V low attendance due to illness - how do we manage GCSEs?

[TheMildManneredMilitant]

Hello all, I could really do with some ideas as don't know where to go.

Dd is in year 10 and massively struggling with school attendance. She's nauseous/exhausted most of the time but still nothing diagnosed. (We've had multiple blood tests, some things like low iron and vit d identified but not shifted even with treatment).

She's probably at 40% attendance for the year and now we're on an agreement with school to do an hour a day, with a view to building it back up. I don't see her getting better and don't think we're ever going to get to full days. We have some core work to do outside of that which she's completing, but there are whole subjects where she hasn't had a lesson for weeks.

She's really bright but must now be so far behind. We can supplement some work at home through oak academy and look at some tutors but I just feel so overwhelmed by it. Me and Dh work full time and can't be there to constantly teach/cajole her.

We've got mocks this week - if she can get in for them. That'll give us a baseline. But beyond that just don't know how to manage this.

Any ideas about how to get her through her gcses? Or anyone been in a similar position and can offer reassurance it will be ok eventually?

Hey sorry you are all going through this it’s so tough and we can only be as happy as ours kids. I remember how stressed I was.

But we’ve been there - I won’t go into the why’s too long - bur my daughters attendence was at 23 percent for year 10 and 11 and she managed 7 GCSE’s at 7 and above including a 9 in Art. We were beyond proud of her. How did she do it ? I still ask myself that but sheer determination on her part. She studied and studied hard, and we guided her and encouraged her. I think having a goal to work towards helped her, she knew what she wanted to do at collage and she hooked onto that.

We didn’t pay for any tutors, but we paid for some online learning website that was called edspace (i think) and also nearer to her GCSEs one that assess’s their practice exam papers and tells them their predicted grades and how to get the grade up (she found that really useful). Back to Edspace that was really good it assesses them and tells them their gaps and sets work to plug their learning- it is for English, maths and science. Cost £15 a month but so worth it.

We were also lucky the school was so supportive, but they knew she was bright and would bump their grades up if they just allowed her to do it her way. But honestly it was all her, if your daughter is bright, like you say she is, then she needs to dig deep and study it can be done if she really wants it.

Goodluck OP I hope it all works out - my daughter is much better now, attendance at collage still not at 100 percent and she has good and bad health days- but again they have no worries about her work so are very supportive.

DS 18 wasn't in school from year 9 to sixth form due to anxiety and an eating disorder. He's now got an EHCP and is doing his GCSEs with plans to become an aerospace engineer. If she has support from school and the LEA, she can do it.

Also wanted to add we never put pressure on her. I said I believed in her etc but that it doesn’t define her and she can always do resits and we will be proud of her whatever the results. And genuinely, other than art, I had no idea she would do so well. It really was all her, it actually chokes me up still to think about it all.

Has your daughter been tested for celiac? Just a thought as that can lead to those deficiencies and exhaustion

Sending my best wishes. My dd is midway through GCSEs on about 50% through Ys10 and 11, due to anxiety and possible POTS. It's tough; I wish you lots of luck in getting support.

Please be mindful and I don't mean to 💩 on anything but if she's wanting to do A levels then you need to be aware that they are more intensive than GCSE so if she can't get herself into school she will really really struggle with A level. Id be pushing for a standard ART course if that's her area of interest..

Hi op. My dd hasn't been to school at all for nearly 3 years. She is joined up to KingsInterhigh and about to into into year 10 and start her gcses. You can study in different years for each subject ie if your child was behind in x you can have them join the lessons of the year below. It's not particularly cheap, it'll be around £7.5k for year 10 but it's a decent option.

Could she manage an online school? Many of them have packages for five subjects, so she could do the three core subjects, plus two more that she enjoys and will be relevant for her future studies. It would be less demanding and stressful than going to school. I think they charge around £4-600 for five subjects, but there are a few to look at.

My DD (now 19) was the same as yours. Stomach problems, severe exhaustion, and about a 35% attendance rate in Year 11. We had various meetings with the school about her attendance and she was seeing a specialist in London for every test going. In the end they diagnosed IBS, but I knew this was wrong.
School would make no real provision for her, and they did not offer any additional help in preparing her for GCSEs. They also wouldn't let her reduce the amount of subjects she took.
The only thing they offered was that she could take her exams in a separate room to all the other students, in case she needed to rush to the toilet.
She managed to pass all her GCSEs at grade 5 or above as she was quite bright, but the results did not match her potential.
We deferred college/further education for a year, and in that year I pushed for a second opinion and she ended up at Great Ormond Street and diagnosed with one gastro related condition, two rare vascular conditions and a heart problem, all congenital.
She has just finished the second year of college, and she has coped much better with a 3 day course.
I am very proud of her!

I would make the next school meeting produce a written minimum GCSE plan, not just a hope of building attendance. For each subject: keep or drop, exam board, missing topics, how work will be set, who checks it, and what happens if she is too ill for mocks. Then prioritise English Language, maths, science and one subject she wants for the next step.

My DS didn’t attend school from year 9-11. We had similar in terms of feeling sick, being absolutely exhausted and in the early days barely being able to get out of bed. When he did manage something, it would wipe him out for the rest of the week. We eventually saw a paediatrician who diagnosed him with post viral fatigue, and said it would take 2-3 years to get better, and gradually he would notice that things would start to feel better, and he would begin to manage more.

LIke you, I was so worried about GCSEs and what impact this would have for him. Up until the time that he was ill he had been doing really well at school and was being predicted high grades. Obviously the longer, he was off the harder it was for him and he went into school when he could. This averaged 2 half days in week in year 10, and 2 full days a week in year 11 during the first term, but in the second term his attendance took a bit of a dive again. I think this was partly due to him realising he’d missed so much it was going to be so difficult to catch up. One of the challenges when they are unwell, is that there is only so much they are going to be able to take in, and the reality for my DS was that his body wasn’t in the space for learning. We reduced the number of GCSE’s that he was sitting, he did the core maths, English and sciences and a couple of subjects that he enjoyed. He did ok, considering he’d barely been at school and scraped what he needed for the next step. His school had said they’d be happy to have him for a-levels even if he didn’t quite get what he needed as they knew the background and knew he was capable but he decided he wanted a fresh start in college and honestly hasn’t looked back! He’s just finishing yr13 now.

Throughout it all we prioritised his mental health over school attendance to some extent by encouraging him to maintain his friendships. Friends are really important to him so he went out at the weekends with them when he was able. This helped him hugely so that he didn’t feel isolated and alone, and it made going into school on the days that he could easier as he had social connections and people who were pleased to see him.

The biggest adjustment I had to make was to my own expectations, and worries about him not doing well at GCSE. I was so worried about how how this could affect his whole life and what he was missing out on. I was feeling anxious about it and was upset and crying a lot!! I was constantly looking for an explanation and seeking a diagnosis that could explain why he was experiencing the symptoms that he had. Honestly, it was exhausting. It was hard to watch him going through something so hard at such a formative stage until i started to realise that it didn’t have to be and that my reaction to the situation wasn’t helping anyone either.

There are so many different routes that people can take and still achieve the things that they want to, it doesn’t matter how you get there. Health has to take priority. Once I started to accept this it got so much easier for me to deal with too. There’s always a plan B, C, D and E was what I kept saying to him.

Sorry this has turned into an essay OP, what I came here to say really is that it does get better, they get better and life moves on. Think about what is important to her and focus on that, also make sure you look after yourself too!

I agree with talking to the school/LEA about alternative provision. I had a few pupils who did this - they remain the responsibility of the school and remained on my register but the actual teaching is done by specialist providers (sometimes online). Don’t worry about the teacher - all I had to do was mark their mock papers (which I would have had to do anyway!) Ask about something like Tute https://www.tute.com - or there may be something local to you.

I have had similar issues with my daughter due to illness. You will need to speak to your LA about S19. Section 19 if the LAs duty to provide suitable education to a child who can not attend school due to illness. You DO NOT need an EHCP or anything like that, or a diagnosis. Your child just needs to have missed 15days off school or be expected to miss 15 days off school. These 15 days do not need to be in a row, they can be spread out.

The agreement of 1 hour a day, this needs to be a recognised part-time table and should only be in place for 6 weeks with the objective to increase attendance to full time. This seems unlikely in your case. And part time table she be properly done with the LA aware and in agreement. The part time table should also be reviewed regularly.

Ask your school to do the joint medical needs protocol. This will mean that her medical professionals and school share information so that appropriate support can be put in place.

My daughter has S19 now and its working out much better. If you Google your area with "alternative provision local offer" you should be able to find a list of providers and see what is suitable for your child.

Ive been there and done it all so if you'd like any further help then feel free to ask

What I'm wondering is whether the school environment is part of the problem or making things worse? If so you might want to think about 100% home tutoring (funded by the LA) rather than her keep pushing herself for 1 hour a day. I think there's medical tuition available, or as part of an alternative provision package.

Lots of good advice already - I just wanted to suggest checking for Lyme Disease if you haven’t already? It’s an easy check even if you don’t remember her ever having had a tick bite.

@TidyLurker I feel like I could have written some of that post and I'm so glad to hear things worked out, thank you for sharing.

Thanks others for suggestions as to what might be going on health wise. She's definitely been tested for Lyme, low thyroid, celiac, vit deficiencies. So it could all be mental health, but it just never felt like that at first although it's definitely being impacted now.

Also - could your daughter have Long Covid? There are about 2 million of us. Having caught a mild dose of Covid in January 2021, I'm only just now almost recovered. If I do a lot of physical stuff, I pay for it with the sort of fatigue that feels as if my batteries are almost empty. Today I've been to church, visited friends in a nursing home and at 4pm am really tired. Daren’t tell my husband as he'd make sure I didn't do so much and that would make me sad. There are no tests for LC, but our GPs seem to understand that it's a definite problem... Lots in common with ME

Have they checked her for Addison’s disease, do you know? You may have to request the doctor specifically check.

It can make you critically ill if untreated so it’s worth asking a doctor about.

It may be worth exploring some other options than A levels. If her health issues persist and her attendence remains at this level she will struggle to 'catch up' with A levels as they are a big step up from GCSEs

My dd passed (with A’s or a*’s) 12 GCSE’s on very low attendance (asd, complex mental health issues and some other stuff) by self studying the materials her teachers gave her and study guided, those cpg? ones. I did cajole a bit at the end but to be honest she revised very little. The actual quality of material for gcse isn’t huge, teachers spend a lot of class time dealing with the class so a reasonably bright child can learn the material quickly, using a tutor if they struggle in a particular area. Every child is different but her school were convinced she would fail yet, not so much!

Have they ruled out a Functional Vit B12 deficiency? You can’t rule it out if they have only tested serum / total / active B12. You need to get the metabolites tested (Methylmalonic Acid and Homocysteine) - GPs can’t refer for these, it is only hospitals that can refer for these blood tests. Essentially, a Functional Vitamin B12 deficiency is where you have high levels of Methylmalonic Acid and / or Homocysteine in your blood, (but ‘normal’ B12 levels in your blood) as it happens when your body is not able to use B12 at the cellular level, even though you may have lots of B12 in your blood. Vit B12 keeps MMA and Homocysteine levels down… when the levels of these metabolites get high it causes a lot of damage.

Also for those on this thread with Long Covid and ME / CFS, i think there is research out there showing that Vit B12 injections can help (i think ME has been linked with high Homocysteine levels in the brain?). Worth looking into anyway, if anyone is interested.

(I am not a doctor, but I have a functional B12 deficiency)..

There's options like online schools now as well, like Minerva, and they vary in cost and hours. If you are looking at tuition it's worth knowing the main platform types in the UK whether you are looking for online or in person:
commission-based (MyTutor, Tutorful, Spires - platform takes a cut each lesson between 18-49%)

one-off finder's fee (Tutorperch) - you pay once to get the tutor's details then deal directly with the tutor you have chosen, no commission

monthly subscription (Superprof)

premium agency (The Profs, Tutor House) - higher rates but more involvement, sometimes chose the tutor/s for you).

Sorry if someone has already said this, but it sounds like Coeliac disease to me! It’s autoimmune and often very overlooked by GP’s. I got diagnosed by accident!

Can she repeat y10?

I'm ADHD, I have had exhaustion for so many years, so bad that I worked a maximum of 25hrs pw. Once I started on ADHD meds, it was like someone flipped a switch, within a week the exhaustion had gone and I work full-time since around 3 years ago. Also sleeping much better, having a positive impact on the next day.