Help completing EHCP documents.

Here is some help completing EHCP documents. This task can be challenging so allow yourself time to really think about what the questions you are being asked require you to do and allow yourself time to really think about what your child needs, Below is an example of a completed questionnaire presented by an Ed Psych prior to their visit to a school to visit a your person. The name and gender of the child has been changed. Please get in touch with me if you would like any more advice.

 My Childs early years until starting school

Arthur was born 15 weeks premature, at 25 weeks gestation. His birth weight was 1lb12 oz. (810g) and he spent the first seven and a half months of his life in a neonatal intensive care unit, twice during that time our family gathered around him to say goodbye to him as we were told he would not survive the night.

He was moved to three different hospitals because senior medics at Southampton made unfortunate decisions (for which they have subsequently apologised) that nearly killed him. He had major stomach surgery three times, was on the liver transplant list for months because of liver damage from the medicines he was receiving, developed gangrene in his gut, had sepsis, indeed, the horrible list of tragedies that befell our boy because of the decisions made in Southampton in April 2008 are terrible to read.

He has a huge scar across his stomach, has 30 + puncture wounds on each arm and leg from drips of every kind and has a lump of scar tissue on his right chest from the line they put into him when they could find no more veins. We were told on discharge that he had been the sickest baby in Lewisham Hospital, a regional centre, in central London, for a number of months.

His discharge notes from Lewisham Hospital, where he stayed for 5 and a half months of this seven and a half month intensive care stay (100 miles from our home), record the following principal issues

  1. Extreme prematurity (born at 25 weeks)
  2. Intestinal Obstruction – Necrotising Enterecolitis
  3. Pneumothorax
  4. Large intraventricular haemorrhage (IVH Grade 3 on both sides)
  5. The cranial Ultrasound had shown bilateral grade 3 IVH (brain bleeds) with periventricular cysts, dilated ventricles more on the left than the right.
  6. Bacterial Sepsis/septicaemia
  7. Infection of Brovial Line
  8. Infection of long IV Catheter
  9. AnaemiaHi had 5 surgical procedures, 3 of which were over 8 hours long. He had half of his small intestine removed (50cm), leaving him with short gut syndrome, so he struggles to absorb nutrients, and suffered with daily diarrhoea – up to ten times a day- until he was 6 when by a process of elimination, we removed all dairy and gluten from his diet and although he is still extremely sensitive, he now only has an upset tummy about once a week. He managed this throughout mainstream school.There is an ocean of paper work to say he has brain damage, is smaller, thinner, has fine and gross motor skills impairment and gets anxious in crowds. We wish that this paper work did not exist and that he had not gone through this nightmare.Before he went to school, Arthur was gregarious, curious, generous to a fault and courageous in terms of play apparatus he would try. He also bore pain in a way that medics tell us is “typical of very premature people”i.e. He showed no outward signs of distress when he hurt himself.Arthur went to the local village Burley Primary School (BPS) for three years starting in reception. He immediately stood out as being physically weaker, smaller in general less able than his peers. We were told he had “global developmental delay”. By the end of the first year at Burley Primary School he had developed the habit of apologising continuously when he had done nothing wrong, crying and scratching his face when he felt he had made a mistake. He seemed overwhelmed in the environment at BPS and seemed exhausted by at the end of each day. Arthur also began to shrink back from any form of competition because he was unable to compete on any level. As well as the self-defeating and damaging habits I have already written about, he developed the hitherto unknown habit to Arthur of absenting himself from social gatherings at home. We noticed very quickly that when groups of adults, and particularly children, met at our house Arthur would quickly go to his room and play on his own. It seemed as if he had stopped knowing how to engage with his peers in medium to large groups. We feel this is because Arthur was unable to function on this level in any way. The Community Paediatrician had made a referral for Occupational Therapy and Speech Therapy at the beginning of Year R. The OT, who still sees Arthur today, had serious concerns about his safety in the playground at Burley Primary School, both physically and mentally and about the amount of support he needed in class. She had also referred Arthur to the Specialist Teaching Advisory Service who described the same issues.
  10. In February 2014 (Year 1 at Burley Primary School) Arthur was assessed by the local Authority Occupational Therapist (COPY ATTACHED DOCUMENT 2):- His scores were as follows:-
  11. Furthermore, despite an IPA being put in place by Burley Primary School we were told by professionals who visited him and observed him that he struggled to remain focused and seemed tired during the school day. They also wrote about seeing him clinging alone to the school walls and playing on the white lines on the asphalt alone and about how he actively sought to be away from the crowds of the playground to find safety. This is not a good place to be in when you have to learn how to read write and to make friends.
  12. By the start of the year 1, it was clear he was emotionally and physically overwhelmed and depleted by the effort of going to BPS which seemed to be a place he survived in rather than learnt in. He began to need to wear a hoodie with the hood up at every opportunity and in ways that far exceeded acceptable levels he worried about work he had to complete, where he would sit the next day and who would be teaching his class (his teacher never changed and was always present).
  13. By February of his first year he cried frequently at night before going to school, would use the toilet to urinate frequently before school, would repeatedly clench his fists nervously as we took him in to school and would put his hands over his ears when he was in school or in its vicinity. He would scratch at his own face when distressed or frustrated.
  14. In May 2012 before he started school an EA2 form was completed by the Community Paediatrician stating Arthur would likely need extra support at school to achieve his potential – Copy attached DOCUMENT 1
  15. You will understand that his early years before school were about his family and friends holding him and hugging him as much as we could to help him recover from this difficult start.
  16. He has chronic lung disease – a result of the premature birth that means his lungs did not have a chance to develop in utero, so is prone to coughs and wheezes with every cold.
  17. We were told by consultants that he is a miracle; however it was unlikely that he would have been through the journey he had without long term injury and that these injuries would reveal themselves to us as he grew up.

Manual Dexterity – 1 Percentile –

Aiming and Catching – 1 Percentile                                  

Balance – 5 percentile

TOTAL TEST SCORE: – 0.5 percentile – indicating significant motor needs overall

The School had put into place an IPL for Special Educational Needs and Arthur was having speech therapy or Occupational therapy four times a week in the morning before the start of the school day with a TA assigned to do this. The Speech and Language therapy reports we have also state that despite this intervention Arthur has made no progress.

Dr Valerie Shrubb, the Community Paediatrician referred Arthur to Owen Leigh Optometry who has confirmed that Arthur has visual processing difficulties – please see attached report DOCUMENTS 3 and 4 and his requirements to assist with them.

We have also had an up to date Speech and Language Therapy report completed – confirming Arthur’s communication difficulties including social interaction and distractibility please see attached DOCUMENT 5

We have also had a further Occupational Therapy reports completed, please see attached DOCUMENTS 6, 7 and 8

These reports record the following problem areas that are current for Arthur :-

 

 

OT

Gross Motor Skills

Underlying Foundation Skills – eg motor planning, bilateral skills

Fine motor skills including refined grasp/in hand manipulation

Functional skills eg pencil skills,scissor skills

Focus/concentration

Hypermobility

Poor core stability

Struggling to support his needs moving forward without 1:1 support in the classroom

Oversensitive to noise

Plays alone

Lack of stability in his core, pelvis and shoulders still significant

 

SENSORY

Lack of postural tone, proprioceptive, tactile and visual integrity

Avoiding due to sensitivity of noise and light, tasks much more of an effort for him

Auditory sensitive

Poor tactile discrimination

Visual Spatial Difficulties

Sensory processing disorder

Significant Auditory defensiveness

Sensory based motor disorder (somatadyspraxia)

 

VISUAL

Eye movement weakness in direct/focussed attention

Tracking skills

Eye Teaming

Visual special (perceptual) and weak Directionality skills

Very poor convergence

Weak stereopsis

Some restriction of eye muscle balance which relates to fatigue when reading

 

SPEECH AND LANGUAGE

Motor Speech Difficulty that results in unintelligible speech

Speech and Language therapy targets have remained the same for the last 4 years

Significant Difficulties with word finding

Difficulties expressing himself with his peer group leading to isolation

Significant difficulties with attention control

Difficulties following directions and information in class

At high risk of social isolation and significant emotional distress

Vulnerable due to small stature and physical weakness

Difficulties with eye gaze

Difficulties filtering out noises outside the room

Difficulties filtering out visual distractions

Difficulties with maintaining posture – poor core stability

 

 

 

 

 

What is your child like now?

Learning achievement and educational progress

What is going well today?

Arthur was moved to a much smaller school for the last academic year. This has been a very good transition for Arthur, we are starting to see him developing his “voice” again and his anxiety about school is slowly falling away. Perhaps the most obvious sign that he is now happy is the weight and height we are seeing him develop in ways that are back to levels we used to see before he went to Burley Primary School.

He has been having daily OT interventions, and using the “writing without tears” system recommended by the OT his letter formation is slowly improving.

At the end of his first year in this much smaller school he no longer clenches his fists before school. He has very nearly stopped the habit of scratching his face when he is over whelmed and worried and only urinates once in the morning. He has stopped apologising continuously even when there is no need to do so.

He is no longer fearful about going to school where he has numerous different teachers, one for every subject, and is now easily able to incorporate this into his life without ever needing to speak to us about it. He still puts his hands over his ears but he is he losing the habit of needing to wear a hood up in crowds, although he still becomes very agitated in crowds of children without his hood.

Now, in a smaller school, in which he seems to feel safer and less threatened, he is at last in a position to start his academic journey, and learning to make friends.

What needs to change?

Arthur needs 1 to 1 help for a number of reasons.

The gap between what he is cognitively able to do but is physically unable to do because of the issues outlined in the attached reports and listed above need to be bridged. This gap is causing him to have erroneous beliefs about himself that impair his ability to access education and friendships. He is in a smaller environment which, we know because he tells, is more manageable and is less emotionally, psychologically and physically challenging. He can now start to be helped to unpick and undo the limiting self-beliefs he holds about himself that developed over his first three years in school. To do this he needs dedicated support in the classroom to support his literacy and numeracy where there is an understanding of his physical weaknesses, his motor skill issues, his communication issues, his visual difficulties.

His teachers and OT tell us frequently that Arthur has the ability (“it’s all in there” they say), but currently his catalogue of issues compromise his ability to do the necessary number of processing tasks to get it down on paper.

The legacy of his premature birth and the further health problems he has suffered, mean that he struggles to write, his handwriting is very poor, he struggles to verbalise, to sit still, to look at the work, to focus, to learn – he is a very bright boy and without 1 to 1 support he will never achieve his potential.

He also needs dedicated support at playtimes because he needs intensive help relearning, and learning for the first time, that he can interact socially at school with his peers for he still appears entrenched in a pattern of relating he developed of playing on his own.

He also needs the dedicated support with his OT and SALT programmes so he can have these during the day not when he is exhausted after or before school

How will that change make a difference to your child?

We believe and concur with the professionals who view Arthur as capable and willing to learn but fundamentally physically compromised by brain damage he sustained in the first months of his life.

We believe that with the benefits more support will bring, in terms of what Arthur sees he can achieve in the classroom and in the playground, Arthur will begin to see that school is a place of learning, where his naturally inquisitive nature (which we see returning over the last year) will thrive and enable him to reach his full potential.

 

Friends and relationships

What is going well?

As we and others who have observed Arthur since he was five have already made clear, before Arthur started school he was gregarious and friendly to one and all without being precocious.

Arthur’s first three years of schooling compromised his nature terribly and caused him to withdraw from making friends with peers because he found the environment overwhelming, confusing and entirely unmanageable despite the initiatives and interventions the school put in place.

Now, in a smaller environment, he will be able to develop socially contingent behaviour because he has a fewer number of peers manage himself around. We see Arthur beginning to represent himself in a way that shows us he is just beginning to see himself as part of the group rather than standing on the outside of the group looking in.

He has to be encouraged to make friends with his peers, he seeks adult company as a preference, his play is always is a land of make believe which his peers struggle to understand or they think is babyish, he will shout when he feels he is not understood or heard. He feels he has no friends to play with at school and is unable to begin to play with the children in the playground, although he wants to desperately and swings alone every day unless prompted to do otherwise by staff.

What needs to change?

Arthur needs to learn he is valuable and equal to all others.

Arthur educational ability needs to be set free from his physical and communication difficulties so he can begin to achieve educationally.

Arthur needs help with socialising with his peers.

Arthurs numerous specific needs outlined in the professionals that have seen him show he requires 1 to 1 support in his daily life at school.

 

How will that change make a difference to your child?

This will make Arthur feel part of things. It will create confidence in him as he sees he can be as he sees others are e.g. natural and comfortable in talking and engaging with others without parents/staff around.  

When Arthur starts to make friends more easily he will have better self-belief and will see that the world is something he can engage with rather than the world being something you must protect yourself from.

With support in the classroom and outside at play with his peers, Arthur will come to terms with his differences, and the terrible start he had in life and his learning will be set free from the legacy of his prematurity and brain damage.

Health and well-being

Arthurs current and future mental health is contingent on ensuring at this stage in his life, that we repair the damage done during his earlier education and allow him what he needs to be able to achieve, he is capable of so much more. He needs the help to get there.

How will that change make a difference to your child?

I refer to the Future in Mind document which talks about “Promoting, protecting and improving our children and young people’s mental health and wellbeing.”

This document talks shows how children with disabilities are more prone to poor mental health. With extra, dedicated, support in a small environment Arthur will achieve and prove to himself that he can compete, in his own way, in this world. His mental health will be safeguarded and he will develop the inner strength he needs to enter adulthood as an independent and self-supporting man.

 

Writing your Childs EHCP plan

It is vital to us that Arthurs EHC plan names the New Forest Small School as his educational establishment.

Having tried, and failed, at a state primary school, it is evident to us that it is not the right way forward for Arthur. The local authority OT that was in charge of his care has confirmed Arthur is now in the correct establishment for his specific needs and is making progress – see documents 7 and 8.

The professional reports all clearly state Arthurs need for a small class structure.

Arthur no longer scratches at his own face, or urinates continuously at the fear of going into school. He has stopped clenching and unclenching his fists for hours at a time in the morning before school. He is gaining weight, and growing – a sure sign of happiness in a child with short gut syndrome.

His time in the playground is no longer a safeguarding issue; his tiny size and lack of strength do not dominate his time outside at play.

He is now understood, supported and his education is led by his own abilities and we firmly believe he is in the right place for his educational needs.

We would like to see the following in an EHC plan for Arthur:-

1 to 1 support for 5 hours a day so he can make progress and get the support he needs to learn and socialise, daily help with OT and SALT exercises so he is able to address these issues during the school day without having to do them out of school time when he is exhausted.

His own laptop/tablet at school as he struggles so much with paper based work.

The support of an Ed Psych to ensure he is developing as he should.

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