Communication and training
Communication passports are a means for children and young people to share important information about themselves with others. They should always be written in the first person. The content of each passport should be personalised according to the needs of the child or young person and usually contains information about their family and friends, communication skills, medical needs, eating and drinking skills, likes and dislikes. Communication passports can be particularly important around periods of new staffing, transition and change. Passports should be easily accessible and be kept up-to-date. Information going into the passport is collated from the child or young person, family, carers, friends, school staff and health professionals. For further information see www.callscotland.org.uk .
Eating and drinking profiles
It is good practice for each child or young person with an eating, drinking or swallowing difficulty to have an eating and drinking profile. This will usually be created by the speech and language therapist and occupational therapist. It will provide information such as correct positioning, modifications to food and drink and the level of support the child or young person will require. The profile should be kept in the same place that the child/young person has their snack and lunch and reviewed regularly. Staff should always refer to the profiles when supporting a child/young person with eating or drinking.
Training for staff and parents
There is a high incidence of eating, drinking and swallowing difficulties among children and young people with complex additional support needs. This can result in a reduced ability to swallow food and drink safely and can lead to inadequate food intake, resulting in either general under-nutrition or specific nutrient deficiency. The importance of training to ensure all staff feel supported, comfortable and informed when working with children and young people with eating and drinking difficulties cannot be underestimated. For a school to develop and deliver a comprehensive and coherent approach to healthy eating, it is vital that all staff feel informed, confident and competent in delivering their elements of the agenda. Staff development not only applies to teaching staff but also to the wider school workforce including caterers, administrative and support staff.
The need for all staff who work with children and young people with complex additional support needs to be trained by the speech and language therapist to recognise, understand and manage eating, drinking and swallowing difficulties is considered crucial. Helping someone with eating difficulties to eat can be complex and stressful and it is essential that staff are given sufficient support from colleagues when this is challenging. A dietitian and occupational therapist may also be involved. A school could develop its own eating and drinking policy which could outline the specific training requirements the children and young people in their school needed. It may be appropriate in some cases to provide procedures for staff to help staff know what to do if difficulties arise, particularly when out of school.
Multidisciplinary teams are best suited to provide training in this area. It may be useful to begin with an audit of staff, caterers, and parents/carers to identify what the training needs are. This can be used to plan and deliver what training is necessary. Training needs can then be reviewed regularly, and particularly, when the needs of individual children changes.
Staff development needs around food can be broad and might include:
- good practice in supporting pupils with eating and drinking.
- selective eating.
- practical food awareness.
- food hygiene and safety.
- nutrition and diet, including the signs and consequences of poor nutrition, and children who are over-weight.
- food presentation.
- eating, drinking and swallowing difficulties and their effects on nutrition and safety.
- a practical session of food preparation and texture modification.
- non-oral feeding.
- communication systems, for example use of photographs and picture symbols and relevant signs (ie Makaton, Signalong) to communicate with children and young people more effectively.
Training of staff involved in food preparation and in particular, catering staff, is essential. This is to ensure they understand the nutritional implications of changes made to a standard menu for a child or young person with a special dietary need, the need for modifying the consistency of food, and to ensure the safety of children and young people requiring this. Good practice would ensure that a cook working in a school, and in particular a special school, where there is a proportion of children and young people with special dietary needs, should have sufficient training to ensure they are confident in providing the diets required.
It can be helpful to set up a rotation of staff to observe each others' practice around helping children and young people with eating and drinking difficulties to eat and drink. This can ensure consistency of approach, and help evaluation and improve practice.
In order to access training, schools should contact their local authority or NHS in the first instance to scope what is readily available. It is good practice to try to be flexible about when training is provided so as to ensure staff can participate and benefit fully.
Case Study Example: Eating, Drinking and Swallowing Policy - Braidburn School, Edinburgh
At Braidburn School there is an eating, drinking and swallowing ( EDS) policy that highlights the minimum amount of training required for staff that are assisting children and young people with EDS difficulties. All such children and young people can only be assisted at mealtimes by an appropriately trained member of staff. Each child or young person has a limited number of helpers. As well as general training, child specific training is also provided. See appendix D for a sample EDS policy.
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