My child is not in school, can we still get support from school health?
Yes – we work with all school aged children in different settings
My child wets the bed, how do we get support?
Behaviour
Behaviour is how we conduct ourselves. It is our actions, reactions and functioning in response to everyday environments and situations. Challenging behaviour is used to describe behaviour that interferes with a child’s daily life. Managing any child’s behaviour is essential in maintaining order and routine/structure in the lives of busy families. It also helps to set children up for success.
It is important to be aware that behavioural difficulties can often be caused due to difficulties/delays in other areas including: sensory processing, understanding language, being abele to self regulate, social skills and planning skills.
Behaviour includes:
Sensory processing: being able to accurately process sensory stimulation in the environment as well as in one’s own body.
Self regulation: being able to understand, maintain and change emotion, behaviour, attention and activity level appropriate for a task or situation presented to them.
Emotional Development/regulation: is the ability to understand another person’s emotion, take it on board and regulate your own emotional response
Impacts:
Behaviour can impact a child’s life in many different ways:
Health and or quality of life: Challenging behaviour may seriously affect a child and parent/carers health and quality of life. They may not be able to take part in certain tasks/activities. Miss out on family occasions, days out, social clubs/groups.
Reduce risk: Some risks associated with challenging behaviour include self-harming (this can include eating or inhaling foreign objects, hitting their head or throwing their body on the floor) which can result in serious injuries. Accidental injury can also be a common issue in children with aggressive behaviour, not only for them, but anyone involved in their care or in close contact.
Dietary needs: refusal to eat certain foods or eat too much of a particular food which may result in dietary deficiencies, weight loss or gross obesity.
Social isolation: Challenging behaviour can often lead to social isolation. Children may be frightened to make friends through fear of being hurt themselves
School transition: social isolations is likely to impact on their sense of well being and transition to school.
Reduce mental health issues: Research also suggests that lack of social skills can lead to loneliness and depression from an early age.
Maturity: How a person behaves is a direct reflection on their maturity.
-
Child Development
Child Development
Children undergo a number of changes throughout their growth until adolescence in relation to physical, speech, intellectual and cognitive development. Specific changes occur at specific ages of life. Known as developmental milestones, these changes can help you track whether your child is developing at the correct pace. Failure to reach these milestones may indicate developmental disorders or genetic conditions.
There are 5 stages of child development:
Newborn – During the first two months of life newborns have an automatic reaction to external stimuli. They can move their head from side to side, see close-up objects and turn towards sounds. They will cry to indicate they have a need, such as being hungry, tired or needing a nappy change. By the third month of life, newborns start to smile at people.
Infant
A child has developed a lot of new abilities but the time it reaches it first birthday. Between the age of 3-6 months an infant can recognise familiar faces, begin to babble (talk), have control over their head movements and bring their hands together. Between 6-9 months, infants will start to sit unaided. They will start to bounce on their legs when held in a standing position. Infants will also look in the direction of someone if their name is called.
Between the age of 9-12 months, infants can start to point at things, pick up items, start to craw and stand with support. They can also copy sounds and gestures.
Toddler – Between the ages of 1-3, children can stand alone, learn to walk unaided, begin to climb stairs and run. They can wave hello and goodbye, hold a crayon or pencil, draw circles and learn to speak a number of works and even start to construct small sentences. They will also be able to follow simple instructions/tasks.
Pre-school
Between the ages of 3-5 years a child’s fine motor skills become refined. They can dress themselves, throw and catch a ball as well as skip and hop. They will be able to complete longer sentences easily. By the age of 4 children will be able to use the toilet by themselves.
If a child is having difficulties with behaviour you may notice:
- That they get frustrated easily or more in comparison to their peers.
- Will not carry out tasks or do the complete opposite to what is being requested of them.
- May have frequent tantrums
- The tantrums may last for a long time.
- Difficulty starting or maintaining friendships
- May become physically aggressive
- Changes to sleep routine, trouble getting to sleep or staying asleep throughout
- They are difficult to discipline.
- ‘Typical’ behavioural strategies are ineffective.
Strategies for parents
Introduce a set time period for example 10 minutes where you can have w uninterrupted one-to-one with the child and time to build on your relationship.
Play alongside your child, mimic, what they are doing.
Give short instructions.
Look out for signs or triggers that may cause your child to become upset. Keep a record of these.
School Age
Between the age of 6-17 children learn to become independent of their parent/carers and begin to form their own opinions. Children’s speech, writing and learning skills become embedded and their emotions will further develop and they will experience jealousy, love, sadness as well as many more. They will express their emotions through words and gestures. Children will further develop friendships and form best friends during this stage.
-
Learning disability
A Learning disability affects the way a child will learn, understand new information, learn new skills, how they communicate and their ability to cope independently.
Learning disabilities can be mild, moderate or severe. Some children diagnosed with a mild learning disability may be able to talk easily and do things independently but may need longer to learn new skills. Others may not and will have difficulty communicating and may have other disabilities.
If your child is diagnosed with a learning disability you can contact your GP who can then refer you onto any specialist support that may be needed.
If you are unsure if your child has a learning disability you can speak to your GP, child’s school, Paediatrician.
-
Support with distressed behaviour
Lift off – Parent Education programme around behaviour that can be completed at home in your own time. The course is available in two sessions and will explain what normal behaviour is and identifies challenging behaviour and ways to manage it.
Online trainingc
Behaviour – ages 7-11 session 1
Behaviour – ages 7-11 session 2
Once you have completed this training, please email confirmation to medch.schoolhealth@nhs.net
-
Behaviour management strategies
There are a number of different strategies that you can try with your child to help them understand their behaviour and make positive changes:
Be a role model for your child – Manage your own behaviour in a way that you would want your child to react. This at times can be difficult as we all lose ourselves but a child likes to be shown the right way to do something.
Show your child how you feel – don’t be afraid to be upset in front of your child.
Actively listening – let your child know you are listening to what they are saying by engaging with them, nod your head and say their words back to them as you have understood them.
Get down to your child’s level – if they are on the floor, sit down with them so that you are the same height, this will take any intimidation away.
Rewards Charts – are a powerful way to help change a child’s behaviour by giving them stickers or points towards a reward when the do something or behave in way that you would like them to. It helps to reinforce the behaviour that you want and helps the parent/carer to focus on the positives in a child’s behaviour.
ABC Model – Understanding where misbehaviour comes from which allows you to identify triggers, actions to combat the misbehaviour and the consequences.
Complete objectivity – Remaining calm, neutral and level headed when you are dealing with a child’s misbehaviour is a way of helping to calm the situation and can signal to the child that you are trying to understanding the behaviour in order to help them.
Consistent approach to consequences and rewards – the key is to remain consistent, whether that is in your rewarding of good behaviour or trying to manage inappropriate behaviour. You must treat every child the same. If you warn a child of a consequence you need to follow this through. The same applies for rewarding good behaviour. This will help the parent/carer to remain in control and will help to manage the behaviour better in the future.
Family rules – this is a good way of setting out what is expected of a child in terms of their behaviour and can link in with a rewards chart. Make sure to include the child in what rules are formed, this will give them a feeling of being listened too. You then explain the consequences if the rules are not kept.
Offer praise for positive behaviour – offering praise and positive feedback for god behaviour can help a child’s self-esteem and help to change attitudes and/or behaviour.
-
FAQs
If your child is aged 5yrs+ and wets the bed, you can speak to your school nurse or GP for support and advice
What emotional wellbeing issues can school health support with?
The School Health emotional wellbeing team can provide a short-term therapeutic support for child struggling with feeling sad, anxious, stressed, angry or self-confidence. If your child needs counselling or more specialist support we will try and signpost you to the right support.
I think my child may have additional needs, how can school health support
The school health team can offer you an initial assessment to explore your concerns and help signpost to the right support.
Who is the Medway School Health team for?
Our School health team support children and young people aged 5-19 years who live in Medway and/or attend a Medway state school
Where can I get support for challenging behaviour?
If you are worried about your child’s behaviour, we would recommend discussing this with their school to understand whether there is any difference in behaviours at home and school. Your school might even be able to signpost you to a course to better understand your child’s behaviours and development. You may want to consider referring to school health for an initial health needs assessment to better understand the concerns.
What happens if my child is referred to school health?
The School Health team would normally complete an initial assessment to gather more information about your child’s area of need. Following this assessment, we may make recommendations for you to try and/or signpost and refer on to other services to best meet your child’s needs.
I am worried about a child / Young person who lives in Medway, what should I do
If you are worried about the safety or wellbeing of a child/young person who lives in Medway you can report this to Medway Social Care or anonymously to NSPCC. If the child/young person is in immediate danger, you should call 999.
Report to Medway social care referral: https://www.medway.gov.uk/info/200170/children_and_families/600/concerned_about_a_child
Report to NSPCC: https://www.nspcc.org.uk/keeping-children-safe/reporting-abuse/nspcc-helpline/
How Often are school liaison meetings?
Primary and Secondary schools are offered a 1-hour liaison meeting once a term with their link school nurse.
How do I refer for anaphylaxis/epilepsy and asthma awareness training?
School health can offer an awareness session once a year to schools who have children and young people with a confirmed diagnosis. Schools are required to complete a referral (incl. copy of care plan(s) in order to deliver a session tailored to the needs of the child(ren) at the school.
Who is the link School Nurse for our school?
The Schools SENCO should have this information. However, if you are still unsure, you can contact the School Health team on 0300 123 3444 or email: medch.schoolhealth@nhs.net and request the details of your link school nurse.
How do I contact my link school nurse?
You will have a scheduled contact with your link school nurse once a term at the liaison meeting. However, if you require support outside of this meeting you can contact the link school nurse via email/telephone. Alternatively, you can contact the Duty School Nurse on 0300 123 3444 or medch.schoolhealth@nhs.net
Is it best to use a self-referral or a professional referral into school health?
School health have the option for self-referrals and professionals’ referrals. It is important that all referrals are discussed with the child and family before being made. All referrals received will be carefully screened, so that the best support can be accessed by the child/young person. It is important to make this decision based on the family’s individual needs
Can a young person see the school nurse without parental consent?
Yes, for older children, we consider using Gillick competency to better understand the young person’s understanding. School Nurses have the young persons best interest at heart and we work strictly to the confidentiality rule and would only break confidentiality if we were worried that a child or someone else was at risk of harm. When assessed as safe and appropriate, we would support young people to talk to their parent/carer(s) for additional support.
How can I help to keep my child safe online?
It is healthy to set age appropriate boundaries and have open discussion with your child about online safety. ‘Think UK now’ have some excellent resources to support you but child line also have some helpful resources. Schools will also be able to offer support around online safety. www.thinkuknow.co.uk
I am concerned about my child’s relationships (with peers / boyfriends / girlfriends)
It is important to talk about healthy and unhealthy relationships with your child and help them understand consent from an early age. The NSPCC and Childline have some helpful resources for parents, professionals and children/young people https://www.childline.org.uk/info-advice/friends-relationships-sex/sex-relationships/healthy-unhealthy-relationships/ .
You may consider a referral to school health, we can offer support and advice to your child on health relationships and consent.
If you have urgent concerns about a child’s safety and wellbeing you can contact Medway social care or contact NSPCC to make a referral.
Report to Medway social care referral: https://www.medway.gov.uk/info/200170/children_and_families/600/concerned_about_a_child
Report to NSPCC: https://www.nspcc.org.uk/keeping-children-safe/reporting-abuse/nspcc-helpline/
How do I access the Lift-Off behaviour presentations?
Visit the Medway Community Healthcare School Health website. You will see the ‘Lift off’ link on the top right corner. There are two Lift Off presentations which are free and targeted at understanding the behaviours and development of primary school aged children. This presentation may not be appropriate for children with some additional needs.
What support is there for children who are not accepted by the Indigo Pathway (Neurodiversity pathway for ADHD, ASD and Sensory processing)?
Your child’s school will continue to use ‘core standards’ which are support strategies tailored to your child to help them thrive in school. Your school may also be able to signpost you to parenting course to learn new strategies to continue to support your child. If you feel your child could have an underlying medical need, please complete a referral to the school health team for an initial assessment.
You may also consider referring to Medway’s Small Step service who offer support to children and families pre and post diagnosis of ASD and ADHD. You may consider a referral to Early Help/Family solutions if you are worried about your child’s behaviour having an impact on their wellbeing and/or the family’s safety.
What emotional support is available for children aged 5-18?
From time to time we all struggle with our emotional health and wellbeing. For some children and young people they can find it difficult to manage and understand these feelings. Difficulties that children and young people will vary but could include low mood, issues sleeping, loss of appetite, difficulty concentrating, avoiding school or social situations. We offer emotional support over the course of 4-6 sessions. Providing practical techniques and strategies to help children and young people move forward. To access this support or for more information please see our emotional wellbeing page, complete an online referral or call 0300 123 3444
How do I support my child through bereavement or loss?
We are sorry to hear this. Your child and of course the whole family could be experiencing grief. There is no right or wrong way to deal with grief but some symptoms are: shock, numbness – this is usually the first reaction to loss and can be describe as being in a daze or removed from real life. Sadness – this can happen at any time and for no reason. Tiredness/exhaustion, Anger /short tempered or irritable, Survivors guilt. Encourage your child to talk to someone, even if they cannot talk to you find an adult in their life they feel comfortable to be open with. If you want more information about bereavement services and support, please visit Holding on letting go, Winston’s Wish or CHUMS
What do we offer the young people in the sessions
Develop their understanding of the situation, useful strategies they engage with to increase their resilience, and then I say that’s its very young person led
-
Additional support
Video by Public Health Network Cymru
Resources
Published on: 27 March, 2025
Share this page:
