SAVTI (Successful Academic and Vocational Transition Initiative): Pediatric Oncology Group of Ontario (2010-2011)

Advances in the treatment of childhood cancer over the last decades have resulted in consistent and dramatic gains in survival rates through the use of various combinations of chemotherapy, surgery and radiation therapy. Overall survival rates are now in excess of 82%, resulting in an ever increasing pool of survivors of childhood cancer.

With survivorship, however, comes a cost. A substantial proportion of survivors experience significant physical, emotional and neurocognitive late effects resulting from their disease and treatment. A subset of the cured patients, notably those treated for leukemia with cranial radiation or intensive chemotherapy, and those treated for brain tumours with cranial radiation, will have varying degrees of compromised neurocognitive function, a consequence estimated to affect up to 60% of survivors.

The unique pattern of neurocognitive compromise observed in this population may include some or all of:

• slowed rate of information processing
• increased forgetfulness
• poor working memory
• lack of automatic processing
• inattention and distractibility.

Superimposed on this profile of complex learning disabilities, young survivors of brain tumors may experience:

• persistent fatigue
• weakness in one or more limbs
• impaired vision or hearing
• organically-based inertia
• physical deformity

Additionally, the peak occurrence of childhood cancer is in the 1 – 5 year old age group, a time of maximum knowledge absorption and school readiness. Consequently, educational attainment may be compromised by missing significant amounts of school time in this window

Thus a significant challenge exists for these adolescent survivors and their families as they transition from the child-centered to adult-focused education and health care systems.

The SAVTI project has, as its express purpose, achieving linkages between the silos of medical and mental health care, secondary and post-secondary education, training, vocational, community and social services, in an effort to advise and direct these adolescents toward defining realistic career goals and identifying and pursuing effective pathways to their achievement.

The goals of SAVTI are to use knowledge and information drawn from the health sector to:

• identify education and employment barriers for individual youth
• facilitate their access to identified, optimal, realistic education and employment pathways
• develop the necessary systemic and client-specific strategies to successfully achieve educational and vocational objectives, such as the alignment of neuropsychological profiles with educational and vocational opportunities
• share health care provider knowledge of survivorship with educators and counsellors who will serve as ongoing resources for the individual.

The SAVTI Project, implemented by the Pediatric Oncology Group of Ontario (POGO) began in Toronto (GTA) in 2002, operating in collaboration with the Hospital for Sick Children, the Ministry of Health and Long Term Care and George Brown College. The success of the program dictated expansion across the Province of Ontario, to enable  greater access for all appropriate survivors. In 2007, SAVTI launched a search for funding for the expansion, – and The Lawson Foundation became instrumental in our quest to go beyond the GTA. Through a very generous grant of $450,000 over three years, we were able to offer access to SAVTI to survivors attending POGO Survivor clinics at the hospitals in Hamilton, London, Ottawa and Kingston. This has made an enormous difference to a number of survivors and their families.

One such survivor is Victor Okeowo:

Victor was diagnosed at 6 months with an optic glioma – a tumour that blinded him in one eye and later left him with little vision when it reoccurred behind the other eye. Beyond the visual impairment, the tumor and its treatment have impacted his learning abilities. Victor’s struggles with school have been lifelong. “He loves to learn,” says Victor’s father Baba Okeowo. “Some kids pretend to be sick so they can stay home, but Victor would always pretend to be well when he was feeling sick so that he could go to school.”

Victor followed an independent education plan designed for special education students and obtained a high school certificate. Transitioning beyond the protected world of secondary school became a major problem for Victor. With a SAVTI counsellor’s help, he has achieved his goal to go to college and work in an office, through a college vocational program and co-op placement. He won the 2010 Xerox scholarship awarded to a successful college student who has been involved with SAVTI and the next step is to help Victor find meaningful employment.

“To be honest, before POGO’s SAVTI, we didn’t know how we were going to help Victor succeed. He is an ambitious guy and it could have all gone to waste. Now he has a certificate, he has work experience. Our son is very ambitious and now he has the opportunity to fulfill that ambition.” – Baba Okeowo

A bridging grant in the amount of $150,000 from The Lawson Foundation, in 2010, gave SAVTI the time to pursue further, stable funding from other sources - in which we have been successful. We, and the children we serve, are very grateful and truly appreciative of what The Lawson Foundation funding has allowed us to achieve. 

[1]  Hewitt M, Weiner SL, Simone JV, editors. Childhood Cancer Survivorship: Improving Care and Quality of Life. Washington DC; The National Academic Press: 2003, p49-77.