It’s that time of year again. It begins with the sudden appearance of loose-leaf paper and three-ring binders, then multipacks of underwear and socks. When shoe-shopping gets under way, it’s all over but the bus ride: It’s back-to-school time, boys and girls!

Luckily, back-to-school time comes just once a year, except for boys and girls with a serious, chronic illness like cancer.

For them, continuous breaks for treatment or to recover from its side effects can make it feel like they're always in the process of getting ready to go back to school. Sooner or later, with or without new underclothes, it's that time of year again.

Believe it or not, that’s a good thing. After all, it’s not summer vacation that's coming to an end, it’s cancer treatment.

But ensuring a smooth return to the classroom takes more than a trip to the mall. The best approach, pediatric experts agree, involves a coordinated effort -- beginning as soon as it’s known that a school break is needed -- by family and friends, the school system, the health-care team, and, certainly not least, a very determined kid with cancer.

With better treatments and much-increased survival, pediatric cancer researchers have been able to learn a lot about the effects of cancer therapies on children years down the road. For example, problems with learning and emotional development, with varying degrees of severity, commonly plague childhood cancer survivors.

As a way of keeping these problems to a minimum, parents are strongly advised to find ways of continuing their child’s education when hospitalization is necessary or when cancer therapies leave the child too tired or ill to attend school.

Keeping up with schoolwork, even partially, they say, speeds a student’s reintegration into school and makes it much less stressful.

A quick return benefits everyone, say the authors of the ACS document “Children Diagnosed With Cancer: Returning to School.” As they point out in the introduction:

It is important that children return to school as soon as possible after the diagnosis of cancer. Children have a sense of purpose in school and receive the clear message that they have a bright future and potential for a full recovery from cancer. Parents will also benefit when their lives return to a more “normal” one. Siblings will also get some much-needed extra attention. It truly is a “win-win” situation for the whole family.

To get a sense of quickly a child can fall behind, parents should think of how much catching up they have to do after just a couple of weeks away from work, says Laurie Leigh, director of the School Program at St. Jude Children’s Research Hospital in Memphis.

No matter how well children keep up with schoolwork, readjusting to the school environment becomes more difficult the longer the absence, and peer groups become more distant. Parents can help reduce away time by taking the following steps, even before treatment begins:

• Get the ball rolling. When a child can’t attend school, Leigh says, your options are home-based services provided through your local school system or hospital-based services, if available where your child is being treated. Initiate contact with both institutions to see where you stand.
• Ask for help at school. Even hospital-based services must be coordinated through the local school system, Leigh points out. Quickly get key people in the school involved on your child's behalf -- a favorite teacher, principal or superintendent, guidance counselor, or school nurse. They can help make sure interim lesson plans are put together for the hospital- or home-based tutor, keep classmates up to date, and help advocate for your child rights or need for special accommodations.

Different sets of circumstances that occur during treatment breaks can dampen a child's enthusiasm for returning to school, and hurt his efforts at reintegration.

Again, parental involvement can help. Some ways include:

• Keep friends in the loop. No child wants to fall too far behind in their knowledge of what their social group deems cool and uncool, of who likes who, and what clothes or music they might own that have recently been classified as dorky. When that happens, watch your child's enthusiasm for school plummet.

  To keep your child socially connected, Leigh suggests an occasional visit from a classmate, or a computer chat session if your child is old enough. Siblings that are around the same age can help by carrying important gossip, the latest jokes, and even homework back and forth from school.

• Get workload adjusted when needed. The school contacts you made early on can prove invaluable if you need help getting an unmanageable workload lightened. Expectations for what your child accomplish should be reasonable but also flexible if necessary, Leigh says.

• Educate teachers and friends. Keeping teachers aware of what your child goes through medically helps them recognize certain side effects and understand the reasons your child misses school. Educating classmates about cancer, specifically their friend's cancer, can help reduce anxiety, teasing, and social shunning.

If a child seems to have a learning problem after treatment has ended, parents should consider approaching a school psychologist or counselor to request testing, according to the authors of "Children Returning to School."

In fact, if the child has had radiation to the brain, it's a good idea to ask for testing whether you notice a problem or not, they say. Testing will evaluate reading, writing, and math skills as well as memory, comprehension, attention, concentration, and fine motor skills.

Armed with that information, the school may suggest your child could benefit from an Individual Education Plan (IEP).

An IEP is developed by parents and teachers to meet the individual needs of a student. It describes a child’s learning problem, sets specific educational goals, and refers to other services that might be needed, such as occupational therapy or speech therapy. As a rule, the IEP should be regularly evaluated, with adjustments made as necessary.

For more on IEPs, see “Children Diagnosed With Cancer: Returning to School.”