Many effects of cancer treatment are invisible, especially when the child has high intellect.
This is common among retinoblastoma survivors. Children may do less well in subjects requiring good vision, rapid processing skills, short-term memory or sequential mathematical operations.
Teachers often conclude the child is inattentive or needs to work harder. However, if your child struggles to keep up in class, or lacks enthusiasm for school, she may be experiencing one or more of the following challenges.
Be aware of your child’s dominant hand in relation to the affected – or most affected – eye. If she is left-handed, she will already have difficulty writing as the hand moves ahead of the text, as opposed to behind it when writing with the right hand.
Children with vision loss may turn their head to see more clearly. This is more pronounced when the dominant hand is on the same side as the eye with least vision. Turning the head misaligns the shoulders, causing sloping lines.
Many children with retinoblastoma cannot focus well, especially if their eye cannot remain still. They may have difficulty forming straight lines, and their writing may “wobble”. Encouraging your child to write more slowly, or use print rather than joined up text, nay improve legibility.
Reading and Comprehension
Children with impaired vision read slower than fully sighted peers. Small font size, poor contrast between text and background, italics and certain typefaces may pose a challenge. Children may struggle to explain the plot or follow written instructions if concentration is consumed by reading rather than absorbing the content.
Clear type and larger fonts or audio can overcome these issues. If the problem persists even with these interventions, a learning disability may be emerging. If this happens to your child, work together with the teachers to identify and address the problem so your child can thrive.
Memory and Processing Skills
Radiotherapy can reduce mathematical processing skills. This is not an indication of lower intellect. Allowing more time to complete tasks usually produces a very good or excellent standard of work.
Radiotherapy can also impact the child’s ability to memorise and retrieve facts. If this is an issue, work with the teacher to develop practical solutions, including memory strengthening exercises.
Planning and Organisation
Planning is crucial for children with impaired vision, who may require more time to complete work. Your child may need help to develop organizational skills, but a well organized child will be calmer and more productive.
Body language is a form of non-verbal communication through body posture, gestures, facial expressions and eye movements. Research suggests body language accounts for between 60-75% of all communication between humans.
Children with low vision often cannot see body language. For example, a visually impaired child may be seen to “interrupt” because she misses the subtle visual indications people give immediately before speaking. Make your child’s teacher aware of this, and share any solutions you have developed.
Most retinoblastoma treatment occurs at an age when children are developing essential social skills through interaction with others. If your child is struggling socially, talk with her about her concerns, and focus on building her confidence. You may wish to ask a psychologist for advice.
Some treatments and associated stresses can cause attention deficits that result in inattention and/or hyperactivity. Children may be more impulsive or easily distracted than their peers, especially during active treatment. If your child experiences such issues, discuss them with the teachers and work together to identify potential solutions.