Support for children with medical conditions such as asthma, diabetes, epilepsy and anaphylaxis are the subject of this SENCO Week, as Linda Evans offers SENCos related advice

We shall soon be into the hayfever season, when many children suffer from respiratory problems, and those with asthma can find their discomfort increased. Many of us can sympathise with children and young people who suffer with a range of debilitating physical conditions, not only during the spring and summer months but all year round. This e-bulletin we consider how you as a SENCo can implement good policy and practice in school which supports these pupils and minimises the negative effects on their learning and achievement.

Support for SENCos

An increasing number of children in mainstream schools rely on medication, particularly those diagnosed with asthma, diabetes, epilepsy and anaphylaxis. It’s important that all staff understand the effects of these conditions and how to deal with attacks and episodes appropriately, so you should ensure that all staff know:

  • the procedures for managing prescription medicines which need to be taken during the school day
  • what to do in case of an emergency
  • how to support children who frequently miss lessons because of attending therapy sessions, hospital appointments, etc. (eg, copies of teacher’s notes saved in special folder; catch-up sessions with a buddy or TA; letting the pupil have his own copy of the text book; someone having the responsibility of keeping the pupil up to date with regard to announcements, plans for field trips, and so on)
  • there are also social and friendship issues arising from frequent absences – pupils can often find themselves left out of friendship circles. Can this be addressed in Circle Time or elsewhere?
Managing medicines in schools and early-years settings (DfES/Department of Health, 2005) provides advice for schools and their employers to help in the development of such policies. It explains the roles and responsibilities of employers, parents, carers, governing bodies, headteachers, teachers and other staff, as well as local health services. It considers staffing-issues such as employment of staff, insurance and training. Other issues covered include drawing up a healthcare plan for a pupil, confidentiality, record keeping, the storage, access and disposal of medicines, home to school transport, and on-site and off-site activities. It also provides general information on the four most common conditions — asthma, diabetes, epilepsy and anaphylaxis. The document also contains a set of forms which can be photocopied by users. Medical Conditions at School: A Policy Resource Pack has been compiled by the Medical Conditions at School Group to compliment the DCSF guidance Managing Medicines in Schools and Early Years Settings. Both documents are available at: www.teachernet.gov.uk/wholeschool/healthandsafety/medical/.

Asthma
Children with asthma have airways which are sensitive to various triggers, such as colds and viral infections, dust mites, pollen, exercise and stress. The lining of the airways becomes irritated and swells, causing wheezing and coughing and impeding the passage of air through the body. Different types of inhaler are used to treat asthma, but the most common type seen in schools is the blue ‘reliever’. This is used to relieve symptoms when they occur and should be available to a child at all times.

The main implications for schools are the effect of outside play and PE when the pollen count is high, and the effects of strenuous exercise on pupils for whom this may be a trigger. Keeping calm and reassuring a child who has an asthma attack are probably the most important points to remember – but staff should be aware that a severe attack can be very serious if not treated appropriately.

Asthma UK has downloadable school policy guidelines that provide information on asthma, how to support sufferers during PE and sports, and what to do when a child with asthma joins the class. It provides comprehensive information on how to develop a school asthma policy and asthma register, with an example. Also available are school asthma cards and information and posters for young people to encourage them to be active with their asthma. See www.asthma.org.uk.

Diabetes
This is a common condition, reported to be on the increase in the UK, and occurs when there is too much sugar in the blood. Sugar levels are usually controlled by insulin, but children and young people with diabetes are unable to produce enough; they therefore have to be careful about what they eat, and possibly take tablets or inject insulin to control it. Related issues for schools to consider include:

  • allowing pupils to monitor their blood sugar levels and inject insulin in an appropriate place (perhaps with help) with proper disposal of syringes
  • acknowledging that water, and possibly snacks, should be accessible. Pupils may need a meal plan detailing dietary requirements. They may need to jump the queue at lunchtime!
  • allowing pupils to visit the toilet as often as needed – with a discreet system in place for signalling to the teacher
  • taking care during PE lessons – the child should participate but may need to eat before/after exercise.

Diabetes UK has information on diabetes in school, which discusses insulin injections, diet, snacks, hypoglycaemia reaction and how to treat it. Children with diabetes at school — What all staff need to know can be ordered from Diabetes UK Distribution; telephone 0800 585 088 or visit www.diabetes.org.uk.

Epilepsy
This condition is characterised by the child experiencing seizures but can often be controlled by medication. The majority of children who have epilepsy early on will grow out of it. ‘Absence seizures’ are the most common in children – they may stop what they are doing and may stare, blink or look vague for just a few seconds; this type of seizure can sometimes be mistaken for daydreaming or inattention. Teachers may be able to help by providing written information at the end of a lesson and helping pupils to catch up on things missed. Absence seizures can occur many times a day.

Epilepsy Action (British Epilepsy Association) has information for schools in Epilepsy — A teacher’s guide. This looks at classroom first aid, emergency care, medication and school activities. Also visit www.epilepsy.org.uk.

Anaphylaxis
This is an acute allergic reaction requiring immediate medical attention – often in the form of an Epipen (adrenaline) – to reverse the reaction. It is most commonly triggered by substances to which the child is sensitive. Most notorious at the moment are nuts (especially peanuts), but eggs, milk, shellfish and stinging insects can also cause allergic reactions. Schools obviously need to know exactly what the child must avoid, with careful monitoring at snack time and lunchtime. They should be prepared to act quickly if necessary. An Epipen should be near at hand, and staff should know how to use it.

The Anaphylaxis Campaign website contains guidance for schools, which discusses anaphylaxis, treatment, setting up a protocol, and support for pupils and staff. It also includes a sample protocol. See www.anaphylaxis.org.uk.

This e-bulletin issue was first published in March 2009

About the author: Linda Evans is the author of SENCO Week. She was a teacher/SENCO/adviser/inspector, before joining the publishing world. She now works as a freelance writer, editor and part-time college tutor.

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