Why paediatric first aid is non-negotiable for SEND nannies
By Guest Post, posted
As the founder of SteadySteps by Daria, a SEND nanny agency, I have one requirement I never bend on: every nanny I introduce must hold current paediatric first aid training. It isn’t a bonus or something we’ll sort out later. It is non-negotiable, and I believe it should be for every family too, whether or not your child has additional needs.
I say this because I’ve noticed that some nannies treat first aid as a certificate to collect, and some families assume it’s covered without checking. When you’re caring for a child with SEND, that gap matters more. Here is why, and what it looks like in real situations.
Why standard training isn’t the whole picture
Many neurodivergent children are no more likely to be hurt than anyone else, and every child is different. But some features of SEND change how an emergency starts, how it looks and how a nanny needs to respond. Research suggests that some of the extra risk comes from co-occurring conditions, such as seizures and ADHD, not from autism alone (see the study). That’s why a nanny needs both training and an understanding of the individual child.
The specific situations SEND nannies may face
1. A child who can’t tell you what’s wrong
A non-speaking or minimally speaking child can’t say “my ear hurts”, “I feel sick” or “I swallowed something”. A nanny has to notice the changes: a different cry, pulling at an ear, refusing food, holding the stomach, or a change in behaviour or colour. First aid training teaches how to assess a child quickly, and a nanny who knows the child will spot when something is off.
2. Pain that doesn’t look like pain
Some children have sensory differences that mean they react very little to an injury, or far more than the injury seems to deserve. A child might walk on a sprained ankle without complaint, or not show that they have a fever. A nanny can’t rely on the usual signs and needs to check carefully.
3. Seizures
Epilepsy is more common among some neurodivergent children. A seizure can happen at home, in the park or on the bus, and the nanny needs to stay calm, keep the child safe, time it and know when to call for help. If a child has been prescribed emergency medication, training to give it usually comes from the child’s healthcare team, in addition to first aid training, and the nanny needs to know the family’s written plan.
4. Choking
Some children have sensory-led eating habits, difficulty chewing or swallowing, or a habit of putting non-food items in their mouth. Others eat very fast or stuff food in. A nanny needs to recognise choking, know the right response for the child’s age and understand how to reduce the risk at mealtimes.
5. Allergies and reactions
A child who can’t describe a tingling mouth or a tight throat may only show a reaction once it has become serious. A nanny needs to know the signs of an allergic reaction, how to respond and what the child’s emergency plan says, including any prescribed medication.
6. Wandering and bolting
Some children run off suddenly, towards roads, water or crowds, and can be very fast. A nanny needs a plan for outings, such as holding hands near roads, choosing safe places and knowing what to do in the first minutes if a child goes missing. If a child may have been in water, or seems unwell afterwards, call 999.
7. Meltdowns and shutdowns
During a meltdown, a child may fall, hit their head on a hard surface, bite, scratch or hurt themselves. A nanny’s first aim is to keep the child safe and calm, without restraining them in ways that could cause harm. Afterwards they need to check for injuries, which the child may not be able to point out.
8. Self-injurious behaviour
Some children bang their head, bite their hands or pick at their skin when they’re distressed or overwhelmed. A nanny needs to know how to respond calmly, how to treat minor injuries and when to seek medical advice, and to share what they saw with the parents.
9. Impulsivity and risk-taking
Children with ADHD, in particular, can climb, jump and run without stopping to think. Falls, bumps and cuts happen. A nanny needs to be ready to deal with the injury and also to look out for signs of something more serious, such as a head injury.
10. Differences in touch and handling
Many children dislike being touched, or can’t tolerate certain contact. First aid sometimes needs hands-on care, such as cleaning a graze or applying a plaster. A nanny needs patience, a calm voice, and ways to explain gently what’s happening, and to give the child time, because a frightened child may resist help.
What I’d ask every parent to do
Make paediatric first aid a requirement, not a preference.
Ask to see the certificate and check the date.
Ask the scenario questions above, and listen to how the nanny answers.
Put refresher training in the diary.
Share what no course can teach: how your child shows pain or fear, any medical conditions and medication, known allergies, their triggers, and a written emergency plan with contact numbers.
Walk through the plan together, and update it as your child grows.
It protects every child
I’m writing from a SEND perspective, but this applies to every child and every nanny. Paediatric first aid is one of the most important things a nanny can bring into your home, and it costs little compared with the peace of mind it gives you.
At SteadySteps, I personally interview every nanny and I work with each of the family closely. Current paediatric first aid is part of that process, every time. We are proud to partner with TrainAid so that paediatric first aid is never a barrier for anyone. All SteadySteps nannies and families receive 10% off their training. If you’d like to know more, please reach out to me at info@steadystepsbydaria.com and I’ll point you in the right direction.
This article is general information and doesn’t replace accredited first aid training or medical advice.
About the author: Daria is the founder of SteadySteps by Daria, a London-based agency matching families of neurodivergent children with carefully vetted, SEND-trained nannies across the UK. She has over ten years of childcare experience. www.steadystepsbydaria.com
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