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Please help. Options for a y11 'too unwell for school'

(36 Posts)
TeenPlusTwenties Sun 05-Jul-20 09:50:09

Suppose my finishing y10 DD is still too mentally unwell for fulltime school next academic year. sad What options are there and how do we go about exploring them? I'm feeling too overwhelmed right now to think clearly.

Please?

OP’s posts: |
RippleEffects Sun 05-Jul-20 09:57:06

Is she still registered with a school?

Do you have an official statement that she's too unwell from school from CAMHS or a consultant?

Do you have an appointed family liaison/ family support worker?

AmazingGrace16 Sun 05-Jul-20 10:01:14

The local authority has overriding responsibility to provide education. Speak to them, they may have schools that can do home tuition etc.
If still too unwell then explore an EHCP as it'll open avenues for college which sounds like she may need.

TeenPlusTwenties Sun 05-Jul-20 10:12:17

Is she still registered with a school?

Yes

Do you have an official statement that she's too unwell from school from CAMHS or a consultant?

No. But anxiety which was coming on before lockdown has escalated. She is due to attend this week and at the moment I doubt she will get into the car as she is that scared.

Do you have an appointed family liaison/ family support worker?

No.

The local authority has overriding responsibility to provide education. Speak to them, they may have schools that can do home tuition etc.

What role should I be looking for to speak to? Does it make any difference that she is adopted?

If still too unwell then explore an EHCP as it'll open avenues for college which sounds like she may need.

What is the first step for that?

Is attending on a part time timetable an option?

OP’s posts: |
Aria20 Sun 05-Jul-20 10:20:52

It very much depends on the school, if you work with the school and the LA they are more likely to help with things like part time timetables. Has she engaged with the online learning during lockdown as if so it could be an option to explore.

You can apply to your LA for an ehcp assessment (in England) but the waiting list is months and that was before all the corona back logs so whilst it would be worth contacting your LA to potentially get the ball rolling, be aware that the length of the whole process may mean you won't get the relevant support you need in time.

Is she under CAMHs (CHYPMHs it's now known!) or does she have a social worker as you've said she's adopted? If not you can refer yourself, you should be able to google it for your area, but it usually adds more weight if you are referred by the GP. Again though they are so stretched that their criteria for even an assessment is ridiculous... I had to take my 11yo son to a&e for an urgent mental health assessment due to trying to run in front of a lorry on a main road and jump out of second floor window at school!! Because despite numerous attempts at referrals from me, school and GP he wasn't deemed severe enough to meet their criteria for assessment!

It is a fight to get help and support so good luck x

10brokengreenbottles Sun 05-Jul-20 11:53:36

The LA have a statutory duty to provide education for those too unwell for school. If the LA won't or are slow in doing so (as they often are) you should threaten Judicial Review. This is the guidance. If you google your LA and medical needs EOTAS tuition you may be able to find their offer and the contact details of who to speak to. It could be online provision, home tutoring, small group or hospital tuition.

Alongside that you should submit a parental request for an EHCNA. IPSEA have a model letter you can use here. Normally the legal timescale for the LA to decide whether it is going to assess is 6 weeks, and you can threaten JR if they fail to stick to it. However, the deadlines have been relaxed, but only where the reason they can not meet the deadline is because of covid-19. Some LAs have decided they aren't carrying out assessments at all at the moment, but that is illegal.

Aria20 anyone waiting months for an EHCNA prior to Covid-19 should look at JR. The relaxation of the timescales do not apply where the deadline was prior to 1st May.

Part time timetables should be short term working towards reintegration. Long term part time timetables are illegal whether or not parents agree to it. See page 17 here.

RippleEffects Sun 05-Jul-20 12:05:12

It helps to have people onside. I have three DC, two with additional needs. One current yr 11 with full EHCP and diagnosis as long as your arms, the other yr 4 some diagnosis doesn't qualify for EHCP as working with school her needs are met. Her diagnosis is social communication disorder which mainly presents as severe anxiety (she physically shuts down/ freezes and is completely unable to engage when she gets overwhelmed. Sometimes she just faints) Most of the time she's a happy engaged child.

With my DD, yr 4, we have had a differentions with her peers from back in yr R. Working with the school she went into the class a few moments before her peers via reception so wasn't pushed and bashed around, she had a peg at the end of the row of coats, a draw for her work/ stuff in a slightly different location. She had the option to stay in at break time if she needed time out, she tried but wasn't forced to join in school swimming lessons (she can swim) because they were very noisy and everyone got very excited. She became very overwhelmed and it took two adults to help her out the pool. Because school have witnessed the extreme side of her anxiety getting the basic extra support hasn't been a massive fight.

DD has documented evidence of her strugles and a diagnosis which helps us get the support moving into each new year group phase.

An EHCP application is unlikely to get taken seriously if you aren't able to prove by documentation a track record of problems and needs not being met. I'm not suggesting you don't apply but suggesting initially you focus efforts on building a paper picture of needs and working out what support is lacking that you're requesting from the council beyond what school can provide. The EHCP supports a young adult through to 25 and post 16 support are starting to be more onboard with adhering to support needs so its not something to write off just because it wont be in place for September of yr 11.

DS1 YR11, autistic full EHCP major presenting difficulty is anxiety and need for rigid rules and structures to be followed. DS1 has also had a seperate entrance into school. His first point of contact has been within the autism provision he's attended rather than a bustly over excited class of teens. He then partook in a full academic timetable of subjects but we droped PE, he does PE from home i.e. we make sure he does some exercise every week, this enabled some downtime within the academic week to work through any issues in other subjects. For each subject he packs up and leaves just before the rest of the class so peek busy periods in coridors are avoided. His allocated seat in classrooms is to the side at the front so near the teacher for support and near the door should he need to remove himself from the class if overwhelmed.

DS has a place to withdraw to, a quiet supervised classroom in school. Not doing his subjects has never been an allowed option, by me or school, its a route I see others taking and don't know how you go back from. Once you start to get significantly behind in a subject its a mountain to climb to get back into it. I see it as a one way street. If that is the best option then take it but think of the end game, you can't partially drop a subject. You're better off focussing fully on 5, 6 or 7 than doing 9 part time.

If my DS is having an overwhelmed day he does his work in the quiet classroom. Sometimes he has to do it in an evening/ at the weekend if he hasn't been able to get the work before the lesson.

We dropped PE to create lag time in his week, he also didn't do all form group sessions - again creating catch up time. I did consider dropping RE but he wanted to keep going with it (he's very driven).

Dropping subjects without an EHCP is very difficult due to schools strict number crunching but saying you'll do certain subjects from home out of core school hours may be an option they would consider.

The three people to start by getting onside are your childs form tutor, the school SENCO (Special Educational Needs Coordinator) and the head of year.

If you haven't addressed your concerns with the school already, I'd start by sending an email to the form tutor and CC SENCO and Head of Year.

Detail the problems you were seeing with anxiety, the impact and I always find its useful to propose a few positive ways forwards whilst inviting their suggestions and recomendations. Include your contact details - email, mobile, landline and good times to contact. I say email because your message may be printed and you want them to be able to get intouch easily.

You say she is mentally unwell for fulltime school and I will try not to be too blunt but do you mean that due to her anxiety you don't know how she will cope (yes it is very overwhelming as a parent their anxiety is completely contagious and to resist the desire to keep them where they are safe and secure at home is a real daily battle), or you absolutely catagorically know she can't?

If there is a chance she can, the meassures to put inplace are that she is in school 5 days a week, every week but with pressure relief options. Different start/finish time to lessons, quiet classroom/ use of library space, academic curiculum only, emotional support etc.

If she is physically debilitated by her anxiety and sleeping/ shut down 20 hours a day then a part time timetable with medical support is something the school may consider.

TeenPlusTwenties Sun 05-Jul-20 12:22:59

Thank you all for the long & detailed replies.

School are good, but they are having a lot to juggle at the moment...

I don't honestly know how bad she is or whether she will cope. She is due in this week and is terrified. If we get her in she may find it OK, but we tried it earlier this term under the 'keyworker and vulnerable child' provision and she couldn't cope.

She hasn't been able to engage with schoolwork this term bar the odd 30mins here or there. She is now behind in every subject. Just before lockdown school had agreed to drop a subject, I am looking for her to drop one more next term (unless there is a miraculous turn around in the next 8 weeks.)

I guess by 'part time' I mean attending for lessons, but if for example due to dropping something she has nothing after lunch, then coming home rather than staying to work independently in school.

If there is a chance she can, the measures to put in place are that she is in school 5 days a week, every week but with pressure relief options. Different start/finish time to lessons, quiet classroom/ use of library space, academic curriculum only, emotional support etc

Yes. this is the kind of thing I think could really help.
If we can get her in.

I will read the replies again later when I'm more with it.

OP’s posts: |
LolaSmiles Sun 05-Jul-20 12:32:15

There's some great advice already, but definitely speak to your child's school. Is there a senior leader responsible for pastoral or inclusion you could speak to. Sometimes that all falls to the SENCo, other times it's two separate roles. It depends on the school.

This isn't meant to sound unsympathetic, but I'm aware that typing can sound different to speaking. It's worth objectively clarifying which category your DC falls into:
1. Is displaying signs of anxiety and as a parent you are worried that they will struggle to attend mainstream. This may include being upset on a mornings some refusal to go to school but they are still managing other areas of their life or managing other areas but less so than normal
2. Your child is displaying signs of anxiety, it's affecting how they function across their life, and school refusal is part of this.
3. Your child's mental health is at a point where they are unable to function with daily tasks and/or they are close to a crisis point.

That will make a difference to what educational provision will look like for your DC.

The aim is usually to keep children in mainstream with reasonable adjustments and additional support with relevant agencies.

If that's not possible then you will probably need to have medical support and the school aware of DC's issues. In my experience LAs can be slow at resolving these situations as there's not as much alternative provision around as would be ideal.

In my LA there's a team covering provision for hospital and medical education. Sometimes this means attending a smaller specialist setting, other times this means teachers from the team do home tuition.Any provision through this model is not the same as the provision in mainstream school so it might be that DC gets a smaller range of subjects as students unable to access mainstream need more time and support for other issues and reducing the academic load supports this.

LolaSmiles Sun 05-Jul-20 12:33:28

I cross posted with you OP. Sorry.

RippleEffects Sun 05-Jul-20 12:42:09

I feel like this awful hard mum lots of the time but I have really strict boundaries in place. For me achieving 5 days a week in school is a really important thing (we never fully achieved it). DS1 has know there isn't the option to opt out of school but there is the option to feel safe and secure and get space when needed within school.

If the car and going out are becoming a fear can you attempt to break this before managing all the anxieties trying to get into school at once.

Does the car need cleaning? We all need 20 minutes fresh air for our vitamin D a day (I think thats a fact and not something I just made up to get my DC out the house once a day). DS1 is allowed to sit in the back garden or potter in the front - cleaning the car would count as his fresh air.

Building on from stepping out the house, a short drive to post a letter so she can jump out the car and pop it through the slot so you don't have to park. Then droping a letter to school, she can wait in the car. Then taking the school uniform order/ another letter into reception - hopefully you can wait with engine running and she can take it, or you go together. Then another trip where she goes in and you arrange that her form teacher/ senco/ a familiar adult is available to casually say hello (assuming an appropriate adult is in school - at ours lots, especially in pastoral roles, are now school based).

10brokengreenbottles Sun 05-Jul-20 12:54:08

I agree, when an anxious DC gets out of the routine of something, anything, then it is 10 times harder the next time. It becomes a vicious circle. They worry about other things on top of the original worry.

I agree on the Vit D too. It may be helpful to start supplements Teen.

TeenPlusTwenties Sun 05-Jul-20 14:08:07

She has been going for regular short walks in the neighbourhood round some specific routes where we can see if people are coming.
She will also go in the car.
The getting out of the car concern is specific to going in to school - the step into the unknown.

School is a worry re: crowds, germs, lack of social distancing, pressure, mean kids, level of work, being behind.

She struggles currently to make simple choices like A or B for lunch.

OP’s posts: |
AmazingGrace16 Sun 05-Jul-20 14:18:49

There's lots the school can do to support this too.

A video tour around the school to see how it looks currently. An in person tour before returning to lessons so she knows what to expect. Going into reception just to meet a key member of staff. All staggered approaches to returning to school.

It might be helpful if she can identify the barriers. I have a talking mat I use with some of my students to try and unpick some of the concerns. It has cards on it with statements like "worried about catching covid". "worried that my friends might've moved on" "unsure about what to do if I feel worried" etc etc etc. They then get placed on a rating scale to start the conversation.

I've seen you've had some responses regarding EHCP. It shouldn't take longer than the statutory time frames (20weeks) however the first step is a needs assessment which takes 6 weeks to be agreed or not. Ipsea are great.

RippleEffects Sun 05-Jul-20 16:09:54

Anxiety is very easy to feed, as a parent we often fall into the feeder category.

Life is full of choices. Should I open my eyes in the morning or pull the duvet cover back over my head? As adults we have learnt to accept the concequences. Sometimes, we do pull the duvet back over. That might mean the kitchen is a sty when we get up, we're putting the load on our other half to deal with DC and will owe them a return favour, we have to rush off to work without breakfast because we've made the call to stay in bed.

She has many choices to make each day, does she have any consequences of the outcomes of her choices?

Some are inconsequential like with lunch would you like a tuna or cheese jacket, once they're made up if she hasn't chosen, you choose which and follow up with I'll have the tuna that leaves the cheese for you. No further discussion, choice was given, choice was taken not to decide. No punishment/ reward of any choice just consequence. By not choosing the choice was made for her.

The basics of life are not up for negotiation in our house. Getting up, washed, dressed. Eating three meals a day, being civil or apologising when you've slipped up. Bedtime routine and sleeping are a big deal too. I say even if you can't sleep, resting in bed during the night time hours helps you and the rest of the family to stay in a routine.

The consequence of not staying in bed or messing around significantly at bedtime resulting in being tired and grouchy, are a few days of earlier wind down before bed time. So tech off at say 7pm. Not eating food is all meals/ food at table and stay at table until they're eaten.

The fundamentals of sleep, nourishment and fresh air are the basics for building the rest of life on. If these have slipped off the priority list then I find everything else goes up the spout as well.

She hasn't really engaged with school work for months - how much of this is choice with no consideration to consequence? If her anxieties are around being behind, that has been her choice. Its happened, it is what it is and now she is faced with new choices. She has the choice to re-engage and gather the work (with lots of support) to be closer to where she should be come September. She also has the choice to acknowledge where she is and request that she's included in catch up sessions that every school will no doubt be doing for year 11's. She has the choice to not push herself too hard and accept that if she'd like to pursue academically beyond yr 11 she may need to resit core subjects down the line.

Its not rights and wrongs. As a young adult she is making choices, they have consequences and as a parent we help encourage towards choices but they are the only ones who can manage the consequences of their decisssions. You can reinforce none of these choices are catastophic. They just lead down different paths.

There are about 9/ 10 weeks before September school. Even if she hasn't engaged since lockdown, she has the choice to start to engage now and have topics she's on top of. The choice to remove some pressure on say 2 subjects so she knows when she heads back in September those are in hand. Maths, English and Science were the three I insisted DS keep upto speed on. Maths and English levels at GCSE are still one of those core things that get asked for on applications throughout life and if you get below a level 4 I think you now have to resit at 17 and again at 18 unless a level 4 is achieved in the first resit. So the consequence of not working is the acceptance of delaying inevitable work.

TeenPlusTwenties Sun 05-Jul-20 17:06:00

Ripple Although in essence I agree with you, I do think most of the time DD hasn't been choosing not to do school work.

OP’s posts: |
RippleEffects Sun 05-Jul-20 17:22:20

I'm playing devils advocate a little. Being deliberately firm/ harsh to provoke the questions and boundaries. Its a method thats worked well with me. Made me question my own style and choices. I really do get how incredibly heartbreaking it is.

I do stand by some of the time it is a choice, but only to an extent. With DS's autism, somedays there is more to work with than others. Thats why I always aspired to 5 days a week in school and made it clear that was the intention but didn't completely reliably achieve it.

Somedays there is a choice, others there really is none. Those where in the whole day there are no opportunities to engage for even a short get work for future days in order are, for us, quite rare. With most anxiety in my limited experience from what I have seen of DS and his peers, is this is how it is. It isn't a fixed bad place. Its a place that somedays/ hours is more accessible than others.

Pushing isn't really an option, as no doubt you've found. Within our control as the parent is boundaries and encouraging choices.

Helping to offer choices by working with school so the choices are less harsh. A choice isn't school or no school. Its lesson, or lesson in quiet room, its time out in quiet room then trying next lesson fresh. Whole days don't get blown off. Just write off the bit that didn't work and do your best to start each lesson fresh.

TeenPlusTwenties Sun 05-Jul-20 17:48:37

Helping to offer choices by working with school so the choices are less harsh. A choice isn't school or no school. Its lesson, or lesson in quiet room, its time out in quiet room then trying next lesson fresh. Whole days don't get blown off. Just write off the bit that didn't work and do your best to start each lesson fresh.

Yes, that's helpful.

OP’s posts: |
KoalasandRabbit Sat 11-Jul-20 18:01:14

If you've not done already I would tell school all the problems and any solutions you think may help, anything that has worked at home or in the past at school, anything that triggers problems.

The problems appear in 2 categories - germs (crowds, germs, social distancing) and being behind (pressure, feeling behind etc). Though would also check there's no bullying as well if she's anxious and said about mean children.

The germs is that fear of all germs or covid? I would provide her with handgel and also reassure her on the stats re children and covid. Let school know. You maybe able to get help via GP and get CBT therapy but waiting lists are long and its very stressful to do at a time she's under a lot of stress. It's based on facing your fears but one at a time slowly and seeing nothing happens or nothing that awful happens. With all the pressure and lockdown she may not be strong enough to engage in this so I might go with hand gel and maybe her showering once a day after school rather than before. But don't let her add more and more safety behaviours as this will worsen it.

With the school work could she maybe catch up a bit over the summer, could you help her with it? I have one with autism and I have to do everything with him and find alternatives, there is a lot of throwing himself on the floor, growling but I've made it clear not learning is not an option. I will help, I will type things, liase with teachers send things in, find alternatives but there's no do nothing option. Though when he's at total breaking point we do take breaks. I also find he is better after food and later in the day.

Re getting help school can refer you to a family support worker or a youth support worker, think you can also self-refer via early help, may vary by area. They may have access to counselling / CAHMS though CAHMS is very hard to get help from here. Oak National has resources online, mine like seneca but wide variety of sources.

Other people who maybe able to help is LA SEND team, if its not them they will forward it on to whoever it is. There's also an Inclusions person at LA who should be able to help. LA should be able to get Ed Pscyh in. Other option would be home schooling but then you are very much on your own if you deregister so not a choice I would do lightly. You could try for an EHCP but we've never managed to get one and my son has had full-time TAs at primary and school sending home once a week at secondary but we get refusal to assess. Having said that after a battle we've always got support but its taken me fighting for it one day a week to get it and involving as many people as I can.

Medication is another option, not one I'm that keen on but some people have success with it.

KoalasandRabbit Sat 11-Jul-20 18:08:45

Does she have any friends that she could chat to / meet up with before going back? Is there a child at school she would like to sit by? Is there a place in the class she would feel happier sitting by? My DS prefers to be by the door, he's also (pre covid) allowed to leave when he wants if stressed. Sometimes anxious children prefer to be at the back where they are not seen though by the teacher might mean it would be easier for them to see if she's OK. My daughter often sits by a girl who is very anxious and she speaks for it - it maybe there's another child who could help her. The teachers might know one (or at least a kind child).

10brokengreenbottles Sat 11-Jul-20 18:32:36

Teen I hope DD has managed a better week. Don't deregister, if DD is not well enough to attend that's OK, but she should remain on roll. It is easier to get support when on a school's roll, mainly because you are someone's 'problem'.

Koala you should appeal a refusal to assess. The LA may concede before tribunal, but if they don't you are likely to win. The legal threshold is has or may have SEN and may need SEN provision via an EHCP. Your DS definitely meets that test if the school are illegally excluding him.

TeenPlusTwenties Sat 11-Jul-20 18:50:32

Thanks koala and bottles

She managed to go in for one lesson on Monday, but then freaked out for the rest of the day and Tuesday. She went in for 15 mins on Friday and met pastoral support outside but still had quite a bad reaction to that too.

So this week:
- counselling for DD ongoing
- re-contacted GP & requested referral to CAMHS
- spoken to Ed Psych
- spoken to post adoption support

School are being as helpful as I can expect under the pandemic circumstances, I wouldn't deregister.

OP’s posts: |
TeenPlusTwenties Sat 11-Jul-20 18:52:25

What she needs is to go to a day place for counselling and therapy dogs. But I don't think such places exist, do they?

OP’s posts: |
Hazelnutlatteplease Sat 11-Jul-20 18:57:43

Interhigh. It's an internet home schooling option. If you have a statement sometimes you can get LEA to pay the fees.

Less pressure to go somewhere to attend, if you miss a class its recorded so you can catch it up later. No need to interact with anyone else if you dont want. Attend in on a if getting up is too much on a particular day.

I know a couple of kids similar to your description it has worked really well for

Hazelnutlatteplease Sat 11-Jul-20 18:59:04

Attend in pjs if getting up is too much! Apologies for typo

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