First GP appointment today for DD, help me not get brushed off.

[Thedryjanuarydiaries]

I’ve posted a few times about my daughter (12 and Y8) who’s is really struggling at school and at home with her behaviour.

Getting her into school has been absolutely horrendous and I believe she is really struggling as she has gone from quite a shy and quiet girl, certainly to other adults, to a child that is quite reactive.

We have always believed NT from home life and she has been picked up as a child “that struggled with concepts” in primary but up until now it’s never spilled over but I think hormones, mixed with the struggle of a big comprehensive seconds have made it impossible for her to mask.

First GP appointment today (which she will be at) and I’m just looking for some advice on how I dotn get brushed off, what I want to ask for and how I get it.

Previous thread.

https://www.mumsnet.com/talk/am_i_being_unreasonable/4992716-y8-daughter-and-school?reply=132508263

Are you suspecting autism? Anxiety?
I think understand what you would like the outcomes of the appointment to be is important.

@londonsquirrel I don’t know to be honest, she is our 3DD but 1st where there has been any ND and certainly 1st where we have needed extra help..

I would like her assessed or on some kind of pathway but I don’t want to go in like I have self diagnosed her off Google because of poor behaviour (it’s definitely not that) but equally we need some kind of action as it’s affecting her attendance and mood.

At a guess I would say some form of ADHD, due to difficulties concentrating but again I don’t know.

Hi OP, think the key is to go armed with as much data as possible in terms of descrptions of incidents, using examples from two more settings, including information about fequency and severity. If you have any correspondence from the SENDCO/School, refer to it.

Be prepared to explain why this feels unlikely to you to be simply about bad 'choices' in terms of behaviour. You can say you have been wondering whether this either needs to be considered from the lens of possible neurodiversity, and/or whether it is flagging unmet needs in terms of anxiety/low mood and mental health, without sounding like you've gone in for an amateur diagnosis. Good luck!

It can be helpful to look up the referral process in your local area so you know what should happen in your area. This way you can make sure you cover any information the referral/questionnaires need. Write down the points you want to cover so you don’t forget anything.

Separately to the diagnostic process, have you requested an EHCNA? If not, you should - on their website, IPSEA has a model letter you can use. In the meantime, if DD can’t attend school full time, and she doesn’t sound in a position to do so, the LA must ensure she receives alternative provision. Forcing DD to attend school when she is finding it overwhelming to the extent she is, is likely to cause further trauma.

Thank you, the last couple of posts have been really helpful…

I find it so easy to articulate me concerns and what is happening in written form but not so much when face to face and worry I’m not advocating for DD as well as can do so I’m really grateful for any/all advice.

@SearchingForSolitude Can I ask what a EHCNA and IPSEA are?

We have had our first appointment, I was quite nervous going in, both because I didn’t want to get brushed of but DD and I haven’t had a direct conversation (not for the lack of trying on my end) and was worried she would totally shut down or become quite reactive and dismissive…

GP was ok, she didn’t brush me off I did feel she listened, she did say it’s quite hard to know whether this was ND or normal teenage behaviour (I did remind her this is my 3rd 12 year old and well aware of are related mood and hormones) but said with the facts I gave her she would be happy to refer with a report from the school, which I guess is where I’m going now…

DD is terrified that this all means that she will be pulled out of class and brought down to the SENS unit at school, which I guess as a 13 year old girl comes with quite a lot of stigma.

Well done OP, sounds like a good outcome? Do try and reassure DD that any SEND provision shouldn't ever be 'done' to her, without her views being obtained first. (And in reality, it typically takes time and pressure for families to get any sort of adjustments or provision in place...)

Glad the appointment went well.

An EHCNA is an Education, Health and Care Needs Assessment. It is the first step you request as part of the Education, Health and Care Plan (EHCP) process. An EHCP is a legal document that set out a DC’s needs and support they require. The Needs Assessment is the assessment to determine DC’s needs and the support reasonably required.

IPSEA is a charity who supports parents of DC with SEN. They have lots of helpful information on their website, including model letters. They also have an advice line.

Any advice on how to word my email to the school and ask for a report to be made on behalf of DD.

I know HoY what organising a round Robin meeting and DD is on a progress sheet at the moment. They also were aware of todays GP appointment and was asked to contact them afterwards.

We also have meeting with assistant head next week which was requested by the school and I think is purely about falling attendance, I’m not sure if any link and the comms doesn’t seem the best but I will obviously be trying to tie it all up together within that meeting.

Follow up any verbal conversation or meeting with emails so you have a paper trail as evidence should you need it.

Are DD’s absences being recorded as authorised? They should be.

Email stating due to DD’s ongoing difficulties you have spoken to the GP and in order to refer DD for X (you don’t say whether the referral is for an ASD assessment, ADHD assessment or a more general assessment) the GP has requested a report from the school. Please can they give you a copy of a report for the GP ASAP.

Due to the challenges that you face at home and in school the gp is willing to refer dd with a report from school.
Hopefully this will help us all so I appreciate your assistance and hopefully if we work as a team dd will get the support she obviously needs
Schools love it if you mention teamwork 👍🏻

I have had quite a passive aggressive letter back from the school/HoY

I did cc in the deputy head and the school SEND director and made it clear that I was unhappy with the level of communication and support for from the school so I think I have pissed her off but I felt my hand was forced due to lack of response.

Apparently she is still waiting on feedback from DD teachers with the regards to the Round Robin meeting (this will be fed back to me in due course apparently but she is giving the teachers at least 2 weeks!! Pretty sure it’s 3 today!)

HoY had asked what information the GP has asked to be included in the report and Im feeling stupid for not asking more about it in the appointment, when the GP requested us to get in motion via the school or sounded like something that had a set format and something the school would be familiar with.

We have a meeting with the assistant head this week as well regarding attendance which I believe the school are trying to push as separate from any referral/DD’s struggles etc but I’m keen not too as it is all part of the same thing.

Somebody up thread said they DD absence’s shouldn’t be marked down as unauthorised, how do I address that and make it clear that she’s not just a naughty/rebellious kid not going to school.

Also I’d love to hear about the LA (what does this stand for? ) and them providing alternative provision…

Any advice on this all would be really helpful,

DD still isn’t going to school and managing behaviour both at school and home is becoming more and more challenging.

LA stands for local authority. Under s.19 of the Education Act 1996, LAs have a statutory duty to ensure compulsory school age pupils unable to attend school receive a suitable full-time education. Email the Director of Children’s Services requesting provision - on their website, IPSEA has a model letter you can use. Post back here if the LA refuse, delay or ignore you and you will be advised what to do next.

Alongside this, request an EHCNA. IPSEA has a model letter you can use for this, too.

Request DD’s attendance record if you don’t already have access to it. Then, if absences are being recorded as unauthorised, send an email to the school requesting the absences are authorised. Remind them DfE’s attendance guidance states they must record absences due to illness (physical and mental health related) as authorised. Add in that the regulations (Education (Pupil Registration) (England) Regulations 2006) make clear where a pupil is absent because they are unable to attend due to their medical needs the absence must be regarded as authorised.

You could email the GP surgery asking what information they require in the school report. Each area has their own referral process/forms. A good starting point is including any difficulties, including EBSA, DD is having at school and any support already tried.

@SearchingForSolitude Wow this is all so helpful, thank you so much.

I’m on it this morning although all sounds so daunting and complex.

Positive admin day…

Spoke to GP and then passed onto school what she would like outlined in their report.

Emailed attendance officer and requested a copy of attendance and asked for any unauthorised absences to be switched to authorised and quoted them DD rights in lines with DoE and (Education (Pupil Registration) (England) Regulations 2006)

I was very polite in that email as I haven’t been great at contacting the schools on the days DD doesn’t go in. Not only do I find it quite stressful to explain the reason why she isn’t going to school, sometimes I can convince her and she will go after lunch and sometime I’m either working and don’t know or it’s become quite heated between me and DD and I’m ready to throw the towel in!

I know it is stressful, but going forward, on the days DD can’t attend school or doesn’t attend until the afternoon, you should be contacting the school. Not least because it creates a paper trail as evidence.