EHCP in a private school

[Acronymsandinitialisms]

My son, 8 and in year 3, is on long waiting lists with CAMHS for autism and ADHD.

He's bright, fun and interesting, but needs support with his anxiety and impulse control (hitting other children when provoked and shouting out in class being the most concerning and problematic). I really want him to stay in his current school as I think moving again (he moved into yr2 and this is his first proper year there because of lockdowns) would unsettle him, and he would think/know that it was because of his behaviour, and that would hurt him. Also, small class sizes, buckets of sport and outdoorsiness that work well for him.

A couple of people have mentioned looking into an EHCP. I don't expect this to cover school fees - we are fully prepared to do that - and I'm wondering what practical benefit an EHCP might have in a private school, and whether the school might be able to use it as an excuse to get rid of him if they decide they can't meet his stated needs. They are already talking about needing to find a new school if the hitting continues (it's roughly once or twice a term, usually in unsupervised time like in the playground and sometimes in response to someone hitting him first), and we're working hard on addressing this behaviour at the moment. If the EHCP offers any degree of protection from expulsion or access to additional resources in his current school then I'd be keen, but I don't want to give them the tool with which to lever him off their books.

We are considering private assessments, but this is very, very expensive, we're not rich, and these also have a waiting list, just not as long! Any advice/experiences welcome.

Following

Does anyone know if we can stay on the CAMHS waiting list and benefit from their recommendations when we reach the top of the pile, or is the fact that we've gone private going to mean that we are dropped from the NHS route? The report I have is almost entirely narrative apart from the conclusion that he has ASD and not ADHD and offers little insight into his particular difficulties. The school recommendations page is just a list of things that a teacher may want to think about for an autistic child in their class, and some of them don't apply to my son. How do I build a list of accommodations?

How would CAHMS know you've gone private if you don't tell them? I'd cross that bridge when you come to it I think. Regarding school, I've worked closely with the SENCO, teachers and the SLT on a case by case basis. For instance, the deputy heads were helpful with i) school refusal and ii) adjusting the PHSE system respectively; the SENCO works on academic and social skills; the music head and science head have needed me to point out that a) just because DD agreed to play a solo in assembly doesn't mean she actually can/will and b) no way Jose is independent science research happening over the holidays.

It is q private school though. If you're dealing with a state school they may not have capacity to do much which is why ECHPs matter.

As you can see from these examples, DD is what they used to call high functioning, but that often makes staff forget she really is quite impaired in some ways.

It is a lot of work...

Thank you, @Phineyj - been a longish road for my two, but I think we're there now.

OP there's specific guidance in the NHS which sets out that people who go privately must not be disadvantaged, or denied NHS provision, on that basis. However theory and practice are not always the same, and as Phiney says, if you go privately there is no reason to tell anyone unless you want to do so. It doesn't go via your GP, unless you want it to, so just say you don't consent and explain the reasoning.

When I have wanted info shared (eg the ADHD diagnosis) I have had to do so, too. It's never been done by the private clinician. So you can decide on what works best for you.

I'm afraid my experience of CAMHS is that they are a very troubled service, and very impacted by funding. In our area, they are also controlled by the LA, and not the wider NHS (though still NHS funded) which rather compromises their objectivity, given the LA is also tasked with funding educational provision. The average block of sessions is just 6, which for most children is barely enough to build trust. For diagnostic purposes they are still fine, I think, but I'd be wary for treatment, now, to come via them. Which is heartbreaking to have to say, given the implications.

Oh, and diagnostic reports are always narratives, followed by generic recommendations. That's why I said I don't think that diagnoses are that valuable, in comparison to OT, SLT and ed psych reports. They don't specify how the diagnosis impacts the individual child, let alone what needs to happen to meet those needs, which the other reports do.

Again, we paid to have my son diagnosed, and nothing happened till we paid for SLT, OT and EP assessments, several years later. With my daughter we paid for SLT, OT and EP assessments, and then her EHCP was granted before her state-funded diagnosis was made.

A diagnosis tells you why your child has needs, but not what those needs really are, far less how they should be met. By itself I think it's fairly worthless, tbh.

@perfectstorm that's very helpful and makes a lot of sense, thank you. I have a meeting with my son's counsellor next week and am trying to get in touch with his OT. We never paid for her to do an assessment as we were trying to save money but I'll definitely book one now.

To add, a diagnosis via CAMHS may not result in the support and recommendations you want anyway. Many are diagnosed with a basic report written and promptly discharged.

@Acronymsandinitialisms I would just stress that you need a medico-legal person to assess, if you want careful and precisely specified recommendations. Otherwise, you could end up with another very general report, which won't achieve much.

Think of this as being like a builder - you need to make sure the one you use is competent, and also that they aren't competent at an area wholly different to that you need. You'd not want one who specialised in building roads to do a kitchen extension.

Yep. In fact I don't know anyone whose child is able and autistic who has had any other experience, over the past few years at least.

perfectstorm waves, I’m the poster with a DS1 with EOTAS. It was our experience with DD2 and DS3 over 10 years ago and over 5, respectively, one via CAMHS and one via community paediatrician.

I called my local autism advice charity yesterday and they recommended talking to Sendiass about the recommendations, which I'll try to do this week.

Be careful with SENDIASS, some are good but too many are not and repeat the LA’s unlawful policies. They receive LA funding so aren’t wholly independent. IPSEA and SOSSEN would be better if you can speak to them.

Hello, @Imitatingdory!

OP, SENDIASS locally told me my kids would never get an EHCP. My eldest has a high needs EOTAS - meaning no specialist setting was deemed able to meet those needs - and as I've said, my younger has a funded place at an independent school, plus some direct therapeutic provision. They were very wrong.

They've told other people the same, in similar cases. They've also told others not to bother appealing a refusal to assess for an EHCP unless they have a private report saying they need one (including a family on benefits) which is so, so not the law. The threshold is quite low, in fact, and these parents have diagnosed children and struggle in school, even with the school trying to support them. They are clearly well above the threshold to assess.

SENDIASS varies by area, but in many areas they are a contracted service. If companies are competing for an LA-funded contract, the chances they will tailor their provision to that which serves the LA is clearly high, and in other cases, the LA trains SENDIASS workers on what they tell them is the law, and in fact train them on the LA's policies, which are in breach of the law. The same goes for mediation; in almost all areas, I think, mediators quietly allow the LA to mislead parents on the law with impunity. In one case, a Judicial Review was needed to force that mediation company to comply with the law themselves, rather than side with the LA best interest as a set policy.

I would never trust either SENDIASS or mediation companies.

IPSEA or SOSSEN provide all SENDIASS can, but they are parent-led charities. They genuinely give excellent advice, and all they care about are the best interests of children with SEN.

www.ipsea.org.uk

www.sossen.org.uk

Both have useful pages for information on processes, and free phone line advice.

If you could only afford either an EP report or an OT report but not both, which would you choose? He sees the OT every week already, so she knows him.

I haven't really got a clue how to go about finding someone medico-legal. This is all very new and I'm naïve and feeling daunted.

A quick Google for local educational psychologists has thrown up almost nothing useful.

@Acronymsandinitialisms

Search for independent educational psychologists in your area using:
the British Psychological Society’s directory of chartered psychologists

• www.bps.org.uk/lists/DIR

the Association of Child Psychologists in Private Practice

• www.achippp.org.uk/

You may want to make sure they have experience of working with children with ASD/ADHD and of writing reports for EHCPs/Tribunals.

If this is for a SENDIST appeal and you cannot afford assessment contact Parents in Need, who can sometimes help fund reports.

Personally, if you can only secure 1 assessment I would go with an EP assessment because you should already have some evidence of OT needs from the weekly appointments.

I agree with @Imitatingdory, if you could only afford one report the EP one should be the most significant. Because the point of the EHCP is to set out the support your child needs to be educated, and the EP report sets out your child’s educational needs.

OT can be a great additional piece to explain sensory needs but on its own will likely miss a lot about reasonable educational expectations etc.

The Local Authority funded our EP report. In order to make the application we had doctors reports, OT, SALT and clinical psychologist report. We hadn’t commissioned an EP as couldn’t find one. But since the LA’s one was produced no one’s really looked at any of the other reports and used the EP as the main doc for everything.

I think it is case specific and my reasoning of EP over OT in this case is because OT needs are already evidenced to an extent. But in some other cases I would suggest the other way round. EP reports aren’t always more significant than OT (or SALT or other professionals), and just as OT will miss some necessary SEP, so will an EP, as an EP will not cover all educational needs only those within their remit. OT (and SALT and other therapies) can also be educational needs and provision. A child whose sensory needs aren’t met is unlikely to be able to function well within an education establishment. Without evidence OT (or SALT or other therapies) is needed it will not be included in the EHCP.

The LA must always seek advice from an Ed Psych as part of the EHCNA, but unless you are lucky it is unlikely to be as detailed, specific and quantified as an independent assessment.

In order to make the application we had doctors reports, OT, SALT and clinical psychologist report.

You didn’t need all this. The LA may have wanted that but the threshold for an ECHNA is significantly lower - a) has or may have SEN, and b) may need SEN provision to be made via an EHCP. Anything else is unlawful.

I think it depends on the needs of the child, unfortunately. One of the real kickers is that you can't know what a child's needs are until you have them properly assessed, so it's a stab in the dark, working out which reports to do first.

If you have an OT working with your child already, and you recently had a clinical psychologist assess, then personally I would get the SLT, because the LA have to use an ed psych as part of the statutory EHCP assessment, by law, but don't an SLT or OT. So you are guaranteed a free EP report - and autism is a social communication difference, so a really good SLT is also vital, IMO. Having said that, the LA EPs in our area are excellent, at least those who have worked with my two are, so if your area might send a crappy professional to do a cack-handed assessment, then a private one could well be worthwhile.

The main thing is to ensure you have a strong report that supports the EHCP assessment request to begin with. It doesn't really matter which professional it's from, as long as it finds needs sufficient to support the assessment. (Your existing clinical psych diagnostic report may already achieve that - the threshold for an EHCP assessment is pretty low, so if needs are noted that may mean an EHCP is required, and assessment is necessary to establish that, then you're there.)

In terms of private EPs who have lots of medico legal experience and skill, as well as being good clinically: Patsy Kershaw, Lindsay Peer, Jemma Levy, Andrew Allen are all excellent. Medico legal people travel, so they don't need to be local. Our SLT travels to the midlands for us from Sussex, and that's not unusual.

If your child is seeing an OT then you can ask the LA to request a report from them rather than paying for a report yourself. I'd get a good EP report - try to get someone with experience with your child's difficulties and, ideally with tribunal experience (though that often comes at high cost which may not be affordable)

but if you have had no SLT input I'd do that one. The SLT report for my child was possibly the most useful. LA EP report wasn't as rubbish as some. That said my EP (one on the list @perfectstorm mentioned) did provide excellent evidence for the school we wanted and a little more additional support than the LA EP, but I think we might have managed to get the school without the EP report but LA might not have conceded before tribunal so it would have been another term waiting......

@sprongle1 @perfectstorm my son's biggest problems at school are social. Do you have any recommendations of Speech therapists who could do a social communication assessment, please? We're in the south east.

I used Libby Hill, who is excellent for ASD in girls and PDA and I'm sure she or Natasha who works with her would be great. They assess online, but most SLTs that work with Autistic children would do a higher level language assessment and recommendations for an EHCP and there will be ones in the SE. Make sure, if possible, that you see an example report first - you want one where they list outcomes and provision to meet the outcomes in the report so the LA can just cut and paste it in!

I know people who have been delighted with Libby Hill, and she takes a really strengths-based approach to autism, but she's a long way from you. www.private-speech-therapy.co.uk

We use Helen Pearson, also amazing, who is based in Sussex. You would need to book her in now as she's booking into October (just slotted one of mine in for an updated assessment), and to email asking if you can go on her waiting list for any cancellations, explaining the urgency. She may also be assessing a child in your town earlier, and able to see you on the same day - she's assessed both my own and a friend's child on the same day before now. www.kids-communication.co.uk

Juanita Hurley is also excellent, and based in a London clinic so closer, but I think she's expensive. www.londonautismpractice.co.uk/team

I know people also rate Sharon Horswell, who is in Devon: www.autismhopeandfuture.co.uk

Medico-legal people with fantastic reputations often have long waiting lists, as there aren't enough of them - and I wouldn't be tempted to go for someone without that experience and expertise with EHCP level reports, either, as if they don't specify and quantify properly then you can't secure what they recommend. If the wait seems long, book now because they won't get any shorter, and all the above people have parents desperate for cancellations, so if you change your mind even a fortnight before, they really aren't going to mind - someone else will bite their arm off.

I wouldn't personally accept an online assessment for SLT (if the issues are a lot to do with ability to share focus with another person, body language and personal space etc, as it is with my kids, then online assessment can't properly find what is going on - again, it varies so much depending on the needs of the individual child, as that works better for some, including a friend's daughter who can't easily engage in person, but can online...).