Local authority or private OT assessment

[Forestmumlondon]

The school have recommended that my 5 year old is assessed by an OT as he is having some trouble socially in school and 'navigating the school day'. I've had a quote from a private practice locally which is nearly 1k.. the school said we may be able to go through the Local authority and that they think the waiting list might not be too bad.

Is there a difference between the LA assessment and private, is it worth paying for private (other than the fact it may be quicker)?

They have no worries academically he is bright, reading well, articulate etc. But has been doing quite a bit of hitting and teasing other kids / misbehaving and it's been going on for a long time (preschool picked up on it too).

They also recommended Speech and language assessment, even though he has no trouble with speech.. they said that speech patterns can indicate certain things (or something like that!) which will be £350.

New to all of this and just want to do the best for him! But don't want to throw money down the drain.

Am also not particularly eager to put a label on him, we went for an initial assessment when he was 4 referred by preschool for autism, and the assessor said she had no worries about him and thought it was just normal 4 year old behaviour. So hoping these assessments don't try and shoe horn a diagnosis onto him!? As I'm not sure that would be helpful.

Independent assessments are often more comprehensive than LA assessments. LA assessments often don’t routinely cover sensory integration OT.

SALT is about far more than the physical ability to speak. For example, it can help with social difficulties.

If you are thinking of going down the EHCP route, you should make sure whoever you use has SENDIST experience.

And if you are thinking of going down the EHCP route, unless money is no object, you may want to wait to see what the LA reports are likely so you can target your money most effectively should you have to appeal.

I don't really know anything about the EHCP route so not something we're aiming for at the mo.. he is in a private school so I'm hoping there might be more support and resources available than there would be in state. Who knows. I think we'd get exemption from VAT with an EHCP so that would be an added bonus! But as mentioned I'm really not pushing for any kind of diagnosis.

Many LAs would not normally undertake an OT assessment outwith the EHCNA (the needs assessment as part of the process of getting an EHCP) process, and even during EHCNAs they often unlawfully refuse. This is even more so for a child in an independent school.

You could request an NHS referral. Although there will probably be a wait for this and many ICBs don’t commission sensory OT. And as like LA reports, it will probably be less comprehensive than a good independent assessment.

Exemptions from VAT only apply if the independent school is named in the EHCP and funded by the LA. Getting an EHCP doesn’t guarantee that would happen.

EHCPs aren’t about diagnosis. They are based on needs.

Not all independent schools are supportive of SEN and offer more than state schools. It depends on the school. When they do/can provide more support, they may charge.

I'd get a private one (in my experience the LA would only fund one as part of a needs assessment for an EHCP anyway - and even then it's a fight!). Ours cost far less than that though - maybe £400?

My ASD/ADHD son is in a private school by the way. They're not used to severe SEN but are great with him. They do charge us for every single extra though, so it's a relief to have an EHCP sorted to cover that.

Thank you @surreygirl1987 and @perpetualplatespinning ! I will get another quote then, in the region of £400 would be better. Happy to spend the money on private if it will be more comprehensive than LA which sounds like it might be. They recommend one in Lewisham called 'Whole Child' (£950) and one in Dulwich called Sterling practice.

That's interesting to know the school has to be named on the EHCP to be VAT exempt. I do feel like where he is quite good for his needs.

@surreygirl1987 out of interest what kind of extras do they charge for, and how does the EHCP help with that (beyond VAT exemption)?

£1k is at the higher end of normal but within the normal price range, I’m afraid. It very much depends on who you use and what they offer. For example, those who offer a comprehensive assessment including SIOT and provide a medico-legal report will be more expensive than those who don’t have any (or only basic) sensory integration training/qualifications/experience &/or don’t have experience of medico-legal report writing. If you are in and around London, you could look at Aniesa Blore, Melinda Eriksen, Diana Pierags and Moyna Talcer. Unless you get lucky, many who are good will have a waiting list, though.

Within an EHCP, all the special educational provision (from things like 1:1 or an intervention in a group of 4 to therapies such as SALT and OT) a child requires should be detailed, specified and quantified in the EHCP. Then the LA is responsible for funding it.

My son has OT once a week, SALT once a week, and ELSA once a week (it was that or Play Therapy). The EHCP covers the cost of all these things.

Thr EHCP also covers the cost of the school fees for him (the LA doesn't have to pay VAT though as, because it's an EHCP it is VAT exempt, so the LA pays the fees excluding VAT).

We pay for anything extra that he needs that we couldn't get written into his EHCP (eg Clin Psych sessions). They are not cheap (£60 an hour I think) but we are relived to have the other things covered so we cheerfully pay for that. He is a transformed child due to all this support - it's potentially life-changing.

We forked out for a lot of assessments prior to getting the EHCP as we knew we needed lots of evidence or it would be rejected. It was still a fight but was worth every penny we spent (and the credit card debt!) to get all this in place.

I would agree with this re OTs actually. I should add that although our OT assessment was cheaper, the sole reason we went with her is because she works at the school and is basically the school's OT. Her assessment was decent in my opinion but her wording wasn't quite precise enough, I found out later when I did some training through IPSEA on EHCP appeals. I got her to rewrite some bits in the end. If I went through the process again I probably would pay more for someone who really knows what they're doing with medico-legal report writing. SALT report could have been better too (but was only around £200).

@surreygirl1987 in case you ever decide you want to pursue it via appeal, things like CP sessions can be part of EHCPs. In my experience, parents are even more likely to need to appeal for it than they are with things like SALT and OT.

Oh wow such much to learn (and so many acronyms!). Sounds like a EHCP is no bad thing and maybe something to aim for. If it would mean LA paying the school fees that would be incredible! Bit daunted by the process though, not sure I have the mental energy currently for it to all be a fight / millions of forms and admin.

Thanks - yes, we did consider that. And we have some pretty good evidence that they ignored which I think we could win with. But honestly, we were just so delighted and relieved to have got it through - and to have the school fees paid - that we were very happy to leave it there. I appreciate the heads-up though!

Yep, sooooo many acronyms! I'll warn you, it usually is a fight. I spent months on it, and had to fight tooth and nail for it. So prepare yourself mentally for that it you're not 'there'. But it can be very much worth it.

If you are ever unsure what an acronym stands for, ask. There are loads, and no-one who is new to the SEN world will know them all.

EHCP - education, health and care plan
EHCNA - education, health and care needs assessment
LA - local authority
SENDIST - special educational needs and disability tribunal
ICB - integrated care board
OT - occupational therapy
SIOT - sensory integration occupational therapy
SALT - speech and language therapy - you will also sometimes see it referred to as SaLT or SLT.
CP - clinical psychology.
ELSA - emotional literacy support assistant
IPSEA - independent provider of special education advice - a charity supporting families who have DC with SEN. (The other main charity for SEN advice is SOSSEN.)

To get a wholly independent school named in an EHCP, you would need to show the LA’s proposed school(s) can’t meet needs &/or it isn’t unreasonable public expenditure.

Hi, I was wondering how you got on with finding someone to assess? I have a similar 4 year old, and am unsure where to start with finding and appropriate/reasonably priced/well recommended OT service near us (Lewisham)

@mazzj you could try Melinda Eriksen, Aniesa Blore, Diana Pierags, and Moyna Talcer.

Thank you. Could I just check on which basis you’re recommending them? Is it as professionals you’ve worked with in the past past or that you have familiarity with their practices? Much appreciated

Private is faster, but local authority is free

I support parents of DC with SEN. As part of that I have seen a lot of reports from countless professionals. The women I mentioned are all well regarded.

Excellent, thank you

We're going with Whole Child in Lee, he's got an appointment this weekend...

Apparently more through than the LA and shorter waiting list. We'll see if it's worth it.

I hope you don’t mind me asking how it went/if you were happy with the set up at whole child? Would be a very local option for us!

It seemed ok. So pricey though for just two hours with someone, although I guess there's the time writing up the report too. I'm not sure how helpful it'll be really for my son.

May I ask how much you paid please?

It was about £920