Teacher Resources

Recommended School Accommodations for Children and Adolescents with Sickle Cell Disease


Children and adolescents with Sickle Cell Disease may miss school due to fever, infection, pain, or other illness. Missed school days may be due to routine clinic appointments, medical tests and procedures, illnesses managed at home, or more prolonged hospitalizations. The following accommodations may be warranted:

  • Attendance Accommodations (i.e., provision that medical indicated absences, in and of themselves, do not cause decline in grades or legal action taken against the family). School concerns regarding attendance should be discussed with the family.
  • Creation of a systematic method for collecting and handing in missed assignments. A structured system may lead to fewer misunderstandings regarding the assignments needed or when they are due.
Academic Accommodations

Teachers are encouraged to carefully monitor the student for cognitive and/or behavioral changes. These changes may indicate SCD-related changes that need to be discussed with the family and medical providers.

  • Sudden declines in academic performance may be a sign that a student has experienced a silent stroke. If you notice any changes in the student, please talk to the parent and/or medical providers as soon as possible.
  • Children and adolescents with SCD may demonstrate deficits with memory, attention,   organizational tasks, and project follow-through. If any concerns are noted in these areas, parents and/or the medical team should be notified.
  • Accommodations to improve organizational skills may be warranted. These accommodations are similar to those typically provided for Attention=Deficit/Hyperactivity Disorder and often involve the following types of accommodations:

¦ Increased communication between home and school
¦ Careful monitoring of specific target behaviors
¦ Providing prompts to write down specific information
¦ Redirection to assigned tasks
¦ Provision of a low-distraction environment for test-taking
¦ Additional time for completion of timed assignments and examinations
¦ Classroom seating in lower distraction areas of the room (e.g., preferable away from doorways and windows, near the front of the class.)

  • Additional time for completion of missed assignments
  • Assignments missed due to health problems or appointments should be reasonable shortened to ensure that the total amount of make-up work is not too overwhelming.
Physical Accommodations
  • Children and adolescents with Sickle Cell Disease should not be required to lift heavy objects
  • An extra set of books to keep at home—provision of extra books prevents children and adolescents from having to carry heavy books to and from school in a backpack.
  • Permission to use a rolling backpack may be needed to prevent having to carry heavy books while at school.
  • Permission to ride the elevator at school
  • Allowance of rest periods as needed to prevent fatigue
  • Extra time between classes: this accommodation may be necessary for adolescents attending middle school, junior high school, or high school to prevent carrying too many books at once.
  • Children and adolescents with SCD should prevent becoming too chilled. Exposure to cold temperatures can cause pain episodes to occur. The following types of accommodations may be needed:¦ Seating away from air conditioner vents in the summer months.

¦ Access to a coat, jacket, sweater, or blanket.
¦ Children and adolescents with SCD should not be outside of extended periods of time if the temperature is below 45-50oF. Wind child, the student’s appropriateness of dress, and the amount of time spent outside should always be considered in this determination.
¦ Bus transportation to the home may be warranted to prevent standing in cold weather for prolonged periods or time.

Health-Maintenance Behaviors

All children and adolescents with Sickle Cell Disease require some basic accommodations to ensure that they stay healthy. The following accommodations should be provided regardless of disease severity:

  • Access to Drinking water as needed (may include permission to carry a water bottle to class or to be excused as needed to drink from the water fountain).
  • Restroom access as needed-children and adolescents with Sickle Cell disease need to use the rest room at their request; they should not be told to wait.
  • Symptoms that indicate a call to parents and warrant medical attention:

¦ Fever of 101oF or greater
¦ Swelling
¦ Pain
¦ Sudden or persistent headache
¦ Rapid Heartbeat
¦ Changes or difficulty in breathing
¦ Persistent or severe coughing
¦ Paleness of skin

  • Ice should NEVER be applied to injuries
  • Teachers should monitor children for changes in behavior that may indicate they are not reeling well. Such changes may include irritability, increased fatigue, and social withdrawal.
Parents should be informed if any of these behavioral changes are noted.
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