Seeking advice adhd

[mrsbittersweet]

Hi all, looking for some advice.

DS4 was the calmest, happiest baby ever. Everything changed when he started nursery at 2.5 – constant complaints about behaviour, not listening, lashing out, etc. Nursery were adamant he had autism and needed support PDA profile. I didn’t think he had autism but started to think I am in denial and applied for an EHCP and he got some help but nothing really improved.

He’s now in Reception and things have actually got worse. Aggressive episodes, not following rules, getting overwhelmed. He’s on a reduced timetable with 1:1 and school say they’re struggling.

I’ve been so stressed I took him to a private child psychiatrist. He’s diagnosed ADHD (combined type) and says DS does not meet criteria for autism at the moment, though he has a few traits and definitely anxiety, especially in social situations. He says he wouldn’t diagnose a child like him with autism, his adhd is affecting his mental health and social communication.

Now I just feel lost. Nursery said autism, ehcp is based on social communication needs but private psych says ADHD + anxiety. His behaviour is so extreme at school but he’s a totally different child at home, hyperactive but willing to please and cooperate.

I don’t know what to do next. He is too young for medication. Focus on anxiety? I honestly feel like I’m failing him and I don’t know who to believe anymore.

Has anyone been through similar? What actually helped your child?
Any advice welcome.

Some DC do present very differently at nursery/school compared to how they present at home. More often it is appearing to cope at school and exploding at home, but sometimes it is being more dysregulated at school.

It sounds like you need an early review of the EHCP. IPSEA has a model letter on their website that you can use to request this. How thorough was the ed psych assessment DS had during the EHCNA? Did DS have SALT and OT assessments? Has he been assessed by a clinical psychologist?

Other than 1:1, what provision is in the EHCP? Provision in EHCPs is based on needs, not diagnosis. What has the school tried? What outside agencies have they approached?

Is the reduced timetable your decision? Or is the school imposing it? The school shouldn’t be doing that. If you want DS to attend part-time, he can. However, if you want DS to attend full-time, he can unless the school is formally suspending DS. Don’t worry if DS is formally suspended. A formal suspension rather than an unlawful informal exclusion it will a) provide you with evidence of unmet needs to support pursuing additional support, b) force the school to follow due process, c) limit the number of days the school can suspend for, d) allow you to challenge any suspension, and e) once DS is compulsory school age will ensure he receives alternative provision once he has reached that threshold.

You may find the school suspension and exclusion guidance helpful here. Most of it applies to those below compulsory school aged. Where it doesn’t it explicitly says so as stated on page 6.

Of particular interest may be:
“20. Any exclusion of a pupil, even for short periods, must be formally recorded. It would also be unlawful to exclude a pupil simply because they have SEN or a disability that the school feels it is unable to meet…An informal or unofficial exclusion, such as sending a pupil home ‘to cool off’, is unlawful when it does not follow the formal school exclusion process and regardless of whether it occurs with the agreement of parents.”
And
“30. A part-time timetable should not be used to manage a pupil’s behaviour”

You might also find reading 2.17 of the School Admissions Code (which you can see here) helpful if the school is imposing a part-time timetable. It makes it clear it is your choice:

“Admission authorities must provide for the admission of all children in the September following their fourth birthday. The authority must make it clear in their arrangements that where they have offered a child a place at a school:
a) that child is entitled to a full-time place in the September following their fourth birthday;
b) the child’s parents can defer the date their child is admitted to the school until later in the school year but not beyond the point at which they reach compulsory school age and not beyond the beginning of the final term of the school year for which it was made; and
c) where the parents wish, children may attend part-time until later in the school year but not beyond the point at which they reach compulsory school age.”

Ask school to refer to CAMHS for autism assessment. It's very unusual for under 6 yr old to be diagnosed with ADHD. How did the assessment look like?