SEND for the paediatrician: children and young people with special educational needs and disabilities

Disabled children and young people, including those with special educational needs, have rights to the same high-quality health care as anyone else would expect to receive. Whilst policies and practices vary over time and across jurisdictions, maintaining a structured approach and broad vision should ensure that each and every need of all children and young people is identified, accurately described using clearly understandable terms, documented and communicated to all who need to know in the child or young person's wider team. Visible needs are more likely to be addressed in the health care plan and services for visible needs are more likely to be intelligently designed and delivered. Paediatricians can equip themselves to better assess the acute and ongoing needs of disabled children and young people, using freely available resources and by networking with the multidisciplinary team with expertise in the field. This short review provides some helpful definitions and gives a structure for how to proceed. It also offers signposting to some useful resources and advice to paediatricians and healthcare professionals working with children with Special Educational Needs and Disabilities (SEND).     

SEND for the paediatrician: children and young people with special educational needs and disabilities

Disabled children and young people, including those with special educational needs, have rights to the same high-quality health care as anyone else would expect to receive. Whilst policies and practices vary over time and across jurisdictions, maintaining a structured approach and broad vision should ensure that each and every need of all children and young people is identified, accurately described using clearly understandable terms, documented and communicated to all who need to know in the child or young person’s wider team. Visible needs are more likely to be addressed in the health care plan and services for visible needs are more likely to be intelligently designed and delivered. Paediatricians can equip themselves to better assess the acute and ongoing needs of disabled children and young people, using freely available resources and by networking with the multidisciplinary team with expertise in the field. This short review provides some helpful definitions and gives a structure for how to proceed. It also offers signposting to some useful resources and advice to paediatricians and healthcare professionals working with children with Special Educational Needs and Disabilities (SEND).     

Helping children with disabilities: special educational needs

The paediatrician hoping to understand and help children in a complete way needs:

• •to understand the implications of the illness or disability for the child's ability to learn
• •to understand the ways the educational system tries to meet the needs of children
• •to be able to write clear medical advice for education statements when requested
• •to be able to support parents through what can be a daunting bureaucratic process.

This article aims to inform paediatricians about the working of the 1996 Education Act in England and Wales. This legislation and its accompanying guidance enables support for children who have difficulty accessing the educational curriculum.     

Tricks of the trade: Assessment of high-tech gear in special needs children

Advances in neonatal and pediatric care have improved the lives of many children. However, many of these children have become dependent on high-tech devices, such as cerebrospinal fluid shunts, gastrostomy tubes, tracheostomy tubes, and indwelling venous catheters. Along with all their advantages, these devices are prone to complications and malfunctions. The emergency physician is frequently called on to differentiate signs and symptoms that may represent a life-threatening complication of this hardware from common and benign pediatric illness. Understanding how these devices work will assist in troubleshooting malfunctions. This article addresses common issues encountered with cerebrospinal fluid shunts, gastrostomy tubes, tracheostomy tubes, and indwelling venous catheters.     

Psychopharmacology for young children: clinical needs and research opportunities

In response to concerns about the increasing use of psychotropic medications in preschoolers, the National Institute of Mental Health and the Food and Drug Administration convened a workshop in October 2000 to examine the current state of knowledge regarding psychopharmacology for young children and discuss a variety of topics relevant to research in this age group, including safety, efficacy, investigational methods, and ethical aspects. The meeting gathered researchers, practitioners, ethicists, industry staff, and family and patient representatives. Efficacy and safety of psychotropics have not been systematically evaluated in preschoolers. The major limitation to this research is the diagnostic uncertainty surrounding most manifestations of psychopathology in early childhood. Research in developmental psychopathology is needed to clarify diagnosis and provide sensitive and specific methods for clinical trials. Possible approaches to expanding the research basis of this area of clinical practice, including a recently started study of methylphenidate in preschoolers, are reported here.