Child Psch referral - a good idea & who refers?

[roundabout1]

I'll try to be concise! My dd (7) has been suffering with a post viral fatigue type illness since January. She has had lots of time off school & we seem to be in endless meeting with us wanting something, school wanting another & dd stuck in the middle. She has never been that confident & always been anxious about school. Now this is much worse because of the amount of school she has missed & also because she is so anxious about feeling ill (or more ill) when at school. Does Ed Psch sound a good idea in this situation. Thanks for reading

An ed psych will assess around educational needs. The school would normally decide of a referral was needed and then refer. Are the school suggesting this?

We have (yet another - sigh!) meeting with school tomorrow. No one suggested the idea of it, just feel we need someone supporting dd really. Have a feeling that dh will go into the meeting with guns blazing as has been a catalogue of incidents at school recently that we are not happy with. I am struggling knowing when dd is fit to be at school, we are stuck in a cycle of her being ok (ish) then overdoing it & then being off for a week. I am sure there have been times when she could have gone into school but I've let her stay off.

I'm not sure this falls under the remit of an ed psych tbh. Ask about a school counsellor or cahms perhaps

Probably not ed psych. How about the school nurse?

Thanks, I wasn't sure what a school nurse did tbh but googling their role it does seem more inkeeping with that.
Thanks

Hello My daughter has hadproblemsfor 4 years approx -never got real diagnosis but could be abdominalmigraine or IBS but resulted in her missing a lot of school. Now in High School and became quite bad a year ago past and has hardly been in since then. Appears to be anxiety issues in amongst other diagnosis. Please read the chat under heading '12 year old school refusal' as this will give you insight on other people with similar situation. I would not wish what we are going through on anyone and you need good help. We have not had good help - Ed Psych did nothing. Cahms slightly better but not often enough. I am fighting now for weekly sessions of CBTand maybe tutor but not hopeful of getting it. School situations have sometimes made things worse. Hope this helps in some way.

oncebubblly - thanks for your post. I'm sorry to hear what you have gone through with your dd. I will find your post & read through it. We had a meeting y'day with school & are being referred to a Local Support Team. I was going to ask for a CAHMS referral but to be honest it is largely physical & only a small part psychological - I think & the Local Support Team have a shorter waiting list. I have found this extremely stressful, obviously partly because I was worried about my dd but also just the day to day, do we force her to school? how unwell actually is she? It's just taken over our lives & dominates everything even though she is not seriously ill.

DD had a few sessions with someone at CAHMS initially to talk about how she felt about her medical condition (which is exacerbated by stress), but ended up talking about a whole load of other things.

She was referred by her paediatrician initially, but we were also advised to get school to refer as well, as that can sometimes bump you up the waiting list. As it turned out we were fast-tracked via the children's ward at the hospital after a A&E admission , but they were happy to work on "getting back to school full-time with a medical condition" issues.

midnight - thanks for that. The head did say that we can always change our mind, if we fnd its not working for us he will refer onto CAHMS if we so wish. I am sure talking about it would help & also she is a born worrier so sure she would end up atlking about loads of other things too!

oncebubbly - I'm struggling finding your post, sorry

round - oncebubbly posted on my post too. second page i think.

i think CAMHS is a good idea - it being presented to my dd as help around dealing with long term illness. and yes it may throw up other things?

so confusing tho .

Feels like I'm banging my head against a brick wall. Head gave me a copy of his referral letter today. His interpretation of the problem is completely different than mine, we had a long meeting last week & from his referral would think he's been to a different meeting. No mention made of school having a problem/lack of understanding off dd's problems, says we are struggling getting a medical diagnosis or any advice of paed - completely true. Says we are having increasing difficulty coping with dd's behaviour - true in a way but only regarding school. The main problem is our lack of coping strategies for dd apparently. This comes a week after our dd was b***ed by the pe teacher for missing pe again (I'd given her a note) They just seem completely unwilling to accept that their lack of understanding of dd's problems is causing dd a huge problem re school.

Don't worry too much about what it says if is referral to CAMHS. Just use it to push the referral and get CAMHS appt and assessment and hopefully some strategies for school and home

Some schools are good at this you know mindful!

I am a HT in a primary and we have successfully reintegrated school phobic children on a number of occasions (4 in the last two years). But it needs a bit of imagination and lots of time.

You need to ask the school for
An agreed part time timetable starting I'd suggest with an hour a day, only doing her favourite subjects at first
No homework at all (so home is a total refuge from school)
A mentor and 'safe space ' I.e one person who she can talk to regularly or go and find if feeling anxious, and a a bolt hole place to for refuge when feeling ovwhelmed
4 weekly reviews of the above and no changes unless all parties agree, in particular no ad hoc changes without child's agreement or trust will break down

As for attendance statistics the school can get this arrangement agreed by the chair of governors and if well documented as a proper pastoral strategy will be fine for all external authorities (for ofsted etc it wouldn't
be a problem if it was shown to be an arrangement benefitting a child's education, and helping them back into school)

BTW I am using the term 'school phobic' in its widest sense I.e children who find school very anxiety making, not necessarily a diagnosed mh condition.

Also for attendance stats etc at school I just take these children out of the calculation, and work out their attendance as a % of what their's could be. Thus my stats still come in at well above national average.

I also think worth getting on camhs wait list now - if local support team (what is that) resolves the issue just come off. I understand your view that is mostly physical but maybe be a larger psychological element than you realise. The cycle you describe of boom and bust is physical but can only be altered by changing behaviour and thinking. Longer it goes on more psychological, emotional bits get added. Also sounds like having a clear, shared formulation of what's happening between you, school and paeds will be v helpful and that's Camhs job.

Thanks everyone
The service she is being referred to liases between school & us & everyone else & also will offer counselling to her & to us. My concern was to get her to speak to someone before she becomes very down over this, it happened at the end of last school year but the over the summer she became much happier. I recognise that there is a huge psychological element to this but my main concern is school lack of recognition of this. I understand they worry about their attendance figures but surely the happier dd is the better her attendance is likely to be. She is happy to do school work at home as she enjoys it & worries what she is missing out on so it reassures her in that respect. A mentor/safe place would be great for dd, I think I will ask for that, the worry for her is that people dont believe her & to be honest I dont blame her for thinking that as in my opinion school haven't done anything to show her that they do believe her. I stated that I felt that this was one of the main problems she had & was told that school didn't think that mattered at all. Surely if it matters to dd then it is important as it becomes part of the problem?

mindful - our problem is because of the physical problems dd has she has had to stop all clubs & activities so socially she really is missing out. Even playing with her best school friend can't last more than a few hours as she gets too tired & then ill. As a result her best school friend has been spending more time with other friends so dd has been feeling more left out, so then feels more different & then feels more fed up with the situation. It just seems a vicious circle.

Just realised a huge error in my earlier post - head thinks we have been let down by gp's & paeds as they have failed to diagnose the problem. We have a diagnosis although vague of a post viral illness following a bad virus or poss glandular fever. I do not have a problem with the diagnosis, I know they have ruled out all the nasties, she's had loads of blood tests & at the end of the day nothing shows up but she obviously isn't well, if the paed is saying that there is obviously something wrong but that it will never show up on a test I don't see that having a name for it will make any difference. We have been given management advice so to make sure dd does a regular amount of activity to avoid the crashing & burning vicious circle that it is so easy to be in. Anyway after yet another meeting today, thank goodness dh wasn't in this one as he gets so easily side tracked from the main issue! we have sorted a few things out but the head is adamant that without a "proper diagnosis" we will struggle getting help as without the diagnosis everyone will assume its a psychological problems solely. Dd is back at the hospital next week so will try & get in touch with them first. I dont want to say the problems we are having regarding school believeing there is a problem in front of dd. There are so many other problems with school & her main problems is that she doesn't feel anyone believes her anyway so really dont want her to hear that.

I'd ask paeds to cc head into letters? They can do this if you consent. Get them to explain it in writing even if it is vague. Head wants a nice clear label but a letter from a dr might satisfy her need to feel sure about the siuation. I'm sure you can engineer a chat with dr without daughter. Depending on the set up send her on an errand, grab dr while she is off being weighed or whatever.

Thanks bissy - School have a letter from paeds already although it gives a vague diagnosis & how to manage it, ie - a regular manageable amount of activity rather than days of doing nothing & then days at full pelt. I suppose in the letter school have it doesn't state all the tests than she has had done to rule out other things so school could be inclined to think paeds are dragging their heels. I rang Paeds y'day & spoke to secretary & explained problems with school, was hugely reassuring actually as she went ona bit of a rant about headteachers thinking they know best etc etc. Anyway she is suggesting paeds writing/phoning head, dd had an appointment end of nxt week but she's bought it forward so dd can be seen asap & then school can be informed.

roundabout1 - I hope things have improved for you & your dd since you last posted. I picked up on this thread only today and I just wondered if you have been in touch with the charities which work to support people with post viral fatigue, such as the ME Association or Action for ME? They may be able to offer some further ideas if you haven't managed to move forward, but I have my fingers crossed that you have.

tinkbelle - only just seen your reply. Thank you, sadly things haven't improved & seem to be on a downward spiral, we are leaning towards a chronic fatigue diagnosis but seeing a specialist in april so not confirmed yet. Dd's behaviour has deteriorated considerably & at times she is one very unhappy, angry little girl. We seem to be on numerous waiting lists for counselling etc but have been told to be prepared for a long wait. Thank you I have been in touch with a few charities & it is great to hear that her behaviour seems "normal" for the situation. I think if she had a firm diagnosis, something concrete that she could tell people it would improve things as she just thinks no one believes her. School are being more understanding but endless problems still

mindful - thank you, I'm glad your ds has had such a good recovery. I will continue to try & get dd bumped up the lists so she can see someone. Trouble is that to everyone else she seems fine, physically & emotionally although school have mentioned she is very quiet. It is only at home when no one else is around that she lets her guard down on her emotions & stops putting a brave face on everything. It all makes it so much more frustrating as I do feel as if I've a healthy child as I'm sure that is what she looks like to most people.