School refusal/anxiety

[JustAnotherBrickInTheWall]

Where do I go for help for my child?

Ed Psych? Clinical psychologist? Occupational therapist? Play therapist?

I've no clue where to start and I don't want to drag them from pillar to post. School starts again next week (it's a new school) and the shouting and refusal to go have started up again. I can't cope with another year of school anxiety.

Possibly a clinical psychologist in the first instance.

I had this with my dd from the age of 13 (now 20). Deemed to have anxiety for several years and unsuccessfully treated for it, but now awaiting private diagnosis of ADHD (which is a much better fit for her issues - and ADHD in girls in particular is often misdiagnosed as anxiety because all the masking and herculean effort in trying to fit it has its consequences)

My reason for telling you this is use google and do your own research. Don't assume that clinical professionals always make the right diagnosis in mental health - because frankly they don't

I have no advice but I am in the same boat. DD has anxiety and was referred to CAHMS, we did therapy with them which wasn’t helpful. They suggested that we go for a neuro pathways assessment, which I completed and sent to school 2 months ago, but school has been closed!
School starts on Monday and she doesn’t want to go. I’ve emailed some of my issues but I have been pushed back with no suggestions of any allowances. I asked about a ECHP plan and they’ve gone quiet.
They think she can do full days from Monday. We’ll be lucky if she does more than a handful of hours next week.
The irony being she wants to go to school and she wants to do well!

Did you speak to the school last year? What support are they providing?

Apply for an EHCNA. IPSEA have a model letter you can use. An EHCNA is helpful because you can get assessments e.g. SALT, OT, psychiatrist, clinical psychologist without sitting on the normal waiting lists. And if the LA agree to issue an EHCP therapies can be part of the EHCP. @JubileeTrifle you can apply yourself.

If DC is compulsory school aged and can’t attend school, including because of their MH, the LA must provide a suitable, full time alternative.

Ask for a referral (or in some areas you can self refer) to CAMHS - will be a very long wait, but better to get on the list sooner rather than later.

Our schools answer is to give her access to the quiet classroom. Where they love her as she is quiet and studious. She finds it horrendous and oppressive and has breakdowns if she is in there too long from the lack of interaction.

Ive got the form for the EHCNA open. I’m giving them a few days grace to see if they actually do something next week.

Nothing to add to how to move forward other than to echo what Thatsnotmycar has written.

I would like to add that you maybe best not referring to this as school refusal and framing it as school not meeting needs. It puts the emphasis back on them and the LA/ other profs and agencies. Also, it's true. If your child was having their needs met they would be OK to go to school.

Also, request the referalto camhs as part of the ehcpna, it's a reasonable request giventhe circs and they should assess within the needs assessment timeframes. If not you can raise it at appeal.

I agree with applying for an EHCP. If you can afford it get a private Ed psych assessment as it will be far more through than an LA one.

I think involvement from an educational psychologist would be your best bet. An EP could help to set up a plan with the school, you and your DC to help them feel better about coming into school. Where I work, CAMHS won't support with school anxiety. An EHCP application is not necessarily the most helpful route. It can take a very long time from application to issue (if it's even agreed) and you really need something to happen for your DC now. The longer they are off school, the stronger their anxiety is likely to become. A school should not need an EHCP to put in place the sorts of things that most anxious children need.

I would also suggest you apply for EHCNA. The CAMHS waiting list in our area is beyond ridiculous, so if you can afford it, would recommend seeking out a private educational psychologist who is also a clinical psychologist. We were successful in geting an EHCP (after an appeal) and moved schools to a much smaller, quieter school. Although we did get the EHCP, the LA refused a CAMHS assessment as part of the EHCNA, even though we specifically requested it. They also refused to include any CAMHS therapy within the EHCP. If you have a private report it will give you some ammunition to fight the LA with. If you can't afford to get any private reports, don't let that put you off though - you can apply without any diagnosis. For us, the move to a new school was very successful and the school refusal never resurfaced. Fight for what you know your child needs.

@Justrealised I don’t like refusal either, it makes it sound like it is an active choice, doesn’t it?

An EHCNA request absolutely is the right way to go. No one is saying an EHCP is necessary for school to provide support, or for the LA to provide alternative education. They are saying an EHCP is the way to legally guarantee support that is otherwise typically unavailable and enforce those rights.

Personally, unless money is no object, I wouldn’t seek an independent Ed Pysch at this point. If you need to appeal any EP assessment now may be considered out of date by the time you get to a hearing. In the past reports up to 2 years old were considered recent, but in the last couple of years SENDIST have considered reports much younger out of date. Also, you may find the LA EP assessment is OK, but you need e.g. an independent OT and SALT.

If you need to appeal and can’t afford independent assessments and aren’t eligible for legal aid Parents in Need can sometimes help fund assessments.

Yes anxiety is a better description. The school is private, we can afford private help fortunately but I don't know where to start. I've had a psych Ed recommended but they are full and not operating a waiting list. Who could assess for ADHD/ASD?

Also for those of you whose children have been assessed for ADHD/ASD, how did you explain to your child what the assessment was for? Did you even explain or wait until you know the results? I'm not sure I'd even get my child to go to an appointment.

Is an anxiety a better description? The anxiety is no doubt real (as it is in my dd's case) but could be a symptom rather than the root cause see here. Just don't rule anything out at this stage

this link on school anxiety and refusal

I think anxiety describes it well, but as Limitsup posted, the anxiety is often caused or exacerbated by other unmet needs, and if those needs were better met the anxiety would lessen.

You could tell them you are going to see someone who can help help you understand why they struggle with certain things and how you can help them. Many DC by this age have already realised they are ‘different’ to their peers, and some have even worked the diagnosis out themselves.

The LA’s duties apply equally to independent schools. Ed Psychs currently have very long waiting lists. A psychiatrist can assess for ADHD. A gold standard ASD diagnosis should be multidisciplinary.

Thanks for the links. There might well be an underlying cause to the anxiety, we won't know without an assessment. DH and I disagree on this, he thinks the issues are environmental and that she just needs to build resilience and push through the anxiety to learn that she can do it, otherwise it becomes a bigger deal next time.

Hi , we took my son to a private psychiatrist , we knew he had ADHD and other traits just by his unwillingness to learn at school his outbursts . The school wouldn't help and he was at a crucial time where he had to get an assessment for a report and waiting for a referral on the NHS we were told would be 7 years . He was 11 at the time .
He didn't want to go but I said to him that it would stop the horrible time he was having at school and he would be able to sleep better , that we would try for a couple of visits and see how we went . We did just that , his psychiatrist was fantastic, she put him at ease straight away . She said at the first meeting that she wanted to apologise on behalf of all the teachers who said he was naughty , because he wasn't . He smiled and said , thank you . It meant so much to him .
He kept seeing her until he left school , she helped him through with medication and therapy , however once he left school he didn't need medication anymore .
He's 23 now and all that's behind him . I remember our first psychiatrist meeting and his Doctor said , he will grow out of it , I know you don't believe me but he will .

Have you considered that maybe that particular school is not the right one for her?

How old is your DD?

Louislong that's so encouraging that it all worked out!
DD is 11, she's not naughty in class, In fact her teachers say she does really well. She struggles with transitions and sticking at anything however. She's an only and hates being on her own without a friend, she's permanently bored.

This very much sounds like my niece . The traits are exactly the same . I am trying so hard to get my sister to get help for her . She thinks by getting her moved down from top set to middle will help her.

She is so very shy , she is very well behaved at school but is very slow at completely at some subjects in class . Her grades are excellent though .

At home she is different towards my sister , her behaviour is intolerable, more of what a teenager is going through . I am convinced she has adhd with Autistic tendencies ( which go hand in hand ) .

My sister went to the school , the doctor , she got referred . She got refused help because the school said she was ok at school . Now she has left it .

This is exactly why I want to get some help directly as the old school won't be doing anything for us and she's too new for the new school to do anything for a while. Hope your sister gets some help, it's exhausting.

It is , you do need to keep badgering the doctor and the services . I friend of mine did until they got so sick and tired of her sitting outside the their offices they helped . She had 3 boys all with adhd, one with dexpraxia too . Once everything was put into place at school the eldest with the most concerns for my friend came out with A's in his GCSe, did his A levels and is now doing his apprenticeship.

I fought hard every day for my son , every day the school would phone me telling me the negatives he would be doing , I would fight back . From year 7 onwards it was a battle to keep him school , if they had there way they would of thrown him out , they didn't need the hassle . Despite the diagnosis it was a hassle .

My son did well at school but not because of them , I had to fight for everything he got . Extra time in the exams . He was entitled to sit in a room supervised and not in a hall . He could have a time out card when things got too much in class . The thing is my son wasn't naughty , but to them because he didn't just sit there he was .
He left school and trained to become a Tree surgeon .

At my youngest sons parents evening they asked how he was I told he was great and they then asked what he was doing for a job , half expecting me to say he was unemployed. The look on their faces when I told them . They said that it was excellent he had achieved that , I turned before walking off and said , this was his doing , determination, hard work and nothing to do with them as they had failed him miserably!

I wish I had taken a picture of their faces .

Your daughter is ok still to get help and there is help out there to get . It doesn't matter if she's new at the school . If the school has senco sound them out . Tell them your concerns and they will assess her . If you then feel it's not going anywhere then try elsewhere. School is the best place to start first .

Hi sorry you're going through this too, it's tough on the whole family.
If you Google emotionally based school avoidance for your area you'll find a fairly new set of guidelines for schools. I think you'll find this useful as it's what schools are following now.
I'd also recommend a Facebook group called not fine in school, useful for support and advice.