Returning to School

Consider school re-entry as an ongoing process that begins when a student is injured or has a prolonged school absence. Each stage may require different skills, tasks, and information sharing. Ongoing open communication between the school, child, and parent is essential to a child receiving adequate support. School re-entry can begin, stop, and resume at any point throughout the recovery process.

It is common for children who have been injured or who have visible differences to need help with school at certain times, such as when:

  • Starting school (daycare, pre-school, or kindergarten)
  • Returning to school after an injury or hospital stay
  • Moving from one grade to another
  • Changing schools (refer to the “School Changes” module for more information)

The return to school process can be affected by:

  • Special needs of the student
  • Age of the student
  • Severity and location of injury
  • Presence of visible differences
  • Length of time away from school
  • Ongoing medical, rehabilitation, or recovery issues
  • New or long-term disability factors
  • Other individual factors, such as:  family resources, social support, coping behaviors, previous experiences in school, prior academic performance, etc.

There are things you can do throughout a student’s recovery to help them re-acclimate. It is helpful to think of this process in stages. Click on each stage below for information and tips on successfully completing it.

Post Injury: Initial Communication

  • Identify a family spokesperson to give and receive information.
  • Obtain information about the child’s injury and anticipated period of absence from school.
  • Prepare yourself and other students in the class by:
    • Staying informed on the child’s recovery progress
    • Anticipating potential classroom accommodation needs
  • Clarify circumstances of the injury event impacting the family: loss of home, other injuries or deaths, uninjured siblings within the school district, etc.
  • Ask about family preferences regarding:
    • Information to be shared with other students
    • Hospital or home visits by students or teachers
    • Plan for sharing ongoing information with the school about the child’s recovery
  • Once you have spoken to the family, plan to familiarize yourself with:
    • Burn injuries
    • Medical treatment and recovery
    • Physical and emotional needs
    • Injury prevention education
  • Talk with your students about their classmate’s injury:
    • Provide accurate information
    • Prevent or correct rumors
    • Discuss their reactions and answer questions
    • Discuss ways in which they can support the student

Absence from School

The length of treatment or hospitalization can vary. The longer it is, the more important it is for the student to maintain contact with the school. Here are a few ways to help encourage that contact.

  • Ask the family if they are using Care Pages or other free patient blogs to keep family, friends, and school peers updated and involved in the child’s recovery.
  • If approved by the family, have students draw pictures, write letters, or make cards for their injured classmate.
  • Offer to send classroom assignments to the student.
  • If the student is hospitalized, coordinate school lessons with the hospital’s child life or school program. To view an example of the University of Michigan Hospital School, click here.

The medical team determines when a child is medically ready to return to school. Ongoing communication with the parents will help identify a student’s potential return to school date. Consider asking the parents to send you a medical information form when the student is ready to return to school.

Returning to School, Initial Preparations

  • Anticipate that children may need additional school re-entry planning and help if they have:
    • Extended hospitalization or absence from school
    • Visible changes in appearance
    • Altered physical or functional abilities
    • Ongoing medical or rehabilitation treatment
    • Expressed fears or concerns about returning to school
    • New or pre-existing behavioral or cognitive issues (ADD/ADHD, learning disability, developmental delay, anger management, etc.)
  • Refer to the list of available resources that you can use to help prepare for the student’s return.
  • Identify a plan of action that will facilitate the child’s re-entry back into the classroom.
  • Consider requesting a meeting with the parents and student to identify the child’s needs and level of function before the student’s return to school.
  • Discuss if a school re-entry educational intervention will occur, and answer specific questions such as:
    • When should it be held (prior to return, during a school visit, or the day of the child’s return)?
    • Who will be presenting (child, parents, teacher, etc.)?
    • What content or information will be covered?
    • Will it be held in the classroom or as a school assembly?
    • Will siblings or their classmates be included?
    • Does the student or parent have other requests?
  • A short classroom visit 1 – 2 days before returning to school can help the student get reacquainted. This short visit may provide a more gradual and relaxed return than an immediate full-day of classes.
  • Include classmates in the process by having them share what has happened in school during the student’s absence.
  • Frequent medical and therapy appointments may need to be accommodated as a part of the school re-entry plan.
  • A student may be able to complete their physical therapy activities at school to minimize absences from the classroom.
  • Ask about any special care or treatment routines that need to be incorporated at school.

Returning to School, Ongoing Considerations

  • The first few days and weeks of returning to school are a period of adjustment. Watch a brief video of one educator’s experience in helping an injured student enter kindergarten.
  • Symptoms of Post-Traumatic Stress Disorder (PTSD), depression, or anxiety may surface at any time during school re-entry, and may need to be treated.
  • Parents, school personnel, and the child need to speak frequently and assess the success of the transition back to school. It is important to share this assessment with each other to focus on what is working and to identify any issues that still need to be addressed.
  • Set up parent-teacher or parent-counselor conferences as necessary.
  • Encourage other school personnel (e.g. bus drivers, coaches, cafeteria monitors, etc.) to review the REACH program materials.
  • Keep substitute teachers and other school personnel updated on the school re-entry plan, including any unique accommodations needed.
  • Evaluate if any special needs or medical accommodations that were initially put into place are still working effectively.
  • Monitor the reactions of school personnel and other students in the classroom, school, and bus.
  • Seek additional help and advice if students or staff have difficulty dealing with the child’s return.
  • Be mindful of your own thoughts and feelings.
  • Seek assistance when problems seem beyond your skills or comfort level.
  • If the returning student has a sibling in your school, consider:
    • The sibling can be at risk for issues with guilt, teasing, bullying, acting out, or other behavior problems.
    • Discussing the potential need for school-wide education on visible differences, injuries, teasing, or bullying.
    • Sharing ideas and collaborating with other school personnel on ways to handle the school return.
    • Coordinating the school return and educational intervention plan with the sibling’s teachers.

Completion of the School Year and Plans for Next Year

  • To facilitate a smooth transition to the next teacher and school year, review and report:
    • How the child and peers adapted
    • Special needs or accommodations required
    • Difficult situations that caused problems for the child or peers
    • Interventions that helped
    • Educational materials used to assist the child and classmates
    • Attendance issues
    • Planned reconstructive surgery or medical procedures that might impact the next school year

Depending on the age of the child, there are special considerations to keep in mind when facilitating their school re-entry process. Click on your student’s age range below for more information. Since every child is different, you may find it helpful to review the advice for other age ranges as well.

Children 2-6 Years Old

Injuries or prolonged hospitalization at a young age may contribute to developmental delays in behavior, motor skills, speech, emotional reactions, hearing, etc. These delays may first be recognized in the school setting. Here are some things to keep in mind when working to re-integrate a young student.

  • Incorporate discussions on visible differences into social skills training with studentsRefer to the “Social Skills Training for Visible Differences” module for additional tips.
  • Young children can misinterpret or misunderstand what they see and ask blunt questions like:
    • “Is he old?” (Burn scars can look like the wrinkles they have seen in older people)
    • “Does it hurt?” (Newly healed skin appears red)
    • “Why are you wearing a costume?” (Some burn wounds require wearing special pressure garments or face masks)
  • Children at this age often use simple or special words to describe their injury and appearance. Ask parents to share these words with you.
  • Open curiosity and staring are common for younger children. Refer to the “Managing Questions and Stares” module for additional tips.

Children 7-11 Years Old

Appearance becomes more important to children in this age group. They can be less accepting of others who are different. Children must learn to deal with larger groups of peers with diverse backgrounds and experiences. As a result, students who have previously adjusted well at school may need extra support or help at this age.

It is important that the student not be defined by their injury or appearance. General discussions on differences in appearance or function can be incorporated in your regular teaching activities so the student isn’t singled out. Focus on the things the child is able to do vs. things they are limited by.

Here are some other things you can do to help your student successfully re-integrate into the classroom.

  • Encourage involvement in extra-curricular activities that will build confidence and skills.
  • Include coaches and group leaders throughout the school re-entry process; encourage them to review the REACH program materials.
  • Notify the family of upcoming special school events or activities, so they can be considered during planning for elective medical treatment or therapies.
  • Children with chronic illness or injury are known to benefit from additional social skills and problem-solving training.
  • Identify local social skills training programs, and refer students for additional support and help as needed.

Teens 12-17 Years Old

It is important to engage the student in their school re-entry process, and ask them what their wishes are. The student may have strong opinions about how much help they wish or need. Since students of this age often have several teachers and interact with multiple classrooms of peers throughout the day, the school re-entry process must be well-coordinated among all school staff involved.

The student may need help in understanding or clarifying mistaken beliefs about how an injury or chronic illness will impact:

  • Social activities and relationships
  • Current educational program participation
  • Plans for a career or advanced education
  • Employment