SPECIAL HEALTH CARE NEEDS-INTERVENTION

SPECIAL HEALTH CARE NEEDS-INTERVENTION

INTERVENTION

Health disorders can affect children’s learning and progress in numerous ways. According to Winzer (2008) “Student learning will be hindered as a result of missed class time, and consequently results in limited vitality, short attention spans, and limited mobility.” Students with physical disabilities are affected in areas such as physical strength, communication, independence and daily living skills.

Medical Intervention

Children with special health care needs bring a range of challenges that extend beyond simple monitoring of drug usage, to classroom adaptations to accurate adaptive equipment for mobility and communication. (Winzer, 2008, p.416)

Children with special health care needs can require a range of interventions including surgical procedures, prosthetic devices, drug therapy, diet management, and ongoing medical treatment.

Classroom health related procedures include gastronomy, tube feeding, and administration of oxygen, nebulizer treatments, and suctioning.
Gastronomy tube feeding (or G-Tubes) are tubes placed directly into the stomach of children to assist with feeding individuals who cannot eat orally. Usually meal replacement shakes are injected into the tube with a syringe to feed the individual. These are used in cases where the individual cannot swallow, or chew on their own. Children with Cystic Fibrosis are prone to needing them, as they can have problems with gaining weight.

Oxygen is usually administered via a face mask and an oxygen tank. It can also be administered via a trach tube. “The goal of oxygen therapy is to relieve hypoxemia, decrease work of breathing and to reduce myocardial stress. Oxygen is considered a medication and is therefore administered in the lowest possible concentration to produce the most acceptable oxygenation without causing toxicity. When delivering oxygen, the caregiver must ensure that it is properly humidified to prevent drying and irritation of the respiratory tract and to facilitate secretion removal.” (http://www.sickkids.ca/Nursing/Education-and-learning/Nursing-Student-Orientation/module-two-clinical-care/OxygenTherapy/index.html)

“A nebulizer changes medication from a liquid to a mist so that it can be more easily inhaled into the lungs. Nebulizers are particularly effective in delivering asthma medications to infants and small children and to anyone who has difficulty using an asthma inhaler.” (http://www.webmd.com/asthma/guide/home-nebulizer-therapy) These treatments can be delivered with either a tabletop unit or a battery powered unit. Tubes are connected to a mask which is placed against the child's face and the medication is delivered through the air and by breathing through the mask.

Children with trach tubes often need to have them cleaned out by suctioning the fluids out. 

 “Suctioning clears mucus from the tracheostomy tube and is essential for proper breathing. Also, secretions left in the tube could become contaminated and a chest infection could develop. Avoid suctioning too frequently as this could lead to more secretion buildup.” (http://www.hopkinsmedicine.org/tracheostomy/living/suctioning.html) This is done by squirting sterile saline solution into the tube and then suctioning it out with a small machine.

 

Health Service Plan- a document that outlines the student’s specific needs, strategies that support the child, responsibility of the staff, training and resource required

Emergency Protocol- contains information regarding emergency practices and strategies developed by parents, school staff, and medical staff.

Therapy

Some students may require therapy from a variety of therapists that may include physical, and occupational therapists, and speech and language pathologists. Therapy is necessary to help students understand and deal with the stress of their disability (Winzer, 2008, p.418).

Technical Aids

Most technical devices are designed to increase personal independence. Some examples include assistive, adaptive, prosthetic, and orthotic aids, allow students to minimize the effects of their disability (Winzer, 2008, p.418)

Educational Intervention

There are many accommodations and adaptations for students with special health care needs (Winzer, 2008, p. 418)

Accommodations:

• A team of medical personnel to address health needs.
• Educate yourself about the health conditions, including etiology, developmental consequences, and prognosis.
• Be aware of the treatment procedures
• Have an emergency protocol
• Maximize learning time by adjusting the classroom schedule for students with limited vitality

Medical Management

In order to adequately assist children with health care needs in the classroom, teachers must be aware of physical conditions that may require special equipment or devices, and special classroom arrangements needed to accommodate medications, allergies, poor muscle strength, and special feeding problems which extend beyond the educational requirements (Winzer, 2008 p.421)

Service Delivery Model

“Students who are technology dependent, or medically fragile, may be placed in a variety of educational settings depending on the type and severity of the condition, the services available, and the prognosis of the disability” ( Winzer, 2008, p.420)

The chronically ill students attend hospital schools provide long term care for children. Here Special Education teachers provide regular instruction in the classroom setting

For students who are no longer in the hospital but not yet ready to attend school, home bound instruction is available. This means a home visiting teacher provides individual instruction following the curriculum of the student’s classroom ( Winzer, 2008, p.420)

“Teachers should approach medical information from an educational and cooperative perspective, not from a diagnostic or treatment one. In addition to learning about a particular condition, it is also wise to seek out the specifics of the individuals case. It is important to have an understanding of both daily and emergency procedures.

Bennett, S., Dworet, D., Weber, K. (2008).  Special Education in Ontario Schools (6th ed.). St. Davids, Canada: Highland Press, pp. 180-181.

Winser, M. (2008).  Children with Exceptionalities in Canadian Classrooms (8th ed.). Toronto, Canada: Pearson Prentice Hall, pp. 416-421.

Nebulizers: Home and Portable Nebulizers for Asthma Treatment. (n.d.). WebMD. Retrieved from http://www.webmd.com/asthma/guide/home-nebulizer-therapy

Suctioning. (n.d.). Suctioning. Retrieved from http://www.hopkinsmedicine.org/tracheostomy/living/suctioning.html

Oxygen Therapy. (n.d.). Oxygen Therapy. Retrieved from http://www.sickkids.ca/Nursing/Education-and-learning/Nursing-Student-Orientation/module-two-clinical-care/OxygenTherapy/index.html