Key Takeaways

    • You know your child best and know when they may be experiencing changes to their learning needs when returning to school after a cardiac arrest.  
    • If you notice changes in your child’s thinking or learning abilities, you can request an additional evaluation from the school to determine whether they are eligible for school support or services to best support your child.
    • Neuropsychological evaluations can assess the effects of your child’s cardiac arrest on their cognitive function and support their school in identifying which supports or services may be helpful. 
    • Resources such as Section 504 Plans and Individualized Education Plans are available to support your child at school as they transition to new learning needs.
Are there resources to support my child returning to school?

Children who have had a cardiac arrest may experience changes to their thinking and learning due to effects on brain development. Though it can take time to adjust to these changes, many resources are available to support you and your child through this transition, including additional support and services at school.

New learning needs

After a cardiac arrest, one aspect of going back to a new normal may include returning to school. Upon return, you may notice (sometimes months later!) that your child is experiencing changes to their thinking and learning abilities. These changes could be related to the effects of low oxygen on brain functioning and development during the cardiac arrest event and recovery process. 

Children who have had a cardiac arrest often experience changes in cognitive function – or how the brain thinks, learns, and understands – such as:

    • Attention: Your child may struggle to pay attention in the classroom or focus on more than one task at a time. Your child may need additional time to process information.
    • Executive function: Planning ahead, organizing ideas, following step-by-step instructions, or managing emotions and behaviors may be harder. 
    • Learning and memory: It may be harder to remember short-term information or retain newly learned content at school. 
    • Language: Pronouncing words correctly, communicating ideas, or understanding others may be harder.
    • Visual-motor skills: Your child may struggle to understand visual information or use their fine motor skills (small, precise hand movements using your hands and fingers) during activities that require writing, typing, or drawing.
Starting the evaluation process

If your child is having difficulties in these areas, help may be available at school. Two primary kinds of evaluations are a useful starting point to understand your child’s new learning needs. While the evaluations differ in scope and purpose, they can complement each other to determine how best to help your child. During both of these assessments, your child may be asked to participate in various learning activities such as answering questions, looking at pictures, completing puzzles, drawing shapes, and demonstrating their reading and math skills. 

Learning based tests

This evaluation is performed by a school psychologist and other educational team members through your child’s school district. These assessments focus on how your child is learning in the classroom and can provide information about academic strengths and weaknesses. This kind of evaluation is also required to determine what supports or services – such as classroom accommodations, specialized instruction, or therapies — may be available to them at school. The evaluation team will discuss the results with you, and if eligible, provide a formal written plan (see below). If you are interested in this type of evaluation, talk to your child’s principal, your school district’s main office, or a special education consultant.

Cognitive Functioning

This evaluation is performed by a pediatric neuropsychologist, either in hospital or community settings. These assessments focus on how your child’s brain is functioning after their cardiac arrest and its impact on their thinking, learning, and behavior. The evaluation can provide information about cognitive strengths and weaknesses, relevant diagnoses, and treatment recommendations. These recommendations may include support and services across settings, such as school plans, outpatient therapies, mental health counseling, and/or community support. The pediatric neuropsychologist will discuss the results with you and provide a written report, which can also be shared with your child’s school to help them determine what supports or services they may need. If you are interested in this type of evaluation, talk to your medical team or insurance company about referring you to available options.

School supports and services

Depending on findings from your child’s evaluation, they may be eligible for formal support and services at school. In the public school system, two primary kinds of plans can provide help to your child’s new thinking and learning needs. 

Section 504 Plan

Section 504 of the Rehabilitation Act of 1973 is a federal civil rights law that protects the rights of students with disabilities. If your child has a health-related condition that substantially limits their learning and functioning in the classroom, a 504 Plan can provide accommodations to reduce barriers and help them succeed in their general education setting (regular classroom). Examples of support include extra time on tests, shorter assignments, copies of notes, and/or visits to the nurse’s office when needed. 

Individualized Education Plan (IEP) 

The Individuals with Disabilities Education Act is a federal special education law that ensures students with disabilities are provided with a free appropriate public education. If your child has a health-related condition that negatively impacts their educational performance, an IEP can provide more comprehensive modifications to meet their learning needs. An IEP is a written plan that includes formal annual goals and tracking of progress. Examples of services include special education in a different classroom with a resource specialist (“pull-out” services) or working with a special education teacher in the classroom (“push-in” services). Services could also include interventions such as speech/language therapy, occupational therapy, physical therapy, or mental health counseling.

Sources

National Center for Learning Disabilities. (2024, January 6). IEPs vs. 504 plans. https://www.ncld.org/ieps-vs-504-plans/ 

Office for Civil Rights. (2023, July 18). Protecting students with disabilities: Frequently asked questions about section 504 and the education of children with disabilities. United States Department of Education. https://www2.ed.gov/about/offices/list/ocr/504faq.html 

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Topjian, A. A., de Caen, A., Wainwright, M. S., Abella, B. S., Abend, N. S., Atkins, D. L., Bembea, M. M., Fink, E. L., Guerguerian,A.-M., Haskell, S. E., Kilgannon, J. H., Lasa, J. J., & Hazinski, M. F. (2019). Pediatric post-cardiac arrest care: A scientific statement from the American Heart Association. Circulation, 140(6), e194–e233. https://doi.org/10.1161/CIR.0000000000000697  

Thank you to our contributors

Paulina Schuhler, Alexander Tan, & Neethi Pinto

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