Complex and Medical Needs

How Can a Tutor Help My Child with Complex and Medical Needs?

Cerebral Palsy

Cerebral palsy is a condition which affects a person’s muscle control and co-ordination. It’s generally caused by an injury to the brain which occurs during or shortly after birth and according to the charity Scope, it affects one in 400 people in the UK. It can also go along with other health issues such as epilepsy, problems with feeding, behavioural issues or learning difficulties.

It’s often very obvious when a person has CP as their movements may be stiff, jerky or uncoordinated and their speech may be slurred. It can also affect their fine motor skills, making smaller tasks such as doing up a button or handwriting, tricky.

Deafness or Hearing Impairments

Children can be born with hearing difficulties, affecting one or both ears, or they can develop over time due to injury or illness. They can be profoundly deaf – meaning they cannot detect any sound at all – or be moderately or mildly impaired, perhaps struggling only with certain sounds or frequencies.

These difficulties can be ‘conductive’ – meaning sound doesn’t travel from the outer to the inner ear, perhaps due to blockage or structural damage to the eardrum or bones of the inner ear. Alternatively, it may be ‘sensorineural’ impairment – due to damage to the auditory nerve, the cochlea or the brain. If it’s both, the difficulties are classified as ‘mixed’.

Hearing Problems Can be Exhausting

Naturally, auditory problems can have an enormous effect on a person’s education and social life, though hearing aids, implants, sign-language and lip reading are helpful for some people. Even so, it’s important for parents and teachers to recognise that a child with hearing difficulties will be working extra hard to comprehend the world around them, which can lead to exhaustion and frustration.

Carers can make life easier for hearing-impaired kids, experts say, with a few, simple strategies such as using pictures to aid communication and making sure a child has a clear view of your face as you speak.

Problems with Sight

Similarly, children with visual impairments or sight-loss may be born that way or acquire this over time due to brain damage, injury or illnesses. Common difficulties, such as short or longsightedness, are easily corrected with glasses or contact lenses but more complex medical conditions – of which there are many – can mean a young person will never have good eyesight. In this instance, audio materials or Braille (a system of raised dots which represent the alphabet) can help some kids access learning.

Visual difficulties can also be an integral part of other conditions. Dyslexic people, for example, often have ‘convergence’ problems, meaning that each eye is focusing on a different letter. In extreme cases, a page of writing can appear to jiggle about.

Deafblindness

As part of a profile of complex needs, however, problems with hearing or sight occur alongside other conditions, meaning children may also be struggling with other neurological or sensory challenges, physical disabilities or learning difficulties.

Some people have both visual and auditory difficulties – often referred to as ‘deafblindness’ or ‘multi-sensory impairment’. According to the experts, most deafblind people have at least some level of vision and hearing though again, it varies according to each individual. Often, they point out, deafblindness is connected to the way someone’s brain processes what they see and hear, rather than a malfunction in the eyes or ears themselves. As with other sensory impairments, people can be born with these problems or acquire them later in life.

Brain Injury

As the most complex organ in the body, the brain controls everything – from physical movement and bodily processes to behaviour, thoughts and memory. Where someone’s brain has been damaged due to a physical accident or an illness such as meningitis or a stroke, it can have a massive effect on all aspects of their life. A person with acquired brain injury (ABI) will have an individual profile of difficulties, depending on the areas of the brain that have been affected and the extent of the impairment.

Although it’s usually easy to see where an adult with ABI is struggling, it often takes longer for the effects of brain damage to fully manifest in children. According to the charity the Child Brain Injury Trust, the full extent of a child’s challenges may not be clear until adolescence or early adulthood as the young person develops and matures.

Many of the behavioural difficulties caused by ABI, they say, are similar to those faced by kids with other kinds of special needs. For example, a child with brain injury may have problems with impulsivity, mood-regulation and executive skills or take longer to process information and complete tasks.

Children With Complex Needs are Still People

Educationalists agree that pupils with complex needs need experienced and dedicated teachers who are willing to look beyond the disabilities to the person beneath. Children with complex needs are more likely to engage in learning, they say, if it focuses on topics of interest. A sensitive teacher will get to know the signs that the student is engaged which may be as subtle as a smile, an eye-movement or uttering a brief sound.

Useful contacts

• Sense
  The charity Sense offers support and advice to families of children with complex needs including deafblindness and brain injury. Visit them here.
• The Royal National Institute for the Blind
  The Royal National Institute supports blind and partially sighted people by providing advice, services, resources, and campaigns to improve accessibility and independence. Visit them here.
• The Royal National Institute for the Deaf
  Royal National Institute for Deaf People supports deaf people and those with hearing loss by providing advice, resources, advocacy, and services to improve accessibility and inclusion. Visit them here.
• The National Deaf Children’s Society
  National Deaf Children's Society supports deaf children and their families by providing advice, resources, advocacy, and help to improve communication, education, and inclusion. Visit them here.
• The Child Brain Injury Trust
  The Child Brain Injury Trust provides information, training, advice and counselling for families and professionals. Visit them here.