Jeff's Story

Facing Illness with Equanimity

Jeff had his first seizure when he was ten years old. Since then, he has been having seizures regularly, every four or five weeks. Soon after he entered secondary school, his classmates realised that he had epilepsy, and some started teasing and bullying him. A few even pretended to have a seizure in front of the class to make others laugh.

Most of his classmates considered it funny and didn't realise their teasing had hurt Jeff. His teachers did not really know how to handle the situation. They tried to intervene by simply reprimanding his classmates, which made Jeff even more embarrassed.

When he was in Form 3, the most troublesome classmates who always harassed him were placed in another class. From then on, he had an easier life at school.

There was, however, something else that troubled him. His medications had side effects and made him fall asleep in class sometimes. But he managed to learn his subjects and completed his homework as assigned. Some teachers, who were at first unaware of Jeff's health conditions, reprimanded him for his inattentiveness. After being informed of his medical treatment however, they accepted his occasional sleepiness and helped him catch up with class work.

Jeff's only remaining concern was his classmates' reactions when he had seizures. He did not want to interrupt the lessons to become the centre of attention. He gradually came to understand that there were things that he could not change. But he learned how to live with his health conditions and made the best of his school life.

Jeff has now learnt to accept his situation with equanimity. He is doing well in some subjects and strives to lead a normal life. Encouraged, he sometimes dreams about his own future.

Chronic Illnesses

Every now and then a teacher may have a student with a chronic health condition. Chronic health conditions encompass a broad spectrum of illnesses and include:

• Allergies
• Asthma
• Cancer
• Diabetes
• Epilepsy
• Haemophilia
• HIV / AIDS
• Systemic lupus erythematosus

The needs of students with chronic illnesses vary, depending on their specific conditions and the severity and length of time the students have had the ailment.

Special Considerations

It is important for educators to be familiar with the medical treatments their students may be receiving. It is always a good practice to discuss with the parents or even the attending doctors the students' individual needs. The following may also be beneficial to students with chronic illnesses:

• Ensure that the physical environment can cater for the special needs of the students
• Maintain communication with the parents to help them better understand how to assist their children to tackle the problems they are facing
• Provide extra-tutoring or remedial classes for students with chronic illness
• Prepare for contingencies that may arise during the teaching process
• Work out a well-structured and sustainable study programme that addresses the students' needs
• Assist the students to form and maintain meaningful interpersonal relationships
• Impart correct information about the illness for all students and foster an atmosphere of understanding and acceptance, drawing attention to avoid any labelling and stigmatisation

How can I make my class inclusive for students with chronic illnesses?

To assist students with chronic illnesses to learn effectively and to enjoy school life, some adjustments are necessary. Educators may consider adjustments in teaching methods and performance assessments. Examples of such adjustments are:

• Make necessary adjustments to facilitate participation in outdoor activities and in certain classes (such as in arts, science, physical education) that might cause harm, risk or difficulty to students with certain chronic illnesses
• Make special arrangements for examinations such as allowing the students extra time where appropriate
• Allow students with chronic illnesses flexible attendance schedules in case they need to take frequent or long sick leave
• Provide supportive counselling where necessary

Some tips on illness-specific adaptations:

Schools and teachers are advised to consult the attending doctors of the students before adopting the following adaptations:

Allergies

Students who have allergies may feel lethargic and sleepy. There may be frequent but brief absences from school, occasional decrease in attention span and lack of concentration. Some students may display occasional spells of hyperactivity and irritability.

Tips on adaptation:

• Seat the student in a well-ventilated area
• Remind the student to take prescribed medications
• Help the student to avoid contact with known allergens and irritants as much as possible

Asthma

Students who have asthma may look pale, sweaty and agitated. They may experience chest discomfort and feeling of tightness in the chest at times. Low self-esteem, avoidance of physical exercise and difficulties in mixing with other students are also some common problems faced by students with asthma.

Tips on adaptation:

• Where the student needs pre-exercise medication, ensure that he/she has taken the medication as needed
• Encourage the student to take control of asthma by using preventive measures to avoid a serious attack

Cancer

Frequent or long absence from school for medical treatment, impaired sensory or physical condition and a lack of motivation are some of the factors that may impact adversely on the school life of a student with cancer.

Tips on adaptation:

• Make available reading lists and handouts earlier in the term - this will assist the student when he/she has to be absent due to illness
• Help the student stay organized and informed about assignments and activities

Diabetes

In general, a student with diabetes can participate in all school activities, but it will help if the educator can assist the student in monitoring his/her food intake and activities, especially in younger children.

Tips on adaptation:

• Have sugar or juice available at all times and inform parents of insulin reactions. However, educators are reminded not to give food or drink to the student when he/she is unconscious.
• Keep the student supervised at all times following a reaction
• Seek medical help when necessary

Epilepsy

Students with epilepsy may look sleepy at times resulting from reactions to medication, especially when they are adjusting to find the right level of medication. Some students may fear mixing with their peers because of the social stigma associated with the illness (as a result of not fully understanding the illness).

Tips on adaptation:

• Discuss with the student and his/her parent about the student's special needs in the event of a seizure
• Discuss with the student the most appropriate way to let other students know about his/her epileptic condition
• Explain to the rest of the class what epilepsy is and what may happen during a seizure. Foster an atmosphere of understanding and acceptance among fellow classmates

Haemophilia

In principle, students with haemophilia can participate in all school activities. However, it is important for the educators to take every precaution to prevent the student from bleeding. Educators may also want to discuss with the attending doctor possible ways to help the student with haemophilia in case he/she bleeds.

Tips on adaptation:

• Be familiar with the symptoms and severity of the student's illness
• Communicate with the parent/student to understand what activities the student is able to do and what activities should be avoided
• Adopt all practicable safety procedures to prevent the student from sustaining any injury, for example, providing the student with heel or knee protectors
• Create a support group for the student to report any emergencies and bleeding
• Report to the parent incidents of bleeding as soon as possible

HIV/AIDS

Most students with HIV/AIDS at school will be asymptomatic. However, they are at greater risks of acquiring infectious disease, such as measles. Educators should therefore take care to avoid exposing these students to the risk of other infections. Educators should also note that these students may have feelings of isolation, fear, depression, grief, anger and guilt. Such emotional feelings can be increased or lessened by the reactions of family members, teachers, peers and other people in the community.

Students who have developed AIDS may need to be hospitalised requiring spells of absence from school.

Tips on adaptation:

• Adopt universal precautions for blood and body fluids in everyday practices and instruct all students on proper infection control procedures
• Disseminate correct information about HIV/AIDS to prevent possible discrimination arising from misunderstanding of the illness
• Be sensitive to the emotional needs of the student and refer him/her for counselling or other help where necessary
• Provide supportive counselling and flexible class and test schedules where appropriate

Systemic Lupus Erythematosus

Students under the influence of lupus may feel lethargic and sleepy as a result of the reaction to their medication. There may be frequent but brief absences from school, occasional decrease in attention span and lack of concentration.

Tips on adaptation:

• Modify assignments to accommodate reduced energy levels and impaired concentration
• Create a support group to help the student stay organised and informed about assignments and activities should he/she need to be absent from school

DDO and the Code of Practice on Education

The Disability Discrimination Ordinance (DDO), effective since 1996, protects persons with a disability from discrimination, harassment and vilification on the ground of their disability.

The Ordinance makes particular references to the field of education to ensure that persons with a disability have equal opportunities in education. It requires educational establishments NOT to discriminate against students with a disability and to make reasonable accommodations to address their special needs. Such accommodations may include adjustments in teaching, communication, and assessment methods. The DDO also prohibits harassment in educational establishments, including harassment of students with a disability by other students. The law binds the government, educational establishments and their employees, and in the case of harassment and vilification, even the students.

The Code of Practice on Education under the DDO was issued in July 2001 by the Equal Opportunities Commission (EOC) to provide guidance on the legal requirements under the DDO in the field of education. It serves to assist educational establishments in developing policies and procedures that prevent and eliminate disability discrimination, and educators in making provisions for students with disabilities. It covers a wide range of practical guiding principles on matters such as admission, providing access, curriculum design and assessment.

The Code is an aid for providers and recipients of educational services. It helps the providers to better understand what constitute non-discriminatory good practices in education, and the recipients to understand their rights and obligations.