Managing the Behaviour

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Managing the Behaviour and Learning for Pupils
with Medical Needs
Linda Aslett NCC Children and Young Peoples
Service Hospital and Outreach Education Pupil
Referral Unit
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Hospital and Outreach Education Statement of
Intent. To provide access to appropriate
education for all children and young people with
medical needs, keeping education alive in the
pupils life, maintaining progress and enabling
them to achieve their potential.
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Section 19 of the Education Act 1996 provides
that Each LEA shall make arrangements for the
provision for suitable education at school or
otherwise than at school for those children of
compulsory school age who, by reason of
illnessmay not for any period of time receive
suitable education unless such arrangements are
made for them.
All pupils should continue to have access to as
much education as their medical condition allows
so that they are able to maintain the momentum of
their education and to keep up with their
studies. Access to Education
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LAs have the responsibility to ensure that

• Pupils are not at home without access to
  education for more than 15 working days

• Pupils with an illness/diagnosis indicating
  prolonged or recurring periods of absence should
  have access to education from day one

• Education should be broad, balanced and similar
  to that available in school

• Pupils have a minimum entitlement to 5 hours
  teaching per week.
• Access to Education

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Hospital and Outreach Education (HOE) provides
for all students between 3 and 16 years

• Teaching in Northampton and Kettering General
  Hospitals

• Teaching of groups in bases in Northampton and
  Kettering

• 1-1 teaching in the home

• 1-1 support from teaching assistants in the home

• Family Liaison Worker support

• Advice and support for schools.

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Students are referred by school to HOE because
they have

• Long term or recurring physical conditions

• Chronic medical conditions

• Short term physical conditions

• Acquired brain injuries

• Mental health difficulties including anxieties
  relating to attending school.

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• Hospital and Outreach Procedures
• Remain on roll at mainstream placement
• Core teacher role
• ILP
• Personalised curriculum
• Regular reviews.

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Curriculum entitlement
Schools have a responsibility to provide a broad
and balanced curriculum for all pupils. The
National Curriculum is the starting point for
planning a school curriculum that meets the needs
of individuals and groups of pupils. The
National Curriculum. Handbook for Secondary
Teachers in England.
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Although PRUs do not have to teach the full
National Curriculum, they should offer a balanced
and broadly based curriculum that includes
English, mathematics, science, PSHE, ICT and
careers education and guidance post-13.
Guidance for Local Authorities and Schools
Pupil Referral Units and Alternative Provision.
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Suitable education is defined as efficient
education suitable to the age, ability, and
aptitude and to any special educational needs the
child (or young person) may have.
Pupils receive an education of similar quality to
that available in school, including a broad and
balanced curriculum. Access to Education
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• Personal Development Curriculum
• Protective Behaviours (www.protectivebehaviours.co
  .uk)
• Solution Focus Activities (www.brieftherapy.org.uk
  )
• PSHE
• Careers Education
• Citizenship
• Self-esteem and confidence building activities,
  anxiety management and relaxation
• RE SMSC
• Enterprise project
• Active curriculum.

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• Possible characteristics of students with
  anxieties relating to attending school
• Schools tried variety of strategies to re engage
  them with learning
• Parents actively involved in trying to get their
  child to attend school
• Students will probably have been out of school
  for several weeks or months
• Students concerned and confused about their
  future.

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Behaviours

• Disaffection
• Anxiety / depression
• Confusion
• Low self-esteem
• Social isolation

• Avoidance and withdrawal
• Reluctance
• Changes in mood and/or attitude
• Self harm
• Obsessive behaviour.

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• Strategies for students at Key Stage 3
• Detailed baseline assessment
• Social engagement
• Engagement in learning
• Teaching in groups
• Focus on teaching core subjects including ICT
• Focus on Personal Development curriculum
• Managed and supported reintegration to mainstream
  placement or alternative
• Regular reviews to monitor progress
• Continuous liaison with other agencies.

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• Strategies for students at Key Stage 4
• Focus on reduced number of subjects studied at
  GCSE or alternatives
• Focus on Personal Development curriculum
• Engagement in personalised learning
• Teaching in small groups
• Greater input from Connexions
• Extended work experience placements
• Further education taster courses
• Managed and supported reintegration to school or
  integration to alternative learning setting.

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• Considerations for planning an ILP
• Issues causing the initial anxieties
• Pupils age
• Pupils ambitions
• Provision in terms of pastoral care and academic
  routes offered by school
• Medical advice
• Agencies involved
• Local provision of alternatives (if appropriate).

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Group Task You will be given a card with a
description of a pupil on it. In groups read the
information about the student and discuss what
you think would be the most useful plan for this
student .
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• Case Study 1
• Reduced GCSEs to 5 ½
• Intensive support from Connexions to choose and
  apply for college placement for post 16
• Self esteem and confidence building activities
• Support from CAMHS
• Regular 1-1 discussion sessions
• Time to play
• Support to maintain personal interests.

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• Case Study 2
• Withdrawn from GCSEs
• Completed AQA unit awards
• Completed ASDAN Learning for Living programme
• Opportunities for Community Service
• Extended work experience placement
• Intensive support from Connexions to apply for
  place on E2E programme post 16
• Self esteem and confidence building activities
• Regular 1-1 discussion sessions.

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• Case study 3
• Protective behaviours
• Self esteem and confidence building
• Baseline assessment and target focused teaching.
• ????

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• Effectiveness of HOE support
• 73 during 2004 2005 re-engaged with learning
• Improved attainment in basic skills
• Evidence of achievement
• Increased confidence and self esteem
• Equipped with strategies to cope with variety of
  difficult social situations
• Signposted to a variety of agencies for continued
  support.

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• Conclusion
• Changes in the breadth and balance of the
  curriculum allows
• Focus on pupils emotional needs
• Focus on coping strategies
• Changes in pupil behaviour and attitude.

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Ofsted February 2006 Pupils are very well
cared for and supported and the curriculum is
tailored to closely match with their learning and
additional needs. pupils develop very well as
young people and become sufficiently
self-confident and self-assured to return to
their other schools. Over their time at the
PRU, they (pupils) begin to like themselves again
and develop better attitudes to their futures as
they become sufficiently strong enough as young
people to return to their other schools.
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References DfEE. (1999) The National Curriculum.
Handbook for Secondary Teachers in England.
London. HMSO. DfES. (2001) Access to
Education. London. DfES Publications. (DfES
0732/2001) DfES. (2005) Guidance for Local
Authorities and Schools Pupil Referral Units and
Alternative Provision. DfES Publications