Skip to main content

Alert COVID-19

Please find service updates and current visiting rules in our COVID-19 section.

This site is best viewed with a modern browser. You appear to be using an old version of Internet Explorer.


Pain, loss of sleep, fatigue and anxiety may cause changes in behaviour including:

  • Withdrawal
  • Poor concentration
  • Frustration or aggression

The following points may help:

  • To build resilience and self-esteem the child should be encouraged to participate in all activities including those with responsibility such as “class monitor roles"
  • The child should be encouraged to meet self-care needs, but may need support
  • Leisure activities and hobbies should be encouraged.
  • Support and understanding of the family may also alleviate stress


Immunomodulatory drugs may reduce the ability to fight infection, but not to a level that means they need to be excluded from school at any time.

If a child is on methotrexate and there is contact with chicken pox or measles please let the parents know. We may need to arrange medication if there is close playing contact for greater than 15 minutes with a child with the infection.

Live vaccines (BCG) should not be given if immunomodulatory drugs are taken.


In some inflammatory conditions a fever may be a normal part of the illness. If this is the case please accommodate this at school and offer any medication recommended.

Not all fevers should be attributed to infection and parents are usually able to advise you.

Chronic pain

Some children may have pain caused by inflammation or damage to tissue but in some a specific cause for the pain may not be found.

No matter what the cause of the pain, there are various strategies that a child or a family and school can use to help them child cope and optimise school attendance.

More about pain management

Fatigue and tiredness

These features can be debilitating without strategies to help the child cope.

We are happy to provide further information on how to help - just contact us. Please also feel free to update us with the parent's consent if you feel this would helpful in the pain management.


A child with inflammatory conditions may become more vulnerable to bullying due to weight gain from taking steroids or becoming less involved in activities. The change in body image from joint abnormalities or irritability from increased inflammation may also increase vulnerability.

If there is a problem with bullying we are more than happy to support the child in the development of coping strategies.