Type 1 and Type 2 Diabetes

Diabetes is a chronic medical condition that affects many children in the United States. The chapter provides an overview of type 1 and type 2 diabetes and focuses on the roles of school-based providers in helping students with diabetes, in collaboration with families and medical providers. Specific strategies, such as educating school personnel and peers about the conditions and treatments and recognizing and responding to symptoms of the conditions, are discussed. Providing assistance with, and supervision of, self-management tasks, monitoring symptoms, and identifying and implementing appropriate school-based accommodations are some key activities school-based professionals adopt to support students with diabetes. Additionally, addressing any learning or psychological concerns and assessing for possible diabetes-related contributors are critical. Included in the chapter are handouts with helpful resources for professionals, lists of measures for assessing concerns common to children with diabetes, and a tool to support student engagement in self-management activities related to diabetes care.

Cardiovascular Disorders

Congenital heart disease (CHD) is one of the most common birth defects in the United States, affecting approximately 1% of births per year, with most children surviving into adulthood. Despite improved survival, individuals with CHD remain at high risk for neurological, cognitive, and psychosocial challenges that affect quality of life across the lifespan and have specific implications for working with children with CHD in the school setting. This chapter describes several common complications of CHD, as well as acquired heart defects, that have implications for how children with the conditions present in the school setting. The chapter also provides information about common neurodevelopmental disorders associated with these medical conditions and the effects of the conditions on psychological adjustment and quality of life in children. Finally, the chapter concludes with a review of intervention strategies that school-based professionals may adopt when working with children with heart conditions.

Neurodevelopmental Disorders Presenting in Early Childhood

Neurodevelopmental disorders are a group of conditions that manifest in early childhood and are associated with differences in brain development. They are associated with difficulties with learning, movement, language, or social behaviors. This chapter provides school-based clinicians with a broad overview of neurodevelopmental disorders that present in early childhood, with a particular focus on those associated with specific underlying medical conditions. The reviewed medical conditions and complications include genetic and congenital anomalies, cerebral palsy, and preterm birth. For each of the varying medical complications and conditions, the chapter discusses the assessment and management of the associated neurodevelopmental difficulties, with a focus on applications for the school setting. The chapter ends with a broad overview of school-based intervention strategies and approaches that are commonly implemented when working with children with neurodevelopmental disorders.

Academic Issues Related to Pediatric Health Conditions in Schools

Children with chronic health conditions may experience academic challenges for a multitude of reasons. This chapter provides an overview of the educational difficulties encountered by children with pediatric health conditions. It also provides a summary of the causes of some of the difficulties, such as the neurodevelopmental effects of a medical condition or treatment, school absenteeism, and school refusal. The chapter includes a table summarizing the neurocognitive effects of common pediatric health conditions. Information about school-based strategies for students with chronic health conditions is presented. The strategies include individual health plans, individualized accommodations, and individualized interventions to address factors that may affect educational outcomes. Finally, the chapter includes a problem-solving framework for school-based professionals to use when engaging in educational planning for a student with a pediatric health condition.

Hematologic/Oncologic Disorders and HIV

Schools across the country serve children with a variety of health-related conditions, some which are hematological disorders (i.e., related to blood or bone marrow). Of these, some are oncologic disorders that affect the blood (e.g., leukemia), others are disorders of the blood system (e.g., sickle cell disease), and others are infectious diseases that may involve blood-borne pathogens (e.g., human immunodeficiency virus). This chapter describes each of the aforementioned disorders with a specific focus on factors of particular relevance to school-based clinicians and teachers. Common symptoms and relevant complications with each condition are listed in a table. Each condition’s description includes a case example to emphasize practical applications of material presented. Subsequently, pertinent considerations for assessment and intervention work in the school setting are highlighted for the three conditions concurrently.

Pulmonary Disorders

Pulmonary disorders affect the functioning of the lungs. Two of the most common pulmonary disorders in children are asthma and cystic fibrosis, and for each of these two conditions, the chapter provides a review of the symptoms, treatment, and prognosis, as well as associated risk and protective factors, sociocultural and environmental considerations, and legal and policy-related concerns. Reviews of common school-related concerns and psychological comorbidities associated with each condition are presented, and the topics are illustrated by case examples. The chapter includes specific information strategies and recommendations for school-based professionals to collaborate with children, families, and medical providers to support youth with these conditions in the school setting. Also included are handouts with information about important considerations in working with students with asthma and cystic fibrosis and potential resources for school personnel, students, and their families.

Gastrointestinal Disorders

Gastrointestinal (GI) disorders include a range of disorders that may affect children and adolescents with varying symptoms and levels of severity. This chapter presents a description of GI disorders common in childhood and the management or treatment approaches for each. The disorders reviewed include celiac disease, inflammatory bowel disease, constipation, and encopresis. For each of the major conditions, the chapter provides a review of difficulties that a child with the condition may encounter, including school-related issues, barriers to adherence, behavioral/emotional difficulties, and academic problems. Specific strategies for schools to implement when working with students with the conditions are provided, including approaches to assessment, intervention, and legal and ethical considerations. A series of handouts to assist with the strategies are included. Finally, the chapter concludes with a list of resources useful for school-based professionals working with students with GI conditions.

End-of-Life and Grief Issues in the School Setting

School-based clinicians are likely to encounter the death of a student or a student’s family member in their work. Providing a supportive school environment is crucial for those coping with the death of a loved one or peer. The role of school mental health professionals in assisting children, families, faculty, and staff in the aftermath of a death is complex and multifaceted. This chapter serves as a guide for school-based clinicians who work with students who are possibly facing their own death or coping with the death of a peer or family member. The chapter provides an overview of developmental stages of understanding the concept of death and strategies for professionals and families to talk about death and dying with children. Specific strategies for facilitating a supportive school environment, working with bereaved students and peers, identifying struggling students, and supporting school personnel are discussed.

Cognitive-Behavioral Interventions for Pediatric Health Concerns in Schools

Children with chronic medical conditions often require more mental health supports than their peers without health problems due to increased levels of stress related to the uncertainty of their health, frequent absences from school, and other demands associated with the treatment or management of their illnesses. This chapter provides information about the use and adaptation of cognitive-behavioral therapy (CBT) intervention strategies for children with chronic health conditions in schools. Research supports the efficacy of using CBT in school settings for children displaying varied chronic medical conditions. The chapter reviews the key components of CBT as well as research, scholarship, and clinically relevant information on the use of CBT interventions for pediatric health concerns as they relate to school-age youth. In particular, the following evidence-based CBT components are discussed: psychoeducation, cognitive restructuring, relaxation training and stress management, and behavioral exposure.

Childhood Chronic Illnesses in the Schools

Approximately one in five schoolchildren presents with a special healthcare need. Schools are tasked with providing free and appropriate education to all students, which may include both accommodations and specialized services to children to address challenges associated with their medical conditions. The first chapter of this book provides a brief overview of types of presenting conditions, challenges, and considerations that school-based providers may encounter when working with this population of students. The chapter includes a table of common medical terms, procedures, and treatments. Several case examples with accompanying discussions are described to illustrate common themes, challenges, and considerations that students with chronic medical conditions may encounter in the school setting. Finally, the role of culture in the symptom presentation, treatment, and education of students with chronic health needs is discussed.