Is SALT and OT detailed, specified and quantified in F of the EHCP? Or is the wording vague and woolly? If the former and it isn’t being provided, write to the Director of Children’s Services reminding them of their duty under section 42 of the Children and Families Act 2014 and informing them if they fail to ensure the provision is provided you will be forced to pursue legal action. If that doesn’t work, you need a pre-action letter. SOSSEN can help with that, but there is a charge, so you may want to look elsewhere. Then, if the pre-action letter fails, JR proceedings will resolve the situation. However, if the wording is vague and woolly, it can’t be enforced and you should request an early review to try to tighten up the wording.
Does the OT include sensory integration OT?
When you asked for social care assessments, did the LA refuse assessment or did they assess but refuse support? When you say you appealed, do you mean you complained? If so, when was that? If it was last year, they should have responded by now. If the complaint didn’t resolve the matter, you can ask for an independent review and if necessary complain to the LGO. Depending on specifics, JR may be possible.
If you ever have to appeal the education side of the EHCP, you can ask SENDIST to also look at social care provision, getting an independent social worker assessment if necessary (if you can’t afford independent assessments and you aren’t eligible for legal aid Parents in Need can sometimes help fund them). And some social care provision is actually special educational provision so should be in F of an EHCP.
Also look at your LA’s short breaks offer.
Have you checked for a sore throat or mouth? That can lead to holding saliva and food in the mouth.
The screaming could be a stim. The toileting issue and holding saliva and food in his mouth can also both be sensory issues.