Information for teachers

年轻时患关节炎可能会使学校生活变得非常困难。但是，您作为老师或学校工作人员的成员有几种方法可以提供帮助，而您可能是您的学生在学校快乐和成功的区别。

They may need some changes to their routine and physical environment. For the school, these relatively minor changes should be straightforward to implement, but for the young person the benefits could be huge.

By law, schools are required to make sure that having a condition like arthritis doesn’t put a young person at any disadvantage to their peers in terms of accessing their school or learning. There is plenty of support available to help you make any reasonable adjustments, including the possibility of financial support.

对于年轻人来说，拥有罕见且长期的医学疾病（如关节炎）可能是孤立的经历，这可能会影响他们的心理健康。

We have worked with some fantastic young people to create this comprehensive guide to help key staff understand how to ensure a young person with arthritis has a positive time at school and is able to achieve their potential. The quotes throughout are genuine ones from the young people we worked with.

You’re not expected to be an expert in arthritis overnight. Having good two-way communication with the young person and their family is a great place to start.

If someone with arthritis is joining your school, invite them to look around and have a chat about how their condition affects them and what support they need. It’s important to keep this conversation going throughout their time at school.

在与年轻人及其父母协商时，将为学生编写护理计划。这些计划可能在全国各地都有不同的名称，例如个人医疗保健计划或个人教育计划。该计划应包含有关其病情和药物的信息，以及两者如何影响他们的学校生活和教育。它应该阐明他们需要的支持。重要的是该计划保持最新状态。

If you have access to one, your school nurse or community nurse should be able to help you write the plan, and you might be able to get input from the young person’s healthcare team. You could ask the parents if they can set this conversation up.

Ensuring that a wide range of teachers know about the young person and their needs can help. Problems have occurred in the past with staff outside of the young person’s core group of teachers, who weren’t aware there was a pupil with arthritis in the school.

Young people don’t like having to regularly tell adults about their arthritis and the problems it causes, so raising awareness among your colleagues would help avoid this.

Providing practical help and understanding will make a big difference, and it’s best if you can make any agreed changes subtly, as they won’t want to stand out from the crowd. They also won’t want sympathy or pity.

“有时我用尽了每一盎司的能量，简单地上学。”

When children get arthritis, it’s calledjuvenile idiopathic arthritis (JIA)。This is a long-term condition. Juvenile means it was diagnosed before the age of 16. Idiopathic means we don’t know what caused it, and arthritis means inflammation in a joint.

在英国，估计有12,000名16岁以下的儿童患有JIA。

It sometimes takes a while for a young person to get an official diagnosis.

The main symptoms of JIA are pain, swelling and stiffness in joints. Commonly affected joints include those in the hands, knees, elbows, back, and feet. At times it can be very difficult to move joints.

贾is different from骨关节炎，，，，which affects around nine million people in the UK. Osteoarthritis tends to affect people from around the age 50 onwards, and is caused by mechanical changes and damage in a joint.

贾is an autoimmune condition. The young person’s immune system is overactive and causes unnecessary and harmful inflammation in joints and elsewhere around the body.

年轻人有关节炎通常经验疲劳。这是一种压倒性的疲倦，无法治愈睡眠或休息。这可能使您的学生很难集中精力，这有时被称为“脑雾”。

贾是看不见和不可预测的。有一天，您的学生看起来似乎很好，然后变得僵硬，疲惫，接下来是很多痛苦。症状的突然恶化被称为“爆发”或“耀斑”。

“没有一天是一样的；我可能度过了一个愉快的疼痛日，觉得自己可以参加马拉松比赛，第二天由于疼痛而无法下床。”

Jia患有JIA的年轻人可以在眼睛中炎症，称为葡萄膜炎。这是可以治疗的，通常与用于治疗关节炎的相同药物。他们也可能需要眼球。如果没有治疗，它可能会对视力，甚至可能导致永久损害，甚至可能导致失明。葡萄膜炎可能会影响年轻人在学校的视力。

Other musculoskeletal conditions

在那里are other conditions that can affect young people’s joints, muscles, bones, and tendons – known as the musculoskeletal system.

Like JIA they can cause pain, stiffness, fatigue, isolation, and affect the young person’s mental health. Therefore, some of the content in this webpage should be helpful for your school when supporting a young person with one of these conditions.

Here is some top-level information and where you could turn to for further support.

• Lupuscan cause inflammation in any part of the body. It’s an unpredictable condition that can cause lots of problems. Some of the more common symptoms are joint pain and swelling, skin rashes, and fatigue. It can potentially cause inflammation in major organs, such as the kidneys, heart, lungs, and the nervous system. For more information see:www.lupusuk.org.uk/lupus-in-young-people/。
• Myositisis the name for a group of rare conditions that affect the muscles. The main symptoms are weak, painful, or aching muscles. The main types of myositis are polymyositis, which affects many different muscles particularly the shoulders, hips and thighs, and dermatomyositis, which affects many different muscles and causes a skin rash. For more information see:www.myositis.org.uk。
• Scleroderma是当皮肤（无论是在身体的外部还是内部）时，像疤痕组织一样硬化。有不同类型的硬皮病，影响儿童的最常见类型称为局部硬皮病，这意味着只涉及皮肤。少数儿童患有系统性硬化症，会影响皮肤和内部器官。有关更多信息，请参见：www.sruk.co.uk/scleroderma/scleroderma-children。
• 当有人很福莱希联合高流动性对企业有利ble joints, which can cause pain and tiredness. It can affect balance and co-ordination and, in some cases, cause joint dislocations. Treatment involves improving muscle strength and fitness. For more information see the School Toolkit for joint hypermobility (JHS) and Ehlers-Danlos syndrome (EDS) and JHS:https://theshooltoolkit.org。

Medication for JIA and other conditions affecting the immune system

如果不治疗,贾可引起长期damage to joints. Thankfully, there are many good drugs to treat JIA.

在JIA中，问题源于过度活跃的免疫系统。因此，许多治疗方法通过抑制免疫系统来起作用。这是狼疮，肌炎和硬皮病治疗的原则，它们也是自身免疫性的。

甲氨蝶呤通常给予关节炎儿童，这种药物可以大大改善症状。但是，这会使他们感到非常恶心和疲惫。

甲氨蝶呤is taken once a week and any side effects usually happen around the time it’s taken. So, your pupil may feel anxious and upset before they’re due to take it.

如果一个年轻人正在从药物治疗中遇到副作用，则可能需要在安静的房间里抽出一些时间，例如学校护士办公室，如果您有的话。

Drugs that suppress the immune system can make a young person more likely to pick up infections, which can then be more serious. This makes it important that your school practises good general hygiene procedures, and strictly observes the rule that children with sickness or diarrhoea stay off for 48 hours.

对于年轻人而言，水痘会更严重。重要的是要让年轻人及其家人立即知道是否有案例，尤其是如果他们可能与水痘接触。

一些药物以及关节炎本身可以使年轻人对太阳更加敏感。在夏季学期，重要的是他们佩戴防晒霜。询问父母这是否是一个问题。如果是这样，您可能需要提醒他们，或者年幼的孩子可能需要您的帮助。

If a drug isn’t treating their condition well enough, or is causing severe side effects, they could be taken off it and tried on something else. Therefore, your pupil could be on several treatments during their time at your school. They may be anxious when they change drugs, their condition might flare, or they could experience new side effects. Once someone is on the right drug for them, it can dramatically improve their health.

“药物很糟糕。他们弄乱了您的胆量，有时候我可能需要下班才能弹出浴室，或者有些空气。”

Arthritis can affect a young person’s ability to walk. They may find it difficult to get around school and feel vulnerable in busy corridors or on stairs. At times they may need to use crutches or a wheelchair.

他们可能会发现很难携带沉重的袋子。

If a young person with arthritis is struggling to walk between lessons in good time, it would be useful to have a gentle private chat with the pupil to look for solutions. Young people can get upset if they can’t keep up with their peers and get embarrassed coming into lessons late.

“My school is very spread out, so I will often be doing around 11,000 steps a day or more – which is super challenging to say the least! Having to walk this much between lessons is very painful and will often tire me out, which means that I will be less focused in the lessons as I am exhausted.”

The following measures have helped young people with arthritis:

• Schools have designed timetables to limit the amount of walking the student has to do and ensures they avoid busy corridors and stairs.
• Having one or two friends always accompany the pupil around school gives them practical and emotional support.
• Being able to leave books and equipment in a locker or classroom located near their classes.
• 在课程结束前几分钟离开课程的许可，以帮助他们上下一课。
• Flexibility with uniform, such as wearing trainers that provide comfort and support.
• Being given passes to get around the school during lesson times.
• 如果有学校，能够使用电梯。
• Handrails on both sides of stairs.
• Having duplicate books, so they can leave some at home and some in school.
• Digital resources for schoolwork, so they don’t have to carry books around.

“Being able to arrive to lessons 5 minutes late meant I could use a quieter set of stairs and avoid being trampled.”

贾可以影响年轻人的手和手腕。这可以使写作甚至少量困难和痛苦。

“I always feel pressured to keep up in lessons and when the class is finished writing I am still going and can’t relax.”

Some solutions young people told us about:

• Notes being available at the start of a lesson, so they don’t have to write everything down.
• 配备笔记本电脑，平板电脑或类似设备可以使用。
• Taking photos of notes on a board.
• 如果年轻人面对班级的前面，这将有所帮助，因此他们不必扭曲以查看事物。
• Pencil or pen grips.
• Keeping the amount of writing to a minimum and if they have to write, giving them regular breaks.
• A sloped desk might help the young person, because the angle means they won’t have to lean over. Good overall posture when they are writing is important.
• 管理他们给予多少作业，尤其是写作，因此他们一口气没有太多要做的事情。如果任务需要写作，父母或其他家庭成员可以成为他们的作业抄写员吗？

“Doing a lot of writing can cause issues and lead to me being out of action for days.”

“When I am in pain sometimes it makes it harder for me to concentrate, so some fresh air would help.”

Pain and stiffness are among the most common and difficult challenges for a young person with arthritis.

Sitting still for too long is not good for someone with arthritis. It will help if they can get up, stretch, and walk around regularly. However, the young person may feel self-conscious doing this.

与年轻人谈谈他们认为这可以将其纳入课程和一天的时间。以下可能会有所帮助：

• The young person being given errands to do, such as taking something to the office or to another teacher.
• 让年轻人有一种微妙而同意的方式让教学人员知道他们很痛苦，也许他们可以将他们传给老师，戴上徽章或将特定物品放在桌子上。
• 老师可以要求整个班级站起来，四处走动并定期伸展，以避免关节炎的年轻人感到沮丧和尴尬。毕竟，对每个人都定期走动是一件好事。

Some school chairs might be uncomfortable for a young person with arthritis, particularly if they are small and hard. Sitting on the floor can be painful and difficult, and stools without back rests, such as those often in science labs, can cause problems.

与年轻人谈谈座位安排以及哪些椅子对他们来说很舒服。与年轻人交谈职业治疗师about this, as well as other aspects of school life, would help. Ask the parents if they can set up this conversation.

“I struggled to sit on the stools in the science lab. I used to be quite sore after sitting on those.”

从关节炎疼痛和僵硬往往是更糟糕的是我n the mornings and some days your pupil may struggle to get in on time. They might find morning lessons difficult.

“我可能和我的朋友一起笑着开玩笑，但第二分钟我可能会痛苦。”

Since the COVID-19 pandemic, teachers are often encouraged to keep windows and doors open to improve ventilation. This can cause problems for young people with arthritis, as the cold can make pain and stiffness worse. Talk to your student about ways to avoid this being a problem.

在那里may be things the young person likes to do if they’re in pain. Talk to them and see if they can be accommodated. It might be they need to take some pain medication or rub pain relief cream into a joint and sit in a quiet room. Working out a plan for taking pain medication during school hours will be important.

“我的年度脑海总是确保检查我，如果我告诉他我很痛苦，他总是会看到我是否需要任何东西，或者他会安排帮助我回家。”

Overwhelming tiredness, or疲劳，，，，is very common among young people with arthritis. The psychological aspects of this on a young person can’t be underestimated.

Young people also talk about ‘brainfog’ when they’re unable to concentrate. They can feel detached from what is going on around them.

“If you ask me a question when I have brainfog, you're most probably not going to get a very good answer.”

患有关节炎可能使年轻人难以获得足够的睡眠，这可能会进一步影响集中度和情绪。

If their fatigue is bad, the young person may need to rest in a quiet room. There’s no cure for fatigue, but good understanding, kindness, and trying to accommodate the young person’s proposed solutions will help.

“I was given physiotherapy exercises from the hospital to help with hypermobility and JIA. My parents let the school know and my PE teacher worked my physio exercises into the warm up and warm down sessions. None of the other pupils knew so I didn’t feel singled out as it was something we could all do. It really helped me feel included and it meant I was getting the exercises done as well.”

许多关节炎的年轻人告诉我们有关PE课程遇到的问题。有时他们可能无法做同学所能做的一切。例如，在潮湿或寒冷中的身体接触运动和运动可能并不总是可能。

他们可能会对在同学面前进行体育锻炼的前景感到紧张和尴尬。

Young people with arthritis have told us they want to take part in PE whenever possible, at a level appropriate to them.

体育课程可以并且应该是一个关节炎的年轻人的积极经历，并且有很多方法可以通过PE来获得。最好的方法将涉及与年轻人交谈，以了解他们是不可能的。

“体育都是全部或一无所有。它针对具有高水平的人。我将无法在寒冷的一天打橄榄球。它可能会随着雨水而猛烈抨击，每个人都必须出去。如果我试图加入，如果我做不到，我不得不停下来感到很尴尬。我曾经每周都会害怕去体育。我感到尴尬。”

Physical activityis a key aspect of managing arthritis well. For example, having strong muscles can take the strain off a joint affected by arthritis. The right type of exercise can help a young person stay flexible and have a good range of movement in their joints.

年轻人的关节炎每天都可能差异很大。在他们无法做的日子里，要确保他们知道自己没有做错任何事情，并避免引起人们注意。

了解PE部门对关节炎的年轻人有很大帮助。

“有时候，我可以超越我班上的大多数人，有时候我花了五分钟才能上楼梯。”

It would be good to make sports days accessible for all, and not put pressure on young people with arthritis to do more than they’re capable of.

“我记得必须在体育日选择我必须参加的五场比赛 - 这不是可选的。有时候，有贾的人会在某些运动中挣扎。我的表现非常差，这在这么多人面前令人尴尬！”

由于医疗任命及其一般状况，关节炎的年轻人可能会比同龄人错过更多的上学日子。

如果年轻人的症状不好，他们可能需要长时间放学时间。

Missing school can cause a huge amount of anxiety and worry, as well as affecting their education.

“When I am home from school with a flare up it’s not because I don’t want to be in school, I genuinely cannot move.”

Anything and everything you can do to help a young person keep up with their schoolwork will be greatly appreciated. The following will help:

• 定期与年轻人沟通，并确保他们有所有课程。
• 尽可能延长内部学校的截止日期。
• 在学期开始时，将年轻人制定远程学习计划计划，以防他们突然出乎意料地放学了一段时间。
• 有一个出席奖励计划，该计划不会因医疗状况而罚款几天。
• Talk to the young person before they are due to return to school, to agree a plan and address any concerns.

“At school I would change the pressures on attendance. People would always get prizes for 100% attendance, and I’d get automated letters sent saying they were concerned about my attendance. This made me feel worse as I’d really struggle with missing school anyway and would always try to be in even when really unwell, so this made that effort feel like nothing.”

“这不仅是在持续疼痛的身体上精疲力尽；这也在精神上排水。”

毫不奇怪，许多关节炎的年轻人会感到愤怒，恐惧，孤立，沮丧和焦虑等各种感觉。

Pain，，，，疲劳，药物的副作用，无法做同龄人所做的一切，对于年轻人来说是很多。并且年轻人像关节炎这样的罕见疾病可能是一种孤独的经历。

在那里is evidence that stress and worry can cause flares of贾。

It will help if you regularly check in with them, try to relieve any pressure, and be there to help and support in any way they want you to.

It can be a massive help for them to have a nice, understanding, and supportive friendship group, so it’s worth keeping a discreet eye on that side of their school life.

“Arthritis can make people feel left out, excluded, vulnerable and insecure about how society views them.”

Some healthcare professionals believe that all young people with JIA should be offered access to psychological and counselling services as routine. However, there are a limited number of professionals in comparison to the young people who need their help. Maybe the school could help with access to a counsellor or apsychologist，，，，if the young person and their parents want that to happen.

“关节炎和我必须服用的药物对我对生活的情绪和态度产生了很大的影响。”

When arranging a school trip, try to carefully consider the needs of the young person with arthritis.

If you can, visit the area prior to the trip to reduce any risks and look at access into and around the venue.

与年轻人及其父母交谈，向他们介绍时间表，并找出他们希望参与的内容。beplay广告

Make sure you know all about the medication they need to take, as well as how it needs to be stored.

在活动中发挥创造力，并试图让年轻人觉得自己没有错过。如果有体育锻炼，例如年轻人可能无法做的长途漫步或攀岩，请计划替代方案。

Make sure any transport is comfortable and plan regular breaks on journeys. The accommodation should have good access and possibly either bedrooms on the ground floor or lifts if needed.

Let the staff at the venue and any instructors know you have a student with arthritis. They may be able to provide alternative arrangements or equipment.

Some young people may need special consideration for exams, such as extra time or the use of a computer or scribe. This may require the student being in a separate room under exam conditions.

相关考试委员会需要提前要求这些住宿。年轻人的风湿病团队may be able to provide a letter of support.

如果年轻人发现写作和打字困难，他们可能会在课程上挣扎。在截止日期之前，在很多时间内与他们谈谈这件事，看看他们是否需要学校提供的任何东西。笔记本电脑，平板电脑或类似设备上的语音识别软件可能会有所帮助。

考虑职业选择时，您的学生可能需要一些额外的支持和授权。统计数据表明，尽管关节炎的年轻人在教育中经常会高于平均水平，但他们有时会发现很难找到第一项工作。

在那里’s a great deal that the school can do to boost the young person’s confidence and aspirations. Early work experience which matches their strengths and ensures success can:

• 提高他们的自信心
• improve their CV
• 帮助他们实现自己的优势和任何发展领域
• give them realistic insight into the world of work.

Good careers advice for young people with arthritis will be a realistic and positive focus on what they can do, rather than what they can’t do.

Encouraging the young person to be ambitious and confident is important. There will be life skills that the young people will have developed through managing their condition that many of their peers won’t have – these may include:

• being organised
• being determined to overcome challenges and obstacles
• showing resilience
• 创造性思考以避免或克服问题。

It would be good to stress to the young person that these are skillsets that could be transferrable to the world of work which they could tell future employers about.

The physical limitations arthritis causes a young person can impact on their ability to learn, which means they can be considered as having a special educational need. Therefore, it will help to get your special educational needs co-ordinator involved.

It might be possible to talk to the young person’s rheumatology team, such as aspecialist nurse，，，，物理治疗师， 要么职业治疗师。The parents may be able to set up such a conversation. These are busy healthcare professionals, so this might be tricky to arrange, but it is worth asking.

Your school nurse may be able to help or put you in touch with relevant professionals. For example, every local authority in the UK should have a community paediatric occupational therapist. It might be worth seeing if you can invite them into your school.

对于哪些医疗保健专业人员将能够为您提供帮助，在英国各地可能会有所不同，有时可能会觉得这种外部支持并不明显。坚持不懈，与您的学校护士和其他任何可能在您的地方当局，学院小组管理团队或教育委员会提供帮助的人，以确保您获得所需的专家支持。

And please always remember that trained and experienced staff at Versus Arthritis are on hand to offer advice and information. You can email them at:ypfsuk@versusarthritis.org。

Life at school, just like life in general, can at times be tough for a young person with arthritis.

One of the worst things for any young person is to feel different from their peers. Arthritis can cause a sense of isolation, exclusion, and loneliness that can be just as bad, if not worse, than the pain, stiffness and fatigue.

在整个学生与您之间保持良好的双向沟通​​，这意味着您可以根据他们的独特需求来定制支持和关心。

With the right support and understanding, having arthritis shouldn’t stop anyone from achieving their full potential and thoroughly enjoying their time at school. You could make that difference for your pupil.

在法律上要求学校支持关节炎的年轻人，因此他们的病情不会使他们在获得学校建筑物方面对同龄人的任何劣势，或者有机会在学习中发挥全部潜力。

To achieve this, schools are required by law to make any reasonable adjustments necessary to help the young people overcome barriers caused by their condition.

This is covered under the Equality Act 2010 in England, Scotland and Wales; and the Special Educational Needs and Disability Act (Northern Ireland) 2016. Under these laws, arthritis is classed as a disability.

It’s the responsibility of governors to ensure that schools have the means to fulfil that duty, and to make sure they are meeting these obligations.

在那里is statutory guidance for school leaders and governors from each of the four nations within the UK that sets out legal requirements for supporting a pupil with a medical condition.

• 在学校的医疗状况中为学生提供支持，2015年12月向英国申请。请访问：www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3
• Supporting children and young people with healthcare needs in schools – published by The Scottish Government, December 2017. Visit:www.gov.scot/publications/supporting-children-young-people-healthcare-nealthcare-neads-schools/documents/
• Supporting learners with healthcare needs – published by the Welsh Government, March 2017.https://gov.wales/supporting-learners-healthcare-needs-1
• Supporting Pupils with Medication Needs Guidance, from the Department of Education in Northern Ireland, February 2008. Visit:www.education-ni.gov.uk/publications/supporting-pupils-medication-needs

In England, Ofsted inspectors will assess how well a school supports pupils with a medical condition as part of its assessment of a school’s safeguarding standards.

Your school may be entitled to funding to pay for reasonable adjustments to help your pupil. To be eligible for this, the young person would need to be assessed by an educational psychologist.

With this information page we aim to provide ideas of the types of reasonable adjustments you could discuss with your pupil and their family to help them achieve their best.