Caring for children with Caring for children with

special needs

Outcomes of workshop

• Have an understanding of the role of the school nurse

within Federal Law 29.

• Be confident to promote the individual rights and values

of children with disability and or additional needs.

• Work to the basic tenets of best practice provision.• Work to the basic tenets of best practice provision.

• Increased awareness of the condition and disorders

encountered in an educational setting.

• To increase use of an Holistic model of care and support.

• Understanding roles within multi-professional IEP and

CP.

Federal LawTo be successful a team approach will be required with

each person’s role being clearly defined and performance

managed

Note:

• The UN Commission on Disability: “giving individuals the • The UN Commission on Disability: “giving individuals the

opportunity to maximise their talents”

Ratified by Shaikh Khalifa Al Nayern Dec 2010

• Secretary General to the UN:

“ Let all bear in mind that a society is judged not so much by the

standards attained by its most affluent and privileged members as

by the quality of life which it is able to assure for it’s weakest

members” - Javier Perez de Cuellar

Intervention Planning

What is School Nursing and Disability?

• Disability school nursing is a person-centred profession with the primary aim of supporting the well-being and social inclusion of children with disabilities and/or social inclusion of children with disabilities and/or additional needs through improving or maintaining their physical and mental health.

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What do School Nurses do?

• Act as champions for children with disabilities and or additional needs and their families. additional needs and their families.

• Undertake a range of activities to promote better health for children with disabilities - advising, teaching and supporting

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• liaise with other professionals to enable children to live full and rewarding lives within their communities.

• specifically provide nursing input and direct support to • specifically provide nursing input and direct support to people with complex needs related to their disability.

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• work in a wide range of settings - central to success is partnership working with the individual child, their families, other professionals, organisations and the wider community.

• Many School Nurses have developed additional skills through a range of advanced post-registration training courses. Skills-based courses include those relating to: ‘”challenging behaviour”, epilepsy management and nurse prescribing

Basic Tenets of Special Needs

Care in Schools• Rights

• Independence

• Choice

• Inclusion• Inclusion

• Personalisation (person centred planning)

Also consider:

• Attachment

• Security

• Friendship

• Continuity

Disability and Additional

Needs - Categories of Need

• School nurses will be expected to work with children identified as having special educational needs (SEN)such as General Learning Difficulties and Specific Learning Difficulties. Learning Difficulties.

• This will include pupils with medical conditions, physical disabilities, sensory impairment, speech and language disorders, mental health needs, social, emotional and behavioral related difficulties.

• They will be expected to support the development of whole school nursing and health policies.

Categories and Co-morbidity

of Need

• Cognition and Learning

• Physical Disability

• Sensory Impairment – HI/VI

Medical Conditions

LD

DepressionSLT

• Medical Conditions

• Autism Spectrum Disorder

• Social, Emotional and Behavioural

(Note: these vary according to country)

Asperger’s

Depression

ADHDBowel

problems

SLT

Conditions and Disorders

Teachers and School Nurses

May Encounter

• Epilepsy

• Asthma, Hayfever and Eczma• Asthma, Hayfever and Eczma

• Diabetes

• Coeliac Disease

• Down’s Syndrome

• Cystic Fibrosis

• Cancer and Congenital Heart Disease

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• Tourette’s Syndrome

• Cerebral Palsy

• Spina Bifida and Hydrocephalus

• Mobility problems• Mobility problems

• Sensory Impairment – HI/VI

• Speech and Language Disorders

• Autism, Asperger’s, Pervasive Developmental Delay

• Challenging Behaviours

Disability Discrimination (1)Admissions

Parents are asked to give details of any disability which affects their child on the ‘Additional Information Form’when applying for their child to be admitted to the school.

The school will ensure that reasonable adjustments are made so that a prospective pupil with a disability is not put at a substantial disadvantage when being assessed.

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Teaching and Learning

1. The school will draw up a care plan and an individual education plan (IEP) as necessary to support the disabled learner. This will be drawn up support the disabled learner. This will be drawn up in co-operation with parents, the student and their carers.

Note: this will also be done for a member of staff with a disability.

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2. The SENCO and School Nurse, working with other teaching staff and parents, will be responsible for ensuring any additional support and for monitoring that learner.

3. The school will ensure that there is adequate training of staff so the school is able accommodate the needs of a disabled learner & any member of staff.

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4. The school’s broad and balanced curriculum is delivered in such a way that it meets the needs of all learners.

5. The school will ensure that, ‘within reason’, 5. The school will ensure that, ‘within reason’, adjustments are made to the teaching to support the needs of a disabled learner e.g. providing text in bigger font, sitting a child near the front etc.

Disability Discrimination (2)

Intimate CareThe school will ensure the privacy of children with disabilities when intimate care is being provided.

StaffingEnsure a very clear equal opportunities policy is Ensure a very clear equal opportunities policy is practised as it refers to staffing.(See Equal opportunities policy under staff recruitment, in the Notes of Guidance.)

Physical EnvironmentSee School Action Plan for changes to the physical environment that have been carried out and are planned.

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Contact with Parents and CarersMake reasonable adjustments where possible, to allow parents with a disability to have access to school events and school staff e.g. moving the venue of a Parents’ Evening, giving a disabled parent access to the lift etc.

Complaints ProcedureAll parents have access to our complaints procedure about any issue. The Disability Rights Commission can also give advice to parents and disabled people.

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Early Intervention Programmes ie Early Bird, PEEP, Portage

Where necessary the relevant care plan is produced in consultation with the school’s Health and Safety Manager, School Fire Officer, School Nurse and Manager, School Fire Officer, School Nurse and parents - caretakers and other relevant colleagues have the PEEP distributed to them.

IEPs = Individual Education PlanningDown’s Syndrome - Exemplar

What is an IEP?

Multi-Professional Planning

What is Downs Syndrome?What is Downs Syndrome?

Features of Downs Syndrome

Educational challenges

Treatment

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Classroom Management Strategies

� Circle Time with class to discuss Down’s Syndrome

� Toilet Training and information

� Checking on absence� Checking on absence

�Understanding individual learning difficulty

� Ensuring child wears HA or glasses

�Understanding child’s signing eg Makaton, PECS

� Liaise with parents, Outreach Support Team and staff

� Support development of self-help skills

CP = Care Plan/Intimate Care Plan

Cerebral Palsy - ExemplarMulti - Professional Meeting to Discuss and Formalize Plan

• Discuss the disability with the whole class and develop “Buddy System”

• Discuss the disability with the whole class and develop “Buddy System”

• Train special needs classroom assistants in care support needed

• Ambulant children should sit at desks with ankles at right angles and resting on the floor

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• In-house physiotherapy and occupational therapy input

• Children in wheelchairs should have height moveable tables

• Use appropriate information and communication technologytechnology

• Sensory support

• Speech and Language therapy

• Medication regime eg epilepsy, diabetes

• PE recommendations and support

Examples of Plans Available

Blood

Glucose

Immediately

before Break

and Lunch

Immediately before

swimming

During PE/ Games

(if requested by

child)

After

PE/Games/

Swimming

(reconnect

before testing)

All other times

(if requested by

child)

*Insert name* – Diabetes-

Actions to take at different

blood glucose levels

before testing)

Below 4.0

HYPO

Give 3 glucose

tabs.

Bolus for

food.

Eat food.

Retest not

required,

retest alert

can be

ignored.

Under 3.0

Give 3 glucose tabs.

Disconnect pump.

Must not swim

Retest 10 mins

Between 3.1 and

4.0

Give 3 glucose tabs.

Disconnect pump.

OK to swim.

Retest 10 mins

Give 3 glucose

tabs then send

accompanied to

medical room

with green bag.

(Retest alert 15

mins)

She will return

when BG is above

4.0

Give 2 glucose

tabs.

Retest alert 15

mins.

Give 2 glucose

tabs.

Retest alert 15

mins.

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Between

4.1 to 10.0 Bolus for

food.

Eat food.

Between 4.1 and

7.0

2 JB, Disconnect

pump

Between 7.1 and

10.0

Enter correction

into pump:

2 JB’s

Continue with

games

Do nothing Do nothing

into pump:

If correction bolus

suggested, deliver

50% (rounded

down).

If ‘BG is Below

target’ then eat 2JB

Disconnect pump

after bolus

delivered

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10.1 and

15.0

HIGH

Bolus for food

Eat food

Enter correction

into pump:

If correction bolus

suggested, deliver

50% (rounded

down).

If ‘BG is Below

target’ then eat 2JB

Disconnect pump

Enter correction

into pump

Continue with

games

Enter correction

into pump

Enter correction

into pump.

Disconnect pump

after bolus

delivered

Above

15.0

VERY HIGH

Use Alcohol

swab then

retest.

If still over 15

bolus for

food.

Use Alcohol swab

then retest.

If still over 15 enter

correction into

pump:

Deliver any bolus as

suggested.

Disconnect pump

after bolus

delivered

Use Alcohol swab

then retest.

Enter correction

into pump

Continue with

games

Use Alcohol

swab then

retest.

Enter correction

into pump

Use Alcohol

swab then

retest.

Enter correction

into pump

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• If ***** has 2 consecutive tests under 4.0 she

should be treated then sent to medical room

(accompanied).

• Two tests over 15 at different times of the day may

indicate a delivery problem. Please call home. indicate a delivery problem. Please call home.

• Never correct a hypo retest. The retest is to show a

rise to above 4mmol and must never be corrected,

even if over 10mmol.

• ***** to ALWAYS eat 2 Jelly babies at the start of PE

and Games. No blood test required.

Information Sharing and

Communication

• Pro-active services not reactive

• Open Door Policy

• School Database eSIS

• IEPs• IEPs

• Care Plans

• Regular Review/case studies - multi professional

Rights of the Students

How Will They Help the Student

• Use the things you know about your health and disabilities to help you stay healthy in the future.

• Try to find ways to understand you more, what you want and support you to do the things that are important to and support you to do the things that are important to you.

• Help explain why and how you might be treated for any health problems.

• Try and find ways to help you that are already proven to work.

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• Help you to think about ways to keep well and safe.

• Help you to understand why you do something if it is very troubling to you or other people, and help you to do things differently and to cope with any worries or fears you have.

• Make sure that you and your supporter(s) know about other people who can help you, especially people who work in the health service.

• Work with people who provide care for you to help them to support you in the best ways possible.

• Know about important new ideas and information that may help you.

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that may help you.

• Help stop people with a disability and/or additional need getting unfair treatment.

How Can You Help?

Ethics

• Data Protection

• Confidentiality

• Islamic Law

• Privacy of Medical Accommodation• Privacy of Medical Accommodation

• Bereavement and Loss

• Safeguarding Children

Benchmarks of best practice

• Practice is values based

• All nurses have essential competencies for practice for

Disability

• Can respond to the diverse needs of individual children • Can respond to the diverse needs of individual children

• Supports Health promotion. Pro-active in all educational

settings

• Supports Mental health care , using wider Holistic model

of care

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• Safeguarding vulnerable children

• Develop mechanisms to access other service

providers to cover deficits within school provision

• Support the development of a Privacy policy in the

school

• Develop evidence based best practice for self

• Access induction training in Disability and or

Additional Needs

• Attend regular supervision and team meetings

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• Attend regular supervision and team meetings

• Care is based on individual need

• QA should include Care multi-professional reviews