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  5. 9 - 11 years
Announcements and latest updates

Welcome to the Right Decision Service (RDS) newsletter for August 2024.

  1. Contingency planning for RDS outages

Following the recent RDS outages, Tactuum and the RDS team have been reviewing the learning from these incidents. We are committed to doing all we can to ensure a positive outcome by strengthening the RDS to make it fully robust and clinically resilient for the future.

We would like to invite you to a webinar on 26th September 3-4 pm on national and local contingency planning for future RDS outages.  Tactuum and the RDS team will speak about our business continuity plans and the national contingency arrangements we are putting in place. This will also be a space to share local contingency plans, ideas and existing good practice. We would also like to gather your views on who we should send communications to in the event of future outages.

I have sent a meeting request for this date to all editors – please accept or decline to indicate attendance, and please forward on to relevant contacts. You can also contact Olivia.graham@nhs.scot directly to register your interest in participating.

 

2.National  IV fluid prescribing  calculator

This UK CA marked calculator is now live at https://righdecisions.scot.nhs.uk/ivfluids  . It has been developed by a multiprofessional steering group of leads in IV fluids management, as part of the wider Modernising Patient Pathways Programme within the Centre for Sustainable Delivery.  It aims to address a known cause of clinical error in hospital settings, and we hope it will be especially useful to the new junior doctors who started in August.

Please do spread the word about this new calculator and get in touch with any questions.

 

  1. New toolkits

The following toolkits are now live;

  1. Updated guidance on current and future Medical Device Regulations

We have updated and simplified this guidance within our standard operating procedures. We have clarified the guidance on how to determine whether an RDS tool is a medical device, and have provided an interactive powerpoint slideset to steer you through the process.

 

  1. Guide to six stages of RDS toolkit development

We have developed a guide to support editors and toolkit leads through the process of scoping, designing, delivering, quality assuring and implementing a new RDS toolkit.  We hope this will help in project planning and in building shared understanding of responsibilities throughout the full development process.  The guide emphasises that the project does not end with launch of the new toolkit. Implementation, communication and evaluation are ongoing activities throughout the lifetime of the toolkit.

 

  1. Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:
  • Thursday 5 September 1-2 pm
  • Wednesday 24 September 4-5 pm
  • Friday 27 September 12-1 pm

To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)

7 Evaluation projects

Dr Stephen Biggart from NHS Lothian has kindly shared with us the results of a recent survey of use of the Edinburgh Royal Infirmary of Edinburgh Anaesthesia toolkit. This shows that the majority of consultants are using it weekly or monthly, mainly to access clinical protocols, with a secondary purpose being education and training purposes. They tend to find information by navigating by specialty rather than keyword searching, and had some useful recommendations for future development, such as access to quick reference guidance.

We’d really appreciate you sharing any other local evaluations of RDS in this way – it all helps to build the evidence base for impact.

If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot  If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.

 

With kind regards

 

Right Decision Service team

Healthcare Improvement Scotland

0 - 5   6 - 8   12 - 14   15 - 18   A - Z

Typical development 9 - 11 years old

Each child will be different and may not present as their chronological age because of past experiences or additional needs.(8) Therefore, you may need to use language and resources from other age/stage sections of this toolkit.

Typical development 9 - 11 years old (1)

  • From about the age of 10, children become more interested in adult sexuality. They fantasise more about sexuality and hear and see all sorts of things online, on TV/films and watch or hear about things on social media which arouses their curiosity. Nevertheless, their response may be prudish or offhand if you try to talk to them about sexuality. 
  • The first steps towards love may be taken during this phase: young people start to have ‘crushes’ and make cautious advances towards one another (holding hands, kiss on the cheek, etc.) 
  • At the younger end of this stage, some children will have a phone and many won’t. This changes at the upper end of this age range. In 2022 Ofcom reported that 91% of 11 year olds owned a smartphone.(2)  
  • By age 11, 27% of children have seen pornography.(3) 

What children should be learning at school and how to back it up at home

All children in Scotland should be getting Relationships Sexual Health and Parenthood (RSHP) lessons at school as part of the Health and Wellbeing curriculum. Individual schools can choose what resources to use but most will now use Go to website: rshp.scot, as it is the most up to date resource. All the content on this website is available for anyone to view and use.

These links take you to an overview of what children are learning at school and what you can do in the home setting to back this up.

Information from Go to website: rshp.scot:

 

Support and learning required from carers and staff

All children need help from adults to distinguish between appropriate and inappropriate behaviour. Past trauma may mean that a child or young person displays inappropriate and sometimes sexualised behaviour. Be clear with everyone in the house or care setting about what is acceptable and about the need for personal privacy. (8)

Managing friendship ups and downs

All children going through these changes need adults to help them understand that the emotions are part of puberty and that it is normal but that it can be unsettling as it can feel like you are not in control of your body. It’s important that children are not labelled as ‘moody’ or ‘grumpy’ but these feelings and behaviours are linked back to puberty and they are helped to manage their feelings. 

Puberty

On average, girls are about 2 years ahead of boys in puberty development at this stage. However, some boys will be starting to experience these emotional fluctuations and need the same support and patience. All children should learn about the changes at puberty for both boys and girls, to help understand what is happening to them and to their peers.

  • The sex hormones become active, manifested in behaviour and physical development, but also in perception and emotional mood swings. All children will experience emotional changes, usually a year or two before physical changes. Girls usually reach puberty two years earlier than boys. Obvious physical changes include the growth of breasts and an increase in height. 

This document is an overview of changes that happen to all children/young people. It is suitable for children age 9-13yrs to read and discuss with you or for you to read together - Go to website: Puberty and your body | Childline

These videos are useful to support discussions:

Puberty: feeling depressed, happy and other emotions (duration 1 minute 45):

 

Early or delayed puberty – information about reasons Go to website: Early or delayed puberty - NHS (www.nhs.uk)

 

Puberty changes in boys age 10-13 years - Top signs boys are in puberty (duration 3 minutes 24):

 

 

Puberty, body odor and other changes for boys (duration 2 minutes 33):

 

 

Puberty changes girls aged 9-12 - Top signs girls are in puberty (duration 1 minute 57):

 

 

Breast development and worries about it.

This is a short video for a child/young person to watch and discuss with you - Does breast size really matter? (duration 3 minutes):

 

 

See also A-Z Periods and Periods below

Additional Support for Learning Needs – the national teaching resource has resources specifically designed for learners with additional needs: Go to website: Learners with Additional Support Needs (ASN) - RSHP

This website is specifically about puberty and has lots of interactive games to help your discussions if your young person has additional needs: Go to website: Planet Puberty.

Helping children prepare for periods

Girls will need support to prepare for their first period in terms of their feelings about this and on a practical level. They will need in choosing products they want to try from the full range of what is available.

These short videos can help discussion: 

Menstruation: what to expect (duration 3 minutes 18) by amaze.org:

 

Tampons, Pads and Menstrual Cups (duration 2 minutes 9) by amaze.org: 

 

Online safety

At this age children might be online more with less supervision, doing homework, chatting to friends, playing games or watching YouTube. It is helpful to talk with them about how being online is like being in a place, and wherever they are they need to be and feel safe. Children need help to learn about what information not to share and about coming to you if something they see or hear upsets them.

At this stage, it is recommended that parental controls are still used to restrict access to inappropriate content.

Go to website: InternetMatters.org Parental controls

Step by step parental controls guides to help you to set up the right controls and privacy settings on the networks, gadgets, apps, and sites they use to give them a safer online experience.

Pornography

At the upper end of this stage some children will see pornography online. They are more likely to stumble across it than deliberately search for it and/or be shown images by a peer. The possibility of this should be covered as part of online safety discussions with 11-year-olds especially if they have, or are getting, a phone.

One of the safety rules needs to be that they tell you if someone shows them pornography or if they come across it online. Easily accessed online pornography presents a distorted view of sex that often shows sexual violence carried out on women and caregivers need to be able to talk about this with a child who has seen pornography.

The NSPCC have some Go to website: helpful guidance about how to do this.

Behaviours that are not developmentally typical and how to respond

This tool has been developed by Stop it Now for parents, but is suitable for carers and staff to use. It describes behaviours that are developmentally expected and behaviours that are not healthy or safe.

Carers who are concerned about a child’s behaviour should share their concerns with the team around the child as a first action.

Staff should refer to their locality guidance and protocols.

Parents Protect: Helping you understand the sexual development of children aged 5-11