Forging a path back to school after orthopedic trauma

Orthopedic trauma can force children to miss school, sometimes for an extended period. But even when patients have regained enough mobility to return to school, their schools aren’t always equipped to welcome them back.

“Trauma is different from many other orthopedic conditions because it’s so unexpected,” says Kristin Livingston, MD, director of the Orthopedic Trauma Program at Boston Children’s Hospital. A sudden injury leaves families no time to plan for their child’s care or how they’ll resume their activities. “Many times, patients remain at home long after they’re ready to get back to school because the school can’t accommodate them.”

In her practice, Livingston has patients who:

• Feel unsafe navigating crowded school hallways on crutches
• Have no way of attending class on an upper floor in a school with no elevator
• Are unable to take notes due to an upper extremity injury

How soon a student can return to class seems to depend in part on which school they attend. “Some schools make it so easy for kids to return,” says Livingston. Other schools offer few accommodations at all.

Beyond physical healing, missing school can have a profound effect on a patient’s well-being — academically, socially, and emotionally. Often, an extended absence also has financial ramifications on families when a parent has to miss work to stay home with their child.

What does it take for a child to return to school?

Little research exists looking into what barriers prevent orthopedic trauma patients from returning to school or how that impacts them and their families. Livingston and her colleagues are working to fill this gap on a national level by creating a tool that researchers at institutions around the country can use to gather data.

To this end, the team developed a set of questions that they’ve used in preliminary interviews with patients and families. While they have several more steps before they can roll out a data-collection tool, several themes have emerged from their work so far:

• Being able to get around school safely is a significant factor in whether or not a child can return to school.
• A child’s inability to return to school tends to place a greater burden on families with fewer resources, such as child care.

“Our goal is to show the measurable impact that a lack of school accommodations has on patients and families,” says Livingston.

Such information can be used to establish the types of support a child will need based on their injury. On a broader level, it can also help make a case for greater school accommodations so that children recovering from orthopedic injury can return to school sooner.

In the meantime, orthopedic specialists and primary care physicians can help their patients by involving a social worker in their care, one who can help connect families with community resources that may facilitate their child’s return to school.

Learn more about the Orthopedic Trauma Program.