Sickle Cell Disease and Schooling

Sickle cell anemia is an inherited disease that involves red blood cells. Patients affected by the disease have a reduced number of red blood cells, which results in anemia and fatigue.

A mutation in the HBB gene that provides instructions to build part of the oxygen-binding hemoglobin protein leads to sticky, sickle-shape red blood cells. Due to their odd shape and stickiness, the red blood cells tend to get trapped in small blood vessels. This is known as vaso-occlusive crisis (VOC), which can be very painful.

Children with sickle cell anemia do not have learning difficulties, but fatigue and recurrent pain can influence their ability to concentrate in school. They are also more frequently absent from school compared to other children because they must attend doctors’ appointments or because they are having painful episodes. Children with sickle cell anemia, therefore, may require extra help or adaptations to the usual school routine.

Sufficient hydration and bathroom breaks

Dehydration can trigger VOC and drinking regularly is better than drinking large amounts at once, so children with sickle cell anemia should be allowed to drink water during class.

Children with the disease may also have to go to the bathroom frequently and should be allowed to do so whenever they need to.

Extreme temperatures

VOC can also be triggered by cold and very hot temperatures. The classroom should, therefore, be well heated during winter, and the sickle cell child should not sit in front of a fan or under air conditioner vents. He or she should also be permitted to wear multiple layers of clothing when feeling cold. In case of an injury, a cold pack must not be applied to the pain site.

Adaptations during physical education

Children with sickle cell anemia can do moderate exercise but need regular breaks because of fatigue. Teachers should try to find an activity that is less tiring and at the same time does not draw too much attention to the individual needs of the child, which they may find embarrassing.

Recognize signs of a stroke

Strokes sometimes occur in children with sickle cell anemia. A stroke is a blockage of a blood vessel in the brain that causes damage. When a stroke affects only a small part of the brain, it can easily go unnoticed. A typical sign of a stroke is a decline in school performance or difficulties in concentrating. Because teachers see the children every day in the classroom, they are in a good position to spot small changes in performance or behavior. Teachers should immediately contact the parents if they notice any difference in learning.

Emotional well-being

Children with sickle cell anemia are often smaller in size, have delayed puberty, and experience jaundice or yellowing of the skin and eyes. This makes them an easy target for bullying and teasing. Because they have to be careful when exercising, they also have fewer opportunities to play with other kids. Teachers may try to organize team building activities that allow these children to socialize and build relationships with their peers.

Communication with parents

It is essential that teachers talk about the children’s school performance with the parents. Regular communication is also necessary to discuss alternative ways to complete assignments and catch up with missed schoolwork when the child is not able to attend class.

Recognizing pain

Sickle cell anemia patients frequently experience pain, and it is essential that teachers know how to react. A scale from one to 10 may help teachers recognize the pain that is worse than usual and to decide when an emergency contact needs to be called. Parents may want to provide care plans to teachers and caregivers that give instructions about giving pain medication to their child.

504 plans and individualized education plans (IEP)

A 504 plan or an individualized education plan (IEP) provides adaptations to the child’s regular education program. A 504 plan is monitored by classroom teachers, whereas an IEP is controlled and delivered by additional support staff. Both plans are documents to ensure remedial instruction. Parents are involved in the development of the plan, which should be updated yearly to meet the child’s needs.


Sickle Cell Anemia News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.