Physical and medical

Sensory, Medical and Physical – Physical and Medical Needs

Definition of physical and/or medical needs

When children and young people have long term physical disabilities and/or enduring medical conditions which significantly impact on their life, including their education. It is important to note that the level of difficulty resulting from a clinically measured physical or medical impairment will inevitably vary from child to child.

The code of practice (2015) by the Department for Education states:

A child of compulsory school age or a young person has a learning difficulty or disability if he or she:

  • has a significantly greater difficulty in learning than the majority of others of the same age, or
  • has a disability which prevents or hinders him or her from making use of facilities of a kind generally provided for others of the same age in mainstream schools or mainstream post-16 institutions

The code of practice also mentions that “long-term health conditions such as asthma, diabetes, epilepsy, and cancer” (page 16) is included in the definition of medical and physical needs a child may have.

 

How to identify need

The child’s needs are usually identified by health professionals, parents and in some instances school/setting staff. Where a child’s primary need is medical and/or physical but has not yet been identified by health professionals, it might be useful for school staff to observe the child and compile what signs, symptoms and characteristics they have observed. This might be helpful to use when raising concerns later.

  • Exhaustion and distractability
  • Fatigue - energy deprivation and muscle loss
  • Muscle pain
  • Weakness in arms / legs
  • Variations in muscle tone, such as being either too stiff or too floppy.
  • Stiff muscles and exaggerated reflexes (spasticity)
  • Stiff muscles with normal reflexes (rigidity)
  • Lack of muscle coordination
  • Tremors or involuntary movements.
  • Loss of coordination (arms and legs).
  • Mobility issues - Unsteady or awkward gait
  • Bumping into obstacles / clumsy behaviour
  • General pain
  • Physical problems e.g. with legs, joints etc.
  • Elimination / urination problems
  • Respiratory Problems
  • Shortness of breath.
  • Chest tightness or pain.
  • Trouble sleeping caused by shortness of breath, coughing or wheezing.
  • A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
  • Headaches
  • Temporary confusion.
  • A staring spell.
  • Uncontrollable jerking movements of the arms and legs.
  • Loss of consciousness or awareness.
  • Psychic symptoms such as fear, anxiety or deja vu.
  • Increased thirst and urination.
  • Hunger.
  • Weight loss.
  • Irritability.
  • Fruity smell on the breath.
  • Blurred vision.

The list above is in no way exhaustive and every child’s needs are unique and individualised. Therefore, if you do have concerns, please discuss these with the SENCo in school or designated member of staff in early years and post-16 settings. The SENCO/head would then meet with parents to involve health professionals and a referral to the sensory, physical and medical team at North Yorkshire County Council would follow.

 

How to support in schools

Physical or medical impairment will inevitably vary greatly from child to child. Every child or young person has a very unique, individual set of needs. Support would be individual and specific.

Please read the Guidance for Supporting CYPS with Medical Conditions in Schools for in-depth advice and information on how you can support a child with physical/medical needs in schools. This can be found in useful documents on the main Inclusive Education Service landing page.

This includes the documents such as Individual Health Care Plan (Appendix 6), request to administer medication, record of medicines given and other paperwork. 

Here are a few good practise prompts to ensure that you are a Disability Friendly School.  Consider the following:

 

The Physical Environment

  • Physical Access – Is the school able to provide young people with appropriate access?
  • Disability Friendly Facilities, Fixtures and fittings – For example, does the school have a hygiene suite, disabled toilet and wheelchair access.
  • Is school planning to meet DDA compliance?
  • Does school have a Disability Access Policy?
  • Has the school looked at the NYCC Disability Checklist*?

 

An Inclusive Curriculum

  • Classroom management – think Access - appropriate seating, clear and clutter free classrooms. Is the classroom wheelchair friendly?  Can the pupil access all necessary areas of the classroom/setting?
  • The right equipment from height adjustable desks to easy grip scissors.
  • Teaching Strategies – follow advice from The Physical Medical Team and other health professionals.
  • Planning – share planning with key staff
  • Recording – handwriting/scribe/ICT/speech recognition software
  • Speed of work – methods of recording
  • ICT Throughout the curriculum – making it accessible – adapted settings, specialist programmes, specialist equipment
  • Role of support staff
  • Modified school day – e.g. allowing for individual needs and personal care
  • Fatigue management
  • Curriculum areas and activities where special consideration is needed, e.g. Physical Education

 

The Social Curriculum

  • Enhancing self esteem
  • Facilitating friendships
  • Awareness building
  • Break/lunch/change of lessons
  • Extra-curricular activities
  • Off-site visits
     

The Transition Process

  • A well planned transition – advice from the Physical Medical Team

 

Additional support

When to refer to NYCC

Once the child or young person has been screened and diagnosed by health professionals with a medical condition, if you need additional support to ensure they can access the curriculum and learn within the classroom.

A referral, with parental consent, should be made to the Inclusive Education Service (IES) – Sensory, Physical & Medical Team (Physical and Medical team) can be made. The referral will usually come from the consultant but may also come from the setting, school or parents.

The Request for Involvement (RfI) form can be found on the CYPS website at http://cyps.northyorks.gov.uk/special-educational-needs-disabilities on the IES landing page.  The guidance for a RFI is on page 22 on the appendix I: SPA Frequently Asked Questions (in the SEND: Inclusive Education Service Core and Extended Offer).

 

How will the Sensory, Physical and Medical team help the child?

In NYCC as part of the Inclusive Education Service, we have a small team of specialist teachers, qualified to support children with Physical and Medial Needs.  This Team is part of the Sensory Physical & Medical Service. The Service aims to:

  • Assess the needs of children and young people from 0 – 25 who have a physical and/or medical need using their specialist knowledge and experience.
  • Give support, advice and training to children and young people, parents, schools/settings.
  • Teach specialist developmental skills to the children and young people.

 

Support offered to a child and/or young person can include:

  • Visiting Early Years children in a setting (usually at the point of transition).
  • Individual support to CYP in schools and colleges
  • Support and advice to parents, settings, schools and colleges
  • Advice to enhance quality first teaching
  • Delivery of bespoke advice, interventions and programmes
  • Multi-agency liaison with other professionals e.g. health professionals such as physiotherapists, Occupational therapists and Speech & Language Therapists.
  • Back Care and Moving and Handling Training for setting/school staff.
  • Training to staff in settings, schools and colleges e.g. specific need awareness and/or intervention.

  

Moving and Handling Facilitator

  • Advises and delivers training to schools and the wider work force about the moving and handling of children and young people who have physical impairments. For example, back care awareness, hoist training, problem solving and personal emergency evacuation planning.
     
    Assessment, advice and training provided by specialist teachers in the Physical & Medical team.
     
    Assessment and advice
     
    Initial assessment of physical and medical need
    Access assessments (school/setting) and adaptations needed
    Independence
    Fatigue management
    Recording of work
    Scissor assessment
    Computer Access
    Fine motor and pincer
    Swimming assessment
     
    The SPM team have Support Practitioners who deliver Intervention programmes such as Body awareness / Fine Motor, Pincer Grip and Mid Line Development / Scissor Skills.
     
    Child and/or young person (CYP) specific training on:-
  • Specific condition awareness for the CYP (impact of the condition, physical access to the setting and access to the curriculum, for example the differentiation of subjects e.g. PE & Inclusive Sports).
  • Supporting children and young people in school with medical conditions.
    This is about how mainstream schools should manage medication and what to do when they have pupils, or are planning ahead for pupils, with medical needs.
    The training will further develop skills and understanding of how medicines should be managed within schools – storage and related paperwork.  How to write Individual Health Care Plans and manage them.  Planning for off site visits.
  • Managing continence needs in mainstream primary and secondary schools
    The reasonable adjustments school should be making
    How you should be planning ahead to develop your facilities in school
    What you should include in a whole school procedure
    How to write a Toileting/Personal Care assistance Plan for children / young people / staff roles and responsibilities
  • Supporting Children and Young People with physical disabilities to record their work in mainstream schools
    To explore different methods of recording and identifying the best method for the CYP.
  • Adapting a computer / iPad to meet the needs of physically disabled children & young people in mainstream schools
    How to use technology to suit the CYP
    Equipment available / Accessibility settings
     
    Who else can help the child?

There are many health professionals from the NHS that work to support children and young people with physical and medical needs, for example:

  •  community nurse/school nurse,
  • health visitors
  • specialist nurse
  • paediatrician
  • occupational therapist
  • speech and language therapist
  • physiotherapist
  • general practitioner

They will work alongside educational professionals inside and outside of the school and setting to ensure the child’s needs are met.

 

National websites

There are also several organisations that can help children and young people with physical and medical needs such as;

  • ERIC (Education and Resources for improving Childhood Continence – www.eric.org.uk) might be helpful for parents/carers, early years and education professionals and healthcare professionals for a child who has bladder and bowel needs.
     
  • PDnet is a network for those supporting learners with physical disability (you can find them at https://pdnet.org.uk).
     
  • Disability sport (www.disabilitysport.org.uk) can help and guide professionals, including teachers and teaching staff how to adapt the physical education curriculum for children with physical and medical needs.

 

The following websites look at several specific medical conditions and might provide support for the child. They are;

  • Epilepsy (https://www.epilepsy.org.uk / www.youngepilepsy.org.uk)
  • Duchenne (www.actionduchenne.org / www.decipha.org (maths advice)
  • www.muscular-dystrophy.org is another helpful website.
  • Muscular Dystrophy UK, Educational Guidelines document, Dept. of Education
  • Spinal Muscular Atrophy (SMA – www.smauk.org.uk)
  • Spina Bifida (www.spinabifidaassociation.org)
  • Cerebral Palsy (www.cerebralpalsy.org.uk)
  • Friedreich’s Ataxia (www.ataxia.org.uk)
  • Child Brain Injury Trust (https//childbraininjurytrust.org.uk)
  • Asthma UK (www.asmtha.org.uk)
  • Diabetes UK (www.diabetes.org.uk)
     
     
    If you believe that there is information that should be amended or added to this webpage, please contact the Inclusive Education Service.
     
    Page last updated: May 2019