#1 DISCLOSURE OF ILLNESS
Respect for the family's wishes regarding disclosure.

RECOMMENDED TEACHER RESPONSE:
Confer with the parents and/or child regarding disclosure. Some children desire to share information about sickle cell disease with their peers, however, the confidentiality of those who do not should be maintained.

#2 ACADEMIC PERFORMANCE
The academic performance of some children with sickle cell disease may not be consistent with their innate ability.

RECOMMENDED TEACHER RESPONSE:
Similar to children without sickle cell disease, factors that impair academic performance should be identified and addressed.

#3 ABSENTEEISM
Complication of sickle cell disease may cause frequent absences.

RECOMMENDED TEACHER RESPONSE:
Provide the parent/student with current and makeup homework and, if necessary, suggest how tutorial help can be obtained.

#4 CLASSROOM PARTICIPATION
Children with sickle cell disease have anemia and thus may experience fatigue toward the end of the school day.

RECOMMENDED TEACHER RESPONSE:
If possible, excuse the child from the ongoing instructional activities to rest for a short period. When fatigue becomes a chronic problem, parents should be notified.

#5 PAIN EPISODES
Pain episodes that occur during school.

RECOMMENDED TEACHER RESPONSE:
Confer with parents regarding this issue, e.g. who should be notified. Pain episodes are not usually an emergency, but medical attention should be sought as soon as possible. A fever should receive prompt medical attention.

#6 WATER FOUNTAIN PRIVILEGES
Children with sickle cell disease are encouraged to drink large amounts of water to ensure adequate hydration.

RECOMMENDED TEACHER RESPONSE:
Permit children with sickle cell disease unlimited access to water. Consider allowing the child to keep a covered cup at their desk.

#7 BATHROOM PRIVILEGES
Sickle cell disease may cause frequent urination due to the kidney's inability to concentrate urine, and the child's fluid intake.

RECOMMENDED TEACHER RESPONSE:
Allow children with sickle cell disease non-disruptive access to the rest room.

#8 GYM PARTICIPATION
Children with sickle cell disease may experience shortness of breath or other symptoms with strenuous physical activity.

RECOMMENDED TEACHER RESPONSE:
Teachers should encourage gym participation but permit the student to rest when necessary. If the child's physician excuses participation, appropriate use of this time should be arranged.

#9 OUTSIDE RECESS
Children with sickle cell disease may be sensitive to temperature extremes.

RECOMMENDED TEACHER RESPONSE
Enforce appropriate dress for the weather. Overexposure to extreme hot or cold weather should be avoided.

#10 SELF-ESTEEM
Children with sickle cell disease are at risk for low self-esteem and poor self image.

RECOMMENDED TEACHER RESPONSE:
Create classroom opportunities for children to feel good about themselves. This is, of course, important for all children, but especially for those children who have a chronic illness.

#11 TEASING
Teasing from schoolmates may occur because of:

• Yellow discoloration of the white part of the eyes, caused by a pigment that is released from the breakdown of red cells. This does not affect vision.

• Small stature.

• Delay in the development of secondary sex characteristics.

This information is abstracted from: Parent/Teacher Guide, How Parents and Teachers can work together to Achieve School Success for Children with Sickle Cell Anemia.