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Brittle bones (osteogenesis imperfecta)
Although children with brittle bones may not have learning difficulties, their medical condition will affect them at school and may make access to some areas of the National Curriculum more difficult. They may also have missed out on normal pre-school experiences,[link widoczny dla zalogowanych], which may have delayed their learning in some ways.It is important that children with brittle bones are helped to live as normal and independent a life as possible. There are different types of brittle bones and whilst some children may suffer relatively slightly, others will be severely affected,[link widoczny dla zalogowanych], being of short stature and unable to walk. Some children may need to use walking-sticks, crutches or specialised wheelchairs in school. Physical alterations to the building may be needed. In some children, fractures can be caused by everyday activities such as opening a door or picking something up. All staff need to be aware of procedures in case of a fracture. Children with brittle bones often have joints in their hands that are affected by their condition and may need to change their writing hand or the way they hold a pencil. Whilst many forms of PE may be unsuitable for a child with brittle bones,[link widoczny dla zalogowanych], swimming is a particularly good exercise and should be encouraged. Special toilet arrangements may be needed if the child uses a wheelchair or has shortened arms. Key characteristicsA child with brittle bones may have: frequent absences from school while fractures heal some learning delay as a result of physical problems eg. taking longer to learn to write difficulties with gross motor skills difficulties with fine motor skills some respiratory problems poor self-esteem and low self-confidence anxiety about their safety in the school environment.Support strategiesYou may need to: liaise with hospital and home tuition services when necessary take advice from an occupational therapist to support the development of motor skills provide a writing slope if necessary provide a pencil-grip or experiment with different types of pen make special arrangements such as ICT for recording work if the writing arm or hand is fractured – a specially adapted computer keyboard or a voice-activated word-processor can be very useful in these situations make flexible arrangements for PE lessons and for playtimes if necessary use a buddy system for specific times of the day provide specialised training for a teaching assistant to help with lifting and to assist with using the toilet if necessary offer emotional support as the condition worsens – children may have to come to terms with using a wheelchair make use of circletime to talk about problems and/or provide an adult mentor organise physical access to different parts of the school if necessary ensure that appropriate adult support is provided at times of physical vulnerability encourage participation in all school activities as far as possible.Support agenciesBrittle Bone Society
The exclusionThe head teacher wrote to the parents of R and F telling them that neither R nor F could come back to school, but that they would be given help in completing their course at home. He should, of course, have told the parents immediately, ideally by telephone followed by a letter, of their right to make representations to the governing body.


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