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1. Describe a range of chronic illnesses and physical difficulties that children may experience, explaining how chronic illnesses and disabilities can impact on children’s learning and development. You should make reference to how the setting can adapt their practice to support children’s learning and development and identify the professionals that may be involved in supporting children with chronic and physical disabilities.
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All children will likely have many different health problems during infancy and childhood, but for most children these problems are mild, they come and go, and they do not interfere with their daily life and development. For some children, however, chronic health conditions affect everyday life throughout childhood. A chronic illness affects your child’s normal activities, and requires lots of hospitalizations and/or home health care and/or extensive medical care.
There are different types of chronic conditions. I have chosen to describe some of these and their impact on the child’s learning and development.
Asthma is a chronic inflammatory disease of the airways, associated with widespread, variable outflow obstruction. The symptoms are that the child can have difficulty breathing, tightness in the chest, they wheeze and they can cough
It is reported in Patient UK that ‘The UK has one of the highest prevalence’s for childhood asthma internationally, with about 15% children affected. An asthma attack is when something irritates your lungs and your airways narrower making it difficult to breathe. The triggers could be colds, flu, exercising, pollution or allergies to dust, animals and pollen.
Children with chronic asthma will feel “different” than other children because their activities may be limited, and, in many cases, their families must change how they live to accommodate the child and also the practitioners . For example asthma could affect the child’s sleeping patterns making them tired and unable to concentrate. This may delay their intellectual development and they may show negative behaviour. If the child cannot partake in strenuous activities it can affect their motor skills. This may lead to a delay in their physical development and they may not being able to participate in sports. This could make them feel socially excluded. Also if a child uses daily inhalers which contain steroidal medicines could restrict their growth.
The child’s doctor should produce a ‘personal asthma plan which should inform you what medication the child is on. When they are doing this the child and their parents should be involved and it should be renewed every year. A child has a special need if they ‘come from a social group whose circumstances or background are different from most of the school population. (Frederick and Cline,2002:36)
Another chronic illness is diabetes. Net Docter states that 90%-95% of children under 16 years old will have Type 1 diabetes which is caused by the inability of the pancreas to produce the hormone insulin. This type is called an ‘autoimmune disease’ were the body immune attacks one of its own organs or tissues. The symptoms are, feeling thirsty, tiredness, losing weight, frequent urination, stomach pain, headaches and changes in behaviour. When diabetes is diagnosed, your child should be referred to the regional specialist in childhood diabetics.
If it is not treated the child’s eyes can be damaged with high levels of glucose within their blood, the small blood vessels within the nerves can be damaged. Stinging and burning sensations throughout the child’s limbs, vomiting and diarrhoea could happen. The child’s vision can become damaged and be blocked. With this blockage it could prevent light passing through the retina and cause permanent damage to the eyesight. Diabetes can increase the danger of the heart diseases or having a stroke.
The blood glucose level is the amount of glucose in the blood. Glucose is the main source of energy for the body’s cells and is carried to each cell through the bloodstream. The hormone insulin allows the glucose to get into the cells. In type 1 diabetes, the body can no longer make insulin, so the glucose can’t get into the body’s cells. This causes the blood glucose level to rise. Treatment goals for kids with diabetes are to control the condition in a way that minimizes symptoms, prevents short- and long-term health problems, and helps them to have normal physical, mental, emotional, and social growth and development. To do this, parents and kids should aim for the goal of keeping blood sugar levels as close to normal as possible. In general, kids with type 1 diabetes need to take insulin as prescribed. They should eat a healthy, balanced diet, paying special attention to the amount of carbohydrates in each meal and the diabetes meal plan. Also to monitor blood sugar levels several times a day an get regular physical activity.
Following the treatment plan helps kids stay healthy, but treating diabetes isn’t the same as curing it. Right now, there’s no cure for diabetes, so kids with type 1 diabetes will need treatment for the rest of their lives. But with proper care, they should look and feel healthy and go on to live long, productive lives, just like other kids
To adapt your practice you should identify a member of staff who will be trained to help if a student has a ‘hyper attack’. This person needs to comeand see the diabetic student as soon as symptoms start to appear as with a severe “hypo” they may become unconscious. Call an ambulance as quickly as possible. Encourage them to participate in all aspects of school life but help them to manage my diet and exercise needs. Before and after any physical activity make sure they test their glucose levels and have a snack if necessary A sugary drink or glucose tablets kept nearby will be helpful if they experience a hypo. It is important that designated staff is trained to give insulin injections. A good point.
There are a designated number of professionals known as the diabetic care team. The people involved in this team are paediatrician who specialises in diabetics, a nurse, and dietician and child psychologist. The role off this team is to support the child and their family support to enable them to live a full and normal lifestyle by helping with testing the blood glucose levels, instructions in giving insulin injections, a healthy diet, exercise, emotional support and advice.
Another chronic illness is epilepsy. A number of things can cause epilepsy. These include brain damage or a brain malformation. Some people who have damage to their brain or a brain malformation may have behaviour problems. Epilepsy can be caused by a brain tumour or meningitis. . In the hours or even a few days before a seizure, a child’s mood or behavior may also change. This is called a prodrome. Children who have frequent seizures have prodrome symptoms more often than children with better seizure control.
It’s quite usual for a child who has focal (partial) seizures to appear to be behaving differently. These behaviours mayinclude gagging, lip smacking, running, screaming, crying, and/or laughing. They may not be conscious of what they are doing, but they are in fact having a seizure. After a seizure it’s quite usual for a child to be confused, have a headache, feel sleepy of have problems with vision and speech. It can cause a change in the child’s behavior and they may have delusions or hallucinations.
A paediatric neurologists or a paediatric specialist in epilepsy will diagnose epilepsy in children and a care management plan together will be agreed with the parents and the child. There are various medicines to help the child with epilepsy but these can cause side effects such as sleepiness, irritability, mood changed and confusion.
Most children with epilepsy can lead a normal life but they have a greater risk of developing learning difficulties. They may benefit with one to one support because they have little retention span. A risk assessment is needed to enable professionals putting in control measures from the risks identified.
Some children have various physical disabilities. One physical disability is Cystic Fibrosis. A child with Cystic Fibrosis has a faulty gene that affects lungs and the digestive system. Poor growth is one of the first signs of Cystic Fibrosis. A child with Cystic Fibrosis makes thick mucus within the respiratory tract, which can make them suffer from nasal congestion, sinus problems, wheezing, and asthma like symptoms. As the symptoms progress, they can develop a chronic cough that produces globs of thick, heavy, discolored mucus. They also may suffer from repeated lung infections. It can
also affect the liver, the sweat glands, and the reproductive organs. The symptoms can emerge in the child’s first year. Today you can get screening as part of the NHS newborn screening programme..
Children with Cystic Fibrosis will not require any special adaptations but it is important that you teach the importance of a healthy diet. It is important you allow a child with Cystic Fibrosis extra time to eat during lunch, to snack throughout the school day and to take enzymes and nutritional supplements to increase calories Children with this physical disability may have a lot of absence of school and therefore their school work may suffer and this may cause a delay in their intellectual development.
The professionals involved with children who have Cystic Fibrosis is a physiotherapist. They provide the child with different techniques to loosen the mucus that builds up within their lungs and digestive system. One technique is teaching the child stretching and exercises because with the child persistently coughing with the build- up of mucus their muscles in their chest and shoulders can become tight and weak. Stretching and exercising should promote good posture and keep the muscles mobile.
Caring for a child with Cystic Fibrosis can be tough at times, but parents need not feel alone. Doctors can usually refer them to a local support group linked to the Cystic Fibrosis Foundation.
Another physical disability is Spina Bifida. This is a congenital defect of the spine in which part of the spinal cord and it’s meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes learning difficulties.
Children with this display symptoms that can fall into three categories. The first one is Cognitive Development. The brain of a child with Spina Bifida may not develop fully and 50% of the children with this condition will develop learning difficulties. They will have difficulties in problem solving, have little concentration span, understanding spoken language, have difficulty reading and have poor co-ordination skills. In order to develop interventions that will result in better long term outcomes researchers at the Children’s Learning Institute (CLI) have been studying children with spina bifida to see how they perform on language and cognitive skills compared to typically developing peers. This research is creating a new understanding of spina bifida to help create effective solutions for everyday learning in spite of this condition. Another symptom is mobility. Children with spina bifida often have some form of paralysis in their lower limbs and will need support with their mobility. The third symptom is they have bladder
and bowel difficulties. This means that they are incontinent and this is a common difficulty associated with spins bifida
Practices can be adapted by making sure where possible and necessary, lifts or ramps should be used to allow the child to gain access • to the building, and play areas within the building. Toilets should also be fully accessible and free from clutter. Also try to ensure that doors are wide enough and easy enough for the child to open. Obviously it may not be possible to install, but automatic doors and those that involve a touch switch would be more beneficial for the child to operate, instead of having to rely on someone else giving them access. It is good practice that the layout of furniture within the classroom that there is sufficient space for the child to move around and there are handrails on walls to support the child.
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Two children’s views are Yes, they should come into our class, because they are only human with a wheelchair, and a wheelchair is like a bike, so it’s a person with a bike. Yes, because children come to school to learn and a wheelchair does not stop them learning (Hodkinson, 2007a:71)
Every child with severe spina bifida will need extensive and intricate care. This requires the involvement of a specially trained team of professionals. Included in this care team are paediatricians, neurosurgeons, orthopaedic surgeons, neurologists, endocrinologists, urologists, physical medicine specialists, physical therapists, orthotics specialists, occupational therapists, psychologists, nurses, dieticians and social workers among others. Ideally, the child with spina bifida should receive care at a specialised multidisciplinary spina bifida setting where all the necessary specialists are and services can be delivered in a coordinated fashion. These specialists will collaborate with your primary care clinician. Professionals within the education system will be important to develop a health plan at school, ensure appropriate physical supports in the school setting including mobility, access to the classroom, and adapted physical education, provide specialized educational supports when needed, and plan for the transition to adulthood.
Visual Impairments this is when a person has sight loss that cannot be fully corrected using glasses or contact lenses. This can be caused by congenital birth defect, an accident or an illness, genetic condition and complications of epilepsy, down syndrome and severe conjunctivitis. It can affect have an impact on the general development of a child in three areas. Firstly physical skills and mobility for example when a child exploring is harder and as a result physical skills can be delayed. Secondly is communication skills , this is more difficult because a child learns communication skills by their ability to interpret, looks at body language , gestures and facial expressions . Lastly their independence because it is harder to carry out everyday tasks including self help skills.
You can make many modifications for the visually impaired student. Books on tape can replace textbooks. Tape recorders can capture lectures or assist in composition. Computers can help compose papers, while voice synthesizers can read each page back to the student. Partners assigned within the classroom can provide specific assistance such as help with gathering materials and organizing for work. You must always make sure that in the classroom you organise the furniture appropriately within that setting and remove all obstacles such as toys. One to one work with their key worker can develop their skills and to enable them to build their self esteem and confidence.
The ideology if inclusion should not be viewed as a new phenomenon indeed, its origins may be traced back to the early 1900s and the welfare pioneers who believed in a non-segregated schooling system (O’Brien, 2002)
A child with visual impairment will have been referred by their GP to a paediatrics ophthalmogy department .
The last physical disability is hearing impairment. This is when a child’s hearing is affected due to an underlying condition or injury. There are two different types of hearing loss. Conductive Hearing Loss which is blockage of the ear cause by wax or fluid. This is usually a temporary condition. The other is sensorineural hearing loss which is a problem with the inner ear or between the inner ear to the brain.
When a young child has a hearing impairment it can be detrimental on the child’s development so the earlier it is detected the quicker they can obtain support. It can have an impact on their speech and language skills due to the child unable to hear what is being said to them. Because of this it can lead to the child’s developing learning skills so this stops them from achieving. Children with a hearing impairment find it hard to interact with other children. This can lead to them having no confidence and low self-respect. Hearing is what keeps us in touch with our world. It plays a significant role in expressing and receiving language. Hearing loss creates problems in how an individual expresses and receives language in turn causing social, communication, and educational problems (Hall, Oyer, & Haas, 2001).
Teachers need to make special considerations when teaching hearing-impaired children. Much of the consideration involves common sense that sharpens through close collaboration with the student, the student’s family, and the speech language pathologist (SLP). The student and student’s family can certainly offer the teacher support on a daily basis through constructive criticism of what is or isn’t working for the child in the classroom. You should ensure that the child has an optimal hearing and listening environment in the classroom. The child should sit close to the teacher to enable them to lip read what the teacher is saying. The teaching using facial expressions is good practice and good lighting to reinforce clear vision for the child. Teachers need to be sensitive to the social, academic, and emotional challenges a child with hearing loss has in any given day. Hall, Oyer, and Haas (2001) suggest that teachers support hard of hearing students by frequently checking to ensure the child understands information provided in class.
When a child has complete loss of hearing there are other forms of communication. This could be Makaton or British Sign Language where the support worker can communicate with the child by signing, using their hands to communicate.
Hodkinson A and Vickerman P (2009) Key Issues in Special Educational Needs and Inclusion Los Angeles Sage.
Peer L and Reid Gavin (2012) Special Educational Needs A Guide for Inclusive Practice Los Angeles Sage.
TEACH Magazine Sept 01.2010 p 5
Hall, B. J., Oyer, H. J., Haas, W. H. (2001). Speech Language & Hearing Disorders: A guide for the teacher (3rd ed.). Needham Heights, MA: Allyn & Bacon.
O’Brien,T. (ed) (2002) Enabling Blue skies………dark Clouds, London Optimus
Hodkison, A (2006) ‘Conceptions and misconceptions of inclusive practice. Research in Education, 76: 43-55
Hodkison, A (2006) ‘Conceptions and misconceptions of inclusive practice. Research in Education, 73: 15-29
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