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Chapter 5 E-materials



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Appendix 5.1 Issues to consider in a nursery setting


































  Possible barriers Possible solutions
Daily therapy programmes Time Programmes constructed to integrate into nursery activities
Some aspects of programmes to be delivered by parents at home
Someone to carry out the programme Several staff trained to deliver the programme so it can be shared
In-service training for nursery staff delivered by therapist
Training for staff Attendance at relevant external courses
Provision of a statement if special educational needs should provide financial support towards individual input for a child
Using postural management equipment Finance Funded via statutory or possibly charitable provision (health or education)
Look for pieces of kit that may provide multiple functions
Keep kit as small as possible
Provision of equipment
Storage space
Manual handling training of staff for effective, efficient and safe use
Staff should attend manual handling training but a therapist should advise on use of equipment for individual children (how to get children in and out, the time equipment should be used for, how to check regularly to keep in good order, etc.)
Use of orthotics Staff are afraid they might hurt a child
Occasionally staff link orthotics to handling that they associate with child protection issues
Staff should be given very clear instructions on the use of orthotics – how they should be taken off and put on, duration of use, what to do if they have any problem
Use of mobility equipment Crowded environment with lots of toys on the floor
Staff are often initially worried that a child my fall
Choose kit that is stable and a child is fairly confident to use
Practice therapeutic walking in a clear uncongested area
Use a buggy or wheelchair in situations where it is just not safe to use walkers
Ensure that staff are aware of policies to follow if a child hurts himself
Teach a child how to get up from the floor and ensure staff know how this should be encouraged


Appendix 5.2 Some issues to consider in a primary setting










































  Barriers Solutions
Small and often crowded classrooms Little space for the use of positioning equipment
Difficulty moving around with mobility aids
Consider the place a child sits in the classroom
Being near the door offers easy access and is nearer to a toilet should this be necessary in a hurry
Use of equipment and mobility aids
Sitting on the floor Not always possible to be able to work at the same height as peers
If only able to sit with legs out, others may trip over and not enough space
Sit on a small chair
Sit on a floor cushion used to mark a place with enough space
Specifically identify a suitable space for a wheelchair or supportive seating which ensures safe access for the whole class
PE and swimming Health and safety issues for both child and staff
Child not able to keep up with peers
Child cannot cope with the cold for some outdoor activities
Not able to access standard equipment
Appropriate training for staff in both manual handling and differentiation of activities
Alternative activities to do with a small group when it is cold outside
Possible alternative activities – swimming or horse riding
Plan, e.g. swimming, choose a pool with suitable access and ensure that pool staff are aware of the special needs of the child
Break and lunch times Crowded situations where children often like to rush around
Specific difficulties with controlling food in the mouth
Difficulty managing dinner trays and cutlery
Health and safety training
Liaise with OTs and SALT
Position at the beginning or end of the queue
Identify a place in which a wheelchair or supportive seating will fit
May have some kind of tube feeding Training for staff for tube feeding and the identification of a suitable place for this to happen
Personal care Child protection issues
Manual handling
Access to toilets is often difficult
Appropriate training in many of these areas is essential
OT advice re hoisting and suitable adaptations
Track hoisting may help small space issues
Unable to toilet independently
Incontinence
More than one person trained to manage all personal care situations
Catheterisation
Unable to change independently for swimming or PE
Try to have PE or swimming first lesson of the day so children can come ready changed under their clothes



Case Study 5.1





School




At this stage John had little in the way of independent function apart from head control and he had communication difficulties.


The special school enabled John to have daily physiotherapy and to receive input from different specialists within the school.


John showed significant improvement during the year in his function and ability to communicate and was showing signs of improving academic abilities.


Therefore it was considered appropriate to transfer John back to his mainstream school as it was felt that this would provide the stimulus and challenge to enable him to maximise his potential.


Planning and meetings were crucial to ensuring a smooth transition.


The team necessary to support John included: physiotherapists, speech and language and occupational therapists, teachers and non-teaching staff, educational psychologists.


A joint professional approach was important to ensure the provision of the required level of ongoing rehabilitation and treatment that John needed alongside the school work.


The physio- and occupational therapists provided training for the school staff and helped to problem solve any issues involving the integration of John into the normal routines of the school.


Following the preliminary meetings any equipment that had been identified as being required was ordered.


The physiotherapist and one of the school staff began the process of preparing school staff for their roles in helping to integrate John back into the school.


John made steady progress in his independent function, communication and academic abilities over a 2-year period.


Ongoing therapy sessions at school and attendance at aquatic pysiotherapy sessions and rehab sessions outside of school meant that John achieved the ability to stand with support and walk with walking aids and the support of 2.


John has a teaching assistant who is dedicated to him at school who is able to ensure school staff are updated on any new approaches to his management that are undertaken by the therapists in or outside of the school.

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Nov 5, 2016 | Posted by in MANUAL THERAPIST | Comments Off on E-materials

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