DD won't go to school - anxiety

[PickledLily]

Every Monday it's the same, especially when DH is away. Her school have put strategies in place during the day for when she is in the classroom for when she gets overwhelmed (she's year 5), and this has been working well. I'm 3 weeks into a new (mostly home based) and demanding job and can't just take the time off, so she is spending the day moping around, asking what she should do but refusing any suggestions.
I'm at my wits end. Any suggestions to help get her into school?

Thanks for the ideas Trump, I hadn't thought about her sitting in the library or somewhere else that's quiet.

Sorry wrong PP should be Teen not trump

No diagnosis yet, but I have my suspicions there might be ADHD at least. No signs of dyslexia. Dyspraxia - not sure - she has very good hand eye co-ordination and balance, but she is massively untidy and disorganised.

We had help from camhs early intervention for my dd when she was in year 4 with similar problems. It helped a bit but they also quickly pointed out a possible neuro diversity. So was referred onto the ASD assessment pathway.

I'm surprised senco hasn't mentioned camhs yet.

I'd never have put two and two together for my dd having ASD but it soon became clear as we looked deeper into her issues.

She's now year 8 and has an ehcp. She goes to an alternative provision unit in a hospital school where class sizes are around 7. Copes much better but still has bad days. She gets cbt through camhs to help her deal with the anxiety.

Best of luck

We had a great deal of help with dd from our local EWO (education welfare officier), over 10 years ago. I think from memory that thé contact was via thé school.

I'd say push the SENCO for a psych assessment - you'll probably need this before you get any decent concrete help, & have the school step up (if my experience is anything to go by).

My eldest DD has been an anxious child since nursery (plus introverted, hates noisy environments etc), & it built to a point where she was refusing to go to school off & on from Year 7 onwards, citing anxiety. I wish I'd pushed for help then... Fast forward to the end of year 9 & she was hospitalised with AN - ED's often go hand-in-hand with anxiety/OCD. I don't mean to be alarmist, & it's VERY unlikely that your daughter will end up in the same situation, I'm just saying act now. I only wish I could turn back the clock myself

Actually, @forlornlorna is right - it's CAMHS your DD would be best being assessed by. Your SENCO should be able to refer, as should your GP, though you may be able to self-refer too (confusing my youngest & her dyslexia diagnosis via school-organised Ed Psych with eldest & OCD assessment organised via CAMHS while an in-patient for AN... FML)

If DD can’t attend school the LA should be providing alternative education.

In addition to this you should apply for an EHCNA, you don’t need any further evidence, the threshold for a needs assessment is relatively low - a) has or may have SEN, and b) may need SEN provision to be made via an EHCP. DD meets that threshold. If the LA agree to assess, an EHCNA can include assessments from, among other professionals, a psychiatrist &/or clinical psychologist. The benefit of this is it is governed by statutory timescales, so you won’t be sat on a waiting list for years.

This is all so helpful, thank you. I'm clueless about the process.
DD ending up with an ED is a big concern and at the back of my mind.
Should I contact the LA? What is an EHCNA, what does it do, and how do I apply, via/to the LA?
Sorry so many questions!
This all feels a bit unreal.

EHCNA is an education health and care needs assessment, the first step to getting an education, health and care plan. Have a look at IPSEA’s website, which has lots of useful and accessible guides to the process.

Thanks Ginger, I'll take a look.

IPSEA have a model letter you can send to the Director of Children’s Services at the LA to request an EHCNA.

An EHCNA is the assessment prior to getting an EHCP, or not. The EHCNA includes various assessments. It must include:
a) the child’s parent or the young person;
b) educational advice (usually from the head teacher or principal);
c) medical advice and information from a health care professional;
d) psychological advice and information from an educational psychologist;
e) advice and information in relation to social care;
f) advice and information from any other person the local authority thinks appropriate;
g) where the child or young person is in or beyond year 9, advice and information in relation to provision to assist the child or young person in preparation for adulthood and independent living; and
h) advice and information from any person the child’s parent or young person reasonably requests that the local authority seek advice from.

H means you can request things like psychiatrist, clinical psychologist, SALT, OT.

In the meantime, for medical needs EOTAS tuition, write to the LA asking them to make provision for DD under s.19 The Education Act 1996 because she has been absent for more than 15 days (or if she hasn’t yet she it is clear she will given the history and her current difficulties). If they refuse complain and threaten Judicial Review. Usually the threat works, but if it doesn’t contact SOSSEN for help with a pre-action letter, which almost certainly will make the LA take note, and also consider complaining to the LGO.

We are lucky to be able to pay for a private Ed psych who can see DD in a couple of weeks. In the meantime I assume I push for CAHMS so she's 'in the system' and look at getting an EHCNA. Anything I need to be aware of if getting a private Ed psych rather than waiting for one via cahms? I assume cahms/school will take the EP's input into any decisions about adjustments/support?
Also, any more suggestions for small steps to get her back to school? She says going in early is best to avoid the crush at the school gate. Not sure I'll get her out of the front door to start with though.
Sorry that so many of you are going through this too.

Have a read of PDA society as well. It gives you a different way to parent to help some of the things that sound like are difficult for her. It’s helped me understand our DD whose similar. www.pdasociety.org.uk/ It’s really hard work though.

Ed psych is usually provided through the council rather than CAMHS and it’s likely if it agrees to assess her for an EHC plan it will want its own Ed Psych to see her - there is a bit of mistrust about privately commissioned reports in council send departments in my experience. So you may be better off requesting the EHCNA and then seeing what happens. If the council refuses to assess you will have a right of appeal and that is the point where a private EP assessment may become more useful.

Unless money is no object, I would hold off the private EP assessment. Apply for an EHCNA, and one should be done if the LA agree to assess. Even if you have a private EP assessment, as Ginger posted, the LA are likely to do their own anyway. You may find that the LA EP assessment is OK, but the SALT/OT/other report isn’t and you need to appeal and prioritise an independent OT assessment or SALT or MH reports.

If you asked for an EHCNA, and the LA agreed to assess you can ask for psychiatrist or clinical psychologist advice and the LA would be bound by the statutory timescales, so no need to sit on CAMHS waiting list for ever and a day.

The school and LA should take note of the independent report, but many act unlawfully by stating they don’t accept them. If you appeal though SENDIST will.

@PickledLily

We are lucky to be able to pay for a private Ed psych who can see DD in a couple of weeks. In the meantime I assume I push for CAHMS so she's 'in the system' and look at getting an EHCNA. Anything I need to be aware of if getting a private Ed psych rather than waiting for one via cahms? I assume cahms/school will take the EP's input into any decisions about adjustments/support? Also, any more suggestions for small steps to get her back to school? She says going in early is best to avoid the crush at the school gate. Not sure I'll get her out of the front door to start with though. Sorry that so many of you are going through this too.

Ask school if there's the possibility of a part time timetable starting with just half an hour a day and building up to full days. If she knows she has to only go for half an hour then she is more likely to be willing to go. Appreciate this is an absolute nightmare with work etc but has worked for a lot of people I know.

I'm not sure you'd have to wait for an EHCNA to get an EP assessment - your school SENCO may be able to request/arrange one (ours did for the dyslexia diagnosis).
Also, re private ED/Psych, many work across both private & NHS/LA. While the LA might be snotty about a private assessment, it might bump you up the CAMHS waiting list - though if you start actual private treatment following the assessment, this will rule you out for CAMHS care.
And, totally agree about partial days/phased return - far more chance of success if you build up to full days gradually. Many returns to school are done like this. My eldest DD just had a gradual transitioning back to full days prior to being discharged from a residential ED unit before Christmas. Your school should support this.

20thCenturyWolf given the pressure on school’s EP time at the moment it is unlikely OP’s DD will get an EP assessment via school quicker than if OP applied for an EHCNA.

Unless short term aimed at reintegration part time timetables are unlawful whether or not parents agree to it, so whilst a part time timetable may help if it turns into something longer term, which it may do with how long DD has been having difficulties for, it is unlawful.

We were in a similar boat to you 2-3 years ago (DD now also in year 5). It led to an autism diagnosis, which I had suspected for a while but everyone else dismissed. We’re about to start the EHCNA process so a lot of these posts are really helpful. (Be warned that apparently there is a high likelihood of the LA knocking you back at the first stage, but appeals are very often successful.)

Anyway, all is not perfect now but mornings are a lot better. What eventually worked for DD was to get to school for usual time (appreciate this is easier said than done but maybe if it goes ok Tues - Fri then it will spread to Mondays too?) and then go to a quiet room with a friend for 5 minutes. That way DD avoids the hustle and bustle of lines/bells/busy playgrounds and can join the class when it’s calmer. Obviously this was individual to DD but might be worth trying something similar - she was never up for ‘helping’ with special jobs but this approach achieves the same ends.

Good luck with it all, it is so hard whatever the cause

My DD is in her late to change now but she has suffered from emetophobia since she was about eight this causes a great deal of anxiety and in senior school from about year nine school refusal she's have been having CBT and therapy and I'm managing to get her into school nearly every day.

Have you considered something like that it's more common than we think and also longs runs alongside OCD and other anxiety issues

Thanks for all your insights, lots to think about. School have agreed 2 weeks of half days with a review next week and said she has high sensory needs. DD managed to go in for half a day today and was given a great job to do which she loved. But my god, getting her in was a nightmare. Nearly 2 hours of being firm, distracting her, there were tears, trembling, thrashing, running away, refusing to go in, then panicking because she thought she might be late, real internal conflicts going on. When I did get her to the gate and she saw her friends (who were all lovely to her) she was ok, not great, but ok to go in. We were all exhausted.
When I picked her up she was in good spirits and buzzing, almost manic at one point, telling me about her special job. But this evening she was back to worrying about tomorrow.

I agree re part time timetables. I've seen them successfully used at secondary to reintegrate students. I've also seen them used longer term to prevent the anxiety returning or becoming overwhelming. We have a couple of students who arrive 10 mins late and leave 10 mins early to avoid the noisy transition times. If that is what is required to keep students in school long term, then we'll do it. I know technically it falls into 'unlawful' but it's best for the student, parents want their child in school and the child gets a better education missing 20 mins than missing a whole day.

You have had lots of useful advice here, I wont attempt to parrot what other people have said but I agree you must push for CAMHS as assessments will be by then and depending on your LA, are not always quick.

Do pursue what you can afford privately.

I was the child you describe, there were always issues but around age 9 they were further triggered and I became entirely unmanagable in the effort to get me to school. As a young adult I was diagnosed as Autistic with PDA (which I think I have seen mentioned, it is a profile/presentation of ASD but can present very differently to what you may associate with it - and is increasingly found to have been incredibly overlooked).

These may be of no use at all, but although I wouldn't have chosen any of these methods at her age, as a teen I wished greatly for access to a few things I've seen mentioned - GOOD noise cancelling headphones for class time when teacher wasn't talking, homework done at school rather than home, the option of exams taken in a drastically reduced capacity room, something socially justifiable to keep me away from lunch/break crowds.
We do also (my Mother and I), wish we had pulled me out and homeschooled me. We did eventually find funding via scholarships to finish my High School education privately, this did help some, but we do see with hindsight that when we reached the worst years of my attendance I would have had a better education outwith the school environment.

I don't mean to suggest at ALL that what I explain above would be best for your Daughter, but her behaviour is SO like mine that I felt I should share my experience!

You say she’s worse when DH is away and it’s just you. Does she still play up at all when it’s him? Or does she do as she’s told more? How is she in general when he’s there?

If she goes in ok most of the time for him, I don’t know if that points at you being too soft or him being too hard on her. Perhaps others with SEN experience could comment on that.

Re the good job she had. It would be interesting to see how she’d be if she got told in advance for the next two weeks that’s what she’d be doing. It could take the fear away and give her something to look forward to and take her mind off her fears? That would perhaps get her back into a more normal pattern of behaviour. If it could be arranged?