Information for teachers

How can arthritis affect school life?

Many people think arthritis only affects the older generation. But 1 in every 1,000 young people in the UK has arthritis.

Arthritis in young people can be complex. Its severity varies from one person to another, and someone's symptoms can alter greatly from day to day. Read more about the symptoms and treatment of juvenile idiopathic arthritis (JIA).

A caring and friendly school environment, and staff with positive, understanding and compassionate attitudes, will make a big difference for a young person with arthritis. The key is a genuine ethos of inclusion so that a young person with arthritis has an equal opportunity to participate fully in school life and reach their potential.

When a young person has arthritis

Growing up with a long-term (chronic) illness can pose many physical, emotional and practical obstacles. It’s important to meet early on with your pupil and their parents/carers to find out:

  • how the condition affects your pupil
  • what they need to make sure they have a positive school experience and what school staff can do to help
  • whether they want other pupils to know about their condition.

If a member of your pupil's rheumatology team can attend the meeting they can give you additional medical information and a professional perspective that could be important. The rheumatology team should work with your school to help you understand your pupil's medical condition and needs. Ideally this will include assessment and co-ordination by an occupational therapist, a physiotherapist or a rheumatology nurse specialist.

Your school will need to consider the practical implications of a young person’s arthritis and where necessary help out by making technical and practical alterations.

Difficulties during lessons

Most young people with arthritis can manage perfectly well, with help, in mainstream schools. Your pupil may not need extra help in class on a regular basis, but it’s still useful for you to know about their condition as growing up with a chronic condition can affect psychological well-being.

It's also important to understand that they may need time out of school for hospital and GP appointments, as well as during severe flare-ups of their arthritis.

If your pupil has more severe arthritis they may need long-term support.

Your pupil might not always be able to participate fully in PE and drama lessons. They might want to avoid some contact sports, such as rugby, for example.

It's a good idea to talk with your pupil and their parents about what activities they'd like to participate in and what activities they might need to opt out of.

Exercise is a crucial aspect of a young person's ongoing self-management of their arthritis. They will most likely have a physiotherapist who will discuss and plan a weekly exercise programme with them.

Effects on concentration

If your pupil is in pain, they may be moody, irritable and tired. This can reduce concentration and may be especially bad towards the end of the day.

If you think they're ever using their arthritis as an excuse to get out of doing work, raise it with them sympathetically at an appropriate time. Your pupil may be trying to communicate an unidentified problem with you.

Fatigue can be an overwhelming problem for young people with arthritis. It can be related to:

  • chronic pain
  • disturbed sleep
  • anaemia
  • the effects of inflammation.

Mobility

Getting to and from school/college, as well as around the building, may be difficult. Taking the stairs may cause problems.

Stiff joints, particularly in the morning, may sometimes make your pupil late for school. They may be stiff after a period of sitting and may move less quickly than others.

Carrying heavy bags can be difficult when the arthritis is active.

Effects on their body

Your pupil may find it hard to use their hands properly. They may have difficulty writing, managing tools or doing physical tasks like going to the toilet alone or doing up buttons.

If your pupil has eye complications (uveitis) related to their arthritis, they may have difficulty with their sight.

Many young people have issues around body confidence and this could especially be the case with young people with arthritis.

The disease can affect the shape and size of joints. Many young people with arthritis take steroids, which can lead to weight gain. If this leads to any teasing or bullying, this must be tackled immediately.

What practical support can I give?

Schools are legally obliged to provide equality of opportunity for all pupils. This means that schools must not discriminate against a pupil with a disability by giving them a level of teaching, support and access to facilities that would put them at a disadvantage to their peers.

Ensuring this doesn't happen may require the school to make some reasonable adjustments so pupils with arthritis can participate fully in school life.

Getting around

Painful and stiff joints can make movements slower or more difficult. Ask your pupil sensitively if they’d like any modifications put in place.

They might be worried about being singled out for special treatment, so be careful to help practically as much as possible and without making them feel awkward or upset at unwanted attention, especially when they're starting at a new school or college.

Be flexible about your pupil arriving late or leaving early and allow extra time or help for moving between lessons. This is more of an issue in secondary schools and colleges, where lessons are often in different rooms.

Where possible, arrange for lessons to be in downstairs classrooms. If this isn't possible, let them use lifts where available. If necessary, give them a lift pass. Think about access for wheelchairs and crutches where necessary.

Give your pupil a ground-floor locker or let them leave textbooks in a secure place. If possible, give them two sets of books, one for school and one for home, so they don't have to carry them around.

Be flexible about uniform rules where there are specific needs, for example with footwear.

Give them a pass which explains any special provisions to avoid them having to repeatedly explain their needs or get in trouble. This could include, for example, a toilet pass, late pass, shoe pass, lift pass and inside break pass.

What emotional support can I give?

Growing up with a chronic illness and managing any limitations caused by arthritis can be tough and affect emotional well-being. Young people with arthritis will share the normal anxieties of their peers but may have additional concerns related to their condition and what might happen in the future.

The illness can affect the whole family and schools will need to be aware of the needs of siblings too. A Pastoral Support Plan (PSP) may be useful for some.

Making the most of playtime and breaks

Play and leisure time is an essential part of school life, to develop friendships and peer support. It also allows young people to let off steam and promote positive emotional well-being.

It’s important that young people with arthritis are encouraged and enabled to join in with their classmates during playtimes or breaks.

Exercise is good for arthritis and joining in will help your pupil to avoid feeling different. Sometimes, however, they may find running about or standing around in cold weather difficult, so you might occasionally let them and some of their friends play inside for some or all of break-time.

If it's possible, seats and sheltered areas of the playground would help your pupil and would probably be used by a lot of other children as well.

Deciding whether to tell classmates

Telling people about a chronic illness is a very personal decision. A young person with arthritis needs to be made aware of the potential advantages and disadvantages of telling people, so they can make an informed decision. This can provide young people with a larger support network and greater confidence.

A young person with arthritis may need to be equipped with the skills and confidence to tell people about their condition.

Sometimes children/young people want others such as a local physiotherapist or occupational therapist to come and talk to the school or class about their arthritis.

If your pupil wishes to keep details of their condition to themselves and not tell their classmates, or just tell a selected number of friends, that is a decision that should be respected.

If your pupil has to spend some time out of school because of their condition or treatment, they'll probably find it difficult to reintegrate with their class at first. Sensitive handling of this situation and encouraging classmates to be kind and understanding, without making too much of a fuss, would be really helpful.