Inclusive Childcare - North Lanarkshire Council

Transcription

Inclusive Childcare
toolkit
please consider the environment before printing this document
© Copyright Statement
This Toolkit has been produced by Early Years & Childcare, North Lanarkshire
Council to support inclusive practice within early years and childcare settings
across North Lanarkshire Council and should not be copied by or distributed
to any party without the prior permission of Early Years & Childcare, North
Lanarkshire Council.
Publication Date: April 2010
North Lanarkshire Council / Early Years & Childcare
Municipal Buildings, Kildonan Street, Coatbridge, ML5 3BT
Tel: 01236 812 281
service and people first
Toolkit Explanation
This toolkit will give you information and advice, contacts, ideas
and suggestions for activities to help you support children who
have additional support needs. It will also explain how you can
treat each child fairly.
Please remember that the information in this toolkit is there
to serve as a guide, and that there is no intention that the
information given should form the basis of any assessment
of additional support needs; this is the role of approppiate
professionals.
Inclusive childcare toolkit
2
Forewords
In North Lanarkshire Council, we are committed to making sure that all children
are able to achieve their potential, by using effective partnership working to
improve outcomes for all children. As part of our commitment we are working
with Capability Scotland to develop this guide for childcare professionals. We
want to make sure that you have the support you need, and we want to provide
services that are centred around each child. This guide will help us make sure we
support any child who has additional support needs.
The inclusion childcare toolkit will give you information on supporting children with additional
support needs and it will help you feel confident in the care you are providing. I am confident
that this toolkit will improve childcare provision in North Lanarkshire and make sure that
every family can access a childcare service that meets their needs.
The toolkit is the first of its kind and will make a positive change. It will also make sure that
everyone in the statutory, private and voluntary sectors across North Lanarkshire can develop
their skills.
Please let us know what you think of this toolkit, as your comments will help us improve the
work we do.
Christine Pollock
Executive Director of Learning and Leisure Service
North Lanarkshire Council
Over many years, Capability Scotland has worked with hundreds of disabled
children, their families and education, care and activity providers to develop
services. North Lanarkshire Council has worked with Capability Scotland to make
sure that these services are more accessible . This partnership with the council
has allowed us to use our experiences across the statutory, voluntary and private
sectors in North Lanarkshire and elsewhere to create this toolkit. I believe that
this toolkit will give you some simple and helpful information, which will you find
invaluable in making the best provision for a child with a disability.
This is not a complete ‘how to guide’, as all children and all service providers have individual
needs. However, the toolkit does provide practical tips, definitions and information on how
you can meet legal requirements and develop the care you provide for a wider range of
children and their families.
Mark Bevan
Head of Children’s Services
Capability Scotland
3
Contents
1. Introduction
7
2. Definitions
9
3. General strategies
11
• Things to consider / put in place
11
• Checklist of Required Procedures
13
• Top Tips
13
• Tips for the play environment
14
• Promoting Inclusion Poster
14
4. Multi-Agency working
15
5. Promoting positive behaviour
18
6. • Promoting Positive Behaviour
18
• Promoting positive behaviour- hints and tips
19
• Safer Assistance Manual Handling
22
Communication
25
• Communication Strategies
25
• Sign Language
27
• Symbols
29
• British Finger Spelling Right-Handed resource
33
• British Finger Spelling Left-Handed resource
34
• Early Years Verbs resource
35
4
7. 8. 9. Planning inclusive games & activities
36
• Introduction to Planning Games and Activities
36
• Sensory Experiences
37
• ‘Making things’
38
• Game ideas
44
• Colouring-in Pictures
45
Examples of good practice
59
• Capability Scotland case studies
59
• Inclusive Childcare Project North Lanarkshire case studies
62
Policies, programmes and the law
64
• Our policies and programmes
64
• Relevant laws
67
• Reasonable adjustments
70
• Case study four – Renfrewshire Work 4 All4. Case studies
(examples which you can use in discussions with your staff)
72
10.
Resources
73
11.
Additional Support Needs (ASN) 77
• Additional Support Needs Overview
77
• ASN factsheets (with hints & tips)
80
»» ADHD
»» Asperger’s Syndrome
»» Autism
»» Brain Injury
»» Cerebral Palsy
»» Down’s Syndrome
»» Dyslexia
»» Dyspraxia
»» English as an Additional Language
»» Epilepsy
»» Hearing Impairments
»» Learning Disabilities
»» Physical Impairments
»» PICA
»» Speech and Language Impairments
»» Visual Impairments
81
84
88
92
96
99
102
105
108
110
113
118
121
124
126
128
5
• Other fact sheets on additional support needs »» Albinism
»» Anaphylaxis
»» Angelman Syndrome
»» Anxiety Disorder
»» Asthma
»» Crohn’s Disease
»» Cystic Fibrosis
»» Deafblindness
»» Dystonia
»» Edwards Syndrome
»» Fragile X Syndrome
»» Hydrocephalus
»» Spina Bifida
»» Sturge Weber Syndrome
»» Tay Sachs Disease
»» Tourette’s Syndrome
»» West Syndrome
»» Williams Syndrome
12.
13.
Mental Health
131
132
133
134
135
136
138
139
140
142
144
145
147
149
151
153
154
156
158
160
• Mental Health in Children / Young People
160
• Self Harm / Self Injurious Behaviour
167
• How you can help children and young people with mental-health problems
169
Contact Details
173
• Local Organisations
173
• National Organisations
182
14.
FAQ
199
15.
Acknowledgements
202
6
1.
Introduction
All children have a right to be included in all parts of society, and every child has the right to play
and have fun. It is important that all children, including those with additional support needs, have
the opportunity to play. We are all responsible for making sure this happens.
Under Getting It Right For Every Child (GIRFEC), it is our responsibility to work with children, families
and other professionals to put the child at the centre of all that we do. (For more information on
GIRFEC, see the section ‘Policies, programmes and the law’.)
Our approach:
We believe that people are not disabled just because they have an illness or disability.
Our aim is to make sure that all children and young people can:
• be successful learners;
• be confident;
• be responsible; and
• make a positive contribution to society.
What it means to be ‘inclusive’
Think of inclusion as ‘fairness’ – it’s important that you treat each child fairly, according to their needs. This
applies to all children – no matter what their illness or disability, where they live or how they communicate.
Having a fair service does not just mean working fairly with children – you need to work fairly with everyone
that is involved in that child’s life.You need to develop respectful relationships and work as part of a team with
your staff, parents and other professionals.
To make sure you are completely fair, you will need to deal with physical barriers and barriers to do with
attitudes (for example fear and embarrassment). It doesn’t mean that you need to be an expert on inclusion, but
you must show a positive ‘can-do’ attitude.You must show that you are willing to remove these barriers.
Why should my childcare service be inclusive?
Your childcare should be inclusive for the following reasons.
• All children have the right to play together.
• All children belong together. This has advantages and benefits for everyone – children can learn from one
another and it encourages children to get involved in society and make a positive contribution.
Introduction
7
• You wouldn’t think less of a child or send away a child who didn’t have additional needs, so why would you do
this to a child who does?
• If children play together, this will improve their social skills.
• Making adaptations will not just benefit the child with additional support needs, but all children.
• If you separate children from others because of additional needs, it may affect their ability to build friendships
and appreciate and respect people’s differences – but an inclusive approach will help with these things.
• By law, you must make ‘reasonable adjustments’ for children with disabilities. This means that children with
disabilities must be able to use play areas. (For more information, see the section ‘Reasonable adjustments’ on
page 70.)
Inclusion works and is happening across the country. (For examples of how this is working across Scotland, see
‘Examples of good practice’ on page 59.)
If a service is truly ‘inclusive’, it will not separate children with additional needs and it will include all children in
all parts of the service.
Inclusion should be and is becoming everyday and ‘normal’. The best opportunities for children come from care
that is inclusive. Some children you care for may have a disability or additional support needs, and it is important
to treat each of them fairly according to their needs.You should support all children and encourage them in a
caring and fun environment.
The inclusion childcare toolkit and how it can help you
The childcare toolkit will give you information and advice, contacts, ideas and suggestions for activities for
supporting children who have additional support needs. It will also explain how you can treat each child fairly,
and how to make your care inclusive. The contents page lists everything in the toolkit.
Please remember
You should treat each child as a child first, and you should always deal with the disability second.
There is a section on specific additional support needs on page 77. The information in this section is only a guide
and it does not allow us to diagnose a child with additional support needs – this is done by the appropriate
professionals only.
Note
Throughout this toolkit, if we refer to ‘parents’, we also mean carers, guardians and so on.
Introduction
8
2.
Definitions
Throughout this guide we may refer to inclusion, diversity, equal opportunities and additional support
needs (ASN). These are common terms which you should become familiar with. If you need more
information, you can search for more detailed explanations on the internet.
Inclusive
All children and young people have the right to equal access to services, and they should all be equally included
in play (games and activities), childcare and social opportunities, which means being social, being part of a group,
being together, but also being allowed to be an individual.
Think of inclusion as ‘fairness’ – it’s important that you treat each child fairly according to their needs – and this
applies to all children.
Having a fair service does not just mean working fairly with children – you need to work fairly with everyone
that is involved in that child’s life.You need to develop respectful relationships and work as part of a team with
your staff, parents and other professionals.
Diversity
Diversity refers to the unique differences in our society. All children are different, whether it’s because of their
height, weight, ethnic background, disability, and so on.
Diversity can be complicated, for example people in a minority group are not necessarily the same as one
another, and some people may be members of more than one minority group.
Diversity refers to the positive parts of difference. All children are individuals and will contribute differently in or
to your childcare service, but all of their contributions are valuable and you should value them.
Equal opportunities
Equal opportunities is about making sure all children receive appropriate care and have equal opportunities to
play and learn.
It does not mean treating everyone the same.
Additional Support Needs
According to The Education (Additional Support for Learning) (Scotland) Act 2004, additional support needs are
defined as follows.
‘A child or young person has additional support needs for the purposes of this Act where, for whatever reason,
the child or young person is, or is likely to be, unable without the provision of additional support to benefit from
school education provided or to be provided for the child or young person.’
Definitions
9
Additional support needs (ASN) covers a range of things that may result in barriers to learning and play. This
means that as well as disabilities such as autism spectrum disorder, attention deficit hyperactivity disorder
(ADHD), and cerebral palsy, other things are also taken into account. These include things such as:
• children who use English as a second language;
• parents who have drug or alcohol problems;
• children who are being bullied;
• children in disrupted families;
• children with behaviour problems; and
• children who are carers themselves.
This means that additional support needs refers to children and young people who face barriers to their learning
because of things to do with their:
• health or disability;
• learning environment;
• family circumstances; and
• social and emotional development.
Definitions
10
3.
General strategies
This section gives you some general advice to
make sure you are considering the needs of all
the children you care for, including those with
additional support needs.There is more specific
advice in section 12, Mental Health.
Contents
• Things to consider and put in place
• Checklist of the procedures needed
• Top tips
• Play tips
• A poster for promoting inclusion
Things to consider and put in place to make
your service more inclusive
Getting everyone involved (often called ‘multi-agency working’) – Who is involved in making decisions
in your service? You should get all children, parents, carers and relevant organisations involved.You need to value
each person and get them involved. (For more information, see section 4 ‘Multi-agency working’ on page 14)
Be flexible – Are you providing information in appropriate formats and languages? Could you provide the
information in these different ways? (For more information, see section 6 ‘Communication’.)
Be welcoming – The place where you provide care will only be inclusive if all children feel welcome, safe and
accepted.You should make it clear that you will work with everyone to see how you may be able to meet their
needs.
Think about the images you present – Are all of your posters, signs, activities, and resources relevant to
all of the children? Do they promote positive images of disability, and do they reflect the local community? (For
more information, see the section ‘Inclusive Games’ on page 36.)
Attitudes – It is important to have a positive attitude when you are promoting inclusion.Your staff may need to
forget things that they usually assume, for example that specialist services are better or that ‘care’ is the priority, not
play.Training on disability, equal opportunities and awareness can help to deal with this.You also need to tell parents
what their role is, and you should encourage them to have a positive attitude to inclusion.
Supporting staff – It is important to deal with each child’s needs, but it is also important to deal with your
staffs’ needs.You need to make sure that your staff are including all children, for example they are dealing with
the children’s fears, worries and anything they are not certain about.
Encourage independence – You should recognise that it’s not just about meeting people’s needs. All children
have talents and interests that they would want to build on, so you should give each child the opportunity to
develop.
Be clear from the start – You should tell parents and children what you expect from them and tell them any rules
before you provide your care. But, it is often unwritten rules that cause problems, so think about any extra rules or
General strategies
11
things you expect and which you should write down. All staff need to know what each other’s roles are from the
start.You need to know what you can and can’t expect of people in different roles.
Make adaptations for all children – You may need to make adaptations for the child with additional support
needs, and you may also need to deal with the response from children without additional support needs.You
could maybe discuss how to welcome a new child, but to avoid singling out the child with additional support
needs. Always speak to the child’s parents before you give any information about the child with additional
support needs to anyone else.
Consider your policies and procedures – You may already have the following in place, but you should
consider how relevant they are when you are working with a child with additional support needs.
1. An inclusion policy – Make others aware of your commitment to inclusion.
2. Equal opportunities – Show that you recognise minority groups can be discriminated against, and show what
your service will do to deal with this.
3. Admissions – What arrangements do you make for including children with additional support needs?
4. Arrangements and procedures for children who are moving from one care service to another, for example
from early-years care to primary school – Describe what arrangements are in place, how children deal with
the changes, including those with additional support needs who may find the move more difficult to cope
with. Also, give your staff advice on who they could contact to help make the move easier for certain children.
5. Physical access to the place you provide care – Describe the current access and say what your future plans
are if you need to make changes.
6. Transport – Say how you help children with additional support needs get to your service, and how you
organise outings.
7. Activities – Explain how you allow all children to be involved in activities, and what changes you have made,
or will make, to allow this.
8. Health and safety – Have a general policy which explains your arrangements for health and safety, for example
risk assessments and arrangements for children with additional support needs. There will be more specific
risk assessments in children’s individual files.
9. Personal help – This will apply to all children and you should consider issues to do with privacy and the
choices children make.
10.Challenging behaviour – Say how you deal with challenging behaviour, whether or not the child involved has
additional support needs.
To make sure you have appropriate policies and procedures in place, see the ‘Checklist of procedures needed’.
General strategies
12
Checklist of procedures needed
Everyone should be able to access the following policies, procedures and forms in a variety of formats, for
example in a language other than English, in Braille, in large print, in simple language and so on.You should make
sure that you consider the following in your service, but you must also consider every other possible policy that
is relevant to your service.
Do you have the following in place?
1. An inclusion policy
2. An equal opportunities policy
3. An accessibility policy
4. A confidentiality policy
5. Admissions forms
6. A ‘settling in’ procedure
7. Risk assessments (inside and outside your service and in the community)
8. A fire evacuation procedure
9. A health-and-safety procedure
10. Arrangements and procedures for children moving from care services
11. Procedures for how to lift and handle children
12. Toilet procedures
13. Procedures on personal hygiene
14. A medication policy
15. Procedures on eating (for example, what is your procedure for children using feeding tubes)
16. Policies on managing challenging behaviour and promoting positive behaviour 17. A staff training plan
18. Procedures for reporting accidents and other incidents
19. Others relevant plans, policies and procedures which are appropriate to your service
Top tips
• Make sure that you give children with additional support needs the chance to play with other children who do
not have additional support needs.
• Encourage all children to have a positive image and attitude of disability and what it means for children to be
different from one another.
• Make adaptations where necessary and ask children what they think, especially if it’s about the games they will
play or the snacks they will eat.
• Encourage all children to support one another and play confidently and happily with each other.
• Do not separate children with additional support needs – encourage all children to play together.
• Think about strategies beforehand, if possible. And don’t be afraid to ask others for help and advice.
General strategies
13
• Make ‘reasonable adjustments’ in all play areas inside and outside.
• Make sure that you respect a child’s dignity and privacy.
• Work closely with parents – they will be able to help with strategies they use at home.
Practical tips for making your play area inclusive
• Make adjustments, for example if a child would rather stand in front of the mirror by themselves and play all
day, gradually move the mirror closer to where the other children are.
• Make sure there isn’t any clutter in the play area, and have enough space for the children to play, so they won’t
trip or fall over items.
• All the children must be able to use all of the toilets and play areas.
• Signs and notices should be easy to read or understand. Have some signs in words, symbols, pictures, or even
Braille. Remember that older children may need pictures as well, so make sure the different signs and notices
are on display throughout, and not just in certain areas.
• Offer different chair and table heights. This will help younger and older children, taller or shorter children, and
children who use wheelchairs.
• Make sure children know what the different play areas are for and make this difference clear, for example use
different coloured areas or have coloured strips on the floor.
Promoting Inclusion – what we do
• We adopt a positive, ‘can do’ attitude.
• All children are respected & valued as individuals.
• We listen to individual children & the choices they make.
• All children come to us to play & have fun with their peers.
• We treat each child with fairness according to individual needs.
• Children & staff don’t just talk to each other. We use pictures, gestures, symbols, facial expressions………..
• We encourage children to play in all activities, & make reasonable adaptations to give every child that
opportunity.
• Most importantly, we welcome all children equally & make playing & having fun the first priority.
General strategies
14
4.
Multi-Agency Working
(Working with parents and other organisations)
By getting everyone involved we can support
children and families with additional support
needs and help them make real improvements
in their life.
Contents
• Working with parents
• Working with other organisations
Working with parents
Parents know their child best, so working closely with them will benefit you and your service, the parents, and
– most importantly – the child.
Making decisions
• Involve parents in making decisions about their child’s long-term and short-term aims.
• Encourage parents to continue the work you do at home, for example if you have started using a reward
system and it is working well, parents may want to use a similar system at home.
• Also, if parents use a system at home that works well, you may want to use it.
Sharing information
• Share information with parents and encourage them to share information with you. For example, share
useful hints and tips – what’s worked and what hasn’t?
• If the child has been diagnosed with a particular disability, the parent is most likely to be best person to give
you advice and more information.
• Collect useful and appropriate information from the child’s family to build up your knowledge on how to
support the child. However, if you know that there is information somewhere else which you can get access
to (particularly as services should be aiming to work together), don’t ask parents to repeat themselves by
filling out another form.
Getting permission from parents to work with other organisations
• Ask parents for permission to contact other organisations that work with the child, for example schools,
NHS speech and language services and so on. They may have useful tips and strategies that you can use.
• By sharing information, you would be reinforcing what the child already knows, which could help the child
feel more secure, and it would help you to work more successfully with the child.
Multi-agency working
15
Reaching parents
• Attracting parents with children with additional support needs to your service takes time.
• Families are more likely to come to an event based around a particular theme they are interested in, for
example, a drop-in session aimed at helping parents manage toilet training.
• Another event could be an information day about local support services, where you invite representatives
from a range of local organisations.You could advertise these events by telling professionals working
with families about them. It helps to keep the day informal so parents can meet and find out what each
organisation can offer over a cup of tea. It would be a good idea to have a private room, if this available, for
parents who might want to speak confidentially to any of the representatives.
• Change the way you think about parents being involved. No matter how many ‘hard to reach’ parents you
can work with, there will always be ones that are harder to reach. In reality, many of the so-called ‘hard-toreach’ parents do get involved, and if we refer to them as not getting involved it is easy tooverlook the gains
we are making.
• Work with the parents who always get involved to reach parents who do not normally get involved. The
parents who ‘show up for everything’, ‘the same old parents’ can be the best people to help you get parents
who are less confident involved.
• Target grandparents, carers and adults who can be as supportive as busy parents and often have more time
and sometimes more patience.
• Do not forget the ‘f’ word! We can sometimes overlook the needs of fathers. When we talk about ‘parents’,
most people assume what we really mean is ‘mothers’ and do not involve the fathers in discussions.
• Parent-to-parent surveys which you carry out on the spot are more successful than postal questionnaires.
Working with other organisations
There is no good formula for working with other organisations, it depends on what local resources are
available and who is involved. Working with other organisations is about working with local practitioners,
for example doctors, speech therapists and schools, who have the skills to make sure a service keeps to the
relevant laws and regulations.
When working with other organisations, your work can come under four categories.
1. Strategic
• This means that working with other organisations is easier when each organisation agrees the same aims.
• Time is important – Make sure you set aside enough time to be able to speak to other professionals.
• To get the most out of working with others, contact other childcare services and ask how they successfully
work with other organisations.
2. Operational
• This means having realistic aims. Before you speak to other professionals, make sure you know what kind of
information, answers or support you want from them.
• When you are talking to others, make sure that everyone is clear about one another’s roles. This will help
to avoid two people doing the same work twice.
16
• Try to go on training courses that you know other organisations or professionals are going to. This is a
good way to meet others from the same or different sector and to find out what issues they face and how
they tackle them.You can learn a lot from them by hearing about examples of good practice.
3. Getting community and voluntary organisations involved
• Professionals from the community and voluntary sectors are often willing to help out where possible. Many
work with children who need a bit more support than others, and they will be keen to share ideas and
strategies. Make the effort and contact other organisations to see what support they could give you.
4. Assess the value of your service
• Evaluations are a useful way of checking that you are providing the best possible opportunities in play and
learning. Other organisations which work with the children you care for will also be regularly evaluated
(assessed). It may be useful to speak to the other organisation about any changes they are making, in case
you could also make these changes.
17
5.
Promoting
positive behaviour
Promoting positive behaviour is one of the
first steps to making sure that you can make
all children feel welcome and support them
appropriately. This will help all children to enjoy
their time with you.
Contents
• Promoting positive behaviour
• Promoting positive behaviour - hints and
tips
• Safer assistance and manual handling
Promoting positive behaviour:
Step one – Promoting positive behaviour in your staff
Before you deal with challenging behaviour in children, you need to make sure that your staff behave in a positive
way and have a positive attitude.
Positive attitudes in staff encourage positive attitudes in children and young people. It is important for staff to be
aware of how their own behaviour can trigger negative behaviour in children. Children can pick up on your own
staff’s body language, and whether or not they are smiling. So, if a member of your staff has a negative attitude,
this will affect the children’s attitudes, which will make it more difficult for anyone to improve a child’s challenging
behaviour. Instead, it is extremely important for staff to be pleasant, calm and positive.
All staff must work together to:
• understand the needs of each child;
• develop a consistent way of working with the child; and
• look at strategies that reduce challenging behaviour.
Staff should support and encourage one another to stay positive. If a particular strategy doesn’t seem to work
for one member of staff, all of your staff should work together to look at why it might not be working as
effectively for that member of staff. Help one another to introduce new strategies and be open to new ideas, and
don’t think that asking for help is a sign of weakness. It is in your and the child’s best interest to ask for support.
Step two – Promoting positive behaviour in children
Children show challenging behaviour for a number of reasons.
Challenging behaviour includes:
• crying;
• screaming;
• hitting;
Promoting positive behaviour
18
• punching;
• kicking; and
• throwing items.
A child is more likely to show challenging behaviour if they have problems communicating.
Communication is important in controlling our environment and influencing other people. When a child has
problems communicating, they can become frustrated and so may show challenging behaviour. If the child knows
that if they behave in this way they will get what they want, they are more likely to behave like this in the future.
A child may show challenging behaviour because they:
• have built-up anger;
• are frustrated;
• are scared;
• want to get attention;
• are bored;
• are feeling out of control;
• are in pain;
• are not able to get something that they want;
• are very tired or hungry; or
• are not able to calmly discuss their emotions.
Not all children show challenging behaviour.
Promoting positive behaviour – hints and tips
• If the child shows challenging behaviour, think about whether you need to change all of their behaviour, at
least at first. You should focus on unacceptable behaviour. Unusual or perhaps even annoying behaviour is
less important, for example a child who rocks back and forth or a child who turns the light switch on and
off three times in a row. If you try to deal with all behaviour, it will only frustrate you and the child, and may
actually make the situation worse.
• Take attention away from negative reactions. For example, if the child wants to kick, then give them a ball so
that they channel their energy elsewhere.
• If the child likes to be in control, give them the opportunity to control smaller things. For example, during a
game allow the child to roll the dice instead of taking part in the actual game. This will help to lower their
frustration.
• Make sure that you give every child a snack at reasonable times, and make sure that children can rest
somewhere if they are outside or on a trip, or that you have a quiet area for them to relax inside. If you
don’t have a quiet area, encourage all children to make suggestions about what they would like to see in
a quiet room or corner. Examples may include comfy cushions and chairs, low lighting, calming music and
glow-in-the-dark stars on the ceiling.
• If the child shows challenging behaviour to get something, it is important not to give them the item.
Otherwise, you will be rewarding the behaviour you want to discourage.
19
• To avoid children becoming bored, it is important to offer planned activities and some sort of structure.
However, it is important to give individual children choices in all types of activities.
• Think about the number of choices you give the child. If you give them too many, they may feel
overwhelmed because there is too much information to deal with. It is important to reduce or limit the
number of choices you give a child, if appropriate for that child.
• If the child does not respond to verbal instructions, use a visual prompt so the child knows what you
expect them to do – the prompt could be a symbol, or an actual object. For example, if it’s snack time, hold
up a symbol of a child sitting at the table eating, or pat a chair at the table and point to the food, plate or
cup.
• To help challenging behaviour consider involving other children. For example, you could use another child
as a role model.
• Do a risk assessment on promoting positive behaviour. Work with parents and other adults who also work
with the child to identify and record things that cause challenging behaviour. What strategies do they put in
place at the moment? Try to use these.
• Keep a diary of when challenging behaviour happens. This will help to show patterns in behaviour, which can
help you decide what strategies will work best for each child. For example, if the child starts hitting every
time they are taken to a particular play area, there may be something in that area that the child doesn’t like.
• Think of interesting ways to encourage the child to explain their feelings to you and ways that they can
try to cope with anger and frustration. For example, try to use the ‘volcano technique’. Imagine a volcano
– the bottom is calm and relaxed, the further you get to the top the angrier and more anxious the child is
becoming. You could also use pictures with the child. The child would tell you where on the volcano they
thought they were and you could decide what to do next, for example talk to them or give them space.
• Think of interesting ways to deal with and promote positive behaviour. For example, use the 5p technique.
At the start of the day you give the child about 40p in 5p’s. If they child behaves inappropriately, they have
to give you 5p. The aim after this is for them to work hard to get it back. They could do this by behaving in
a positive way, for example by sharing or taking turns. You don’t need to use real money – pretend money
would also work. You could also use the ‘tree of goodness’ technique. Draw a picture of a big tree without
any leaves. Every time a child does something good, such as sharing, saying thank you and playing well
together with other children, write their name and the good behaviour on a brightly coloured leaf. The child
can then stick their leaf on the tree. You should put the tree somewhere that parents collecting their child
will be able to see it.
• After any challenging behaviour, it is important to talk to the child about why they behaved in that way and
how it made other children and staff feel. But only speak to the child once they have fully calmed down,
otherwise you could make the problem worse. Many children with additional support needs who regularly
show challenging behaviour will have a plan or risk assessment which will tell you the best way to talk to
them about their behaviour. If the child has a plan or risk assessment, it is important to follow the advice in
it.
• Also, after any incident of challenging behaviour, it is important to talk to the other children about the
incident. For example, if a child cannot communicate verbally, you may have to tell the other children that
sometimes the child gets upset or angry when they can’t tell you how they are feeling or what they want to
do, and so sometimes they say bad words or do naughty things. But, they still want to play and have fun with
them and they don’t mean to be naughty.
20
The challenges of children running away
Before going on an outing
• Have a session with all the children about safety, and tell them that no-one should run away.
• Make it a fun session, for example get the children to make up cards that represent ‘no running away’.
• Use role play, for example use toys, road-safety signs, car mats or toy cars to act out different situations so
that children are aware of the ‘outside world’.
Look for games on the internet. Here are a few websites that you may find useful.
• www.trafficclub.org
• www.hedgehogs.gov.uk
• www.thinkroadsafety.gov.uk/arrivelive/index.htm
• www.roadcode.co.uk
During the outing
• Continue to tell children that they must not run away and show them the cards they made, or ask each child
to show you their card several times throughout the outing.
• Provide distractions, for example point out things or take something along to distract the children.
• Play games to distract the children.
Further information:
Kids Behaviour (UK)
Website: http://kidsbehaviour.co.uk
Kids Behaviour (UK) offers a unique reference point for understanding children and dealing with behavioural
problems. Features and articles are written by experts who have experience, or a particular interest in this area.
The Challenging Behaviour Foundation
Address: c/o The Old Courthouse, New Road Avenue, Chatham, Kent ME4 6BE
Tel: 01634 838 739
Email: [email protected]
Website: www.thecbf.org.uk
The Challenging Behaviour Foundation exists to demonstrate that individuals with severe learning disabilities
who are described as having challenging behaviour can enjoy normal life opportunities when their behaviour
is properly understood and they receive appropriate individualised support. The CBF will support families,
professionals and other stakeholders through education, information, research and partnership working to
enable this to happen and will work strategically to influence national policy and practice.
21
Safer Assistance / Manual Handling
‘Manual handling’ has been a commonly used term but practitioners are now moving towards a more acceptable
and inclusive term such as ‘safer assistance’.
Definitions:
As defined by ‘Manual Handling Operations Regulations, 1992 (as amended)’:
• “manual handling operations” means transporting or supporting of a load (including the lifting, putting down,
pushing, pulling, carrying or moving thereof) by hand or bodily force.
• “load” is anything which is moveable e.g. inanimate object, person or animal.
Injuries caused by safer assistance/manual handling:
Lower limbs, arm, finger/thumb, hand, and the most common injury is to the back – either an injury or back pain.
Common causes of back pain and injury:
• Stooping!
• Lifting loads too far from the body!
• Heavy loads!
• Poor posture!
• Pregnancy!
• Age!
The most commonly injured areas of the spine are the cervical (neck) and lumbar (lower back) regions.
How can we prevent safer assistance/manual handling accidents?
• Avoid manual handling wherever possible – ask yourself ‘do I need to manually handle or is there an easier
way to perform this task?’ Sometimes you may require to safely hold a child if the child is putting him / herself
or others at risk. In this case, appropriate training is required, and parental knowledge/involvement is essential
if this is a requirement. (see contacts section below for local contacts who may be able to offer training/
guidance on this)
• Maintain a natural upright posture whenever possible during manual handling, keeping your ‘spine in line’
• Always create a good stable base with your legs and feet – feet shoulder width apart, one foot in front of the
other, knees bent
• Keep any load, object or person close to your body when manually handling
• Remember to use your large leg and buttock muscles to provide the power when manually handling. Move
your feet to change position, do not twist round.
Never stoop and twist from the waist when manually handling!
• And always risk assess – any risks identified can then be reduced. Do the risk assessment and then act upon it.
The following diagram illustrates the guidelines for manual lifting and lowering (17kg = 3 stone; 25kg = 4.5
22
stone):
Legislation: For your rights and responsibilities see below for a list of relevant legislation that applies to manual
handling / safer assistance:
• Health & Safety at Work act 1974, sections 2 & 7 (H.A.S.A.W.A)
• The Manual Handling Operations Regulations 1992 (MHO Regs):
• Explains that employers have a responsibility to avoid hazardous manual handling tasks, to assess and reduce
the risk, review regularly, and provide information on the load.
• Workplace (Health, Safety & Welfare) 1992 reg. 5 to 27.
• Reporting of Injuries, Diseases and Dangerous Occurrences 1995 (R.I.D.D.O.R)
• The Management of Health and Safety at Work 1999 Reg. 14
• Disability Discrimination Act
• Human Rights Act 1998
Useful contacts and websites:
Scotland wide services:
Capability Scotland Therapy Services offer training on Safer Assistance and will tailor it to suit your individual
service requirements and needs.
For more information and to discuss your requirements please contact:
Lynn McCallum, Manual Handling Consultant / Trainer
Address: Therapy Services, c/o Alexander Anderson Centre, 18 East Thornlie Street, Wishaw ML2 8BB
23
Office tel: 01698 372 003 ext 401
North Lanarkshire specific services:
Development Officers, North Lanarkshire Learning and Leisure Services (Moving and Handling training courses)
tel: 01236 812837/812427
www.backcare.org.uk
www.hse.gov.uk/msd (Health and Safety Executive / musculo skeletal disorders)
www.csp.org.uk (Chartered Society of Physiotherapy) – type ‘backcare’ in keyword section
24
6.
Communication
You should take all children’s views into account.
You should involve children in the decisions you
make and give them the opportunity to tell you
their thoughts, feelings and what they would like
to happen. This means that it is very important
to communicate effectively with all children.This
could be more difficult if a child has a speech,
language or learning problem.
Contents
• Communication strategies:
• Sign language (this describes different types
of sign language and where to get and use
symbols)
• Symbols (this describes different types of sign
language and where to get and use symbols)
• British fingerspelling alphabet (right-handed
version)
• British fingerspelling alphabet (left-handed
version)
• Early-years verbs
Communication strategies
Never assume that because a child cannot speak that they will never be able to communicate.Verbal
communication is the most common form of communication, but it is not the only one.You should always use
other types of communication with verbal communication, for example:
• facial expressions;
• gestures;
• body language and touch;
• eye contact;
• objects;
• symbols; and
• communication aids.
It is extremely important that you find out the child’s first language and how they prefer to communicate. Never
make assumptions – always find out what a child is feeling and thinking and ask them what they would like by
communicating with them and their family.
How to improve a child’s understanding of what you and others are saying to them
Communication
25
Signing
• British Sign Language (BSL) and Makaton are commonly used with children. BSL uses hands, facial expressions
and other body language to communicate. Makaton is system of communication that uses signs, graphic
symbols and speech. It is used by and with people who have communication, language or learning problems.
(For more information, please see the fact sheet ‘Sign Language’.)
Speech
• Only say what you really need to – use as few words as possible, and say them slowly. Stress the words using
gestures, for example:
• point to objects;
• mime, such as eating a snack;
• nod your head and give thumbs up for ‘yes’; and
• shake your head and give thumbs down for ‘no’.
• When you give instructions, give them clearly and think about whether the child could interpret them in a different
way.
• When you are talking to a child, make sure that you are at their level. This is especially important if the child
uses a wheelchair.
• Repeat the same words and instructions rather than using different words. This can help the child to
understand the information. If this doesn’t work, use different words. Make sure you give the child enough
time to understand the information and to answer your questions. To make it easier for a child to understand
what you are saying, pause between words.
• Make sure you have the child’s attention before you start to talk to them. Think of interesting ways to get
their attention when they are in a large group.
For example, when you ask children to stop running about during games, say something like ‘Everyone, and {the
particular child’s name}, stop running’. However, you need to be careful not to say one child’s name all the time,
otherwise you could draw negative attention to them. Maybe say a couple of names so you’re including children
without additional support needs.
Also try holding up cards that mean ‘watch and listen’. Make sure that all children know what the cards
represent before you use them in this way. Maybe have a group activity where the children can make the cards
themselves.
• If the child has speech problems, only use one word at a time when you are communicating with them.You
could also label toys, food and equipment with one word so the child finds it easier to understand what you
are saying or referring to.
Visual aids
• As well as pointing to objects, point to people if you are referring to someone. Either point to the actual
person if they are there, or point to a photo of the person.
• Use picture timetables or diaries, drawings, symbols and cue cards to help you communicate with the children.
You can also use a picture exchange communication system (PECS) board, or a portable picture system (see
‘Making things’ in section 7 of the CD for information on how to make simple ones yourself). The PECS board
uses symbols to help children choose what activities they want to take part in, and what they want for snack
time.You can also use a PECS board to ask a child how they’re feeling. The portable picture system uses a
Communication
26
similar idea, except that the child can carry this around with them, which is particularly useful if you’re out
and about. PECS is easy for children to use, but can be difficult to introduce into your care. If you are thinking
about using PECS frequently and for the long term, it is important to get the proper training to make sure you
use it correctly.
PECS is a system that has been developed by Pyramid Educational Consultants.You can find their contact details
in section 13 ‘Contact details’ on the enclosed CD.
• Think about the instructions you give to children – is there an easier way of helping them to understand? Put
the instructions into pictures and have a sequence of events. This could be useful for explaining things such as:
• the rules of a game;
• how to make a sandwich;
• the sequence for getting ready to go outside to play; and
• the arrangements for children playing on the computer.
• When you give instructions, use visual aids to make them clear. For example, when you ask a child to sit on a
chair, point your hand or pat the chair while you give the instruction.
Sign Language
There are several different sign language systems in the UK, for example, British Sign Language (BSL) and
Makaton. When using sign language with a child, it is essential to seek parents’ advice on the language. It can
often be beneficial to use a total communication approach i.e. combining speech with signs, gestures, body
language, etc, but for some this is confusing, and for some people, e.g. those who are deaf, it can be annoying.
British Sign Language (BSL)
• BSL is the most common form of sign language, being the first or preferred language of deaf people in the UK.
• It has its own grammatical structure and syntax and it involves hand, face and body movements.
Makaton
• Makaton is an increasingly used communication method that uses ‘key word’ signs and gestures to support
speech.
• It is primarily used by children and adults who have communication, language, or learning difficulties, and this is
likely to be their main communication method. However, many other people are now using Makaton, and it is
useful for very young children who can learn to use signs before learning to speak.
• People are encouraged to sign first, and when they are able to use speech and signing together, the signs are
dropped, with the view to the person using speech alone.
• Something Special is an award-winning BBC TV series that uses Makaton symbols and signs. It also uses
rhymes and songs to help encourage communication and develop language in a fun and exciting way. DVDs of
Something Special can be purchased on the Makaton.org website (see below).
Communication
27
What are the differences between BSL and Makaton?
BSL
Makaton
Used by the deaf community
It borrows features from BSL but is specifically
designed for children who can hear but who have
communication difficulties
Does not follow the English word order – sentences are It is a much simpler form of communication that
not a direct translation of the spoken language
uses common vocabulary used in everyday speech.
Language programme (that uses the English word
order) involving symbols and signing
Speech is not used alongside the signs
Signing, speech and symbols are used together
Involves facial movements
Does not use facial expressions – people with
cognitive difficulties find faces confusing because
they change so rapidly.
Where can I go for more information?
British-Sign.co.uk
Address: British-Sign.co.uk, Honeysuckle Cottage, Les Dunes,Vazon, Castel, Guernsey GY5 7LQ
Website: www.british-sign.co.uk
British-Sign.co.uk is a website that has information about British Sign Language, including resources, and it gives
people the opportunity to learn basic sign language online.
BritishSignLanguage.com
Website: www.britishsignlanguage.com
BritishSignLanguage.com is a website that uses moving pictures to show the basic signs for BSL. It has a number
of word groups and has a wordsearch facility to locate specific symbols.
Deaf Books (and Deafsign.com)
Tel: Deaf Books: 01594 833 858, Deafsign.com: 01642 580 505
Website: www.deafbooks.co.uk and www.deafsign.com
DeafBooks publish the LET’S SIGN Series of British Sign Language (BSL) educational materials for all ages and
abilities. The Early Years collection includes an illustrated book of signs for carers, a comprehensive pocket
dictionary, posters, flashcards, signed song book & audio CD, keepsake sheets to fill in to record progress, BSL
merit stickers and badges and signing certificates.
The site offers a point of contact for requests and queries and some fun free BSL games and downloads.
Communication
28
To view the whole series and shop on-line please visit www.DeafBooks.co.uk
The resources within the Communication section include Fingerspelling alphabets and BSL Early Years Verbs
handouts which are reproduced with permission from Cath Smith at Deafsign and DeafBooks.co.uk - 01642
580505 [email protected]
The Makaton Charity
Address: Manor House, 46 London Road, Blackwater, Camberley, Surrey GU17 0AA
Tel: 01276 606 760
Website: www.makaton.org
The Makaton Charity provides information and advice on using Makaton, including training details, resources
(some of which are free), family advice, and research.
Symbols
What are symbols?
Symbols are used widely to help children with learning difficulties, but they are also a good method of
communication for all children. Their use ranges from helping children who have difficulties learning to spell,
through to children who are not able to use traditional text as a means of reading and self-expression.
A ‘symbol’ to the majority of us is something that represents something else, - we think of symbols in terms of
signs i.e. road works, toilets, places to eat etc. The term ‘symbol’ is a way of describing or showing a word in a
visual way.
Symbol based language and communication has been developed over many years and the benefits are dependent
on each child’s own needs and preferences.
What is really important to remember when using symbols is that everyone is different with different abilities in
spoken and written language, expression, vocabulary, sight, hearing and other individual factors.
Examples of Picture Communication Symbols:
Example of Widgit Literacy Symbols:
Communication
29
Types of symbols:
Objects as symbols
The simplest level of symbols is objects. These are used all the time with young children to promote their
understanding. For example, a parent will hold up a child’s beaker while saying “Do you want a drink?”. In turn,
children use objects with us to get their message across. In time a child may well shake their beaker to request a
drink. Objects used in this way can be used to support the very beginnings of communication and are known as
‘Objects of Reference’. As a child’s understanding grows, smaller or toy objects can be used to represent items,
for example, a toy bike to represent the child’s own bike.
Photographs and pictures
The next level of symbols is photographs and pictures. Photos and pictures can be attached to a cupboard to let
children know what it contains. In time, they may choose one of the photos to request an item in the cupboard.
Why use symbols?
Children who are unable to use words to communicate due to a particular disability or learning problem need
to have some other form of communication tool available to them. Staff members who work with them on a
daily basis need to be able to understand the child’s needs; ensure they are able to get their particular message
across; and that it helps the child communicate effectively with a staff member e.g. to express their feelings and
to understand a situation or play activity that is going on around them. This will help a child integrate more
effectively and therefore become more involved and interact with all play and other activities being offered to
their peer group.
What are the advantages?
The advantages are:
•
Effective communication - making a symbol communication book can help people make choices.
•
Independence and participation - symbols aid understanding which can increase involvement, choice and
confidence.
•
Literacy and learning - symbol software encourage users to “write” by selecting symbols from a
predetermined set in a grid.
•
Creativity and self expression - writing letters and stories and expressing your own opinions.
•
Access to information - all of us need accessible information and this should be presented in such a way that
the reader can understand and use.
How do I know what symbols to use?
Many children who use symbols to communicate are likely to use them in various settings e.g. at home, at
another nursery or in school. It is important to find out what symbols the child currently uses and replicate this
in your own service. Symbol use will be much easier if you use the symbols that they are used to. Don’t be afraid
to ask parents what they use in the home environment – they know their child best. Also, consider asking other
professionals e.g. the school teacher, what communication methods they use.
Effective symbols incorporate words and pictures. It is important to vary the way you make symbols:
Communication
30
For example, if the child finds it difficult to understand words, then the words on the symbols should be smaller,
and the pictures bigger.
Also, if the child has a visual impairment, then consider making symbols larger in size, or having black symbols on
a yellow background (contrasts in colour could help the child see the symbol better).
Where can I get symbols?
There are various ways of sourcing symbols and relevant software available on the market at present and these
include:
• Use the internet
• Boardmaker – this can be found at www.mayer-johnson.com (American version) or at www.widgit.com/
mayer-johnson/index.htm (British version). However, boardmaker can be quite expensive, and so other
options include: Google search engine is a popular and easy way to search for symbols that you can use to
communicate. Go to www.google.com and using the images search tool you can search for various images
that are relevant to your individual communication needs within your service. Examples of images could be
‘cartoon bike’, ‘cartoon apple’, ‘cartoon happy face’).
Symbol Websites:
• Dotolearn.com
Do 2 Learn has a number of areas on their website e.g. information and advice about disabilities, a section on
songs and games, and picture cards. . For further information visit the website at www.dotolearn.com
• Sclera.be
This website has over 3,000 pictograms available for free use. Simply download and use as required. For
further information visit the website at http://www.sclera.be/index.php
• Widgit Website
This is a website that offers some free resources and has a variety of information and ideas for using symbols.
For further information visit the website at www.widgit.com/
• Symbol World
Symbol world is part of Widgit but is a website for symbol users and readers to share their own ideas and
stories. For further information visit the website at www.symbolworld.org/
• Easy Info Website
This is a website about making information easier for people with learning difficulties. It is about bringing
people together, finding out about good ways of working and sharing ideas. For further information visit the
website at www.easyinfo.org.uk
• Through the Maze Information Website
This website is a great site full of useful symbols to download and use. For further information visit the
website at http://www.through-the-maze.org.uk/pages/Symbols
Also consider using:
• Digital Camera
Take pictures of what the child knows i.e. staff members, mum, dad, various food products to enable them to
point out what or who they are trying to communicate with.
Communication
31
• Clipart on the Computer
The use of the clip art facility within your computer package is also a good source of communication symbols.
Examples of showing emotions and activities could be:
Happy
Sad
Colouring
• Draw them yourself
Use your own ideas and drawing skills or a member of your staff and along with other children within the
service, make your own pictures to use when communicating.
Symbols can be a very powerful tool.
But they are only as good as the person creating the materials they are supporting.
Communication
32
British fingerspelling alphabet
(right-handed version)
Communication
33
British fingerspelling alphabet
(left-handed version)
Communication
34
Early-years verbs
Communication
35
7.
Planning inclusive
games and activities
You can easily adapt games and activities so that
a variety of children can use them.
Contents
• Introduction to planning games and activities
• Sensory experiences (describes the value of
using various sensory items with children)
• ‘Making things’ (explains how to make
communication aids and sensory items)
• Ideas for games (describes a couple of games
you could play)
• Colouring-in pictures (provides a number of
pictures showing people with disabilities, which
you could use in a discussion with children to
help them understand disabilities)
Introduction to planning games and activities
Like any new game, it will take you time to plan, prepare and introduce a game and adapt your activities. However,
all children can help you do this, and it is ‘best practice’ to involve the children in how they think you could adapt
your games and activities. Making adaptations could be an activity in itself. Everyone needs to think creatively – and
have fun doing it!
Getting everyone involved
Make sure that you involve everyone, especially the child you are mainly adapting the game for. It’s not about
singling children out, but including everyone in the decisions you make.
Questions to consider asking children
• What games do you like to play? (Using the talking mat will help, particularly if the child has problems
communicating. For more information, see section 3 ‘Making things’ on the enclosed CD.)
• What part of a game do you prefer to play? (For example, the child may prefer to be the one who blows the
whistle to start and stop children running around, rather than actually running around himself or herself.)
• What support or help does the child need to take part in activities? (For example, the child may need help
to understand the rules of the game, or to actually take part in a game, but after a couple of attempts, they
will know what to do. Or, the child may need help with glueing at the art table, but can colour in pictures
themselves.)
Making decisions
It is important to let all children make their own decisions. If the child has trouble communicating, using the
PECS system will help. This will allow you to give the child a range of choices, but the child will make their own
decisions.
Planning inclusive games and activities
36
Communication
When you are planning games, think about different ways of communicating. For example, some children respond
better to words, some to gestures, some to pictures or symbols, and others to sign language.
Storing games
It is important that you store games appropriately and that you keep the play area tidy and without any clutter.
You should store games:
• low enough so that a child in a wheelchair can reach them;
• with labels or symbols on the front to help someone with a learning disability find the game they are looking
for; and
• in an easy-to-open box so that a child who has trouble with movement can easily open it or pull it out.
‘Sensory Experiences’
Sensory experiences are very important for all children. The five senses give us opportunities to experience
different sights, sounds, smells, tastes, and textures. Many children with Additional Support Needs do not have
the opportunity to explore each of these senses for various reasons.
They may not even understand how to use and develop these senses. As a result, children may need your
support to provide them with sensory stimulation and your support to help them explore their senses.
There are many sensory activities you can provide children with, activities that would benefit all children. There
are many specialist resources that can be purchased from specialist catalogues (see section on Resources Guide).
However, many fun and exciting sensory items can be made by you – some items can be used as a way to help
with communication and others can be used simply as a game or an activity. See the Making Things section which
describes various ideas for items that can be made at a low cost to you.
For other ideas, simply search the internet. A few websites that you may wish to explore to give you further
examples include:
http://www.preschoolrainbow.org/5senses.htm
This website is aimed at young children and gives examples of activities and lesson plans for each of the 5 senses.
http://www.sensory-processing-disorder.com/sensory-integration-activities.html
This website gives a variety of suggestions for different kinds of sensory equipment, toys, games, etc. They also
give suggestions as to what to consider including in your own sensory room.
http://www.earthskids.com/sensoryrecipes.aspx
As the name suggests, this particular website page gives you recipes to make different kinds of play dough, and
other materials to make messy play more fun.
37
‘Making Things’
Making a Talking Mat
Contributions for the following information were
kindly provided by CRIB and the Talking Mats
Research and Development Centre.
The Talking Mat is a low tech communication
framework involving sets of symbols. It was
originally developed at Stirling University to
support people with communication impairment
and is now used in many countries throughout
the world. Talking Mats is an established
communication tool, which uses a mat with
picture symbols attached as the basis for
communication. It is designed to help people with
communication difficulties to think about issues
discussed with them, and provide them with a way
to effectively express their opinions.
Talking Mats can help people arrive at a decision by providing a structure where information is presented in
small chunks supported by symbols. It gives people time and space to think about information, work out what it
means and say what they feel in a visual way that can be easily recorded.
Who is it for?
Talking Mats are designed to help those with communication difficulties. The individual is required to have a level
of understanding in order to complete a Talking Mat successfully. The level of understanding required is of a two
information carrying word level (your Speech and Language Therapist will be able to advise on this).
Talking Mats is particularly useful when seeking a child or young person’s views, and in your service they could
be used to ask children what their likes and dislikes are in terms of activities, and food and drink.
Using Talking Mats properly is essential for it to work effectively. Completing the Talking Mats training course is
highly recommended, particularly if speech and language therapy is required for the child in your care. For more
advice and specialist training go to www.talkingmats.com and for information about the research behind Talking
Mats go to www.aacscotland.com
Why use a Talking Mat?
Talking Mats have been proven to be highly successful as they enable an individual to be able to have their
opinions and thoughts heard through the use of symbols within a structured framework. It reduces the reliance
of others to ‘interpret’ what the person is thinking and feeling and gives a more accurate view.
Ref: www.talkingmats.com
38
Items needed to make a basic Talking Mat:
• A door mat
• Velcro (grip side only)
• Plastic wallets
• Symbols of activities you offer children in your service,
and food and drink. (Symbols could be photographs you’ve
taken yourself, clear line drawings you have made yourself,
or symbols from a website or boardmaker (see section
on ‘Symbols’).You will need symbols that represent ‘Like’,
‘Not sure’ or ‘Maybe’, and ‘Dislike’; as well as a symbol for
‘Activities’, ‘Food’ and ‘Drink’. The others you can choose
yourself. Ideally, symbols should be laminated – they last for longer if they are laminated.
Instructions:
1. Once you have chosen all your symbols, stick a small piece of Velcro (grip side) to the back of each symbol.
2. Categorise your symbols into groups i.e. ‘Activities’, ‘Food’, and ‘Drink’. Keep the symbols safely in their
categories by storing them in plastic wallets.
3. Place the ‘Like’ symbol at the top left-hand corner, and the ‘Dislike’ symbol at the top right-hand corner.
Place the ‘Not sure’ symbol in the middle of these two. The topic area that you wish to discuss should always
be placed in the middle, at the bottom of the mat.
To use:
Once your mat is fully prepared:
1. Show each symbol to the child one at a time and ask the
child a non-leading question i.e. ‘What do you think of jigsaw
puzzles?’ as opposed to ‘Do you like jigsaw puzzles?’
2. Each symbol should be shown to the child one at a time so
that they are fully focussed on what you are asking them.
3. Once all the symbols have been discussed, you can then
clearly see what the child likes and dislikes.
4. A month or two later, you could use the mat again in case the
child changes their mind.
It is a fun activity that all children will want to take part in.
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Making a PECS (Picture Exchange
Communication System board:
Why use PECS?
The PECS board is a way to ask children what
they want to do next i.e. for play or for snack.
The use of PECS was devised by Pyramid
Educational Consultants UK ltd (Website: www.
pecs.org.uk)
Items needed:
• An A4 binder
• Dividers
• Velcro (both the grip and soft sides)
• Symbols of activities you offer children in your service, and food and drink. (Symbols could be photographs
you’ve taken yourself, line drawings, or symbols from a website or boardmaker (see section on ‘Symbols’).
You will need one symbol that says ‘I want’. The others you can choose yourself. Ideally, symbols should be
laminated as they will last for longer.
Instructions:
1. Once you have chosen all your symbols, stick a small piece of Velcro
(grip side) to the back of each symbol.
2. Categorise your symbols into groups i.e. ‘Activities’, ‘Food’, and
‘Drink’. Select one divider for all the ‘Activities’ symbols and secure
strips of Velcro (soft side) onto the divider. Use enough to take all
the symbols (or make up two activities dividers if you have a lot).
You can then attach each of the ‘Activities’ symbols onto this.
3. Make the other dividers the same way.
4. Then sit the A4 folder in front of you so that the opening is closer to you, and the binder is further away.
5. Secure a long strip of Velcro (soft side) at the bottom of the folder in a horizontal position.
6. Then cut out a slightly smaller strip of Velcro (soft and grip sides). Stick both of these together (back-toback). Then position the grip side of this strip onto the long strip that’s already secured (horizontally) to the
A4 folder.
7. Place the ‘I want’ symbol at the left of the strip. This should remain here.
8. Still on the front of the binder, secure 3 strips of Velcro (soft side) in vertical positions above the horizontal
strip.
To use:
To find out what food the child wants for snack:
1. The ‘I want’ symbol should already be in place.
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2. Select several options of ‘food’ from the divider inside the folder. The number of options you choose should
reflect the child’s level of understanding. If the child struggles with understanding, or they struggle to make
decisions, then only use 2 symbols. If the child has a good level of understanding then give them a bigger
choice. Note: ensure you only select symbols of the food that you are prepared to give the child.
3. Show the folder to the child and ask them what food they would like for snack time.
4. The child should select their chosen food and place it on the horizontal strip next to ‘I want’. The child must
then tear off the whole strip and give it to the play leader.
5. You must give the child whatever is next to ‘I want’. If you don’t then you are not using the system properly
and you will struggle to get it to work effectively in the future.
Follow the above for ‘Drink’, and ‘Activities’.
Making a portable pictorial system:
Why use a portable pictorial system?
The portable system will benefit the child as it will be more
discreet than the PECS board. The child simply carries the symbols
around in their pocket or bag and pulls them out when necessary.
If you’re group are going on outings, then the child can carry the
symbols with them without taking a larger, A4 folder.
Items needed:
• Symbols of activities you offer children, food and drink, and
feelings. (Symbols could be photographs you’ve taken yourself, line drawings you have made yourself, or
symbols from a website or boardmaker (see section on ‘Symbols’). Ideally, symbols should be laminated – they
last for longer if they are laminated.
• Something to secure the symbols together e.g. treasury tags.
Instructions:
1. Divide the symbols into categories, e.g. with activities, group them all together and punch a hole in the top
left hand corner. Secure all the activity symbols together, e.g. by using a treasury tag
2. Do this with all the categories.
3. The symbols should be kept with the person while they attend your service.
To use:
As for the PECS system, the portable symbols can be used to find out what activity the child wishes to do or
what food/drink they would like.
• You can simply ask the child what activity they wish to do next. The child can get out their pack of symbols
and show you the symbol for the activity they want to do. One disadvantage compared to PECS is that you
have less control over what items you can offer the child. For PECS, you would select the options the child
could choose from.
Alternative options:
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• If you are on an outing to the zoo, you could make up a symbol set of animals in advance. The child can then
show you the symbol of the animal they want to see next. This can be adapted to any outing.
• For feelings – you can ask the child how they are feeling and they can select the symbol that represents their
feelings. This is particularly useful if the child doesn’t seem themselves.You could ask them how they are
feeling and they may indicate that they feel sad.You could then ask them why they feel sad, and it may turn out
that they feel unwell.
• They could be used to calm the child down if they get easily anxious. The symbols to use, in this instance, are
things that make the child feel particularly happy (find this out by using the Talking Mat). When you see a child
becoming increasingly anxious or upset, encourage them to find a quiet corner, and to take out their cards.
The child can then focus on the symbols that help to make them feel happier. It is a way to prevent behaviour
from escalating, and hopefully avoiding challenging behaviour.
It’s important to think in advance and select your symbols carefully – ensure the child has plenty to choose from.
Making feely bags/cushions:
Why use feely bags or cushions?
Sensory stimuli is always around us, but many children with additional
support needs have difficulty with our sensory world – especially children
with a visual or hearing impairment, or those on the autistic spectrum.
Children with a physical impairment may also lack sensory stimulation
because they are less able to move around and find them. Feely bags or
cushions are simple ways of bringing different sensory stimuli direct to the child. Engaging with such sensations
can encourage children to focus, calm overexcited children, and stimulate passive children. It has benefits for all
children – not just the child with additional support needs.
Items needed:
• Small bags, material or pencil cases.
• Sewing materials and/or Velcro if required.
• A variety of ‘feely’ items e.g. dried pasta, beans, sand, cotton wool, cushion inserts, sponges, buttons, etc.
Instructions:
There are many options:
• If you are using pencil cases, then simply choose the ‘feely’ items you wish to place inside, and then zip the
pencil case. Sew the zip shut to ensure it cannot be opened.
• A more exciting option would be to make your own with different textures of material
1. Select a variety of textures e.g. smooth, silky, bumpy, fuzzy, furry, etc
2. Sew textures together (access to a sewing machine would make this a lot easier and quicker to do)
3. Then either fill the cushion with cushion inserts (the emphasis would be on the textures on the front of
the cushion); or fill the cushion with other items, such as dried pasta (the emphasis would be on feeling the
contents). Note: some children could become over-stimulated if you have too many textures, so sometimes
keeping it simple will work better.
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• Purchase ready-made feely bags e.g. from RNID (see Contact Details
section)
• Or make your own feely bag:
1. Make a bag using suitable material. To allow frequent access e.g. to refill
the contents, secure Velcro to the top of the bag. Then you would simply
need to ‘stick’ the bag shut when not in use.
2. Cut out different types of materials and make your own mini cushions to
put inside (see directions above).
To use:
Feely bags / cushions can be used in a variety of ways. For example
A guessing game – get the children to feel and guess what the contents of
the bags are
• A discussion around senses and the environment – encourage children
to explore different textures and to discuss where they could find the
textures elsewhere in the environment, or even the childcare setting.
• A matching game – encourage all children to close their eyes, and with
their fingers, they should be instructed to feel a matching pair of textures.
Alternative options:
consider scenting some of the contents with lavender, vanilla, coffee, etc to
explore different smells. Or consider adding squeakers, bells, etc to explore
different sounds.
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Game ideas
Pass the Ball
Items needed: balls of different textures, sizes, shapes and even smells and sounds. Bean bags as well as or as an
alternative to balls.
Children can sit on chairs, sit on the floor or be standing. The children should form a circle.
Instructions: Whilst calling out their own name, one ball or bean bag is passed from this child to another across
the circle. The player to catch the object does the same and so on. At regular intervals, another ball or bean bag
should be added to the circle. There will soon be lots of objects being passed around.
Alternatives:
• To promote different abilities, ask children to roll the ball to each other, to throw, to kick, etc.
• To make it harder, children should then go on to call out the name of the child they are passing the ball to.
Purpose: to encourage communication between children. It is a great way to help children to learn each others
names and to encourage friendships. It also helps with coordination.
Guess the Contents
Items needed: bags, labels, different items
Instructions: Label the bags with the first letter of a child’s name, and put different items into the bag that start
with that letter of the alphabet. E.g. for Brian, the bag would be labelled ‘B’ and could contain a toy bus, or a
book.
Each child would guess what is in each others’ bags.
Alternatives: explore different senses by making and using your own ‘feely’ bags and cushions (see the ‘Making
Things’ section).
Purpose: to encourage communication between children, to help with coordination, to give each child a sense of
worth (having a bag assigned to their name), and to encourage children to explore the sense of touch.
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Colouring pictures
Boy having fun
45
Boy playing Basketball
46
Boy playing football
47
Boy reading braille
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Boy using cane
49
Boy wheelchair user
50
Children signing
51
Disabled car badge
52
Girl having fun
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Girl reading braille
54
Girl with glasses
55
Girl with guide dog
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Girl with her doll
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Woman using walker
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8.
Examples of
good practice
Inclusion and inclusive strategies have worked
well in other childcare services in North
Lanarkshire and in other areas of Scotland.This
section will give you information on several
case studies which will show you how inclusion
can lead to success. The case studies tell you
about strategies that have been successful in
other services, and they also give you advice on
strategies that you could use in your service.
Contents
• Capability Scotland (CS) Childcare Services
– Examples of good practice
• Capability Scotland’s approach to inclusion
in mainstream childcare settings
• Inverclyde Play 4 All
• Aberdeenshire Childcare 4 All
• Renfrewshire Work 4 All
• All Together Now, Perth
• Edinburgh Childcare 4 All
• Inclusive
Childcare
Project
North
Lanarkshire Childcare Services – Examples
of good practice
• C & K Nursery North Lanarkshire
Capability Scotland (CS) Childcare Services
– Examples of good practice
Capability Scotland childcare services operate across Scotland and offer a variety of services including
supporting mainstream childcare providers to enable them to offer inclusive childcare support to children with
Additional Support Needs (ASN).
Capability services, such as Aberdeenshire Childcare 4 All, Edinburgh Childcare 4 All, and Renfrewshire Work 4
All, offer training, advice and direct support to mainstream childcare providers.
The process involves assessing the child’s needs and the skills that staff will require to provide support. Capability
staff then work alongside mainstream childcare staff to allow them to shadow Capability support workers and
learn from the strategies that are put in place. Capability staff work closely with the child’s family and other
professionals involved to create an appropriate and effective care plan to ensure the child’s needs will be met
whilst in their new childcare setting. After an agreed time, Capability staff will gradually withdraw their support
worker from the provision. This decision is made when the support workers feel that the provider has the skills
and confidence to meet the needs of the child on their own. This model equips providers with the tools to
undertake future assessments and to therefore meet the needs of future referrals.
These types of services that Capability offers will hopefully allow parents of children with disabilities to return
to or retain employment, training or further education as they will be confident in the support their child will
be receiving. The Renfrewshire Work 4 All project (detailed below) provides similar childcare support, and also
provides additional employment support to the parents to help them with the employment aspect.
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The following information introduces a selection of Capability’s childcare services, some of which have now
ended, and others which are currently operating. Each section details examples of good practice that the service
managers have drawn particular attention to.
Inverclyde Play 4 All
Play 4 All supported children with disabilities into mainstream after school care.
Good practice: One child had very high needs – highly autistic behaviour. He attended 2 days per week. His
support plan for school, and at home was adapted so that all services working with him were working to the
same coherent practice. This reduced the likelihood of challenging behaviour and enabled him to be better
integrated into the mainstream setting. He used boardmaker to communicate and this was put in place in the
club so that the other children and staff could communicate with him. E.g. they had a Velcro board with symbols
to tell the child what activity he was doing and how long this would last for. While he had complex autism, there
were no issues regarding his behaviour.
Good practice: The staff at the club were trained in various things, including use of an Epi Pen, inclusive and
active play, and autism awareness.
Aberdeenshire Childcare 4 All
The service supports the inclusion of children (0-16yrs) with additional support needs in mainstream childcare
in Aberdeenshire.
Good practice: The project has a large mobile lending library. They deliver items on a 4 weekly basis. This
includes stimulating, education, therapeutic and fun toys and equipment which can be borrowed by childcare
providers to support the inclusion of children with ASN. This allows providers to trial large expensive equipment
with new children before purchasing costly items for themselves.
In North Lanarkshire, there is the Toy and Equipment Lending Library (TELL), which all childcare providers in
North Lanarkshire, registered with the Childcare Information Service can access (email: [email protected])
Good practice: In the past they supported staff to work with children who required boardmaker. CS staff
worked with the staff at the club to make up boardmaker symbols and to use them effectively. They have also
made up Makaton packs in the past.
The biggest issue CS staff face is working with staff at the clubs. Many have the skills needed, but are lacking in
confidence and so think they can’t work with a child who needs ‘extra support’.
Renfrewshire Work 4 All
Renfrewshire Work 4 All supports families of children and adults with additional support needs. Staff support the
parents to get back into employment, education or training if the barrier is sourcing care for their child or adult
dependant.
In terms of the childcare support a support worker meets with the family to identify the child’s needs. A
Childcare Profile is completed and the child is then matched with a suitable mainstream childcare service.
Relevant information from the childcare profile is then put into a ‘Quicksheet’ which is then shared with the
identified provider.
Good practice: staff at the club are initially offered ‘Inclusive Play’ training, delivered by Capability Scotland so
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staff realise that they have the skills necessary. Depending on the needs of the child, other training is also offered
e.g. mealtime assistance, safer assistance, epilepsy awareness, disability equality, challenging behaviour.
The CS staff member supports the staff at the club, more so than the child. If more support is required then they
link up with Childcare @ Home who attend the club and support the child on a short time basis until they are
fully included. They will then withdraw support. The majority of cases do not require this level of support and
staff at the clubs are encouraged to work directly with the child from the onset.
Good practice: a PECS system was set up by CS staff which the children and staff at the club use to ask
the child what activity they want to do, what they would like for snack, or how they are feeling. The staff are
encouraged to keep a diary of any problematic or unusual behaviour and to keep in close contact with the
school teacher so that they are all working to the same practice e.g. using the same symbols.
All Together Now –
All Together Now supported children with ASN to access mainstream playgroups, nurseries, and OSC.
Staff observed the child and suggested strategies for supporting the child in the childcare setting. Any 1-1 work
was only done with children with high care needs, but this was on a limited time span.
Staff didn’t work alone – they involved the childcare providers and worked out suitable strategies together.
Support for individual children ranged from 4 weeks, to 4 months, and on the odd occasion, even a year.
There are some reasons why a placement may not work out, e.g. they had one child with a congenital hip
disorder. The child was still able to move around though. However, once the support was withdrawn, (due to the
end of funding for the project) the club no longer wanted to support the child. The child lost their place, but the
club was reported to the care commission for discriminating against the child who could easily be included in
the club.
Good practice: Disability Awareness Training sessions for children were delivered to nurseries, playgroups and
primary schools, and the younger the age group, the more successful the training was. The Disability Awareness
sessions proved very popular in all settings. Staff found that sometimes children weren’t good at mixing with
children with ASN, and vice versa. For example, there was one foster family with two children, and it took
2.5 – 3 months before the children were settled. They lacked confidence because of their previous childhood
experiences. The training helps children to understand disabilities and ASN, and realise that everyone wants to
play and have fun with each other.
Good practice: in the clubs themselves, staff made up sets of boardmaker symbols. Because of the high Polish
community, symbols were also translated into Polish. Speech and Language therapists were also involved in the
use of boardmaker at the clubs. For most children who needed them, it worked really well.
When asked how successful the project had been, the team leader said that it was amazing to see the
improvement in confidence of the childcare staff. They received ‘thank you’ letters from both childcare staff and
parents.
Edinburgh Childcare 4 All
Edinburgh Childcare 4 All supports the inclusion of children with ASN aged 0-16 years in mainstream childcare.
One of the biggest barriers has been the attitude of childcare providers and so it is important for childcare staff
to know their requirements in terms of the Disability Discrimination Act (DDA) as many are not aware of this.
Good practice: staff have been able to offer many suggestions to childcare providers about adapting resources
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in their services, and thinking ‘out the box’ e.g. they supported one girl who would not play with her peers. She
always followed the staff around instead. CS staff suggested putting lines on the ground and all children were told
that they could play on one side of the line, and staff would stay on the other side. This was very effective, and
soon the girl started playing with her peers, as she couldn’t ‘access’ the staff.
Good practice: the project feels that local forums are an excellent way to meet other childcare providers and
to share good practice.
Good practice: Disability Equality training has been sourced from Capability’s Equality Unit, and they have
tailored it specifically to childcare providers. Other training, such as Epilepsy and ADHD, they have bought
in from ‘The Yard’. The Yard is an adventure centre, and an inclusive centre that welcomes all children, but
specifically caters for children with ASN from birth to 18 years. They have various play sessions from MondaysSaturdays.
Good practice: a lot of training for providers is ‘on the job training’, e.g. to suggest and implement strategies,
such as time-out and reward systems.
One other that has been particularly effective is Social Stories training. It enables staff to make personalised
stories which aim to address social situations in which a child or young person is experiencing difficulty; e.g. to
assist a routine, to highlight how a social situation is perceived by others, or to assist the child to carry out a
social skill in a more appropriate way.
Good practice: to get the best support in place for the child, working with parents is crucial, and childcare
providers need to be able to communicate effectively and work well with parents.
Good practice: other examples of good practice are to use happy and sad faces as a way of producing positive
reinforcement. These are used instead of issuing the child with a warning.
If it is a child who requires physical adaptations, then it is more effective to write down a list of suggestions in
advance, as the majority of adaptations are similar in many childcare settings. It will give you a head start.
Inclusive Childcare Project North Lanarkshire –
Childcare Services. Examples of Good Practice
C&K Nursery and Out of School Care
C&K Nursery and Out of School Care provide childcare to children throughout the Cumbernauld area. It has
one Nursery site and four out of school care sites.
At the St. Mary’s out of school care base, two children with additional support needs are being supported and
positively included within the service. One child has autism and challenging behaviour and the other child has
Downs Syndrome and minimum verbal communication. They also support another child with autism when the
family require respite. In order to ensure the service was meeting the needs of all children, staff adapted both
the setting and the activities and this has been a successful process.
Good practice:
• A rota is in place so that staff members work with all the children, developing staff skills and reducing
dependency for those who require a higher level of support e.g. Children stated above.
• A diary system is in place to monitor behaviour, enabling staff to then put strategies in place to positively
manage any challenges that occur i.e. triggers, activities etc.
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• All staff, including childcare mentors attend regular team meetings to discuss the progress of all children and
highlight any areas for development.
• Makaton symbols are on the walls to encourage children to learn non verbal communication.
• Staff members have worked hard as a team to instil a routine for the child with autism that promotes his
independence and inclusion, i.e. he can now hang his jacket up, wash his hands and have a snack unaided.
Good practice: The out of school care works in partnership with the inclusive childcare project. This enabled
one parent to access childcare quickly ensuring that her college course was not jeopardized.
The out of school care work directly with parents/carers to ensure channels of communication are clear.
Good practice: The other C&K Nursery and out of school care bases; Woodlands, Muirfield and Eastfield also
support children with additional support needs. Muirfield and Woodlands are now successfully including two
children without an additional member of staff.
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9.
Policies, programmes
and the law
Our policies and programmes give you advice
on strategies you can use, and by law there are
certain requirements you must keep to. Some
of these are local requirements and relevant
to North Lanarkshire, and others apply to the
whole of the Scotland.
Contents
• Our policies and programmes
• Relevant laws
• Reasonable adjustments
• Case studies (examples which you can use in
discussions with your staff)
Our policies and programmes
North Lanarkshire Council
As a council, our aim is to put ‘service and people first’. We want to:
• make North Lanarkashire financially successful;
• make sure everyone is treated equally; and
• meet people’s needs by providing the best-quality services.
Our Corporate Plan 2008 to 2012 explains the challenges we face in:
• providing best value;
• continuously improving;
• promoting inclusion;
• providing equal opportunities; and
• getting the public involved in developing our services.
In our Corporate Plan we explain our ‘vision and values’, which show our commitment to build on our success
in the past and to keep to our public responsibilities of providing equal opportunities.
Our vision and values explain how we will:
• serve the public and involve our communities in our work;
• plan ahead and lead the way in working with our partners;
• promote equal opportunities and make sure everyone is included in society;
• make the most of opportunities to improve the economy and the environment;
• provide services that are the best value;
• work to the highest standards;
• be open and take responsibility for our actions;
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• value people and treat them with dignity, respect, and meet their needs; and
• look to the future and aim to be the best in all we do.
We use the ‘Social Model of Disability’ as the basis for our work to promote equal opportunities and to tackle
discrimination. This model describes the barriers that people face in their daily lives and how these barriers, not
the illness or disability, are what disables them. The barriers which people face include things such as:
• people’s attitudes, fears and prejudice;
• physical barriers that can prevent people from getting into buildings;
• lack of information and signs in appropriate formats; and
• practices, policies and procedures which discriminate against certain people.
We believe that these same barriers appear in other issues to do with equal opportunities, and we plan to carry
on using the Social Model of Disability to help us tackle these issues.
We are committed to providing services which meet the needs of our communities. We will aim to make equal
opportunities a part of our policies, by making sure that we include issues to do with equal opportunities in the
services we provide to the public and our employees.
You can get more information about our aims, commitment and vision from our website at www.northlan.gov.uk.
Child Protection:
Child protection is an issue that can affect children and families from any background and from any part of
society.
Our Child Protection Committee believes that all children and young people in North Lanarkshire have the right
to be cared for and protected from abuse and harm, in a safe environment in which their rights are respected.
We will work with other organisations to promote the safety and well-being of children and young people in
North Lanarkshire.
Within your service, you are responsible for making sure your child-protection training is up to date and that all
of your staff are aware of the procedures involved.
If you would like to contact one our social work area teams about child protection, please phone them.
• Airdrie – 01236 757000
• Bellshill – 01698 346666
• Coatbridge – 01236 622100
• Cumbernauld – 01236 638700
• Motherwell – 01698 332100
• Wishaw – 01698 348200
• Shotts – 01501 824700
Police (in all areas) – The Family Protection Unit
Phone: 01698 483095 or 01698 483096
In an emergency and out of hours, contact the West of Scotland Social Work stand-by service
Phone: 0800 811 505
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Child Protection Line
Phone: 0800 022 3222
For more information on child protection in North Lanarkshire, please visit our website at www.northlan.gov.uk
and see the section ‘Child Protection Committee’.
Also on our website, you can read more about the following.
• ‘It’s everyone’s job to make sure I’m alright’ – This is our national audit and review of child protection, which
we published in November 2002.
• ‘Protecting Children and Young People: The Charter’ – This was produced by the Scottish Government,
who worked with children and young people on the document. (See their website at www.scotland.gov/uk/
childrenscharter.)
Getting It Right For Every Child (GIRFEC)
Getting It Right For Every Child (GIRFEC) is a Scottish Government Programme which aims to change the
way services for children are run. The programme gives clear authority and responsibility to organisations and
professionals to work with children, families, local communities and each other to give children and young people
the best start possible.
Under GIRFEC, we are responsible for working with children, families and other professionals and making sure
we put the child at the centre of all that we do.
The Early Years Framework
The Early Years Framework (see www.scotland.gov.uk/earlyyearsframework) explains how we and others can
support children and give them the best possible opportunities in life. The framework is based on the UN
Convention on the Rights of the Child (UNCRC), which is an international convention which sets out a child’s
civil, political, economic, social and cultural rights.
We must all promote the well-being of children and young people. We need to make sure that we:
• keep children and young people safe;
• involve children and young people in what we do;
• listen to children and young people;
• value children and young people and all that they do; and
• work effectively with families and other professionals
‘Raising Achievement for All’ policy
North Lanarkshire is one of the largest local authorities in Scotland. It is also one of the most deprived areas,
due to the reduction of traditional industries over the years. Although our efforts to improve the local economy
and promote social inclusion are paying off, there is still a long way to go before our communities are as
financially successful as they should be.
Children and young people in North Lanarkshire are among the most talented you’ll find anywhere.
They work hard and do well at school, but sometimes don’t reach their full potential. It’s difficult to be positive
and to believe in yourself if no-one expects you to do well, if no-one in your family has gone on to further
education or if hardly anyone in your street has a job. Examination results prove this, as students in North
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Lanarkshire are still performing below the national average, despite some remarkable success stories.
There is a lot of evidence that shows there is a link between deprivation and underachievement, and this is a
link that we must break if we are going to give our young people an equal chance to succeed. We must discover
a way of challenging young people and adults to achieve whatever they are capable of, whatever their ethnic
background, sex, ability or disability. For this reason, our education department’s motto is ‘Aiming Higher’, and
they have made our Raising Achievement For All policy a priority.
The policy helps us to make clear what we mean by ‘achievement’, and helps us focus on what we, students,
parents and teachers need to do to raise achievement in North Lanarkshire.
You can see our full Raising Achievement For All policy on our website at www.northlan.gov.uk.
Relevant laws
There is a range of laws which support the rights of children with disabilities to play and to access services.
These include the following.
The Children (Scotland) Act 1995
Under this act, children with disabilities and children affected by disabilities are referred to as ‘children in need’.
Under section 22 and section 27 of the act, local authorities have responsibilities for children.
Under section 22
Each local authority must provide a range and level of services to:
• protect children in their area who are ‘in need’; and
• promote that families must bring up children ‘in need’.
Under section 27
Each local authority must provide day care for children ‘in need’ who are aged five or under. The act also outlines
how, under section 23, each local authority is responsible for children with disabilities.
Under section 23
Services for ‘children in need’ must be designed to:
• reduce the effect the disability has on a disabled child;
• reduce the effect a child’s disability has on another child in the family; and
• give children in need the opportunity to lead lives which are as normal as possible.
Under section 20 of the Children (Scotland) Act 1995, local authorities must publish information on children’s
services in its area, and in particular, services for children affected by a disability.
You can get full information on the Children (Scotland) Act 1995 at www. scotland.gov.uk/
Publications/2004/10/20067.
The Equality Act 2010
The Equality Act came into force on 1st October 2010. The Act brings together previous discrimination
legislation, including the Disability Discrimination Act 1995, into one single Act. It defines disability as a “physical
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or mental impairment which has a substantial and long-term adverse effect on a person’s ability to carry out
normal day to day activities”. The Act covers education providers including nursery services operating from
schools, indoor and outdoor adventure playgrounds, leisure centres, play areas in public parks, playgroups and
some private nurseries. Out of school care groups are also included. The Equality Act protects disabled people
from five different kinds of discrimination: direct discrimination where discrimination occurs because of a
person’s disability; indirect discrimination when a rule is applied equally, but puts disabled people at a particular
disadvantage; discrimination arising from disability is discrimination because of something connected to the
person’s disability; discrimination by perception is where discrimination takes place because a service provider
thinks a person is disabled even if they are not; and discrimination by association is discrimination against
someone because they are associated with a disabled person.
Service providers must avoid discriminating against disabled people and must make reasonable adjustments when
their service is not accessible to disabled people.
In addition to avoiding discrimination, service providers must make reasonable adjustments if a disabled person is
experiencing difficulty accessing a service by:
• changing the way you do things
• overcoming physical barriers
• providing equipment or assistance
The duty to make reasonable adjustments aims to make sure that a disabled person can use a service as close
as is reasonably possible to get to the standard usually offered to non-disabled people. Many of the adjustments
a service provider should make will not be particularly expensive and they are not required to do more than it
is reasonable for them to do. What is reasonable depends on, among other factors, the size and nature of the
goods, facilities or services they provide. For example a childcare provider could improve the paths in the garden
so the outside space can be accessed by disabled children with a mobility or visual impairment
Full Details of The Equality Act 2010 at: http://www.opsi.gov.uk/acts/acts1995/ukpga_19950050_en_1
The Disability Equality Duty 2006
The Disability Equality Duty is part of the Disability Discrimination Act 2005. Under the Disability Equality Duty,
all public organisations must promote equal opportunities for people with disabilities. The public sector need to
consider how their work will affect disabled people, and they should take action to promote equal opportunities
by getting disabled people involved in all of their work. This includes involving children in all parts of the care you
provide for them.
Under the Disability Equality Duty 2006, organisations must be prepared to take extra reasonable steps to
promote equal opportunities. It’s not about treating everyone the same.You do not want to discriminate against
a disabled child, and you do not want to ‘positively discriminate’ by treating a disabled child more favourably than
another child. Instead you should treat each child fairly, according to their needs.
You can get full information on the Disability Equality Duty 2006 at www.dotheduty.org.
UN Convention on the Rights of the Child (UNCRC)
Under article 31
Every child is entitled to rest and play and to have the chance to join in a wide range of activities, including
cultural and artistic activities. All of these rights apply to all children.
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Under article 23
We must help disabled children be as independent as possible and help them take a full and active part in
everyday life. Play is an important part of everyday life for children, and under article 24 of the UNCRC a child
has the right to the highest level of health possible.
You can get full information on the UNCRC at www.everychildmatters.gov.uk/uncrc.
Education (Additional Support for Learning) (Scotland) Act 2009
The Education (Additional Support for Learning) (Scotland) Act 2009 was previously the Education (Additional
Support for Learning) (Scotland) Act 2004, and was amended in May 2009. This act is about education authorities
and people who work with children and young people, whether you are a teacher, classroom assistant, nursery
nurse, childcare worker or if you work for one of the many voluntary organisations supporting children and
families. The main aim of the act is to improve the system for identifying and dealing with the needs of all
children and young people who may face a barrier to learning and need extra support.
Here are some of the main points in the act which relate to the rights of children with additional support needs.
Educational authorities should:
• have appropriate and efficient services for each child or young person with additional support needs, and for
whose education they are responsible for;
• consider the needs of each child or young person with additional support needs, and the support they
provide;
• provide appropriate support for pre-school children with additional support needs if the child is under school
age (unless they are at a prescribed pre-school), belongs to the authority’s area, and has additional support
needs as a result of their disability;
• have arrangements to identify additional support needs and to consider if a child need a co-ordinated support
plan (CSP);
• prepare a CSP if a child or young person needs one;
• get advice and information (including formal assessments) from other organisations, such as health services,
social-work services and voluntary organisations;
• publish their policies and arrangements for identifying and dealing additional support needs, what the role and
rights of parents and children are and who parents should contact to get information and advice; and
• provide independent mediation services for all parents of children with additional support needs and publish
information on these services.
You can get full information on Education (Additional Support for Learning) (Scotland) Act 2004 at www.opsi.
gov.uk/legislation/scotland/acts2004/asp_20040004_en_1.
For information on the amendments resulting from the Education (Additional Support for Learning) (Scotland)
Act 2009, see www.opsi.gov.uk/legislation/scotland/acts2009/pdf/asp_20090007_en.pdf.
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Reasonable adjustments
You will not always have to pay to make ‘reasonable adjustments’. Sometimes it may involve buying something
that would help make things easier for a child, but often it is about adjusting what you already have in your
service. Often, many of the reasonable adjustments you make will benefit all children, and not just the child with
Examples of reasonable adjustments may include the following.
Changes you can make
• Change the set-up of your service so that someone who uses a wheelchair or walking aid is able to move
around freely and is able to access everything without bumping into things.
• If you have a small incline or steps, providing a ramp at an entrance would not cost very much and would help
people who use a wheelchair.
• Replace taps or door handles with easier-to-use ones.
• Ask staff to change their attitude, for example by making sure staff make all children feel welcome.
• Make sure you make adaptations for all children, and not just those with obvious, often physical disabilities.
Make an effort to make adjustments for, and to understand, ‘hidden’ disabilities.
Think of different ways to communicate with the child or family
• Use symbols, for example to label toy boxes, areas of the room and so on, so that a child with learning
problems is able to understand where toys are.
• Provide information in a variety of formats, for example have signs or forms in other languages, in Braille, in
large print and so on.
Change your policies, procedures or practices
• Make sure your policies and procedures include all children and are fair, and make sure that you keep to them.
• If children find it hard to concentrate because of their condition, for example if they have autism or ADHD,
allow them to choose the activities they want to do, even if other children are doing other activities.
• Adapt games to make them more accessible. For example, a child with sight problems would be able to play
ball games easier if the balls were a bright colour, large and textured, as they would be able to see them and
grip them better.
• Be more flexible, for example do not force children to take part in activities that they don’t want to be
involved in just because you think they need to be included in everything.
• Make sure you adapt your dress code. If you have a worker from another agency who is there to provide a bit
of extra support for your staff team, ask them to wear your uniform. If the worker dresses differently from
the other staff, the children will be quick to single that worker out and quick to associate the worker with
particular children who may need a bit more support. This could have a negative effect on your work.
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Help to make reasonable adjustments
You will be able to make many reasonable adjustments, but if you need advice, support or other help, you can
find contact details in section 13 on the enclosed CD.
Examples
• Partners in Play can give you advice and information on strategies so you can make sure your service includes
everyone.
• Able Aid Mobility may be able to help with mobility aids.
• The Royal National Institute of Blind People (RNIB) and the Royal National Institute for Deaf People (RNID)
may be able to give you advice on adaptations you can make for children with sight and hearing problems.
• Toy and Equipment Lending Library (TELL) can provide a range of toys and resources to help make play easier.
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Case studies (examples which you can use
in discussions with your staff)
Case Study 1:
Craig is 8 years old. He has a physical disability and uses a walking aid to help him move around. His local after
school club has two rooms. One is on the upper floor (for under 10s), and the other is on the ground floor (for
over 10s). There is also one small step to the entrance of the building.
Craig’s mum approached the after school club to enquire about a place for Craig, but the club said that it
wouldn’t be suitable as the under 10 room is on the 1st floor.
Q. Do you think the staff have done the correct thing?
A. No – this is an example of a childcare service treating a child ‘less favourably’ for reasons associated with their
disability. There are several ‘reasonable adjustments’ that the club could make to include Craig in their service.
Q. What kind of ‘reasonable adjustments’ do you think they could make?
A. There are various options. Some examples may include:
Changing the age of rooms, i.e. move the under 10s to the ground floor room, and the over 10s to the first floor
room,
If changing rooms isn’t an option then they could provide suitable hand rails, and do a risk assessment in order
to help Craig go up the stairs,
The club could provide a small, inexpensive ramp to enable Craig to enter the building.
Case Study 2:
Sally is 5 years old. She attends her local service over the summer period. She often displays challenging
behaviour which is associated with her additional support need. The service has arranged to go on an outing to
the local park but some of the staff are concerned that it would be too dangerous to take Sally with them. Their
reasons were that she has a tendency to run away, and she displays problematic behaviour when she doesn’t get
her own way.
Q. Should Sally be included in the outing to the park?
A.Yes – otherwise, the staff are discriminating against Sally because of her behaviour that is a result of her
Q. What kind of ‘reasonable adjustments’ do you think they could make?
A. There are various options. Some examples may include:
Conducting risk assessments that will minimise any risks for all children,
Preparing Sally for the outing in advance, e.g. discussing how everyone will get there, what they will do at the
park, what they might do and see at the park, and that it is important to stay together and not to run away. The
staff could easily make this into a game or activity that all the children will benefit from,
Talking to Sally’s parents – do they have useful tips or strategies for going on outings?
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10.
Resources
The resources section gives you a list of useful
documents and specialist websites where you
can buy specific resources to help you make
sure you include all children in your care.
Documents / publications
Best Play
– what play provision should do for children (2000) – can be found at www.playengland.org.uk/resources/bestplay.pdf
While it is a publication for England, it has received support by Play Scotland. It gives information on the
definitions of play, its role in child development, the consequences of play deprivation, and our roles as adults in
play provision.
Games to Play with Babies (Paperback) by Jackie Silberg
ISBN 1 897 675 542
Description: This collection contains 250 fun-filled games for the first year of a baby’s life. It includes singing
games, finger and toe games and many others to help encourage language skills, coordination, imagination,
dexterity and confidence.
Games to Play with Toddlers (Paperback) by Jackie Silberg
ISBN 1 897 675 550
Description: This collection contains 250 fun-filled games for toddlers. There are games for all occasions, from
riding in the car to playing with teddy and many others to help encourage language skills, coordination, listening,
observation and creativity.
Games to Play with Two Year Olds (Paperback) by Jackie Silberg
ISBN 1 897 675 569
Description: This guide offers hundreds of practical ways to harness a two-year olds’ natural enthusiasm,
curiosity and energy and turn everyday events into learning experiences. It includes language and counting games,
imagination games and nursery rhymes.
Specialist catalogues:
Many fun and exciting items, particularly sensory items, can be made you or bought from high street stores at
little cost to yourself. However, specialist catalogues offer new innovative ideas and it is always useful to explore
the various catalogues or websites to see what items are available. The following organisations specialise in a
range of various items for differing age groups:
Resources
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Galt Educational
Address: Johnsonbrook Road, Hyde, Cheshire SK14 4QT
Tel: 08451 20 30 05
Website: www.galt-educational.co.uk
Galt Educational offers resources for early education, including furniture, nursery equipment, toys and games.
They also have a section for Inclusion resources.
Hope Education
Address: Hyde Buildings, Ashton Road, Hyde, Cheshire SK14 4SH
Website: www.hope-education.co.uk
Hope Education offers teaching resources for pre-school, primary and secondary schools. They offer a wide
variety of art, craft, English, ICT, and maths resources.
Music Education Supplies (MES)
Address: Park Lane Business Park, Kirby-in-Ashfield, Nottinghamshire NG17 9GU
Tel: 08450 264 703
Website: www.mesdirect.com
MES is a specialist supplier of percussion instruments, primarily to the primary school market (there is also an
early years section). The MES catalogue holds over 2000 different instruments for all ages and has a wide variety
of instruments from around the world.
Red Bee
Address: Red Bee Education, Locomotion Way, Camperdown Industrial Estate, Newcastle upon Tyne NE12 5US
Tel: 0191 268 4141
Website: www.redbee.biz
Red Bee offers high quality, innovative products. It can offer resources to compliment all the curricular and play
requirements for your establishment.
ROMPA
Address: Goyt Side Road, Chesterfield, Derbyshire S40 2PH
Tel: 0845 230 1177
Website: www.rompa.com
ROMPA’s resources and products are designed to improve quality of life for people with sensory difficulties.
Resources
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Sense Toys
Address: 13 Barnsbury Terrace, London N1 1JH
Tel: 0845 257 0849
Website: www.sensetoys.com
Sense Toys helps you find and choose which toys you need, explains how to use them and why they work –
practical information and advice for parents and carers, especially for those learning about and coping with
additional needs for the first time.
SpaceKraft Ltd
Address: Titus House, 29 Saltaire Road, Shipley, West Yorkshire BD18 3HH
Tel: 01274 581 007
Website: www.spacekraft.co.uk
SpaceKraft Ltd offers a wide range of multi-sensory equipment and sensory products.
Step by Step
Address: Lee Fold, Hyde, Cheshire SK14 4LL
Tel: 08451 25 25 50
Website: www.sbs-educational.co.uk
Step by Step offer early years products, educational toys and games, nursery toys and equipment, arts and crafts,
outdoor and indoor play and more. There is also a specific section for ‘Special Needs’.
TFH UK (Special Needs Toys)
Address: 5-7 Severnside Business Park, Stourport-on-Severn, Worcestershire DY13 9HT
Tel: 01299 827 820
Website: www.specialneedstoys.com
TFH has over 1,000 products – they are described as ‘fun, innovative and often unique’.
The Transporters
Address: Changing Media Development Ltd, 2 Sheraton Street, London W1F 8BH
Website: www.transporters.tv
The Transporters is a website where you can purchase a DVD pack which aims to help children with autistic
spectrum conditions who find it hard to recognise the causes of emotion and the facial expressions that go with
them.
Resources
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Wonderbox
Address: Room 31/32, Hydepark Business Centre, 60 Mollinsburn Street, Glasgow G21 4SF
Tel: 0141 557 1666
Website: www.wonderbox.co.uk
Wonderbox offers a range of toys, games and activities designed to be shared between parents, carers and
children.
Yorkshire Purchasing Organisation
Tel: (main office) 01924 824 477
Website: www.ypo.co.uk
YPO represents a ‘one stop shop’ for quality products, with product and services as diverse as school and
curriculum resources, furniture, ICT equipment and many more.
Resources
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11.
Additional Support Needs
This section lists a number of disabilities and
conditions that are commonly asked about. This
section also contains fact sheets which may help
you understand a number of conditions. If we
have not mentioned a certain condition, there
are various organisations that can give you advice
and information, please see section 13, Contact
Details and section 14, FAQ.
Contents
This section is made up of the following
documents.
• Information on additional support needs
• Fact sheets on additional support needs (with
hints and tips)
• Other fact sheets on additional support needs
Section two
Fact sheets on additional support needs (with
hints and tips)
• ADHD
• Asperger’s Syndrome
• Autism
• Brain Injury
• Cerebral Palsy
• Down’s Syndrome
• Dyslexia
• Dyspraxia
• English as an Additional Language
• Epilepsy
• Hearing Impairments
• Learning Disabilities
• Physical Impairments
• Speech and Language Impairments
• Visual Impairments
Section three
Other fact sheets on additional support needs
• Albinism
• Anaphylaxis
• Angelman Syndrome
• Anxiety Disorder
• Asthma
• Crohn’s Disease
• Cystic Fibrosis
• Deafblindness
• Dystonia
• Edwards Syndrome
• Fragile X Syndrome
• Hydrocephalus
• PICA
• Spina Bifida
• Sturge Weber Syndrome
• Tay Sachs Disease
• Tourette’s Syndrome
• West Syndrome
• Williams Syndrome
Additional support needs
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Information on additional support needs
How to use this section: You should treat each child as a child first, and you should always deal with the disability
second.
The information on each additional support need is only a guide and it does not allow us to diagnose a child with
additional support needs – this is done by the appropriate professionals only.
Every child is unique and will not show the same symptoms or characteristics as another child. Again, please
remember that that you should only use this information as a guide.
Some fact sheets contain hints and tips to include children in your childcare service. These hints and tips are
simply suggestions – it is important to be creative and find other ways of working with every child. It is also
important to share any ideas with other childcare providers to make sure you are giving each child the best
possible chance of being treated fairly and being included in your service.
In each fact sheet we have included information from the websites, and you can find contact details at the end of
each fact sheet. For the most up-to-date information, please contact the organisation direct.
Description: Additional support needs covers a range of things that can cause a barrier to learning and play.
This means that as well as disabilities such as autistic spectrum disorders, ADHD, cerebral palsy, and having to use
a wheelchair, we need to take other things into account. For example, a child will have additional support needs if:
• they use English as a second language;
• their parents have drug or alcohol problems;
• they are being bullied;
• they are part of a disrupted family (for example where there has been a separation or divorce);
• they have behaviour problems; and
• they are carers themselves.
This means that additional support needs refers to children and young people who experience barriers to their
learning because of things to do with their:
• health and disability;
• learning environment;
• family circumstances; and
• social and emotional development.
Below is some information on several types of additional support needs.
Communication problems: If a child has problems communicating, they may also have problems with their speech,
language, hearing and sight.
The causes and effects of someone’s additional support needs vary from person to person. A child may inherit
some of their communication problems from their parents, or they may be caused by environmental factors or a
brain injury.
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There are many signs to look for if you think a child has a communication problem. For example, if a child has a
problem with communication, they may find it difficult to:
• concentrate;
• understand meanings and instructions;
• speak clearly, and may stutter;
• remember things;
• solve problems; and
• cope with certain social situations.
If a child has a communication problem, they may also have problems with their sight, hearing and touch. For
example, they may bump into things, find it difficult to identify other people in group situations, find it difficult to
follow conversations and so on.
If a child has a hearing problem, this may also cause speech or language problems. For example, the child may
have to strain to hear what people are saying and will ask others to repeat words, and they may struggle to speak
or get confused easily because they have only heard part of a conversation.
Communication problems, including problems with language and speech, may be caused by a physical problem,
such as a cleft lip and palate. The child may find it difficult to speak.
Specific disabilities in which children have problems with communication include attention deficit hyperactivity
disorder (ADHD), autistic spectrum disorders and cerebral palsy.
Physical disabilities: If a child has a physical disability, they will have problems moving around and will have less
independence than other children, which will make it difficult to carry out everyday activities. Children with
physical disabilities often use devices or mobility aids such as:
• crutches;
• canes;
• wheelchairs;
• walkers or relaters; and
• artificial limbs.
A child could have a physical disability because they have been in an accident, or it could be caused by a medical
condition.
Learning problems: Learning problems may affect a child’s reading, writing, spelling and memory.
It may be difficult to spot whether a child has a learning problem. If a child finds it difficult to understand things
or carry out tasks, they may feel worried and stressed, and so will start showing difficult behaviour.
Problems with emotion and behaviour: A child who has problems with their emotions and behaviour may
struggle with social relationships and self-esteem, and may be disruptive. These problems may be caused by the
stress of other problems in their life. A child may also have a behaviour problem which is linked to a particular
disability they have, and this may cause them to behave in a certain way.
Final thought Some children may have a co-ordinated support plan and have already been diagnosed with a
particular disability. If the child that you are supporting has been diagnosed with a disability, you can get more
information and some hints and tips on how to include that child better into your service on the enclosed CD.
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ASN factsheets (with hints & tips)
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ADHD Factsheet
What is it?
Attention Deficit Hyperactivity Disorder (ADHD) is a disorder in which a child’s behaviour is largely
characterised by inattention hyperactivity and impulsivity. It is thought that ADHD affects approximately 5% of
the general population, and that about 50% of children who are diagnosed with the disorder will continue to
exhibit these behaviours as adults. ADHD is also about three times more common in males than females.
Attention deficit hyperactivity disorder (ADHD) is the most common childhood-onset behavioural disorder.
ADHD is also called attention deficit disorder (ADD) or hyperactivity. The disorder shouldn’t be confused with
normal, boisterous childhood behaviour.
What are the causes?
The exact cause is not fully known, but research indicates that it may be due, in part, to inherited imbalance
neurotransmitters (chemicals that transmit nerve signals in the brain). One of the main problems of ADHD
seems to be that the brain fails to filter the huge amount of stimulation we receive every minute of every day.
What are the characteristics?
Those with ADHD find it more difficult to:
• Stay focused and ignore distractions e.g.:
»» Become easily bored during activities;
• Have difficulty following instructions;
»» Shift from one incomplete activity to another.
• Control what they do or say (because they are impulsive) e.g.:
»» Have difficulty making decisions (and appropriate ones);
»» Are inattentive to details;
»» Are disorganised and/or forgetful;
»» Have difficulty playing quietly;
»» Non-stop talking.
• Control their movements e.g.:
»» Find it difficult to sit still, and are more restless;
»» Are fidgety;
»» Find it difficult to wait their turn, which often leads to interrupting others;
»» May become aggressive and sometimes display violent/uncontrollable moods and behaviour;
»» Often run, instead of walk;
»» May show defiance / disobedience.
• Maintain an adequate diet and get the right nutrition e.g.:
»» May have a poor appetite;
»» Are thirsty.
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»» Physical / health symptoms may include:
»» Flushed face, red ears;
»» White spots on nails;
»» Family history of migraine;
»» Allergies;
»» Colic/sickness on feeds;
»» Eczema;
»» Asthma;
»» May be small for their age;
»» May become hot and sweaty.
• Other common symptoms include:
»» Being unable to think about the consequences of their actions;
»» Engaging in physically dangerous activities without considering the consequences.
Hints and Tips:
• Knowledge of the child: gather as much information about the child as possible e.g. speak to parents, teachers
or anyone else that works with the child (with the parent’s permission). Use the information well e.g. how do
others focus the child’s attention – are there simple ideas you could easily replicate?
• Structure: provide some sort of structure as free choice can lead to anxiety e.g. use symbols on a visual chart
as a way of informing the child what activities they can do and when. A visual timer can inform the child how
long they will be participating in a particular activity for.
• Rules/instructions: these should be consistent i.e. follow through anything that is said. Children with ADHD
may forget rules and instructions almost as soon as they have been given and so they should be given in simple,
precise, concrete language. Check with the child that they understand what you’ve said. Don’t overload them
with information – give instructions one at a time allowing sufficient time for the information to be processed.
Memory aids will also help children to remember instructions e.g. when giving the child instructions to get
ready to go on an outing, show them pictures e.g. jacket, then shoes, then bag, etc.
• Games: when playing games try to limit the number of children in the group, where possible, and if appropriate.
This will help the child to be more focussed on the activity / game, and could keep the child calm, certainly
more so than when in larger groups. Try to avoid competitive games – or encourage games that are only mildly
competitive.
• Communication is key: the child with ADHD is often fidgety. Allow them to carry around ‘fidgety’ toys, such as
a ‘Fuzzy Tangle’. It can be used to keep their hands or fingers ‘busy’, and will often reduce stress. You may find
that talking to the child will be easier while their hands are fidgeting with an object. The Fuzzy Tangle opposite
is coated in a soft fuzzy surface and fits in the palm of the hand. It can be twisted, turned and rolled up.
• Quiet time/space: the child with ADHD could appear very boisterous or impulsive and it’s important for staff
and other children not to invade physical and personal space. A quiet corner is a good way to relax and calm
down after stressful situations, or if activities at your service are getting a bit overwhelming for the child and
therefore providing too much excitement.
• Be positive: give the child plenty of positive comments and don’t just communicate negatives to the child.
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Reinforce positive behaviour whenever possible and soon after any good behaviour. The more you do this,
the more it will be reinforced. If rewards for good behaviour are no longer effective, then find new ways of
rewarding the child.
• Consistency: ensure all staff are working to the same rules and strategies, and that all share any problems or
concerns.
Contact details for more information:
* ADDISS (National Attention Deficit Disorder Information and Support Service)
Address: P O Box 340, Edgware, Middlesex, HA8 9HL
Telephone: 020 8952 2800
Website: www.addiss.co.uk
ADDISS is a charity providing people-friendly information and resources about ADHD.
* Hyperactive Children’s Support Group
Address: 71 Whyke Lane, Chichester PO19 7PD
Tel: 01243 539966
Website: http://www.hacsg.org.uk
The Hyperactive Children’s Support Group has been successfully helping ADHD/Hyperactive Children and
their families for over 30 years. The group supports the belief that using drugs should be a last resort, and
that a dietary and nutritional approach should be top priority.
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Asperger’s Syndrome Factsheet
What is it?
Autistic Spectrum Disorders, or an ASD, includes Autism and Asperger’s Syndrome. Asperger’s Syndrome is a
lifelong disability that affects how someone communicates, how they relate to others and how they make sense
of the world. There are three main areas of difficulty, often referred to as the ‘triad of impairments’, which are
difficulty with social communication, difficulty with social interaction, and difficulty with social imagination.
There are similarities with Autism, however people with Asperger’s Syndrome have fewer problems with
speaking, and are often of average, or above average, intelligence. Unlike Autism, they tend not to have the
accompanying learning disabilities, but could have specific learning difficulties, such as dyslexia and dyspraxia,
or other conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Epilepsy. There are also
associations with motor difficulties, and mental ill health in older children and teenagers.
There are around 1 in 100 people in the UK with an ASD, from all nationalities and backgrounds. Asperger’s
Syndrome appears to be more common in boys than girls.
The exact cause is not known but research indicates that genetic and environmental factors together are
important, and may account for changes in brain development.
Similar to Autism, each person will display a mixture of characteristics, but the effect of each varies significantly
from person to person.
• Difficulty with social communication:
»» They may be recognised as being immature in their ability to understand non-verbal communications
such as tone of voice, gestures, facial expressions and emotions.
»» They may have a limited ability to have a reciprocal conversation e.g. difficulty knowing when to start/
end a conversation.
»» Poor grasp of verbal communications. e.g. difficulty using or understanding jokes, and literal meanings
of words such as ‘You’re pulling my leg’, means that someone is joking with you, but to the person with
autism it sounds like you are accusing them of physically tugging your leg.
»» They may use complex words and phrases without knowing their meaning.
• Difficulty with social interaction:
»» There may be difficulties in making and maintaining relationships/ friendships and they may not be sure
how to go about doing this. This could make them very anxious.
»» They may have difficulty understanding unwritten ‘social rules’ or behave in an inappropriate manner
e.g. they may stand too close to another person, or they may always tell the truth when it’s not always
appropriate.
»» They may appear distant or uninterested in other people and may become socially withdrawn.
»» They often prefer playing with e.g. mechanical objects which are predictable, and less likely to play with
other people who often seem unpredictable and confusing.
»» They can become extremely anxious if routines are changed (e.g. if the timetable for the day changes, or
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the taxi runs late) or if they cannot solve a problem.
• Difficulty with social imagination:
»» They may have difficulty understanding and guessing others’ thoughts, feelings and actions and they may
have difficulty predicting what will happen next.
»» They may have limited imaginative play and often prefer to act out the same thing repetitively e.g.
organising things related to their interest.
»» They may struggle with pretend games, and often prefer games with logic and rules in place.
»» In social play they may be socially naïve, intrusive, or dominating.
Additional characteristics:
•
Obsessive interests - many will develop an intense or obsessive interest. Interests could be lifelong, or it
could be replaced by another one. Some could be encouraged so that e.g. if there is a love of science then
the child may be able to work in a related area when they are older. Special interests could serve several
functions e.g. to overcome anxiety, to provide relaxation, to occupy time, or to help understand the physical
world.
•
Sensory sensitivities – there could be a lack of sensitivity or they could be overly sensitive, and it could occur
in any of the 5 senses (sound, touch, smell, taste and sight).
•
Lack of sensitivity could include being unable to feel pain or temperature extremes (e.g. a boiling heater), and
some may rock or spin to help with balance and posture or to help them deal with stress.
•
Being overly sensitive could include experiencing feelings of anxiety or pain to certain textures e.g. the child
might want the comfort of hugging, but may experience a fear of being engulfed and losing control. When
eating, if food is mixed together on the plate, the various tastes could cause a sensory overload in the child’s
mouth.
Hints and Tips:
•
Knowledge of the child: gather as much information about the child as possible e.g. speak to parents, teachers
or anyone else that works with the child (with the parent’s permission). Use the information well e.g. know
what the triggers are to challenging behaviour and how to deal with it.
•
Structure: provide some sort of structure as free choice can lead to anxiety. A visual timer can inform the
child how long they will be participating in a particular activity for. Give them plenty of notice when an
activity will finish.
•
Rules/instructions: these should be consistent i.e. follow through anything that is said. Rules/instructions
should be given in simple, precise, concrete language. Check with the child that they understand what you’ve
said.
•
Quiet time/space: do not expect the child to take part in all activities that involve play with other children.
Give them physical and personal space. A quiet corner can be a good way to relax and calm down after
stressful situations.
•
Be positive: give the child plenty of positive comments and don’t just communicate negatives to the child.
•
Interests: if the child has a special interest, try to use it as a way of engaging with others e.g. if the child likes
rubbish, have a recycling project; if they like shiny objects, incorporate this into a sensory area or use shiny
materials at the art table; if they like reading, encourage them to read stories to younger children.
•
Environment: be aware of the environment and avoid any sudden changes. Prepare the child fully in advance
85
of any changes to the setting or routine.
•
Consistency: ensure all staff are working to the same rules and strategies, and that all share any problems or
concerns.
•
Thinking ‘out of the box’: consider the things that might upset the child e.g. if the child doesn’t like the noise
of scraping chairs, have a carpet or cover the legs in felt. Talking through issues with the child could help to
reduce anxiety and increase tolerance.
* Autism Resource Centre (ARC)
Address: The Quadrangle, 59 Ruchill Street, Maryhill, Glasgow G20 9PX
Tel: 0141 201 6247
ARC offers a range of services to people with Autism, their families, and carers. The core services include
diagnosis, support, training and information.
* HOPE (for autism in North Lanarkshire)
Address: The HOPE Centre, 145 Chapel Street, Airdrie ML6 6LH
Tel: 01236 779 191
Website: www.hopeforautism.org.uk
HOPE for Autism is described as a ‘life-line’ by families affected by Autistic Spectrum Disorders (ASD) in
North Lanarkshire. They run a range of successful and fun activities for children and young people over 6
days a week.
* National Autistic Society
Address (Scottish office): Central Chambers, 1st Floor, 109 Hope Street, Glasgow G2 6LL
Tel: 0141 221 8090
Website: www.autism.org.uk
The National Autistic Society (NAS) champion the rights and interests of all people with autism and aim to
provide individuals with autism and their families with help, support and services that they can access. The
website has information about autism and Asperger’s Syndrome, the NAS and its services and activities.
* The Scottish Autism Service Network
Address: National Centre for Autism Studies, Room D002, David Stow Building, The University of Strathclyde,
76 Southbrae Drive, Glasgow G13 1PP
Tel: 0141 950 3072
Website: http://www.scottishautismnetwork.org.uk/index.html
The Scottish Autism Service Network is a hub for direction to provision for people affected by Autistic
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Spectrum Disorders and for sharing good practice, information and resources with local professionals,
groups and services across Scotland.
* The Scottish Society for Autism
Address: Hilton House, Alloa Business Park, Whins Road, Alloa FK10 3SA
Tel: 01259 720 044
Website: www.autism-in-scotland.org.uk/index.php
The Scottish Society for Autism has 40 years experience of working with people with autism. They offer
specialised training to families and professionals, and provide a range of support for people with autism.
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Autism Factsheet
What is it?
Autistic Spectrum Disorders, or an ASD, includes Autism and Asperger’s Syndrome. Autism is a lifelong
developmental disorder that affects individuals in a variety of different ways. There are three main areas of
difficulty, often referred to as the ‘triad of impairments’, which are difficulty with social communication, difficulty
with social interaction, and difficulty with social imagination.
Many people with autism also have a learning disability, but individuals will have varying ‘degrees’ of learning
disability. Other conditions that are sometimes associated with autism include Attention Deficit Hyperactivity
Disorder (ADHD), Dyslexia and Dyspraxia. Also, around 28% of children on the spectrum also have epilepsy.
Even children who are not already diagnosed with epilepsy may begin having seizures as they reach puberty (see
factsheet on [Epilepsy] for more information).
ASD affects around 1 in 100 people in the UK, from all nationalities and backgrounds. Boys are four times more
likely to have autism than girls.
The exact cause is not known but research indicates that genetic and environmental factors together are
important, and may account for changes in brain development.
Each person will display characteristics from the three main areas of difficulty, but the effect of each varies
significantly for each person.
• Difficulty with social communication:
»» Poor grasp of non-verbal communications e.g. difficulty using or understanding tone of voice, body
language or facial expressions.
»» Poor grasp of verbal communications.
»» e.g. difficulty using or understanding jokes, and literal meanings of words such as ‘You’re pulling my leg’,
means that someone is joking with you, but to the person with autism it sounds like you are accusing
them of physically tugging your leg.
»» Speech may be limited, and so sign language or visual aids and symbols may be a more effective way of
communication.
»» There could be problems with repetition of words, but this doesn’t mean that they have poor language
skills or a lack of understanding. They might just need a bit more time to process information.
• Difficulty with social interaction:
»» They may have a lack of social skills or display inappropriate behaviour e.g. they may stand too close to
another person, or they may always tell the truth when it’s not always appropriate.
»» They may appear distant or uninterested in what’s going on around them and would prefer to be in their
own company than with others.
»» They may have difficulty understanding emotions and could appear insensitive to others’ feelings.
»» There may be difficulties in making and maintaining relationships/ friendships and they may not be sure
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how to go about doing this.
• Difficulty with social imagination:
»» Play is often solitary and repetitive. Some children may enjoy imaginative play but they prefer to act out the
same thing each time, and may not like another child trying to change things.
»» They may not understand the concept of danger and could run out onto busy roads.
»» They may have a love of routines and would not cope well in new or unfamiliar settings, or if something
in a setting is changed. It is important to warn the child in advance and prepare them fully for any
changes they are likely to experience. This will help all of you to cope with the changes.
Additional characteristics:
•
Obsessive interests - many will have an obsessive interest or an intense knowledge of a particular subject.
This could be anything, such as trains, music, collecting shiny objects or even watching the credits on films.
Some could be encouraged so that e.g. if there is a love of science then the child may be able to work in a
related area when they are older.
•
Sensory sensitivities – there could be a lack of sensitivity or they could be overly sensitive, and it could occur
in any of the 5 senses (sound, touch, smell, taste and sight).
•
Lack of sensitivity (hyposensitive) could include being unable to feel pain or temperature extremes (e.g. a
boiling heater), and some may rock or flap their hands to stimulate sensation.
•
Being overly sensitive (hypersensitive) could include experiencing feelings of anxiety or pain to certain
textures, or to background noises that others can block out (e.g. phone ringing, clicking of a pen top). They
could feel nauseous if overly sensitive to smells such as perfume.
•
Sensory processes can also include:
»» Vestibular (sense of balance from the inner ear) in which there could be the appearance of rocking or
spinning, or hyperactivity in order to stimulate the child’s senses; or being wobbly on their feet if they are
hypersensitive.
»» Proprioceptive (sense of body in space) in which the child may display a liking for leaning against the wall,
touching walls/doors/ceilings etc; or walking on tiptoes; or deep pressure on the skin (some incidences
of self-harm may be due to this – see section on [Self-harm] for more information).
Hints and Tips:
•
Knowledge of the child: gather as much information about the child as possible e.g. speak to parents,
teachers or anyone else that works with the child (with the parent’s permission). Use the information well
e.g. know what the triggers are to challenging behaviour and how to deal with it.
•
Structure: provide some sort of structure as free choice can lead to anxiety e.g. use symbols on a visual chart
long they will be participating in a particular activity for. Give them plenty of notice when an activity will
finish.
•
Choices: don’t overload the child with too many choices – keep them to a minimum in case the child
struggles with an overload of information. Also, when offering choices, make sure that you rotate the final
choice i.e. ask the child twice which they would prefer e.g. orange or apple, then apple or orange. If you do
not rotate the choices like this then the child might not be giving you their actual choice but will instead
echo you (also known as pali lalia, which means the child will simply repeat your words). If you find that the
child continues to repeatedly ask for the final choice, then introduce picture choices.
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•
said. Don’t overload them with information – give instructions one at a time allowing sufficient time for the
information to be processed. Also, give the child time to respond to instructions or questions – they may
need a bit longer to absorb and process the information/instructions.
•
Communication is key: do not assume verbal language has been understood – always use photos,
symbols and drawings to complement verbal language where possible. Ensure familiarity with the child’s
communication methods.
•
Word use: think about the words that you use and what they mean to the child. For example. some children
don’t respond well to the word ‘no’. The child may associate it with being unable to do something that
they really want to do. However, other children might not like the actual word or how it sounds, and so it’s
important to think of a substitute word or show them a picture/symbol instead.
•
stressful situations. Children on the spectrum often have a sensory need for pressure. Something like a
weighted wrap or cushion, or ‘lap pad’, would be a useful item to have available. There are many different
designs available so you can choose one that will be more appealing for a particular child. The child could
have it draped over their shoulders, or sitting on their lap. The child who uses the weighted cushion, will
often display increased attention, and decreased hyperactivity.
•
•
Interests: if the child has a special interest, try to use it as a way of engaging with others e.g. if the child likes
rubbish, have a recycling project; if they like shiny objects, incorporate this into a sensory area or use shiny
materials at the art table; if they like animals, have a play theme, e.g. at the zoo, on the farm, where all the
children can play together. Also, using the child’s special interest works well for reward charts instead of
simply disciplining the child for any bad behaviour, e.g. if the child likes Thomas the Tank, then reward them
with a Thomas sticker rather than using a disciplining technique such as the naughty step. Consequences to
actions can be confusing to the child due to ‘central coherence deficits’, and so the child will find it difficult
to understand the purpose of discipline, therefore a reward system will be more effective.
•
Environment: be aware of the environment and avoid any sudden changes. Prepare the child fully in advance
of any changes to the setting or routine.
•
concerns.
Tel: 0141 201 6247
* HOPE (for autism in North Lanarkshire)
Tel: 01236 779 191
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Website: www.hopeforautism.org.uk
days a week.
Tel: 0141 221 8090
Website: www.autism.org.uk
The National Autistic Society (NAS) champion the rights and interests of all people with autism and aim to
provide individuals with autism and their families with help, support and services that they can access. The
website has information about autism and Asperger’s Syndrome, the NAS and its services and activities.
Address: National Centre for Autism Studies, Room D002, David Stow Building, The University of Strathclyde,
76 Southbrae Drive, Glasgow G13 1PP
Tel: 0141 950 3072
Website: http://www.scottishautismnetwork.org.uk/index.html
Tel: 01259 720 044
Website: www.autism-in-scotland.org.uk/index.php
The Scottish Society for Autism has 40 years experience of working with people with autism. They offer
specialised training to families and professionals, and provide a range of support for people with autism.
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Brain Injury Factsheet
The Brain Injury factsheet is divided into 2 areas: Head Injury and Acquired Brain Injury.
Head Injury
What is it?
A head injury is any accident or trauma that affects the head or face. Children are particularly prone to having
minor head injuries as they have high energy levels and little sense of danger. These are usually a minor bump or
knock to the head which do not require emergency medical attention. However, there are some cases where
urgent medical attention is important.
When is urgent medical attention required?
If a child has any of the following symptoms following a head injury it is important to seek urgent medical
attention:
•
Any loss of consciousness,
•
Any signs of neck or spinal injuries,
•
Appearing dazed or groggy,
•
Seizure or blackout,
•
Any changes to hearing, sight or speech,
•
Straw coloured fluid leaking from the child’s nose or ears - this could be a sign of a skull fracture requiring
urgent medical attention,
•
Nausea or vomiting ,
•
Loss of memory,
•
Some of these symptoms may take time to develop so it is good practice to observe the child closely for a
period of time following any head injuries.
Head Injuries can be caused by road traffic accidents, falls, sports injuries or assaults.
What can I do?
If it is a minor injury, advise the parent(s) to observe the child for any changes to behaviour or symptoms during
a 24-hour period.
Urgent medical advice should be taken if the child loses consciousness, becomes drowsy, confused, vomits
persistently, has seizures, has fluid coming from the ears or nose, or seems unwell.
Note: not all head injuries will cause injury to the brain.
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Acquired Brain Injury (ABI)
What is it?
An ABI is any injury to the brain following birth. Brain Cells (neurons) are unable to repair themselves unlike skin
and bone, therefore effects from an ABI can be lifelong. The brain is responsible for everything that the body
does, how you think and how you feel. It controls speech, feelings, behaviour, memory, movement, sight, hearing
and other senses. If a child’s brain gets injured it is referred to as an acquired brain injury or ABI.
Brain Injuries are sometimes classed into either traumatic injuries or non-traumatic injuries.
• Traumatic brain injuries happen as the result of physical forces or interventions including:
»» Road traffic accidents,
»» Assaults,
»» Falls,
»» Poisoning,
»» Surgery and treatment to remove brain tumours.
• Non-Traumatic injuries can happen as the result of illnesses or medical problems including:
»» Meningitis,
»» Encephalitis,
»» Stroke,
»» Brain tumours.
What are the effects?
In adults, the great improvements after a brain injury generally occur within the first two years, but for children
it is very different. It can take months and quite possibly years for the injury to become obvious for two reasons.
Firstly, it is only when the injured part of the brain develops that the extent of a brain injury can be known.
Secondly, the teenage years are when most young people begin to fine-tune skills such as independence and the
ability to plan their life. For young people with an acquired brain injury difficulties in these areas can become
much more obvious during this time. Acquired brain injury affects every individual differently – no two cases are
the same.
What we can tell you, however, is that children may experience difficulties in the following areas
after a brain injury:
• Physical:
»» Tiredness and fatigue,
»» Doing things at a slower pace.
• Thinking:
»» Taking longer to process information,
»» Difficulties concentrating,
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»» Difficulties focussing attention – being easily distracted,
»» Forgetfulness – particularly in relation to new information and recent events,
»» Following verbal instructions,
»» Organising and planning.
• Emotions:
»» Depression,
»» Anxiety,
»» Fearful,
»» Obsessive.
• Behaviours:
»» Acting on impulse – without thinking through the consequences,
»» Immaturity,
»» Aggression,
»» Sexually inappropriate behaviour.
These issues are usually linked and can affect a child with an acquired brain injury in their daily life and have an
impact on a child’s education. It is really important that everyone who works with a child with an acquired brain
injury understands the effects and recognises that the issues are linked and can develop, or lessen over time.
Hints and Tips:
•
Knowledge of the injury: Effects from an acquired brain injury can be subtle and can develop gradually over
time therefore it is good to keep an open mind and find out as much information as possible about the
injury. It can be helpful to speak to medical professionals (with the parents’ permission) about the injury and
likely effects. In particular neuropsychology reports can provide lots of valuable information about the effects
of the child’s injury.
•
Accessible enivronments: Ensuring that environments are well laid out and organised, if necessary with labels
on cupboards and boxes and limiting the amount of visual information and pictures on walls. Provide extra
time to navigate around environments and get to different classrooms. If children find it difficult to remember
routes to and from different areas providing a buddy can help.
•
Repetition and instructions: Repetition of information can help with memory difficulties and written
reminders and notes to take home can be useful if the child has difficulty remembering auditory information.
Likewise providing one clear instruction at a time will be beneficial rather than several instructions all
together.
•
Diaries etc: Diaries, notebooks, text reminders and watches can be useful items for aiding memory.
•
Rest periods: Remember that a child with an ABI is likely to experience a lot of fatigue and may benefit from
shorter sessions, regular breaks and time for quiet activities.
•
And finally: Following an ABI, families can experience grief at the loss of the person they once knew. Children
with an ABI may find it difficult and frustrating to find that they cannot do some of the things that they could
do before their accident. ABI can bring several family changes and is likely to have financial implications for
families. Providing a listening ear and acknowledging that families may grieve for the child they once knew can
help the situation. Grief may include feelings of anger, guilt, regret, denial and sadness.
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* Child Brain Injury Trust
Address: 21 Saughtonhall Drive, Edinburgh, EH12 5TW
Tel: 0131 337 9523
Web: www.cbituk.org
* Headway
Address: 190 Bagnall Road, Old Basford, Nottingham, Nottinghamshire, NG6 8SF
Tel: 0115 924 0800
Web: www.headway.org.uk
* The British Institution for Brain-Injured Children (BIBIC)
Address: Knowle Hall, Bridgewater, Somerset TA7 8PJ
Tel: 01278 684060
Web: www.bibic.org.uk
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Cerebral Palsy Factsheet
What is it?
Cerebral palsy (CP) is a general term used to describe a disorder affecting body movement and muscle
coordination.
The symptoms of cerebral palsy vary from child to child. No two people with CP will be affected in the same
way, as some may have mild effects but for others they can be severe or profound.
The type of CP a person has depends on which area of the brain is affected. There are four types of CP and
these are Spastic cerebral palsy (spasticity), Athetoid cerebral palsy (athetosis), Ataxic/hypertonic cerebral palsy
(ataxia), Dystonic cerebral palsy (Dystonia).
Cerebral palsy is caused by damage to the part of the brain which controls movement and posture, and this
normally occurs before, during, or soon after birth. Other causes include:
•
Brain not forming properly, for no apparent reason,
•
Lack of oxygen before, during or after birth,
•
A genetic disorder which can be inherited,
•
Infection in mother during first few weeks of baby’s development in womb,
•
Other infection e.g. meningitis contracted after birth,
•
An accident, such as car crash, causing head injury.
Cerebral Palsy (CP) may not be noticed immediately after birth. Children with CP are slow to meet
developmental motor milestones, in other words slower than average in acquiring certain mobility skills. Typical
effects can include:
•
Tightness or stiffness and weakness in some muscles,
•
Degrees of difficulty in moving the body, which can be mild or severe,
•
Difficulty performing coordinated actions, such as reaching and grabbing,
•
Shortening of some muscles,
•
Limited movement of joints, or uncontrolled and involuntary movements,
•
Seizures,
•
Muscle contractions,
•
Difficulty sucking or feeding,
•
Irregular breathing,
•
Delayed development of motor skills, such as: sitting, rolling, crawling, walking;
•
Speech problems such as slurring and drooling,
•
Visual problems,
•
Hearing problems,
•
Spasticity,
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Spastic Cerebral Palsy (spasticity): associated with a difficulty to relax the muscles.
Athetoid Cerebral Palsy (athetosis): affects the areas of the brain which allow coordinated and smooth
movements. Athetosis involves an inability to control the movement of muscles.
Ataxic/hypertonic cerebral palsy (ataxia): affects coordination of movement and usually affects all four
limbs and the trunk. In addition, ataxic cerebral palsy is characterised by poor or low muscle tone, also known as
hypotonic and the child could appear unsteady and shaky, and have poor balance.
Dystonic cerebral palsy (Dystonia): the person may experience rapid changes in body tension or tone.
This means that when someone intends to change their position then their muscles become very tense or very
floppy.
Sometimes it may be difficult to know what kind of cerebral palsy a person has, as it can be a mixture of the
above four, if more than one of the movement systems is impaired.
Hints and Tips:
•
teachers or anyone else that works with the child (with the parent’s permission). Use the information well
e.g. know what the triggers are to challenging behaviour and how to deal with it.
•
long they will be participating in a particular activity for. •
information to be processed.
•
•
Eye sight: some children with CP could have a visual impairment and so it is important to find out to what
degree they are affected and put strategies in place to make participating in games and activities easier (see
factsheet on [Visual Impairments] for some useful tips). The most common visual impairment is a squint.
Children may have visual field defects which means that they may have difficulty making sense of what they
see. They may have difficulty focusing or recognising objects.
•
•
•
Environment: children may be unable to see the world or certain objects in 3D, and instead they will appear
2D. Ask parents and the child how their spatial perception is affected and ask them for suggested supportive
strategies. It might be that the child can’t cross roads without help because they are unable to judge
distances and speed of cars.
•
Snack time: chewing and swallowing can sometimes be difficult. If so, support from a speech and language
therapist would be very useful. They can give you pointers on what food should be avoided.
•
concerns.
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•
Do not make assumptions: many people make instant assumptions that someone with a physical impairment
must also have a learning disability. This is often not the case, and you should stress to your staff team that
assumptions should never be made about a child’s learning ability and level of understanding based on how
physically affected they are by the condition.
* Capability Scotland
Address: Head Office, Westerlea, 11 Ellersly Road, Edinburgh EH12 6HY
Tel: 0131 337 9876 (Voice), 0131 346 2529 (Text)
Website: www.capability-scotland.org.uk
Capability Scotland’s mission is to transform people’s expectations of what is possible and ensure that
disabled people achieve equality. It provides a range of services for children and adults with many types of
disability, including those with complex needs and learning difficulties and children and adults with cerebral
palsy. The website offers details of adult and children’s services, news and campaigns, advice and information.
Capability Scotland has an advice service (ASCS) which provides free confidential advice and information
on a range of disability issues including advice on cerebral palsy. Anyone interested in disability issues can
use ASCS. ASCS has a small lending library which includes resources about cerebral palsy and resources for
children about disability. Anyone can borrow these. The library catalogue can be viewed on the main website.
Contact ASCS at the Head Office address or on 0131 313 5510 or via email.
* Scope Response
Address: PO Box 833, Milton Keynes MK12 5NY
Tel: 0808 800 33 33
Website: www.scope.org.uk/response
Scope and Dial UK have merged to provide an expanded national advice and information network providing
free, impartial and expert information, advice and support to disabled people and their families.
* The Scottish Centre for Children with Motor Impairments
Address: The Craighalbert Centre, 1 Craighalbert Way, Cumbernauld G68 0LS
Tel: 01236 456100
Website: www.craighalbert.org.uk
The Scottish Centre for Children with Motor Impairments is one of Scotland’s Grant Aided Special Schools
that provides day school education for nursery, pre-school and school age children with motor impairments.
The centre is family focussed and allows children to achieve their full potential, develop independence and
life skills.
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Down’s Syndrome Factsheet
What is it?
Down Syndrome is a genetic disorder known as trisomy, where a person inherits an extra copy of one
chromosome. People with the Syndrome have three copies of chromosome 21 rather than two. This additional
genetic material can alter the physical and intellectual features of the child, typical features associated with Down
Syndrome.
Many of these distinct physical characteristics and varying degrees of cognitive dysfunction can range from mild
to severe. Cognitive disabilities occur when a person has difficulty thinking, processing, and storing information
in order to solve problems.
It’s not known why this abnormality occurs, but it affects around one in 1,000 babies born in the UK - about 750
babies a year - and is the most common cause of learning disability.
Down Syndrome is considered a genetic disorder and most cases are not inherited. Instead, the disorder is
usually caused by a spontaneous mutation, or error, during the development of the egg, sperm, or embryo.
There is no cure for Down’s Syndrome, but there are many things that can be done to make sure that those
with Down’s Syndrome reach their full potential and lead independent, enjoyable and fulfilling lives. People with
Down’s Syndrome live active, satisfying lives well into middle age and beyond.
The severity and specific type of symptoms vary significantly among people. People are generally born with
distinct physical characteristics, as well as mental disabilities that range from mild to severe. These are:
• Physical Characteristics:
»» Small head,
»» Short neck,
»» Deep crease in the palm of hand,
»» Poor muscle tone, loose ligaments,
»» Small hands and feet.
• Facial Features
»» Flat face with an upwards slant to the eye,
»» Protruding tongue,
»» Small and low set ears,
»» Irregular shaped mouth,
»» Narrow and high palate,
»» White spots on the iris of the eye,
»» Irregular or crooked teeth.
Children with Down Syndrome also have some degree of intellectual impairment which range from mild to
severe:
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•
Congenital heart disease,
•
Hearing Problems, such as glue ear which affects 60-70% of children,
•
Intestinal problems, such as blocked small bowel or oesophagus (a tube that allows passage of food to the
stomach),
•
Celiac disease,
•
Eye problems, such as cataracts,
•
Thyroid problems,
•
Skeletal problems,
•
Dementia, similar to Alzheimer’s.
Hints and Tips:
•
or anyone else that works with the child (with the parent’s permission). Don’t be afraid to ask parents for
tips and strategies in order to provide the best possible care for the child, and to ensure the child is able to
play with peers in your service.
•
Help the child to understand: a child with Down’s Syndrome may display challenging behaviour e.g. hitting or
kicking. However, the child may not understand that doing this hurts other children and adults. The child needs
to be told that this kind of behaviour is unacceptable. Suitable ways of doing this are explaining it by way of a
story book.You could make one up yourself with a combination of words and pictures e.g. explain that hitting
and kicking is sore to other people and that it makes other people feel sad. Then consider encouraging the
child, and other children to draw pictures about what makes people sad and what makes people happy.
•
Be aware of triggers of challenging behaviour: the child with Down’s Syndrome may not be able to talk
very well, or they may struggle to understand things, such as emotions and feelings. If this is the case then
frustration may be shown by the child displaying challenging behaviour. Try to encourage the child to use
other ways of communicating if speech is difficult. If they struggle to understand emotions, then it may be
helpful speaking to the child’s parents or school teacher to see how they address these issues.
•
Structure: structure is important, particularly if the child has associated learning or intellectual disabilities. To
help consider using symbols on a visual chart as a way of informing the child what activities they can do and
when. A visual timer can inform the child how long they will be participating in a particular activity for.
•
•
•
•
Promoting positive behaviour: give the child plenty of positive comments and don’t just communicate
negatives to the child. Promoting positive behaviour will help the child to understand that they have done
something good.
•
concerns.
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* Down’s Syndrome Association
Address: Langdon Down Centre, 2a Langdon Park, Teddington TW11 9PS
Tel: 0845 230 0372
Website: www.downs-Syndrome.org.uk
The Down’s Syndrome Association aims to help people with Down’s Syndrome to live full and rewarding
lives. They provide advice and information, and run training courses throughout the UK for members,
professionals and carers.
* Down’s Syndrome Scotland
Address: 158/160 Balgreen Road, Edinburgh EH11 3AU
Tel: 0131 313 4225
Website: www.dsscotland.org.uk
Down’s Syndrome Scotland works to improve the quality of life for everyone with Down’s Syndrome in
Scotland. The site provides information, support and advice on publications, information, news, and events.
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Dyslexia Factsheet
What is it?
Dyslexia is a specific learning difficulty that mainly affects reading and written work, including spelling. It is
characterised by difficulties in processing word-sounds and by weaknesses in short-term and working memory.
The effects of dyslexia may be seen in spoken language as well as written language.
Dyslexia appears to affect more boys than girls but research is not conclusive. It is not related to intelligence,
race or social background. Dyslexia varies in severity and often occurs alongside other specific learning
difficulties, such as Dyspraxia or Attention Deficit Disorder. There can be considerable variation between the
degree and nature of individuals’ strengths and weaknesses.
Evidence indicates that difficulties may be due to problems in the left hemisphere of the brain which deal with
language processing. In turn, genetic differences seem to be linked, and dyslexia tends to run in families.
The way in which dyslexia affects people differs from individual to individual, as do the reasons for the specific
difficulties experienced.
Dyslexia is not related to intelligence, race or social background. It may occur alongside specific learning
difficulties e.g. Dypraxia, which also emphasises the fact that there are variations in strengths and weaknesses,
and that each individual differs from another.
The characteristics of dyslexia can differ from person to person, and each person with dyslexia will have a unique
pattern of strengths and weaknesses.
• Characteristics of dyslexia in young children
»» a delay, or difficulty, in developing clear speech,
»» mixing up certain words and phrases - for example, saying ‘by mall’ instead of ‘my ball’;,
»» being unusually clumsy and uncoordinated if there is accompanying Developmental Coordination
Disorder or Dyspraxia,
»» a difficulty in being able to appreciate rhymes, for example, they cannot understand the connection
between the words ‘hat’ and ‘cat’,
»» having persistent problems with dressing, or tying their shoe laces which will be more pronounced if
Developmental Coordination Disorder is also present.
• Characteristics of dyslexia in children aged between 5-7 years of age
»» difficulty in learning the alphabet,
»» Inability to read. Some young children with dyslexia appear to learn very well (using a look and say
approach), but when memory overload takes over, reading skills break down. Not having grasped phonics,
the youngsters will start to struggle, and even the words they knew seem to get lost,
»» having problems writing, in terms of letter formation,
»» difficulty telling left from right,
»» problems remembering simple sequences, such as the days of the week,
»» low attention span and problems concentrating.
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• Characteristics in children aged between 7-12 years of age
»» poor progress at school compared to their classmates,
»» becoming frustrated, which can either lead to behavioural problems, or to them becoming quiet and
withdrawn,
»» problems following instructions, remembering more than one thing at a time, with reading, spelling and
written work, multiplication tables, number bonds, etc. There may not be difficulties spelling when sitting
a spelling test, however, spelling difficulties may appear when the child tries to write a creative essay
(therefore it is not just a simple spelling exercise but involves more complex thinking).
Hints and Tips:
•
Dyslexia is life-long, but its effects can be minimised by targeted literacy intervention, technological support
and adaptations to ways of working and learning.
•
teachers or anyone else that works with the child (with the parents’ permission).
•
Computer use: allow children to use computers, etc in your service, make necessary adaptations to the
equipment. E.g. use keyboard stickers that make it easier to identify the letters, text to speech technology as
well as speech to text.
•
information to be processed. To try to ensure assimilation of instructions, get the child to repeat them before
attempting to start on them. If giving written instructions then consider the font types and size of letters.
Larger words are easier to see and read than smaller ones, and some fonts are easier to read than others
e.g. ‘arial‘ is often the favoured font, although sometimes ‘courier’ is preferred as it has equally spaced letters.
Therefore the length of the word reflects the number of letters in it. This means that the child can more
easily decide when a word ends and another one starts e.g. ‘courier’ and/or versus ‘Helvetica narrow’ and/or.
Also, having words in double spacing can be easier to read than single spacing.
•
Communication is key: do not assume verbal language has been understood – always use photos, symbols
and drawings to complement verbal language where possible. Engaging with the child is vital. It’s a two-way
process to ensure understanding.
•
Multi-tasking: multi-tasking i.e. doing more than two things at once, can be difficult. Therefore it is important
that you don’t ask the child to do too many things at once. As with rules/instructions, keep things simple –
offering games, activities, rules and instructions one at a time so as not to confuse the child.
•
•
Be positive: give the child lots of praise, emphasise the positive comments and don’t dwell on the negatives.
•
Consistency: ensure all staff are working to the same rules and strategies, and that everyone share any
problems or concerns.
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* Dyslexia Action Scotland (Glasgow centre)
Address: Napiershall Street Centre, 39 Napiershall Street, Glasgow G20 6EZ
Tel: 0141 334 4549
Website: www.dyslexiaaction.org.uk
Dyslexia Action is a national charity and the UK’s leading provider of services and support for people with
dyslexia and literacy difficulties. They specialise in assessment, teaching and training and they develop and
distribute teaching materials and undertake research.
* Dyslexia Scotland
Address: Stirling Business Centre, Wellgreen, Stirling FK8 2DZ
Tel: 01786 44 66 50
Website: www.dyslexiascotland.org.uk
Dyslexia Scotland is the voluntary organisation representing the interests of dyslexic people in Scotland.
It offers a range of high quality services and aims to influence positive national change. Its services include
the Dyslexia Helpline (0844 800 84 84); Tutor List; Training and Awareness raising (conferences, seminars,
workshops and training events); Supporting projects and research; Advice and Information (website, leaflets,
guides and resources); an Adult Network; local activities and support provided by a network of volunteer-led
branches across Scotland. Contact your local branch in North Lanarkshire on 01236 77 98 91.
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Dyspraxia Factsheet
What is it?
Dyspraxia is a neurological condition that impairs the organisation of movement. Many assume the child is just
‘clumsy’. All areas of development could potentially be affected, but problems are typically associated with
thought, perception and language.
Dyspraxia can be difficult for all those involved, especially for the child, but with help and support, the difficulties
can be reduced effectively.
The cause of dyspraxia is not known, although research suggests that it’s due to an immaturity of neuron
development in the brain rather than any actual brain damage.
• Birth – 3 yrs old:
»» Babies can be irritable from birth and may exhibit significant feeding problems,
»» Many children with dyspraxia fail to go through the crawling stages, preferring to ‘bottom shuffle’ and
then walk,
»» They may be slow to achieve expected developmental milestones, e.g. they still may not sit
independently, roll over, sit, stand, walk or speak when expected.
• 3-5 yrs old:
»» The child may not be able to run, hop, jump, or catch or kick a ball although their peers can do so,
»» They may have difficulty maintaining friendships; or judging how to behave in company,
»» They may have little understanding of concepts such as ‘in’, ‘on’, ‘in front of’ etc.
»» They may have difficulty in walking up and down stairs,
»» Problems dressing,
»» Be slow and hesitant in many actions,
»» Appear not to be able to learn anything instinctively and must be taught skills,
»» May fall over frequently and bumps into objects,
»» May have difficulty with jigsaws or shape sorting games,
»» May be immature in artwork abilities,
»» Are often anxious and easily distracted.
• 5+ yrs (school age):
»» Are likely to have all the difficulties experienced by the pre-school, with little or no improvement,
»» May have very high levels of motor activity, including feet swinging and tapping when seated, handclapping or twisting, and may be unable to stay still,
»» May have high levels of excitability, with a loud/shrill voice,
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»» Have a tendency to become easily distressed and emotional, and prone to temper tantrums,
»» Often avoid physical games,
»» May struggle in group situations,
»» Find it difficult to remember and /or follow instructions, especially when given more than two at a time,
»» Are often poorly organised,
»» There is often a lack of any sense of danger (jumping from heights etc),
»» Are often messy eaters and frequently spill drinks, and they may prefer to eat with their fingers,
»» May be sensitive to sensory stimulation, including high levels of noise, tactile defensiveness, wearing new
clothes,
»» May have limited concentration and poor listening skills,
»» May struggle to form and retain relationships with other children,
»» Many report physical symptoms, such as migraine, headaches, and feeling sick.
Hints and Tips:
•
Although dyspraxia cannot be completely cured, there are ways of coping with it and ensuring children
achieve their full potential. Once a child has been diagnosed, they can work with a team of different
specialists, such as occupational therapists, speech and language therapists, specialist teachers and
psychologists, and together they’ll help with ways of dealing with the condition.
•
teachers or anyone else that works with the child (with the parent’s permission).
•
•
•
Quiet time/space: all children would benefit from a quiet space – even to play in. the child could read stories
or have others read to them.You could also make the quiet area more appealing by playing various games:
»» ‘quiet mouse’ game: one child is the ‘quiet mouse’ and they have to look for a new ‘quiet mouse’. The
rest of the children need to be as quiet and still as they can to be in line for being the next ‘quiet mouse’.
The mouse points to the child he/she thinks is the quietist and the next mouse repeats the action.
Children often really enjoy this game, and it helps to relax them. The game can be as short or as long as
you need, providing the children remain interested.
»» ‘If you can hear me’ game: similar to ‘Simon Says’, except that you whisper to the children, ‘If you can
hear me, touch your nose….pat your head….etc’ The children need to be quiet in order to hear.
•
Incentives are useful e.g. provide personal charts and stars/stickers to use as visible awards.
•
Art table: the child with dyspraxia will find it easier to draw or write if their work is on a sloping surface, and
dycem (or a similar type of non-slip mat) is good to keep their artwork on the table i.e. so that it doesn’t slip
off. Use appropriate pens, crayons, etc. For example, triangular-shaped or animal-shaped crayons are easier to
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grip than typical crayons. Felt-tip pens are easier to use as they require less hand pressure than crayons or
pencils.
•
Physical activities: the child may try to avoid physical activities because of fear of failure. Keep any instructions
clear and simple, and repeat them frequently in case the child forgets. Simple adaptations that could be made:
»» For bat and ball activities, provide various equipment e.g. lightweight, large-headed bats, large foam balls.
»» For target games or skittles, provide bean bags instead of or as well as balls – the larger the target the
easier the game will be.
»» To avoid fear of failure, non-competitive activities / games will be better – these will also help the child
to work/play at their own level.
•
Environment: the dyspraxic child could be easily distracted. Think about where the child would be best
placed for certain games or activities e.g. encourage them to sit with their back to a window or a door so
distractions in the background aren’t a problem for the child.
•
concerns.
•
Games: think about ways that you can adapt games, or just make games more fun:
»» Dressing-up games can help the child practice their everyday coping skills – using large or oversized
dressing-up clothes will make it more fun to play with instead of typical everyday clothes that they are
often rushing around trying to put on properly.
»» Feely bags are also useful as they are fun items to touch and feel, and they encourage the child to use
hand coordination.
»» Games such as ‘Heads, shoulders, knees and toes’, and ‘Incy Wincy Spider’ will help with body awareness,
copying abilities, and speed of movement.
* Dyspraxia Foundation
Address: 8 West Alley, Hitchin, Herts SG5 1EG
Tel: 01462 454 986
Website: http://www.dyspraxiafoundation.org.uk
* Local Group:
Edindyspraxia is a local group whose aim is to help support children and their parents. They hold regular
meetings every 6 weeks where parents can exchange information and tips with each other. Invited speakers
are also scheduled to come and talk about Dyspraxia issues.
Tel: 0131 667 0175
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English as an Additional Language Factsheet
There are many families in the UK who use English as an additional language. This includes children and parents.
It can be difficult for the children to communicate with their peers and childcare staff if they have a poor grasp of
the English Language. Similarly, childcare staff may find it more difficult to communicate with the child’s parents if
they also use English as an additional language.
The following are hints and tips that may make it easier on everyone at your childcare service.
Hints and Tips:
•
Make your service welcoming: think about the welcome signs and pictures you display to welcome children
and parents into your setting. Can all children and parents understand these? Welcome signs, signs for toilets,
signs for exits, etc would all be more beneficial if they were in appropriate languages e.g. Polish, Urdu, etc, as
well as English. Visual signs that have pictures or symbols will also make this easier to understand.
•
Knowledge of the child: gather as much information as possible from anyone else that works with the child
(with the parent’s permission). For example, link up with the school. How do the teachers or staff at the
school communicate effectively with the child and the parents? How do they ensure that the child is mixing
with the other children?
•
Communicate effectively with the parents: offer alternate language forms e.g. change the language of the
registration forms, policies and procedures, and anything else you send to parents. Parents need to know
the rules and responsibilities so that they educate their child on these. If you communicate effectively to the
parents in the first instance then this could help avoid any misunderstandings or embarrassment to them,
their children and you, later on.
•
Respect different cultures and religions: many families who use English as an additional language will come
from a different cultural background and / or have different religious beliefs. Families may adhere to strict
cultural practices and it is important that you, your staff, and other children respect these. Again, it is
important to ask parents about their culture or religion and ask them what you can do to ensure their child
is included in your service whilst respecting their beliefs. E.g. there may be requirements at snack time, a child
may be required to cover-up when playing sports, girls may not be allowed to have any skin contact with
boys, etc.
•
Choices: try to offer choices in picture format, where possible. If speech can only be used, then try to limit
the number of choices you offer the child if they struggle with the English language. Otherwise, this could
lead to frustration and embarrassment. As the child’s understanding improves, then you can increase the
number of choices.
•
Rules/instructions: rules/instructions should be given in simple, precise, concrete language. Check with the
child that they understand what you’ve said. Don’t overload them with information – give instructions one at
a time allowing sufficient time for the information to be processed. Also, give the child time to respond to
instructions or questions – they may need a bit longer to absorb and process the information/instructions.
•
Communication is key: do not assume verbal language has been understood – try to use photos, symbols and
drawings with English words written on them (and other languages) to complement verbal language where
possible. This will help the child to get a better grasp of English. Using such picture aids with all children, will
help them gain a better understanding of other languages. Speak clearly and repeat important words – and
always talk naturally. Accompany all speech with non-verbal communications such as hand gestures, nodding/
shaking head, facial expressions, etc.
•
Be aware of other children: Be aware of how other children are responding to the child and stop or prevent
bullying. Educate the other children about different cultures. Children will benefit from learning about other
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countries, and other cultures, but it is important not to single one child out. Instead of having a session on
the child’s particular language, have several sessions to educate the children on several cultures.
•
Word use: think about the words that you use and what they mean to the child. Try to avoid literal
interpretations of language that will confuse the child e.g. ‘It’s raining cats and dogs’
•
Encourage socialisation among all children: Socialising with other children and playing games with others may
be difficult. However, this should be encouraged. It will help children learn about different cultures and obtain
a better understanding and acceptance of such differences. Try to encourage team games, and even use a
buddy system in the initial stages to try to encourage children to mix with one another.
•
Think of novel activities: e.g. an art activity: all the children make posters representing words, phrases,
pictures of objects, etc that they frequently use in the service. Or the children make up posters of different
categories e.g. games, food, drink, outdoor play, animals, etc. Write them in various languages as appropriate.
This will help all the children to mix together, and again help to understand each others’ cultures. Displaying
these on the wall will provide a good visual aid or reminder to children. It will also help to make the service
feel more welcoming.
•
Are there any other issues? For example, as well as a language barrier, the child may or may not have another
additional support need, such as trauma from a previous life, or other hidden impairments. As with all
families, it is important to talk to parents and children and let them know that they can talk to you at any
time they wish.
* Multilingual Family in the UK
Website: www.multilingualfamily.co.uk
The website is primarily for information for parents – it advises of support groups that parents can access.
There are also a number of links for various languages. These links list various websites, resource sites and
other organizations that can help with that specific language.
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Epilepsy Factsheet
What is it?
Epilepsy is a tendency to have recurrent seizures (sometimes called fits) that originate in the brain. An epileptic
seizure is caused by a sudden burst of excess electrical activity in the brain, causing a temporary disruption in the
normal message passing between brain cells. This disruption results in the brain’s messages becoming halted or
mixed up.
The brain is responsible for all the functions in the human body, therefore the seizure experienced depends
on the location of epileptic activity in the brain; how widely the brain is affected; and how rapidly it spreads.
There are more than 40 different types of seizures ranging from brief absent moments, to episodes of losing
consciousness, falling to the floor and jerking.
Epileptic seizures may occur at any age from birth onwards. Around one in 200 school-age children has epilepsy
and around 10 per cent are severely affected. Epilepsy may be due to:
•
brain damage caused by a difficult birth
•
a severe blow to the head
•
a stroke which starves the brain of oxygen
•
an infection of the brain such as meningitis
•
a brain tumour
•
genetic conditions
Epilepsy with a known cause is called ‘symptomatic’ epilepsy. For 6 out of 10 people there is no known cause and
this is called ‘idiopathic’ epilepsy.
The main symptoms of epilepsy are repeated seizures.
The different types of seizures are:
• Partial seizures: where only a small part of the brain is affected. There are two types of partial seizure:
»» Simple – this is a seizure where person remains conscious. Some possible symptoms of simple partial
seizures are:
-- experiencing changes in the way things look, smell, feel, taste or sound,
-- experiencing an intense feeling of déjà vu (a feeling that these events have happened before),
-- experiencing a sudden intense emotion, such as fear or joy,
-- the muscles in arms, legs and face may become stiff,
-- experiencing twitching on one side of the body.
»» Complex – this is a seizure where a person’s consciousness is affected, experiencing a loss of sense of
awareness and no memory of the event. The symptoms of complex partial seizures are characterised by
strange and random body behaviour such as:
-- smacking of lips,
-- rubbing of hands,
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-- making random noises,
-- moving arms around,
-- chewing or swallowin.
During a partial seizures, the child will not be able to respond to anyone else, and they will have no
memory of the event.
•
Generalised seizures: where most of the brain is affected. There are six main types of these seizures:
»» Absences - this type of seizure mainly affects children. They cause the child to lose awareness of their
surroundings for about 5 to 20 seconds. The child will appear to stare vacantly into space, although some
children will flutter their eyes or smack their lips. They can occur several times a day. Though they are
not dangerous, they may affect the child’s performance at school, and play.
»» Myoclonic jerks - these types of seizures cause arms, legs or the upper body to jerk or twitch - much
like if you have received an electric shock. They often only last for a fraction of a second.
»» Clonic seizure - this causes the same twitching as myclonic jerks, except that the symptoms will last
longer, often up to two minutes. Loss of consciousness may occur.
»» Atonic seizure - this causes all of the muscles to suddenly relax, so the child often falls to the ground
face first and can injure themselves. This type of seizure is also known as a ‘drop attack’.
»» Tonic seizure - unlike an atonic seizure, this causes all of the muscles to suddenly become stiff. The child
loses balance and may fall backwards and hit their head.
»» Tonic-clonic seizure - this type of seizure has four stages:
-- Stage 1: Aura (warning). Not everyone will have this.
-- Stage 2: Tonic. The body will become stiff. There will be a loss of consciousness and the person will
fall to the ground. They will not be breathing normally.
-- Stage 3: Clonic. The body begins to jerk.
-- Stage 4: Recovery. Jerking stops, breathing returns to normal, the child may be confused and
disoriented. They may have wet themselves during the seizure. They may be very tired and their
muscles might hurt. It is important to check if they need first aid.
-- Stages 2 and 3 of the seizure normally last between one and three minutes. If they last more than five
minutes or are longer than the child’s normal seizure you should call an ambulance.
-- Tonic Clonic seizures are the most common type of seizure, accounting for 60% of all seizures
experienced by people living with epilepsy.
-- People can experience any of the above types of seizure, but usually the pattern of somebody’s
symptoms remains the same. This pattern is known as an ‘epilepsy Syndrome’.
Hints and Tips:
•
teachers or anyone else that works with the child (with the parent’s permission). Use the information well,
e.g. find out what type of seizure the child experiences and how long they usually last for, find out how they
are affected, and find out the characteristics that you should watch out for.
•
Warning signs: it is not possible to prevent a seizure from occurring, but you can act on the warning signs
you can see that a seizure is on the way, e.g. get the child to a safe place or getting them to lie down if they
usually fall.
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•
Triggers: it is rare that seizures are triggered by flashing lights or bright lights. This kind of epilepsy is called
photosensitive epilepsy and only 5% of people with epilepsy have it. There are several triggers that are much
more common: skipping medication; lack of sleep; feeling ill or too hot; stress/boredom; missing meals and
dehydration. Again, it is important to be aware of any triggers, and to keep a diary of when epileptic seizures
occurred and what the child was doing beforehand, or the environment that they were exposed to, in case
there are particular triggers. If you know that the child has photosensitive epilepsy and could be affected by
flashing or bright lights, then do not allow children to play with toys that have this facility – use alternatives
instead. If flashing or strobe lights suddenly come on, get the child to cover one eye with one hand and this
may stop a seizure from occurring. There is some evidence that wearing polarised sunglasses can help if a
child’s seizures are triggered by reflections of the sun on water or dappled light from trees. Talking to the
child’s parents will give you a better idea of how to tackle such issues.
•
Be prepared: try to make sure that the person is in a safe place. Do not move the child unless they are in
danger i.e. on a road. Move objects away from them if you can, try to remove glasses to prevent the child
from hurting themselves, and never put anything in the child’s mouth. Try to put a pillow, cushion, or jacket
under the child’s head to make it safer and more comfortable for them.
•
Comfort the child: after an epileptic seizure the child may feel confused, disoriented, and upset. Talk to the
child in a calm voice and reassure them to make them feel better. They may also have been incontinent
during the seizure so try to maintain their dignity and help them discreetly.
•
Consistency: ensure all staff follow the same procedures when working with the child. The child is likely to
respond better if they are used to the same procedure.
* Epilepsy Scotland
Address: Head Office, 48 Govan Road, Glasgow G51 1JL
Tel: 0141 427 4911
Helpline: 0808 800 2200
Helpline text: 07786 209 501
Website: www.epilepsyscotland.org.uk
Epilepsy Scotland provides a confidential helpline (0808 800 2200) email and text information service to
anyone affected by epilepsy. They also train people in managing epilepsy and run information and awareness
events. They have a guide for teachers and one for parents and are currently developing resources for
children. The website has information specifically for people who have been diagnosed with epilepsy, and
there is a section on seizures for people who want to find out more about them. There are also leaflets and
publications on issues relating to epilepsy, such as first aid, safety, driving, first aid and employment, which can
be downloaded or posted to you free of charge.
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Hearing Impairments Factsheet
What is it?
Hearing impairments are described as deafness or hearing loss.
The ear consists of three parts: the outer ear, the middle ear and the inner ear. The outer ear is made up of the
visible part of the ear on the side of the head, the ear canals that go into the head and the eardrum. The eardrum
is a thin layer of tissue that separates the outer ear from the middle ear.
There are different types of hearing impairments:
1. Either the person has acquired their hearing loss. This person has not been born with a hearing loss, and so
their first language is English and they may or may not wish to learn other communication strategies, such as
sign language or lipreading.
2. Or, the person is born to the deaf community. In some cases, their first language is sign language e.g. BSL
(British Sign Language) but many children born deaf either use hearing aids or cochlear implants, and
many are educated in mainstream education. People whose first language is BSL may find written English
challenging.
What is the difference between hearing aids and cochlear implants?
• Hearing aids:
»» allow the child to hear as much as possible with the hearing that they have,
»» are worn on the child’s body (behind or in the ear),
»» increase the volume of all sounds and have a microphone to receive sounds.
• Cochlear implants:
»» provide a sensation of hearing and are used when children are unable to hear from or benefit from the
use of hearing aids,
»» come in 2 parts – one part is worn like a hearing aid and the second part is surgically implanted,
»» operate by electrodes (implanted) which stimulate the hearing nerves to provide a sensation of hearing,
»» For more information on cochlear implants in children, see the National Deaf Children’s Society (NDCS)
contact details at the end of this fact sheet.
Hearing impairments are divided into conductive hearing loss and sensorineural hearing loss.
• Conductive hearing loss is caused when something interferes with the transmission of sound from the outer
ear to the inner ear. Depending on its cause, conductive hearing loss can either be temporary or permanent.
• Sensorineural hearing loss is caused when there is a problem with your inner ear, or the pathway from the
inner ear to your brain. Sensorineural hearing loss is irreversible and cannot be cured.
Definitions of deafness, according to the RNID are as follows:
• Mild deafness: the quietest sounds heard between 25 and 39 decibels. Understanding speech in noisy areas
may be difficult.
• Moderate deafness: the quietest sounds heard are between 40 and 69 decibels. Understanding speech without
using a hearing aid may be difficult.
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• Severe deafness: the quietest sounds heard are between 70 and 94 decibels. People with severe deafness tend
to rely on lip-reading or sign language, and this may be the case even though they may have a hearing aid.
• Profound deafness: the quietest sounds heard are 95 decibels or more. Some people may rely on lip-reading,
but the many use BSL (British Sign Language) as their first or preferred language.
Note: some deaf people use lip reading as a form of understanding verbal speech, however many do not.
People are either born deaf or they experience hearing loss in childhood or adulthood. People who are born
able to hear but who become severely or profoundly deaf after learning to speak are sometimes described as
deafened.
• Causes of conductive hearing loss include:
»» middle ear infections,
»» build up of fluid in the middle ear (glue ear),
»» blockage of the ear canal by earwax,
»» injury to the eardrum,
»» otosclerosis (a disorder of the middle ear),
»» rheumatoid arthritis.
• Causes of sensorineural hearing loss include:
»» injury to the hair cells from loud noise,
»» viral infections of the inner ear, such as mumps or measles,
»» viral infections of the auditory nerve, such as mumps or rubella,
»» acoustic neuroma (a non-cancerous growth near the auditory nerve),
»» meningitis,
»» encephalitis,
»» multiple sclerosis,
»» brain tumour,
»» stroke.
In many cases, hearing impairment has both a conductive and a sensorineural cause. Prolonged and repeated
exposure to loud noise – including loud music – can damage your hearing.
The characteristics of a hearing impairment vary depending on the cause. Some of the possible characteristics
may include:
»» hearing loss on one or both sides,
»» partial hearing loss,
»» poor balance,
»» lack of coordination,
»» seizures,
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»» vertigo,
»» visual problems,
»» earache,
»» discharge from the ear,
»» pain,
»» dizziness,
»» whistling sounds in the ears,
»» loss of balance or co-ordination.
»» children can become withdrawn, lack confidence or be frustrated.
Hints and Tips:
or anyone else that works with the child (with the parent’s permission). Don’t be afraid to ask what kind of
support the child requires in terms of hearing impairment adjustments. There may be simple things you can easily
do in your service.
Communication is key:
• When talking to the child, make sure that you talk to them at their level – this is particularly important if the
child is also a wheelchair user.
»» It is also important to talk to the child face-to-face. Some children lip-read and to do this successfully,
face-to-face communication is vital. If a child lip-reads then you should talk at a normal pace and try not
to emphasise words. Also, lip-reading will be easier for the child if you talk your usual way – speaking
unnaturally will distort your lip patterns. Use plain language and don’t waffle.
»» Consider the lighting of the room – make sure it’s well lit, and don’t have your back to a window as this
creates shadows. Shadows would make it more difficult for the child to read facial expressions or to lip
read.
»» Don’t rely on verbal communication, use gestures and facial expressions as well. If the child uses sign
language (either Makaton or BSL) then try to learn it yourself, even just a few signs. Try to encourage
other children to use the signs as well – children often enjoy and find it easy to learn simple signs.
• Background noise: try to keep background noise to a minimum, where possible. High ceilings and tiled areas
can distort sounds, so while it’s probably not practical for your service to lower the ceilings, try to ensure
that floors are carpeted, curtains are used, and/or soft furnishings are on offer. All of these will help to
absorb sound, and so can help to minimise the effects of noise, therefore helping the child to focus on more
meaningful sounds.
* British Deaf Association Scotland
Address: 1st Floor, Central Chambers, Suite 58, 93 Hope Street, Glasgow G2 6LD
Telephone: 0141 248 5554
Fax: 0141 248 5565
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Website: www.bda.org.uk
The Scottish Deaf Association represents the interests of Britain’s deaf people who use British Sign Language.
It aims to protect and advance the interests of deaf people.
* Hearing Concern LINK Scotland
Address: The Eric Liddell Centre, 15 Morningside Road, Edinburgh EH10 4DP
Telephone/Textphone: 0131 447 9420
Website: www.hearingconcernlink.org
Hearing Concern LINK provide support and information to people with a hearing loss and their families.
* NDCS (National Deaf Children’s Society) Scotland
Address: 2nd Floor, Empire House, 131 West Nile Street, Glasgow G1 2RX
Telephone: 0141 354 7850
Textphone: 0141 332 6133
Website: www.ndcs.org.uk
Freephone helpline:
Telephone/Minicom: 0808 800 8880
The National Deaf Children’s Society is the national charity dedicated to creating a world without barriers
for deaf children and young people. NDCS is an organization of families, parents and carers, providing
emotional and practical support through their freephone helpline, a network of trained support workers, and
a wide range of other support services as well as publications and their website.
NDCS offers free publications to parents of children with deafness and professionals working with deaf
children. Particularly useful ones to childcare providers working with deaf children include: ‘Understanding
Deafness’; ‘Hearing Aids’; and ‘Cochlear Implants’. See their website for more information and how to register.
* RNID Scotland
Address: Empire House, 131 West Nile Street, Glasgow G1 2RX
Telephone: 0141 341 5330
Textphone: 0141 341 5347
Website: www.rnid.org.uk
Information Line for general information:
Telephone: 0808 808 0123 (freephone)
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Textphone: 0808 808 9000 (freephone)
There are 840, 000 people who are deaf or hard of hearing in Scotland.
RNID Scotland is the charity working to create a world where deafness and hearing loss do not limit or
determine opportunity and where people value their hearing. We aim to achieve this by campaigning and
lobbying, with the help of our members and our volunteers, raising awareness of deafness and hearing loss,
providing services and through social, medical and technical research.
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Learning Disabilities Factsheet
What is it?
There are a number of different types of learning disability, most of which either develop before or during
birth, or due to a serious illness in early childhood. There is no clear and widely accepted definition of learning
disabilities, however what is clear is that the disability significantly impacts a person’s life and the disability will
remain throughout their lifetime.
There are 1.5 million people with a learning disability in the UK (Mencap figures). The severity of the learning
disability differs between individuals. Some people are only mildly affected, so that others may not really notice
any differences. Some people are severely or profoundly affected, and / or they may have more than one disability
(e.g. sensory or physical impairment, complex health needs, mental health difficulties, challenging behaviour). This
is known as ‘profound and multiple learning disabilities’ (PMLD).
Those with a learning difficulty have difficulties with learning, understanding and communicating, coping
independently and adapting to new situations, and the support required will also vary between individuals. Those
with PMLD will need full-time support in every aspect of their lives, from learning and communicating, to aspects
that those without learning disabilities perform without much thought e.g. eating, washing, and dressing. While
communicating is difficult for those with learning disabilities, those with PMLD will particularly struggle with this
aspect.
Social exclusion is often a problem for people with a learning disability and many face challenges due to the
negative attitudes and prejudices from others around them. 8 out of 10 children with a learning disability are
bullied.
Some people with a learning disability may also have other associated conditions or disabilities e.g. Cerebral Palsy,
Epilepsy, Autism, or Asperger’s Syndrome (see corresponding fact sheets for more information), none of which
are a result of the child’s upbringing.
Note: a learning disability is NOT the same as a mental illness. Anyone can develop a mental illness, and many
mental illnesses can be cured or controlled. However, a learning disability begins before adulthood and will
remain with the individual. It will not be ‘cured’.
According to figures from a Scottish Executive report, ‘The same as you?’ (May 2000):
• 20 people in every 1000 have a mild or moderate learning disability
• 3 to 4 people in every 1000 have a profound or multiple disability.
The full report can be found at the following website: http://www.scotland.gov.uk/ldsr/docs/tsay-00.asp and
updated figures for adults with learning disabilities in local authorities can be found at http://www.scotland.gov.
uk/Publications/2007/03/23090219/0
Learning disabilities are caused in various ways, and often the cause is unknown. Learning disabilities could be
caused by problems in the development of the baby’s brain either before birth (problems with the brain and the
spinal cord, if the mother has an accident or illness, or due to the baby developing certain genes); during birth
(lack of oxygen or born prematurely); or shortly after birth (early childhood illnesses).
Some people can inherit a learning disability due to parents passing certain genes onto the unborn child. Two of
the most common inherited learning disabilities are Fragile X Syndrome and Down’s Syndrome (see appropriate
fact sheets for more information).
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Children with learning disabilities exhibit a wide range of characteristics, and even more so if there is an
associated disability. Some characteristics that may be related to learning disabilities are:
•
Being overly excitable during group play,
•
difficulty discriminating size, shape, colour,
•
difficulty with time concepts,
•
distorted concept of body image,
•
general awkwardness,
•
poor visual-motor coordination,
•
hyperactivity,
•
poor organisational skills,
•
easily confused by instructions
•
disorganised thinking,
•
poor short-term or long-term memory,
•
impulsive behaviour,
•
low tolerance for frustration,
•
poor peer relationships,
•
inappropriate, unselective, and often excessive display of affection,
•
failure to see consequences for their actions,
•
overly gullible and easily led by peers,
•
poor adjustment to environmental changes,
•
overly distractible and difficulty concentrating,
•
difficulty making decisions.
However, these are only a handful of possible characteristics. Some people with a learning disability may not
exhibit any of these. Some people may have distinguishing facial features e.g. those with Down’s Syndrome,
however many will not have such obvious characteristics. Each individual is different and it’s important to
remember this when working with any child with a learning disability.
Hints and Tips:
•
Knowledge of the child: gather as much information about the child as possible e.g. speak to parents, the
child themselves, teachers or anyone else that works with the child (with the parent’s permission). Use the
information well e.g. know what the triggers are to problematic behaviour and how to deal with it.
•
Attitudes: ensure that all staff and children are welcoming and that the child isn’t subject to bullying.
•
long they will be participating in a particular activity for.
•
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information to be processed. If you’re giving written instructions, then ensure words are simplified, and to
use pictures where possible to make instructions more concrete. Also, provide instructions step-by-step, one
at a time. If possible, demonstrate actions to the child first.
•
communication methods. Always repeat what you say to make sure that the child understands.
•
•
Friendships: encourage all children to play together but don’t force friendships. If the child struggles to make
friends, then consider a buddy system so that the child is not always left on their own.
•
•
Books: books are a good way of interacting with the child, but the simpler the books are to read and
follow, then the easier and more enjoyable the book will be. Books on tape might be a better alternative –
incorporate this within the quiet area.
•
concerns.
•
Staff knowledge: training for staff will give staff more confidence and understanding to support children with
learning disabilities. This will help staff to give the children the same play opportunities as the other children.
* Enable Scotland
Address: 2nd Floor, 146 Argyle Street, Glasgow G2 8BL
Tel: 0141 226 4541
Website: www.enable.org.uk
Enable Scotland campaigns for a better life for children and adults with learning disabilities and supports
them and their families to live, work and take part in their communities. They run a growing range of flexible
person-centred services; and make sure that children and adults with learning disabilities and their carers are
at the heart of everything they do.
* Mencap
Address: 123 Golden Lane, London EC1Y 0RT
Tel: 020 7454 0454
Website: www.mencap.org.uk
Mencap is the voice of learning disability and everything they do is about valuing and supporting people
with a learning disability, and their families and carers. They provide high-quality, flexible services that allow
people to live as independently as possible in a place they choose; provide advice through their helplines and
websites; and campaign for the changes that people with a learning disability want.
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Physical Impairments Factsheet
What is it?
Physical impairment refers to reduced physical mobility or independence, which impacts on an individual’s ability
to perform everyday activities. Children with physical impairments often use devices or mobility aids such as
crutches, canes, wheelchairs, walkers/relaters, or artificial limbs to obtain mobility.
The nature and causes of physical impairments are varied. The main causes are:
•
Accidents which could result in:
»» spinal injury,
»» amputation,
»» acquired brain injury affecting motor skills and limb control.
• Medical conditions such as:
»» cerebral palsy,
»» Spina Bifida,
»» muscular dystrophy/atrophy,
»» multiple sclerosis,
»» nervous system diseases,
»» circulatory diseases,
»» respiratory diseases,
»» arthritis,
»» other muscular-skeletal disorders,
»» head injury/stroke,
»» inherited conditions passed on genetically,
»» exposure to drugs or chemicals during pregnancy.
•
Children with physical impairments may experience:
»» poor muscle control,
»» weakness and fatigue,
»» difficulty walking,
»» problems talking, seeing, speaking,
»» sensing and grasping (due to pain or weakness),
»» difficulty reaching things,
»» difficulty doing complex or multiple manipulations (push and turn),
»» difficulty with twisting motions.
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Some people with severe physical disabilities rely on equipment such as mobility aids and assistive technology.
Commonly used assistive technology includes mobility aids (e.g. crutches, wheelchairs), manipulation aids (e.g.
prosthetics, orthotics, reachers) communication aids (e.g. single switch-based artificial voices), and computer/
device interface aids (e.g. eye gaze-operated keyboards).
Hints and Tips:
•
or anyone else that works with the child (with the parent’s permission). Find out how best to support the
child in your setting. If the child uses a wheelchair, can they come out of their chair for certain situations e.g.
particular games, and do they need support in order to do this?
•
Assumptions: never make assumptions – just because the child uses a wheelchair or walking aid, does not
mean that they have a learning disability or that they aren’t intelligent. Get to know the child, and their
individual personality, and encourage other staff and children to do the same. Also never assume that
wheelchair users require assistance – ask the child if they need help before giving it.
•
Communication: when talking to the child in a wheelchair, ensure you talk to them face-to-face at their level.
If you always talk from above or behind them, it can make the child feel threatened, or even degraded.
•
Computer use: to allow children to use computers, etc in your service, make necessary adaptations to the
equipment; e.g. provide keyguards – these are rigid plates with holes that are positioned over the keys. They
make it impossible for the child to press more than one key at the same time. The child is therefore able
to lean on the keyboard without damaging it. Other options to make computer use easier is to provide a
trackball which is an upturned mouse. A normal mouse involves using your hand to hold the mouse in place
whilst pressing the button, and this can be a problem for children with physical impairments. However, the
trackball will remain stationary while the button is pressed.You can also purchase varying sizes of trackballs
so that the child can use fingers, palms, or even feet, to move the mouse around.
•
Environment: be aware of the environment and ensure that it’s free from clutter, that there are no upturned
carpets, and that there are no broken paving stones or potholes outside. Doing this will be of benefit to all
children.
•
Physical access: 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.
•
Offer positive comments and encouragement: if the child struggles to do something, don’t point this out direct their attention to what they are able to do, therefore increasing their self-esteem. Encouragement
can sometimes be more important than physically supporting someone. Give the child plenty of positive
comments and don’t just communicate negatives to the child. This is good practice for all children. If there
are tasks that the child struggles with, then encourage the staff team to consider why it might be a difficulty
for the child i.e. what barriers is the child facing. Encourage staff to consider how to overcome these barriers
in order to give the child the same opportunities as the other children.
•
Consider appropriate adaptations: ask yourself the following questions in order to make sure that children
can take part in games:
»» How can I ensure that the child can play themselves with minimum support from a playworker?
»» What materials or modifications to toys, games, etc is required?
»» Does the child require adaptive technology or equipment for any activities? If so, do parents have any
spare equipment?
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•
Game ideas: a wheelchair user may have fewer opportunities than non-wheelchair users to explore different
textures and to use their muscles. Where possible, give the child play opportunities to incorporate this e.g.
»» Provide access to water and sand play,
»» Play ‘feely’ games such as ‘guess what’s in the bag/box’ or ‘guess the contents’ (see [Game Ideas]),
»» Give the child opportunities to explore textures with their feet e.g. when painting or using play dough get them to make shapes/patterns with their toes instead of their fingers,
»» If the child wants to play with skittles, instead of using balls where they have to swing their arms, allow
them to toss bean bags instead,
»» When playing ball games e.g. catch and throw, it may be easier to use velcro equipment i.e. a board is
strapped to their hand and the child only needs to catch the ball (or other item) on the Velcro board.
* Ability Net
Address: PO Box 94, Warwick CV34 5WS
Tel: 0800 269 545
Website: www.abilitynet.org.uk
Ability Net is a registered national charity with over 20 years experience helping people adapt and adjust
their information and communications technology (ICT). The ‘Public Services’ section on the website
suggests various hardware and software e.g. computer adaptations that may be useful, perhaps for childcare
settings to allow children to access computers and computer games.
Tel: 0131 337 9876 (Voice), 0131 346 2529 (Text)
disabled people achieve equality. It provides a range of services for children and adults with many types of
disability, including those with complex needs and learning difficulties and children and adults with cerebral
palsy. The website offers details of adult and children’s services, news and campaigns, advice and information.
Capability Scotland has an advice service (ASCS) which provides free confidential advice and information
on a range of disability issues including advice on cerebral palsy. Anyone interested in disability issues can
use ASCS. ASCS has a small lending library which includes resources about cerebral palsy and children’s
resources about disability. Anyone can borrow these. The library catalogue can be viewed on the main
website. Contact ASCS at the Head Office address or on 0131 313 5510 or via email.
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PICA Factsheet
What is it?
Pica means that an individual eats inedible objects such as chalk, soil, paper, stones and faeces. The child may try
to eat one specific item, or a variety. While some objects may pass harmlessly through the body, Pica can be
potentially life threatening.
Pica is generally diagnosed in children over the age of 2. For children, Pica is only diagnosed when eating the
non-food substance is developmentally inappropriate.
It is not yet known what causes Pica, but research indicates that it may be related to mineral deficiencies such
as an iron deficiency. Certain conditions and situations can also increase an individual’s risk of developing Pica.
These are:
• learning disabilities,
• autism,
• nutritional deficiencies,
• pregnancy.
Individuals with a learning disability may display Pica behaviour. It is thought that the more severe the individual’s
learning disability the greater the chance that they will display Pica.
The individual may develop Pica for behavioural reasons:
• Social attention: the child may be receiving a lot of attention, even though it may be negative attention, which
therefore rewards those eating inedible objects.
• To obtain something favourable: the child may receive a favourite item after eating inedible items, which is
rewarding to them, or they may receive a rewarding journey, e.g. a ride in the ambulance.
• To escape from an activity or situation: the child may have learnt that to escape from an activity or situation, all
they need to do is to eat inedible items.
• For sensory stimulation: try to establish if there is a similarity in the objects being eaten, e.g. in texture, smell,
taste. The child may enjoy a particular texture, smell, taste and so continues to put it in their mouth for
stimulation.
• All of the above are reinforced when the child eats an inedible object, therefore encouraging the child to
repeat it again and again.
There are two signs of Pica:
1. Craving for non-food substances.
2. Eating non-food substances. e.g.
There are also some health risks associated with Pica stemming from ingesting foreign substances these are:
•
Intestinal blockage,
•
Vomiting,
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•
Constipation,
•
Choking,
•
Intestinal perforation or tear,
•
Dental surgery,
•
Poisoning/ parasitic infections.
Note: - If you are worried about an individual who has eaten an inedible object it is very important to contact
their GP or your nearest accident and emergency department for medical advice.
Hints and Tips:
•
Parents: The parents should get in touch with their GP who may refer the child to a clinical psychologist. The
assessment will be carried out by the psychologist, who will then identify a behavioural support plan.
•
Before you as the childcare provider receives guidance, you could consider:
•
Environment: Managing the environment so that inedible objects are out of reach, where possible.
•
Inaccessible inedible objects: Ensure that an adult keeps a close watch on the child to try to prevent the child
from attempting to eat inedible objects.
•
Diary: Keep a diary of when they try to eat inedible objects and what objects they try to eat.
•
Also, if the child engages in Pica because of the behavioural reasons above, then:
»» Social attention: ensure positive attention is given when the child is not engaging in Pica; and limit
negative attention – instead use speech to give instructions only, using a neutral voice tone.
»» To obtain something favourable: try to encourage playing with or asking to play with their favourite items
without engaging in Pica. A symbol or signing system may help.
»» To escape from an activity or situation: try to find out why the child wants to escape from the activity,
and ensure all staff know what signs to look out for to indicate that the child wants to move on to
something else.
»» Sensory stimulation: find out what kind of sensory feedback they enjoy and try to offer experiences of
the same sensory feedback without it being harmful.
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Speech & Language Impairments Factsheet
What is it?
Speech and language impairment (SLI) means a communication disorder, such as stuttering, impaired
pronunciation, language impairment, or a voice impairment that affects a child’s performance.
Speech and language disorders refer to problems in communication and related areas such as oral motor
function. These disorders range from confusion with simple sounds to the inability to understand or use language.
There may be no identifiable causes but sometimes the difficulties are unrelated to any other difficulty or
disorder - they are therefore said to be specific language difficulties. Some children, however, may have both a
specific language difficulty and other disabilities. Speech or language difficulties could be due to:
• Autism,
• Learning difficulties,
• Motor speech difficulties e.g. Dyspraxia,
• Cerebral palsy,
• Brain injuries,
• Viral diseases,
• Physical impairments such as cleft lip or palate.
Some children do not develop speech and language as expected. They may experience difficulties with any or all
aspects of speech and language - from moving the muscles which control speech, to the ability to understand or
use language at all. These difficulties can range from mild to severe (and long-term). Difficulties may include:
• Mild or moderate hearing impairment,
• Behavioural difficulties,
• Impaired self-esteem,
• Short memory span,
• Problems acquiring literacy skills i.e. reading and spelling,
• Writing difficulties,
• Emotional and social difficulties.
Hints and Tips:
• Knowledge of the child: gather as much information about the child as possible e.g. speak to parents, teachers
or anyone else that works with the child (with the parent’s permission).
• Structure: provide some sort of structure as free choice can lead to anxiety e.g. use symbols on a visual chart
long they will be participating in a particular activity for. Give them plenty of notice when an activity will finish.
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• Rules/instructions: these should be consistent i.e. follow through anything that is said. Rules/instructions
• Communication is key: make sure that you have the child’s attention before speaking to them, and make sure
that they are listening. Do not assume verbal language has been understood – always use photos, symbols and
drawings to complement verbal language where possible. Ensure familiarity with the child’s communication
methods. Speak to the child face-to-face so that they are able to read facial expressions as well as listening
to the words you say. Speak clearly and repeat important words – and always talk naturally. Pause between
questions, instructions, etc to give the child time to respond – do not finish sentences for them as this can be
very frustrating for the child.
• Quiet time/space: do not expect the child to take part in all activities that involve play with other children.
• Be positive: give the child plenty of positive comments and don’t just communicate negatives to the child.
• Environment: try to avoid distractions e.g. in games, try to keep group sizes small so that there are fewer
distractions.
• Consistency: ensure all staff are working to the same rules and strategies, and that all share any problems or
concerns.
* AFASIC Scotland: unlocking speech and language
Address: 1 Prospect 3, Gemini Crescent, Dundee DD2 1TY
Telephone: 01382 561 891
Website: www.afasicscotland.org.uk
Afasic is the UK charity representing children and young adults with communication impairments, working
for their inclusion in society and supporting their parents and carers. Afasic Scotland responds to the needs
of parents and young people in Scotland. It provides training and information for parents and professionals
working in children’s services.
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Visual Impairments Factsheet
What is it and what are the characteristics?
Visual Impairments describe people who are blind or partially sighted. If the person is visually impaired, they will
have some loss or distortion of vision.
If someone’s sight completely improves as a result of glasses or lenses then this person is not classed as visually
impaired. So, those who are visually impaired tend to be described as “blind” or “partially sighted”, however,
within both of these categories, there is a wide spectrum and people experience different levels of visual
functioning.
• Blind: a person who is blind has no sight at all. Another term to be aware of is those who have “light
perception”. People with light perception are not blind but have enough vision to identify a light source and
may even see shadows. Those who are “educationally blind” may have some low vision but primarily learn
through non-visual techniques.
• Partially sighted: a person who is partially sighted has a significant and permanent loss of sight but is not blind.
However, they are still able to function primarily by using visual means.
Cerebral Visual Impairment (CVI) is a condition where some of the special vision parts of the brain and its
connections are damaged. Children with CVI often have good visual acuity (clear, sharp vision), however they
have difficulty understanding or ‘making sense’ of what they see. As the child grows older the visual difficulties
may slowly improve, and once the damage is done it does not get worse.
Vision requires our eyes and brain to work well together, with our eyes sending visual information to our brain
to be processed.Visual impairments occur when there are problems of the eyes and nerves (Ocular Visual
Impairment), or in the processing of the information by nerve impulses (Cerebral Visual Impairment). Therefore
causes of visual impairments may be due to:
• injury or trauma to the eyes,
• abnormal blood vessel growth following premature birth and diabetes,
• genetic conditions.
Colour blindness, which is hereditary, is the reduced ability to perceive particular colours, often red and green.
Hints and Tips:
• Knowledge of the child: gather as much information about the child as possible, e.g. speak to parents, teachers
or anyone else that works with the child (with the parent’s permission). Don’t be afraid to ask what kind
of support the child requires in terms of visual impairment adjustments. There may be simple things you can
easily do in your service.
• Make simple adaptations beforehand: before the child comes to your service try to think of adaptations you
can make in advance. For example, ensure different rooms/ areas can be distinguished, e.g. provide different
flooring between areas – the quiet area might be carpeted and the snack area may have hard flooring. On
activity boxes, or the doors to rooms, have meaningful objects, e.g. a paintbrush stuck on the door of the art
room, or on the box of art material. Consider putting stickers on any glass doors – otherwise the child may
not identify it as being a door.
• Communication is key: when talking to the child, say the child’s name before speaking to them so that the child
knows that it is them that you are talking to or addressing. When talking to the child, make sure that you talk
to them face-to-face. The child with a visual impairment may still be able to see some things, e.g. objects or
outlines, so it is important that the child knows who they are communicating with. When speaking to the child,
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speak at a normal pace and don’t shout at the child. Shouting could make the child feel that you are angry with
them.
• Computer use: to allow children to use computers, etc. in your service, make necessary adaptations to the
equipment, e.g. use keyboard stickers that make it easier to identify the letters. Also have wording (on the
computer or on print-outs) in ‘Arial’ font as opposed to ‘Times New Roman’ font, as the latter has ‘serifs’ (tails
on the letters) which make it more difficult to read. Also consider changing the size of the mouse pointer
(arrow) on the screen – many computers allow you to change this without having to purchase specialist
software.
• Posters, signs, etc: Children will be able to see items clearer if there is a visual contrast, e.g. black writing/
images on a white or yellow background is easier to see than, e.g. blue writing on a green background. Avoid
using red and green colours where possible as distinguishing between these is a common difficulty. Also avoid
words that are fully in CAPITAL LETTERS as it is more difficult to distinguish the letters in such words.
• Be positive: give the child plenty of positive comments and don’t just communicate negatives to the child. For
example, at snack time the child may be messy because they are unable to see clearly. It is therefore important
that you encourage and don’t draw unnecessary attention to the child being messy, particularly when other
children are around.
• Environment:
»» Layout: when the child first enters your service, give them a guided tour of the service and make sure
they know exactly where games can be found or where physical games are played. Make sure the child
knows where the toilet, quiet area, no-go areas, etc. are. To help prepare them fully, allow the child to feel
different textures to get a better sense of the layout of your service.
»» Lighting: all areas should be well illuminated (using artificial and natural light where possible). Some
children may require low levels of light – check with the parents for advice. Shadows may confuse a
child, e.g. they may suggest a step or a hole in the ground or a different floor covering. Try not to have
extreme contrasts in light, e.g. going from a dull room to the bright sunlight – try to offer a compromise,
such as a dimmer switch so the artificial light can be turned up or down as appropriate.
»» Furniture: as with posters, colour contrast is important on furniture. Try to ensure that handles,
switches etc. contrast well to their background; and try to ensure that furniture contrasts with the main
surroundings to avoid any potential accidents/ hazards.
»» Stairs: these should also have contrast in colour by using marked edges to easily distinguish them.
•
Ball games: when playing ball games consider the type of balls the children play with – are they suitable for
a child with a visual impairment? Larger and brighter balls are easier to see, and balls that are textured (e.g.
with bumps) are easier for the child to catch. Also encourage children to kick or pass balls to each other
instead of throwing them.
* Action for Blind People
Address: 14-16 Verney Road, London SE16 3DZ
Tel: 0800 915 4666
Website: www.actionforblindpeople.org.uk
Action for Blind People is one of the largest charities in the UK providing free and confidential support for
blind and partially sighted people in all aspects of their lives.
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* Royal National Institute of Blind People (RNIB) Scotland
Address (Head Office): 12-14 Hillside Crescent, Edinburgh EH7 5EA
Tel: 0131 652 3140
Website: www.rnib.org.uk
RNIB Scotland is the leading charity working with blind and partially sighted people in Scotland. RNIB
Scotland delivers services to members who need support, and campaigns for their civil and welfare rights.
They support children and adults with sight loss to live full and independent lives. The Education and Family
Services Department promotes the interests of children and young people with sight problems and provides
information and advice to parents, and advice on local and national support networks.
* V.I.Scotland (Visual Impairment Scotland)
Address: Scottish Sensory Centre, The University of Edinburgh, Holyrood Road, Edinburgh EH8 8AQ
Tel: 0131 651 6078
Website: www.viscotland.org.uk
V.I.Scotland is an organisation to support children with visual impairment and their parents that live in
Scotland. They provide up-to-date information about services available and the website has a section on the
A-Z of Visually impairing conditions.
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Other ASN factsheets
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Albinism
What is Albinism?
People with Albinism are born with little or no pigment in their eyes, skin and hair, although in some cases the
reduced pigmentation only affects the eyes.
There are two main types of Albinism:
Oculocutaneous Albinism: involves the eyes, hair and skin.
Ocular Albinism: involves primarily the eyes, although some may have slightly lighter skin and hair compared with
other family members.
Albinism occurs because children have inherited genes that prevent the production of the enzyme that controls
the usual amounts of a pigment called Melanin. It is passed from parents to their children through genes. In the
majority of cases, both parents must carry an Albinism gene to have a child with Albinism.
What are the symptoms?
• sensitivity to light,
• very pale blue or blue/ grey eyes,
• eye problems, such as wandering eye (also called Nystagmus),
• poor vision (which usually cannot be fully corrected with glasses or contacts),
• functional blindness (in some cases),
• extremely pale or white skin,
• extreme sensitivity to sunburn,
• white or very blond hair.
In certain rare types of albinism such as Hermansky-Pudlak Syndrome, other symptoms include:
• bleeding disorders,
• lung disease,
• bowel disease,
• infections,
• hearing loss,
• nervous system disorders.
The common forms, Type 1 and 2 albinism are not associated with these more serious symptoms.
* Albinism Fellowship
Address: PO Box 77, Burnley, Lancashire, BB11 5GN
Tel: 01282 771 900
Email: [email protected] Website: www.albinism.org.uk
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Anaphylaxis
What is anaphylaxis?
Anaphylaxis (also known as anaphylactic shock) is a severe, potentially fatal allergic reaction. Anaphylaxis is the
body’s immune system reacting badly to a foreign object (e.g. food or a substance) that it wrongly perceives as a
threat. The whole body is affected, usually within minutes of contact with an allergen, but sometimes the reaction
can take place hours later.
Anaphylaxis can be triggered by a very wide range of foods and other agents. The most common include peanuts,
nuts, sesame seeds, fish, shellfish, dairy products and eggs. Anaphylaxis can also be caused by an allergic reaction
to wasp or bee stings, natural latex (rubber) and certain drugs, such as the antibiotic penicillin.
•
generalised flushing of the skin,
•
nettle rash on the body,
•
swelling of throat and mouth,
•
difficulty swallowing or speaking,
•
changes in heart rate,
•
severe Asthma,
•
abdominal pain, nausea and vomiting,
•
sudden feeling of weakness (drop in blood pressure),
•
the person collapses and becomes unconscious.
What is the treatment for a severe reaction?
Pre-loaded adrenaline injection kits should always be carried by an anaphylaxis sufferer. If they are unable to self
medicate, then, according to the Anaphylaxis Campaign (contact details below), anyone who has been suitably
trained can administer adrenaline injectors through an exemption on the Medicines Act (see questions 8 and 21
on the Resuscitation Council website: http://www.resus.org.uk/pages/faqAna.htm)
Adrenaline (also known as epinephrine) acts quickly to constrict blood vessels, relax smooth muscles in the lungs to
improve breathing, stimulate the heartbeat and help to stop swelling around the face and lips.
* The Anaphylaxis Campaign
Address: PO Box 275, Farnborough, Hampshire GU14 6SX
Tel: 01252 546 100
Website: www.anaphylaxis.org.uk
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Angelman Syndrome
What is Angelman Syndrome?
Angelman Syndrome is a rare condition in which children have learning difficulties and speech delay that are
usually severe. They also have jerking movements, tongue-thrusting, and epilepsy. Many children also have a
fascination for water, which is usually running water.
Angelman Syndrome is a chromosomal disorder caused by the absence of a gene. 75% of those with Angelman
Syndrome have a similar genetic fault to that found in another genetic condition, Prader-Willi Syndrome, but
occurring on chromosome 15 inherited from the mother rather than the father.
The condition is usually diagnosed between 4 and 10 years of age, but sometimes earlier.
• Delay in developmental goals in the first one or two years of life,
• Behavioural traits of a 2-3 yr old occur (e.g. a cheerful mood and burst of sudden and unexplained laughter),
• Facial appearance becomes noticeable with the development of a pointed chin, thin wide mouth and
protruding tongue (usually in the second year of life),
• Epileptic seizures often start at 18 months to 2 yrs of age. Types of seizures include jerks, atonic or static and
stiffening seizures,
• Walking is late to develop and usually between the ages of 2 and 5 but walking is often unsteady,
• Speech delay is very common and severe,
• There may be problems with understanding instructions and expressing their thoughts,
• Many children will communicate by facial expressions.
* ASSERT
Address: PO Box 4962, Nuneaton, CV11 9FD
Tel: 0300 999 01 02
Website: www.angelmanuk.org
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Anxiety Disorder
What is an Anxiety Disorder?
An anxiety disorder is a mental health problem that can affect people of all ages, including children. Anxiety
disorders are the most common type of mental health disorder in children which can be persistent and intense
and disrupt their daily routines. Anxiety is a sense of worry, apprehension, fear and distress.
There are many factors that contribute to the development of anxiety disorders in children. These may include
genetics, psychological factors and environmental factors.
When children are anxious, they may experience a range of physical symptoms. These happen because of the
bodies’ “fight or flight” response, which is caused by the release of the stress hormone adrenaline.
• Symptoms typically fall into two groups: physical symptoms and the emotional/psychological symptoms of
nervousness and fear. E.g.
»» raising of blood pressure and heart rate,
»» vomiting & diarrhoea,
»» stomach pains,
»» tingling or shaking,
»» weakness and shortness of breath,
»» dry mouth,
»» dizziness,
»» difficulty swallowing,
»» being irritable or quick to anger.
• Also affected are:
»» the child’s thinking and decision making ability,
»» their perception of the environment,
»» their learning and concentration.
* Mental Health Foundation
Address: Scotland Office, Merchants House, 30 George Square, Glasgow G2 1EG
Tel: 0141 572 0125
Website: www.mentalhealth.org.uk
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Asthma
What is Asthma?
Asthma is a long-term condition in which over-sensitive airways become narrow and inflamed, making it difficult
to breathe in and out normally. Asthma is one of a group of allergic conditions, including eczema and hayfever,
which often occur together.
The viewing and agreeing of Asthma is a detailed process, and so this fact sheet only just touches on Asthma,
in terms of the causes, symptoms, and ways in which you could help. Asthma UK offers a free resource
which describes the First Aid Asthma Plan for children and young people in your care, addresses the basics
of understanding Asthma, and also has images of the various medicines/inhalers that may be used. As with all
additional support needs, it is important to engage with the child and their family in order to find out how each
individual is affected.
The cause of an Asthma attack is not always clear. Asthma often runs in families and the tendency to get
inflamed airways can be inherited.
There are several common triggers that have been identified:
•
viral infections such as colds and flu,
•
irritants such as dust, cigarette smoke and fumes, chemicals,
•
allergens e.g. to pollen, medicines, animals, house dust mites or certain foods,
•
exercise - especially in cold, dry air.
Asthma symptoms may be mild, moderate or severe and may include:
•
frequent coughing spells, which may occur during play, at night, or while laughing. A cough may be the only
symptom present,
•
less energy during play,
•
rapid breathing,
•
complaints of chest tightness or chest “hurting”,
•
a whistling sound (wheezing) when breathing in or out,
•
see-saw motions (retractions) in the chest from difficult breathing,
•
shortness of breath, or loss of breath,
•
tightened neck and chest muscles (some children might complain of a tummy-ache),
•
feelings of weakness or tiredness,
Not all children have the same symptoms, and these symptoms can vary from one Asthma episode to the next in
the same child.
What can be done?
Each child who has Asthma will be given a Treatment Plan by their doctor. If you know that the child has Asthma
then it is important to consult the child’s parents to find out how best to support that child. The treatment plan
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will give details of how many puffs of the inhaler the child should take, what the signs are that the Asthma is
getting worse, and what to do if it does not get better.
Whether or not a treatment plan is available, in the event of an Asthma attack you should:
•
keep calm and reassure the child,
•
sit the child down (don’t lie them down), give them space and try to relax them,
•
ensure any tight clothing is loosened,
•
give the child his/her reliever (usually blue) inhaler immediately (up to 4 puffs),
•
if there is no immediate improvement, give the child their reliever every 2 minutes for 10 minutes,
•
after 5 to 10 minutes, or 10 puffs - if the child doesn’t feel better, you should call an ambulance but continue
giving the child their reliever every few minutes until help arrives.
* Allergy UK
Address: 3 White Oak Square, London Road, Swanley, Kent, BR8 7AG
Tel: 01322 619898
Website: www.allergyuk.org
* Asthma UK Scotland
Address: 4 Queen Street, Edinburgh EH2 1JE
Tel: 0131 226 2544
Website: www.asthma.org.uk
Asthma UK provides a free resource that would be useful for any setting to have handy, whether required
for the children in the setting, or for the staff or parents. To get your free copy please contact Asthma UK’s
Supporter and Information Team on:
Tel: 020 7786 5000
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Crohn’s Disease
What is Crohn’s Disease?
Crohn’s disease is an ongoing disorder that causes inflammation of the digestive tract. Crohn’s disease can affect
any area of the digestive tract, from the mouth to the anus, but it most commonly affects the lower part of the
small intestine.
The cause of the disease is unknown, but it is thought that viruses and bacteria play a part. A diet low in fibre
and high in chemicals is also thought to have a role in the illness.
Stress is thought to exacerbate the illness which can affect any part of the digestive system.
The symptoms of Crohn’s disease can often be vague and difficult to identify. The most common symptoms are:
•
delayed development and stunted growth,
•
abdominal pain (lower right area),
•
diarrhoea,
•
rectal bleeding (if bleeding is severe it could lead to anaemia),
•
weight loss,
•
arthritis,
•
skin problems,
•
fever,
The range and severity of symptoms varies.
What is the treatment?
Sufferers of Crohn’s disease will usually be seen regularly by a specialist team. It’s important that a healthy diet
with high fibre content is adhered to at all times. Treatment aims to increase their quality of life as much as
possible.
* National Digestive Diseases Information Clearinghouse (NDDIC)
Website: http://digestive.niddk.nih.gov/index.htm
NDDIC is a website that provides information on a number of conditions. In the search box, type in Crohn’s
Disease and it gives you more information about this condition
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Cystic Fibrosis
What is Cystic Fibrosis?
Cystic Fibrosis (CF) is an inherited genetic disorder. People are born with Cystic Fibrosis; they cannot catch it.
It affects the lungs and digestive system by clogging them up with thick, sticky mucus. This makes it difficult to
breathe and to digest food properly.
There is currently no cure for Cystic Fibrosis and it has a large effect on daily life and reduces life expectancy.
CF is a genetic disorder. Some parents have a faulty gene called the Cystic Fibrosis Transmembrane conductance
regulator or CFTR gene.
In order for a child to develop the condition they need to inherit two of these genes, one from both parents to
get the condition.
Symptoms usually first develop within the first year of life, but may not appear until later childhood. The severity
of symptoms can vary.
The cells that line the airways of the lungs make mucus thicker than normal. It is not cleared from the lungs
easily. This can trap bacteria in the small airways and can lead to infection and inflammation.
Symptoms which typically develop include:
•
A persistent cough which typically produces a lot of mucus,
•
Wheezing,
•
Shortness of breath and breathing difficulties,
•
Recurring chest infections.
* Cystic Fibrosis Trust
Address: 11 London Road, Bromley, Kent, BR1 1BY
Tel: 020 8464 7211
Helpline: 0845 859 1000
Web: www.cftrust.org.uk
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Deafblindness
Deafblindness is a unique disability, where neither sight nor hearing compensate for the impairment of the other
sense. It is sometimes known as dual sensory impairment or multi-sensory impairment and is a combination
of visual and hearing impairments which can be of any type or degree. Most people who are multi-sensory
impaired have some useful vision and hearing.
There are over 70 known causes of deafblindness. Causes in children can be due to various factors:
•
prenatal infection (such as rubella),
•
genetic/chromosomal Syndromes (such as Down Syndrome),
•
birth trauma,
•
maternal heavy alcohol and drug use.
Usher Syndrome (a genetic condition of people born deaf or hard of hearing, who gradually start to lose
their sight. The sight loss usually begins in late childhood and is caused by an eye condition known as Retinitis
Pigmentosa. Early symptoms include night blindness and loss of peripheral vision).
Usher Syndrome is not connected to learning disabilities or other physical problems. It is an inherited condition
that is passed down through the family. For a child to have Usher Syndrome, both parents must either carry the
affected genes, or have the same type of Usher Syndrome themselves.
Children who are deafblind share similar characteristics related to learning and interaction:
• Cognitive,
»» Inability to perform basic academic tasks,
»» Difficulty in performing functional life skills.
• Communication
»» Difficulty with spoken language,
»» Limited vocabulary.
• Behaviour
»» Exhibits low frustration tolerance,
»» Difficulty in demonstrating age-appropriate behaviour,
»» Exhibits problems in adjusting to change,
»» Exhibits self-stimulatory behaviours such as body rocking,
»» Exhibits inappropriate behaviours in touching and smelling objects and/or people.
• Physical
»» Difficulty with environmental mobility,
»» Difficulty with vision,
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»» Difficulty with hearing,
»» Difficulty with physical ambulation (motor problems/ orthopaedic problems/ cerebral palsy),
»» Displays seizure activity,
»» Difficulty with eating,
»» Difficulty with bowel and/or bladder control,
»» Difficulty in administering self-care.
* National Centre for Deafblindness UK
Address: John and Lucille van Geest Place, Cygnet Road, Hampton, Peterborough PE7 8FD
Tel: 01733 358100
Website: http://www.deafblind.org.uk/
* Sense Scotland
Address: 43 Middlesex Street, Kinning Park, Glasgow G41 1EE
Tel: 0141 429 0294 (Text: 0141 418 7170)
Website: www.sensescotland.org.uk
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Dystonia
What is Dystonia?
Dystonia is a neurological (brain) disorder that affects muscles and movement.
The brain sends the wrong signals to some of the muscles in the body. This causes repetitive muscle spasms,
contractions and body twisting which can be painful. In most cases brain functions, such as memory, are not
affected.
Dystonia affects men, women, and children of all ages. Dystonia in children is different from Dystonia in adults. It
is most common between the ages of five and 16, although it can occur in children as young as 1 year.
Often the leg or foot is affected first, and then the rest of the body including the legs and the back.
Childhood Dystonia is also known as Dystonia muscularum or primary torsion Dystonia. It can be caused by
a lack of dopamine or secondary to cerebral palsy (for more information on cerebral palsy see appropriate
factsheet [Cerebral Palsy]), stroke, drugs or other degenerative conditions. It is not a life-threatening condition
but it is life debilitating.
The causes of Dystonia are still not fully understood, but there appears to be a problem in an area of the brain
called the basal ganglia, involved in controlling movement.
Dystonia that develops in childhood is often inherited through one or more affected genes. Most primary
segmental or generalised Dystonia is inherited in a dominant manner, which means that if a parent has this type
of Dystonia, there is a 50% chance of passing the Dystonia gene to each child. Only 30% of those who inherit the
gene develop Dystonia.
What are the types of Dystonia that start in childhood and adolescence?
•
Generalised childhood onset Dystonia,
•
Dopa-responsive Dystonia,
•
Myoclonus Dystonia,
•
Secondary Dystonia.
•
Generalised Dystonia: can affect the muscles of the legs, arms and back as well as other muscles of the body.
It varies from one person to another,
•
Dopa-responsive Dystonia: affects the limbs and other parts of the body causing abnormal twisting, and
postures which may be painful. This can vary at different times of the day,
•
Myoclonus Dystonia: causes painful jerky movements of limbs and body,
•
Secondary Dystonia: affects muscles of the arms, legs, and trunk, as above. It’s the cause that’s different.
What can I do to support the child?
Talking to the child’s parents/guardian will help you to find out the best ways of supporting the child.
Be aware that the child may need a bit more support to integrate with the other children. Social isolation and
bullying can be experienced by children and young people because of Dystonia.
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Another problem that may arise is that some children or young people may get into trouble at school and in
other social environments, or present with antisocial behaviour because of the emotional issues (e.g. depression,
embarrassment, outrage) that they experience. It is important to be aware that this may be the case.
* The Dystonia Society
Address: 1st Floor, 89 Albert Embankment, London, SE1 7TP
Tel: 0845 458 6211 .
Website: www.dystonia.org.uk
(Glasgow support group can be contacted on 0845 803 1006)
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Edwards Syndrome
What is Edwards Syndrome?
Edwards Syndrome is a severe chromosome abnormality and is caused by an extra (third) copy of chromosome
18. Many babies with Edwards’ Syndrome have difficulties with feeding, so food may be given via a nasogastric
tube or directly into the stomach through a gastrostomy.
Edward Syndrome is caused by a genetic abnormality occurring before conception, when the egg and sperm cells
are made. A healthy egg or sperm cell contains 23 individual chromosomes - one to contribute to each of the
23 pairs of chromosomes needed to form a healthy, 46 chromosome cell. However, sometimes egg and sperm
cells are left with 24 (or more) chromosomes. It is the joining of these egg or sperm cells that eventually cause a
trisomy foetus to be formed.
The symptoms that develop in children with Edwards Syndrome vary from child to child.
• Characteristic facial features include:
»» a small jaw and mouth,
»» widely spaced small eyes with narrow eyelid folds and drooping of the upper eyelids,
»» skin mottling,
»» low-set, malformed ears,
»» The hands may be clenched, with the second and fifth fingers overlapping the other fingers.The thumbs
may be underdeveloped or absent. Webbing of the second and third toes may also occur.
• Structural malformations of:
»» heart, kidneys, brain, digestive tract, and genitals may be present and cause the child difficulties,
»» trouble feeding and breathing,
»» delay in growth and development,
»» infections of the lungs and urinary system are also common.
There may be severe impairments in verbal communication, as well as motor delays. Moderate or mild learning
difficulties may also be present.
* SOFT UK
Address: 48 Froggatts Ride, Walmley, Sutton Coldfield, West Midlands B76 2TQ
Tel (SOFT UK Scotland): Liz Egan 01698 818 380
Helpline: 0121 351 3122
Website: www.soft.org.uk
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Fragile X Syndrome
What is Fragile X Syndrome?
Fragile X Syndrome is the most common inherited cause of learning difficulties. It causes a wide range of
problems with learning and behaviour, which occur more commonly in boys than in girls.
Boys with Fragile X Syndrome have some degree of learning difficulty, ranging from mild to severe. Girls with the
Syndrome can be of normal intelligence, sometimes with more subtle difficulties commonly in Maths and social
relationships. However, about a half of girls with the Syndrome have mild or moderate learning difficulties and a
few have more severe difficulties.
Fragile X Syndrome is a genetic disorder caused by a change in a gene. The gene that causes the Syndrome is
called FMR1, which is involved in brain development.
In people affected by fragile X there is an increase in the size of part of the FMR1 gene and this stops it from
working properly. This is what causes fragile X.
Learning difficulties ranging from mild to severe. The following is a list of the symptoms that can occur:
• Intellectual:
»» delayed, distorted speech and language development,
»» attention deficit and hyperactivity,
»» anxiety and unstable mood,
»» Autistic like behaviours and features i.e. poor eye contact, hand flapping, social anxiety, shyness and
insistence on routine.
• Physical Features: Rarely all of these and sometimes none are present:
»» long face with large ears,
»» flat feet,
»» large jaw,
»» double-jointedness i.e. in fingers,
»» seizures (epilepsy) which affect 20-30% of males with fragile X,
»» Problems with co-ordination,
»» Recurrent ear infections,
»» Long/short sightedness,
»» Floppy muscle tone.
What is the treatment?
There is no cure for Fragile X Syndrome, but there are ways to help with the symptoms. Help is available to deal
with the learning, physical, social and emotional, speech and language, and sensory problems common in Fragile X
Syndrome.
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* The Fragile X Society
Address: Rood End House, 6 Stortford Road, Great Dunmow, Essex CM6 1DA
Tel: 01371 875 100
Website: www.fragilex.org.uk
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Hydrocephalus
What is Hydrocephalus?
The brain and spinal cord are surrounded by a clear fluid called cerebrospinal fluid (CSF). This fluid is produced
and stored in cavities (ventricles) in the brain and supplies important chemicals and nutrients and carries away
waste from the brain cells. Any excess fluid drains away and is absorbed by the body.
In Hydrocephalus, the CSF is unable to drain away and fluid accumulates. The ventricles then enlarge which
causes pressure on different parts of the brain and compresses the surrounding brain tissue.
80 – 90% of children who have Spina Bifida will have Hydrocephalus although it can occur as a separate condition
for many other reasons. (For more information of Spina Bifida, see the relevant factsheet [Spina Bifida]).
How is Hydrocephalus treated?
Some forms of Hydrocephalus require no treatment. However, the most common form of treatments is by
insertion of a shunt or valve into the brain which is carried out under a general anaesthetic. This enable the
fluid to drain away, however there is a risk of shunt blockage and childcare workers must be aware of the signs,
symptoms and action to take.
The Scottish Spina Bifida Association can provide training and information on Hydrocephalus and advice on
implementing individualised protocols (see contact details below).
What are the effects of Hydrocephalus?
Common effects of Hydrocephalus are those concerned with learning and comprehension and can vary
extensively. The most common difficulties are:
•
Concentration and short term memory,
•
Balance and spatial awareness,
•
Following instructions,
•
Changes in routines,
•
Appropriate social skills,
•
Being easily influenced and led,
•
Fine motor skills.
* Scottish Spina Bifida Association
Address: The Dan Young Building, 6 Craighalbert Way, Cumbernauld G68 0LS
Tel: 01236 794 500
Website: www.ssba.org.uk
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* Association for Spina Bifida and Hydrocephalus
Address: 42 Park Road, Peterborough, PE1 2UQ
Tel: 0845 450 7755
Website: www.asbah.org
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Spina Bifida
What is Spina Bifida?
The spine, brain and spinal cord develop between the 14th and 23rd day after conception and make up the
central nervous system. All bodily functions are controlled by the brain when it receives information from
nerves throughout the body. The information enables the brain to pass messages to different parts of the body
through the spinal cord which runs down the centre of the spine. The spine is made up of 33 separate bones
called vertebrae which cover and protect the spinal cord.
In Spina Bifida some of these vertebrae are not completely formed. Instead, they are split and the spinal cord and
its coverings usually protrude through a sac-like bulge on the back. Spina Bifida means “split spine” and this split
may involve one or more vertebrae and usually occurs around waist level or below.
Most children with Spina Bifida will have Hydrocephalus (see factsheet on Hydrocephalus).
What are the types of Spina Bifida?
There are 3 forms of Spina Bifida:
• Myelomeningocele (pronounced my-lo-men-injo-seal): this is the most common type. The “sac” contains
nerves, part of the spinal cord and cerebrospinal fluid. The nerves are damaged and this damage affects the
functions in the body below the location of the split such as bowel and bladder control and mobility although
these vary enormously.
• Meningocele (pronounced men-injo-seal): in this milder form of Spina Bifida, the split in the vertebrae is not
big enough for the spinal cord to come through, but a “balloon” of skin filled with cerebrospinal fluid and
blood vessels bulges out. The nerves are not usually damaged and therefore the effects are usually mild.
• Spina Bifida Occulta: this means “hidden” Spina Bifida and is very common. Most people have one vertebrae
involved which is significant and will have no effect whatsoever. However, for a small number of people the
fault is more extensive where the split is bigger and 2 or more vertebrae are affected.
How is Spina Bifida treated?
The baby will be seen by a surgeon immediately after birth to assess the need for an operation to close the
back. The main reason for this is to prevent infection and is not a cure as the nerve damage cannot be repaired.
However, there are many methods of managing the physical effects of damage.
The baby will be assessed for sensation and movement in lower limbs and for bowel and bladder function. If
there is an impairment in these functions, there are various modern methods to manage these, and the Scottish
Spina Bifida Association can provide further details and training (see below).
* Scottish Spina Bifida Association
Tel: 01236 794 500
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* Association for Spina Bifida and Hydrocephalus
Tel: 0845 450 7755
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Sturge Weber Syndrome
What is Sturge Weber Syndrome?
Sturge Weber Syndrome is a congenital neurological and skin disorder. The most common characteristic is a
facial birth mark (‘port wine stain’). The skin around the eye, forehead, or scalp can be affected. Sometimes the
stain can appear in other places on the child’s body, in addition to the facial mark. In approximately 13% of cases,
the stain may be completely absent.
It is not known why Sturge Webber Syndrome occurs, but it is not considered to be a familial disorder. The
Syndrome affects males and females, and from all nationalities.
Each individual is affected in different ways, and to different extents of severity.
As well as the port wine stain, other associations include:
•
Glaucoma,
•
Seizures,
•
possible developmental delays and learning disability,
•
weakness on one side of the body
•
Angioma which is a layer of blood vessels over the covering of the brain. This tends to affect one side of
the brain, with variations of severity between individuals. On rare occasions, both sides of the brain may be
affected.
Are there treatments?
Medical interventions can help to improve quality of life. Examples include:
•
anti-convulsant medication for seizures,
•
eye drops or oral medication for glaucoma,
•
laser treatment that can lighten the colour and decrease the size of port wine stains (this can be done in
children as young as 1 month of age).
* Sturge Weber Foundation UK
Address: Burleigh, 348 Pinhoe Road, Exeter, Devon EX4 8AF
Tel: 01392 464 675
Website: www.sturgeweber.org.uk
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* The Hemispherectomy Foundation
Website: http://hemifoundation.intuitwebsites.com
* The Sturge-Weber Foundation
Address: PO Box 418, Mt Freedom, NJ 07970-0418 USA
Website: www.sturge-weber.com
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Tay Sachs Disease
What is Tay Sachs Disease?
Tay-Sachs Disease is a rare inherited genetic disorder that affects the central nervous system and causes the
gradual destruction of nerve cells in the brain and spinal cord.
Tay-Sachs Disease is caused by a recessive gene - you must have two copies of the gene to have the disorder. The
recessive gene responsible for Tay-Sachs Disease causes an enzyme deficiency - affected children are missing a
vital enzyme (called hexosaminidase A, or Hex-A).
There are 3 forms of Tay-Sachs: Classic Infantile, Juvenile and Late Onset.
What are the Symptoms?
• Classic Infantile: babies seem healthy at birth, but the ability to crawl and swallow starts to cease. Breathing
difficulties are common after these first symptoms.
• Juvenile: Most symptoms appear when the child is aged between three and six months. Symptoms are:
»» development slows down,
»» the child does not seem alert,
»» loss of muscle strength,
»» deafness,
»» blindness,
»» severe constipation,
»» increase in respiratory infections,
»» risk of seizures,
»» difficulty swallowing,
»» poor functioning lungs,
»» and running, skipping and playing become increasingly difficult.
In the final stages:
»» the child will become paralysed and completely non-responsive,
»» ‘cherry-red spots’ can sometimes be seen on the retina,
»» Most children do not live past their 5th birthday,
• Late Onset: Tay Sachs can appear later in life and causes motor difficulty, slurred speech and occasionally
mental illness.
There is no cure or treatment for Tay-Sachs disease however research is being funded by NTSAD.
For Further Information:
* National Tay-Sachs and Allied Diseases Association, Inc
Website: www.ntsad.org/
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Tourette Syndrome
What is Tourette Syndrome?
Tourette Syndrome is a disorder that becomes evident in childhood and continues for life. The prime symptom
is to have repeated tics, which are motor (bodily movement) and vocal. A tic is a sudden movement or sound
that is repeated over and over, has no purpose and, in general, you cannot help doing. For example, blinking,
throat clearing, head nodding, etc. However, children with Tourette Syndrome have many types of tics, or sudden
movements and noises, and the tics can be prevalent throughout their life, although they can wax and wane.
1 in 100 people in the UK have Tourette Syndrome.
• Neurological: Tourette Syndrome is a neurological, and not a mental health condition. There are minor
anomalies in the structure and working of the brain in children with Tourette Syndrome. There seems to be a
problem with a number of the brain chemicals, such as dopamine and serotonin.
• Genetic: Most research adheres to the theory that the condition is inherited. It is generally believed that a
factor in genes are responsible for most cases of Tourette Syndrome. Genes are passed onto a child from each
parent and determine what we look like, how our body functions and even what diseases we may get. A child
is more likely to develop Tourette Syndrome if they have a father, mother, brother or sister with the condition,
or related conditions.
• Environmental: It has been said that environmental factors can exacerbate the development of the condition,
but this has not been proven.
The main symptom is multiple (many) tics. These are classified as either motor (bodily movement) or vocal tics.
•
Motor tics include things such as:
»» blinking, head turning, head nodding, kicking, facial grimacing, touching, licking, or smelling objects.
•
Vocal tics include things such as
»» Throat clearing, coughing, sniffing, yelling, or making animal sounds.
• There are several other symptoms that sometimes occur. These include:
»» Coprolalia - the involuntary use of obscenities and swear words. This only occurs in about 1 in 10 people
with Tourette Syndrome. Note: if this occurs, the person cannot help swearing, and it is not a reflection
on their moral character or upbringing.
»» Echophenomena - copying what others say and do.
»» Palilalia - repeating your own last word or syllable after the end of a sentence.
»» Non obscene socially inappropriate (NOSI) behaviours - such as saying inappropriate or rude personal
comments.
If a person has Tourette Syndrome they are also likely to have one or more related conditions. The most
common conditions seen with Tourette Syndrome are listed below:
•
Obsessive Compulsive Disorder or Obsessive Compulsive Behaviour (OCD/OCB),
•
Attention Deficit Hyperactivity Disorder (ADHD or ADD),
•
Learning difficulties. Mood disorders such as depression or anxiety,
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•
Conduct disorders,
•
Autistic Spectrum Disorders (ASD),
•
Self harming behaviours such as head banging.
Treatment:
Psychological (‘talking’) treatments
There are various psychological treatments that are effective in helping to ease the symptoms and problems
of Tourette Syndrome. These include Cognitive Behavioural Therapy (CBT), Habit Reversal Training (HRT),
hypnotherapy and social skills group training.
Education and support
There is a lot of evidence that if people with Tourette’s are well informed about the condition, then the person
will be able to better manage and accept their condition.
* Tourette Scotland
Address: Algo Business Centre, Glenearn Road, Perth PH2 0NJ
Tel: 01738 450 411
Website: www.tourettescotland.org
Further reading:
Tourette Syndrome, The Facts (2nd Edition) by Mary Robertson and Andrea Cavanna (ISBN: 978-0-19929819-8)
This book can be ordered through the Tourette Scotland website.
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West Syndrome
What is West Syndrome (infantile spasms)?
West Syndrome is the term used to describe a form of epilepsy that typically starts in the first year of life. The
main symptom of West Syndrome is infantile spasms. These spasms often consists of a very rapid, sudden jerk
accompanied by bending forward of the head, arms and legs, and stiffening of the limbs.
West Syndrome is diagnosed based on the occurrence of infantile spasms and the presence of an abnormal ECG
(brain wave recording).
From the age of one to two years, if not before, the infantile spasms may stop but other forms of epileptic
seizures may well occur.
West Syndrome is not simply one condition, but occurs as a symptom of various different brain conditions. There
are many causes of West syndrome, and often no obvious cause is identified. The causes may include:
•
severe brain injury at birth,
•
brain malformations,
•
metabolic diseases,
•
chromosomal abnormalities,
•
a genetic condition called Tuberous Sclerosis (one of the most common causes).
In children with West Syndrome, infantile spasms may occur in the first year of life, typically between three and
eight months old. Spasms are characterised by:
•
sudden flexion (bending forward) in a tonic (stiffening) fashion of the body, arms and legs,
•
an initial spasm can be followed by a further spasms. This is known as spasms occurring in ‘runs’ or ‘clusters’,
•
it is common for babies to become irritable and for their development to slow or even go backwards until
spasms are controlled (e.g. they may have learning difficulties),
•
children experiencing a spasm often display a change in their behaviour, such as a loss of interest in their
surroundings or appearing to ‘switch off’.
The main treatments are steroids or vigabatrin (Sabril) which are carefully used/ administered. The treatment
may cause unpleasant side effects and so it is important to speak to the child’s parents so that you are aware of
these and how best to support the child.
* West Syndrome Support Group
Address: c/o Contact a Family, 209-211 City Road, London EC1V 1JN
Tel: 01252 654 057
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* Epilepsy Action
Address: New Anstey House, Gate Way Drive,Yeadon, Leeds LS19 7XY
Tel: 0113 210 8800
Website: www.epilepsy.org.uk
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Williams Syndrome
What is Williams Syndrome?
Williams Syndrome is a rare congenital abnormality. It occurs at random in approximately 1 in 25,000 births and
is non-hereditary in the general population. The Syndrome leads to medical and developmental problems.
William’s Syndrome can manifest itself in both mental and physical strengths and weaknesses, as well as being
apparent in the face and body. Children with William’s Syndrome will also share many personality traits, such as a
higher level of anxiety.
Williams Syndrome is caused by a micro-deletion of the gene that makes the protein elastin from chromosome
7. This protein is responsible for providing strength and elasticity to blood vessel walls.
Children with Williams Syndrome usually have distinctive physical and developmental characteristics.
• ‘Elfin’ facial features such as:
»» Upturned nose,
»» Widely spaced eyes,
»» Star shaped pupils,
»» Wide mouth with full lips,
»» Small chin,
»» Slightly puffy cheeks,
»» Irregular, widely spaced teeth.
• Other features include:
»» heart or blood vessel problems,
»» low birth weight,
»» difficulty eating and gaining weight,
»» developmental problems in activities such as:
-- Talking,
-- Potty training,
-- Walking ,
-- Reading & Writing.
The following develop later than other children their age:
•
learning disabilities,
•
problems with coordination and balance,
•
high energy, talk excessively,
•
sensitive hearing, may get startled easily by loud noises,
•
very vulnerable and unable to recognise risky situations.
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Despite all of the above problems, a child with Williams Syndrome may excel with other intellectual skills, such as
verbal and communication skills and also possess a good long term memory.
* The Williams Syndrome Foundation (UK)
Address: 161 High Street, Tonbridge, Kent TN9 1BX
Tel: 01732 365 152
Website: www.williams-Syndrome.org.uk
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12.
Mental Health
Mental health is a complicated area and can
affect a child or young person, as well as the staff
working with them. This section is about mental
health in children and young people, and the
effects of self-harm.
Contents
• Mental health in children
• Self-harm in children and young people
• How can you help children and young people
with mental-health problems
Mental health in children and young people
About 10% of children and young people suffer from mental-health problems.
It can be difficult to understand a child’s mental and emotional needs and the problems they are facing.
To have good mental health, children need to:
• be confident;
• have high self-esteem;
• feel safe and secure; and
• receive appropriate support, advice and discipline from adults around them.
As a childcare provider, you are responsible for helping to make sure that the children you care for have good
mental health.
If you are worried about a child’s mental health, you should tell their doctor.
If a child has a mental-health problem, they may:
• worry too much;
• be hyperactive or fidget;
• persistently refuse to do what you ask them;
• be aggressive;
• frequently have temper tantrums;
• be depressed or sad;
• get irritated; and
• often refuse to take part in activities.
The Scottish Government Framework – ‘The Mental Health of Children and Young People: A Framework for
Promotion, Prevention and Care’ – says that all adults are responsible for a child’s mental health. As part of
your responsibilities in caring for children, you have a responsibility to support their mental health. For more
information about the framework, please got to the Scottish Government’s website at www.scotland.gov.uk/Publi
cations/2005/10/2191333/13337.
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Types of mental health conditions
Depression
All children and adults have days where they feel stressed or sad. However, if a child continues to feel down, and
this is getting in the way of their daily life, the child may be suffering from depression.
Depression affects 1 in 33 children, and 1 in 8 young people. Depression can affect a child’s:
• ability to socialise (they may often be by themselves);
• relationships with their friends and family (relationships are more difficult to to make and keep); and
• their schoolwork (depressed children often perform less well in school than their peers).
The child or young person is also at greater risk of committing suicide if they are depressed. Estimates show that
over 90% of young people who commit suicide were depressed. The risk becomes even greater for young boys
who are abusing alcohol or drugs.
What can cause children and young people to be depressed
• A history of family illness
• Stress or a stressful event (such as a divorce, separation or death in the family)
• Discrimination
• Physical problems
• A chronic illness (an illness which lasts for a long time, even for life)
• Psychological problems
• Abuse or neglect
The risk is greatest for children who experience abuse or neglect, or who have a chronic illness.
Usually, if a child or young person is suffering from depression, they will also have other mental-health problems
or be disruptive.
Treatment depression
The good news is that depression can be treated, particularly if it is identified early. As with any mentalhealth problem, a doctor must deal with depression. Treatment may involve psychotherapy, medication, or a
combination of these.
Eating disorders
People tend to think that eating disorders are more likely to affect teenagers, but they can affect men and
women at any age. It can be more worrying if a child has an eating disorder, as the symptoms and effects of the
disorder tend to be more dramatic and can cause the child to be extremely ill.
Unfortunately, eating disorders are becoming more common, and it is thought that around 2% of the female
population is affected by an eating disorder (the rate is higher among teenage girls).
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Types of eating disorders
Anorexia
Anorexia nervosa is a psychological illness where a person has a low body weight, and the image they have of their
body is distorted. They will also be obsessed by the fear of putting on weight.
A person with anorexia tries to control their body weight by starving themselves, over-exercising, or by using
other ways of controlling their weight. The person becomes very scared of putting on weight and feels that they
are not able to eat normally like everyone around them as they feel that they would become overweight if they
did this.
While most people think that anorexia only affects women, about 10% of cases involve men. While anorexia is
more common in teenagers, it can also affect younger children.
The effects of anorexia
Physical effects
• Extreme weight loss
• Stunted growth (particularly in children)
• Hair becomes thin
• Constantly feeling cold
• Dry skin
• Headaches
• Bruising easily
• Extreme fatigue (feeling tired and weak)
Psychological effects
• A distorted body image
• Poor insight
• Obsessive thoughts about food and weight
• Wanting to be ‘perfect’
• Refusing to accept that their weight is dangerously low
Emotional effects
• Low self-esteem
• Being scared of becoming overweight
• Mood swings
Behavioural effects
• Exercising excessively
• Fainting
• Becoming withdrawn from society
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• Self-harm
• Being very sensitive to references about body weight
• Constantly checking themselves in a mirror
• Sudden changes in personality
• Taking unusual pleasure in looking after others (including cooking for them)
Bulimia
Bulimia refers to someone who often binges on large amounts of food and then makes themselves sick or uses
laxatives.
People with bulimia will have very low self-esteem and be very self-conscious about their weight and appearance.
The person slowly starts to believe that they are overweight (most of the time the person will not be
overweight), and so they decide to go on a diet. However, the diet becomes so extreme that the person begins
to lose control over it. They will binge on food which they have decided isn’t part of their diet, and once they eat
the food they can’t control how much they are eating. After bingeing on the food, the person feels ashamed and
is scared that they will put on weight, so they do all they can to stop themselves from gaining weight. The person
may make themselves sick (sometimes called purging), use laxatives or diet pills, or even over-exercise.
They will tend to do this in cycles. After a binge the person decides that they will never lose control again.
However, they tend to go through the cycle very frequently – sometimes several times a week or even several
times a day depending on how serious the bulimia is.
The effects of bulimia
• Dehydration (caused by frequently being sick)
• Problems with the mouth (caused by the child frequently putting their fingers or other objects into their
mouth or throat)
• Constipation
• Cuts or scars on the child’s hands
What you can do
• Be positive and encourage children to follow your lead, particularly at snack times. Try not to focus on the
food they are eating, but try to encourage the child to talk about their feelings.
• If the child has been diagnosed with an eating disorder, make sure you speak to their parents and any other
professional (as long as their parents give you permission). This will help you learn about the particular
disorder and how it affects the child you are caring for. They will be able to give you advice on how to best
support the child.
Anxiety Disorders
Anxiety disorders are the most common type of mental-health problem which affect children. Anxiety means
that a child may be worried, nervous, scared and upset.
Anxiety is normal in all children at some point in their life, and everyone feels stressed at some point, for
example when they are:
• starting school or nursery for the first time;
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• taking a test or exam; or
• acting in a school play.
As adults, we are generally able to cope with daily stresses, but children find it more difficult.
Anxiety only becomes a problem when it starts to get in the way of the child’s daily life, for example when it
stops them from going to school and clubs, sleeping and making friends.
Anxiety disorders affect around 10% of children.
There are usually two types of symptoms.
1. Physical symptoms – such as feeling sick, having headaches, stomach pain, diarrhoea, being short of breath and
feeling weak.
2. Emotional symptoms – such as feeling nervous and scared.
The more severe the disorder, the more the child will struggle to think, make decisions, concentrate and learn.
What can cause anxiety disorders
• Genetics
• Psychological factors
• Environmental factors
How anxiety disorders are treated
As with any mental-health problem, a doctor will deal with anxiety disorder. The doctor will probably refer the
child to a child psychologist. Treatment may involve psychotherapy, medication, or behavioural therapy.
Types of anxiety disorders
There are many different types of anxiety disorders
Generalised anxiety disorder (GAD)
GAD is when a child is always scared and worried in everything they do, and they struggle to control this. They
might worry about things that have already happened, or about things that may happen.
If a child has GAD, they often find if difficult to concentrate and sleep and they may be restless and get irritated
and tired easily. The child will often want to please others and may be seen as a ‘perfectionist’.
What you can do
• If a child you are caring for has GAD, it is important to try to help them focus on positive thoughts – turn
everything negative into a positive.
• Make sure that you praise the child when things go well and focus on the positives.
• Try not to let them dwell on things that didn’t go to plan, for example if they accidentally drop their snack or if
their team loses in a sports game – they may think this is their fault.
• Also, watch for other children’s reactions to the child – do they blame them for anything that goes wrong and
do they pick on them? Any negative attitudes towards the child will only make them feel worse.
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Separation anxiety disorder (SAD)
Social situations and relationships are difficult if a child is constantly worrying about being away from home, their
parents or their carers. A child may be worrying that something bad might happen to either themselves or their
parent or carer when they are apart.
The child may be seen to be ‘clingy’, as they want to be around their parents constantly and they will often be
too afraid to sleep alone at night. Children who suffer from SAD will often have nightmares, headaches and
stomach pains.
What you can do
• Make up a planner to use with the child. Make it visual - by using illustrations, so the child can see what
happens between the time their parent or carer drops them off and the time they go home. The planner
should include the activities for the day and how long each activity will last. If the child is able to tell the time,
then use a clock. However, you would need to make sure that the child doesn’t focus on just the clock and
nothing else.
• Try to make sure games and activities keep the child’s attention on playing and having fun, and to try to take
their mind off their parents or carers.
• Treatment for SAD includes trying to change the child’s thoughts and behaviour, so if you are able to keep
their thoughts on positive things and help them socialise with other children, you can only be helping them.
Post-traumatic stress disorder (PTSD)
PTSD affects children who have experienced a physical or emotional trauma, for example, abuse, a death in the
family, a natural or man-made disaster or being in an accident. The child may often have nightmares in which they
go through the trauma again. A child with PTSD may:
• be irritated easily;
• have trouble sleeping;
• find it difficult to eat; and
• feel worried.
What you can do
• If a child has PTSD, it is unlikely that they will come to your service as they are likely to be very scared of and
emotional about going to new places and being in new situations.
• However, if the child does come to your service, it is important to talk to their parents or carers about how
you can support the child and what reasonable adjustments you would need to make to try to make it as easy
on the child and you as possible.
• Treatment for PTSD usually involves counselling, which will try to deal with emotions and any behaviour
which is a result of those emotions.
Panic disorder
Children who have panic disorder will suffer from unexpected and repeated periods of intense fear, as well as
physical symptoms of being short of breath or having a racing heartbeat. These are commonly known as ‘panic
attacks’. Panic attacks can last several minutes, or even hours. They are more common in teenagers, but may start
in childhood.
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Usually, the child will seem worried, even when they are not having a panic attack. Sometimes it can become so
severe that the child could develop agoraphobia (the fear of going into open spaces or public places) or severe
depression, and the risk of suicide becomes greater.
What you can do
• As with PTSD, if a child suffers from panic disorder they are not likely to come to your service as they will
probably not be good in social situations where there are many people.
• However, if the child does come to your service, it is important to talk to their parents or carers about how
you can:
• support the child;
• make sure the child doesn’t feel worried; and
• include them in games and activities without them feeling panicky.
• Treatment for panic disorder usually involves trying to change the behaviour which is linked to the child’s panic
attacks.
Social phobia
Social phobia tends to affect teenagers in their mid-teens. A teenager who has social phobia will be constantly
scared of social situations and having to do something in public.
Physical symptoms of social phobia
• Sweating
• Blushing
• Shortness of breath
If a young person has social phobia, they are also likely to suffer from low self-esteem, and will be sensitive to
criticism.
Obsessive compulsive disorder (OCD)
OCD can affect children at any age. If a child has OCD, they will often have thoughts or ‘obsessions’ which they
cannot control. They will believe that if they do not do something in a certain way, something bad will happen.
To try to block out these thoughts, the child may perform routines or rituals (‘compulsions’).
Examples
A child may switch the light switch on and off many times because they are scared that something bad might
happen to them if they don’t.
A child may repeatedly wash their hands because they have a fear of germs.
The obsessions and compulsions take up so much time and effort that the child will feel extremely worried and
on edge.
OCD can disrupt a child’s daily life so much that they will find it very difficult to concentrate and their sleep may be
affected, which can make them feel tired and agitated throughout the day.
It can be difficult to spot OCD as many children are able to hide their behaviour. But there are certain signs to
look out for, such as if a child constantly want reassurance about what they are thinking, or if they have tantrums.
A child may start to show signs of OCD after a stressful event, for example when they start a new school or if
someone in their family dies.
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Tourette’s syndrome is a type of OCD and is more common in boys and in children who develop OCD at a
younger age. ADHD, learning disorders and other anxiety disorders are more common in children with OCD.
What you can do
• The child will need professional treatment to deal with their OCD. Treatment for OCD involves the child
facing their fears, which helps them to stop their obsessions and compulsions. The treatment is called cognitive
behavioural therapy (CBT). CBT encourages children to relax when they face their fears, which helps them feel
less anxious. CBT is often used for treating children with anxiety disorders.
• For the treatment to be successful, the child will need support from everyone around them. This means that
the best thing you can do is talk to the child’s parents or carer to find out how you can help them deal with
their obsessions and compulsions. Also, make sure that your staff and the other children you care for aren’t
encouraging any obsessive behaviour.
Self Harm/Self Injurious Behaviour
Self-harm is when a child hurts themselves on purpose.
Many children with severe additional support needs may also self-harm and show challenging behaviour.
Being involved with or seeing self-harm can be upsetting and difficult to manage. This section aims to give you
more information so you can support other childcare providers and help the child who is harming themsleves.
Self-harm can include any of the following.
• Head banging
• Cutting
• Punching
• Nipping
• Pulling hair
• Biting
• Burning
If a child has additional •
support
needs, they may harm themselves because they:
Scratching
• feel frustrated;
• feel misunderstood;
• cannot tell people about their needs;
• are uncomfortable in a certain situation (and if they harm themselves, they think they will be able to get away
from the situation);
• are reacting to something;
• have very high pain thresholds and do not think what they are doing is hurting;
• are trying to show their emotions; or
• feel like too many changes are taking place.
A child may also self-harm because they have been or are being sexually, physically or emotionally abused. The
child may be doing this to take away from the pain they have experienced, or because they have no feeling of
self-worth because of what they have experienced.
No matter why the child is behaving in this way and whether or not it causes them physical pain, this can affect
your emotions.
If a child you are caring for self-harms, you should do the following.
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167
• Stay calm.
• Support the child to make sure they are safe.
• Ask your colleagues for support (if appropriate).
• Talk to the child to try and stop the behaviour.
• Do not physically get involved unless this is absolutely necessary, as this may make the behaviour worse if the
child is upset or does not like people in their space.
• Wait for the behaviour to stop and then make sure you and the child are safe by cleaning any wounds, dealing
with any injuries and so on.
• Talk through the incident with the child so they are not carrying any negative emotions around with them.
• Make sure that the child is safe and has totally calmed down, then give them some space to think.
• At the end of the day, make sure you speak to your supervisor to discuss the incident, how you are feeling
and what you can do to make sure everyone will be safe if it happens again. Also, think about the incident and
discuss whether there was something that caused it and what you could have done to avoid the situation.
Think about what support you will give your staff in the future.
• Amend the child’s profile or care plan if it does not already say that the child self-harms.
• Finally, you must discuss the incident with your manager and follow your child-protection and safe-care
procedures.Your manager may then discuss the incident further with any other organisations (if appropriate).
Please respect the child’s privacy at all times.
You may want to get further training if you feel it is appropriate. (For more information, please see section 13
‘Contact details’ on the enclosed CD.)
More information
The National Self Harm Network provides support and information for people who self-harm, and their
friends, families and carers. It also campaigns to raise awareness of the issues relating to self-harm, works with
professional organisations, including schools and universities, and provides an online support forum.
The National Self Harm Network
PO Box 7264
Nottingham
NG1 6WJ
Website: www.nshn.co.uk
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How you can help children and young people
with mental-health problems
• Provide opportunities for the child to have good mental health. For example, encourage the child to:
• exercise regularly;
• eat healthy;
• play inside and outside; and
• have good relationships with all children.
• Help the child to feel welcome and make sure you value their thoughts and opinions.
• Show an interest in each child and be optimistic around them.
• In games and activities, make sure all children have the opportunity to succeed and praise them when
appropriate.
• If the child experiences any changes in their home or personal life, encourage them to talk to you and be
open about their feelings. Turn any negative feelings into positives
More information
* Anorexia and Bulimia Care (ABC)
Anorexia and Bulimia Care (ABC) offers support and advice to anyone who is suffering because of an eating
disorder. ABC support people who are suffering from anorexia or bulimia, as well as their families, carers and
care providers.
Anorexia and Bulimia Care (ABC)
Providence House
The Borough, Wedmore, Somerset BS28 4EG
Phone: 01934 713 789
Sufferers’ helpline: 01934 710 679
Parent helpline: 01934 710 645
Website: www.anorexiabulimiacare.co.uk
* Anxiety UK
Anxiety UK provides a wide range of services for people living with anxiety disorders, including one-to-one
therapy. The ‘Stressed out’ project is designed to support young people who are experiencing anxiety and
stress.
Zion CRC, 339 Stretford Road, Manchester, M15 4ZY
Phone: 0161 227 9898
Website: www.anxietyuk.org.uk
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* Beating eating disorders (Beat)
Beat is a charity which provides help and support for people with eating disorders and their families. The
young people’s website (FYP) is specifically for young people.
103 Prince of Wales Road, Norwich, NR1 1DW
Phone: 01603 619 090
Website: www.b-eat.co.uk
* Bipolar Fellowship Scotland
Bipolar Fellowship Scotland is a membership-based voluntary-sector organisation. They provide information,
support and advice for people affected by bipolar disorder, their carers and others with an interest in its
work.
Studio 1015, Mile End Mill, Abbeymill Business Centre
Seedhill Road, Paisley, PA1 1TJ
Phone: 0141 560 2050
Website: www.bipolarscotland.org.uk
* ChildLine
ChildLine provides help on all issues relating to children’s emotional and physical well-being.
Phone: 0800 111 111
Website: www.childline.org.uk
* Depression Alliance Scotland
Depression Alliance Scotland works to make sure that those affected by depression and their carers have
the information, support and care they need to have the best possible quality of life.
11 Alva Street, Edinburgh, EH2 4PH
Phone: 0845 123 20
Website: www.dascot.org
* Depression in Teenagers
Depression in Teenagers is a website which deals with depression in young people. It can give you
information on how to recognise the symptoms of depression, as well as giving you suggestions on how to
deal with the symptoms.
Website: www.depressioninteenagers.co.uk
* KidsBehaviour
KidsBehaviour is a unique website which gives you information to help you understand children and how to
deal with behaviour problems. The website gives you advice, help and support to deal with a child’s behaviour.
Daresbury Point, Green Wood Drive
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Manor Park, Cheshire, WA7 1UP
Website: www.kidsbehaviour.co.uk
Mental Health Foundation is a leading charity which provides information, carries out research and
campaigns and works to improve services for anyone affected by mental-health problems, whatever their age
and wherever they live.
Scotland Office, Merchants House, 30 George Square
Glasgow, G2 1EG
Phone: 0141 572 0125
* OCD UK
OCD UK is a national charity which provides support services and campaigns for improved access and
quality treatment and care for children and adults with OCD.
PO Box 8955, Nottingham, NG10 9AU
Phone: 0845 120 3778
Website: www.ocduk.org
* Papyrus
Papyrus is a voluntary UK organisation committed to preventing suicide among young people, and promoting
mental health and emotional well-being.
Phone: 0800 068 41 41
Website: www.papyrus-uk.org
* Rethink
Rethink is the leading national mental-health membership charity which works to help everyone affected by
severe mental illness to have a better quality of life.
89 Albert Embankment, London, SE1 7TP
Phone: 0845 456 0455
Website: www.rethink.org
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* Scottish Association for Mental Health (SAMH)
SAMH is Scotland’s leading mental-health charity which works to support people who experience mentalhealth problems, homelessness and other forms of social exclusion. They provide services, and actively
campaign to influence policy and improve care services in Scotland.
Scottish Association for Mental Health (SAMH)
Cumbrae House, 15 Carlton Court, Glasgow, G5 9JP
Phone: 0141 568 7000
Website: www.samh.org.uk
* Stress and Anxiety in Teenagers
The website deals with stress and anxiety in teenagers and will give you information on what causes stress
and how to manage it creatively.
Website: www.stressandanxietyinteenagers.com
* Stresswatch Scotland
Stresswatch Scotland provides information, advice and support to help people who suffer from stress,
anxiety, phobias, panic attacks and obsessive compulsive disorder.
Website: www.stresswatchscotland.org
* Wellscotland
Wellscotland is a website which aims to raise awareness on mental health and help people understand
mental-health issues. They encourage people to share information, research, publications and resources
to help improve people’s mental health. The website also has information on how to improve your mental
health, news and events, personal stories, quizzes, top tips and an online diary.
Website: www.wellscotland.info
* Young Minds
Young Minds is the UK’s only national charity committed to improving the mental health and emotional wellbeing of all children and young people.
48-50 St John Street, London, EC1M 4DG
Phone: 0207 336 8445
Website: www.youngminds.org.uk
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13.
Contact details
Local Organisations – contact details
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* Able Aid Mobility
Address: 30 Russell Street, Chapelhall, Airdrie ML6 8SG
Tel: 01236 761 596
AA Mobility is the top supplier of Living Aids and Mobility Aids in Scotland. They stock all ranges of
mobility and independent living aids.
Tel: 0141 201 6247
B
* Barnardo’s, CHOSI 8(2)12 Project
Address: Motherwell Town Hall Business Centre, 1-11 High Road, Motherwell ML1 3HU
Tel: 01698 230 242
Website: www.barnardos.org.uk
Barnardo’s CHOSI 8(2)12 project works in partnership with North Lanarkshire Council to provide
a service to children (aged 8 – 12 years) who are experiencing difficulties at home, in school, in the
community and their families.
* British Deaf Association Scotland
Address: 1st Floor, Central Chambers, Suite 58, 93 Hope Street, Glasgow G2 6LD
Telephone: 0141 248 5554
Fax: 0141 248 5565
The Scottish Deaf Association represents the interests of Britain’s deaf people who use British Sign
Language. It aims to protect and advance the interests of deaf people.
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* Capability Scotland Therapy Services
Address: Therapy Services, c/o Alexander Anderson Centre, 18 East Thornlie Street, Wishaw ML2 8BB
Office tel: 01698 372 003 ext 401
Capability Scotland Therapy Services offer training on Safer Assistance and will tailor it to suit your
individual service requirements and needs.
For more information and to discuss your requirements please contact:
Lynn McCallum, Manual Handling Consultant / Trainer on the contact details above.
Please note: Capability Scotland offers other Nationally available services – see details in the National
Organisations contact page.
* Carers Information Line (North Lanarkshire)
Tel: 0800 028 0287
This is a freephone information service for carers.
Carers Liaison and Support Project (CLASP)
Address: Wishaw Area Team, Kings House, Kings Street, Wishaw ML2 8BS
Tel: 01698 348 226
CLASP provides information and support to carers (including those who support their relatives, friends
or neighbours suffering from a mental health problem, physical disability, long-term illness or learning
disability).
* Child Brain Injury Trust (Glasgow Office)
Address: Unit 19, Chapel Street Industrial Estate, Chapel Street, Maryhill G20 9BD
Tel: 0141 945 4894
Web: www.cbituk.org
The Child Brain Injury Trust (CBIT) is a UK wide charity offering support, information and training on
childhood acquired brain injury.
* Childcare @ Home North Lanarkshire
Address: Dalziel Building, Suite 1.2 Scott Street, Motherwell ML1 1PN
Tel: 01698 250 025
Childcare @ Home North Lanarkshire operates in the North Lanarkshire area, offering high quality
registered care in the child’s own home, 7 days a week from early morning to late evening, as required by
the family.
* Childcare Information Service (ChIS), North Lanarkshire
Address: North Lanarkshire Early Years & Childcare, Municipal Buildings, Kildonan Street, Coatbridge ML5
3BT
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Tel: 01236 812 281
Website: www.scottishchildcare.gov.uk/LocalChis.aspx?chisid=11
North Lanarkshire’s Childcare Information service provides a range of information on childcare, early
years and pre-school education services.
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* Deafblind Scotland
Address: 21 Alexandra Avenue, Lenzie, Glasgow G66 5BG
Tel: 0141 777 6111 (Voice/Text)
Website: www.deafblindscotland.org.uk
Deafblind Scotland is a society in which deafblind people have the permanent support and recognition
necessary to be equal citizens. The site provides information, advice, and support to help people who have
a dual sensory impairment, their families, and friends and the professionals who work with them.
* Dyslexia Action Scotland (Glasgow Centre)
Address: Napiershall Street Centre, 39 Napiershall Street, Glasgow G20 6EZ
Tel: 0141 334 4549
Website: www.Dyslexiaaction.org.uk
Dyslexia Action is a national charity and the UK’s leading provider of services and support for people with
Dyslexia and literacy difficulties. They specialise in assessment, teaching and training and they develop and
distribute teaching materials and undertake research.
E
* Enable Scotland
Address: 2nd Floor, 146 Argyle Street, Glasgow G2 8BL
Tel: 0141 226 4541
Website: www.enable.org.uk
(Local North Lanarkshire office):
Address: 1st Floor, Stirling House, 80-86 Stirling Street, Airdrie ML6 0AS
Tel: 01236 763 771
Epilepsy Scotland campaigns for a better life for children and adults with learning disabilities and supports
them and their families to live, work and take part in their communities. They run a growing range of
flexible person-centred services and they make sure that children and adults with learning disabilities and
their carers are at the heart of everything they do.
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* Epilepsy Scotland
Address: Head Office, 48 Govan Road, Glasgow G51 1JL
Tel: 0141 427 4911
Helpline: 0808 800 2200
Helpline text: 07786 209 501
Website: www.Epilepsyscotland.org.uk
Epilepsy Scotland provides a confidential helpline (0808 800 2200) email and text information service
to anyone affected by Epilepsy. They also train people in managing Epilepsy and run information and
awareness events. They have a guide for teachers and one for parents and are currently developing
resources for children. The website has information specifically for people who have been diagnosed with
Epilepsy, and there is a section on seizures for people who want to find out more about them. There are
also leaflets and publications on issues relating to Epilepsy, such as first aid, safety, driving, first aid and
employment, which can be downloaded or posted to you free of charge.
* Equality and Human Rights Commission
Address: The Optima Building, 58 Robertson Street, Glasgow, G2 8DU
Telephone: 0141 228 5910 (non helpline calls only)
Helpline (Scotland): 0845 604 5510 (Textphone: 0845 604 5520)
email: [email protected]
The Equality and Human Rights Commission Scotland campaigns for equality and human rights for all,
working to eliminate discrimination, reduce inequality, protect human rights and to build good relations,
ensuring that everyone has a fair chance to participate in society.
F
* FBS Advocacy
Address: Unit 23, Coatbridge Business Centre, 204 Main Street, Coatbridge ML5 3RB
Tel: 01236 700 108
FBS Advocacy provides group and individual advocacy services to children and young people in need. They
promote the awareness of children’s rights and support children and young people with disabilities to
exercise their rights.
H
* HOPE (for Autism in North Lanarkshire)
Tel: 01236 779 191
Website: www.hopeforAutism.org.uk
days a week.
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M
Address: Scotland Office, Merchants House, 30 George Square, Glasgow G2 1EG
Tel: 0141 572 0125
The Mental Health Foundation is a leading UK charity that provides information, carries out research,
campaigns and works to improve services for anyone affected by mental health problems, whatever their
age and wherever they live.
N
Tel: 0141 221 8090
Website: www.Autism.org.uk
The National Autistic Society (NAS) champion the rights and interests of all people with Autism and
aim to provide individuals with Autism and their families with help, support and services that they can
access. The website has information about Autism and Asperger’s Syndrome, the NAS and its services and
activities.
* NDCS (National Deaf Children’s Society) Scotland
Address: 2nd Floor, Empire House, 131 West Nile Street, Glasgow G1 2RX
Telephone: 0141 354 7850
Textphone: 0141 332 6133
Website: www.ndcs.org.uk
Freephone helpline:
Telephone/Minicom: 0808 800 8880
The National Deaf Children’s Society is the national charity dedicated to creating a world without barriers
for deaf children and young people. NDCS is an organization of families, parents and carers, providing
emotional and practical support through their freephone helpline, a network of trained support workers,
and a wide range of other support services as well as publications and their website.
NDCS offers free publications to parents of children with deafness and professionals working with deaf
children. Particularly useful ones to childcare providers working with deaf children include: ‘Understanding
Deafness’; ‘Hearing Aids’; and ‘Cochlear Implants’. See their website for more information and how to
register.
* NCH North Lanarkshire (Young Carers Project)
Address: Townhall Business Centre, 1-11 High Road, Motherwell ML1 3HU
Tel: 01698 258 801
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NCH Young Carers Project provides support and social opportunities for children and young people who
have caring responsibilities for a parent or sibling.
* North Lanarkshire Carers Together
Address: 51 Hope Street, Motherwell ML1 1BS (North Lanarkshire Carers Together address: Freepost,
NATN586, Motherwell ML1 1BS)
Tel: 01698 404 055
Website: www.carerstogether.org
Carers together actively links carers and professionals throughout North Lanarkshire. It represents the
interests of carers and works to improve the quality of their lives.
North Lanarkshire Disability Forum
Address: 42 Civic Square, Motherwell ML1 1TP
Tel: 01698 275 710
The Disability Forum offers independent advice and information for people with disabilities in North
Lanarkshire.
P
* Partners in Play (PIP)
Address: Unit G2, Dalziel Business Centre, 7 Scott Street, Motherwell ML1 1PN
Tel: 01698 230 130
Partners in Play enable children and young people with additional support needs to access their local
community groups and activities, in North Lanarkshire. There are two strands to PIP, the Inclusive
Childcare Project and Family Support/Community Support.
The PIP project is an independent parent led organisation which has been providing inclusive services for
children and young people with and without disabilities in North Lanarkshire for 12 years. It’s primary
aim is the promotion of inclusion for disabled young people through ongoing commitment to working
with the whole family. It’s childcare services are targeted at the whole community which includes working
parents, parents who are returning to work and those who are attending training.
The project has developed a range of services to address current gaps an d has a team of trained and
skilled staff who can support young people to access a range of childcare and community provision
through training and advice.
The project has a limited number of direct services, including and out of school club for older children
and youth club which young people can access until they build the confidence and skills to access
mainstream services.
* Princess Royal Carers Trust (PRCT)
Address: Hallcraig Locality, Hallcraig Street, Airdrie
Tel: 0800 028 0287
The trust provides support, training, information, access to services, stress management, pampering,
contact with other carers, and a listening ear with someone who understands.
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* Princess Royal Trust Carers Centre
Address: 46 Campbell Street, Hamilton ML3 6AS
Tel: 01698 428 090
The Lanarkshire Carers Centre provides a range of services, such as support to carers; provision of
information; advocacy for carers; and training and pampering services for carers.
R
* RNID (The Royal National Institute for Deaf People) Scotland
Address: Empire House, 131 West Nile Street, Glasgow G1 2RX
Telephone: 0141 341 5330
Textphone: 0141 341 5347
Website: www.rnid.org.uk
Information Line for general information:
Telephone: 0808 808 0123 (freephone)
Textphone: 0808 808 9000 (freephone)
There are 840, 000 people who are deaf or hard of hearing in Scotland.
RNID Scotland is the charity working to create a world where deafness and hearing loss do not limit or
determine opportunity and where people value their hearing. We aim to achieve this by campaigning and
lobbying, with the help of our members and our volunteers, raising awareness of deafness and hearing loss,
providing services and through social, medical and technical research.
S
Address: Cumbrae House, 15 Carlton Court, Glasgow G5 9JP
Tel: 0141 568 7000
SAMH is Scotland’s leading mental health charity, working to support people who experience mental
health problems, homelessness, addictions and other forms of social exclusion. They provide direct
services, including accommodation, support, employment and rehabilitation, and actively campaign to
influence policy and improve care services in Scotland.
* Scottish Consortium for Learning Disability (SCLD)
Address: Adelphi Centre Room 16, 12 Commercial Road, Glasgow G5 0PQ
Tel: 0141 418 5420
Website: www.scld.org.uk
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SCLD is a charity made up of 12 partner organisations that have joined together with funding from the
Scottish Government to help people make the changes set out in “The same as you?” It offers support to
organisations to help them be more inclusive to people with learning disabilities.
* Scottish Deaf Association
Address: Central Chambers, Suite 58, 93 Hope Street, Glasgow G2 6LD
The Scottish Deaf Association represents the interests of Britain’s deaf people who use British Sign
Language. It aims to protect and advance the interests of deaf people and better inform the hearing public
about deafness.
* Scottish Out of School Care Network (SOSCN)
Address: Level 2, 100 Wellington Street, Glasgow G2 6DH
Tel: 0141 564 1284
Website: www.soscn.org
SOSCN is the lead independent voice for school-aged children in Scotland. They promote quality and
believe that good quality childcare can benefit children, parents and the community. They support the right
to play and the development of a play-care training infrastructure, and aim to support equal opportunities
and work in partnership. They work with children, government and develop links with childcare
organisations worldwide to share good practice.
* Scottish Pre-school Play Association (SPPA)
Address: SPPA, 21 Granville Street, Glasgow G3 7EE
Tel: 0141 221 4148
Website: www.sppa.org.uk
SPPA is Scotland’s largest voluntary sector provider of direct support services to community led childcare
organisation. They deliver essential support and guidance services to providers of pre-school education
and childcare services, including all-day care groups, playgroups, parents and toddler groups and under-fives
groups.
* Scottish Spina Bifida Assocation (SSBA)
Tel: 01236 794 500
SSBA listen and help children, adults and families with Spina Bifida, Hydrocephalus and related conditions.
The main aspects of service delivery is the Family Support Service and Lo-call helpline. The website also
has extensive information on Spina Bifida and Hydrocephalus.
* Sense Scotland
Address: 43 Middlesex Street, Kinning Park, Glasgow G41 1EE
Tel: 0141 429 0294 (Text: 0141 418 7170)
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Website: www.sensescotland.org.uk
Sense Scotland has been working for over 20 years with children and adults who have communication
support needs because of deaf blindness, sensory impairment, learning and physical disabilities. One of the
key areas of expertise is communication. Working closely with people, often on a one-to-one basis, they
aim to find out what people’s aspirations are and how they want to live their lives.
* Shop Mobility
Address: 89 Merry Street, Motherwell, Lanarkshire ML1 1JJ
Tel: 01698 303 199
Shop Mobility provide specialist equipment or adaptations in North Lanarkshire.
T
Address: National Centre for Autism Studies, Room D002, David Stow Building, The University of
Strathclyde, 76 Southbrae Drive, Glasgow G13 1PP
Telephone: 0141 950 3072
Tel: 0141 950 3072
Website: http://www.scottishAutismnetwork.org.uk/index.html
* The Scottish Centre for Children with Motor Impairments
Address: The Craighalbert Centre, 1 Craighalbert Way, Cumbernauld G68 0LS
Tel: 01236 456100
Website: www.craighalbert.org.uk
The Scottish Centre for Children with Motor Impairments is one of Scotland’s Grant Aided Special
Schools that provides day school education for nursery, pre-school and school age children with motor
impairments. The centre is family focussed and allows children to achieve their full potential, develop
independence and life skills.
* Toy and Equipment Lending Library (TELL)
Address: Toy Library, c/o Partnership Centre, Lismore Drive, Coatbridge ,
ML5 5JN
Tel: 01236 757647
TELL is a lending service offered to all childcare providers within North Lanarkshire, registered with the
Childcare Information Service. It is operated by the Education resource service on behalf of the North
Lanarkshire Childcare Partnership.
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National Organisations – contact details
A
* Ability Net
Address: PO Box 94, Warwick CV34 5WS
Tel: 0800 269 545
Website: www.abilitynet.org.uk
Ability Net is a registered national charity with over 20 years experience helping people adapt and adjust
their information and communications technology (ICT). The ‘Public Services’ section on the website
suggests various hardware and software e.g. computer adaptations that may be useful (perhaps for
childcare settings to allow children to access computers and computer games).
* Action for Blind People
Address: 14-16 Verney Road, London SE16 3DZ
Tel: 0800 915 4666
Website: www.actionforblindpeople.org.uk
Action for Blind People is one of the largest charities in the UK providing free and confidential support
for blind and partially sighted people in all aspects of their lives.
* ADDISS (National Attention Deficit Disorder Information and Support Service)
Address: P O Box 340, Edgware, Middlesex, HA8 9HL
Telephone: 020 8952 2800
Website: www.addiss.co.uk
ADDISS is a charity providing people-friendly information and resources about ADHD.
* AFASIC Scotland: unlocking speech and language
Address: 1 Prospect 3, Gemini Crescent, Dundee DD2 1TY
Telephone: 01382 561 891
Website: www.afasicscotland.org.uk
Afasic is the UK charity representing children and young adults with communication impairments, working
for their inclusion in society and supporting their parents and carers. Afasic Scotland responds to the
needs of parents and young people in Scotland. It provides training and information for parents and
professionals working in children’s services.
* Albinism Fellowship
Address: PO Box 77, Burnley, Lancashire, BB11 5GN
Tel: 01282 771 900
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Website: www.Albinism.org.uk
Albinism Fellowship is a purely voluntary run positive, sociable organisation that provides information,
advice and support for people with an appropriate interest in Albinism.
* Allergy UK
Address: 3 White Oak Square, London Road, Swanley, Kent, BR8 7AG
Tel: 01322 619898
Website: www.allergyuk.org
Allergy UK provides advice and support for people with Asthma and their relatives, plus information about
allergies and allergy testing.
* Anorexia and Bulimia Care (ABC)
Address: Providence House, The Borough, Wedmore, Somerset BS28 4EG
Tel: 01934 713 789, Sufferer’s Helpline: 01934 710 679, Parent Helpline: 01934 710 645
Web: www.anorexiabulimiacare.co.uk
Anorexia and Bulimia Care (ABC) offers support and advice to anyone who is suffering because of an
eating disorder: sufferers, their families, carers and professionals.
* Anxiety UK
Address: Zion CRC, 339 Stretford Road, Manchester M15 4ZY
Tel: 0161 227 9898
Website: www.anxietyuk.org.uk
Anxiety UK provides an extensive range of services for people living with anxiety disorders, including
one-to-one therapy. The ‘Stressed Out’ project is designed to support young people who are experiencing
anxiety and stress.
* ASSERT
Address: PO Box 4962, Nuneaton, CV11 9FD
Tel: 0300 999 01 02
Website: www.angelmanuk.org
ASSERT is a United Kingdom based support group of volunteers who have direct contact with people
with Angelman Syndrome. ASSERT can offer advice and support on a wide range of problems whether
you are a carer or a professional.
* Association for Spina Bifida & Hydrocephalus
Tel: 0845 450 7755
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ASBAH is the leading UK registered charity providing information and advice about Spina Bifida and
Hydrocephalus. The website has factsheets about both conditions.
* Asthma UK Scotland
Address: 4 Queen Street, Edinburgh EH2 1JE
Tel: 0131 226 2544
Website: www.Asthma.org.uk
Asthma UK provides a free resource that would be useful for any setting to have handy, whether required
for the children in the setting, or for the staff or parents. To get your free copy please contact Asthma UK’s
Supporter and Information Team on:
Tel: 020 7786 5000
B
* Barnardo’s (Scottish Office):
Address: 235 Corstorphine Road, Edinburgh EH12 7AR
Tel: 0131 334 9893
Website: www.barnardos.org.uk
Barnardo’s works with children with various issues e.g. drug misuse to disability; youth crime to mental
health; sexual abuse to domestic violence; poverty to homelessness. They run almost 400 projects around
the UK, one of which is local to North Lanarkshire – see Local Organisations section.
* Beating eating disorders (Beat)
Address: 103 Prince of Wales Road, Norwich NR1 1DW
Tel: 01603 619 090
Website: www.b-eat.co.uk
Beat is a charity providing help and support for people with eating disorders and their families. The young
people’s website (FYP) is specifically for young people.
* Bipolar Fellowship Scotland
Address: Studio 1015, mile End Mill, Abbeymill Business Centre, Seedhill Road, Paisley PA1 1TJ
Tel: 0141 560 2050
Website: www.bipolarscotland.org.uk
Bipolar Fellowship Scotland is a membership-based voluntary sector organisation. They provide
information, support and advice for people affected by Bipolar Disorder, their carers and others with an
interest in its work.
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* British-Sign.co.uk
Address: British-Sign.co.uk, Honeysuckle Cottage, Les Dunes,Vazon, Castel, Guernsey GY5 7LQ
Website: www.british-sign.co.uk
British-Sign.co.uk is a website that has information about British Sign Language, including resources, and it
gives people the opportunity to learn basic sign language online.
Address: Knowle Hall, Bridgewater, Somerset TA7 8PJ
Tel: 01278 684060
Web: www.bibic.org.uk
BIBIC is a national charity offering practical help to families caring for children with conditions such as;
Autism, Cerebral Palsy, Down’s Syndrome, developmental delay, traumatic and acquired brain injury and
specific learning difficulties such as Attention Deficits Hyperactivity Disorder, Dyslexia and Dyspraxia.
* BritishSignLanguage.com
Website: www.britishsignlanguage.com
BritishSignLanguage.com is a website that uses moving pictures to show the basic signs for BSL. It has a
number of wordgroups and has a wordsearch facility to locate specific symbols.
C
Tel: 0131 337 9876 (Voice), 0131 346 2529 (Text)
disabled people achieve equality. It provides a range of services for children and adults with many types
of disability, including those with complex needs and learning difficulties and children and adults with
Cerebral Palsy. The website offers details of adult and children’s services, news and campaigns, advice and
information. Capability Scotland has an advice service (ASCS) which provides free confidential advice
and information on a range of disability issues including advice on Cerebral Palsy. Anyone interested in
disability issues can use ASCS. ASCS has a small lending library which includes resources about Cerebral
Palsy and children’s resources about disability. Anyone can borrow these. The library catalogue can be
viewed on the main website. Contact ASCS at the Head Office address or on 0131 313 5510 or via email
above.
Capability Scotland’s Training and Consultancy Team offers Disability Equality Training. The team speaks
from experience as each trainer is a disabled person with first hand experience of the barriers that
prevent disabled people from fully participating in society. For more information please contact Elspeth
Molony (Corporate Policy and Consultancy Manager) on 0131 347 1022, or at [email protected]
* Child Brain Injury Trust
Address: 21 Saughtonhall Drive, Edinburgh, EH12 5TW
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Tel: 0131 337 9523
Web: www.cbituk.org
The Child Brain Injury Trust (CBIT) is a UK-wide charity offering support, information and training on
childhood acquired brain injury. CBIT provides the following services: Child and Family Support, Training
and Information, and Raising Awareness.
* ChildLine
Tel: 0800 111 111
Website: www.childline.org.uk
ChildLine provides help on all issues relating to children’s emotional and physical wellbeing.
* Children 1st
Address: 83, Whitehouse Loan, Edinburgh EH9 1AT
Tel: 0131 319 8060
Website: www.children1st.org.uk
Children 1st support families under stress, protect children from harm and neglect, help them recover
from abuse and promote children’s rights and interests.
* Children in Scotland
Address: Princes House, 5 Shandwick Place, Edinburgh EH2 4RG
Tel: 0131 228 8484
Website: www.childreninscotland.org.uk
Children in Scotland is the united voice of over 400 voluntary, statutory and professional organisations
and individuals working with and for children, young people and their families throughout Scotland.
* Contact a Family Scotland
Address: Craigmillar Social Enterprise & Arts Centre, 11/9 Harewood Road, Edinburgh EH16 4NT
Tel: 0131 659 2930
Website: www.cafamily.org.uk
Contact a Family provides support, advice and information for families with disabled children, no matter
what their condition or disability.
* Cystic Fibrosis Trust
Address: 11 London Road, Bromley, Kent, BR1 1BY
Tel: 020 8464 7211
Web: www.cftrust.org.uk
The Cystic Fibrosis Trust provides information and support for people with Cystic Fibrosis and their
families / carers.
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D
* Dance Base
Address: 14-16 Grassmarket, Edinburgh EH1 2JU
Tel: 0131 225 5525
Website: www.dancebase.co.uk
Dance Base is Scotland’s National Centre for Dance. It offers courses, workshops and drop-in classes for
adults and children. They also offer an Outreach Programme for young people of all interests and abilities,
making it fully inclusive. They bring dance to nurseries, pre-school centres, schools, youth groups and
community centres.
* Deaf Books (and Deafsign.com)
Tel: Deaf Books: 01594 833 858, Deafsign.com: 01642 580 505
Website: www.deafbooks.co.uk and www.deafsign.com
DeafBooks publish the LET’S SIGN Series of British Sign Language (BSL) educational materials for all ages
and abilities. The Early Years collection includes an illustrated book of signs for carers, a comprehensive
pocket dictionary, posters, flashcards, signed song book & audio CD, keepsake sheets to fill in to record
progress, BSL merit stickers and badges and signing certificates.
The site offers a point of contact for requests and queries and some fun free BSL games and downloads.
To view the whole series and shop on-line please visit www.DeafBooks.co.uk
The resources within the Communication section include Fingerspelling alphabets and BSL Early Years
Verbs handouts which are reproduced with permission from Cath Smith at Deafsign and DeafBooks.co.uk
- 01642 580505 [email protected]
* Depression Alliance Scotland
Address: 11 Alva Street, Edinburgh EH2 4PH
Tel: 0845 123 20
Website: www.dascot.org
Depression Alliance Scotland strives to ensure that those affected by depression and their carers are
provided with the information, support, understanding and care needed for the best quality of life.
* Depression in Teenagers
Web: www.depressioninteenagers.co.uk
Depression in Teenagers deals with the subject of depression in young people. It is intended that it be used
as a resource to help users to recognise the symptoms associated with the condition as well as offering
suggestions on how to combat symptoms.
* Disability Rights Commission (DRC)
Website: www.drc-gb.org
The Disability Rights Commission website is a comprehensive site explaining work and services of DRC
plus information and advice for disabled people, employers and service providers and legislation, your
rights and requirements, campaigns and a link section (as well as a specific section for Scotland).
Contact details
187
* Down’s Syndrome Association
Address: Langdon Down Centre, 2a Langdon Park, Teddington TW11 9PS
Tel: 0845 230 0372
Website: www.downs-syndrome.org.uk
The Down’s Syndrome Association aims to help people with Down’s Syndrome to live full and rewarding
lives. They provide advice and information, and run training courses throughout the UK for members,
professionals and carers.
* Down’s Syndrome Scotland
Address: 158/160 Balgreen Road, Edinburgh EH11 3AU
Tel: 0131 313 4225
Website: www.dsscotland.org.uk
Down’s Syndrome Scotland works to improve the quality of life for everyone with Down’s Syndrome in
Scotland. The site provides information, support and advice on publications, information, news, and events.
* Dyslexia Scotland
Address: Stirling Business Centre, Wellgreen, Stirling FK8 2DZ
Tel: 01786 44 66 50
Website: www.Dyslexiascotland.org.uk
Dyslexia Scotland is the voluntary organisation representing the interests of dyslexic people in Scotland.
It offers a range of high quality services and aims to influence positive national change. Its services include
the Dyslexia Helpline (0844 800 84 84); Tutor List; Training and Awareness raising (conferences, seminars,
workshops and training events); Supporting projects and research; Advice and Information (website, leaflets,
guides and resources); an Adult Network; local activities and support provided by a network of volunteerled branches across Scotland. Contact your local branch in North Lanarkshire on 01236 77 98 91.
* Dyspraxia Foundation
Address: 8 West Alley, Hitchin, Herts SG5 1EG
Tel: 01462 454 986
Website: http://www.dyspraxiafoundation.org.uk
Local Group:
Edindyspraxia is a local group whose aim is to help support children and their parents. They hold regular
meetings every 6 weeks where parents can exchange information and tips with each other. Invited
speakers are also scheduled to come and talk about Dyspraxia issues.
Tel: 0131 667 0175
Contact details
188
E
* Eating Disorders Association (BEAT)
Address: 103 Prince of Wales Road, Norwich NR1 1DW
Adultline: 0845 634 1414 Youthline: 0845 634 7650
Web: http://www.edauk.com/
BEAT is the leading UK charity for people with eating disorders and their families. Beat is the working
name of the Eating Disorders Association. They provide helplines for adults and young people, online
support and a UK-wide network of self-help groups to help people beat their eating disorder.
* Enquire
Address: Children in Scotland, 5 Shandwick Place, Edinburgh EH2 4RG
Tel: 0131 222 2425
Website: www.enquire.org.uk
Enquire is the Scottish independent advice and information service for additional support for learning
(special educational needs). It is managed by Children in Scotland and funded by the Scottish Government.
Enquire also provides training and outreach and produces a range of free publications.
* Epilepsy Action
Address: New Anstey House, Gate Way Drive,Yeadon, Leeds LS19 7XY
Tel: 0113 210 8800
Website: www.Epilepsy.org.uk
Epilepsy Action is the largest member-led Epilepsy organisation in Britain, acting as the voice for the UK’s
estimated 456,000 people with Epilepsy, as well as their friends, families, carers, health professionals and
the many other people on whose lives the condition has an impact.
As well as campaigning to improve Epilepsy services and raise awareness of the condition, they offer
assistance to people in a number of ways including a national network of branches, accredited volunteers,
regular regional conferences and freephone and email helplines
H
* Headway UK
Address: 190 Bagnall Road, Old Basford, Nottingham, Nottinghamshire, NG6 8SF
Tel: 0115 924 0800
Web: www.headway.org.uk
Headway UK provides support to local groups and helps to deliver high quality services through guidance
on policies, procedures, standards and training. The website has a variety of information including a section
for professionals.
Contact details
189
* Hearing Concern LINK Scotland
Address: The Eric Liddell Centre, 15 Morningside Road, Edinburgh EH10 4DP
Website: www.hearingconcernlink.org
Hearing Concern LINK provide support and information to people with a hearing loss and their families.
* Hyperactive Children’s Support Group
Address: 71 Whyke Lane, Chichester PO19 7PD
Tel: 01243 539966
Website: http://www.hacsg.org.uk
The Hyperactive Children’s Support Group has been successfully helping ADHD/Hyperactive Children and
their families for over 30 years. The group supports the belief that using drugs should be a last resort, and
that a dietary and nutritional approach should be top priority.
K
* Kids Behaviour (UK)
Address: KidsBehaviour, Daresbury Point, Green Wood Drive, Manor Park, Cheshire WA7 1UP
Website: http://kidsbehaviour.co.uk
Kids Behaviour (UK) offers a unique reference point for understanding children and dealing with
behavioural problems. Features and articles are written by experts who have experience, or a particular
interest in this area
M
* Mencap
Address: 123 Golden Lane, London EC1Y 0RT
Tel: 020 7454 0454
Website: www.mencap.org.uk
Mencap is the voice of learning disability and everything they do is about valuing and supporting people
with a learning disability, and their families and carers. They provide high-quality, flexible services that allow
people to live as independently as possible in a place they choose; provide advice through their helplines
and websites; and campaign for the changes that people with a learning disability want.
* Multilingual Family in the UK
Website: www.multilingualfamily.co.uk
The website is primarily for information for parents – it advises of support groups that parents can access.
There are also a number of links for various languages. These links list various websites, resource sites and
other organizations that can help with that specific language.
Contact details
190
N
* NASPCS – The Charity for Incontinent and Stoma Children
Address: 51 Anderson Drive,Valley View Park, Darvel KA17 0DE
Tel: 01560 322 024
NASPCS provides a contact and information service for parents on the practical day-to-day management
of all aspects of coping with a child with either a colostomy, ileostomy or urostonmy. They also try to give
advice on the incontinence often encountered with bowel and bladder problems.
* National Centre for Deafblindness UK
Address: John and Lucille van Geest Place, Cygnet Road, Hampton, Peterborough PE7 8FD
Tel: 01733 358100
Website: http://www.deafblind.org.uk/
The National Centre for Deafblindness UK provide advice and information to anyone wishing to learn
more about Deafblindness and the lives of deafblind people.
* National Digestive Diseases Information Clearinghouse (NDDIC)
Website: http://digestive.niddk.nih.gov/index.htm
NDDIC is a website that provides information on a number of conditions. In the search box, type in
Crohn’s Disease and it gives you more information about this condition.
* National Tay-Sachs and Allied Diseases Association, Inc
Website: www.ntsad.org/
The mission of the National Tay-Sachs & Allied Diseases Association is to lead the fight to treat and cure
Tay-Sachs, Canavan and related genetic diseases and to support affected families and individuals in leading
fuller lives.
O
* OCD UK
Address: PO Box 8955, Nottingham NG10 9AU
Tel: 0845 120 3778
Website: www.ocduk.org
OCD UK is a national charity that provides support services and campaigns for improved access and
quality treatment and care for children and adults with OCD.
* One Parent Families Scotland
Address: 13 Gayfield Square, Edinburgh EH1 3NX
Tel: 0131 556 3899/4563
Contact details
191
Website: www.opfs.org.uk
One Parent Families Scotland are a national voluntary organisation and members include lone parents,
various organisations working with lone parents and others who just simply want to support he cause of
lone parents. They offer a telephone helpline service on topics such as benefits, employment, maintenance,
funding for education, holidays, childcare and parenting problems. They have a wide range of fact sheets
and a specialist library service for adults and children.
P
* Papyrus
Tel: 0800 068 41 41
Web: www.papyrus-uk.org
Papyrus is a voluntary UK organisation committed to the prevention of young suicide and the promotion
of mental health and emotional wellbeing.
* Play Scotland
Address: Midlothian Innovation Centre, Pentlandfield, Roslin, Midlothian,
EH25 9RE
Tel: 0131 440 9070
Website: www.playscotland.org
Play Scotland works to promote the importance for all children and young people, and campaigns to
create increased play opportunities in the community. The website has a useful resources section and
offers guidance for play.
* Pyramid Educational Consultants UK ltd
Address: Pavillion House, 6 Old Steine, Brighton BN1 1EJ
Tel: 01273 609 555
Website: www.pecs.org.uk
Pyramid Educational Consultants provide high quality training, consultation and support to parents, carers
and professionals involved with children and adults with communication difficulties. In addition to training
and workshops on PECS (Picture Exchange Communication System), they offer a variety of consultation
services based in the home, school or community.
R
* Rethink
Address: 89 Albert Embankment, London SE1 7TP
Tel: 0845 456 0455
Contact details
192
Web: www.rethink.org
Rethink is the leading national mental health membership charity that works to help everyone affected by
severe mental illness recover a better quality of life.
* RNIB Scotland (Royal National Institute of Blind People)
Address (Head Office): 12-14 Hillside Crescent, Edinburgh EH7 5EA
Tel: 0131 652 3140
Website: www.rnib.org.uk
RNIB Scotland is the leading charity working with blind and partially sighted people in Scotland. RNIB
Scotland delivers services to members who need support, and campaigns for their civil and welfare rights.
They support children and adults with sight loss to live full and independent lives. The Education and
Family Services Department promotes the interests of children and young people with sight problems and
provides information and advice to parents, and advice on local and national support networks.
S
* Scope Response
Address: PO Box 833, Milton Keynes MK12 5NY
Tel: 0808 800 33 33
Website: www.scope.org.uk/response
Scope and Dial UK have merged to provide an expanded national advice and information network
providing free, impartial and expert information, advice and support to disabled people and their families.
Address: Cumbrae House, 15 Carlton Court, Glasgow G5 9JP
Tel: 0141 568 7000
SAMH is Scotland’s leading mental health charity which works to support people who experience mental
health problems, homelessness and other forms of social exclusion. They provide direct services, and
actively campaign to influence policy and improve care services in Scotland.
* Scottish Childminding Association (SCMA)
Address: (Head Office) 7 Melville Terrace, Stirling FK8 2ND
Tel: 01786 445 377
Website: www.scma.org.uk
SCMA promotes childminding as a quality childcare service, through reaching their vision and key
priorities for childminding.
Contact details
193
* Sleep Scotland
Address: 8 Hope Park Square, Edinburgh EH8 9NW
Tel: 0131 651 1392
Website: www.sleepscotland.org
Sleep Scotland is a charity which supports parents and carers of children and young people with additional
support needs and sleep problems.
* SOFT UK
Address: 48 Froggatts Ride, Walmley, Sutton Coldfield, West Midlands B76 2TQ
Tel (SOFT UK Scotland): Liz Egan 01698 818 380
Helpline: 0121 351 3122
Website: www.soft.org.uk
SOFT UK helps those affected by Trisomy 13, Trisomy 18 (Patau’s and Edwards’ Syndrome) and related
disorders.
* Stress and Anxiety in Teenagers
Web: www.stressandanxietyinteenagers.com
The website deals with the subject of Stress and Anxiety in teenagers and will help users consider what
causes stress and how to manager it creatively.
* Stresswatch Scotland
Address: 23 Campbell Street, Kilmarnock KA1 4HL
Tel: 01563 570 886
Website: www.stresswatchscotland.org
Stresswatch Scotland provides information, advice and support in the recovery of people who suffer from
Stress, Anxiety, Phobias, Panic Attacks and Obsessive Compulsive Disorder.
* Sturge Weber Foundation UK
Address: Burleigh, 348 Pinhoe Road, Exeter, Devon EX4 8AF
Tel: 01392 464 675
Website: www.sturgeweber.org.uk
Sturge Weber Foundation UK was launched in 1990 by Contact a Family and is an independent voluntary
support group for families and adults who suffer from this syndrome.
T
* Talking Mats Research and Development Centre
Address: Scion House, University of Stirling, Stirling FK9 4NF
Tel: 01786 485 105
Contact details
194
Website: www.talkingmats.com
Talking Mats is a low tech communication framework involving sets of symbols. It was originally developed
by the AAC (Alternative and Augmentative Communication) Research Unit to support people with
communication impairment. Since its original conception, additional research has taken place and now it is
an established communication tool. It is designed to help people with communication difficulties to think
about issues discussed with them, and provide them with a way to effectively express their opinions.
* The Anaphylaxis Campaign
Address: PO Box 275, Farnborough, Hampshire GU14 6SX
Tel: 01252 546 100
Website: www.anaphylaxis.org.uk
The Anaphylaxis Campaign provides support and information to the growing number of people at risk
from life-threatening allergic reactions (Anaphylaxis), particularly to foods, and works vigorously to achieve
a safer environment for all those with severe allergies.
Address: Knowle Hall, Bridgwater, Somerset TA7 8PJ
Tel: 01278 684060
Website: www.bibic.org.uk
BIBIC is a national charity offering practical help to families caring for children with conditions such as
Autism, Cerebral Palsy, Down’s Syndrome, developmental delay, traumatic and acquired brain injury and
specific learning difficulties such as Attention Deficits, Hyperactivity Disorder, Dyslexia and Dyspraxia.
* The Challenging Behaviour Foundation
Address: c/o The Old Courthouse, New Road Avenue, Chatham, Kent ME4 6BE
Tel: 01634 838 739
Website: www.thecbf.org.uk
The Challenging Behaviour Foundation exists to demonstrate that individuals with severe learning disabilities
who are described as having challenging behaviour can enjoy normal life opportunities when their behaviour
is properly understood and they receive appropriate individualised support. The CBF will support families,
professionals and other stakeholders through education, information, research and partnership working to
enable this to happen and will work strategically to influence national policy and practice.
* The Dystonia Society
Address: 1st Floor, 89 Albert Embankment, London, SE1 7TP
Tel: 0845 458 6211
.
Website: www.Dystonia.org.uk
(Glasgow support group can be contacted on 0845 803 1006)
The Dystonia Society aims are to provide mutual support for those affected by Dystonia, and to raise
awareness of the condition through education and promotion of research.
Contact details
195
* The Fragile X Society
Address: Rood End House, 6 Stortford Road, Great Dunmow, Essex CM6 1DA
Tel: 01371 875 100
Website: www.fragilex.org.uk
The Fragile X Society provides support and information to Fragile X families; encourage research into
all aspects of Fragile X and publisice the results; and educate and inform the public and professionals
about Fragile X in order to raise awareness and understanding of the syndrome. The website has various
factsheets on aspects of Fragile X.
* The Makaton Charity
Address: Manor House, 46 London Road, Blackwater, Camberley, Surrey GU17 0AA
Tel: 01276 606 760
Website: www.makaton.org
The Makaton Charity provides information and advice on using Makaton, including training details,
resources (some of which are free), family advice, and research.
* The National Self Harm Network
Address: PO Box 7264, Nottingham NG1 6WJ
Website: www.nshn.co.uk
The National Self Harm Network provides support, distraction and information for individuals and their
friends, families and carers. Also campaigns to raise awareness of the issues relating to self-harm, working
with professional organisations, including schools and universities. Also provides an online support forum.
Tel: 01259 720 044
Website: www.Autism-in-scotland.org.uk/index.php
The Scottish Society for Autism has 40 years experience of working with people with Autism. They offer
specialised training to families and professionals, and provide a range of support for people with Autism.
* The Williams Syndrome Foundation (UK)
Address: 161 High Street, Tonbridge, Kent TN9 1BX
Tel: 01732 365 152
Website: www.williams-syndrome.org.uk
The Williams Syndrome Foundation is run by parents for parents. They have useful information about the
syndrome on the website, and links for further information.
* Tourette Scotland
Address: Algo Business Centre, Glenearn Road, Perth PH2 0NJ
Tel: 01738 450 411
Contact details
196
Website: www.tourettescotland.org
Tourette Scotland provides advice and support for children and adults with TS and their families. They
produce newsletters, advice sheets and leaflets; raise awareness amongst public and professionals in
Scotland; provide a telephone helpline for information; and arrange informal meetings with guest speakers.
* Turner Syndrome Support Society (TSSS)
Address: 13 Simpson Court, 11 South Avenue, Clydebank Business Park, Clydebank G81 2NR
Tel: 0141 952 8006
Website: www.tss.org.uk
TSSS is a national charity caring for the needs of those with Turners Syndrome throughout the UK. The
society offers support and information to both girls and adult women with Turner Syndrome, their families
and friends. The Society enjoys a good relationship with relevant specialists to promote a good basis for
education and understanding of the management of Turner Syndrome.
V
* V.I.Scotland (Visual Impairment Scotland)
Address: Scottish Sensory Centre, The University of Edinburgh, Holyrood Road, Edinburgh EH8 8AQ
Tel: 0131 651 6078
Website: www.viscotland.org.uk
V.I.Scotland is an organisation to support children with Visual Impairment and their parents that live in
Scotland. They provide up-to-date information about services available and the website has a section on
the A-Z of Visually Impairing conditions.
W
* Wellscotland
Web: www.wellscotland.info
Wellscotland aims to raise awareness and understanding, promote sharing of information, knowledge,
research, publications and resources in mental health improvement. It also has information on how to
improve your mental health, news and events, personal stories, quizzes, top tips and an online diary.
* West Syndrome Support Group
Address: c/o Contact a Family, 209-211 City Road, London EC1V 1JN
Tel: 01252 654 057
The West Syndrome Support Group supports those who are affected by West Syndrome.
Contact details
197
Y
* Young Minds
Address: 48-50 St John Street, London EC1M 4DG
Tel: 0207 336 8445
Web: www.youngminds.org.uk
Young Minds is the UK’s only national charity committed to improving the mental health and emotional
well-being of all children and young people.
Contact details
198
14.
FAQ
This section gives you answers to common
questions the public asked us during consultations
we carried out when producing this guide.
Who do I contact in North Lanarkshire to get more advice and support if a child I care for has
additional support needs?
If you would like more advice and support, you should contact our Early Years and Childcare Department.You
can ask the Inclusive Childcare Project to assess your needs and the child’s needs, and they will then give you the
support you need.
Support may include the following.
• Training – relating to the child’s condition and how to care for a child with additional support needs.
• Resources – which will help you support the child and help them develop.
• Adaptations – to make sure all children can use your service.
• Staff – increasing or reducing the number of staff you have, in line with advice from Additional Support for
Learning.
North Lanarkshire Council, Early Years and Childcare
Phone: 01236 812 818
I can’t get back to the childcare provider in time for them closing at 6pm. What are my options?
Are there any childcare providers who work after 6pm?
Some childminding services are open later than other services. Please contact the Family Information Service
(FIS) in North Lanarkshire.
North Lanarkshire Council, Early Years and Childcare
Phone: 01236 812 281
Website: www.northlanarkshire.gov.uk/familyinformationservice
North Lanarkshire’s Family Information Service provides a range of information on childcare, early years and
pre-school education services.
• Childcare @ Home may also be able to provide services after 6pm.
FAQ
199
• Childcare @ Home work in North Lanarkshire area, and offer high-quality registered care in your own home.
They provide care seven days a week, from early in the morning to late in the evening, as needed by the family.
• Childcare @ Home North Lanarkshire
Dalziel Building
Suite 1.2 Scott Street, Motherwell , ML1 1PN
Phone: 01698 250 025
Can I be sued if I am not ‘inclusive’?
No, but you must have made ‘reasonable adjustments’, as needed by the Disability Discrimination Act 1995. The
child’s placement may not work out for many reasons, but as long as you have made appropriate adjustments you
cannot be sued. Reasonable adjustments may include:
• changing the set-up of your service so that someone who uses a wheelchair or walking aid is able to move
around freely, and is able to access everything without bumping into things;
• using symbols around your service, for example to label toy boxes, areas of the room and so on, so that a
child with a learning disability can find toys and knows how to use certain equipment; and
• adapting games so that all the children can take part. For example, a child who has a sight problem would find
it easier to play ball games if the balls were large, textured and a bright colour.
Note
You can find more examples in the section ‘Policies, programmes and the law’ on the enclosed CD.
Can I refuse to take on a child who has an additional support need?
No.You cannot refuse to care for a child who has an additional support need. The Disability Discrimination Act
1995 says that you should not refuse to care for a child because they have a disability.
For more information, visit the Equality and Human Rights Commission website at www.equalityhumanrights.
com.
Is there a shop in North Lanarkshire where I can order adaptations or specialist equipment?
Yes – Shop Mobility.
89 Merry Street, Motherwell, Lanarkshire , ML1 1JJ
Phone: 01698 303 199
For other useful contacts, please see section 13 ‘Contact details’ on the enclosed CD.
Should I tell other parents that there will be a child starting the service who has an additional
support need? How much do I tell them?
You should have a confidentiality policy – follow this for every child you’re supporting in your service.
FAQ
200
Are there any resources I can access to help me include a child with an additional support need
into my service?
The Toy and Equipment Lending Library (TELL) is a good place to get resources in North Lanarkshire. TELL is a
service which lends toys and equipment to all childcare providers in North Lanarkshire who are registered with
the Family Information Service. TELL is run by the Education Resource Service, on behalf of the North Lanarkshire
Learning and Leisure Services. TELL has a number of resources that would be useful for any child you care for, and
has a particularly good section for children with sight or hearing problems.
Toy Library
c/o Partnership Centre, Lismore Drive, Coatbridge, ML5 5JN
Phone: 01236 757647
FAQ
201
15.
Acknowledgements
Thank you to everyone who helped put this guide
together. Thank you for taking time to read and
comment on the various sections.We have taken
all comments on board and amended the guide
as appropriate.
Capability Scotland lead officers who researched and developed the guide with North Lanarkshire
Council
• Jennifer McRae (Lead Officer for Inclusive Childcare Development, Capability Scotland)
• Elaine Fox (Manager, Capability Scotland)
North Lanarkshire’s Inclusion Services Working Group
• Anne Marie Bready (Education Officer, Early Years & Childcare, NLC (North Lanarkshire Council))
• Ellen Paterson (Creche Development Co-ordinator, NLC)
• Judith Elliott (Childcare Development and Support Worker, NLC)
• Elaine Fox (Manager, Capability Scotland)
• Jennifer McRae (Lead Officer for Inclusive Childcare Development, Capability Scotland)
• Jeanette Hodge (Manager, PIP Project)
• Holly Hoskisson (Inclusive Childcare Co-ordinator, PIP Project)
• Russell Cunningham (Senior Educational Psychologist, NLC)
• Dawn Cunningham (Additional Support Manager, NLC)
• Martin Egan (Service Manager, Children and Family Support, NLC)
We also worked with parents, out-of-school care staff, nursery staff and childminders at the
following events.
• Childminding conference – 24 January 2009
• The independent and pre-5 nursery forum – 10 March 2009
• The out-of-school care forum – 24 March 2009
• Various inclusive play training courses – throughout March 2009
• The SCMA network meeting – 1 June 2009
Acknowledgements
202
In November and December 2009, we held consultations with the following people and
organisations.
• Young people from the Route 13 group
• Parents of young people
• The Scottish Spina Bifida Association
• Papillion Nursery
• Firtrees out-of-school care and nursery
• Staff from North Lanarkshire Council social work service
• C & K nursery and out-of-school care
• Cumbernauld YMCA
• Lanarkshire Childcare Services Central and North
• Oscars Playscheme
• Workforce Development and Training
• North Lanarkshire Council nursery centres
• Princess Royal Carers Trust – Lanarkshire Carers Centre
• Pre 5 Groups
• Kilsyth Children’s Club
The following people also helped with this guide.
• Mark Bevan (Head of Children’s Services, Capability Scotland)
• Gerry Shield (Quality Improvement Officer – Inclusion, NLC)
• Linda Henderson (Child Protection Officer, NLC)
• Pat Holland (Development Officer, Support for Learning, NLC)
• Margaret Barrett (Development Officer, Support for Learning, NLC)
• Capability Scotland’s Inclusion Forum
• North Lanarkshire Council Learning and Leisure Services, Early Years and Childcare Team
• Elspeth Molony (Corporate Policy and Consultancy Manager, Capability Scotland)
• Joanne Bagley (previous Assistant Research Officer, Inclusive Childcare Development, Capability Scotland)
• Lynn McCallum (Manual Handling Consultant and Trainer, Therapy Services, Capability Scotland)
Acknowledgements
203
The following local and national organisations also approved our fact sheets.
• Andrea Bilbow (ADDISS)
• Sally Bunday MBE (Hyperactive Children’s Support Group)
• Colin Smith (Autism Manager, HOPE)
• Nicola Milne (Mosaic Project, Capability Scotland)
• Lorna Thompson (Advice Service Capability Scotland (ASCS))
• Diane Lowrie (The Craighalbert Centre)
• Vicky Coalter (Senior Teacher, Dyslexia Action Scotland)
• Cathy Magee (Chief Executive, Dyslexia Scotland)
• Linda Kerr (Dyslexia Scotland, North Lanarkshire branch)
• David Jones (Dyslexia Scotland, North Lanarkshire branch)
• Pamela Spence (Helpline and Information Officer, Epilepsy Scotland)
• Florence Edmond (Policy and Research Officer, Royal National Institute for Deaf People (RNID))
• Alan Macqueen (NDCS)
• Arianna Patterson (Director, Afasic Scotland)
• Mary Dallas (Education and Family Services Manager, Royal National Institute of Blind People (RNIB))
• Hilary Hill (Membership Coordinator and Trustee, Albinism Fellowship)
• Moira Austin (Helpline Manager, The Anaphylaxis Campaign)
• Asthma UK Scotland
• Anne Hayler (Cystic Fibrosis Trust)
• Val Wells (Service Development Manager, The Dystonia Society)
• Rosemary Davies (SOFT UK)
• Wendy Bowler (Family Support Worker, The Fragile X Society)
• Anne Metcalfe (Events and Information Coordinator, Scottish Spina Bifida Association)
• Gemma Honeyman (Family Support Policy Officer, The Challenging Behaviour Foundation)
• Kimberly Kubilus (Director of Member Services, NTSAD)
• Ruth Smith (Information Co-ordinator, Tourette Scotland)
• Cheryl Lenny (Information Officer (Rare Disorders), West Syndrome Support Group)
• Kathy Bairstow (Epilepsy Action)
• John Nelson (Chief Executive, The Williams Syndrome Foundation)
• Kate Hayman (CRIB)
• Lois Cameron (Talking Mats Development Manager, Talking Mats Research and Development Centre)
Acknowledgements
204
Thank you to everyone from Capability Scotland who proofread this guide.
• Mark Bevan (Head of Children’s Services, Capability Scotland)
• Elaine Fox (Manager)
• Natasha Weir (Assistant Research Officer, Inclusive Childcare Development)
• Claire Wallace (Administration Assistant, Inclusive Childcare Development)
• Eric Mitchell (Children’s Services Manager)
• Sam Maxwell (Team Leader, Edinburgh Childcare 4 All)
• Shirley-Ann Wilson (Support Worker, Edinburgh Childcare 4 All)
• Louise Davies (Support Worker, Edinburgh Childcare 4 All)
• Nicola Bwye (Support Worker, Edinburgh Childcare 4 All)
• Ashley Paterson (Support Worker, Edinburgh Childcare 4 All)
Acknowledgements
205
206
This information can be made available in a range of languages
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and accessible formats.

Inclusive Childcare - North Lanarkshire Council

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