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Returning to school – physical considerations

  • Even after treatment has finished, a student may still experience difficulties with fatigue, cognition, speech, vision, hearing, mobility and motor skills. Talk through these issues with the student and their family and arrange further assessment and support if it’s appropriate.


    Cognitive or physical fatigue is experienced by some young people for many years after treatment. This can affect everything they do. Tasks which used to involve little effort may now be mentally exhausting. It may be hard to remember things or concentrate. After a full day at school, homework may feel impossible.

    Cognitive difficultiesRCH teacher Ross and Tyrone playing Didgeridoos

    Some young people may have developmental damage which can’t be repaired or which may become more obvious over time.

    You may notice that they struggle with some of the following skills or school subjects:

    • information processing
    • non-verbal skills
    • memory or previously learnt knowledge
    • attention span or carrying out a sustained activity
    • accessing new information
    • following instructions
    • organisational skills
    • maths (which demands quick information processing and memory skills)
    • foreign languages (which demand quick information processing and memory skills).

    Discuss arranging an educational psychology assessment if a young person is having difficulty with information processing.

    Speech, language and communication

    Speech and language difficulties are experienced by some young people after treatment. These difficulties may come and go over time. Early recognition can prevent problems such as frustration, low morale and social isolation.

    Discuss arranging a speech pathology assessment if a young person is having difficulty with their speech and language.

    Vision and hearing

    Vision or hearing can be affected in a number of different ways as a result of treatment for some health conditions, for example:

    • decreased direct vision, blindness or partial blindness
    • blind spots in one or both eyes
    • squints and double vision
    • poor coordination or eyes may flicker and be slow to follow objects.

    If a young person is experiencing problems with vision and hearing, they may be eligible for additional support through the Program for Students with Disabilities or the Literacy, Numeracy and Special Learning Needs Program.

    Mobility and motor skills

    Some young people may have problems with fine and gross motor skills.

    Gross motor skills

    A young person’s mobility may be affected by factors such as balance and coordination, muscle tone and strength, attention and concentration.

    Consider some of the following options if a young person’s mobility or gross motor skills are affected:

    • offer physical assistance such a wheelchair or aids to move about the school
    • use classrooms on the ground floor
    • help them adapt and revise their physical expectations
    • offer alternative ways for them to be involved in physical education classes or games, such as scoring or umpiring
    • provide a friend or buddy to carry their bags around school
    • arrange for them to leave class five minutes early so they can get around the corridors without the rush and noise of crowds
    • implement procedures for their safe evacuation in the case of a school emergency.

    Fine motor skills

    Fine motor skills are the smaller hand movements which include the ability to use tools such as pencils and scissors. The ability to grasp and release may be slow, weak or unsteady to the point where your child will need assistance in the classroom with certain activities.

    Consider some of the following options if a young person’s fine motor skills are affected:

    • use specific aids where possible such as pencil grips, adapted scissors and other equipment
    • take advantage of computers or other technology to assist
    • make sure they have a good sitting position (consider table height, chair and how well the body is supported)
    • use equipment that’s the right size, with a non slip surface or convenient grips (particularly for classes in food technology or materials and for science experiments)
    • use paper with larger lines or squares
    • use a sloping table or board for writing.

    Discuss arranging an occupational therapy assessment if a young person is having difficulty with mobility or motor skills.

    Put support structures in place

    Talk over any issues with the young person and their family and devise strategies to combat any of these effects.

    Document these in the young person’s Student Health Support Plan and Individual Learning Plan.

    More information

    The Department of Education and Early Childhood (DEECD) Health and Wellbeing website has lots of information and resources to assist schools to support the health and wellbeing needs of their students.

    The School Policy and Advisory Guide has plenty of information for government schools about student health.

    The Program for Students with Disabilities (PSD) provides additional support for eligible students with disabilities in regular and specialist government schools.

    The Literacy, Numeracy and Special Learning Needs Program provides additional support for eligible students in Catholic schools to improve the learning outcomes of educationally disadvantaged students, including students with disabilities.

    The Literacy, Numeracy and Special Learning Needs Program and Victorian Government targeted funding through the State Support Services Program provides additional support for eligible students in independent schools.

    Outcomes for Victoria’s Children provides information and data related to how Victoria’s young people are faring and how this can be used by schools to inform and improve student support services.

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