Home-Schooled Because of Illness: Keeping a Sick Child Socially Connected

In home education for a sick child, friends are often missed more than lessons. Read tips for families on easing loneliness and keeping social bonds alive.

The school bus no longer comes to the door in the morning, the school bag waits in a corner, the lunch box is no longer packed. For a child who cannot go to school because of a serious illness, a treatment period in which immunity is weakened or a long recovery, lessons continue at home, with a teacher visiting a few times a week, or remotely. Parents often worry first about lessons falling behind; but over time they realise that what the child misses most is often not maths, but the games at break time, the whispers of the classmate sitting next to them, the noise of the classroom. Home education for a sick child means the child carries the burdens of the illness and the loneliness of being separated from their peers at the same time. In this article I look at the feelings these children experience, how they differ by age and what the family, the teacher and classmates can do to protect social bonds. Decisions such as when and under what conditions the child can return to school or to crowded settings should always be made together with the treatment team.

What Does a Child in Home Education Because of Illness Go Through?

School is not just a place where a child learns lessons. It is where they make friends, feel they belong to a group and build their own world a little away from adult supervision. When this space suddenly closes, it can open up a bigger gap in the child's life than it appears.

Commonly encountered feelings include:

• Feeling left out: Hearing about what happened in class only afterwards, not understanding the in-jokes, thinking "Everyone forgot me while I was away."
• Feeling different: The question "Why am I the only one at home?" and feeling cut off from peers.
• Boredom and reluctance: Hours spent all day in the same room, looking at the same screens.
• Fear of falling behind: Especially in school-age children, the fear of falling behind their friends in lessons or having to repeat a year.
• Anger: Resentment directed at their parents, at the restrictions, at the illness or at their "healthy" friends.
• Fear of returning to school: Anxiety about how friends will greet them after a long absence.

These feelings are not always put into words. A young child may become more irritable or clingy; a school-age child may resist homework; a teenager may shut themselves in their room and bury themselves in a screen.

Why Are Social Bonds as Important as Lessons?

In a child's development, peer relationships are where many skills are learned, from sharing a desk to team games: waiting their turn, resolving disagreements, sharing, joking, being included in a group. When these experiences are interrupted for a long time, the child loses not only their friends but also the opportunity to practise these skills.

Moreover, the illness surrounds the child's life largely with adults: doctors, nurses, parents, the teacher who gives lessons at home. All of them mean well, but all of them are people who make the child do things and direct them. Relationships with peers, by contrast, are one of the rare areas where the child is an equal and feels like a "child" rather than a "patient". For this reason, for a child in home education because of illness, protecting social bonds is not a luxury but an important part of the recovery process.

Home Education and Loneliness at Different Ages

Preschool and the first years of primary school

For young children, friendship usually means "the person I'm playing with right now". At this age, friends who have not been seen for a long time may be quickly forgotten; but this does not mean the child does not feel lonely. A preschool child may show their longing by clinging to their mother constantly, acting out school in their games or asking often about their teacher. In this period, playing "schools" at home, receiving a short voice message from their teacher and putting drawings by classmates up on the wall can make the child feel that their bond with school has not been broken.

The last years of primary school and middle school

At this age, the friendship group is an important source of feeling valued. The child wonders what is happening in class and who is friends with whom, and is afraid of being left behind. Not being able to join school trips, performances or matches is upsetting. For a child approaching the LGS (Turkey's national high-school entrance exam), anxiety about lessons may also increase. In this period, regular contact with one or two close friends helps the child not to feel like a stranger when they return to school.

Adolescence

For a teenager, peers are at the centre of identity development. A young person in home education may feel pushed out of their friendship group and that first relationships, parties and events in class are all happening without them. Social media can be both a means of connection and a source of pain: seeing the photos their friends post is a reminder of every event they could not attend. It is important to give the teenager room to make their own decisions on this, and to decide for themselves whom they stay in touch with and how much. For example, a young person may not want to be in the class's general group chat and may prefer to message only two close friends; this choice can help them both stay connected and be protected from overwhelming comparisons. I have discussed in detail how loneliness can look in young people in the article on loneliness in teenagers.

What Can the Family Do? Practical Tips

The suggestions below should be adapted to the child's state of health and the treatment team's recommendations. In particular, do not make decisions about visits and crowded settings without consulting your doctor.

• Create a daily structure. Even on home education days, a routine of getting up, getting dressed, lesson time, breaks and playtime gives the child the feeling of a "school day". Days spent in pyjamas can, over time, cause the days to blur into one another.
• Keep up the connection with the class. By talking to the teacher, you can arrange for the class to send the child short videos, letters or drawings, and, where appropriate, for the child to "join" a lesson through a video chat.
• Protect one or two close friendships. Rather than a large group, planning regular video calls with one or two friends the child genuinely values, or short home visits if their health allows, keeps the bond alive.
• Find shared activities. Reading the same book with friends and talking about it, playing an online game together, or drawing at the same time and comparing pictures creates an easy bond, including for children who find conversation hard.
• Give the child a say. The child should also be able to decide who visits and when, how much information is given to the class, and whether they want to appear on camera if they have lost their hair or their weight has changed.
• Balance screen time. For a child staying at home, the screen is both a means of connection and a means of escape. Rather than banning it altogether, it works better to support use that keeps them in touch with friends and to limit passive watching all day.
• Involve siblings and cousins. Play with children at home or among close relatives can make up for part of the peer relationship.

The parents' own burden

The home education period often means that one parent, usually the mother, takes on the child's care, their teaching and being their playmate all day long at home. This multi-role arrangement soon becomes exhausting. Tension over homework and the parent's dilemma, "They're ill and they don't want to study either, how hard can I push?", are common. Clarifying lesson times with the home education teacher, keeping the parent's teaching role limited and allowing yourself small breaks during the day protect both your relationship with the child and your own resilience as a parent. Sharing the care in turns with your partner or with a grandparent also lightens the load.

For the teacher and classmates

Teachers play a very important role in deciding how the class will remember their ill classmate. With the permission of the family and the child, giving the class a short explanation suited to their age, keeping the child's desk or coat peg in place, setting aside a spot for them on the class noticeboard and including them in holiday or New Year cards sends a strong message: "I haven't been forgotten." Asking classmates, "What would you like to write to them?" also helps the children themselves feel useful.

What to Say, and What Not to Say, to a Child in Home Education Because of Illness

The sentences below are fictional examples; the aim is to see the difference in attitude.

Sentences you might do well to avoid:

• "Lucky you, you don't have to go to school, enjoy it." (It ignores the child's loss.)
• "Your friends have probably forgotten you by now." (Even said as a joke, it voices the child's greatest fear.)
• "If you fall behind in lessons, you'll have to repeat the year." (It increases anxiety and lowers motivation.)
• "You're ill, you don't need to see anyone." (It belittles their social needs.)

Sentences you could try saying:

• "You miss your school and your friends, and that's completely understandable."
• "Which of your friends would you like to talk to this week?"
• "Would you like to send your class a video, or shall we write a letter?"
• "We'll carry on with lessons at your own pace; we'll make a plan with your teacher."

For a child in home education, the greatest lesson is knowing that the classroom door is still open to them.

Let's say an eleven-year-old girl who has been having lessons at home for months receives a short voice message from her classmates every Friday. There is nothing big in the messages: who fell over at break time, which teacher taught them a new game, what has run out at the school canteen… But every Friday the child waits for this message, and after listening to it she records her reply in her own voice. This small ritual makes her feel she is still part of the class.

Preparing for the Return to School

When the home education period one day comes to an end, returning to school brings its own anxieties. The child may worry about how they will be greeted with their changed appearance, about friendship groups having broken up, about being behind in lessons. Planning the return gradually, visiting the school beforehand while it is empty, meeting the teacher and the school counselling service, and deciding together with the child what will be told to the class can make the process easier. I have discussed this topic in more detail in the article on returning to school after illness.

When Should You Seek Professional Support?

Sadness and boredom from staying at home are expected reactions. However, the following signs suggest that consulting a child and adolescent mental health professional may be helpful:

• Marked reluctance and an inability to enjoy anything lasting for weeks
• Refusing all contact with friends, never answering calls or messages
• A seriously disrupted sleep pattern, with night and day mixed up
• Anxiety, stomach aches or bouts of crying that intensify as the return to school approaches
• In teenagers, expressions of hopelessness, remarks such as "Nothing means anything"

If a child or young person talks about harming themselves or wanting to die, always take it seriously; in an emergency, call 112 (emergency services). Share any marked changes in mood with the child's treatment team as well; where necessary, an assessment by a child and adolescent psychiatrist may be important.

How Is a Child in Home Education Because of Illness Supported in Therapy?

In work with young children, play offers a safe space for the child to express their longing, anger and fears. In child-centred play therapy, the child can re-enact the themes of school, friendship and hospital through toys and make sense of these experiences at their own pace. You can find information on the child and play therapy page.

With school-age children and teenagers, work can focus on loneliness, anxiety about returning to school, a changing body image and how to tell friends about the illness. In a cognitive behavioural approach, it is possible to notice thoughts such as "Nobody will want me any more", test them against real experiences and practise social skills again in small steps. In sessions with parents, the topics are building a daily routine at home, supporting the child's autonomy and the family's own tiredness. During periods when the child cannot leave the house because of limited mobility or the risk of infection, online sessions can be an option.

Frequently Asked Questions

Can a child in home education see their classmates face to face?

This depends on the child's state of health and the stage of treatment. Always ask the treatment team about rules on visits during periods when immunity is weakened. If face-to-face meetings are not possible, video calls, letters and voice messages are good ways to keep the bond going.

Should I push my child if they do not want to see their friends?

Pushing usually backfires. First try to understand the reason for the reluctance; they may be embarrassed about their appearance, feel tired or be afraid of rejection. Suggesting easier steps, such as starting with a voice message without appearing on camera, keeps the door open.

How much should the class be told about the child's illness?

The family and, if possible, the child should make this decision together. Generally, rather than the name of the illness, a short, age-appropriate explanation of why their friend is not at school and how they can support them is enough.

What can be done if the child's motivation for lessons drops during home education?

Short study periods, clear and achievable goals, and noticing small successes support motivation. As there may be tiredness and difficulties with attention related to the illness, it is important to set expectations realistically together with the teacher and the treatment team.

• #home education
• #chronic illness and school
• #loneliness in children
• #patient psychology

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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