DD not able to stay in all her classes due to health issues - what should the school be providing re teaching time?

[SirChenjin]

Quick background - DD (15) has severe anxiety-related IBS. Currently under a Paed Consultant and waiting for an appointment for guided self help and CBT with CAMHS (4-8 months waiting list). Has also had 10 sessions with a private counsellor.

The main problem is that she finds 'quiet' classes very stressful as her stomach and bowels make terrible noises, and the anxiety this produces is so severe and sudden that she experiences terrible pain and has to run to the toilet before she soils herself. As a result, she now sits out of these classes and works in the library by herself. Although she gets work from those teachers, she is missing out on teaching time - and as a result her grades are suffering. She has very important exams coming up this year and the next 2.

Is there anything that the school or LA should be doing to ensure that she is getting this teaching time? We're in Scotland, if that makes a difference.

If she's getting the work provided I'm not sure that there's anything else that could be done. Certainly in my school there's no spare time for a teacher to give 1-1 unless they give up lunchtimes etc of their own goodwill - but quite often lunches are already taken up by marking or other catch up or revision classes.

Could she have home tutoring? Is there any possibility of a part-time timetable - so in school for some lessons and home tutoring for others?

A home tutor for that number of hours across the week is out of our financial reach, unfortunately.

Would the school consider some sort of.background music or something so she could attend class?

I have absolutely no idea but couldn't read and not post. Does this count as a disability? I'm wondering if there is any way your dd would be eligible for any funding so you could use it to pay a tutor.

Is the school or the local authority signed up to any online learning packages like SAM Learning that she can access?

No, they won't have background music on - it would disturb the teaching I think. She listens to her headphones in the library and that seems to help.

How would I check to see if this counts as a disability? Sorry, this is all very new to us and we've no idea what we're doing.

What are online learning packages? That sounds interesting...

Can't she Skype into some lessons? There she'd get the participation and teacher experience as well.
The only accommodation the teacher would have to think about if for group work.

I am sure there are others out there but my DC's school has a SAM Learning account for each student, it seems to work on a 'test yourself then get feedback' system.

It is possible to buy a single user GCSE package for £49 - something the school might do as part of their access arrangements if that's out of your reach.

link

Just some random suggestions:

Has she/you explored her sitting at the end of a row next to a sympathetic friend or two and not bang in the middle of the class?

When is she at her most anxious? Is it when the teacher is talking/ teaching and interacting with the class? Or is it when they are working quietly on their own? Could their be instances when she exits the room after the teaching part?

Is hypnosis a possibility?

Oops there

How would I check to see if this counts as a disability

It is a disability under the Equality Act if it has a substantial and long term effect on her ability to do her normal daily activities. There is no hard and fast list of conditions that qualify.

Substantial means the effect is more than minor or trivial. Long term means 12 months or more.

That's probably as clear as mud. Sorry.

Thanks for the heads up re the eLearning. We're in Scotland, so the SAM Learning isn't appropriate for our curriculum but I'll check to see if there are others out there which are relevant to Scotland.

We've played about with different seating arrangements in class, but it's the silence that upsets her and causes the sky-high anxiety/immediate physical symptoms. The classes aren't really taught as a teaching block followed by a point at which she could leave - and when she does leave she has to put up with the inevitable questions. Hypnosis is a good idea - I will definitely look into that, thanks.

Re a disability - do we need to get a GP or someone to confirm that it is a disability? It would be fantastic if we could get help towards the cost of tutoring.

If she was so ill that she was at home all the time, the amount of suggested teaching time is 3-7 hours so I don't think missing a few lessons will generate any funding for extra tuition.

www.gov.scot/Resource/Doc/158331/0042883.pdf

I think that was updated last year - will look at the Govt guidelines in more detail and see if there's anything that might cover her situation.

At our school students are issued with a white card if they have a medical reason for needing to leave the classroom.

The students just show the card and we let them out without questions. As a safeguarding issue we record who has left the class, whether on a white pass or for any other reason. Is that something that could be implemented?

I hope a solution is found soon.

She already has that card, and has the key to the teachers toilets which means that she can just run as needed to the nearest loo (the school have been very helpful and supportive) - but the pupils in her classes tend to ask her where she was or what the matter is, and she finds it hugely embarrassing.

It sounds like a frustrating situation. How does she know if it is going to be a lesson she can attend or not, does she go along anyway but excuse herself if she can't stay?

If the school is letting her use the toilet as she needs to and giving her the choice between being in class or being set lessons for private study they could probably argue that they are fulfilling the requirement to make reasonable adjustments.

Depending on what subjects it is there are lots of useful videos on YouTube and places like Khan Academy, you could spend some time with her in the evenings working out which bits she isn't understanding and find things together.

I have stress triggered IBS although mine is not as severe as your DD and I utterly sympathise. Back when I was at school the IBS element of my anxiety hadn't really emerged yet although I did used to be sick every morning so I have no direct experience of what your poor DD is going through. I do think the school need to be making more of an effort to help her cope though. This is debilitating, and must be making school such a negative experience for her. Is there a pastoral support person you could talk to? Come at it from an emotional health angle? The obvious issue is that the more of an issue this becomes the more it will feed into the anxiety and the IBS episodes will get worse. That cycle needs to be broken. I'm struggling to think of how it can be achieved though. I think an audio link from the class to her in a different location is the answer. So a skype link without video and only one way so the class doesn't necessarily know it's on. If she's allowed headphones in the library then she could sit in there, laptop connected to the skype feed and headphones in so as not to disturb others.

When I was doing A-Levels (not that long ago, I'm 24 now) I had difficulty attending school for different reasons, and my head of year gave me a school laptop to use. The idea being that teachers could then email me copies of the PowerPoint presentations they used and I could access them anywhere on the school property which was vital as often It rooms were full an almost all my work and communication with staff was via email. So if back then they could provide tech for someone struggling but not classified as disabled I don't see how they can't be accommodating now. I'd push it OP. Make an appointment to see head of year and a pastoral person and push that she wants to learn, she wants to participate, she can't and she needs support to enable her to access education in a way which won't have a negatived impact on her emotional and mental health.

She now avoids these quiet lessons altogether - which is hugely frustrating, and something that we (and the CAMHS team) agree needs to be addressed.

Although she gets the lessons, she doesn't get the teaching time so struggles to make sense of some of them - maths in particular. BBC Bitesize and Youtube is helpful to a point - but it's hard for her when she doesn't understand the concept, iykwim?

Sorry - I'm sounding really negative, I don't mean to . This has been going on for many months now, and she's in real danger of not passing her Nat 5s and getting onto the Higher class in key subjects - not because she's mucking about but because she physically and mentally can't stay in every class. She's a bright, hard working, polite, lovely young woman and it's heartbreaking to watch - if it was a physical thing she'd have been treated by now but the time between our initial visit to the GP and being seen by a psychologist will be more than a year.

Shadow - thank you so much for that post, it was so helpful. It sounds like you had a really rough time of it. If you don't mind me asking, what treatment you got for your stress related IBS? I'm going to phone Pupil Support now and make an appointment to see what more can be done. Using IT more is something that we will definitely look at. The school have been great to date but I feel that we now need to push for more support, especially as the next 2 years are so important.

Following on form OddBoots are there any supported study sessions after school that could provide a short catch up opportunity for her most critical subjects?

If you can't afford a tutor could you get a sixth former to help as part of their Duke of Edinburgh volunteering element? Obviously a sixth former doesn't have the skills of a qualified Maths or English teacher but if your DD is a linguist you might find a native language speaker among the pupils for example...

My eldest worked out that other schools' websites also publish info on the syllabus and notes which can be helpful. For example say they are studying specific poets sometimes another school's English Dept has a slightly different approach or does them in a different order that sort of thing... Could be worth a look.

I'd second using Skype too and if not Skype then a sound recording of the lesson would be useful . It would be so easy to do.

Thanks for all the suggestions

I don't think a 6th Year would work sadly - they have exams coming up themselves and have already allocated their volunteering time through the Saltire Award, plus the idea of being somewhere quiet and sitting next to someone with the bowel noises going on puts her off the idea of a tutor. She does look at other schools websites, and finds them helpful.

I will definitely look at Skype/recording the lesson. Does anyone know if there are any issues around confidentiality etc I need to be aware of?

I'm glad it helped. You mentioned Dd is under a consultant? That's great because when I was younger IBS wasn't really something that was diagnosed so as a child I didn't actually have a diagnosis or medication for it! My medical notes say "morning sickness" at the age of ten due to the throwing up every morning and whenever stressed and this then mutated to IBS by my teens. At that time I used to take over the counter standard immodium type drugs whenever I had a flare up. As an adult with a diagnosis my GP took the approach of treating the anxiety as he believed the IBS episodes were a symptom of the anxiety rather than a separate condition. However I then had two pregnancies and didn't like being on anxiety meds while pregnant as there was conflicting advice about whether it was safe or not so I came off them. Tbh they didn't do a great deal to reduce the episodes anyway, I'd just be less aware of them coming on.

These days I just sort of cope. Have immodium for really bad episodes and have prescription anti emetics in the cupboard for emergencies. I was hospitalised twice in the last few years with severe abdo pain and they think that was connected as they occurred at times of trauma/distress and nothing could be found on scans or X-rays. If it happens again I will be referred. I've got used to knowing when I'm likely to have a flare up, what my worst triggers are and rather than pumping my body full of drugs I try and manage the triggers. Lying down in a dark room doing some deep breathing and focussing on finding "calm" often staves of an episode. I'm sorry that I can't be more helpful or suggest a miracle cure. It's really very unpleasant and IME not treated in quite the same way as non anxiety/stress IBS. Doctors have always been quite dismissive and reluctant to prescribe.