PAWS program helps pediatric patients make the grade

LEXINGTON, Ky. (March 26, 2025) — Kids have one job — to be kids. 

They go to school. They hang out with their friends. With support and routine, kids thrive at their jobs — completing schoolwork, passing tests and advancing to the next grade with their best friends right next to them.  

When kids are hit with a devastating diagnosis, such as cancer or a blood disorder, that reliable routine is upended. Surgeries, procedures, medical appointments and prolonged hospital stays can be disruptive to not just their education, but to their emotional and mental well-being as well. Without the consistency of a school day, regular interactions with fellow students and instruction from their teachers, patients can fall behind, compounding the ever-present stress and anxiety that accompanies a chronic illness. 

But the patients in the DanceBlue Kentucky Children’s Hospital Hematology/Oncology Clinic have a secret weapon: a small team of superheroes with the power to extend homework due dates, get extensions on school projects and secure every accommodation the patient requires to be successful in school.  

Meet Courtney Emery and Dixie Marz, the school intervention specialists in the Providing Assistance With School (PAWS) program at Kentucky Children’s Hospital (KCH). Their job is to act as educational liaisons between the school, the family and the medical team on behalf of patients. When a child or young adult is unable to attend school due to intensive treatment, PAWS helps by coordinating with teachers, securing accommodations and offering academic assistance wherever the student is — be it in the clinic, hospital or at home. 

The program started in 2014 with support from Cowboy Up for a Cure and funds raised by UK students through the student organization DanceBlue. From preschoolers to grad students, Emery and Marz work to ensure that no student falls behind due to their illness. 

“This impacts a lot of our patients,” Emery said. “They lose their routine when they have to go to the doctor so frequently, and with that, they lose motivation. It can be so easy for a patient to allow this to become an excuse as to why they aren’t doing so well in school.” 

By connecting directly with the patient’s teachers and school administrators, they can develop a 504 plan, which is a federally mandated requirement that students with disabilities have equal access to educational opportunities. The 504 plan allows the patient additional accommodations such as having extra time to complete an assignment, use of assistive technology or a modified class or learning schedule. If the patient needs additional support, such as specialized instruction or the assistance of an education specialist at their school, the PAWS team with work directly with the school to develop a written individualized education plan. 

“If the students are old enough, they are a part of the conversation,” said Emery. “We tell them, if something’s not working and you feel like you’re struggling with class, we’ll talk about it and come up with another accommodation to help you be successful.” 

Those additional accommodations can include periodic breaks during the school day if they are feeling fatigued, a quiet area to work if they struggle with focus or, if they are immunocompromised, having their own set of materials or dedicated desk space that they don’t share with other students. The Kentucky Department of Education works with school districts to have instructors come to the patient’s home or hospital to assist those who are unable to attend school at all. Emery and her team work with the local school teachers and families to provide the necessary documentation so that students and families can take advantage of all resources available. 

It’s not just the frequent absences that can impact their education. Side effects from medications can include extreme fatigue, impaired memory, concentration or cognition. With a side effect commonly known as “chemo brain,” patients can struggle with short-term memory, have trouble finding the right words or learning new skills and take longer to perform tasks. The effects can be concurrent with treatment or show up years later. 

“We work with our students in the long-term follow up clinic because there are so many side effects from chemotherapy,” Emery said. “We call them cognitive late effects, and they can develop anywhere from three to eight years after treatment. They could be excelling academically, and all of a sudden, they can’t process information the same way, or they’re forgetting things.” 

Emery recalls a patient who was diagnosed during her sophomore year of college. Throughout high school, she was a high-performing student, taking AP and dual-credit courses. During treatment, she found it harder to learn, focus and remember. She wasn’t used to struggling with schoolwork and felt demoralized and unmotivated. Emery connected her with the disability resource office at her college and worked with them to find additional methods of support.  

Patients face another, less tangible barrier while in treatment, one that can’t be solved by a confab of educators and administrators. Mental and emotional health are just as important as physical health, and schools provide a social environment that is essential to emotional development. With frequent and prolonged absences, patients feel disconnected and disheartened. Within the clinic, there is another team dedicated to helping patients navigate the mental and emotional roadblocks. 

“We have a really robust psychosocial team at the DanceBlue Clinic,” Emery said. “We have social workers, psychologists and child life specialists who really empower the patients when they’re having difficulties.” 

Direct and honest conversations are key, said Emery. And that includes talking about life after treatment. Some patients have trouble visualizing their futures, so Emery and her team developed a way to help them see the road ahead. 

“Unlock Your Future” is a college and career fair for KCH patients that provides them with an opportunity to meet with representatives from a number of colleges, universities and trade programs to discuss application processes, financial aid and scholarships. For these patients, it’s a chance to be regular high school students and start thinking about those next steps. These patients didn’t just miss days of instruction; many of them were unable to attend college and career planning sessions at their schools, local college fairs or campus visits.  

“We need these kids to look past right now and know there’s something bigger, better and brighter for them when they get past this difficult time. We recognize that things are difficult, validate their feelings and help them really look toward the future.” 

Since the program was founded, Emery and her team have helped more than 800 patients with their schoolwork in some capacity. They hope to expand the program and assist any KCH patient whose illness or injury can impact their schoolwork. Emery notes that more than a few patients set their sights on careers in health care, inspired by the care they received in the DanceBlue Clinic. And the PAWS team is more than happy to help them chart that course. 

“A child’s job is to go to school, and when you take that out of the equation, it changes their ability to learn,” Emery said. “Having someone that understands what it’s like to be in the classroom is a valuable resource for families. That’s been my goal from the beginning: to be of service to the families and improve the outcomes for all the students I work with.”