https://www.rnz.co.nz/news/national/516641/schools-failing-autistic-and-other-neurodivergent-children-report​

​A report warns schools and early childhood centres are failing autistic and other neurodivergent children on an epic scale.
The Education Hub study said devastating testimony from 2400 people showed the education system was broken and heading for a major crisis.
It was calling for more funding and a law change to force the Education Ministry and schools to provide support for all children with disabilities and learning needs.
 
The Education Hub is a non-profit organisation that connects teachers with education research.
Its report said 15-20 percent of the population was neurodivergent, meaning they had conditions including autism, ADHD, dyslexia and anxiety.
The school system was supposedly inclusive, with schools required by law to enrol local children regardless of their abilities, it said.
However, inclusion was not the reality for many neurodivergent children.
"Inclusion is all but an illusion for too many of our young people, with no specific education
legislation in New Zealand regarding specialist provisions or supports for children with special educational needs," it said.
"Many parents gave heart-rending accounts of the mental health impacts they witnessed in their neurodivergent children during the time they attended school, describing trauma responses, clinical depression, anxiety, self-harm and suicidal ideation from as young as the age of six."
​The education system focused more than $600 million a year on children with the highest needs, which meant neurodivergent pupils who did not have challenging behaviours tended to miss out, the report said.
"In addition, at some schools, accommodations for neurodivergent students are being arbitrarily denied or discouraged."
When support was provided, it was often inadequate, the report said.
Education Hub founder Nina Hood said it was clear there were big problems.
"The system is completely broken. There's very little that is working particularly well.
"There are significant issues with funding. It's really, really hard for many neurodivergent students to get access to any publicly funded services and those young people who are getting access to public services, in most cases it's not enough support."
There were too few specialists working with neurodivergent children - and teachers needed more help, Dr Hood said.
"They are having to bear a huge burden trying to support these neurodivergent students and for many teachers they want to be doing the best by their students but it is incredibly hard."
More funding was part of the answer, she said.
But the law needed to change so that all children with disabilities had an absolute right to the support they needed.
"Neurodivergent children ... have the right to attend school but at the moment they don't actually have the right to receive the resourcing and support they need in order to actually succeed and thrive at school," Hood said.
 
Frustrated and exhausted
Tami Harris from Acorn Neurodiversity, a trust helping neurodivergent children and young people in Auckland, said the report accurately reflected what many families were going through.
"Families feel like a burden to their school and, in fact, are often discouraged from enrolling their child at the school directly and feel like they're constantly needing to fight to get the things that their child needs."
The situation was "incredibly bad" and New Zealand's neurodivergent children were much worse off than children in other countries, she said.
"The access that our families would have if they lived across the pond in Australia or really anywhere else, they would be getting a suite of comprehensive services if they had a disability or some form of learning challenge."
Rebecca, the mother of a child with autism and ADHD, said trying to get support for her daughter was exhausting.
"I've been out of work, in work, out of work purely to spend time advocating, ensuring my daughter's needs are met, ensuring I'm at home when she's been sent home. Yes, it's been a real roller-coaster."
Many people tried their best to help, but the system was too difficult to navigate, she said.
"Individuals [are] working within a system that's convoluted, complex and just doesn't have enough to meet the basic needs of children with learning needs."

​University student Annabelle said she teared-up when she read the report.
Going through school with undiagnosed ADHD and autism was tough, because even with supportive teachers, the system made neurodivergent students feel like failures, and seemed to provide help for students only after they had failed, rather than supporting them to succeed, she said.
"It's not acceptable for the students and it's not acceptable for the teachers. It's not acceptable for the leaders, it's not acceptable for anyone working in schools.
"Trying to navigate a system that's built like an ambulance at the bottom of a cliff is ridiculous."
​
Hostile environment
In the report, several respondents said the situation in schools was so bad they would be better off home-schooling their children.
A school's special education coordinator told the study: "If I had a learning support child I would seriously homeschool my child. At times I suggest to parents the same. The New Zealand school system currently cannot support these students."
Many respondents were especially unhappy with so-called modern learning environments, which have large, open, shared spaces for teaching.
Most said teachers' lack of knowledge about neurodivergent children was a big problem.
And schools that did a good job tended to attract more neurodivergent children, a teacher told the researchers.
"It is a concern to me that the schools/staff that have embraced better approaches to supporting neurodiverse students (and others with special needs) often are flooded with those students.
"This is unfair, does not always come with extra funding/resources, and allows those who are deliberately blind to remain that way."
Another respondent said specialists were burnt out and every Education Ministry speech therapist they knew was looking for another job.
 
 
 
Author: John Gerritsen
Sourced from Radio New Zealand website:
https://www.rnz.co.nz/news/national/516641/schools-failing-autistic-and-other-neurodivergent-children-report
 

Type 2 Diabetes prevalance and risks
 
17 per cent of New Zealanders over 65 have Type 2 Diabetes (around 135,221).  This is an alarming statistic due to the complications Type 2 Diabetes can cause for a person’s overall health.  Type 2 Diabetes is a disorder of the endocrine system.  It’s an impairment in the way the body uses and regulates glucose in the blood.  Subsequently too much glucose is circulating in the blood and can lead to disorders of the nervous, immune and circulatory systems.
​Nutrition as a simple intervention in the aged care setting
 
Low carbohydrate nutrition has been researched, with good outcomes, as a therapeutic measure for those with Type 2 Diabetes.  This can be of significant use in the aged care setting, as a simple measure for improving the quality of life for those with Type 2 Diabetes.  Particularly where other lifestyle measures such as exercise may be limited due to mobility, nutrition is a simple daily measure that can be used to treat Type 2 Diabetes and reduce clinical costs.
 
Here is some practical advice around implementing this and monitoring residents.  Individual advice for each resident should be sought from a Registered Clinical Nutritionist trained in low carbohydrate nutrition and the residents medical professional (GP or Diabetic Care Nurse).
 
Positive effects of Low Carbohydrate Nutrition on blood sugar, lipids and body weight reduction
 
Type 2 Diabetes is linked to obesity and elevated blood lipids.  In one study following 64 obese subjects with elevated blood glucose, it is interesting to note that not only a drop in blood glucose has occured but also a drop in body weight and a decrease in blood lipid markers for these patients.  The study was conducted over a period of 56 weeks.  Thus showing a really beneficial effect long term for adherence, blood glucose reduction, body weight reduction and blood lipids.
 
Monitoring in the initial period and ongoing
 
If a resident is prescribed insulin for their Type 2 Diabetes diagnosis it is really important to monitor blood glucose levels closely when embarking on a low carbohydrate lifestyle due to the high risk of hypoglycaemia.  In this instance the care facility staff should moitor blood sugars four times daily (before meals and before bed or as recommended by their registered health professional) and work closely with the resident’s doctor as to when the insulin should be reduced and/or ceased.
 
The risk of hypoglycaemia with diabetic prescription medications is low and whether or not a patient stays on these as blood sugars lower can be discussed with the resident’s doctor on an individual basis.  If a resident is prescribed anti-hypertensives for high blood pressure, then blood pressure should be moitored closely when embarking on a low carbohydrate diet.  The high blood pressure insulin levels can cause sodium retention, and this is often quickly resolved with a low carbohydrate diet.
 
How to implement a low carbohydrate lifestyle
 
From a practical perspective keeping it simple is best.  A diet consisting of 10 per cent carbohydrate, 25 per cent protein and 65 per cent fat across total calories for the day is a good start for most.  Essentially following a low carbohydrate diet is eating eggs, meat, fish, chicken, nuts, seeds, low to no lactose dairy, low sugar fruit and plenty of green vegetables (above ground), and cutting out sugar, highly processed packaged foods, starchy carbohydrates and grains.  Nutrient dense, wholefoods should be consumed predominantly.  Packaged foods tend to be over processed, contain added refined sugar and industrially produced oils that can lead to inflammation.  If you are using any packaged foods check the ingredients first for either of these.  Make sure you know what it is in the food provided.
 
Protein should be prioritised at each meal.  Amino acids contained in protein are the building blocks of the body and increasingly important across the lifespan.  As the aging process occurs the body naturally works against itself by way of a process called sarcopenia (muscle wastage).  You can combat this for residents by ensuring they eat at least 1.8gms of protein per kg (note this is not the weight of the actual food but the weight of the protein content in the food) of bodyweight daily and get at least a little exercise (resistence is best for this and should be appropriate to the resident) daily.

Foods high in protein include eggs, fish, meat, and chicken etc.  Protein powders may also be used where a resident cannot or is struggling to consume enough protein from other sources.  Bone broth and whey protein powders have the best amino acid profile.  Plant based pea protein powders can be used if dairy is not tolerated.  Protein powders are a convenient way to add in protein by way of a smoothie as a snack or a complete meal with the right additions.  Low to no lactose dairy includes full fat yoghurt, butter and cream.  This is of course only appropriate to those who tolerate dairy.
​
In terms of carbohydrates, low sugar fruit consists of berries.  As it is an accumulation of carbohydrate across a day it may be appropriate at times to include a small amount of vegetables such as carrots, pumpkins and onions etc.  Variety will of course improve nutrient consumption also and this should be a priority.  Healthy fats include cold pressed oils, and good quality dairy.
 
 
Ref: Aged Care New Zealand Issue 02 2022
Author:  Rosie James, Registered Clinical Nutritionist

In April 2024 stricter rules for Carer Support payments and Equipment Management Services (EMS) through Enable, were made, to manage Whaikaha’s projected 10% budget overspend. This prompted the Government to review Whaikaha’s performance.  The Independent Review was released on 28 June 2024.
 
The review’s recommendations were:

1. Budgets for Needs Assessment and Service Co-ordination (NASC’s), Enabling Good Lives (EGL) sites and Equipment Management Services (EMS) providers – to be fixed.  Monitoring and reporting requirements to be developed.
2. Freeze funding for residential care - to maintain the current levels of funding for facility based care for 2024/25 pending a review of contract and pricing models. Have a panel to review and approve packages over $105,000.
3. Take no action on price increases for providers in 2024/25.
4. Monitor NASC and EGL performances.
5. Update the assessment and allocation settings – to be implemented by MSD.
6. Establish Flexible Funding criteria and review guidelines - to improve clarity and consistency.
7. Strengthen how agencies work together – Ministry of Health (MOH),  Ministry of Social Development (MSD), and Health NZ.

 
In addition to these recommendations the Government transferred the responsibility for Disability Support Services (DSS) from Whaikaha to the Ministry of Social Development (MSD) in September 2024.
 
In 1993 the responsibility for Disability Support Services was taken away from MSD’s predecessor and transferred to the Ministry of Health where the funds were ring fenced. The move was made because disabled people were not being served well under MSD. The move back to MSD seems to be a retrograde step.
 
Whaikaha was established in response to disabled people requesting a specific department for their issues and to help streamline a system which had become complex and hard to navigate. Not two years into Whaikaha’s existence, this rushed and scathing review of its performance has been done, with barely any input from consumers, their families or providers.
 
Was this fair when for the past six years Whaikaha and formerly the Ministry of Health’s Disability Support Services, ran over budget by about 10% per year?  This wasn’t due to mismanagement by these government agencies, it was the result of chronic underfunding over decades, the growing demand and the ageing population they serve.
 
Effectively these recommendations are a way of rationing services to keep spending within an unrealistically low budget. The recommendations don’t recognise the increasing demand for services is growing yearly as a result of:

• the increased life expectancy of those with disabilities,
• greater survival rates for premature babies and babies born with disabilities
• Autism being added to DSS responsibilities in 2014 with no additional budget allowance.

 
The New Zealand Disability Support Network “estimates a 10.4% increase in funding is needed just to keep pace with rising demand and costs in the disability sector, with 24% in total needed to make up for historic underfunding. Additionally, the Government must fund the stalled Pay Equity settlement for carers and support workers”.
 
The Disability sector supports the most vulnerable New Zealanders and the people who work in the area are either unpaid or paid a low wage to do demanding and very challenging work. Currently nearly all the funding in the sector goes to “frontline” services. Without a realistic increase in funding there will be cuts to “frontline” services even though the Government promised there won’t be cuts to “frontline” services. The government’s defence is they aren’t cutting frontline services they are just asking the sector to stay within budget.
 
The majority of those using DSS have limited ability to advocate for themselves because of their disability and the level of deprivation they live in. This population needs our help to ensure our government looks after this vulnerable group of people by increasing the budget to account for the historic underfunding, and have a system to adjust the budget for the growing demand and the ageing population.
 
 
Shonagh O’Hagan
Therapy Professionals