Our long glorious summer has finally come to an end and it’s very much back to school time. Whatever about the delights of preparing school lunches and ensuring that uniforms still fit, if your child has juvenile arthritis, there are a number of other things to bear in mind which will help ease the transition back to the classroom.
Young people spend a lot of time writing in class, which can present challenges, especially if their hands are swollen or in pain. It’s not unusual either for them to experience fatigue or stiffness, which they may not always be able to explain to their teachers.
We’ve gathered here some of our top tips, which you can read below. Ideas for how to get the kids up in time for school are sadly now within the remit of this post.
If wrists or fingers are affected, this can cause problems with how our hands work. A child may have difficulty writing, managing tools or doing physical tasks. When a child’s joints are inflamed, or they are experiencing pain, they may need extra help with these tasks. At times, a child may write slower than their classmates and may need breaks to rest joints or extra time to complete tasks.
Here are our top tips:
- Use fat/thicker pens, crayons or pencils that are easier to hold and grip.
- Pen/pencil shouldn’t be held too close to the nib/tip. If a child presses heavily on them, it can cause extra stress on the joints. An occupational therapist can work with a child to make this easier.
- Encourage art and crafts and scissors skills at home, this builds up strength in the hands.
- Take lots of breaks and avoid spending too long in the one position. It’s best for children to avoid leaning their head on their hands while writing.
- Photocopy long text that they need to use, this can be helpful when a child’s joints are sore.
- Using a lever arch folder underneath the top edge of the writing surface to give a slope for comfort will be beneficial in the short term. Ensure that the forearm is supported at all times.
- Typing can be used as an additional support instead of handwriting; it is especially beneficial for homework and essays. It’s important that students learn correct typing skills if using a laptop. Some children are entitled to use laptops during the school year if they cannot write at a reasonable speed.
- Note taking can be problematic and they are likely to need breaks often. If possible, providing access to a photocopier or providing notes on a USB is beneficial.
- Use a gel pen or soft lead (2B) mechanical pencil to reduce the stress on joints.
- Purchase pens or mechanical pencils with a non-slip textured barrel.
- Use pen grips on thin pens, only if you feel ok about using them.
- Use elastic bands to create a grip on pens or pencil.
- Change the grip on the pen frequently to distribute the forces to other fingers. Try holding it between the thumb, index and long finger instead of resting it on the index finger.
- Break every 20 minutes to do some stretches, neck and hand exercises.
Fatigue and pain in school
- Most children will feel tired returning to school, but for children with JIA this can cause fatigue. Teachers can find it difficult to spot the signs of fatigue or pain in children; making teachers aware of signs will help them to support your child better. In younger children, this could be non-verbal clues such as facial expressions, e.g. a child rubbing a sore joint.
- Finding the correct balance between pushing a child and knowing when to take rest breaks is often difficult to gauge. Often, taking small breaks can help a child; this avoids pushing themselves too far to keep up with their classmates.
- If a child has a flare, it is a good idea to grade activities. For example, instead of doing three pages of a worksheet, they only do one. Also, it is important for a child to feel included by adapting activities. This will also boost self-esteem and help protect joints. Older children often tell us they do not want to be treated differently to others.
- If possible ensure children have access to hot/cold packs during the school day. Letting teachers know what works best for your child is really important.
- Explain to teachers that when a child is in pain they may have difficulty concentrating, smaller tasks may be appropriate.
- Movement breaks are essential because their posture changes, while also creating energy. Sitting for long periods of time is bad for most people, but for children with arthritis it can cause increased pain and stiffness in the joints. Encourage the teacher to make movement breaks part of the class schedule throughout the day. Here are some ideas for individual movement breaks: handing out notes, ring the bell, sending a message to the office, stretching at their desks and going to get the chalk.
- If a child is unable to do an activity look for an alternative way for them to do it. Keeping children involved with their classmates is crucial, ensuring that children are not isolated or made feel different.
- Ask teachers to practice pacing in school. Encourage the child to pace activities and slowly build up the amount of time they can do each week.
- Acknowledging their pain, many children feel that people do not believe they are in pain. Ask teachers to acknowledge their pain but then encourage participation, this helps the child feel validated.
- Ask the teacher to try to keep the child stimulated, so they do not focus on the pain.