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

This site seems to link to some equine therapy places - never used it ourselves and don't have personal experience of any of these:

www.leapequine.com/find-a-therapist/

There are a couple of posters on the Goose and Carrot Summer Pub thread in SN chat who have used them and have had great experiences. My autistic child loves animals and is great with them - during lockdown he's barely left the house, he hasn't communicated with any other children but he talks to our animals everyday - we have a cat, an indoor rabbit and 3 silkie chickens and it keeps him happy and calm most of the time. So I can see how therapy could work with horses. Another thing I have found useful is the school have just started Teams meetings and watching a few of those and seeing how the children interact with him is interesting but he is oblivious to who is being nice, who is making fun, who is interested etc. That's been his only social interaction since March as he can't go into school, won't use a phone or e-mail. If you feel up to it come and join us on that thread, there's two lovely Mums on there with very similar girls. It's often more about saying how hard that day has been rather than solutions but its nice to have people in similar situations to chat to.

@10brokengreenbottles ah i did not know that! I was prescribed ADs at 15, but yes actually i was under the care of a psychiatrist.

@TeenPlusTwenties from the sounds of it, your DD needs a lot more help than she's getting. I would get an EHCP in place with the school ASAP, and then contact your GP for a private referral to a psychiatrist and therapist. Waiting for CAMHS will take too long - i speak from experience, if her education gets fucked up now it's likely to ruin her life for at least the next decade.

X- posted.

SSRIs are Selective Serotonin Reuptake Inhibitors, a type of antidepressant.

Your DD sounds likes she needs to see a psychiatrist.

In most (? all but can't be 100%) CCGs GPs can't prescribe antidepressants to under 16s without them seeing a psychiatrist.

NICE guidelines suggest antidepressants should only be used alongside therapy, but they can really help when DC are struggling to engage with therapy.

@TeenPlusTwenties is she taking them adhoc or regularly? I'd recommend a prescription of SSRIs taken every day. Before counselling or anything else starts working, she needs the edge taking off in a meaningful way.

Is she medicated? If not i would get on to your GP for a prescription ASAP.

I think its places like this:

www.caspianassistedtherapy.org.uk/

A supportive school makes a huge difference.

You can attend some CAMHS units as a day patient, DS1 attended one for a while, but it is very unlikely DD would be given a place from what you have posted here. Have a look at local alternative provisions. Some have integrated therapy, including animal therapies. (This is the route the poster Koala mentions has gone down). Failing that have you got a local rescue centre that you could walk a dog from? Not the same but it could be better than nothing.

I second posting on the SN section - SN chat and SN children are the busiest.

I'm on the SN chat Goose and Carrot and on there a couple of posters are having animal therapy, not sure what animals it is but therapy animals. I think they do like half a day there and one I think has just got LA to pay. I'm not sure of exact details but if you ask on that thread or SN chat board someone should know. I think you can get it though but may not be dogs. Maybe horses but I'm not too sure but its specialised and very good results.

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

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

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.

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).

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.

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.

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.

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.

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.