
Further sections you may find useful
How to prepare your child’s school and safety aspects to consider in a education environment
This section includes information on monocular vision, sports goggles and visual aids to help your child adapt.
How to keep everyone informed if your child needs treatment while they are at school.
Basic tips on how to make sure your child’s eyes are looked after in school.
Looks at extra assistance your child may need and other education options.
If you run into difficulties regarding care for your child’s eyes in school, a medical professional may be able to support you.