**7. Living a normal life/back to school: During treatment**

Improvements in the ability of medical care made it possible for children diagnosed with cancer to live longer and, in increasing frequency, to be cured. The children are able, while in remission, to live a relatively normal life, somewhat free of their concerns about their illness. We need to help the children to engage in the educational and social activities that accompany normal growth and development . It is not enough for young people simply to survive what was once a life-threatening illness. Survival means that the children have to continue to be educated toward one day becoming fully functioning adult members of society. Thus, parents and professionals have the increasing responsibility of promoting sound academic and social development as the children go through the treatment process.

Going back to school has a very normalizing influence on the child. Integration into school is a critical and essential part of the normal psychological and social development of any child. Children with cancer are not only entitled to attend school, but they must be stimulated to do so. Even while in the hospital, children should continue their schooling, as an indication to them of hope for cure, that their life will continue as normal, despite the illness. Programs should be developed to help the children continue their schooling while in the hospital, and to help them return to their normal life as school children as soon as possible, and their teachers trained to treat the children as normally as possible. We should pay special early attention to patterns and difficulties of socially adaptive behavior in the children and most importantly be aware of the strong link between the use of cranial radiation and subsequent learning deficits. As a group, children with cancer function at less socially adapted levels in school than peers, have a tendency not to reach out to others, not to initiate activities, not to try new things, and not to express feelings freely. The children retain a self-protective attitude. And so, in addition to already being devastated by the emotional stresses associated with a child having cancer and undergoing what to them were extraordinary medical treatments, we know that the cognitive side effects of the therapy place a group of the children at a higher risk not only for learning difficulties, but also for subsequent adaptive behavioral problems.

We cannot freeze children for years during treatment while their peers continue to grow and develop, leaving the children with cancer developmentally far behind and in a catch-up mode. We must prepare children for their future. Not only should we give priority to the children continuing to live a normal life during the course of treatment, we have in fact come to view childhood cancer as a golden opportunity for the children to learn skills in coping that can give them a running start on their preparation for engaging in a fully functioning adulthood.

encouraged to bring the siblings to the hospital if the siblings wish to go, let them visit with their brother or sister, and let them see how the hospital looks; parents should be encouraged to explore the benefits of immediately telling the siblings, and should help choose which person will be the one to inform the siblings, using simple and ageappropriate language and phrasing when delivering the news of the diagnosis; and siblings should have explained to them that they were in no way responsible for causing the cancer.

Improvements in the ability of medical care made it possible for children diagnosed with cancer to live longer and, in increasing frequency, to be cured. The children are able, while in remission, to live a relatively normal life, somewhat free of their concerns about their illness. We need to help the children to engage in the educational and social activities that accompany normal growth and development . It is not enough for young people simply to survive what was once a life-threatening illness. Survival means that the children have to continue to be educated toward one day becoming fully functioning adult members of society. Thus, parents and professionals have the increasing responsibility of promoting sound academic and social development as the children go

Going back to school has a very normalizing influence on the child. Integration into school is a critical and essential part of the normal psychological and social development of any child. Children with cancer are not only entitled to attend school, but they must be stimulated to do so. Even while in the hospital, children should continue their schooling, as an indication to them of hope for cure, that their life will continue as normal, despite the illness. Programs should be developed to help the children continue their schooling while in the hospital, and to help them return to their normal life as school children as soon as possible, and their teachers trained to treat the children as normally as possible. We should pay special early attention to patterns and difficulties of socially adaptive behavior in the children and most importantly be aware of the strong link between the use of cranial radiation and subsequent learning deficits. As a group, children with cancer function at less socially adapted levels in school than peers, have a tendency not to reach out to others, not to initiate activities, not to try new things, and not to express feelings freely. The children retain a self-protective attitude. And so, in addition to already being devastated by the emotional stresses associated with a child having cancer and undergoing what to them were extraordinary medical treatments, we know that the cognitive side effects of the therapy place a group of the children at a higher risk not only for learning difficulties, but also for subsequent

We cannot freeze children for years during treatment while their peers continue to grow and develop, leaving the children with cancer developmentally far behind and in a catch-up mode. We must prepare children for their future. Not only should we give priority to the children continuing to live a normal life during the course of treatment, we have in fact come to view childhood cancer as a golden opportunity for the children to learn skills in coping that can give them a running start on their preparation for engaging in a fully

**7. Living a normal life/back to school: During treatment** 

through the treatment process.

adaptive behavioral problems.

functioning adulthood.
