Advice for school? Son with OSA awaiting surgery...

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Permalink Reply by Kath Hope on February 3, 2013 at 17:38

Hi Laura, and welcome to the forum.

Pleased to hear your son has been diagnosed with OSA, as so many children get missed  Hyperactivity and the ability to focus are 2 of the top symptoms in children - unlike adults who often feel very tired (kids tend to go hyper instead).  It's good to hear he's very bright though, as a lot of the children start to fall behind academically.

There are good stats for children who have their tonsils removed for a cure.  However, always be aware of it as he grows, as OSA can come back in later years.  Unfortunately, not all children are cured from the surgery though so make sure he has another sleep study later.  Also, take a look at this discussion on here about another child that needed surgery http://hope2sleepguide.co.uk/forum/topics/hello-have-just-found-out...

Regarding the school, I would just advise them to excuse his behaviour and difficulties for now, and the important thing is that he gets lots of restful sleep.  Try to ensure that his nasal passages are as clear as possible (not easy I know, as I also had swollen turbinates before my surgery).  Try to get him sleeping on his side and slightly elevated would be good.  (You can just put some thick books under the bed and the bedhead for this).   Don't let him go to bed on a full stomach or fizzy drinks, as the acids will get sucked up during apnoea events.

Keep us posted how he gets on please, and I hope he's one of the lucky ones that surgery helps.

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Permalink Reply by symmit on February 5, 2013 at 8:21

Wow. Never associated all that together but when I was at school I was described as your child, short attention span, hyperactive etc. I slept under 4 hrs a night and snored, had tomsil and adenoid surgery etc. OSA was never mentioned back then! If i ha maybe I would have been in a better place now!

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Permalink Reply by RockRpsgt on February 7, 2013 at 20:02

Remind them that 60-70% of all kids diagnosed with AD/ADHD have undiagnosed sleep issues.

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Permalink Reply by Laura on February 7, 2013 at 23:53

Thanks for your replies! Yes, I just feel like he should have learned so much last year, but couldn't.

Here is the letter I wrote for the school, perhaps it might help someone else, as a starting point for a similar letter? I felt that putting it in writing was good, so that she had something to refer to later, after our conversation, it could be passed on to other school staff, and also that it was easier for me, as I can get quite upset and emotional when I talk about it!

Anyway, here it is...

Dear Miss,

S has been recently diagnosed with Obstructive Sleep Apnoea, and is under the care of Mr. S, an Ear, Nose and Throat Specialist, based in L. As treatment for this condition, S will have his tonsils removed, and turbinates (side walls inside each nostril) shrunk, during a procedure scheduled for March..... Mr. S is confident that removal of the tonsils will help S to sleep deeply, allowing him to participate more productively during the day.  After surgery, it is hoped that we will see improvement in his sleeping, and behaviour.

We have included a fact sheet on Sleep Apnoea, from Sleep Disorders Australia, that briefly explains the condition. Symptoms of Sleep Apnoea in children, often mimic those of children with ADHD.

These are some of the symptoms we have noticed at home, and have been noticed increasingly in the last six months of Kinder at LPS:

• Inability to focus, particularly if many things are happening at once
• Thumb sucking
• Aggressive behaviours, both verbally and physically
• Sensory enhancement, sits close, touching others
• Easily distracted
• Easily frustrated
• Daytime naps are needed each day
• S sleeps in awkward positions, often falling out of bed
• Emotional, easily upset

Some things we have found helpful at home, which may be helpful at school:

• Giving S brief instructions, with eye contact
• Monitoring and encouraging him to stay on task
• Using the morning for more focused activities
• Predictable routines and structure
• Keeping choices to a minimum
• Daily responsibility – at home, he has enjoyed being responsible for our dog, B.
• Discussions about consequences of actions, and how to respond appropriately when provoked.  We have used a ‘no hands on’ rule at home, words only for solving problems, but with limited success. Ongoing!
• Acknowledging and rewarding appropriate social skills e.g. sharing, cooperation
• S has a quiet place at home, where he sometimes chooses to go to think and rest

Please let us know if there is anything we can do for S at school, to help in the next few months, L is available most days for parent help, and would be happy to come in at times when you feel S may need some extra support or supervision. We are most willing to support any strategies you would like to implement at school. Please feel free to pass this letter to other LPS staff, so that they may be aware of his condition, and treatment.

It has been frustrating and upsetting for us as parents, to see S unable to participate in school at his best. He is a leader, intelligent, and caring, but is having difficulty showing his ability. We are hopeful these strategies will be a temporary measure, and that post-surgery, S will more easily be able to make appropriate choices about his behaviour on his own.

Kind regards,

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Permalink Reply by Kath Hope on March 16, 2013 at 22:07

Laura, I've only just noticed your last comment, but I congratulate you on such a detailed description and suggestions for the school.  How did they take it?  Hope the surgery goes well, and please let us know.

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