How do I prepare my child with disabilities for school?
 
RNZ: Serena Solomon

Beginning school is a major milestone for every child. If that child has a developmental, learning or physical disability, that transition is amplified in its complexity. While support is in place from organisations and the Ministry of Education, the often-exhausting burden of smoothing out that bumpy ride largely falls on parents and guardians to advocate for their child.
 
Here is what to consider when a child with a disability is gearing up for school.

​Choosing a school
 
Every child in New Zealand has the right to attend a public school, but that doesn't mean all schools are equal in how they handle children who have unique needs, Catherine Trezona from disability support organisation Your Way Kia Roha says.
 
"That may depend upon the experience they've had with other children, who is on the [school] board and what sort of specialist teachers there are."
 
Meet with each school's leadership to get a sense of their culture and capabilities. Here is a detailed list of questions you can ask the principal or deputy principal.
"A clued-up principal who knows how to access extra funding is amazing," said Lizi Parlby, a teacher who specialises in students with disabilities.
 
Parents should consider if the school grounds have what your child needs - fences if they tend to abscond or quiet places in the case of over-stimulation (see further down for mobility challenges).
Tangaroa picked her daughter's school largely because of its inclusive culture. School leadership was eager to listen and learn what her daughter needed, whereas the other schools seemed more interested in the additional government funding her daughter may or may not bring to the school, she says.
 
"They treated her like she was a normal student, not like there was something wrong with her," she says of her daughter's school.
 
What about specialist schools and Ongoing Resourcing Scheme (ORS) funding?
 
There are about 36 specialist day and residential schools for children with disabilities in New Zealand. To get a place at one of those schools, children need to qualify for ORS funding, which is only available to those with "the highest levels of ongoing need," according to the Ministry of Education.
Children with additional needs should have been linked with an early intervention service to help parents navigate support and funding. This is available from birth until six years old. The early intervention service puts together a child's ORS funding application.

​School accessibility
 
For students with mobility challenges, parents should aim to contact their preferred school 18 months before their child's first day. That is the length of time it might take to sort out accessibility issues such as ramps or mobility equipment, Frian Wadia from Parent to Parent, an organisation that supports parents whose children have a disability, says.
 
"Physical modification and mobility equipment takes a significant amount of time and there are often delays."
 
The cost of this will be covered by ORS funding if your child qualifies. A school can also apply for property modification funds, which includes occupational therapists accessing the school grounds and what your child needs, Wadia says.
 
Getting ready for day one
 
Transitions can be particularly hard for autistic children, Trezona says. Videos of the child going through their new routine can help.
 
"Get the school's permission - even if it is not during class time - to video the child walking through the gate, walking into the classroom, hanging up their bag, greeting the teacher."
Parlby, the special needs teacher, advises parents to get their child acquainted with the school grounds during weekends and holidays before the first day. Get photos printed of the school staff - not just your child's teacher - and create visual timetables of classes and activities so your child understands their new routine.
 
"Photo books and the visual timetables are things that work really well for children that need that routine."
 
Parents can also request that their child's existing friends be in their class or that the school connects them with a peer support buddy so their child has an additional familiar face, Parlby says.
 
How to complain
 
When you feel a school is not accommodating your child - which they are legally obligated to do - your first step is to follow the school's complaint procedure, Wadia says.
If that does not result in a solution, your next step is to go to the school board. Following this, you can head to New Zealand's Human Rights Commission. Wadia had to do this three different times on behalf of her three sons, who have various disabilities.
If the issue is with an individual teacher, you can go to the Teaching Council of Aotearoa New Zealand.
 
Article sourced from Radio New Zealand:
https://www.rnz.co.nz/news/national/535390/how-do-i-prepare-my-child-with-disabilities-for-school 30 January 2025

​Teachers say more and more new entrants are turning up to school without the language skills they should have for their age group. 
 
Too many five-year-olds start school unable to talk coherently, teachers say, and they blame Covid-19 and excessive screen time.
 
Teachers of new entrant school children and early childhood teachers report seeing more children than ever with poor language skills, research by the Education Review Office published today shows.
 
More than a quarter of teachers in schools in poor neighbourhoods said most of their pupils had oral language below the level expected of them, compared to just 3 percent of new entrant teachers in schools in rich neighbourhoods.
 
School teachers said some children could not talk in sentences of more than four or five words, spent a lot of time on devices and had little interaction with books.
 
"There is a complete lack of positional language, pronouns, and simple grammar tenses. A 6-year-old might say 'Me go pee' instead of 'I need the toilet' …", a new entrant teacher told the study.
 
"I have been teaching for 24 years and have never seen this low level of oral language."
Another said: "They have difficulty both with understanding what is said to them and with formulating responses. They often fail to understand what teachers say, [and] miss important points in class."
 
Early childhood teachers told the study they were spotting problems before children start school.
 
"The children want to communicate and try, however, they will often use the same simple words or incoherent sounds to communicate regardless of different contexts and situations," one early learning teacher told the study.
 
"Some of our 4-year-old tamariki like to tell long stories, but it mostly comes out as gibberish, much like an infant babbling," said another.
 
The ERO study said research showed 80 percent of five-year-olds had good oral language, but a significant group of children were behind and Covid-19 had made this worse.
"Covid-19 has had a significant impact. Nearly two-thirds of teachers (59 percent of ECE teachers and 65 percent of new entrant teachers) report that Covid-19 has impacted children's language development.
 
"Teachers told us that social communication was particularly impacted by Covid-19, particularly language skills for social communication. International studies confirm the significant impact of Covid-19 on language development," the report said.
 
Children's vocabulary at the age of two was strongly linked to their literacy and numeracy at age 12, the ERO report said.
 
"Delays in oral language in the early years are reflected in poor reading comprehension at school," it said.
 
However, it also said children's oral language varied a lot up to the first two years of primary school because children's development varied.
 
Quality early childhood education a solution – report
 
International studies showed quality early childhood education supports language development and could accelerate literacy by up to a year, especially for children from poor communities, the report said.
 
It recommended removing barriers to increase enrolments of children from poor families in early learning and increasing the quality of early education available to them through ERO reviews and Ministry of Education interventions.
 
While most qualified school and early childhood teachers know how to help children improve their oral language, some were not confident, the report said.
 
It recommended ensuring the school and early childhood curriculums provide clear progress indicators for oral language.
 
 
Reference:
 
https://www.rnz.co.nz/news/national/525811/more-5-year-olds-starting-school-with-low-speaking-skills-teachers

Code of Health and Disability Services Consumers’ Rights
 
The Health and Disability Commissioner Act 1994 established a Health and Disability Commissioner to oversee this act.  As part of their role they have developed a code of rights.  The act and the code are currently under review.
 
Health and Disability Commissioner (Code of Health and Disability Services Consumers' Rights) Regulations 1996
 
1. Consumers have rights and providers have duties:​
 
(1)     Every consumer has the rights in this Code.
(2)     Every provider is subject to the duties in this Code.
(3)      Every provider must take action to:
             (a)    inform consumers of their rights; and
             (b)    enable consumers to exercise their rights.
 

2. Rights of consumers and duties of provider

The rights of consumers and the duties of providers under this Code are as follows:
 
Right 1
Right to be treated with respect
 
(1)    Every consumer has the right to be treated with respect.
(2)    Every consumer has the right to have his or her privacy respected.
(3)    Every consumer has the right to be provided with services that take into account                                  the needs, values, and beliefs of different cultural, religious, social, and ethnic                                         groups, including the needs, values, and beliefs of Māori.
 
Right 2
Right to freedom from discrimination, coercion, harassment, and exploitation
 
Every consumer has the right to be free from discrimination, coercion, harassment, and sexual, financial or other exploitation.

Right 3
Right to dignity and independence
 
Every consumer has the right to have services provided in a manner that respects the dignity and independence of the individual.
 
Right 4
Right to services of an appropriate standard

(1)  Every consumer has the right to have services provided with reasonable care and                                 skill.
​
(2) Every consumer has the right to have services provided that comply with legal,                                 
(3) Every consumer has the right to have services provided in a manner that                                               minimises the potential harm to, and optimises the quality of life of, that consumer.                                
(4)  Every consumer has the right to co-operation among providers to ensure quality and                           continuity of services. 
 
 
Right 5
Right to effective communication
 
(1)   Every consumer has the right to effective communication in a form, language, and                 
        manner that enables the consumer to understand the information provided.                                          Where necessary and reasonably practicable, this includes the right to a competent                             interpreter.

 (2)    Every consumer has the right to an environment that enables both consumer and               
​          provider to communicate openly, honestly, and effectively.

 Right 6
Right to be fully informed
 
(1)  Every consumer has the right to the information that a reasonable consumer, in                                     that consumer's circumstances, would expect to receive, including:
        (a)    an explanation of his or her condition; and
        (b)   an explanation of the options available, including an assessment of the expected                                 risks, side effects, benefits, and costs of each option; and
        (c)     advice of the estimated time within which the services will be provided; and
        (d)     notification of any proposed participation in teaching or research, including                                            whether the research requires and has received ethical approval; and
        (e)     any other information required by legal, professional, ethical, and other                                                    relevant standards; and
        (f)      the results of tests; and
        (g)     the results of procedures.
 
(2)     Before making a choice or giving consent, every consumer has the right to the                                      information that a reasonable consumer, in that consumer's circumstances,
          needs to make an informed choice or give informed consent.
 
(3)      Every consumer has the right to honest and accurate answers to questions
           relating to services, including questions about:
             (a)     the identity and qualifications of the provider; and
             (b)     the recommendation of the provider; and
             (c)     how to obtain an opinion from another provider; and
             (d)     the results of research.
 
(4)        Every consumer has the right to receive, on request, a written summary of
             information provided.
 
Right 7
Right to make an informed choice and give informed consent

(1)       Services may be provided to a consumer only if that consumer makes an informed
            choice and gives informed consent, except where any enactment, or the common
            law, or any other provision of this Code provides otherwise.

(2)      Every consumer must be presumed competent to make an informed choice and
           give informed consent, unless there are reasonable grounds for believing that the
           consumer is not competent.

(3)       Where a consumer has diminished competence, that consumer retains the right                                  to make informed choices and give informed consent, to the extent appropriate to                                his or her level of competence.

 (4)      Where a consumer is not competent to make an informed choice and give                                            informed consent, and no person entitled to consent on behalf of the consumer is                                available, the provider may provide services where:
             (a)   it is in the best interests of the consumer; and
             (b)   reasonable steps have been taken to ascertain the views of the consumer;  and
             (c)   either:
                    (i)   if the consumer's views have been ascertained, and having regard to those                                             views, the provider believes, on reasonable grounds, that the provision of 
                           the services is consistent with the informed choice the consumer would                                                 make if he or she were competent; or
                    (ii)  if the consumer's views have not been ascertained, the provider takes into                                             account the views of other suitable persons who are interested in the welfare                                       of the consumer and available to advise the provider.
 
(5)       Every consumer may use an advance directive in accordance with the common law.
 
(6)        Where informed consent to a health care procedure is required, it must be in writing if:
                (a)   the consumer is to participate in any research; or
                (b)   the procedure is experimental; or
                (c)  the consumer will be under general anaesthetic; or
                (d)  there is a significant risk of adverse effects on the consumer.
 
(7)         Every consumer has the right to refuse services and to withdraw consent to                           
              services.
 
(8)          Every consumer has the right to express a preference as to who will provide services                          and have that preference met where practicable.
 
(9)          Every consumer has the right to make a decision about the return or disposal of any                           body parts or bodily substances removed or obtained in the course of a health care                             procedure.
 
(10)        No body part or bodily substance removed or obtained in the course of a health care                           procedure may be stored, preserved, or used otherwise than
               (a)   with the informed consent of the consumer; or
               (b)   for the purposes of research that has received the approval of an ethics committee; or
               (c)    for the purposes of 1 or more of the following activities, being activities that are  each                          undertaken to assure or improve the quality of services:
                         (i)  a professionally recognised quality assurance programme:
                         (ii) an external audit of services:
                         (iii) an external evaluation of services.

Right 8
Right to support
 
Every consumer has the right to have one or more support persons of his or her choice present, except where safety may be compromised or another consumer's rights may be unreasonably infringed.
 
Right 9
Rights in respect of teaching or research
 
The rights in this Code extend to those occasions when a consumer is participating in, or it is proposed that a consumer participate in, teaching or research.
 
 
Right 10
Right to complain
 
(1)   Every consumer has the right to complain about a provider in any form appropriate to the     
         consumer.
(2)    Every consumer may make a complaint to:
           (a)     the individual or individuals who provided the services complained of; and
           (b)     any person authorised to receive complaints about that provider; and
           (c)      any other appropriate person, including:
                      (i)  an independent advocate provided under the Health and Disability                                                            Commissioner Act 1994; and
                       (ii)  the Health and Disability Commissioner.
 
(3)      Every provider must facilitate the fair, simple, speedy, and efficient resolution of
           complaints.
 
(4)      Every provider must inform a consumer about progress on the consumer complaint
            at intervals of not more than 1 month.
 
(5)      Every provider must comply with all the other relevant rights in this Code when dealing with 
           complaints.
 
(6)      Every provider, unless an employee of a provider, must have a complaints procedure                           that ensures that:
           (a)   the complaint is acknowledged in writing within 5 working days of receipt,                       
                    period; and
           (b)    the consumer is informed of any relevant internal and external complaints                                             procedures, including the availability of:
                   (i)  independent advocates provided under the Health and Disability                                                               Commissioner Act 1994; and
                    (ii)  the Health and Disability Commissioner; and
           (c)    the consumer's complaint and the actions of the provider regarding that                                                    complaint are documented; and
            (d)    the consumer receives all information held by the provider that is or may be                                           relevant to the complaint.
 
(7)        Within 10 working days of giving written acknowledgement of a complaint, the                                     provider must:
                (a)  decide whether the provider:
                       (i)   a ccepts that the complaint is justified; or
                       (ii)    does not accept that the complaint is justified; or
                 (b)  if it decides that more time is needed to investigate the complaint:
                       (i)   determine how much additional time is needed; and
                       (ii)  if that additional time is more than 20 working days, inform the consumer of  that
                              determination and of the reasons for it.
 
(8)        As soon as practicable after a provider decides whether or not it accepts that a. complaint
             is justified, the provider must inform the consumer of
              (a)   the reasons for the decision; and
              (b) any actions the provider proposes to take; and
              (c) any appeal procedure the provider has in place.

​My Health Passport

The Commissioner has also developed a Health Passport to assist, those of us with disabilities and those of us who have interactions with health services.
 
My Health Passport is a booklet where you can write down information about how you want people to communicate with you and support you when you receive a health or disability service.  Available in a variety of accessible versions.
 
What is My Health Passport?
 
My Health Passport is a booklet that you can carry with you when you visit health and disability services. The booklet has information about how you want people to communicate with you and support you when you use health or disability services.
My Health Passport is not a tool to help doctors diagnose or monitor patients. It is not a substitute for a patient’s medical records.
 
 
The above information has been sourced from the Health and Disability Commissioner website www.hdc.org.nz December 2024

Why do we get corns or bunions and what can be done about it? Should you tackle your own ingrown toenail? And socks, cotton or wool?
 
Christchurch podiatrist Simon Wheeler is the man in the know about how to look after our feet.
 
Toenails
A little but often is his trimming advice.
 
“Rather than once in a blue moon and trying to cut them right back, aim just to cut them straight across the free edge.”
 
Buying the right shoe
Wearing a properly fitted shoe with support and cushioning, is important, and Wheeler suggests supporting your local shoe shop is the way to go.
 
“The trend at the moment is purchasing online, but it’s quite hard to buy footwear online. I think it’s best to actually be fitted at a shop.”
 
Socks and foot hygiene
They need to be changed daily, he says.
 
“Some people sweat more than others, some people will have to change socks more often than daily, particularly if you have gone out and done some sport or activity.
 
“You want to make sure you've got moisture wicking socks. Thin cotton socks do not move moisture away from the skin. You end up sitting in a pool of sweat or moisture.”
 
Go for woollen socks, he says.
 
Toenails as we age
Toenails, like skin and bone, are living and respond to load or to irritation, he says.
 
“They generally thicken because they suffer from trauma. And obviously the older, the longer we live, the more trauma they suffer.
 
“So that's why they thicken up. The most common reason that could be like a one-off trauma, you dropped a hammer on it a cricket ball or whatever.”
 
 
Toenail fungus
“It's common, it's hard to treat. It gets into the nail bed and then in the nail,” he says.
 
Treatments include prescription medication which can “have some quite harsh side effects.”
 
Laser treatment is also an option, but prevention is the best method, he says.
 
“Foot hygiene, first signs of fungal skin infections, athlete's foot, get onto a fungal cream really quickly.”
 
Over the counter anti-fungal creams are highly effective, he says.
 
“The creams for skin infection are 100 percent very effective. Once it starts to get into the nails the more in depth it is in the nails the harder it is to treat.”
 
In-growing toenails
The condition is often hereditary, he says.
 
“They're quite often present in their early teenage years as we start to sweat a bit and the feet are growing.

“And then again, it can be as a result of trauma. You've got to trim them straight across and the risk of you cutting them back yourself is that you introduce a portal for infection, or you miss some of it and you make it a hell of a lot worse.
 
“If you've got an ingrowing toenail with what looks like a skin infection, I would seek podiatry help immediately, as quick as you can.

 
Listener questions:
 
The soles of my feet are covered in coarse, scaly skin and underneath red weeping skin, it's very itchy. I'm desperate.
 
“That sounds like a skin infection of some sort. And so, you should seek medical attention for that. So, a GP or potentially your local podiatrist.”
 
What do I do about thick, yellowing skin that’s become painful?
 
“This is known as a callus, the skin is a living tissue, it responds to what load you put through, the thickened skin or the calluses is its way of protecting itself.
 
“However, often that goes too far. And that yellow thickened skin becomes quite uncomfortable to stand on so often a podiatrist would debride that and take that skin away, which provides instant comfort.”
 
I have damp skin splits that happen between my toes is that athlete's foot?
 
Yes, skin hygiene; natural fibre socks, so we're getting moisture wicking, and antifungal cream, over the counter from the pharmacist.”
 
 Is it important to wash and dry feet when you're in a shared space like a gym shower?
 
“You probably want to wear some real simple, rubber old-school jandals in the shower. And definitely dry thoroughly. So, they're not damp when you're putting them into footwear particularly in the winter.
 
“Otherwise, they're just moist going into that warm, damp environment.
 
“Some people are prone to it, there's no doubt about that. Like some people just seem to get athlete's foot at the sniff of going to a shared shower
 
“If you’re prone you can use the creams for prevention, use sprays these help and anti-fungal talcum powder that you can pop your socks or shoes.”
 
Another listener suffered from painful cracked heels
 
“People that are prone to heel fissures tend to get them again and again, so if you get them, you're going to get them in the future.
 
A regular moisturiser, and you can get cracked heel balm which is a bit thicker. It’s really good to use regularly, especially at the first sign of the crack.”
 
What's your advice for the management of bunions to reduce pain and prevent worsening?
 
“There's, different types of orthotics. Prefabricated ones, but you can get custom made ones which, are probably significantly dearer. But they do a phenomenal job.”
 
Should I pop my blisters?
 
“Probably not, it does give pain relief, but also potentially leads to infections. So salt-water bathing maybe, you’ve got to keep them clean.”