4 year old with constipation and school

[elliejjtiny]

Posted here because I wasn't sure whether to put it in children's health or primary education.

My youngest, aged 4 has just started reception. He is being assessed for asd but it's taking ages. He gets some funding (I think it's called SEN+ funding) but it's not enough for a 1-1 TA. He was at a Sen preschool before with 1 adult for every 2 children.

He has always put things in his mouth that he shouldn't but we were mostly preventing him by supervising constantly, not leaving tiny things out, keeping craft stuff locked away unless 2 adults (or 1 adult and one teenager) are there to help. Preschool were doing similar and he was eating the occasional thing every other week or so but it was mostly under control.

Since he started school he has got so much worse. I can see that he has been eating craft stuff and sand every day at school and now he is constipated. I was worried about the lack of supervision at school but the teachers kept saying he would be fine.

What should I do? Dh does the school run and he has told the teacher he has been eating sand and craft stuff. There has been no improvement though, if anything it's getting worse. I'm not sure if I should be taking him to the gp for constipation or just give him more fruit and veg (he normally eats well though with plenty of fruit and veg though so don't know if it would help much). I'm wondering if it's worth talking to the gp to see if that makes the teacher take it more seriously. I'm wondering if I'm over reacting and being a bit precious last born with him. It annoys me that I make a massive effort to make sure he doesn't eat things he shouldn't at home and then he does it at school.

Hello, This sounds like a difficult situation. I can’t really say much about the more general issue re. school and whether it’s the right place for him. But I would say that you should take him to the GP about the constipation. Don’t leave that untreated. My DS has chronic constipation which we’re just about keeping on top of. I definitely find he’s better able to deal with heightened emotion and stress when he’s not really clogged up. I hope things start getting easier soon.

I think you should get something formally in writing. Ask for a meeting with the class teacher and Senco and get specific steps put on his plan for how they are going to stop him doing this. It's not healthy and could make him really ill. One side is supervision but also other sensory input like a safe chew toy, fiddle toys or regular messy play might help. You need proper OT or other professional advice. While paeds etc wheels are turning slowly, Senco should know who to contact even if they don't have all the answers.

And yes I would take him to the GP. I don't think you're being precious at all. He is not being kept safe.

Thankyou. I wasn't sure if constipation was something you're meant to go to the gp about or treat yourself. I didn't want to be one of those parents who go to a and e for a cold. He is my 5th dc so you would think I would know by now but weirdly this is the first time any of them have been constipated.

Not only do you go to the GP with it, there are hospital clinics!

Oops cross post. Not tried a chew toy but we use fiddle toys with him at home and messy play too. Not sure if it's helping or not, seems to be a bit of trial and error with him.

If he's eating random stuff to the extent that he is constipated then he needs further assessment/diagnosis so you can get help for him.
Has anyone mentioned PICA?

Can you send him with a something on a chain around his neck that he is allowed to chew on? If he has no aide, then teachers can't watch him every minute of the day and also manage the other students (who may have SEN also). Talk to the school and also the GP.

Have you spoken to the senco about starting the echp process? If he is eating random objects I would argue they should be building the evidence to apply ASAP as he clearly will need the support in order to be successful in mainstream

I know you said he is being assessed but if he is putting himself at risk like this they can apply for emergency funding to cover the gap whilst waiting for full
Assessment and ehcp

Yes definitely go to the GP. I would think eating those sorts of things is dangerous and is presumably what's causing the constipation - I would be worried about a blockage..?

I'm sorry to say but if he needs constant supervision he either needs a 1 to 1 TA with him in the classroom, or to be in a different setting. Even in reception children are expected to be more independent and so equipment is freely available and in fact encouraged. It is just not possible for the teacher to be watching him constantly whilst trying to care and educate all the other children. If he cannot be trusted he needs a separate adult or different environment, I know that sounds harsh, but it is better than him getting repeatedly I'll.

Thankyou. I said to the teacher and senco before he started that he would need 1-1 because of his eating random things and because he escapes. I was worried about all the small objects freely available for him to put in his mouth at school. They said that it he saw the other children not escaping or eating sand etc then he would copy them. I was doubtful to be honest and it turns out I was right.

We haven't been given any kind of advice from professionals yet so we are just winging it at the moment. If he gets a diagnosis of autism then we can get support from the children's autism outreach team but at the moment his only diagnosis is speech delay.

I feel very sorry for you, I’m not sure you have been given very good advice by the school to be honest. You are within your rights as a parent to apply for an echp yourself. I would contact the lea Sen team and find out who the School link officer is and go from there. He is a danger to himself and they cannot possibly protect / support him without the proper funding in place. I would also request an ep report asso as without that I doubt you’d get an echp even with the diagnosis

We thought diagnosis would bring practical help but I have to be honest, it really hasn't. We're still winging it. The main difference it's made is that we are more confident in advocating for DS.

I would strongly advise you to proceed as if a diagnosis won't change much. He has clear needs regarding eating things and escaping, and not meeting those needs creates serious well-being / safeguarding issues. You've tried it their way, he is still eating things he mustn't, something needs to change. They have a responsibility to address the need, irrespective of diagnosis, especially when it comes down to basic safety. Sorry, getting a bit ranty Poor lad.

I'd sort the constipation out because that is likely to happen far quicker than school organising support/getting an ehcp etc.
My DS2 is autistic and a compulsive eater of non edibles (paper, cardboard, plastic, sponge, the headboard off his bed and all of his clothes) and he is 21! He is verbal too (wasn't for long time, was very speech delayed) but can't explain why, and it has played havoc with his bowels...he had to be hospitalised to be unimpacted when he was younger! He still has problems unsurprisingly but he's been on movicol for years now and it helps stop him getting too constipated.

Then apply for an EHCP yourself... perfectly legal to do so and usually quicker to get the ball rolling.

You aren't being in the least precious..pica is a serious problem, and he needs much closer supervision.