Schools, local authorities and the NHS have duties to provide support for children with healthcare needs. For some children, not getting the right support can be life-threatening. Here we provide a case study about Kate who is in P6 and has Type 1 diabetes.
After being quite poorly for several months and missing quite a few days of school, Kate was diagnosed with Type 1 diabetes. Kate’s mum arranged a meeting with the head teacher as soon as they found out to talk to the school about the support Kate would need in school. Kate’s mum explained to the school that Kate would need to test her blood and inject insulin throughout the day, and would need an adult to help with this. Kate’s mum highlighted that Kate was quite upset at finding out she was diabetic and was still getting used to the idea. She explained that Kate was easily tired and sometimes struggled to concentrate and remember things.
Getting the right support
The school staff discussed who should support Kate and it was agreed that her class teacher, who was willing to help Kate, would support her with her injections after she had received training from a specialist diabetes nurse. Kate’s mum was keen that more than one staff member was able to support Kate in case of absence, so a pupil support assistant agreed to be trained. Kate’s mum agreed that if there was a situation where both teachers were absent on the same day she would come into school to administer the insulin, but that this should only be in an exceptional circumstance. Kate and her mum did not want her to miss 3 weeks of school while school staff were being trained, so Kate’s mum agreed to administer her injection in the interim. Everybody acknowledged this was not an ideal situation as Kate’s mum had to take time off work and Kate was embarrassed about her mum coming into school every day. The head teacher asked Kate’s mum permission to share information about Kate’s needs with a number of key staff, including the deputy head teacher and gym teacher. The head teacher also asked all staff to read the on-line leaflet ‘Making Connections: Supporting Children with Type 1 Diabetes in Education’.
The head teacher took responsibility for creating and updating Kate’s Health Plan to reflect the school’s arrangements. This would be reviewed and updated at intervals with Kate’s mum and the specialist diabetic nurse. It was agreed that the head teacher would be the contact point for Kate’s mum if she had any questions or concerns.
The class teacher did not feel that Kate needed a individual learning plan at the moment and that she would ensure that Kate knew she could ask for help in class if she was struggling. Kate’s teacher agreed that she would monitor Kate’s learning progress and review this decision next term.
The training the specialist diabetic nurse gave the class teacher included how to administer Kate’s insulin injections, as well as advice on how to help Kate be more independent and administer her injections herself with supervision. The training also included advice about watching for signs of low blood sugar such as tiredness, forgetfulness, strange behaviour and, most importantly, signs of diabetic or insulin coma. It was agreed that if staff became concerned about Kate’s health or behaviour in any way they would test her blood sugar, administer insulin and call her parents.
The learning assistant who had been trained to help Kate subsequently left and there were a couple of occasions when her class teacher was absent which meant that Kate would have been unable to attend school. However, Kate’s mum was able to provide support on a short-term basis. The head teacher agreed to ask for another volunteer staff member as a matter of priority.
Kate’s mum agreed to make sure that Kate always had snacks with her in school and asked that relevant school staff be made aware of signs that Kate needed to eat something, and that she was allowed to eat outside of breaks and lunch time if she needed to.
Kate’s teacher also raised the issue about how Kate would be supported on school trips as she did not always look after all the children. It was agreed that whenever a trip was planned for Kate’s class, the teacher would make sure Kate was in her group and that there was plenty of time and space for Kate to have something to eat and have her injection when needed.
Kate’s teacher had a chat with her to ask her if there was any help she needed and whether she wanted her classmates to know she had diabetes. Kate said she had told her best friends but was happy for other people in her class to know.
Children’s Health Scotland can help families access the best possible healthcare by providing information and resources, support and advice.