I think you have clearly expressed his anxiety, which is great. However, there isn't huge focus on how that affects his school life. Or at least, it kind of gets lost in the detail, I think.
I would do this:
Give a concise 'timeline' of his medical history. Something like:
-xx/yy/zzzz Birth
-xx/yy/zzzz Symptom a started
-xx/yy/zzzz admission to x hospital
-xx/yy/zzzz diagnosis of y syndrome/disease
-xx/yy/zzzz -xx/yy/zzzz repeated admissions for investigation
-xx/yy/zzzz treatment
-xx/yy/zzzz referral to y hospital for detailed investigations
etc.
Then, your letter (I have formalised it a little - it isn't a cozy chat, it is your considered views
)
"Dear Mrs ,,,,,,,,,
Thank you for your letter dated 4th November, I had written quite a detailed letter to you about ** but I will try and add further details for you, which I hope will make it clear that Liam needs an assessment of his needs.
I am also enclosing the minutes of the TAC meeting held in May 2010, which do state that although ** had some support in Reception it would not be continuing in Year 1, even though he had missed the basics of learning which would have a negative effect on any future learning as he progresses through the school years.
After his parents evening appointment this evening, 9th November, is .................................................. .................................................. ....................
** frequent hospital admissions and outpatients appointments are all carried out at Great Ormond Street Hospital in London. . At present he has 2 paediatricians, Mr M Dattani, Endocrinology and Mr Cherian, Urology. The admissions are generally in the autumn/winter months, coupled with general illnesses that young children get and his attendance has been poor (59%). However, the months of May, June and July he is generally in better health and recovers quicker from illness and hospital visits so his attendance levels rise a bit to about 75%,
** medical condition and subsequent hospitalisations, I am told by CAMHS, have had a profound effect on his emotional state
** teacher me that his concentration is bad, he is off task a lot, that he needs lots of encouragement to attempt any work and his reading and writing skills are poor. .
< This is too insignificant ? you are his mother, you know him ? (I know from home life with * and attempting to complete small amounts of work with him that he needs huge encouragement and gets upset extremely easily) ?At home I take every opportunity to support * with his school work. However, he requires huge levels of encouragement to attempt any work, as his self-esteem is extremely low. He gets upset easily and will abandon his work at the slightest setback.?>. Even what appears to be the simplest task, such as making the letters ?o? and ?n? into a word causes him to shut off completely and refuse to attempt any further work.< I find this extremely upsetting on his behalf (change to ?This is extremely distressing to see? > as verbally he is a very bright, talkative child. CAMHS at the TAC meeting on 3rd November said that he has low self esteem, which impacts on his learning achievements.
* anxiety/confidence also his life outside of school. He does not participate in any after school/weekend activities, he did start football training and even won man of the match, however on the 2nd training morning he refused to participate, citing the fact he had been asked to wear a coloured mesh vest for the game. In his words he hadn?t worn it the week before and wouldn?t wear it now. He has flatly refused to go again which I find extremely sad. On holiday he has many little friends at the caravan park we frequent, he is extremely bossy and doesn?t like it if things do not go his way. Again he will not participate in any new activities, he has never played rounders before so a small group of 5 of us went to the park. wouldn?t play it and said quite happily that he would have a little sleep while we played, so he did, he laid down in the field and shut his eyes while we played for an hour. This is usual behaviour for * as far back as I can remember.
< I have received a hospital phone call to inform me that> Liam is to commence another medication on Monday 8th November, this will be followed up 8 weeks later with an admission for tests to see if the medication has helped ease the symptoms.
This The medical symptoms mean frequent testing which leads to more time off school and interruption in his learning, the knock on effect then is the psychological state he is left in which has a profound effect on his cognitive abilities. At present Liam is on 4 drugs (including the new one), these are DDAVP melt, trimethorpin, melatonin and detrusinol. Professor Dattantis for December 8th at outpatients. The nurse made me aware that Liams Growth Hormone results was borderline so they will either commence Growth Hormone Replacement therapy or retesting him.
I hope this information and the subsequent copies of letters enclosed are of help to you.
Yours sincerely"
It just shows that he has had extensive and ongoing medical input. This isn't going away.