Schooling as a part of palliative care in paediatric oncology

For children with incurable life-threatening diseases, social reintegration is an illusion. Schooling for these children is both possible and desirable, but its specific objectives must be adapted. The educational career of 30 French school children with incurable cancer was followed. Data concerning the children's degree of motivation to attend school and its evolution during the course of the disease as well as the measures adopted to maintain school attendance were analysed. Sixty per cent of the children demonstrated a genuine desire to attend school until the advanced stages of their disease. Reading, mathematics and computer work were their favourite subjects, increasing physical disability and fatigue diminished their motivation over time. Refusal to attend school occurred in 40% of the children, who had either extracurricular interests or poorly controlled pain. School attendance for the terminally ill child's part of palliative care and has specific medical and educational goals. As such, its objectives are quite distinct from those of other educational reintegration projects proposed for children with cancer.