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Children with Complex Needs
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Disabled Child/Person The Children’s Act (1989), defines a disabled child as a child who is blind, deaf or dumb or suffers from a mental disorder of any kind, or is substantially and permanently handicapped by illness, injury or congenital or other disability that maybe prescribed Disability Discrimination Act (1995), defines a disabled person as a person with a physical or mental impairment which has a substantial and long term adverse effect on his ability to carry out normal day to day activities
Critiques of the term disabled child/child with a disability Disabled could be seen as a negative word - differently abled was a term used in 1980's as a more positive way of looking at disability Older family members/different cultures may call disability words that used to be acceptable but are now not e.g handicapped Shows children and families may have their own word to describe their child's condition and it is important to be aware of this as what one family finds acceptable another family may find offensive. The term disabled is interpreted by the eye of the beholder. A child may not see themselves as disabled regardless of a condition that they may have.
Vulnerable child Use the Key (2012) A vulnerable child is one that is unable to keep themselves safe from harm or who is at risk of not reaching their full potential and achieving their outcomes
Why is it important for nurses to be aware of definitions of disability/complex health needs? Enables better communication Cultural sensitivity Nurses are role models - use of appropriate language is important as people may look to nurses and copy the words used To enable us to provide individualised care to children and families to ensure they feel respected and valued
Children with Complex Needs Department for Education (2013) Such children have a number of discrete needs that require additional support from more than one agency. Their needs are often chronic and may be lifelong. Different needs tend to interact, exacerbating their impact on the child's development and well-being.
Other words/phrases for complex needs/multiple health needs 'multiple disadvantage', 'multiple disabilities', 'multiple impairment', 'dual diagnosis', 'high support needs', 'complex health needs', and 'multiple and complex needs'
Complex multiple health needs (Complex Needs Group, Scotland, 2006) “A child with multiple and complex disabilities has at least two different types of severe or profound impairment such that no one professional, agency or discipline has a monopoly in the assessment and management.”
Multiple complex disability (Summery Statistics for the Support Needs System) i. severe or profound disabilities in at least 3 of the following disability categories: motor impairment, hearing impairment, cognitive impairment, speech and language impairment, behaviour problems, feeding problems, additional chronic health needs OR ii. severe or profound disabilities in at least 2 of the following disability categories plus the need of at least 2 types of resources: therapy services, additional educational resources, nursing care needs, social care resources, mental health services
Complex Composing of many inter-woven and connected parts of which the links may be difficult to understand
Challenges to caring for a child with complex health needs Insufficient understanding Multiple needs Conflicting priorities Unclear cause & effect Unpredictability – rapid and unexpected change Treatment interaction risks and choices Potential for professional dilemmas
Self efficacy “a person’s belief in his or her ability to succeed in a particular situation”
Multiple health needs Rankin and Regan (2004) Suggest that multiple health needs embrace two aspects of a health problem
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