Going Back to School After a Major Burn Injury

Based on Research by Burn Injury Model Systems

kids getting on bus

Introduction

Going back to school is a very important step in a child’s healing after a burn injury. Learning and being with friends is important to your child’s progress. It is normal for you or your child to feel stress and be worried about going back to school. This stress can be due to changes in the way the child looks or changes in what he or she is able to do. The stress could simply be due to the time away from normal schedules. Although this step might be stressful, we encourage the child to return to his or her familiar school environment. For example, if your child is in a regular public school, we recommend that he or she go back to that environment, even if that choice requires special accommodations.

Back to top

When Should My Child Go Back To School?

  • After spending many days, weeks, or even months in the hospital, the sooner your child gets back to his or her routine the better.
  • While each child’s injury is unique, on average most children go back to school between 7 and 10 days after going home from the hospital.
  • What your child is able to do and the way your child feels about his or her body will depend on the parts of the body affected by the burn, the size of the burn, and their level of selfconfidence. None of these things should keep your child from going back to school.
  • If going back to school full-time doesn’t seem possible, think about starting with a schedule of half-days or every other day.

Back to top

How and When Should I Start Planning for My Child To Return to School?

The plan for your child to go back to school should include your child and family, the school, and all members of the health care team, including the physicians, nurses, therapists, the child life specialist and teachers. Start talking about a back-to-school plan as soon as your child is medically stable and out of immediate danger. The first few days after your child is admitted to the hospital is a good time to start. Starting early gives you time to put a good plan in place.

  • Call your child’s school and let them know that your child is in the hospital. Try to call within 2 or 3 days after the injury. If you can’t make the call, ask a friend or someone on your child’s health care team to call the school. Make sure the school’s principal, guidance counselor or social worker and your child’s teachers are all aware of the situation. Ask them to designate one person with whom you should continue to communicate about your child’s progress.
  • Talk to your child about going back to school. Start the conversation early, while your child is still in the hospital. It will comfort your child to know that he or she will be able to get back to familiar routines and be with friends.
  • Talk with the health care team about the kind of help your child will need at school and how your child’s current school can best provide that help.
  • Get your child’s school work. Ask to have school work sent to the hospital. This may seem early, but having school work lets your child know that he or she will get his or her life back again. It also keeps your child in contact with the outside world and gives him or her hope.

Back to top

What Can I Do To Prepare My Child?

The first priority is to get your child back to doing everyday activities. Friends are also very important.

  • Check with your child’s health care team to see if and when you can set up short visits with close friends. If visiting in person is not possible, try other ways to get them together. Think about video chats, instant messaging, or telephone calls.
  • Talk with your child about what he or she would like to share with others.
  • If your child is able, suggest that he or she keep a diary or draw pictures of life in the hospital. This may help later in explaining to friends and classmates what happened.
  • Be supportive if your child wishes to share feelings, worries, and wishes about going back to school.
  • Many burn care centers have on-site school and fun activities for children. Help your child to take part in these activities.
  • For assistance with preparing you and your child for his or her return to school, consider consulting a psychologist, social worker, or a national organization such as the Phoenix Society for Burn Survivors.

Back to top

What Are Accommodations?

Schools are required by law to provide “reasonable accommodations” for children who have been injured. The school guidance counselor or social worker is typically the person responsible for coordinating this process. These accommodations may be available to your child as he or she recovers from the injury:

  • A flexible schedule. For example, your child may go to school for half a day and then slowly build to a full day.
  • Help taking notes. This may include the use of a special computer or equipment or having another person take notes if their dominant hand has been affected by the injury.
  • Personal assistance. Your child may get help with going to the bathroom, putting on a coat, or other everyday activities at school.
  • More time to take tests. Your child may be allowed more time to take tests if he or she has trouble remembering, learning new things, or concentrating.
  • Changes to physical education. Your child’s physical education class may be adjusted or changed.
  • Help with care of the injury during school hours. Your child may get help with stretching or putting on splints or pressure garments.
  • Visits to the school nurse. The school nurse may be available to give your child medicine as required by you and your doctor. Many of these accommodations will be short term. Your child will need less help as he or she gets stronger and moves more easily. The steps to set up accommodations may differ from school to school. Some schools will ask you to fill out forms, while others may not. If you need an advocate, call the Special Education Department in your school district and talk to them about your child’s rights and what accommodations you are requesting.

Back to top

Structured vs. Informal School Re-Entry Programs

The purpose of a school re-entry plan is to provide the child, the family and the school community with the information and support necessary to ensure a smooth transition back to school. Based on conversations with the burn care team treating your child and your child’s classroom teacher(s), you should decide whether your child needs a more structured school re-entry program or simply an informal plan. A structured program would have a curriculum that might include sample letters to send to teachers and classmates, videos, worksheets, role plays, guest speakers and other classroom activities to raise awareness about your child’s burn injury and recovery. It could be a program developed by your child’s burn center or a national program such as the Journey Back developed by the Phoenix Society for Burn Survivors. You can use some or all of the components of the program as appropriate.

In contrast, an informal school re-entry plan may simply involve having your child’s physician or another member of the burn care team, such as the child life specialist, make phone calls, send a letter, or visit the school. The hospital therapy team can help the school understand what your child can and can’t do. This information can help to make sure that your child is not kept from doing school activities with the other students, such as physical education class and eating lunch. It can also make sure your child does not have to go through unnecessary infection control practices, such as not being allowed to play on the playground or not being exposed to other children in a classroom. Some things to consider when deciding whether or not you want to use a more structured program are the specific nature of your child’s burn injury, whether he or she is shy and quiet, or more outgoing and comfortable with attention. It will also depend upon whether or not your child will be returning to school with pressure garments or splints, their level of endurance and whether or not they are returning to the same school or a new school.

A good example of a back to school program is The Journey Back: Resources to Assist School Reentry After Burn Injury. This program was developed by the Phoenix Society for Burn Survivors. This resource is for the family, child, school, and burn center. The program can be changed easily to fit your family’s needs. The program includes the following tools and materials:

  • Sample letters
  • Sample scripts for phone calls
  • Outline of a curriculum
  • Information for presentations
  • Forms for evaluations and follow-ups
  • Classroom and individual activities for children of all ages

Back to top

Complimentary Programs

Many schools have developed other programs that may help as children return to school. Teachers and students can use the skills they learned in these programs to help your child get back into school. These programs may be called anti-bullying, disability awareness, and social and emotional learning. High schools may offer tutoring, counseling, and violence prevention and peer mentorship programs.

Back to top

What Can I Do After My Child Goes Back to School?

No matter how much planning you do, you and your child may be worried about going back to school. This is natural. Reach out for help.

  • Remember to take care of yourself. Going back to normal activities yourself is an important step for your child. It may be stressful for both of you. Make sure that you look for support for your own feelings. Keeping yourself healthy will be a big help to your child.
  • Speak up for your child. Schools have many children who receive special services.
  • Be your child’s advocate, and ask what services are available for you or your child.
  • Check in. In the first few weeks after your child returns to school, check in often with teachers and counselors to see how things are going. Also check in when things change, like when your child switches grades or schools.
  • Help your child work through problems. Ask your child to be specific about problems. Then work with him or her to come up with solutions for dealing with the problems. For example, if he or she gets teased about looks, come up with different ways of handling it. Take the time to see what your child feels most comfortable doing. Then help your child practice what to say or do.

Back to top

Summary

Children with burn injuries want to get back to their everyday life. Getting back to school is an important part of getting back to normal. Work with your child’s health team, hospital or burn center, and school to set up a school re-entry plan so that everyone knows what your child needs. A good re-entry plan will give your child the medical and school services that he or she needs, and it will help your family adjust and heal.

Resources

Phoenix Society for Burn Survivors (n.d.). The journey back: Resources to assist school re-entry after burn injury. http://www.phoenix-society.org/programs/schoolreentry/

References

O'Brien, K., & Wit, S. (1985). A return-to-school program for the burned child. Journal of Burn Care & Research, 6(2), 108–111.

Rosenstein, D. W. (1987). A school reentry program for burned children part I: Development and implementation of a school reentry program. Journal of Burn Care & Research, 8(4), 319–322.

Blakeney, P., Moore, P., Meyer III, W., Bishop, B., Murphy, L., Robson, M., & Herndon, D. (1995). Efficacy of school reentry programs. Journal of Burn Care & Research, 16(4), 469-472.

Authorship

Going Back to School After Burn Injurywas developed by Lynne Friedlander, M.Ed., and Shelley Wiechman, Ph.D., A.B.P.P., in collaboration with the Model Systems Knowledge Translation Center.

Source

The health information content in this fact sheet is based on research evidence and/or professional consensus and has been reviewed and approved by an editorial team of experts from the Burn Injury Model Systems.

Disclaimer

This information is not meant to replace the advice of a medical professional. You should consult your health care provider about specific medical concerns or treatment. The contents of this fact sheet were developed under a grant (number H133A110004) from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. However, those contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government.

Copyright © 2015

Model Systems Knowledge Translation Center (MSKTC). May be reproduced and distributed freely with appropriate attribution. Prior permission must be obtained for inclusion in fee-based materials.

Back to top