Updated 19 January 2017

Managing juvenile arthritis at school

As a teacher or caregiver you’ll benefit greatly from understanding what juvenile arthritis (JA) is if you have a JA sufferer under your care.


Here’s an outline of what juvenile arthritis is and what you can do to make life easier for both of you.

Juvenile arthritis is a general term for all the types of arthritis and their related conditions that occur in children. JA affects twice as many girls as boys and can occur at any time from infancy until the age of 16.

Some symptoms of JA will go into remission, but some sufferers may be affected by it to some degree for the rest of their lives. An early diagnosis offers the child the best opportunity for a positive outcome.

Like any other chronic disease, JA can affect a child’s performance and well-being at school, but because of the erratic nature of JA, the child may suffer from varying degrees of pain and discomfort. They may feel fine for a while, only to go through a sudden, bad patch of swelling and pain.

This may result in erratic attendance at school, but it’s important that the child attend school as often as possible. Youngsters like to be treated the same as their peers as much as possible. Singling them out for special attention can’t always be avoided, but may lead to feelings of self-consciousness and insecurity.

Encouraging the child to be active when he or she isn’t in pain can help compensate for these feelings of exclusion, but the child should be allowed to limit his or her involvement in demanding activities.

Apply these principles to the side-effects of medication, such as the need to eat before taking medication to avoid stomach trouble.

Many sufferers actively hide their symptoms, but it’s difficult to do so indefinitely – tell-tale signs may include fidgeting and rubbing of joints.

The pupil should be encouraged to be proactive and to take responsibility for dealing with the disease. This can include encouraging the child to wear any splints or braces that make exercise easier, even though the child may feel self-conscious about it.

Participating in sports

Encourage the child to participate in sports which exercise muscles without putting undue strain on the joints e.g. swimming.

Vigorous sports such as basketball, netball, soccer and hockey can be attempted only in periods of remission (joint disease inactive). Contact sports such as rugby should be avoided.

These sports not only help the child to develop coordination and fitness, but also lends a feeling of belonging.

Expressing pain

Some children find it difficult to express their symptoms or changes in joint function. Asking the child to draw him or herself using a variety of colours might help you understand their pain and discomfort.

Ask the child if you can show this drawing to his or her other teachers as a way of helping them gain a better understanding of the child.

Allow for flexibility

Be flexible if the child is occasionally late, as JA can make it very difficult to get going early in the mornings. Your experience as a teacher will help you judge whether the child is taking advantage of your flexibility.

Apply this principle to the time it takes the child to change classes too. Stairs and crowded corridors can be a real impediment if the JA has flared. Consider implementing a “buddy system” with classmates to help carry schoolbooks.Consider seating the child at the back of the class, where he or she can stand and stretch quietly if needs be. Remember that extra room may be needed at a desk.

Using equipment to make learning easier

Using a book holder can reduce strain in the neck. Offer to provide or arrange for thicker pens or pencils, or make writing implements thicker using tennis racket handle tape (purchased at any sports shop). This will make writing easier;

Discuss the use of a computer with your principal and colleagues.

Providing a second set of text books can eliminate the need to carry heavy bags to and from school.

Meeting with parents

It would be beneficial to you and the child to meet with the parents, as they may be concerned about:

- The ongoing costs of medical care;

- The child’s development as an independent, successful young adult;

- The child may be victimised or bullied by his or her peers; and,

- The likelihood that one or more of the child’s siblings may develop JA.

Obviously some of these issues are beyond your control or the scope of your expertise, but it’s worth acknowledging the parents’ fears and concerns. Some parents also feel guilty that they may have passed on the disease to their child.

This mindset may affect the way they interact with others. Encourage the parents to discuss their issues with the child’s doctor.

Read more:

Juvenile arthritis in children

Juvenile arthritis in teenagers


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Arthritis expert

Professor Asgar Ali Kalla completed his MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 1975 at the University of Cape Town and his FRCP in 2003 in London. Professor Ali Kalla is the Isaac Albow Chair of Rheumatology at the University of Cape Town and also the Head of Division of Rheumatology at Groote Schuur Hospital. He has participated in a number of clinical trials for rheumatology and is active in community outreach. Prof Ali Kalla is an expert in Arthritis for Health24.

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