This section may be helpful for teachers who have little or no experience of children with CF or for the parents of CF children who are starting or changing school.

It is important to remember that CF affects each child in different ways with varying degrees of severity. Each child's health can change considerably from month to month or even from day to day.

There are some symptoms that may be particularly relevant at school.

The most noticeable feature of CF is a persistent cough. Although it is not infectious, it may be embarrassing in front of other children, especially as a severe coughing attack occasionally leads to coughing up mucus or vomiting.

Parents or other carers may have to come into school to help their child with daily physiotherapy. Nebuliser treatment may also be necessary.

The number of physiotherapy sessions that take place each day varies according to the child's current state of health. The length of each session will vary from 15 minutes to an hour.

As CF causes malfunctioning of the pancreas, special supplements need to be taken with all meals and snacks. These are available in capsule form and are often taken in large quantities.

Education

Children with CF are as academically able as their peers, so teachers should expect similar standards, but hospitalisation or chest infections can result in prolonged absence from school, so extra help may be needed to catch up with the rest of the class. Examining boards make certain allowances for pupils with Cystic Fibrosis.

Some older children take advantage of portable intravenous antibiotic equipment, which enables them to attend lessons more regularly.

Physical exercise is beneficial for children with CF so they should participate in Games and PE lessons. Illness can result in loss of energy, which should be taken into consideration.

Social and psychological aspects

Children with CF may be teased or picked on at school because of their persistent cough and the fact that they may be underweight and small for their age. Taking tablets and capsules with their meals may also be embarrassing for them.

Physiotherapy is very time consuming, possibly to the detriment of the child's social life, though children with CF often find supportive friends who help with care and physiotherapy.

During teenage years, there is the possibility that physiotherapy and diet could be neglected. Some people with CF experience delayed sexual maturity and this may cause anxiety or insecurity.

Teenagers may require sympathetic treatment and counselling to deal with some of these issues.

Cystic Fibrosis requires a degree of special involvement from teachers. This could include consultations with parents or even practical help.

For further information, see our Growing up with CF and School and CF publications.

Examinations

Although children with CF are as academically as able as their peers, some may have special educational needs. Cystic Fibrosis may also prevent or hinder the child from using certain educational facilities.

The joint council for the GCSE (standing agreement number four) advises that 'Examining groups are required to take all reasonable steps to enable candidates with permanent, long-term, or temporary handicaps or indispositions to demonstrate their attainments.' This means that under suitable safeguards, a grade can be awarded if a candidate is absent from an exam for legitimate reasons. Additional time may be permitted (normally up to 25%) for all types of examination.

If necessary, a candidate can receive treatment during a supervised break. Arrangements can also be made (subject to examining board approval) for candidates to take examinations outside their own centre (ie at home or in hospital).

Disabled candidates may be given additional time to complete course work, or assigned a reduced amount of course work. Again, this is subject to the approval of the examining board.

In order for a pupil to be considered for concessions at GCSE level, they need to have documented their special needs over a number of years. A child with CF should be included on the school's register of special needs as soon as possible.

It is advisable to keep a record of any absences from school, so it can be presented at the request of the examining board.