Severe and complex medical needs
Some children and young people have medical or neurological conditions—such as epilepsy, cerebral palsy, acquired brain injury, or genetic syndromes—that affect brain development and function. These conditions can influence learning, communication, movement, and behaviour in a variety of ways. Conditions may be stable or progressive and are often managed under the care of medical specialists. Not all conditions are evident from an early age, and their impact can vary significantly between individuals.
Epilepsy: The impact depends on the type of epilepsy and how well seizures are controlled. Some children and young people manage well with medication and a healthcare plan, while others with uncontrolled seizures may face significant cognitive and behavioural challenges.
Cerebral Palsy: A lifelong motor condition caused by early brain injury. It can also affect sensation, perception, cognition, communication, and behaviour. Severity ranges from mild (independent mobility) to complex needs (wheelchair use and high levels of support). It may affect:
- One side of the body (hemiplegia)
- Both legs (diplegia)
- All four limbs (quadriplegia)
- Children and young people with neurological or medical conditions may experience challenges in areas such as:
- Cognitive skills (e.g. memory, attention, reasoning)
- Communication and language
- Behaviour (e.g. frustration, withdrawal)
- Independence and learning progress
Some may access learning and the school environment independently, while others may require:
- Specialist equipment
- Adapted environments
- Occasional or ongoing adult support
Educational settings are expected to meet these needs within their SEND budgets, unless the condition significantly affects progress.
A medical diagnosis alone does not automatically indicate special educational needs (SEN). Support should be based on the educational impact of the condition, not the diagnosis itself. Planning should involve collaboration with relevant professionals, such as:
- Specialist teachers
- Speech and language therapists
- Occupational therapists
- Physiotherapists
- Medical Interventions and Funding
Some children and young people may require medical interventions (e.g. gastrostomy, tracheostomy). These are:
- Funded separately from educational support
- Guided and overseen by health professionals
Schools are expected to work in partnership with health services to ensure appropriate care and support is in place.
| Identified barriers and/or need: | Provision and/or strategies: approaches, adjustments and specific interventions expected to be made by settings according to the ages and stages of the CYPs. | How well implemented? | When and how? | ||
|---|---|---|---|---|---|
| Always | Sometimes | Not yet | |||
| Severe and complex medical needs including a life-threatening diagnosis or condition |
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| Ongoing medical condition e.g., diabetes, epilepsy, severe asthma |
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Provision and/or strategies:
- Staff training, including all First Aiders by relevant medical professionals
- Individual Health Care Plan (IHCP) informed by medical professionals
- Risk assessment so that all eventualities are considered, and a response plan identified in advance
- Collaborate with relevant external professionals and the family so that consistent support is provided in different environments
- Carefully plan all transitions, risk assessments for trips with transport to meet needs
- Support PE and other subjects which may require more substantial curriculum adaptations and ensure equipment is provided
- If additional adult support is required, review this regularly to ensure the CYP has as much independence as possible/appropriate
- If there is missed learning due to medical appointments/ procedures/condition, plan how to support learning so that CYP can access the curriculum and prepare for assessments
- Consider support/adjustment for unstructured times that promotes independence while enabling positive interactions with peers
- Consider exam access arrangements for all assessments to enable CYP to demonstrate potential
- Consider an adapted timetable to accommodate CYP medical needs and capacity to cope with the demands of the full curriculum
How well implemented?
When and how?
Provision and/or strategies:
- Staff training, including all First Aiders by relevant medical professionals
- Individual Health Care Plan (IHCP) informed by medical professionals, if required
- Collaborate with relevant external professionals and the family so that consistent support is provided in different environments
- Support PE and other subjects which may require more support to enable the CYP to take part
- Work with the family to support CYP so that with age, they are able to manage their medical condition independently and effectively
How well implemented?
When and how?
Resources
Find out about the terms we use
