Weil Constance M, Rodgers S, Rubovits S
Department of Child and Adolescent Psychiatry, Children's Memorial Hospital, Chicago, IL 60614, USA.
Pediatr Transplant. 2006 Dec;10(8):928-33. doi: 10.1111/j.1399-3046.2006.00586.x.
Pediatric cardiac transplant has become increasingly frequent in the last decade and survival rates have improved remarkably. Outcome research on this population suggests that the majority of children have the capacity for healthy adaptation although 25-40% have been shown to have some type of psychiatric difficulties. As school plays a major role in these children's lives, early intervention and close liaison with schools is indicated to reduce psychological morbidity, enhance adaptation within the school environment and enhance overall adjustment. This paper proposes a model for a school re-entry program for this population. The school re-entry program is aimed at children who are undergoing cardiac transplant and will be entering or re-entering the school system. They may range in academic age from preschool to college level and have been attending private or public schools with placements in regular education programs, regular education programs with resource support, special education programs, and alternative school programs. Others may not have been attending school because of the severity of their medical condition and have been receiving in-home tutoring. Each child is offered school re-entry assistance by a multi-disciplinary team composed of members from the Cardiology Transplant Service. The re-entry program includes cognitive and psychosocial assessment, liaison with the child's school pre- and post-transplant, academic planning and provision of academic, emotional, and behavioral support before, during, and immediately after transplant, a school re-entry visit, and an ongoing school consultation. The goal is to address issues necessary for a successful school re-entry including appropriate academic placement and support, psychosocial adjustment, education of school personnel and ongoing health needs of the student. The next step is to formally evaluate the efficacy of this program in successful school re-entry.
在过去十年中，小儿心脏移植越来越频繁，生存率也有显著提高。针对这一群体的结果研究表明，大多数儿童有能力实现健康适应，尽管有25% - 40%的儿童被证明存在某种类型的精神问题。由于学校在这些儿童的生活中起着重要作用，因此需要早期干预并与学校密切联络，以降低心理发病率，增强在学校环境中的适应能力，并促进整体调整。本文提出了一个针对这一群体的重返学校计划模型。重返学校计划针对的是正在接受心脏移植并即将进入或重新进入学校系统的儿童。他们的学业年龄范围从学前班到大学水平，曾就读于私立或公立学校，安置在普通教育项目、有资源支持的普通教育项目、特殊教育项目和替代学校项目中。其他儿童可能由于病情严重而未上学，一直在接受家庭辅导。每个孩子都由一个由心脏移植服务部门成员组成的多学科团队提供重返学校的帮助。重返学校计划包括认知和心理社会评估、在移植前后与孩子的学校联络、学业规划以及在移植前、移植期间和移植后立即提供学业、情感和行为支持、一次重返学校访问以及持续的学校咨询。目标是解决成功重返学校所需的问题，包括适当的学业安置和支持、心理社会调整、对学校工作人员的教育以及学生持续的健康需求。下一步是正式评估该计划在成功重返学校方面的效果。
