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Reintegration

Young people with ME will reach a point in their illness when they feel ready to start reintegrating into the school day. It may be they have been absent from school for some considerable time but, whatever the background, the move back into school life needs to be carefully planned if it is to be successful.

There are four stages to this process:
Information gathering – teachers learn about the illness and the associated education law.
Communication – teachers speak to the young person and family about their illness.
Planning – together with the young person and family, goals are decided on and how these are to be achieved comfortably.
Review – goals are reviewed realistically.

Information gathering
Teachers and other professionals need to understand the framework they are working in and understand the parameters which underpin decisions. They are then able to communicate constructively with the young person and their family and contribute knowledgeably when attending meetings. Trying to manage without this basic information is like making a cake without any flour.

  • What is ME?
    What is ME?
  • Which legislation do young people with medical needs fall under?
    Educational law and ME
  • What is in the DCSF guidelines for access to education for young people with medical needs?
    ‘Access to Education for children and young people with Medical Needs’ reference DCSF 0732/2001 DCSF-sickchildren or 0870 000 2288.
  • Has the Local Education Authority developed a local policy based on the law and the national guidelines?
    A copy of local policy should be available from the local education offices.
  • Is the student about to take public examinations?
    Exam Concessions
  • What is the ‘Mall Test’?
    This was developed by Dr David Bell MD, a family practitioner and paediatrician in Lyndonville, New York. He says young people with ME who can manage three hours in a busy shopping mall can probably manage one hour of school.

      Communication
      The stage when teachers talk to the young person and their family and learn how ME affects them

      • Visit the young person at home. This makes the family feel safer and they will appreciate the effort.
      • Given the background information, listen to the young person and the family.
      • How does ME affect their lives? For example…
        • What sort of relapsing/remission pattern are they experiencing?
        • Which symptoms are most troublesome?
        • When is their good/bad time of the day?
        • What are their sleep patterns like?
        • How do they feel walking?
        • How do they feel about crowds / noise / lights?
        • How do they feel about starting school again?
        • What tuition have they been receiving?

      It is vital the young person feels they are believed and that they have a voice. They will appreciate the effort taken to collect information and will feel more comfortable with a teacher who is taking the trouble to do the research.

      Planning
      The stage at which goals are agreed for reintegration. Remember…any provision needs to be ‘suitable’ under the law. Provision which overstretches a young person with medical needs will not be considered ‘suitable’.

      • It is vital the young person and the family should not feel they lose control at this stage.
      • A goal should be agreed on with the young person and the family.
      • This may well cause a level of anxiety as this is a big step.
      • The goal should be a small step, realistic and for a trial period.
      • It should be in everyone’s mind that this is an experiment only – potential failure and pressure should not be a part of this.
      • Flexibility has to be constantly borne in mind. Fluctutations in the condition with relapsing/remitting patterns may make usually achievable goals unworkable.
      • Thought should be given to educating classmates about ME and the difficulties of reintegrating into peer groups. (AYME will be able to help with this – phone 08451 23 23 89).
      • Thought also needs to be given to educating teaching staff.
      • Involvement with a GP or Consultant will be beneficial at this stage if there is a positive rapport – this must be with permission from the family.
      • At this stage, thought needs to be given to detail...
        • Is the goal a subject area? (for example, art classes are often successful starters)
        • Is the goal a visit for social interaction only? (for example, over lunch or break times)
        • Where in the school will the visit take place? (SENCOs room / library / downstairs classroom?)
        • Are stairs going to prove difficult?
        • Will the home tutor accompany the young person?
        • Will the young person be met by someone at the door?
        • What about transport to school?
        • Should the young person arrive five minutes late to a lesson to avoid the corridor crush and leave five minutes early?
        • Do all appropriate teachers know the situation? Classmates?
        • Will the student need to take notes/write a lot? Is this a problem?
        • Is the class noisy?
        • Can classroom lights be left off if necessary?
        • Is a ‘buddy’ useful?
        • How will the young person show the teaching staff if they need to leave the classroom because they feel ill? This can be embarrassing for young people. Can they carry a card/letter?
        • What happens about homework?
        • How far does the young person have to carry books? Locker? Is a buddy useful here?

      There should be no pressure applied at this stage as stress can make ME worse. The young person should feel they maintain a level of control.

      Review
      The stage at which goals are reviewed.

      • Wherever possible, this should be carried out at home in an atmosphere of co-operation.
      • The young person should not be made to feel a failure if the goal has not been met.
      • If the goal has not been met, decisions need to be made as to whether the goal was unsuitable, or has the young person relapsed. The relapsing / remitting pattern of ME often makes usually achievable goals difficult – liaison with a GP or Consultant may help this process (permission from the family must be sought).
      • Again, the young person needs to have a voice and be listened to.
      • Once a goal is working reasonably, it should be included in a Personal Education Plan (PEP) which should be reviewed regularly to the benefit of the young person.
      • Flexibility should remain the watchword.

      Young people with ME experience many difficulties as a result of their illness and disruption to their education can prove distressing. With careful planning and realistic goals supported by informed members of staff, a gentle return to normality as the illness begins to recede will see these young people living fulfilled lives and becoming strong members of the wider community.



      • Article last edited on Wednesday 29th July 2009                         print version Printable Version


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