Teen with EHCP won’t leave the house – what support can actually help him back into education?

[WaterlooHowDoesItFeel]

I’m posting on behalf of a friend and have changed some details because I don’t want this to be identifying.

Her teenage son has autism, ADHD and significant behavioural needs. He has an EHCP and has been out of school for a number of months after his previous placement broke down. An emergency EHCP review has already agreed that he needs specialist provision, and the LA is looking for a suitable placement.

The difficulty is that things have now deteriorated to the point that he rarely leaves the house. Attempts to get him out can cause extreme dysregulation and at times physical aggression towards his mum.

So although the LA is looking at schools, the much bigger problem is how he is actually supposed to get from home into education. A taxi or school transport isn’t really the answer because mum cannot reliably get him out of the house and into a vehicle in the first place.

There are CIN meetings and a social worker is involved, but there doesn’t seem to be any real joined-up plan between SEND, social care and health. CAMHS have apparently said therapy can only be offered in an educational setting, which feels completely circular when he currently can’t access one.

I’m wondering whether anyone has been in a similar situation and managed to get proper support with the transition from home back into education.

Has anyone had:

• a specialist worker come into the home and build up trust before gradually supporting the child out into the community/school?
• intensive outreach or engagement support?
• a bespoke transition package written into an EHCP?
• social care funding/direct payments used for this kind of support?
• Section 19 or EOTAS/EOTIS provision while waiting for a specialist placement?
• a genuinely useful multi-agency plan that went beyond CIN meetings?

Residential provision has been mentioned previously because of the level of need, but mum does not want her child to have to live away from home if there is any realistic way of putting proper support around him at home.

She has been asking for help for years and feels like he has fallen through the gap between services, with everyone acknowledging how complex he is but nobody really taking responsibility for getting him from where he is now to the point where he can actually access education.

If anyone has been through something similar, I’d be really grateful to hear what support was eventually put in place, what it was called, and which service actually commissioned or funded it.

I say the below with the one, very big, caveat that without knowing what details you have changed, then it is impossible to know if all of the below is accurate in your friend’s situation.

An emergency EHCP review has already agreed that he needs specialist provision, and the LA is looking for a suitable placement.

When was the review meeting? What stage are they up to? The AR process should be as follows:

1. Updated advice and information must be circulated at least 2 weeks prior to the AR meeting.
2. Then you have the AR meeting.
3. Within 2 weeks of the AR meeting, a report must be circulated.
4. Within 4 weeks of the AR meeting, the LA must inform your friend if they propose to amend or not. I presume they have agreed that? If they are going to amend, they must send the amendment notice/draft/notice of amendment/proposed amendments (whatever the LA/your friend wants to call it) at the same time and your friend must be given at least 15 days to comment on the amendments and state the preferred placement. Does your friend have a preferred placement?
5. Then if the LA is going to amend, they must finalise within 8 weeks of sending the proposed amendments, so max of 12 weeks from the AR meeting.

The EHCP is the key to this.

CAMHS have apparently said therapy can only be offered in an educational setting, which feels completely circular when he currently can’t access one.

This is a lie. CAMHS can offer therapies, both in clinical settings and at home. Having said that, therapies should be in F of the EHCP. The benefit of this is provision not typically available on the NHS can be provided &/or provision in excess of what the NHS offers (e.g. longer sessions &/or more frequently &/or fora greater number of weeks). All without the need to sit on the normal waiting lists. If provision is in F of the EHCP, the LA is ultimately responsible for this provision. This duty is absolute and non-delegable. That applies regardless of any funding arrangements they may want to make.

a specialist worker come into the home and build up trust before gradually supporting the child out into the community/school?

I’m not sure what you mean by a specialist worker(? Your friend would be best to use a job title.) but yes, this is possible. In lots of situations this can be part of a school’s provision as part of transition into a school. In those cases, the school would be named in section I. Lots of s19 provision works to gradually build trust and gradually support DC back into education. In most cases into schools, but not always. The majority of EOTAS/EOTIS packages work towards engagement in &/or out of the home) in one way or another. While many have EOTAS/EOTIS longer term, some reintegrate into schools at a later date.

intensive outreach or engagement support?

The phrase ‘intensive outreach’ is often used to describe a team in mental health services. Yes, that can be possible in what you describe, but what is available will depend on the local NHS offer.

But yes, intensive support for engagement is possible.

a bespoke transition package written into an EHCP?

Yes, a good EHCP will include transition. Since provision in EHCPs is based on needs, it should be tailored to the individual.

social care funding/direct payments used for this kind of support?

Social care funding is very much possible. Many parents have to push for it. That can include for things like being trust and engagement working towards accessing the community. However, the focus of your friend’s wording should be on things other than education - social care are not responsible for education and the will pass the buck. Sometimes LAs even go as far as saying the funding cannot be used during school time during term time.

Has your friend had a proper carer’s assessment and has your friend’s son had a proper assessment of his needs by the children with disabilities team? If refused assessments &/or support, has she challenged the decision(s)? If so, where has she got up to?

The other consideration is, any social care support that educates or trains is actually considered special educational provision, and therefore belongs in F of the EHCP.

Section 19 or EOTAS/EOTIS provision while waiting for a specialist placement?

As long as DC is CSA, section 19 provision should be being provided now. That should continue until DC is in full-time school (if he will be going to school).

EOTAS/EOTIS is only legally possible if it is inappropriate for the provision to be made in a school or college. Waiting for SS wouldn’t prove it is inappropriate.

I have 2 DS with EOTAS/EOTIS/C. It isn’t the easy option. Many have to appeal for a proper package.

a genuinely useful multi-agency plan that went beyond CIN meetings?

Yes, this can happen, but your friend needs a robust EHCP.

I have 3 DC with EHCPs. They all include multi-agency working including termly MDTs. They all including training for members of staff from professionals. The 2 with EOTAS/EOTIS/C include some hours where professionals can seek advice/information from other professionals (in addition to the MDTs and training).

Unfortunately, for many parents, they are the ones who need to lead the charge and drive the process/situation.

Capa First Response | Together for safer families - Capa First Response https://share.google/yrVJWiw2u9gYPUrM8 please recommend this charity to your friend. There are free online seminars she can attend. I know it's only a small aspect of the problem but maybe it might help a little.

Does she think the child might be able to access an online school? What's her financial position?

I would advise Mum to visit schools and if she can't then for a trusted friend to visit potential special schools. My son is AuDHD and currently in school but I have many friends with children who have been out of school for years. When the right special school is named and he is on roll there, they can work to support him into school. Not every school will do this, but they exist. So Mum or friend should ask whether they have a history of supporting out of school children back into school and also what their approaches are. Many schools don't have the expertise or the interest in this work, but I know of radical/progressive schools in my area that do.

I think time is a healer if the child is in burnout. It can take years! There is a reason why he is unable to leave the house so you just need to figure it out.

Education is not the important thing in life for a sen child (believe me I'm BIG for education but it’s not the most important thing for a sen child there are lots of other things which are equally important and different ways to go in life)

What does the child want? This is important. As obviously with weight, height and mental negotiation of a teenager they are not toddlers to pick up etc.

Education isn’t the most important thing mental health is regards hopefully having a “happy child or a little bit with the age etc ”

Is the child medicated? On correct meds? For adhd or doesn’t want to be.

Any GAD - they could provide meds if appropriate but then the child has to want to take them. Or therapy if in trauma if they would accept it.

You can fight for years. Spend loads of cash and still receive nothing.

The mum needs to try to identify if any specialist places she can see her child settling without that no point in fighting for a specialist school.

Which LA? Surrey 💩 so hope she isn’t here!

You need to explore the child's passion and I’d put education on the back burner until happiness improves. Once happiness improves then try to add education.

Thats the view point I’m taking for my child (could be totally wrong) but a happy child is better than a sick child with education if you catch my drift.

Good luck and just listen to the mum - don’t try and force or ask her about what her son is doing she will have so much stress / understand more than you probably realise …. (Although physical aggression is bad so she does need to escalate that even the police if she feels unsafe but education is not a number 1 factor. She needs to lower the demands on the child)