Complex Needs

If you are the type of foster carer willing to give extra time and effort as well as cope with the additional physical demands, you might consider specialising in fostering children with complex needs. At Rainbow fostering we would like you to hear from foster carers keen to develop the additional skills that are needed. As one of the leading independent fostering complex needs fosteringagencies, we will provide all the support and training you will require. Where necessary, this will include providing specialist equipment plus advise on your behalf about any home adaptations that may be required. We also pay an enhanced fostering allowance that recognises the additional costs that are likely to be involved.

There are different types of fostering but all will need to take into account a child or young person’s educational needs. So one of the most important tasks for a foster carer is to support the children and young people in care through their education. Children with special educational needs and disabilities (SEND) will require additional support. The definition of SEND has been established by the Children and Families Act of 2014 which defines a child or young person as requiring special educational needs if they have a learning difficulty or disability which means special educational provision needs to be in place.

Complex needs are defined when a child or young person has significantly greater difficulty in learning than the majority of other individuals of the same age; or if they have a disability preventing or impeding them form making use of facilities provided for other young people of the same age in mainstream schools or post 16 establishments. It is important that anyone considering becoming a foster carer has an understanding of the support and direction that is both in place and reviewed on an ongoing basis. Knowing that support is coordinated provides reassurance around the life changing decision to foster – and especially to foster children with complex needs. There are Health and Well Being Boards (HWB’s) which are established by local authorities that bring together the NHS, adult social care as well as children’s services. Their role is to play a key role supporting; amongst other things, the needs of children with complex and special educational needs including those with illnesses, injuries or conditions of varying levels of severity.

The information below covers most of the conditions that usually fall within the description of ‘complex needs’ that a foster carer might come across. There are also some useful links which will providing additional information. At Rainbow, as providers of independent foster care services, we provide education and training when required around dealing with a wide range of complex needs.

ADHD – Attention deficit hyperactivity disorder

ADHD is an umbrella term for a group of behavioural symptoms that can include hyperactivity and inattentiveness with impulsive behaviour also being an indicator: the general symptoms are short attention span, constant restlessness and overactivity. It is at school that these problems are usually noticed first because a child with ADHD can be disruptive.

ADHD is common. The estimates are that between 5% and 12% of children have the condition. Because all children can be restless, excitable and impulsive a formal diagnosis can sometimes be difficult. It is made harder as there is no one specific test for ADHD and the symptoms can appear different in different children. They differ in girls and boys as well as at different ages. If ADHD is suspected a child will be assessed by a doctor or psychologist. Once it has been decided a child has ADHD a treatment plan will be put in place. There is no cure but the symptoms can be relieved. This is done using medication or therapy – sometimes a combination of both. It is common for the treatment to be arranged by a specialist such as a psychiatrist or paediatrician and then monitored by a General Practitioner.

If you are a foster carer and want more information we recommend visiting –

http://kidshealth.org/

http://www.aboutkidshealth.ca/

Autism and (Autism Spectrum Disorder ASD)

These are general terms used to describe a group of complex brain development disorders which show up to varying degrees in difficulties with verbal and non verbal communication. Marked repetitive behaviour can be a symptom. The clearest signs of autism tend to become apparent when a child is around the age of two or three years. Autism is regarded as a lifelong developmental disability affecting one in one hundred people. It affects how people communicate and relate to others as well as the manner in which they experience the world around them. Individuals on the autism spectrum can also experience an under or over sensitivity to touch, tastes, smells, light, colours or even sounds.

Autism is fairly common with roughly 700,000 people in the UK on the autism spectrum. Taking into account other family members the total number for whom this condition impacts in some way or another is 2.8 million people.

There are three main areas that all people with autism share in common. These areas of difficulty are sometimes referred to as the ‘triad of impairments’ and they are –

• difficulty with social interaction
• difficulty with social communication
• difficulty with social imagination

Autism is referred to as a spectrum condition. People with the condition can be very individual in terms of their needs. Autistic people can usually be relatively independent but others may need to rely on specialist support throughout life. At Rainbow as providers of independent foster care services, we can offer training and support around the management of this condition.

Currently there is no cure for autism but there are a range of interventions that facilitate learning and development. Young people with autism will need additional support with their education.

If you are a foster carer and want more information we recommend visiting –

http://www.autismspeaks.org

http://www.childautism.org.uk/

http://www.autism.org.uk/nationalautisticsoc

Asperger Syndrome

Asperger syndrome is a form of autism and is often regarded as a ‘hidden disability’. This is because it isn’t always easy to tell from people’s outward manner and appearance that they have Aspergers. As it is a form of autism the same ‘triad of impairments’ are present –

• difficulty with social interaction
• difficulty with social communication
• difficulty with social imagination

Although there are similarities with autism, people with Asperger syndrome generally have fewer problems with speaking and can demonstrate above average intelligence. They can, however, exhibit specific learning difficulties which can include conditions such as dyspraxia or dyslexia. At Rainbow as providers of independent foster care services, we provide education and training around dealing with this condition when required. Asperger syndrome can also give rise to difficulties in being able to express emotions as well as social difficulties.

Examples can cover –

• a difficulty understanding when to start or end a conversation
• problems choosing topics for conversation
• a tendency to use complex words or phrases without comprehension of their meaning
• difficulties comprehending tone of voice, facial expressions

People with Asperger syndrome sometimes find it difficult to express themselves emotionally and socially and it can be hard for them to establish and maintain social relationships. This can give rise to anxiety. The syndrome means individuals can display differing characteristics but there are three main areas Asperger sufferers can experience problems around –

• special interests
• sensory difficulties
• love of routines

The cause of Asperger syndrome is not fully understood. It seems to be more common in males then females. The latest research indicates that a potential cause may be a mix of genetic and environmental factors affecting the brain as it develops. Currently there is no cure for the Asperger syndrome but there are a variety of therapies available. When the condition is suspected, a GP will usually refer a case on to other more specialist professionals for a formal diagnosis to be made. When fostering a child with Asperger syndrome there will be plenty of support made available by Rainbow fostering. As an independent fostering agency we tailor any training required to build the confidence and capabilities of our foster carers.

If you are a foster carer and want more information we recommend visiting –

http://www.autism.org.uk/

Asthma

Fostering Children UK wide means that the statistics for asthma are of note. 1.1 million children (1 in 10) children in the UK suffer from asthma and in every UK classroom there are on average 3 children with asthma. It can pose a serious risk – in the UK every nineteen minutes a child is admitted to hospital because of the condition. Pet allergens, cigarette smoke and car fumes are three of the most significant triggers for an attack.

There are treatments available if you are fostering babies, children or young people. If a child starts to experience problems breathing and asthma is diagnosed your GP may prescribe an inhaler. This is also known as a reliever which is a medicine that once inhaled provides instant relief. It quickly relaxes the airways making breathing easier. Fostering babies and toddlers with asthma requires a different approach – a nebuliser is used which creates a mist that is easily inhaled.

Where a foster carer is looking after a child with asthma there are a number of preventative measures that can be put in place. When fostering children consideration must be given when there are pets in the house. If a household pet is the problem fostering a child predisposed to asthma should be avoided. Germs and fur/hair from pets can be one of the very worst triggers.

Dust can also be a trigger as can dust mites. Cleaning can resolve a lot of the problems so a regime of regular dusting, washing and airing bedding is important. Soft toys and cushions should also be cleaned regularly.

When a child experiences an asthma attack it can be alarming but it is important to remain calm. There are warning signs: a child might begin waking at night with a tight chest and experience coughing and wheezing; a child might begin using an inhaler more frequently; the general activity levels of a child may lessen – perhaps just walking affects their breathing noticeably. If an attack comes on an appointment to see a GP should be made. Where an attack is in progress a child should be sat up, clothing should be loosened and they should be given two puffs of the reliever inhaler. If there is no improvement, continue to give them a single puff of the reliever inhaler every five minutes or until the airways relax and normal breathing is resumed. It is important to call an ambulance should symptoms worsen where the child is too breathless to talk or their lips turn blue.

Again, at Rainbow fostering our independent foster care services can include education and training around fostering a child with asthma.

If you are a foster carer and want more information we recommend visiting –

http://www.asthma.org.uk

http://www.netmums.com/

Cerebral palsy/spasticity

The most common cause of spasticity in children and young people is cerebral palsy which includes various conditions that directly affect muscle control and movement. It is a condition that affects around 1 in 400 children. Where children are born with a brain injury leading to cerebral palsy, spasticity may not necessarily occur at birth. It is possible it may appear over time. Spasticity is the condition where certain muscles are continuously contracted. This can cause stiffness and tightness which can adversely affect normal movement, speech and posture.

Cerebral palsy is the most common physical disability seen in childhood. It can be evident in the first twelve to eighteen months of life and it arises as a result of damage caused to the developing brain. In the majority of cases brain injury resulting in cerebral palsy takes place during pregnancy. Apart from their motor disability sufferers are likely to have other impairments. These can include problems affecting learning, vision, hearing, speech and epilepsy. There is no cure for cerebral palsy

Fostering children who have cerebral palsy will clearly place significant additional demands on a carer. At Rainbow fostering being providers of independent foster care services, we offer full support around dealing with this condition. Our training and support package will include –

• telephone support from a dedicated social worker twenty four hours a day fifty two weeks of the year
• paid respite including an enhanced holiday allowance
• transportation assistance
• access to therapeutic support
• support from support workers and supervising social workers

Treatments and therapies: the main interventions with cerebral palsy address difficulties with movement. Prescriptions are available to provide alleviation relating to issues surrounding bodily movement. Some medications such as diazepam can be taken orally with others being injected or delivered via surgically implanted pumps i.e Baclofen. A lot of children with cerebral palsy derive benefit from Botulinum toxin type A injections.

In a low percentage of children with cerebral palsy a neurosurgical procedure is used to permanently reduce spasticity in the legs. This is known as Selective Dorsal Rhizotomy (SDR).

The most common forms of remedial intervention centre upon physiotherapy and occupational therapy. Health professionals concentrate on facilitating a child or young person’s day-to-day movement including walking, sitting, playing, dressing as well as toileting. Other medical interventions may cover issues relating to eating, digestion, speech, saliva control, vision and hearing impairment.

If you are a foster carer and want more information we recommend visiting –

http://www.cerebralpalsy.org.uk

http://www.scope.org.uk

Diabetes

There is a disturbing rise in the numbers of children being affected by Type 1 and Type 2 diabetes.Type 1 is an autoimmune condition resulting in the destruction of insulin producing beta cells – the result of damage caused by the body’s own immune system. About 90% of people with type 1 do not have a family history of the condition. So far in excess of fifty genes have been identified that can increase an individuals chance of developing Type 1. There is ongoing research into environmental factors that may play a part.

As an independent fostering agency, Rainbow keeps abreast of trends that feed through into issues impacting upon children and young people. The statistics raise concerns: roughly 400,000 people in the UK are currently living with Type 1 diabetes and over 29,000 of them are children. The incidence of Type 1 is increasing by around 4% annually – especially in children under the age of five: there has been a five fold increase in this group in the last 20 years alone. Type 1 diabetes affects 97% of all children with diabetes in England. The condition is a burden: having Type 1 will mean a person will have approximately 65,000 injections and have to measure their blood glucose around 80,000 times in their lifetime.

Type 2 is easily the most common type of diabetes in the UK. It used to be more common amongst people over 40; or 25 if of South Asian descent. When fostering children it is worth noting that Type 2 diabetes is becoming increasingly common among young people due to their lifestyle. This is a matter of concern amongst all the fostering networks. With Type 2 diabetes the body is unable to make enough insulin or insulin the body can use. Over time cells become resistant to insulin meaning the pancreas is put under strain from producing the additional insulin required to keep blood glucose levels within the normal range.

It is possible to manage Type 2 diabetes through adjustments to diet and then monitoring blood glucose levels. A lack of exercise can play an important role; when combined with a poor sugar rich diet it can be seen why more and more children are being diagnosed with the condition in the UK.

Some of these children are as young as seven years of age. A surveillance programme conducted on children under 17 in the UK revealed that 95% of those diagnosed with Type 2 diabetes were overweight and 83% obese. It has also been found that the condition is increasing amongst children from minority ethnic groups now being at a higher risk than white children. Fostering children really does mean giving serious attention to establishing good eating habits and making sure that children lead active lives.

If you are a foster carer and want more information we recommend visiting –

http://www.diabetes.org.uk

http://www.kidsfitnessfirst.org/

Child Obesity

The World Health Organisation (WHO) now views childhood obesity as a serious public health issue on a global scale. In this country approximately one million school children are monitored by the National Child Measurement Programme (NCMP). They look at height and weight and a disturbing picture of obesity is emerging. The latest figures give rise for concern – especially when it is known obese children and teenagers are at a much greater risk of developing a range of health problems and remain obese as adults. Their latest figures reveal that for 2014/15 19.1% of Year 6 children 10 – 11 years were obese with a further 14.2% being overweight. 9.1% of Reception children 4 – 5 years were obese and a further 12.8% being overweight.

People become obese when excess body fat is accumulated because the energy from the consumption of food and drink is greater than the rate at which it is expended through physical activity. Usually this happens over a lengthy period of time. The causes that bring this about can be varied and complex. There are thought to be over 100 variables having a direct or indirect impact on ‘energy’ balance. These can include: pressure within society – the media, peer pressure and the effects of the prevailing culture; the food environment – people’s access to particular types of food and patterns of intake; psychological factors – control issues and physical activity where children and young people are leading physically inactive lives.

Any person with a responsibility for children and young people should be aware of this growing problem. Specifically that a third of 10 – 11 year olds and over a fifth of 4 – 5 year olds were found in the NCMP report to be overweight or obese. Lifestyle choices are hugely important. An unhealthy diet combined with a lack of exercise are the major risk factors which can lead to diabetes and cardiovascular disease as well as other serious health problems.

The Department of Health advises that adults should engage in 2.5 hours of moderately intense aerobic activity every week. For children over 5 they should be engaging in moderate to vigorous activity for 1 hour every day. Overall the cost of obesity to the nation has been estimated to stand at £2.5 billion annually with obesity being responsible for 18 million sickness days annually.

At Rainbow fostering as providers of independent foster care services we look to provide guidance around this particular health issue. We encourage healthy eating practices and a diet that is high in fibre, lower-fat, rich in fruit, wholegrain, lean meat and fish. Children need the occasional treats but if they can be part of an active day out so much the better.

If you are a foster carer and want more information we recommend visiting –

http://www.healthyplaces.org.uk

http://www.nationalobesityforum.org.uk

http://dapa-toolkit.mrc.ac.uk

Epilepsy

Epilepsy affects people differently and advice should be sought from a GP or specialist. In the UK, there are around 600,000 people who have epilepsy. The condition is caused by abnormal electrical activity in the brain that can result in seizures. With certain individuals there is no obvious cause such as a specific medical condition. In such cases it is thought that a genetic factor might be responsible. This type of epilepsy is called primary, or idiopathic epilepsy.

Epilepsy can also be caused by a number of conditions which can include birth injuries, head injuries, certain infections such as meningitis, strokes or brain developmental problems during childhood. In such instances this form is called secondary or symptomatic epilepsy.

An epileptic seizure can vary in nature from person to person. They range from being momentary to much longer in duration where individuals may experience convulsions and sometimes lose consciousness. How long a seizure lasts as well as its severity will be determined the level of abnormal electrical brain activity as well as the part of the brain being affected.

Epilepsy is commonly treated by medication. A class of drugs (AEDs) anti-epilepsy drugs are used – there are different types of AEDs and findings show that in around 70% cases they successfully control seizures.

An epileptic seizure can be triggered by a variety of factors. Being tired, stressed, dehydrated or having consumed too much alcohol can lead to a seizure. Some individuals suffer from photosensitive epilepsy which means a seizure can be triggered by strobe lighting or flickering light.

People who suffer from epilepsy can find that it affects their memory. It is known that some epilepsy medicine can have an affect on the memory.

It is important to work to reduce the risk of seizures and mostly this is a matter of common sense: if known, people should avoid the things likely to cause a seizure, regular sleeping patterns are advisable, managing stress is important, take epilepsy medicine regularly and always have an adequate supply ensuring you have it with you at all times.

Fostering children means supporting them at every stage of their education and epilepsy raises certain issues carers need to be aware of. Epilepsy can effect how difficult or easy it is for a child to learn. There are factors at work which can include the condition itself, the particular cause of the epilepsy, the effects of seizures and side-effects from medicines taken to control the condition.

In a study conducted in West Sussex amongst schoolchildren it was found that –

• over half of the children found it harder to learn than other children
• over half of the children experienced memory problems
• slightly under half had problems with the speed they were able to process information
• slightly under half were under achieving – most problems were found with mathematics and understanding their work
• Sixty five percent of parents reported children having problems with attention and concentration

If you are a foster carer and want more information we recommend visiting –

http://www.brainandspine.org.uk

http://www.epilepsy.org.uk

http://www.epilepsysociety.org.uk

Testimonials

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"My link worker has been very helpful, she is easy to talk to and reliable."

"I enjoy being a foster carer, I find it very fulfilling."

"The reward has been from my foster child seeing her blossom and flourish."