Ask The Experts: Help a child understand dementia

Question: One of the parents at my nursery is struggling to care for her mother who has dementia. Grandma lives with the family but her behaviour is getting increasingly difficult. Mum has asked us to help explain this to her son. What shall we do?

June O'Sullivan: This boy's parents have quite rightly recognised the importance of his relationship with his grandmother. Dementia is a debilitating illness and symptoms can include mood swings, angry outbursts and confusion - behaviour that could easily upset a young child.

Find out a bit more about how the condition has affected Grandma's behaviour then get the boy's key worker to have a chat with him. Children accept what they are told if it's done in a way they understand, so ensure the conversation is relevant and personal to his family situation.

It may be useful to say that Grandma's brain is not working very well and it causes her to get confused, forget his name and get cross and upset. Encourage him to make things at nursery to take home to Grandma.

June O'Sullivan is chief executive of the childcare charity and social enterprise, the London Early Years Foundation

Question: I work in a children's residential unit and am worried about the levels of sexual activity among some young people. I want to promote good sexual health but am worried I could be seen to be condoning what they are doing. What should I do?

Jeanie Lynch: Young people in care can be more sexually vulnerable than their counterparts for various reasons including early abuse, missing out on education and getting mixed or false messages from peers.

The need to provide extra guidance to looked-after children was recognised by the government's teenage pregnancy strategy and this led to more support for foster carers and children's home staff. All local authorities should have a sexual health policy for children in care. Policies strive to ensure a balance between safeguarding and child protection and promoting positive sexual health. If you are not aware of your local policy speak to your managers and get hold of a copy.

Specific training has also been developed for carers and residential staff to help them answer awkward questions and promote healthy sexual development. Looked-after children's nurses also have a key role to play alongside schools and parents.

Jeanie Lynch works for Barnardo's and has 25 years' experience of working with vulnerable children and families

Question: As a small unitary authority, trying to sustain a school improvement function is unaffordable. When Ofsted comes, we are in big trouble. Any advice?

Peter Lewis: You are not alone. These services have been "low hanging fruit" for many councils trying to make cuts. Many have negotiated a managed service, often outside local authority control, with schools as board members commissioning the work. The local authority provides oversight, strategy and planning.

This is in keeping with the Department for Education's view that schools should support each other while the local authority guides some of this activity, helping identify trouble spots and focusing efforts to improve.

It's your job to provide the leadership and wise counsel that is often needed. Schools that get into trouble are often not honest with themselves about their strengths and challenges. You can provide that at relatively low cost.

Don't forget the academies. It's your children they teach. Be a champion for them and engage every school regardless of status.

Peter Lewis is a freelance providing interim local authority children's services leadership, and a former DCS in Haringey

Question: We're taking our youth group away but parents are worried some of the young people may have sex. How should we handle this?

Tracie Trimmer-Platman: Your discussions with parents are crucial as they are the ones who will "blame you" if something happens they do not like. Explain your role is to support and supervise their children and ensure they are safe. You also work with young people to promote positive attitudes and values and encourage them to make informed choices, although you cannot control them as such.

Explain they will sleep in different rooms and set out the programme of activities. You might also want to share your policy on contraception - some projects provide condoms - although this may add to parents' anxiety.

Discuss all of this with the young people too and let parents know you have done so. Be careful not to say different things to parents and young people. It is then up to parents to decide if their children can take part.

Tracie Trimmer-Platman is senior lecturer in youth and community work at the University of East London

Email questions, marked "Experts", to cypnow@markallengroup.com