Backward Parenting: Pacing your Child’s Recovery | Part 1
Welcome to another installment of Backward Parenting Your Child with Pain. This two-part series deals with the importance of “pacing” when your child starts to improve. Normally, we like to have children jump right back into things—get back on the horse, so to speak. And that’s typically a good idea. However, as usual, with chronic pain, we have to do things backward. We must encourage them to re-engage slowly but surely, like the tortoise in “The Tortoise and the Hare” fable. Since it’s back-to-school season, “Pacing Your Child’s Recovery: Part 1” deals with…
Getting Your Child Back to School
School reintegration has to be done at a slow, steady pace.
Schools are notorious for expecting either no on-campus attendance (putting the student in a “home hospital”) or full attendance on campus. They always insist that you cannot do both. But I have found that with persistence and a good explanation, they usually find a way to bend.
I explained to the administration that the student has to return to a rehabilitation model. I compare returning to school with recovering from knee surgery.
In that situation, the physical therapist would have the patient slowly build up to more and more exercise. The patient would not run a mile on the treadmill right after surgery (which would be the equivalent of returning to campus immediately). Nor would he refrain from all exercise because the knee would get stiff and weak (the equivalent of a home hospital and no on-campus classes). The knee surgery patient would start small and build up – which, in this analogy, would be the equivalent of attending more and more classes gradually.
I explain to administrators that kids with pain tend to be worse in the morning, so we usually start by eliminating at least the first period. Then, we ask the student which class feels easiest to attend—sometimes it’s an elective, and sometimes it’s something that is difficult to learn at home, like a language or lab science.
If the child is motivated by seeing friends, we start with just coming for lunch and maybe staying for the period right after lunch (once they are there for lunch, it is easier to get them to stay). Then we build towards staying longer. Once they stay from lunch until the end of the day, we build backward to include periods just before lunch and then earlier and earlier classes.
This can be flexible and individualized. For example, I had a client who loved choir so much that she was willing to go to campus for the choir at 7:30 a.m.! After a while, we had her stay for one period afterward and then slowly built up from there. Another client who loved choir had it at the end of the day, so she’d go to choir and then start coming to school earlier and earlier.
Sometimes, there’s a period between the ones they will attend in person. When this happens, I have the school arrange a place (e.g., library, resource center, dean’s office) where they can do their work independently, whether it’s an online course or homework from a teacher.
For the classes that the student is not yet attending on campus, he can either take those online, have a home hospital teacher come to tutor him, or get the work from the teachers, do it at home, and then turn it in when he’s on campus for other classes.
Your child may also not be able to make it to school five days per week at first. Set a reasonable goal and then reward that goal. Your child may start by staying for a set amount of time, three days per week, and then gradually add in a day at a time.
If you have a child who will only do the minimum possible, reward her for going in more days or staying longer on any given day than expected. If your child tends to push herself, limit the time at school to what was preset and reward her for pacing herself.
Another way to implement pacing and decrease the stress of returning to school (therefore making it more likely that your child will actually go) is to start with the goal of just making it into the classroom and sitting through the class.
I even tell my clients not to worry about paying attention, as long as they are there in class. Once they succeed with that, they start taking notes and doing in-class work. The last step is adding homework. This has to be done with the school’s approval, but it is an effective way to get kids back to school.
There are many ways to get your child to re-engage in school, but schools can be very rigid. It takes persistence and education on your part. Teach the school counselor and/or school nurse about the rehabilitation model. They can be helpful advocates for you.
Connect with Friends Before Going Back to School
One primary reason kids hesitate to return to school is that they’re out of the loop socially. That’s why you must encourage your child to start connecting with classmates before returning to school. This can be tough if your child has been out of touch for a long time. She can start by texting the old friend she feels most comfortable with and saying that she hopes to get back together again.
The other main social obstacle is the discomfort of not knowing what to say when kids ask your child where he’s been. The good news is that many kids have not been in school in person because of the pandemic. Schooling for the past year and a quarter was so disjointed that it might not even be obvious that your child was out of school.
But if it is obvious—especially if your child has been out of school and out of touch with friends since before the pandemic—some kids will invariably ask your child where he’s been and/or what was wrong with him. I suggest keeping the answer short and simple and not making it sound contagious (especially now!). Have your child refrain from using the word “sick” or giving medical details.
For example, if your child has CRPS, he can say something like, “I had this bad problem with my leg that I was dealing with, and I had so many appointments that I didn’t have time to come to school.” If he had headaches, he could say, “I was dealing with really bad headaches, and I never knew when I was going to get them. It was hard to come to school consistently, so I just did online school instead.”
Make Sure to Get a 504 Plan for Your Child
A 504 Plan provides accommodations for your child within the standard instructional environment, such as turning in assignments late without penalty, not being penalized for missing class, sitting in a special chair, or being able to leave the classroom to use the restroom at any time without asking for permission.
First, list the accommodations your child would benefit from and then request a 504 meeting to review them and put them into a formalized plan.
One beneficial accommodation is having the school ensure that your child has a buddy in each class who can give her notes and homework assignments on the days she misses.
Make sure to include the accommodation that your child is not penalized under the “participation” part of the grade for missing class and that she has one day to make up assignments for each day that she missed class.
A 504 Plan is fairly easy to obtain and much less involved than an IEP (Individualized Education Plan) because it does not require special instruction.
The school may imply that your child has to start coming full-time as soon as possible, but they rarely enforce that.
If your child is in elementary or middle school, it’s very rare that they do not pass a student on to the next grade as long as she meets the basic grade-level proficiency, even if she missed a lot of school.
If your child is in high school and needs 5 years to graduate, it will not affect his or her life in any way in the future. That’s just what your child needs to succeed.
Whatever happens at the beginning of the school year, don’t lose faith. The year is long, and there is time to slowly get used to being there and doing work. Don’t forget, summers can also be used to catch up on missed work.
Read Part 2 of this series here.
