Physical Disability (PD) Outreach team

The PD Outreach team supports children with a diagnosed physical disability and or medical condition which affects their physical functioning and access to a mainstream nursery curriculum. This includes a wide range of conditions such as cerebral palsy, muscular dystrophy and spina bifida.

Some children do not have a diagnosis, but their physical functioning is such that they require input and the provision of specialist equipment to access the curriculum. For example, children with global developmental delay, some children with Downs Syndrome

Some children have experienced medical trauma which has had impact on their physical functioning such as, an Acquired Brain Injury or sporting accident.

Some children may have learning difficulties and sensory impairments in addition to a physical disability.

Children with complex health needs are supported by our team alongside health professionals such as the community nursing team – Orchard Service, Specialist Epilepsy Nurse and other specialist nursing teams for continence, skin care and oncology.

Children often have long term medical conditions which impact on their ability to access the nursery or school environment (both physical and learning) without some form of adult support and adaptations. We support post-operative children also.

Such medical needs include children with long term heart conditions, breathing conditions, complex continence needs, for example catheterisation, complex epilepsy, as well as children going through treatment for cancer. Our support focuses around physical access, equipment, and implications for learning, for example cognitive difficulties attached to condition such as memory and processing.

There are a number of children who require tube feeding in nurseries or schools - training is provided by the Orchard Team.

Those who can refer are:

• children can be referred via a notification to the Early Years Inclusion Process
• SENCOs from nurseries, pre-schools
• area SENCOs
• school SENCOs
• heath professionals: physios, paediatricians, OTs, Speech and Language Therapists

Parental or carer consent is required prior to a referral.

North Worcestershire:

• Early Years Referral Form Chadsgrove (Word)
• School Aged Referral Form Chadsgrove (Word)

South Worcestershire:

• Early Years Referral Form April 2022 | Regency High School
• School Referral Form April 2022 | Regency High School

Once complete please scan and send to:

• North Worcestershire: Chadsgrove School Support Services PD Team: outreach@chadsgrove.worcs.sch.uk  
• South Worcestershire: Regency High School PD Team: pdoutreach@southregency.worcs.sch.uk 

The support you will receive:

• offer advice on accessible nurseries and following on from this accessible schools
• assist with transition and often lead on transition into school
• liaise about the Education, Health and Care Plan (EHCP) process if relevant or any other support their child may need in relation to accessing nursery and then school
• offer advice on support available in conjunction with other early years colleagues, such as in relation to all areas such as sport or swimming

The support early years setting and schools will receive is:

• on-going assessment of the child’s needs – including specialist assessments
• reports to contribute to EHCP process
• provide advice to parents or carers regarding accessible schools
• liaise with physiotherapists or Occupational Therapists (OTs) to ensure appropriate equipment or furniture is in place so child can access the environment.
• offer support to parents or carers regarding the assessment process
• training to setting on risk assessment of physical needs, safe moving and handling, Individualised Educational Program (IEP) targets, adaptation of teaching styles and resources, advice around cognitive impact of disability, promoting independence, safe use of equipment, use of computers, technology and disability awareness
• co-ordinate transition to school and promote effective communication between settings, including parents or carers

The top ten tips are:

1. be inclusive from the first visit, welcome families and children and see solutions rather than difficulties, sometimes solutions are very inexpensive, for example provision of a grab rail, if works need to be done plan for them, consult owners, they will benefit a wide range of children who may attend the setting in the future
2. involve professionals and gain as much information on the child and their needs as you can and ensure support and paperwork is in place prior to the child starting, work as a team, as many relevant staff as possible should know about the individual needs of the child with physical disability, good practitioners regularly evaluate their practice, training must be started before the child starts and be on-going as the child’s needs change
3. parents or carers are the experts as is the child themselves, often they will have worked out a solution before you consult them
4. be creative with your environment, creating routes and clearing clutter (both physical and visual) to make spaces for a child with disability to get about can be hugely beneficial for all children in early years, not just children with physical disabilities
5. look at all areas of the curriculum and nursery, if it is not possible to make reasonable adjustments , for example are there stairs or the environment cannot be adapted, what alternatives can be offered? Consider the language that you use, keep it clear and simple, reinforced with visual cues. Allow for processing time, which can be longer then you think
6. simple solutions for inclusive practice often work best, for example move more mobile children to the area the child with physical disability is playing rather than keep moving the child with a disability, adapt resources, such as making them larger, slower moving or anchoring them, make sure any  equipment the child needs is in place and used as recommended as soon as possible, such as a bath step
7. no child learns well unless they can access their environment safely and comfortably, think of the best equipment to use for each activity, specialist chair? Wheelchair? Bench? Standing frame? Walker? All can be used creatively
8. do not sit the child with physical disability on their own, even if they are in separate seating for example they cannot sit on the carpet, make sure they have a friend
9. children with physical disabilities may have individual targets such as regular physio routines, incorporate these into your planning in a fun and creative way, physical activities can be incorporated into movement sessions which will benefit all children
10. children are very adaptable, they learn from each other and even young children quickly give time and space to a child with disabilities, communicate sensitively and set high expectations, most importantly have fun and enjoy every moment

Profile: A pupil with a degenerative condition with additional learning needs

‘The Journey’

Nursery or pre-school provision:

• referred at the age of 4
• child met in setting by a specialist teacher from the Physical Disability Outreach Support Team (PDOST)
• liaison with parents and health professionals
• provision of low level aids fro example grab rail and frame around toilet
• assessment and report for EHCP application and subsequent attendance at annual reviews throughout school career  

First School:

• transition visits to school, environmental audit
• training on condition
• assess access to the curriculum looking specifically at: PE, forest school, personal care, dressing, access to recording and ICT as they get older (assessment of writing) 

Middle School:

• condition specific training
• transition visits to school and environmental audit.
• specialist seating to aid independence assessed and provided for example furniture with wheels.
• advice and support re: PE, games, swimming and offsite visits
• writing assessment: provision of ICT equipment as appropriate
• moving and Handling assessment completed and plan written
• suggested referral to Learning Support Team for learning needs assessment

High School:

• transition visits to school, environmental audit
• condition specific training (pupil is often in a wheelchair at this point)
• exam access arrangements
• alternative PE curriculum
• provision of voice activated software as appropriate
• Personal Emergency Evacuation Plan advice
• access to DT and Science assessed, advice given and appropriate equipment supplied
• advice given regarding inclusive sports and out of school activities

Further Education:

• transition advice
• discussion with college about the Traded Services provision available

Impact of the team and the outcomes for the child

Impact and outcomes are:

• continuity of support throughout school career and good links made between health and education services to allow holistic needs to be met
• safe inclusion and access to physical environment across all settings
• training provided to enable school staff to positively support and include the pupil
• ongoing assessment of need by the specialist teacher enables support to be reactive to the pupil’s ever changing condition
• specialist assessments allow pupil to record at a level consummate to their peer group
• moving and handling requirements routinely reassessed and support plans written
• families involved in all decisions