TAM meeting tomorrow with educational psychologist

[Twothough]

Hello, I’m new to mumsnet but have had a last minute TAM meeting called for tomorrow with the educational psychologist (only had one before)

A friend recommended here for some replies as I’m desperate, don’t know where to go or what to say.

So my eldest child, a son who is six, has been having problems since before he was 1. At that age he used to headbutt the floor aggressively in frustration. Everything has escalated and fast forward to now....

The issues we have:
He hurts himself on a daily basis, more frequently at school but sometimes at home, he does this by headbutting walls, hitting himself, hitting himself with objects not just hands. He has done this so badly at times he draws blood.

He hides under tables if he gets upset (usually after these episodes)

His moods can change in seconds to being happy then to this

Usually a very small issue causes these outbursts.

He tries to escape school fairly often.

He has been in speech therapy for 3 years now, but does now mostly speak clearly.

The anger is only ever directed at himself and he never lashes out at anyone else, be that a child or an adult.

Backed by the teacher and school senco (I had letters) the gp made a referral to the child development centre but it got rejected. The GP was absolutely shocked at this.

Now, with the educational psychologist, on our first meeting he just seemed to downplay everything and made no suggestions of going forward. I don’t know how to handle tomorrow? Like what to ask or suggest, there is so much that goes on with my eldest that I don’t even know where to start. The teachers are also pushing for more from him.

I don’t know what I’m asking, just some suggestions of what I could ask or what I should focus on in the meeting?

Sorry if this doesn’t make sense I’m just lost with it all.

Sorry- just to add, he had problems when in utero and I was warned that he could be brain damaged or disabled, he doesn’t appear to be but maybe this has caused a mental disability?

The self harming behaviour needs exploring. Something like an ABC table can be used by yourself/staff to explore why he his harming himself. Are there situations where this always happens? If you could create a situation where you could be sure it wouldn’t happen, what would it look like? This may highlight some differences. It may be a sensory difficulty - this is something the EP could explore or refer on to OT. What is his learning look like?

Some EPs focus solely on cognitive testing but that’s not always the most useful thing for them to do. It seems like this is about his social and emotional well-being and this needs looking at rather than dodging the issue.

Go with a list of concerns - concerns at home, concerns at school. Also consider his strengths as a good EP should ask about them too, eg what works for him, what supports him, what do you do at home that works, how do you calm him?

I’d be very firm about an action plan being formulated with SMART targets that are specific and a date set for them to be reviewed in another meeting. The school is the one that needs to do more, the EP should assess him and make recommendations but won’t actually do the work generally, that’s not their role. His school need to be supporting him.

Idk what TAM means, but I would ask the Ed psy to do a full assessment of DC’s cognitive abilities, reading, numeracy, spelling and writing; and an observation of DC in class. All behaviour is communication and what is DC communicating? It could be he has a learning disability; or specific learning difficulties meaning DC finds it hard to cope in class or pay attention or have the social skills to know how to get along with his classmates?

It might be he has none of things; but this is what Ed psy are there to assess, so get it ruled out now. Then, you and professionals can look at what else might be going on with DC?

Thank you both for your replies. Both have made some interesting points, the part about a situation where it wouldn’t happen, I honestly couldn’t describe to you and be 100% certain he wouldn’t do it in any situation, it’s very unpredictable.

Also about the full asssesment if cognitive abilities sounds helpful and will definitely bring that up.

If the child is doing okay academically a full cognitive assessment isn’t necessary. If you suspect a learning difficulty, it might be something to consider, but it’s not always what EPs are there to do. The school will have paid for limited time so it might not best be used with cognitive assessments. An observation would be a definite.

I’d be considering, as the child has had extensive SALT, whether there are aspects they are still unable to communicate eg how they are feeling, what they think, emotions that overwhelm them and this is illustrated through the self harm. But that’s just one theory, like I said it needs exploring.

To add I’m not slating cognitive assessments at all, they have their uses, I’m just thinking if it’s a case of either/or, then I wouldn’t be picking cognitive assessment personally. I’d be interested in an observation initially and seeing why and what is leading to this behaviour. I’d be very interested in the sensory profile of the child too. I should add I am an EP.

An ABC table would be very useful if you’re struggling to identify triggers for the behaviour. It asks you to identify what came before the behaviour - what was the situation like, what was the environment like, time of day etc. What happened, and then what was the consequence of that (eg child was taken from classroom, child given a hug etc) which helps identify what the child is communicating and seeking from their behaviour.

He does display some sensory issues, he has a lot of problems with food (mainly different textures) doesn’t like anything wet or with sauce for example. Also, certain noises, children screaming and crying, toilet flushing etc.
Also with clothes, can’t wear jeans, have issues with socks not being ‘on right’ he used to be fixated on them but not so bad now.

Ask for an OT referral or assessment of sensory needs from EP.

Ok will do, thank you so much