School

Education is a social determinant of long-term health, and improves social equity. Face-to-face social connection with same-age peers is vital to a young person’s healthy development. Home-schooling or distance education are not recommended for children with chronic pain because they do not offer the distraction of the classroom or daily face-to-face peer contact.

If pain is limiting a child’s school attendance (ie more than 5 absences per month), consider strategies to improve attendance. When a child has had an extended absence due to chronic pain, a graded partial attendance plan may be required—see Suggested features of a school attendance plan for a child with chronic pain  for suggested features of a school attendance plan. See also local guidelines for further advice on school attendance plans (eg Victorian Department of Education Attendance improvement strategies).

Table 1. Suggested features of a school attendance plan for a child with chronic pain

Feature of plan

Description

pace

upgrade the child’s attendance gradually to full-time within 6 weeks

routine

encourage the child to attend some part of every day (eg the first session) 5 days per week to establish routine—start with morning sessions because this is when energy and learning are optimal

increase attendance gradually from one-third of the school day to two-thirds, then add 1 to2 full days per week until full-time

social time

include social time (recess, lunch) each day to rebuild peer connections

healthcare

write a pain management plan that maximises class time and first-line pain management strategies

medications

supply clear instructions to staff and store at the school office—never allow the child to carry medication in their school bag because this poses a risk to themselves and peers

consensus

ensure that the parent/carer, child and teachers understand and agree with the attendance plan

reward

establish a reward system that encourages the child to achieve short-term goals

monitor

review the plan every 2 to 3 weeks and seek assistance if progress is not on track