Safe moving of children with VI and complex needs

Post date: 
Monday, 18 January 2016

Habilitation Specialist, Sharon O’Leary, discusses good practice for safe moving and handling of children with vision impairment and complex needs.

 
When supporting a young person with vision impairment (VI) and complex needs we may have to face challenges that we have not dealt with before, which can seem daunting.
 

What do we need to consider?

On devising a training presentation, I looked at the training I had received over the years and it became apparent how fundamental moving and handling training was. However previous training only focused on people who had a good understanding of the environment, with no empathy towards the individual’s needs and their cognitive level. It didn’t answer questions relevant to the young people I was working with.
 

What can we do to make it right?

Sam’s story

Sam is a new student who has mild scoliosis, global development delay, sensory processing difficulties, cortical visual impairment, tactile defensiveness and unpredictable movement pattern. His existing transfer guidelines were not clear, so staff were unsure of how best to support him in a safe, confident and consistent manner.
 
The transfers we initially looked at were supporting Sam into his wheelchair, from sitting on a beanbag to standing and from his wheelchair to standing. It became apparent that a whole team approach was needed to discuss and agree his transfer guidelines, and for Sam and the support staff to feel comfortable and safe using the techniques.
 
We organised a multidisciplinary meeting, which included all relevant professionals involved in Sam’s education and care. The meeting proved to be beneficial and we developed Sam’s transfer guidelines, taking into account the pointers below in how best to support him:
  • Sam has poor upper-body control and tends to adopt extremes of posture (extension or rotation) to help him to feel where he is in space. When he is displaying this, it was advised not to attempt transfer.
  • Sam benefits from having his hands held (with a gentle squeeze) to help him focus on what he is doing.
  • Sam benefits from simple language and needs time to process things.
  • Like most young people with VI and sensory challenges, Sam needs to have only one person working with him at a time. He doesn’t cope well with several people around him and will exhibit challenging behaviour.  A ‘one person and one voice approach’ is best practice
  • Before transfers, Sam needs to be wearing his boots and a bear hug vest.
We agreed to arrange a meeting in future to discuss any additional or underlying issues which were not currently covered by Sam’s transfer guidelines. This provided the opportunity to share what had and hadn’t worked well, and to see if further training would be needed to support staff with transfers.
 

Sam has already made huge progress and is clearly showing less anxiety around his transfers.

We decided to devise a best practice checklist for young people’s transfers and risk assessments. Good transfer guidelines will take into account the following:
  • Environment
  • Challenging behaviours and sensory issues
  • Vision and physical impairments
  • Providing additional training for support staff with the individual child, if required
  • Considering how to prepare them and ensuring a smooth transition
  • Telling them what is going to happen and making sure they are attentive
  • Using communication that is relevant to the individual child and ensuring key words are always the same
  • Allowing them to anticipate and express what is going to happen
  • On-body tactile cues
  • Preserving their dignity is the key consideration
  • Thinking about the young person’s wellbeing and whether it can be improved
It is important to work as a team when it comes to moving and handling young people with VI and complex needs to achieve the best transfer guidelines for the individual.
 
Written by Sharon O’Leary
Habilitation Specialist – Moving and Handling Adviser
RNIB Pears Centre for Specialist Learning
 
Do you work with children who have VI and complex needs? For more helpful resources, as well as details about VITAL, the professional network for support staff, please visit our complex needs webpage.
 
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