EHCP question. Is it worth mentioning this? And what provision could I ask for?

[TheGardeningGrail]

DS is in Yr7 (heading in to Yr8). He has ASC with sensory processing.

We still have issues with toileting (wee only). He goes to the toilet but his pants constantly smell of wee and need to be changed after school or before any extra curricular.

He does not have a medical complaint relating to this. We don’t know why it keeps happening. I’ve had numerous talks with him about toilet hygiene, but it either doesn’t sink in or it’s just not happening. I don’t know as obviously I’m not present!

We are currently awaiting support from the NHS enuresis service.

DS was refused an EHCP in year 6. We did not appeal but along with a host of other issues, I plan to apply again. His school are unsupportive but do not know about the toileting issues . DS has begged me not to tell them.

What kind of support would you expect in place for this?

If it is related to sensory issues, sensory integration OT could help.

Support could be provided to remind DS to go to the toilet and change when necessary.

@Relaxinghammock Sensory integration has been looked at but unfortunately the sessions are so expensive. His school would never agree to fund them either.

A sensory OT assessment can be part of a EHCNA, and ongoing support included in an EHCP.

Unfortunately in our area, OTs do not offer sensory assessments. DH and I could potentially fund an independent report but we could not fund ongoing sensory OT.

I also think school would refuse to fund private sensory OT and I’m unsure if independent reports can be used to fulfil section F as there’s a crossover between independent and NHS? Does it not become too confusing?

Even if sensory OT is not commissioned in your ICB a sensory OT assessment can be undertaken via an EHCNA and ongoing SIOT via an EHCP.

Independent reports can be used for EHCPs. With an EHCP sensory OT can be funded.

@Relaxinghammock I was unaware of this and will certainly be looking in to this now. 😊

@Relaxinghammock I have had another chat with DS in an attempt to get to the bottom of this issue and to figure out if it’s sensory related.

DS says he will need the toilet, but then a second later he feels like he does not need it. Shortly after that, he is desperate and does not quite make it to the toilet in time. He also does not feel when the pants are wet (they are not sodden but there has definitely been a leak) . This sounds like a sensory issue to me?

Yes, it sounds like it could be sensory (interoception) related.

Whilst it coming up to the school holidays - what's a real pain but might help him- every hr on the hr even if he doesn't need to go to the toilet - set an alarm on iPhone - go to the toilet and try for a wee. Literally every hr all day. See if that helps as they don't know they need to go to the loo ..... if it starts helping maybe you can push the time back to 1.5 hrs for the wee. But they forgot / can't feel like they need to wee bit if he gets into a habit of going to the toilet (plus after breakfast / lunch etc) with or without the need for a wee then it might help ....

Wrt provision, initial things to try are presumably stuff like giving him a watch with an alarm that tells him to go to the loo and try a wee at the start of every break, and possibly pads to soak up anything that is making him smell at school? These address symptoms rather than underlying causes but may be enough?