We believe that health and education are critical determinants of life opportunity.
In the face of imperfect health, education is a gateway into hope of a better future. It may be that hope that sustains the resilience in kids facing serious illness.
But it has to be education now, within the setting of imperfect health. I matter now. My life has value and meaning, beyond this. I am important. I have a ‘tomorrow’.
Kids are surviving illnesses they once did not. Technology is developing exponentially. It is we who need to catch up.
How about health promoting schools, learning hospitals and partnering parents?
What if we started listening to kids about what is important to them? What if we started having more conversations with them, including them and trusting them to tell us what they need and being prepared to learn from them?
What if we stopped calling kids students, learners, patients, and consumers? And call them what they call themselves: kids.
What if we recognised that essentially there is a power imbalance between adults and kids? And this affects every interaction and is deeply felt by kids. Ever been held down to have a naso-gastric tube or cannula placed? Or been rejected or forgotten by your community? (We’re talking here about school as community—the community that kids call theirs.) And what if you had no power or means to change those things? Yes, this has everything to do with vulnerability and power.
What if we see this conversation we are having here, and our work, through just one lens? A child protection lens. Then we look at what we do, and don’t do, firstly in terms of do no harm.
What if we started saving hearts and minds, as well as saving bodies?
What if we stopped talking about what we are doing to help and start asking ourselves what is it that we are doing that is hurting? “Doing” includes omissions and oversights. And if we faced the fact that if our “helping” is ineffective, the impact is not neutral—it can actually hurt by masking the problem.
What if we moved beyond simply complying with codes of conduct to applying the ethics of child protection (and do no harm) to each and every interaction we have with kids and every decision we make.
What if we stopped spinning our wheels on what we know works, instead of getting caught up in the rhetoric of innovation, the new program, the next agenda, being drawn in by a multitude of distractions?
What if we were prepared to question the assumptions we make? Like, sick kids are not fit for their school. That assumption is simply an unhelpful extension of, “she’s not at school this week because she’s got the flu.”
What if we watched for the halo effect and moved into constructive dissatisfaction. And bringing in critical investigation about what happens for these kids, because that should be added to the pictures of smiling sick kids we use to raise important funding. If we must do the latter, then we must pay it back by not simply settling for happy stories in the media and instead digging in to what really happens for them.
What if we started seeing parents as experts on their kids? I know you’re probably saying, but some parents aren’t, can’t and some just don’t care. Then we need to listen carefully to those ones, too, because we’ll be learning a lot about what those kids need. And you might be hope personified for them.
What if we viewed absence in the process as a trigger for inviting participation, viewed collaboration as more than a two-hour conversation, a memorandum of understanding, or an Individual Learning Plan?
Sustainable change (and political agitation) on wicked problems always comes from the people for whom it matters most (history says so). Because it doesn’t press, nor grind enough if you’re not living it. The challenge in this story, of course, is that the constituents are vulnerable kids and families whose circumstances tend to limit their energy and opportunity to have political influence.
What if we got some basic agreement around definitions, so we start to move towards common language as a gateway to better understanding?
What if in hospitals and schools we triaged kids for trauma, then put in place psychological first aid and built trauma-informed practice into our approach. And we moved from “pathologising” and “determining” towards embracing capacity for change: believing in neural plasticity (brains, especially kids’ brains, are built to grow and rewire).
What if hospitals and schools measured from a baseline for indicators in wellbeing, as well as clinical observations and academic scores? What if doctors’ rounds and visits asked about school attendance (hospital/home) and made kids’ connection to school and learning a priority in the total picture of their care? What if hospitals and schools triaged for risk based on the length and frequency of kids’ absence from school and responded?
What if we asked ourselves every minute of every day, why am I doing this? And we could answer with confidence, every time: for the kids, in all ways and every way, for the kids. That’s child-centred practice.
What if we asked why before how, and how before what? A sound process is important to the outcome.
What if we could accept that it takes more than evidence to change behaviour? Behavioural change in adults (education and health practitioners, and parents). This is change in practice.
Practice is lagging behind the evidence — lived and studied. We must change that.
What we are fighting to achieve already sits in a legal framework in Australia, in the rhetoric of healthcare and education for all, in concepts of equity, access, inclusion, justice and indeed the rights of the child. But it’s just not being systematically practised, monitored, and regulated. The goodwill of individuals is necessary but not enough.
What if we understood the power in getting it right for one kid? And know that the benefits from that would likely extend to at least one other, but probably many kids: a sibling or more, friends, school buddies, observers.
What if we changed our organisations from the inside out, rather than waiting for permission?
And, finally, what if we shifted our view from tomorrow, to today?
We believe that everything about this endeavour should be about love. Love what we do, and do it with love.
So many kids rely on us for that.
The notion of “inpatient truancy” is interesting and perhaps closer to the truth than is immediately apparent. A kid who is playing truant is a kid who is escaping or avoiding being where he is supposed to be, and that’s exactly what every sick kid in his heart of hearts would like to do.
My own child in hospital had as his sole and burning ambition to escape the situation … and video games were his only way out. They took his mind away from it all. Anything which required him to be present in the moment also required him to face up to where he was and why, and he feared and hated every moment of it with a passion.
As a parent, I hated the video games with a passion, but I was no less terrified than my son was and I didn’t have the emotional reserves to insist on schooling.
I use the term “schooling” because that’s what was offered – a program of stuff to be taught and learned. “School” is different, it’s a place where kids get to be with their mates to play and learn, where they have connections and an emotional investment. The Hospital School offered schooling. What my stressed and frightened son needed, but couldn’t have, was his school.
This is all by way of putting my kid’s video game obsession into context.
What strategies might you use?
These are some strategies which might have worked, but which were not used, for my son. They’re not particular to the Hospital School setting, but their neglect in the Hospital School setting was probably critical to my son’s failure to engage.
Clear for learning. What mental or emotional state is he in? Is he frightened or anxious? How did he sleep last night (on a hospital bed with other patients pressing buzzers and the drip alarms going off and nurses coming in and out all the time)? Has he had a GA or been fasting or does he have a cannulation coming up?
Assess his learning needs. Listen to his mother when she explains what his needs are. Don’t assume that just because he is 8 years old he will engage with the maths module which “goes” with the 8-yr old age-group. Actually, he loves maths but there is nothing guaranteed to turn him off faster than maths worksheets which are too easy for him, whether he’s in hospital or not. His home school will tell you that too, if you ask.
Make the learning relevant to his interests. If video games are what he’s interested in, then build a program around the video games. When my kid was on the ward we had him designing, measuring and doing scale drawings of a new racetrack for his favourite video game – but this was a family initiative, it was completely separate from the Hospital School work. If we’d had our brains switched on, we’d probably have got him writing up what it was about and why, and maybe creating stories around it. At the least we should have talked to the fabulous HS teacher who used to come and visit, and maybe she would have run with it. It was an opportunity lost.
If possible, give him work that reflects the work his mates are doing. It will mean conferring with his home school, which brings its own set of logistical problems. But it will mean he’ll have something to talk to them about – “hey, what did you write for the paragraph for geography? did you do a spelling quiz? did you think that book was really boring? are you using LEGO for your creative response?” – and this is what “normal” kids do.
Schedule FaceTime or Skype or any kind of connection with his school-friends. The lure of talking to a mate would have dragged him away from anything. But it would have to be “real” talking, or online chat at least, not just email.
A kid in hospital is probably doing it tough. He probably knows what his life depends on, and it’s not maths worksheets. He’s already been severed from whatever school or community he came from, and so he’s got nothing to lose by refusing to cooperate with the Hospital School. Any program developed for him is going to need to target his interests pretty carefully to make it worth his while engaging.
Do you really need a particular set of strategies for inpatient truants, or is it simply that all the regular strategies of student-centred education need to be front and foremost at every instant with no margin for error?