Help with mobility
Painful joints can make movement slower or more difficult. You
can help overcome difficulties with mobility in the following
ways:
- Offer transport to and from school. Arrange transport for
school trips that involve lots of walking.
- Be flexible about a pupil arriving late or leaving early.
- Let the child get up and walk around in class to reduce
stiffness.
- Raise or lower desks and chairs to provide the best seating
position.
- Provide a chair during assembly or carpet time.
- Allow extra time or help for moving between lessons - this is
more of an issue in secondary schools, where lessons are often in
different rooms.
- Provide a ground-floor locker, allow the pupil to leave
textbooks in a classroom, or to have two sets of books – for school
and home.
- Allow the pupil to use the lifts.
- Add a grab rail in toilets or a banister on both sides of
stairs.
- Consider access for wheelchairs and crutches, where these are
necessary.
An occupational therapist can advise on other adaptations or
equipment that may be useful, for example relating to hand
function, writing and keyboard skills.
Help with hand function
Painful hand and wrist joints can make tasks like writing
difficult. You can help in the following ways:
- Allow the child to occasionally wear a wrist splint or brace to
support the wrist while writing.
- Allow breaks from writing, or let the child to do oral work,
use tapes or dictate work where possible.
- Provide photocopies of any long text that needs to be copied
down.
- Allow extra time to finish work and to complete exams.
- Supply a computer or laptop where necessary.
- Allow for extra time or help with buttons, going to the toilet
and other everyday tasks such as opening lunchboxes.
Special aids, like easy-grip scissors and cutlery, pencil grips
and tap turners may also be helpful. Some children may need a
learning support assistant to help with tasks like carrying books,
taking notes and using equipment, on either a part-time or a
full-time basis.
Joining in during breaks
Children with arthritis should join in with their classmates
during playtime or breaks whenever possible. Exercise is good for
arthritis and joining in creates a sense of belonging for the
child. Sometimes, however, they may find running about or standing
around painful, and cold weather can make joint stiffness worse. At
times like these, consider allowing the child and some of his or
her friends to play inside for some or all of break-time.
Physical education (PE) and sports
Regular exercises help with mobility and protect the joints from
damage. Young people with arthritis should be encouraged to take
part in PE lessons and other sports activities as much as possible.
They should generally be able to join in all sporting activities,
although rough contact sports like rugby should be avoided while
their arthritis is active. Swimming and cycling are especially
good.
However, if the child is finding PE difficult s/he should be
allowed to do his or her own exercise programme instead. Every
child with arthritis will have a tailored programme of exercises
designed by a physiotherapist. In some cases physiotherapists may
come into school to treat a child while the rest of the class has
PE.
Extra tuition
Arthritis doesn't in itself affect a young person's capacity for
academic achievement. However, schoolwork can suffer if a pupil
misses school due to hospital visits or stays. Work can be sent
home or home tuition arranged if necessary.
Time out of school
Most young people with arthritis will need regular hospital
appointments to monitor their condition, requiring time out of
school. Occasionally they may need to stay in hospital for a few
days for tests or treatment. Treatment may go on for several years
or even throughout a child's school life.
Hospital tutors will organize work from the National Curriculum.
Ideally this should be done in liaison with the school, to ensure
continuity of education. If possible teachers should arrange work
that can be taken into hospital. For young people who've been very
ill and in hospital for long periods of time, a discharge planning
meeting or case conference may be held. It is very helpful if a
member of staff from school can participate in these meetings.
Classmates
Other children are generally supportive of a child's particular
needs when they understand the reasons – that's why it is a good
idea to discuss arthritis with the whole class. Children with
arthritis are often anxious about telling classmates about their
condition, particularly on transfer to secondary school. This can
cause difficulties, for example if the child has to take medicines.
It's important to provide support that allows a young person to
share as much information as they feel comfortable with. A local
physiotherapist or occupational therapist may be willing to come
and talk at school. Any incidents of teasing or bullying should be
tackled immediately.
Addressing emotional issues
As with any long-term illness, arthritis can cause emotional
difficulties, especially as children grow older. A young person may
be anxious about the future, worried about hospital appointments,
or distressed about falling behind. S/he may resent feeling
different or enjoy the extra attention illness can bring. The
general approach adopted by professionals treating juvenile
arthritis is to encourage a child to be positive and not see
themselves as a 'patient' all the time. A child may need
reassurance and motivation to catch up or join in. A child's
illness can affect the whole family, so teachers need to be aware
of the effect on brothers and sisters too.
Moving to secondary school
Moving from primary to secondary school needs careful and early
planning. Secondary-school pupils have to cope with more stairs and
more moving around between lessons. Parents may need help choosing
the right school. It's a good idea for parents to talk to schools
early – at the end of Year 5 or beginning of Year 6 – to make sure
they are prepared. The SENCOs at both primary and prospective
secondary schools should be able to advise and support parents.
Growing up
As they grow older, children with arthritis may experience
additional challenges, although the age at which such issues arise
varies considerably:
- They may have growth problems, making them shorter than
classmates.
- For some, puberty may be delayed for a few years.
- Physical difficulties can sometimes limit them joining in with
their peers or gaining independence.
- Bullying or teasing at school is a problem for some
youngsters.
- Some teenagers find that 'disclosure' – telling friends,
partners or teachers about their arthritis – is difficult.
- Young people may feel that taking medicines places restrictions
on their lives, for example if they take medications at weekends to
avoid side-effects during school hours.
- Young people may feel unable to discuss issues such as sex or
alcohol with their parents or doctors.
Support from school staff, in liaison with parents, is vital at
this stage to allow young people to understand their condition and
feel in control of their treatments.
Offering career advice
Young people with arthritis often do well academically and many
go on to university or college. But some seem to have difficulties
obtaining a job, possibly because employers have lower expectations
or because of prejudice. Helping a child to plan a suitable future
career early on, and boosting their expectations and self-esteem,
can make a huge difference.