Children and adolescents with Inflammatory Bowel Disease (IBD) face the challenge of living with a chronic and unpredictable condition characterized by uncontrolled inflammation of the intestine. The disease constitutes a risk factor that may affect their psychosocial development and educational progress. Students for whom the disease is part of everyday school life are called upon to face additional challenges such as pain and pain management, frequent absences, reduced energy levels, medication management, possible relapses, and the chronic nature of the disease itself.
Children may be reluctant to talk about their symptoms, while some may limit their daily activities to those with immediate access to a restroom, fearing participation in school-related activities. Within the school environment, they often experience feelings of social embarrassment due to the unpredictable nature of the disease and its symptoms. The sudden and urgent need to use the restroom, difficulty participating in group activities, a possible accident before reaching the restroom, dietary restrictions, and the potential presence of a stoma may all become sources of fear that they may be subjected to teasing. Furthermore, the nature of their symptoms may lead to feelings of isolation due to perceived differences. Delayed physical development and changes in appearance caused by medication side effects can also result in feelings of loss and sadness. Finally, inconsistent school attendance due to frequent absences can negatively affect self-esteem, self-efficacy, and opportunities for social participation.
Parents and guardians naturally experience a range of emotions, including fear, concern about the impact of the disease on educational and psychosocial development, anxiety regarding the management of acute episodes within the school setting, and uncertainty about the appropriate actions required to ensure the effective understanding and support of both the condition and the child at school.
Parents are encouraged to inform the school immediately following diagnosis and to establish meaningful and effective communication and collaboration with school staff. It should not be assumed that because the disease is currently under control there is no need to inform the school. The absence of disclosure does not mean the disease does not exist or that it does not occasionally cause discomfort for the student. In order to provide accurate information to school personnel and support each student-patient so that school becomes a safe environment, the Cyprus Association for Ulcerative Colitis and Crohn’s Disease (CYCCA), in collaboration with Clinical Psychologist M.Sc. Anna Fardi, has developed optional information and guidance forms for primary and secondary school staff that take into account each student’s individual clinical profile and needs.
The forms are based on the strategy of promoting the psychological and educational resilience of children and adolescents with chronic illnesses, one of the most contemporary areas of research and intervention within educational settings. Resilience refers to a student’s positive and effective adaptation, characterized by an internal sense of security and self-confidence, utilizing a variety of coping strategies in response to the stress associated with living with a chronic illness. Promoting psychological and educational resilience within the school environment involves protecting and supporting students in a way that increases their likelihood of academic success, regardless of the challenges their condition may present in daily school life. In this way, schools provide equal opportunities for success to all students.
An essential prerequisite is understanding the student's individualized medical and psychoeducational needs and providing personalized medical and psychoeducational support based on their abilities through meaningful collaboration between the family and the school. Integrating this strategy into the educational environment improves the student’s school experience, enabling optimal participation and performance in academic responsibilities and educational goals while helping manage the disease and reduce school-related stress. It also enhances self-esteem and close interpersonal relationships. Finally, this approach supports educators in effectively managing students with chronic illnesses within the classroom.
The forms include concise information about the physical and psychological dimensions of Inflammatory Bowel Disease, as well as the full range of challenges faced by students with IBD in their daily school life. Parents are invited to complete the individualized disease-related information for their child in collaboration with their pediatric gastroenterologist. The guidance section has been designed around the student's medical and psychoeducational needs within the school setting and includes recommended accommodations during periods of remission, relapse, or return following surgery. The forms contain dedicated information letters for every professional involved with the student, including pediatric gastroenterologists, teachers, school counselors, and school nurses, while taking developmental needs into account by offering different versions for students attending secondary education. The completed forms are submitted to the school principal, remain confidential, are stored in the student’s personal file, and are accessible only to the school counselor and the educators directly involved with the student. Before requesting collaboration with the school, families are encouraged to discuss with their child or adolescent the importance of informing teachers about the condition, emphasizing confidentiality and explaining that this process helps them feel safer both physically and emotionally at school. Parents, pediatric gastroenterologists, and school staff are encouraged to work creatively and collaboratively with the child to support both roles they fulfill—that of student and patient.
Living with Inflammatory Bowel Disease involves adversity and uncertainty. Students should be empowered and supported through opportunities that promote development, stress management, and adaptive skills. Integrating psychological and educational resilience into the educational environment through these forms fosters success, self-esteem, and effective communication.
Anna Fardi,
Clinical Psychologist, M.Sc.
Cover Letter for the Guardians of a Primary School Student
Cover Letter for the Guardians of a Secondary School (Gymnasium) Student
