Respite, schools and OT report

Today was Dinky’s first respite from the 9 hours a week social services have granted her.

She happily went off to the special needs clubhouse with her 1:1 and left me tired and ready to get on to phoning schools.

Well, two schools. I spent a lot of time yesterday morning in between Dinky’s acrobatics and constant need for me to get something for her, going through the list of ‘approved out of county schools’, this includes non maintained in our county. I know not every school is on the list, which is why they make a fuss of them being ‘approved’ aka cheap!

It is a hard thing accepting your child, especially a young child like Dinky, going out of county for her education.

I went through the list of schools, I immediately discounted SLD, MLD, deaf, blind, delicate, epilepsy, and physical. Which left me with 11 autism schools and 44 EBD schools.

 55 schools… I automatically crossed out anything over an hour away… there is no way dinky would be happy with a long drive in the morning. Then I went through the EBD schools to find out how many take them as young as 6… and being a girl, it seems EBD is also a boy thing! 

I was left with Helen Allison National autistic school in Kent- which is an hour away, an ASD school in London- also an hour, and an EBD school 45 minutes away. On looking at the ASD school in London they only cater for more severely autistic children.

Today I phoned both schools. I had already spoken to someone from Helen Allison at the Autism show in London and knew they were happy to take on a child with PDA. Unfortunately they said they don’t have any appointments to view until November! I explained to the lovely person on the phone that Dinky is out of school and that we have been searching for a school and this is the only autism school within an hour from us that understand PDA and can provide the correct support. I explained what happened at the old school and she said she will speak to the person in charge of viewings and see if they can squeeze us in, she promised to phone me back.

I phoned the EBD school and someone was going to call me back.

So I did some housework, then had a bath in peace (result!), but had to jump out as the phone rang, it was Helen Allison school, apparently a parent backed out for Thursday so I can go view it then! Brilliant!

The EBD school phoned back, I asked them if they cater for children with PDA, the response from the head teacher was ‘what is PDA?’. I said it was an autism spectrum condition, the response was ‘oh, not heard of that’. That was the end of that phone call!

I then got the OT report via email,

 

BACKGROUND INFORMATION

 

Dinky was referred to the Paediatric Occupational Therapy service by Dr A ( Locum Consultant Community Paediatrician) on November 18th 2013 due to concerns regarding sensory issues and poor handwriting. She was seen within an OT screening clinic in February 2014, when the need for an assessment at school was identified. At this time Dinky’s Mother was given advice regarding the implementation of sensory strategies (namely calming activities). Dinky was removed from school and therefore received an Occupational Therapy review by means of a home visit on the 17th June 2014.

Dinky has recently been diagnosed with Autistic Spectrum Disorder, Pathological Demand Avoidance (PDA).

 

CURRENT LEVEL OF FUNCTION

 

COMMUNICATION

 

Dinky is a chatty, physically active 6 year old girl who is reported as wanting constant attention and being in control of any situation by teachers at school.

Dinky’s concentration span is short and her use of language reflects her thought processing, which tend to move from one topic to another in quick succession.

Dinky finds it difficult to socially interact with other children in an appropriate way. She experiences difficulties with the processing of auditory sensory information (i.e. sounds) and tends to be overly sensitive to loud or unexpected noises. Dinky’s issues with sound processing are likely to affect her ability to register, process and follow verbal instructions within the classroom and have an impact upon her ability to concentrate and remain calm during noisy times of the school day (e.g. during play times, assemblies or times of transition).

 

BEHAVIOUR AND EMOTIONS

 

Dinky’s main function issue is that of her inability to stay on any given task for more than a few minutes at a time. She is easily distracted (even within the quiet environment of her own home). She prefers tasks to be on her terms and frequently reacts in a negative way if she cannot do things her way. Dinky responds negatively to having boundaries set.

Dinky is a very physically active child, who seeks out movement experiences at a higher rate than other children might do. Her apparent issues with the processing of visual, oral motor, touch, vestibular and auditory sensations have an impact upon her activity levels, concentration ability and regulation (control) of her emotions.

 

LEARNING AND DEVELOPMENT

 

Dinky’s difficulties with attention control, social interaction and challenging behaviour affect her ability to participate in learning activities within a large group setting. She appears to enjoy a wide range of play based activities, but is only able to attend on a task for a few minutes at a time. Dinky holds a pencil in a right handed dynamic (mature) pencil grasp and demonstrates good motor control. However her participation in fine motor tasks is greatly affected by her interest level and ability to concentrate. She is able to snip the edges of a piece of paper using scissors.

Dinky requires a learning environment that caters for her sensory processing issues and can provide regular opportunities for movement based experiences throughout her day. Any learning task will need to be short in nature and encourage Dinky’s interest. Implementation of a sensory diet and a sensory based learning approach would be of great benefit to her at school.

 

 

KEEPING HEALTHY

 

Dinky will require one to one supervision at school, particularly during those physical activities (e.g. PE or day trips) where her danger awareness is likely to be poor. Dinky will find noisy or chaotic times of the day more difficult to manage (including transition times) and will need additional strategies in place at these times to aid her ability to cope.

 

Dinky will require an innovative learning approach in order to encourage her participation and promote her level of concentration.

 

 

SUMMARY OF CURRENT LEVEL OF FUNCTION

 

Dinky presents as a very physically active six year old girl with a range of developmental issues, the most significant of which are her inabilities to concentrate for more than a few minutes at a time, her distractibility, sensory processing issues, social interaction difficulties and refusal to engage in certain activities or comply with boundaries that have been set. Despite her issues with concentration she has developed some age appropriate fine motor skills, but her participation is largely affected by the above difficulties.

 

 

INFORMATION RELATED TO THE FAMILY

 

Dinky’s developmental difficulties and removal from school have had an enormous affect upon family life. Dinky is a challenging child to parent and she requires continual one to one attention in order to ensure her safety, particularly when away from her home environment.

Dinky requires access to outdoor play areas and physical activities on a regular basis which is challenging for the family to provide within their current accommodation.

 

 

RESOURCES

 

Dinky’s family will require ongoing practical and emotional support in order to enable them to care for her in an appropriate way. The physical environment at home will need to be reviewed on a regular basis in order to ensure Dinky’s safety; sensory and developmental needs are being met. Dinky would benefit from the provision of suitable sensory play items and resources at home.

 

 

PROVISION AND RESPONSIBILITIES

 

Dinky will require a series of school visits, to take place during the first half term of her starting at school, in order to assess her sensory processing issues within the school environment and draw up a relevant sensory based programme.

 

Subsequently Dinky will require termly school visits in order to review her sensory based programme and provide a programme of fine motor activities. Both of these programmes are to be carried out by competent, suitably trained staff on a daily basis within the school environment. These activities should be integrated into the wider curriculum in order to promote function and participation.

 

Dinky will require ongoing monitoring of her sensory processing issues and fine motor skill development in relation to aiding her attention and participation within the classroom and promoting independence in self-care and play activities. They will be assessed as least termly by an occupational therapist experienced in working with children with sensory processing and developmental difficulties.

 

Within the educational setting, Dinky will require access to working within a small group and on a 1:1 basis in order to access the curriculum and reach her potential.

 

Dinky will also need to have access to sensory play equipment and resources, which should include access to a sensory play area and a safe outdoor play area.

 

Dinky will require full time one to one support by a teaching assistant who is suitably trained in managing children with complex developmental difficulties.

 

The above recommendations regarding Occupational Therapy interventions will need to be reviewed in line with any ongoing changes relating to the medical management of Dinky’s developmental needs.

 

Occupational Therapist

 

 

So all in all an accurate report. I phoned the OT and asked her to fax this report to the SEN team. She is already on it!

So I phoned the SEN team and let them know it was done.

All these phone calls and I had no interruptions, no shouting, no swinging off me, no jumping all over the sofa, no winding up the dog, no messing about with the guinea pigs and no anything else that normally happens when I am trying to converse with another human being other than Dinky!

It was quite a change!

 

I went to get a new friend of mine’s son, to take him to soft play special needs evening and was meeting Dinky there, by all accounts she had a good day.

 

 

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