The virtues of an holistic approach to education and therapy
Most children may have to miss school lessons three or four times a year for dentist and medical appointments. For a child with a disability or SEN, however, there can be a constant influx of appointment cards which may lead to them missing a lot of their education.
A growing child with a disability or SEN may need on-going assessment from a host of specialists, such as physiotherapists and occupational therapists (OTs). Splints, wheelchairs and standing frames all seem to need constant adjustment, often requiring the child to spend hours away from the classroom. A parent may get conflicting advice from different professionals involved with their child; what if the OT’s advice differs from the speech therapists regarding eating and drinking? What if the physio’s plan for your child isn’t feasible in their classroom environment? Parents may sometimes wonder if all the adults involved in their child’s life ever talk to each other.
Imagine a place where all the therapists are on the school site, in daily contact with each other, the child, their teacher, teaching assistants and parents. A place where each child is known extremely well by the whole team and where the child feels reassured by the consistency of approach. A physiotherapy appointment means going across the corridor, not across town, drastically cutting the child’s time away from lessons. Adjustments to equipment can often be dealt with instantly. Therapists meet informally daily and have more formal meetings fortnightly. In the words of American poet and peace campaigner Mattie Stepanek, “Unity is strength… when there is teamwork and collaboration, wonderful things can be achieved.”
Ryan is a pupil at such a school in Gloucestershire. He is fourteen years old and has spastic cerebral palsy. Like most teenagers, he has constantly changing needs and is growing very quickly. Ryan has access to on site speech and language therapy, physiotherapy, massage therapy, occupational therapy and visiting wheelchair technicians.
I wanted to see what a school week was like for Ryan and to determine how important the holistic approach of the school was to him and his mum. Initially, I talked to Ryan’s mum to see if the school’s approach had influenced their lives. I asked her what life was like before he came to the school:
Life was absolutely manic, we were rushing around between consultants, day centres, eye specialists, doctors and physiotherapists. I wasn’t able to work and it felt like people were invading our home the whole time. They would invariably come round just as I was about to put the tea on, or have a friend round, I couldn’t get anything done.”
I asked her if things have improved for them since he started at the school and, if so, in what ways:
“Yes, I can now work and things fit much better into our home life. We are not being invaded any more! Now I only have to take Ryan to specialist appointments every few months or if he needs his wheelchair assessed. The consultants come into school, he gets lots of physio and, if he is uncomfortable during a lesson, the therapists are only down the corridor and can help him straight away. There is always a nurse on site so I feel comfortable that Ryan is going to receive his medication correctly. If he has a problem with his wheelchair, the wheelchair clinic comes to the school and fixes it for him. I know that if Ryan has had a problem in the night, I only have one phone call to make and the therapists will talk together and work out a solution.”
I asked if this way of working benefited Ryan:
“Enormously, Ryan likes routine and can get upset if plans change…Educationally I know that he would be missing a lot more school if he was having to be taken to appointments, with travelling and waiting, etc….No-one can learn if they are uncomfortable, and I know that between them the therapists and teaching assistants will make sure that he is comfortable.”
I then spent a week with Ryan, attending his therapies with him, to see for myself how this way of working operated. The first session I observed was speech and language. Ryan is working on his literacy skills using the Reading Reflex scheme, and his speech and language therapist works in close collaboration with his English teacher. The level at which Ryan is working is assessed by the speech and language therapist and his English teacher, while the ways in which he accesses literacy resources are more the domain of his OT.
The next session I accompanied Ryan to was occupational therapy. Ryan has some difficulty with eating, and again collaboration has proved invaluable; his speech therapist assesses which is the safest texture for Ryan’s food and his OT works with Ryan on equipment. Indeed, the OT had just had a new switch-operated, automated feeding tool delivered. His therapist told me that she works very closely with the school’s physiotherapy, speech and language and ICT departments to find the optimum position for switches, communication aids, wheelchair joysticks, computers and other assistive devices.
I asked Ryan if he enjoyed the therapies he has at school:
“Yes I do, I like physio and massage the best because I can get out of my chair. Massage is fantastic, I wish I could have it more often because it really relaxes my muscles. I find speech therapy the hardest because it takes a lot of brain power and I get tired easily.”
Does he feel that he misses out on a lot of education? “No, I mostly miss art and PE. I never get taken out of English or Maths.” I asked if he felt the therapists worked well together. “Hopefully they do! I know who to go to if I have a problem”. Finally I asked him if he found having the therapists close to hand was helpful when he was in the classroom. “I really trust the teaching assistants; if they can’t help, they will go and get a therapist to help me. On the whole, the therapists are very good!”
This situation is quite unique in the UK but it is proving invaluable to many students who benefit from this approach. After talking to Ryan, his Mum and his therapists, I agree with Stepanek that “Unity is strength”, and from the smiles and laughter I saw during his school therapy sessions, wonderful things have indeed been achieved.
Coryn Memory is an Early Years Teaching Assistant at St Rose’s School, Stroud:
Article first published in SEN Magazine issue 43: November/December 2009.