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School support for children with chronic pain

Many parents wonder if their child should go to school when in pain. Extensive research and clinical experience indicate that children with chronic pain who attend school regularly do better than those who do not. Pain, academic functioning, psychological well-being, and social engagement can all improve when a child attends school, even if they are in pain.

While chronic pain can be debilitating, we have found that, with the right accommodations in place if necessary, children can succeed in school in spite of pain. The school environment full of distractions — both academic and social — that can help keep a child's mind off pain and help improve coping. Even children who have missed a great deal of school can return to school gradually and resume normal academic functioning.

Some children who have chronic pain need some temporary accommodations to help them re-enter and stay in school, such as:

  • Planning a gradual return to school for students who have missed a significant amount of instruction
  • Identifying a single person at school who can work directly with the student and parents to create a plan for all staff and teachers involved to respond consistently and constructively to pain episodes
  • Identifying pain triggers in school and helping the student determine how to avoid or cope with them
  • Identifying a place for the student to go for short breaks to gain control of pain (as opposed to going home when pain intensifies)
  • Going to the nurse for a dose of pain medication as prescribed
  • Allowing a few extra minutes to get from class to class to avoid overcrowded hallways
  • Making extra books available to reduce the amount of weight the student must carry around school
  • Involving parents in school planning as much as possible, especially to reward the student for attending and participating in school despite pain

Generally, these accommodations can be provided in an informal agreement between the parents, student, teachers and school personnel.

The Individualized Education Plan (IEP) and Section 504 Plan

Many students with chronic pain qualify for and benefit from having a formal Individualized Education Plan (IEP) or a Section 504 Plan, which make certain accommodations available based on federal law.

Section 504 of the Rehabilitation Act is a civil rights law that prohibits discrimination against individuals with disabilities. It also ensures that a child with a disability, such as chronic pain, has equal access to an education. Under Section 504, a child may receive accommodations and modifications if their impairment substantially limits the ability to learn. Alternatively, the federal Individuals with Disabilities Education Act (IDEA) requires schools to develop, upon request, an IEP that meets a child's unique needs and provides educational benefit. A 504 plan meets the needs of most patients with pain who require a formal plan to access accommodations at school. In more rare cases, a full IEP may be necessary.

If a student already has an IEP in place, such as for learning disability or attention deficit problems, it can often be expanded to accommodate for chronic pain.

At Boston Children's Pain Treatment Center, we work individually with each patient and his/her family and school to create a plan that meets the patient's needs. We consult with schools and work in close collaboration with families toward the crucial goal of helping children with pain remain in the school setting.

For information on how we can support your child's success at school, contact us.

Watch: When does pain become a problem?

Dr. Christine Greco, clinical director of the Pain Treatment Center at Boston Children’s Hospital, discusses how chronic pain may negatively affect a child’s daily life and happiness.