MONTREAL, MAY 19, 2011---When a child is admitted to the Montreal Children’s Hospital (MCH) of the McGill University Health Centre (MUHC) , be it for a short or long term stay, they can count on their educational needs being taken care of thanks to the English Montreal School Board (EMSB).
The EMSB has a team of four teachers assigned full-time to the MCH. There are also three other teachers from the Commission scolaire de Montréal (CSDM) who are there to provide attention to French-speaking students. “The teachers at the Montreal Children's Hospital really make a difference for our patients who have to be hospitalized for a long period of time,” said Dr. Harvey Guyda, associate executive director of the hospital. “They bring in the normal part of life in a world filled with challenging medical issues. They provide academic support to our patients to insure that their school year is not compromised and that they will be ready to go back in their own school when being discharge from the hospital. The teachers often go beyond their role by providing emotional support as they become supportive adults who are able to show compassion to the patients.”
This program, administered by the EMSB, provides educational services to children admitted to the medical wards and those attending the out patient clinics, namely hemodialysis and oncology. Services are provided for the entire range of medical situations, which are treated at the hospital. The school range covers kindergarten to Grade 11, both in regular and special needs programs. Hospital stays vary due to the transient population among them. Cases include:
- Repeated oncology, cystic fibrosis and organ transplant admissions;
- Children admitted for sudden illness or injury;
- Scheduled operations;
- Dialysis patients in two or three days during the school week;
- Eating disorders;
Most patients are confined to their room; necessitating a tutorial format. The primary emphasis is on English and math. The duration of the tutorial is normally between 30 to 60 minutes depending on the child’s physical state, their school needs and teachers’ caseload. To provide academic continuity, the ward teachers stay in close touch with the child’s school. As much as possible work done in the hospital mirrors work covered in the child’s regular classroom.
Teaching in the hospital requires balanced communication between patient, medical staff, parents and school.
Herb Treffeisen is the veteran of the crew. A native of Philadelphia, he has taught in the Montreal public school system for more than 40 years and spent half of that time at the MCH. He is responsible for high school students in the wards while Robert Ruffolo handles the elementary side.
Ruffolo, who has been at the MCH for 15 years, recently had to take some time off and retired teacher Christina Zarebski-Gasior stepped in. Peter Tsatoumas and Dan Novak work with students on the psychiatry wards as part of the IPAS (Intensive Psychiatric Assessment Service) program. The CSDM teachers are Phillippe Proulx, Sylvie Dubuc and Katy Desrochers.
Each day the teachers review a list of patients who have been admitted. They will make a courtesy call to the room to see if there is anything they can do of assistance. Sometimes a student is there for only a few short days. In many cases, they are too ill to do anything. But most of them want to keep up with their studies and appreciate the offer. School is not mandatory here.
There are, of course, the long term stays of kids with leukemia, cancer, stomach ailments and eating disorders. With a heavy heart Treffeisen relates stories of cancer patients he has taught at the hospital and grown close to, only to see them pass away. He has worked with students whose illnesses were making them lose a significant amount of class and exam time, even writing letters of recommendation to CEGEPs to vouch for the fact they were keeping up with their work. He even administers exams.
"We try to encourage the children to continue with their education while they're here," Treffeisen said.
Treffeisen says he spends a lot of time teaching math. For that reason, he himself returns to schools on weekday evenings to keep up with the latest changes to the curriculum. His release comes on weekends and the summer when he skis and rows.
Tsatoumas and Novak are part of multi-disciplinary team. “We teach and evaluate kids in areas of academic and psycho-social functioning during a period ranging from a few days to a few weeks,” Novak shares. “Our team makes recommendations to families and schools based on our interaction and observation of the kids.”
TRANSITION BACK TO SCHOOL
If the child must return to school after a lengthy stay at the hospital, the teacher makes school visits to make sure the transition back to their regular classes is as smooth as possible. Melanie, for instance, returned to school needing a daily IV feeding, which made the teacher and the pupils uncomfortable. The hospital teacher made three school visits until everybody felt at ease with the situation. When children return to the clinic for followups, the success of the child’s integration is evaluated and any problems are investigated. If the child has no follow-up visit, the hospital teacher calls the school to make sure everything is going okay (usually after one week ). To normalize as much as possible the life of the child while in hospital
Scheduling a daily school time will make the child feel like a “regular” kid in that he goes to school and has “homework.” When the child looks forward to this time, the success is evident. By allowing the child to keep in touch with his class and teacher (email, sending them letters, etc.) and by using the same tools as in school ( for example computers ) he or she will feel more and more like a “normal “ kid. Children who make frequent trips to the hospital clinics (primarily in hematology and dialysis) usually bring their schoolwork with them. Jennifer might be having difficulty with Secondary IV math, so she will work on it with the hospital teacher while she is at the clinic. When major school or ministry exams (mid-term or year-end) are given at the school, they are also administered by the hospital teacher.
To be an active member of the hospital’s process and make placement decisions when required. Children who cannot return to school upon discharge require homebound teaching. The hospital teacher initiates the paperwork, calls the school administration, and explains the process to the parents. Those children who come to the hospital from remotes areas (the Kativik and Cree School Boards) often have special needs. Solomon, for instance, needed to go to the regional hospital for a month after being discharged from the MCH. Communicating with the student’s school board, the hospital teacher arranged for Solomon to have a tutor in Inuktitut while he was in the hospital, this enabled Solomon to be at a level when he returned to his village school. Serious physical disease often affects children psychologically. Malu was thousands of kilometers away from home, having come to the MCH for leukemia treatments. She missed her friends and her native language. The hospital teacher arranged for her to attend the PELO class in Tagalong at a Montreal school. This gave her Filipino friends and made it possible for her to maintain the school program being followed in the Philippines.
EMSB PLANS VIRTUAL CLASSROOM
The MCH falls under the EMSB Social Affairs Network. Harold Penn is the principal, a role he fulfills on a more full-time basis at St. Raphael School in Ahuntsic, which caters to students with behaviour difficulties.
One of the new projects Penn is working on is the establishment of a virtual classroom in the hospital’s pediatric hemodialysis unit. This will be done in conjunction with the Sir Wilfrid Laurier School Board, which covers Laval and the Laurentians.
“In our pediatric hemodialysis unit, we see patients whom spend as much as 20 hours per week receiving treatments for their chronic kidney diseases,” says the hospital’s Alexander Tom. “These children miss a significant amount of class time, as the clinical expertise and medical technology is principally available during the day. Even if all therapy options could accomodate a chronically diseased or hospitalized child's school schedule, the children are oftentimes tired or sick at the end of their treatments, leaving little energy for their schoolwork. This is why I am trying to organize a virtual classroom where one of our dialysis patients will be connected to his class via internet, 360 webcam, microphone and speakers while he is receiving treatments here at the hospital.”
Plans call for a McGill University student teacher to assist the patient in the clinic while the classroom is connected. “Chronically-ill children suffer from more than just their disease,” says Tom. “These beleaguered children are not infrequently ostracized by their peers because of their different physical appearances, their inability to fully participate in physical activities, or simply because they miss so much school that they cannot fit in. As such, a chronically-ill child's self-esteem is not at its full potential and their peers have no concept of how tough these children are to endure hospital procedures, tons of medications while trying to maintain a normal life. Without excessive hyperbole, this project has to potential to at least increase the amount of school time our young patients need while perhaps concurrently increasing their self-esteem as they can show their classmates how tough they really are and that we are collectively present to support our children with extraordinary and cool means.”
Tom and Penn are working with EMSB Pedagogical Consultant Maureen Baron and the information technology team at the MCH to make this project a reality.