Has anyone taught a child with complex medical needs in mainstream?(20 Posts)
I work as a 1:1 with a pupil with complex needs in p1 in mainstream. Non verbal, behavioural problems and physical disabilities. It's all worked well so far.
Oh my goodness. I have the reverse - a child with a degenerative condition who really should be at special school whose parents insist she is in mainstream and expect us to work her hard all day to catch up with her peers. She falls asleep most afternoons....
Does she have an IPad? There is a really good programme where non verbal children can use an IPad to talk for them. You can use photographs of people and attach their name to it, so if a child wants a specific person, they can touch the photo to say their name! Is she in a special school nursery? If so I would go and see her and assess what you would need for her in terms of equipment, staffing etc. I am guessing she could be incontinent if she has complex needs, so is there somewhere suitable to change her. Think about manual handling training for the staff who will be supporting her. I support a child with cerebral palsy in England, and these are all things I have to be aware of (except he is very verbal!). Does she have an occupational therapist and Physio, as these may have to be included in her daily routine. Hoping this helps.
1. Does the child have whatever the Scottish equivalent of a statement / EHC plan? What is specified in it?
2. Will the child have 1:1 support?
3. In your area, what is the SEN support from external experts like?
I have taught a child with complex needs - limited mobility, visual impairment, very significant learning difficulties, very limited verbal communication - in mainstream. They were also from a traditionally marginalised ethnic / cultural group whose relationship with formal schooling of any kind has historically been difficult, which made things a little more difficult in terms of parental illiteracy and understanding of education.
I benefited enormously from a) experienced and dedicated 1:1 support for the child, who had been with them for the previous year as well (much of the provision we made for the child was totally individualised, and thus rolled on from the previous year into my class), b) a really brilliant team of LA advisors - Ed Psych, visually impaired provision, physiotherapist etc [the statement review had to be held in one of the school's larger classroom, because the team involved was so large] - who helped us to set up that individualised provision and c) a Head with a history of being a SENCo, who really lived out the value that 'every child mattered', rather than in any way being data and progress driven.
You cannot do this on your own - get advice, look at the documentaton, ask questions, form a team with the parent, any 1:1 the child will have, the SENCo and any professionals involved.
Even in a wheelchair, non-verbal etc she should still access all the EYFS areas. Lots more tactile stuff like sand and water.
Sorry, cross posted. I was teaching a higher year, so didn't have the 'floor' issue - yes, you will have to redesign the way the room is laid out to ensure that everything is accessible and has accessible surfaces, any equipment that the child will use at wheelchair height etc. What setting are they in at the moment? Can you visit? Or can you identify another school where a child with similar needs has been successfully accommodated, and pick their brains about the adaptations that they made?
The class teacher sends me the lesson plans for the week and I adapt them to meet the pupils needs. It might be that the class are doing column addition or number patterns, and I sit at the pupils workstation and we do number identification, work with numicon and number writing in the sand play. If the class are doing role play then I try and concentrate on the sensory aspect of it for my pupil. Some stuff is completely inaccessible, ICT for example and so we go and do something that is more suitable. From a social point of view it has been fantastic for the pupil but we all know it has limits and so won't work past P2. I presume your pupil would have full time 1:1?
I don't know what the Scottish system is like but in our part of England at least, schools senco will have direct links with your nearest in borough special school for advice etc. It might be worth asking your head and senco to enquire more with the local authority as a child with complex needs needs more overseeing and specialist advice day to day. Has she got any medical issues? As that needs to be considered as well.
Physio/OT team will be able to advise on adaptations needed in your classroom to enable the child to participate.
Possibly with 1:1 on the floor with them?
Or use of a standing frame?
Tactile things in smaller trays on the wheelchair table.
Lots of things can be adapted. A big one will be the classroom space , potentially lots of extra equipment.
She can't possibly manage without a 1:1. It wouldn't be safe.
DD has less complex needs and she has full time 1:1 support and has done since she started in P1. There has never been any problems with funding for that.
Has someone started the process for a CSP yet. This needs to be done asap. Once the process is started there is a strict timetable so it should be in place for Aug. Get the parents to supply a list of all the professionals involved physio, ot, vision support etc to invite them along for the decision making tree meeting.
The councils access officer should be assessing the school with regard to equipment, changing, how the pupil can access things etc. They should be helping you plan.
In P1 my DDs class cleared out half the desks. The teachers realised they didn't need a table for every pupil as they spend much of the time on the floor etc. This freed up a lot of room for turning circle etc.
Then in each class she has gone into any excess furniture etc has been moved out. I think her teachers have found it quite liberating. It's amazing how much clutter there is in a school that there just because.
I don't think the programme needs wifi once it is downloaded. I think it might be from Crick Software. It is expensive. I saw it in a SEN school I visited, and it wowed me! Manual handling training will be vital, so you don't damage yourselves or the child. A pp mentioned a standing frame. If she has one, it is quite a huge piece of equipment. Find out if she can sign using Makaton, or use photos or symbols.
Yes and I now teach in a special school, for some students it worked well but for others it was frustrating to think of what they could access in other settings.
My biggest tip would be don't only have one 1:1 that can support them- if that person is off then the whole system comes falling down! At least 2 staff need to be confident in supporting this student and this will help with breaks/lunch and developing her independence. Also any medical training around peg feeds etc needs to be in place well before they start (if this is an issue?)
She should be able to transfer to the floor but do ask about a hoist as even small children can be better learning to hoist rather than carried, wedges and mats on the floor would help support this (OT and physio would help with this)and stretching programa are important to develop/keep function- too much time in a chair is never good! You'll probably need room for a standing frame as well as hoists so think about where to store stuff.
Speech therapy and if you have one an asaistive technologist would input into communication devices- there are skills students need to develop before using the more complex apps.
Flo longhorn is an author who does loads of really good books about sensory curriculums if you can borrow/ convince school to buy them.
Does she have any sensory impairments as well?
I think you need some more details from the head really
Uses a wheelchair -does that mean all the time (no child should be in a wheelchair all the time but does she have any mobility -rolling, crawling, walking with a frame etc) -can she move her wheelchair independently?
Poor grip -does this also mean she also has poor hand function, can she deliberately reach for an object -impacts on communication tools available for use
Non-verbal -makes sounds approaching speech so has some level of communication or makes no meaningful sounds?
Is anyone at school trained in makaton/pecs?
So many questions need answering before you can begin to prepare
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