Spencer C H, Zanga J, Passo M, Walker D
Pediatr Clin North Am. 1986 Oct;33(5):1251-64. doi: 10.1016/s0031-3955(16)36119-3.
The school experience is a crucial one for the child with arthritis. In school, these children face obstacles common to all chronically ill children and certain problems unique to a child with arthritis. The school environment for these children has changed drastically in the last two decades with the new civil rights legislation on the state and federal levels. Today there is a better chance of a child with arthritis having a relatively problem-free school experience than ever before. The pediatrician can be a source of information, advice, support, and help with any school problems that the child and parent cannot solve. Most minor problems, such as medication at school, physical education problems, an extra set of books, and extra time between classes, may be solved by an informal telephone call or a letter. More severe problems, such as prolonged and frequent absences, multiple modifications of the school environment, and contesting of school placement, may require the use of more formal channels, including the IEP process and parent advocacy groups. When chronic problems exist in the school system, the pediatrician may choose to work for needed changes that improve the school situation of these and other chronically ill children. The pediatrician also may serve as a valued adviser and educator to the school system in the difficult task of educating these special children.
学校经历对患有关节炎的儿童至关重要。在学校里，这些孩子面临着所有慢性病患儿共有的障碍以及患有关节炎儿童特有的某些问题。在过去二十年里，随着州和联邦层面新的民权立法，这些孩子的学校环境发生了巨大变化。如今，患有关节炎的儿童比以往任何时候都更有可能拥有相对无问题的学校经历。儿科医生可以提供信息、建议、支持，并帮助解决孩子和家长无法解决的任何学校问题。大多数小问题，如在学校服药、体育教育问题、额外的一套书籍以及课间额外的时间，可能通过一个非正式的电话或一封信就能解决。更严重的问题，如长期频繁缺课、对学校环境的多次调整以及对学校安置的争议，可能需要通过更正式的渠道，包括个别化教育计划流程和家长维权组织来解决。当学校系统存在长期问题时，儿科医生可能会选择为实现所需的改变而努力，以改善这些以及其他慢性病患儿的学校状况。儿科医生在教育这些特殊儿童这项艰巨任务中，也可以成为学校系统的重要顾问和教育者。
