Story by Shelley Flannery | Photos by Gary Matoso
Through a unique community partnership, a school at Sacred Heart Children’s Hospital helps pediatric patients keep up with class work
Many children revel in time off from school. But when they’re missing class because of extended stays in the hospital, that’s another subject matter.
Meet Josh Wigen. The 10-yearold from Mica, Washington, was diagnosed with Hodgkin lymphoma, a cancer of the immune system, in September 2016. He went through four cycles of chemotherapy, with each cycle lasting three weeks. Week one was inpatient chemotherapy, where Josh stayed in the hospital for treatment. He was admitted other times when his white blood cell count—a measure of his ability to fight infection—got too low.
“Every single time after week two of chemotherapy, we were admitted for low counts,” says Josh’s mom, Jennifer. “A healthy person’s counts are between 5,000 and 15,000. At Josh’s lowest point, he was down to nine. You have to be careful that he’s not around any sickness.”
Being in and out of the hospital meant Josh couldn’t attend school with the rest of his fifth-grade class at Freeman Elementary School.
“Josh attempted to go to school once during chemo, and that wasn’t good at all,” Jennifer says. “He just wasn’t feeling well, and the doctors recommended he not attend.”
Reducing Stress About School
When children are absent from school because of illness, they fall behind on class work, which makes going back when they feel better more difficult.
“It’s common for kids with cancer to miss a year of school, if not longer,” says Maggie Rowe, a licensed clinical social worker and child life specialist at Providence. “And once the kids were finished with treatment, going back to school presented new problems. Students were not doing well when going back after a year. They were avoiding going to school, causing stress. We also saw high-school students dropping out.”
To investigate these negative effects, Providence formed a small group of leaders that included people from the hospital, local schools and Providence Health Care Foundation. They discovered that school staff were as frustrated as the young patients and their parents.
Teachers and administrators assumed everything would return to normal after treatment, not knowing a lot of kids with cancer develop learning disabilities, because chemo effects memory and organizational skills—all the things that allow you to do well in school,” Rowe says. “So kids were getting labeled truant or lazy or coddled. Schools just didn’t have enough medical information to know what they were dealing with.”
A grant was submitted to the Rypien Foundation to start a school within Sacred Heart Children’s Hospital. And with the funding, the Andrew Rypien School was born. The program started in September 2016 and serves all pediatric inpatients. “It’s not just kids with cancer who have trouble keeping up in school when they’re in the hospital,” Rowe says. “We work with kids who have cystic fibrosis, Crohn’s disease, heart problems and more.”
Providing Easy Access to Academics
The Rypien Foundation grant allowed the hospital-based school to hire two teachers through NorthEast Washington Educational Service District 101: Amy Larson works with students through eighth grade, and secondary teacher Alyssa Vanderzee works with sixth-graders through 12th-graders.
The Andrew Rypien School suits the needs of each family, either providing the curriculum or having teachers work with patients on assignments from their community schools, as in Josh’s case.
“Josh’s teacher would send work home and Josh would work on it with Mrs. Larson,” Jennifer says. “Of course, some days he didn’t even feel like doing that.”
And that was OK.
“The key to what we do is flexibility,” Larson says. “We work with the families to schedule around treatments and things like that.”
Although Larson and Vanderzee do their teaching one on one at patients’ bedsides now, the hospital-based school will open a classroom as soon as space allows.
“Having a classroom is really important to normalization,” Larson says. “Peer interaction and a change of scenery is good for the kids.”
Once the dedicated room is available, Larson and Vanderzee will conduct class two hours each weekday. “The first hour will be academic, and we’ll group the kids based on subject areas,” Larson says. “The second hour will be used for enrichment activities, such as drama or improvisation, science, poetry, writing and games.” Outside of class hours, the teachers will continue to meet individually with children who are too sick to attend class and who need additional help.
Seeing Progress Early On
Even in its first year, the Andrew Rypien School has plenty of success stories.
“I’ve seen tremendous positivity out of the program as far as kids keeping up and not falling behind,” Vanderzee says. “We’ve already had three kids who are getting signed up to take the GED (General Educational Development tests, for high school equivalency) who would’ve been in dropout positions otherwise.”
For children who return to their community schools, Andrew Rypien School staﬀ can make the transition easier. Rowe, for example, will go to a child’s school and present to the class. “I’ve taught fourth- and ﬁfth-grade classrooms all about leukemia—where their classmate was, what their classmate was going through, what happened to their hair,” Rowe says. “It helps normalize what the child has been through.”
Andrew Rypien School staﬀ educate community schools about the new and unique needs of children returning after an extended illness. For example, when a child recovering from a brain tumor was perceived at school to simply not want to do the work, psychological testing revealed learning disabilities and anxiety. “Our job is to help community schools understand the long-term ramiﬁ cations of treatment, illness and injury, which are often complex and nuanced,” Rowe says.
The program also gives parents peace of mind. “We on the teaching end can handle the communication with the school districts,” Vanderzee says. “That eases a lot on the parents’ end. The stress of coordinating with schools and teachers—that’s taken oﬀ the family’s plate.”
Perhaps the biggest beneﬁt of attending school while being in the hospital is to a child’s morale. “We’ve noticed school is a big thing, not just academically but also socially and mentally,” Vanderzee says. “Having that connection and being able to go into a classroom keeps up the positive mentality that they won’t be behind, they won’t be forgotten.”
As for Josh, the Andrew Rypien School has helped keep him on course. “Considering he’s been out of school since October, he’s not terribly behind,” Jennifer says. “We feel conﬁdent that when Josh is ready to go back to school, he will be right where he needs to be.”