Archive for the ‘School Days’ Category


Kids, Sport and Ehlers Danlos Syndrome – a Mum’s Perspective

I have two children with EDS and I thought it might be useful to share some of the ideas we have worked out for ourselves.

We’ve come up with a flyer that can be given to the teachers who supervise school sport.

This information is probably just as useful for any child managing an ever-changing joint condition at school.

People with Ehlers Danlos Syndrome may be in your care.

Be flexible in your thinking and consider our S-P-O-R-T guidelines.

People with Ehlers-Danlos Syndrome do experience varying degrees of symptoms that may not be visible to the naked eye.

Here is an easy to understand reference poster that may assist with a greater inclusion in an activity.

Be a S-P-O-R-T
STOP- May start an activity but they may need to stop.
POSTPONE- Pain and swelling can occur at any time.
ORGANISE- Create some way of an inclusive activity. E.g. scoring, whistle.
REST- Need to keep energy in reserve.
TIRED-Fatigue is frequent and real.

People living with Ehlers-Danlos Syndrome have some or all of the following characteristics- joint hyper mobility, fragile skin, bruise easily, poor wound healing, frequent dislocations and sublaxations, cardiovascular and gastrointestinal issues.

For more information on Ehlers Danlos Syndrome visit www.jointpainrelief.com.au

This information poster does not replace a medical practioners advice.

Hope you enjoy working with this information and you get to see more inclusive interactions.

We’d love to hear about your strategies for keeping kids safe and involved at school.


What To Tell School About Your Child’s EDS

We get a lot of email about the challenge of dealing with schools. I know from experience it can be a bit complicated. Teachers have bigger classes and ever increasing pressures. To help work out the best approach we’ve invited Michelle O’Sullivan, Occupational Therapist from HypermobilO-T to share her thoughts on what to tell schools if your child has EDS. Maybe you have some school experiences you’d like to share. You can join in this discussion by sending in a comment at the end of Michelle’s post. We’d love to hear from you.

Michelle:
Do you tell them everything and let them wrap your child in cotton wool? Or do you tell them the bare minimum so your child fits in with their peers?

This is tricky for any parent of a child with a chronic illness or disability. How much information is enough? How much is too much?

As an Occupational Therapist specialising in hypermobility conditions, including Ehlers Danlos Syndrome (EDS), and as an adult living with EDS hypermobility type, I know there is fine line between too much and not enough information.

Here are some thoughts on what you should tell your child’s school:

School needs to know that your child has a chronic condition. Make sure they understand that your child will have good days and bad days, or even good weeks and bad weeks, but it is a lifelong condition.

Specifics of information will vary between types of EDS:

Vascular Type – you are going to want to tell them everything.

    1. They need to know what signs/symptoms to look out for.
    2. You need a Medical Action Plan. Do they call you or an ambulance? This will depend on the severity of the symptoms your child is experiencing and advice from your doctors.
    3. They need to know what activities your child should avoid and which ones are OK for them to participate in.
    4. They need to know about any medications that need to be taken while at school including pain medication (this usually will be administered by the school nurse or other trained staff member). Talk to your school about their policies on this.

Hypermobility, Classical and other types of EDS:

    1. You need to talk to them about the possibility of dislocations and subluxations and their possible signs and symptoms.
    2. You need a Medical Action Plan. When do they call you versus an ambulance?
    3. Tell them what sports have been recommended; what sports have been banned (usually contact sports). Talk about what your child will do when they are “sitting on the sideline” – could they go to the library? Or read a book? Have a rest?
    4. They need to know that your child is likely to get far more tired, and tire more quickly than their peers. Rests are needed to help with pacing. Where is the appropriate place for your child to rest while at school?
    5. Handwriting may be difficult due to instability in finger, wrist, elbow and shoulder joints. Their writing is likely to be slower and messier than other children. They may actually experience pain when writing and this is very real. It is unlikely that they are “putting it on” to avoid doing work.
    6. They need to know about any medications that need to be taken while at school including pain medication (this usually will be administered by the school nurse or other trained staff member). Talk to your school about their policies on this.

Academic Considerations

Your child may have trouble keeping up with the work load expected; what would you like to see happen?

    Do you want to finish the work at home on weekends?
    Would you prefer your child to be given less work than other children?
    Would you prefer your child to be given the same amount of work but without expectation that it will be completed?

High School
In high school when examinations are timed, your child might benefit from extra time for tests and for external examinations, may require rest breaks, a scribe and or use of a computer. This will need to be applied for through the school and often an Occupational Therapist will do a handwriting assessment to help with the application.

Also for high school students, carrying heavy bags of books to and from school can be problematic. Talk about ways this can be avoided. For example a second set of books my be kept at the school.

School Camps

This can be a really difficult situation, and can be stressful both for your child and for you. Being away from home is hard for some kids without chronic conditions. Depending on your child’s support needs, they may still be able to go on camp, however extra information may be needed regarding things which usually happen at home.

It is important for children to feel included by their peers, and going to camp is definitely a fun experience for most children. However, I’m sure you would agree that the health and safety of your child comes first, and that includes their mental health.

If camp is going to be too anxiety-provoking for your child because of their condition, then perhaps the negative outweighs the positive. Being away from their primary carer (you) can be very scary for a child who isn’t yet able to manage their own condition.

Occupational Therapy

Paediatric Occupational Therapists are able to visit your child in their classroom environment. This is helpful for the child and the teacher so that the child is set up in the best way for them to learn.

The chair your child sits on during the 6 hours they are at school each day is really important, as is the height of their desk, their writing implements, and position in the classroom. If you think your child might need an OT assessment, talk to your school about the possibility. If you need to find an OT, try searching for Occupational Therapy Australia. In Sydney, you can contact me at www.hypermobilot.com.au.

This information should only be used in consultation with your healthcare team. This does not take the place of, or precedence over, personalised medical advice. I hope this has been helpful. You might have some good strategies to add to this post. Please feel free to comment with anything else you feel might be helpful.


Let’s Open Our Minds To Educational Options

I remember sitting in a cafe with a very stressed out Mum some time ago. She was going crazy trying to keep her child at school in the most trying of circumstances.

I suggested to her that perhaps she should try to get her child a place with Distance Education. “Oh no!” she insisted, “the doctor said I must keep her at school.”

I hear this type of thing all the time and I have mixed feelings about it.

Yes school is the most traditional way to further education and paid work but sometimes we really do forget that it is not the only option.

Teenagers deal with incredible pressure at school. They have their own angst, peer acceptance stress and academic performance to worry about as well.

If you add to that the pain and fatigue of a constantly changing medical condition it can be extremely difficult.

Is it really fair to give parents the brief to keep kids at school no matter what?

Is it fair to give those students the impression that they don’t have other good options?

Students who do Distance Education or Home School or even self directed learning do very well at university because they have learnt to manage their own study.

Places like Canning College offer students with health conditions incredible flexibility in catching up on study and finding paths to further education.

So yes if school works for your child – that’s great. If it doesn’t please remember that there are lots of good options out there.

There are other flexible education options listed on the Helpful People page.


Brenda Walker Takes The Pressure Down

Sometimes it feels like everything is coming together. My daughter has been well for a while and she is getting on with her teenage life. Then something happens – a flareup, a virus, a fall – a set back of one sort or another.

For my daughter a virus or a fall can mean a week in bed – often on pain meds.  Flare ups are painful but as she grows up she develops more and more ways of coping.

We had a different type of set back this last week. She has developed low blood pressure. This is pretty normal for teenage girls.

For my daughter it means that her already significant fatigue levels have gone through the roof. She has stopped going to school because she is too exhausted.

We’ve been through lots of health set backs. You probably have too. Sometimes you can shrug them off – other times they hit you hard.

This week I have been hit hard. A big ball of frustration and grief has surfaced. I am so angry that my daughters progress through life is so difficult. My daughter says to me “Mum I want my life to be easy.”

We both sat in the car the other day having a potato chip picnic and trying to laugh at ourselves. The constant set backs make us both grumpy and sometimes grumpy with each other.

I try hard to take a step back and say to myself – “Hey Julia in a week or so this will pass. Ease up. Stop taking life so seriously – it isn’t a race.”

Then the worries snap at my heals.  I worry about her education.  I worry about her joints stiffening up from the reduced activity.   I worry about her putting on weight because she is not moving.  I worry things will stay this way forever. Worry, worry, worry.

I read a wonderful quote the other day in a memoir by Australian writer Brenda Walker called Reading by Moonlight: How Books Saved a Life.

“When I recovered some confidence in my health, I felt that all the minor irritations and anxieties of life – arguments, moments of carelessness, failures of judgement, bad timing, the very things I might otherwise have wished to eradicate – comprised the grain, the detail, the very story of living that I should respect.”

I like to read this when I am heading off into a dark place in myself. Brenda Walker you have nailed it. We get so focused doing the right thing and moving forward that we can fail to appreciate everything belongs in the story.

I’d even go so far as to say set backs in health belong in the story as much as the good days. This is a difficult concept and a deeply calming one.

What strategies do you use to take the pressure down?  I’d love to hear about them.


How To Get Resources for Your Child At School

At the parent group today one of the mothers celebrated that after four years her daughter finally had a lap top at school.

To a lot of people it would seem incredible that a child in chronic pain would have to wait that long.  There are resources out there but it can take a huge effort if you don’t have the right words on the right bit of paper for the right person.

In this case the process for change followed these steps;

  • The child had an assessment by her specialist.
  • He wrote a letter to the school outlining the child’s condition and the effect this condition would have on her.
  • The specialist wrote a referral for a private occupational therapist to visit the school and make an assessment of the school environment.
  • The occupational therapist then produced a report for the school on the changes that needed to be made for the student to fully participate.

The school explained to the family that once the school has the report it must act on it immediately. Apparently there is considerable accountability to Disability Services once such a document is tabled.

In this case all the efforts to lobby the school for extra support had not been effective.  It was not until the family asked the specialist to assist that action was finally taken.

The assistance children can access depends on many factors-

  • The time and energy parents have to knock on doors and ask for questions. (Are both parents working full time?)
  • Access to a specialist with a willingness to assist. (Do families understand that their specialist can help?  Is that person approachable and helpful on this practical level.)
  • The attitude and internal resources of the school. (Some schools have experienced caring staff who will help.)
  • Resources within disability services in that particular area.

If your child needs extra resources at school you might try the process described above.

My husband also recommends writing a letter to the school Principal describing your child’s needs and asking what you need to do to access the available resources – from the school and any related government agencies.

I’d be interested to hear how you have tackled it and what your experience has been.

PS. We had a lap top provided for our daughter by the Centre for Inclusive Schooling. We found these people difficult to deal with.  Once it was too difficult for my daughter to attend school we transferred to School of Distance Education.  Our daughter continued her education from home. The Centre for Inclusive Schooling then asked for the laptop back.  Apparently she could only have a lap top if she went to a day school. Good one guys!


“Excuse Me Miss” – Why Don’t Kids Get Heard At School?

It is not always easy for children to avoid unsuitable activities at school.

It is not always easy for children to avoid unsuitable activities at school.

This morning a group of mothers were chatting at hydrotherapy about problems their children faced at school.

Children with Ehlers-Danlos syndrome who had been told by doctors not to participate in certain activities were still being forced to join in.

“Why didn’t you say something?” parents wanted to know. The children all said they had tried to say no and give their reason, but the teacher just would not listen.

This same theme came up again and again.

Children are not believed.

School notes don’t seem to work because teachers can be different from week to week.

My sister is a teacher.  She told me that so many kids try to get out of sport that teachers become deaf to excuses after a while.

In several of the stories the children suffered painful injuries as a result of being forced into unsuitable activity in the classroom as well as on the sports field.

For these parents I was speaking to, an injury to their child had a big impact.  It might mean having to take time off work.

It could also mean visits to hospitals, doctors or physiotherapists,  medications and watching their kids in extra pain that was avoidable.

It makes me think that this problem could be addressed on several fronts-

  • arming rheumatology kids with assertive skills training
  • developing letter templates that help parents get their message across
  • perhaps a medical alert tag/bracelet could be developed for arthritis kids

I’d be interested to hear whether you have had problems like this and what strategies you have tried.

Netball photo courtesy of tompagenet at Flickr Creative Commons.