帮助患有身体和心理健康状况的孩子充分利用学校的生活

慢性疲劳综合症/ ME

Chronic Fatigue Syndrome/Myalgic Encephalitis (CFS/ME) is relatively common in children, affecting at least 1% of teenagers.慢性疲劳综合症/肌痛性脑炎(CFS / ME)在儿童中相对常见,至少影响XNUMX%的青少年。 It is probably the largest cause of long-term absence from school.这可能是长期缺课的最大原因。

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支持学生             更多信息 

慢性疲劳综合症/肌性脑炎(CFS / ME)症状可能包括:

  • 日常活动后极度疲劳
  • 疼痛(包括头痛)
  • 睡眠障碍
  • 隐忧
  • 头晕
  • 恶心
  • 心理功能受损(注意力不集中,分散注意力,难以集中注意力,记忆力差,“脑雾”)

波动与回报

Children and young people with CFS/ME usually have only a finite amount of energy capacity.患有CFS / ME的儿童和年轻人通常只有有限量的能量。 Therefore they may appear 'well' on one day and take part in activities.因此,他们可能会在一天中表现良好,并参加活动。 However, the normal “recharging of batteries” is impaired.但是,正常的“电池充电”会受到影响。 If they have an active day that exceeds the amount of available energy, then the young person experiences a 'payback' over the next day or two where they may feel 'fluey' and wiped out.如果他们一天的活跃时间超过了可用能量,那么年轻人会在第二天或第二天经历一次“回报”,在那里他们可能会感到“烟道”而消失了。 This is when they are likely to miss school.这是他们很可能失学的时候。 This is also known as a “Boom and Bust” cycle.这也称为“繁荣与萧条”周期。 Fellow pupils may only see children on their 'active' days and therefore it may be harder for them to understand the impact of the condition.同伴的学生可能只会在他们“活跃”的日子里见到孩子,因此他们可能更难理解这种状况的影响。 Young people with CFS/ME may feel left out and misunderstood and therefore be more likely to experience anxiety and low mood.患有CFS / ME的年轻人可能会感到被排斥和误解,因此更容易出现焦虑和情绪低落。 

能量消耗

CFS / ME的管理涉及找出年轻人每天可以花费多少高能量活动时间,而不会产生这种回报。 This is called the baseline.这称为基准。 There are three types of energy expenditure: physical, cognitive and emotional.能量消耗分为三种类型:身体,认知和情感。

  • 物理能量消耗发生在涉及流动性的任何活动中。
  • Cognitive energy is anything to do with thinking tasks – all classroom work is high energy cognitive activity.认知能量与思维任务有关–所有课堂工作都是高能量认知活动。 Other high energy cognitive activity would be watching television or chatting with friends.其他高能量的认知活动将是看电视或与朋友聊天。
  • Emotional energy is often easy to overlook.情绪能量通常很容易被忽视。 This includes any emotional distress, rows, anxiety and 'over-thinking' the young person experiences.这包括年轻人遇到的任何情绪困扰,争吵,焦虑和“过度思考”。 Although this can be difficult to control, it needs to be factored into the available amount of energy.尽管这可能难以控制,但需要将其纳入可用能量中。

治疗方案

CFS / ME治疗计划是针对个人需求量身定制的,可能包括:

调整睡眠-唤醒周期

改变睡眠-觉醒周期可能导致短期内症状增加,这很可能对其入学率产生影响。

改变活动模式

There is usually a reduction in levels of activity at the start of treatment.在治疗开始时,活动水平通常会降低。 Students will often be advised to reduce their planned school attendance in the short term.通常会建议学生在短期内减少计划的出勤率。 It is better to attend for less time, consistently, rather than trying to attend full time and missing random school days/weeks due to payback.最好始终花更少的时间参加课程,而不是尝试全职参加并且由于回报而错过随机的上学日/周。 Once they are achieving a manageable amount of school attendance every day, without experiencing payback symptoms, they will then work on building their attendance back up in a gradual and sustainable way.一旦他们每天都能达到可控制的上学人数,而没有出现回报的症状,那么他们将努力以逐步和可持续的方式增加他们的出勤率。

支持患有慢性疲劳综合症的学生

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以下建议将真正帮助患有CFS / ME的儿童和年轻人发挥其全部学习潜力。

上课时间休息

Some children/young people with CFS/ME benefit from regular rest breaks.一些患有CFS / ME的儿童/年轻人会从定期的休息时间中受益。 These breaks should be in a quiet place, ideally away from the classroom.这些休息时间应放在安静的地方,最好远离教室。 It would be helpful if breaks could be scheduled, especially for younger children.如果可以安排休息,特别是对于年幼的孩子,这将是有帮助的。 Other students prefer a medical timeout card which they can use in lessons if they feel they need a break.其他学生更喜欢医疗超时卡,如果他们觉得需要休息,可以在课程中使用。 They should be allowed to leave the classroom without having to explain why.应该允许他们离开教室,而不必解释原因。 In a quiet space, eg the library, they should spend the time reading or listening to music or doing a downtime activity.在图书馆等安静的地方,他们应该花时间阅读,听音乐或进行停工活动。 They can be expected to return to the lesson after 10-15 minutes.预计他们将在XNUMX-XNUMX分钟后返回课程。

浓度

We have found that young people with CFS/ME benefit from working in chunks of no more than 30-45 minutes;我们发现,患有CFS / ME的年轻人受益于工作时间不超过15-20分钟的工作; severely affected students may only be able to sustain concentration for XNUMX – XNUMX minutes.受严重影响的学生可能只能保持专注XNUMX至XNUMX分钟。 Students often have increased sensitivity to everyday sounds and are likely to be more easily distracted in the classroom environment.学生通常对日常声音具有更高的敏感性,并且在教室环境中可能更容易分散注意力。 Students may experience 'brain fog' ie difficulty processing information – it can be helpful to: provide written instructions and memory aids;学生可能会遇到“大脑迷雾”,即难以处理信息–可能会有所帮助:提供书面说明和记忆帮助; simplify work (eg giving their pupil one task at a time);简化工作(例如一次给学生一项任务); offer extra time for activities and provide support with writing (eg scribing, providing iPads for dictation or typing or providing alternative activities to writing).为活动提供额外的时间并提供写作支持(例如,划线,提供iPad用于听写或打字或提供替代性的写作活动)。

跟上学业

Due to missing school and problems concentrating, young people with CFS/ME may fall behind with their schoolwork.由于缺少学校和集中注意力的问题,患有CFS / ME的年轻人可能无法完成学业。 They may also experience stress and anxiety as a result of falling behind.他们也可能因落后而遭受压力和焦虑。 It may be helpful to help them prioritise their schoolwork and the skills, tasks and homework that is most important to complete.帮助他们优先安排他们的功课以及最重要的技能,任务和家庭作业可能会有所帮助。

考试

Young people with CFS/ME benefit from being allowed to sit exams in a room on their own, or with a few other students.患有CFS / ME的年轻人可以从自己或与其他一些学生一起参加房间考试中受益。 They should be allowed to get up and move around for timed rest breaks.应该允许他们起床并四处走动,以便有时间休息。 For those students taking public exams a request should be made for access arrangements and reasonable adjustments.对于那些参加公开考试的学生,应提出访问安排和合理调整的要求。

情绪和/或焦虑

Young people with CFS/ME are more likely to experience depression and/or anxiety, particularly social anxiety and generalised anxiety.患有CFS / ME的年轻人更容易出现抑郁和/或焦虑,尤其是社交焦虑和广泛性焦虑。 They may need additional mental health support in school and school may need to signpost them to seeking help with their mental health outside of school, including via their GP or specialist services.他们可能需要在学校获得额外的心理健康支持,并且学校可能需要在学校外张贴路标以寻求心理健康方面的帮助,包括通过全科医生或专家服务。

友谊

CFS / ME可能会对友谊产生影响。 Young people with CFS/may benefit from maintaining a sense of belonging and connection with their class during absences.患有CFS / CFS的年轻人可能会在缺勤期间保持归属感和与班级的联系而受益。 This could be achieve from things such as organising contact from classmates (eg sending a card).这可以通过组织同学的联系(例如发送卡片)来实现。

小学的更多信息

Children under the age of 12 can be diagnosed with CFS/ME, although it is less common in this younger age group.可以诊断出XNUMX岁以下的儿童患有CFS / ME,尽管在这个较年轻的年龄组中这种情况较少见。 Younger children need more support to help them follow the guidance on managing their activity.年幼的孩子需要更多的支持,以帮助他们遵循有关管理其活动的指导。 It may be helpful for primary school teachers to meet with parents to discuss a plan of support.小学老师与父母见面讨论支持计划可能会有所帮助。 In addition to the above guidance, the following may be helpful to consider:除了上述指导之外,考虑以下内容可能会有所帮助:

  • Younger children with CFS/ME are more likely to experience problems with anxiety.患有CFS / ME的幼儿更容易出现焦虑症。 Exploring their worries and encouraging them to gradually face their fears, with appropriate support, can help with this.在适当的支持下探索他们的担忧并鼓励他们逐渐面对他们的恐惧,可以帮助您解决此问题。
  • Often younger children find it difficult to express their thoughts and feelings about their health and wellbeing.通常,年幼的孩子很难表达他们对健康和福祉的看法和感觉。 Some teachers have found it helpful to have a check-in system, and communication aids such as emotion cards may be beneficial.一些老师发现拥有签到系统会有所帮助,而诸如情感卡片之类的交流辅助工具可能会有所帮助。
  • 在休息时间,一些老师已经能够安排安静,低刺激的空间以及诸如豆袋和靠垫之类的舒适物品。
  • It can be helpful to reframe restrictions and limitations on the child.重新构造对孩子的限制和约束可能会有所帮助。 For example, some children will be unable to join activities like PE lessons and play breaks.例如,一些孩子将无法参加体育课和休息时间等活动。 These children could be given alternative low energy “roles” such as staffing the school's reception desk.可以给这些孩子其他低能耗的“角色”,例如为学校的接待台配备人员。
  • Some primary school teachers have said that it is helpful to speak to their class to raise awareness about a particular health condition and to promote supportive and empathetic attitudes.一些小学老师说,与他们的班级交谈有助于提高对特定健康状况的认识,并促进支持和同情心的态度。 We would recommend speaking to your pupil and their family first before discussing CFS/ME with your class.我们建议与您的班级讨论CFS / ME之前,先与您的学生及其家人交谈。 

更多信息

CFS / ME资源:

CFS / ME和心情:

这些书可能为教师提供帮助,因为它们提供了一些实用的策略来支持有情绪障碍的年轻人:

  • “克服孩子的恐惧和忧虑:使用认知行为技术的自助指南”,凯茜·克雷斯威尔和露西·威利茨
  •  《青少年抑郁症:针对父母的CBT指南》,莫妮卡·帕金森(Monika Parkinson)和雪莉·雷诺兹(Shirley Reynolds)

谢谢

非常感谢布里斯托尔医学院儿童健康研究中心的Esther Crawley教授,Roxanne Parslow博士,Maria Loades博士和Amberly Brigden博士 www.bristol.ac.uk/academic-child-health 为我们编写此部分。

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