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madsadie

Advice please : Educational/Clinical/Neuro psychologist

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I need to obtain assessment for tribunal and am confused as have been advised by EP that as my son's main problems are anxiety based I may need an independent clinical psychologist's report.

I note from the BBPS/Achipp search that some are listed as Clinical but give education advice ( but would they be seen as qualified to do so at tribunal?) Also I'm wondering if a neuro psych wouldn't be better. Am struggling to afford any at all so thought I could 'kill two birds with one stone' as it were.

 

Can anyone advise.

 

thank you

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I can't help you i'm sorry i don't know the answers to any of these things but just wanted you to know that i read your post and hope someone can answer these questions for you. It sounds like a tricky situation. Best of luck.

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i had an ed psych report done - it did comment on his anxiety - he is currently in school part time and tribunal is next month bit whether it would be enough for you i dont know - could you maybe contact a couple and see what they advise?

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Hi,

 

The LEA Ed Psych is undertaking a report for tribunal next Feb for my son. I was advised regarding a Clinical Psychologist report as son out of school with anxiety/?depression. I spoke to a private Clinical Pscychologist (of which there are none locally) who told me this service needed to be local. My son is now under CAMHS with the involvement of MH Practicioner. I would get referal preferrably through Paediatrician (may ignore GP) on NHS as S_T has just mentioned.

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For our Tribunal I had an independent EP, SALT and OT report and all attended as expert witnesses.

 

I had also gone back to the Developmental Paediatrician and asked for a referal to Clinical Psychology some months earlier [about a year]. This was to an NHS Clinical Psychology team that specialised in working with children on the spectrum.

 

The difference is an educational psychologist specialises in identifying needs within an educational setting. A Clinical psychologist is more about the mental health of the child relating to their diagnosis and also to how they are responding within the school environment, at home and in the community.

 

The Clinical Psychologist is employed by the NHS and not the Local Authority. So they may be more detailed as they are not bound by the LA. An independent one is definately that ie. independent.

 

The NHS professionals can give advice and identify needs and make recommendations that you can submit to the tribunal. However the NHS cannot make the LA do anything. Only the Educational Tribunal Panel can do that. So that is why they need to see all the relevent information from all the relevent professionals.

 

At our Tribunal we also highlighted the fact that the educational professionals were not seeking the advice of the NHS ClinPsych or CAHMS, and when they did give them advice, they were not responding to it at all. There was no joint planning or cohesive delivery of any kind of supportive package or programme to get my son back into school.

 

In our case the NHS Clinical Psychology team were so concerned about my son they also referred onto CAHMS and he was seen by a psychiatrist, who also gave some very useful advice which we used at our tribunal.

 

But I did have to put my concerns and requests in writing to Clinical Psychology for them to reply to my letters. I said that they must identify what his needs were as per the Statementing process and that they must quantify and specify how those needs should be met within school.

 

I also pushed them to confirm if he had an anxiety disorder, which they confirmed he did - which again helped at the Tribunal as that proved he had deteriorated.

 

In my experience it was then the independent Educational Psychologist that bought together everyones advice in his report to state that my son was not mainstream material and that his current school could not meet his needs and that the parental choice of school could. An NHS Clinical Psychologist will not be specific about school placements, but you can ask them them about what they think the type of school should be, what the peer group should be, what class sizes, what expertise within the school etc.

 

A Clinical Psychologist can also undertake assessments of cognitive ability.

 

You can phone anyone you think maybe useful and speak to them about your concerns. It really depends on what you need to strengthen your case to win the Tribunal. If you are trying to prove that your son is not coping, is not mainstream material, has anxiety or mental health needs relating to his diagnosis and to how his needs have not been met in school then an independent ClinPsych might be better for you, especially if they have experience of attending tribunals, and writing reports for them, and also have experience of educational psychology.

 

Do you think you have enough evidence to win your case?

Edited by Sally44

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Hello everyone, and thanks for your replies.

My son was assessed by clinical psychology at Gt Ormond St, who diagnosed AS and various anxiety disorders. They recommended that local CAMHS provide CBT. CAMHS did not appear to like this and treated us very badly. After the first appointment my son was so traumatised he thought he was going to be taken away from us. I persuaded him to go to the next appt and that was when she said to him ' Do you know what having aspergers means, it means you don't like talking, so what's the point in coming?'. This was closely followed by pressure to go on medication, which had specifically NOT been advised by GOSH. she also told me not to go looking at small schools as they were too expensive. I had forgotten at that point that previously we had seen the consultant psychiatrist at CAMHS who wrote a letter ( for the statementing process) supporting a small school with small classes stating that' his anxieties would lessen and possibly disappear'. the LA refused to allow this into the appendices, and it was ignored at tribunal ( presumably because it did not say ' this child must have...', only that she supported our view). In my tribunal application I raised this but it was ignored on the day. I then appealed and was told that it was up to me to have raised the issue at the hearing ( How was it my responsibility to determine the order of events? - that was their job). I appealed again to Upper tribunal on another point in law, which was allowed, but no comment was made about that aspect - I was told the panel were allowed to place whatever emphasis they liked on the evidence.

I had plenty of evidence from professionals all trying to say what was glaringly obvious, but none of them independent ( i. like so many others, did not have the funds). GOSH wrote a letter 'strongly advising' small classrooms with low background noise ( in the event that's what we got, but in a unit completely isolated). OT said he was 'to be taught in small groups where possible'. CAMHS mental health worker who had helped him at school wrote stating he was still finding a big noisy secondary school very difficult to cope with and it was affecting his attendance. ( Her post has now been axed).

It makes me sick that I worked so hard to try and get all the evidence I could without paying, but what for? Tribunal took no notice of any of it and sent him to an even bigger school, seeing it as a 'marvellous opportunity'. They decided to take the evidence of the LA's key witness who had never even met my son. Talk about waste of money for the public purse.

As I said, i appealed and appealed again until I at least got somewhere at UT. Now I have to start the whole business again, but I will not give up. I'm now wondering if I should be going for JR instead.

 

enough of my soap box. the point is no one in NHS/LA can say what they mean and yes I will probably need both reports. I'm beginning to wonder if I should just spend the money on some kind of treatment for him instead, as i can't even find a school who can really meet his needs. So many so called specialist schools have SALT, OT but they don't have Therapy. We tried two specialist schools locally who take asd children who did not understand the anxiety - just expected him to turn up for 3 taster days and spend the time with another boy he'd not met, and insisted he eat in the dinner hall with all the others. I had to fight tooth and nail to get through the front door and then I was accused of 'mollycoddling' him. Two more schools, with autism accreditation would not consider him because they can't cater for children who need help at break times. Is my son the only asd child who suffers this acute social anxiety - I don't think so. the trouble is he does not have aggressive behaviour, is clever, was ok pretty much in junior , had friends - not even on school action. Life shut down on going to senior school.

 

I might try going back to GOSH to see if they can be a bit more persuasive. maybe I should have the EP assessment and see what they say, but then it might be too late to book anything else. The LA EP visited us at home and agreed with me the current school not right and suggested I agree to e-learning ( which I didn't want to). She even said she could come and look at other schools with me, but denied it all at the AR.

 

I have been advised to get social care assessment, but I can see the same thing happening and will have to get an independent social worker. Maybe I should just sell the house to pay for it all. And what for - do children who've been through all this actually do any better in life? Children who've seen their mothers on the verge of cracking up, spending all hours, every holiday working on this wretched appeal after appeal.

 

i really am getting off the soap box now. sorry everyone.

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When you appeal you also submit your case statement. That is another opportunity you have to detail in that that x ,y and z professionals have ALL stated your son needs to be taught in small groups in a low arousal environment.

 

You could also state that none of the LA professionals have seen or assessed your son since xxxxxx.

 

You do need to spell it out. The Panel are good at going through the Bundle, but your case Statement [and also the Working Document] MUST detail what the major issues are.

 

At the Tribunal you can also ask that certain evidence is considered, if you feel it has not been covered on the day.

 

I also took a notebook with me and detailed everything the LA expert witnesses said. I then asked for, and was given opportunity by the Tribunal Panel to address each of those issues, which I did.

 

As the larger mainstream secondary has not worked, you have evidence of that now. And you can highlight again all the evidence you had previously that was saying he was not suitable for such an environment. You can submit anything you want as your evidence. It just needs to be relevant to your Tribunal, which it will be.

 

Have you done a Data Protection Act Search? If not, do you have time for one?

 

I think if no professional has pulled together everyone elses opinion and findings and recommendations, then you need that this time. But you also need to know the major issues yourself and know the bundle inside out and annotate only your copy of the Working Document, and make sure you have submitted your Case Statement which details all the major issues you have had to date and how his current placement is not working.

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What you have said about CAMHS is terrible. I had a similar experience with them promising intervention and after several weeks and their team meetings they referred back to GP. Luckily for me had left contradictary message on my answer phone and on advice from IPSEA rep wrote letter of complaint through PALS. NICE guidelines state interventions other than Meds should be first line of treatment. Letter back from CAMHS stated they had failed to assess my son. They accept they will fail some children like my son! It must be one of the few services which return referals without any assessment.

 

When I saw the Paediatrician she thinks it is down to service provision monetry restrictions. She is writing to the Childrens Commissioner about the situation.

 

It appears to be a continuous battle. I have an IPSEA representative who will come to tribunal with me over refusal to assess. At present the LEA have until Monday to reply to Judge and me about funding information which they have so far failed to do. Have you anyone from IPSEA supporting you?

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Hi madsadie

 

I think you need to get some advice on your specific situation, either give IPSEA or SOS!SEN a call. I have used the SOS!SEN helpline and found it brilliant.

 

Although you say your son's main problems are anxiety based, his anxiety may be an effect of underlying problems - perhaps relating to social communication for example and so maybe a speech and language therapy assessment is required. I think unfortunately the local authority have probably not done a thorough assessment of your son (as is often the case). Ideally you are going to need independent EP, OT and SaLT - as it sounds like you really can't do this then do get advice from one of the helplines about what your best approach is.

 

Sharon

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Hi,

 

Replying to your original post; if you have not had an independent Ed Psych report, I would go for that. Someone who can assess him, go into his current placement and observe and come home and take a history, view docs and talk to him at home.

 

An independent Ed Psych report and the LA one can be miles apart, because LA Ed Psych's won't go against the LA.

 

An independent Ed Psych can comment on any signs of anxiety and how your son reacts at school - she can quiz the staff.

 

The benefit of an Ed Psych is that they can relate your son's anxieties to his educational needs. Did the LA Ed Psych suggest a clinical psychologist? As time is not on your side, and money is not either, I'd go for Ed Psych if you have not had a through report done already - observations are very important, as is noting your son's views.

 

In terms of schools, if you are okay about residential then I'd search further afield -I think many parents have a very positive feeling when they find the right school - some schools might not tick all the boxes, but a +ve atmosphere and a willingness to be flexible and listen normally comes across clearly.

 

And Sally is absolutely right - get those Data Protection requests in - school, LA and health - even if they won't come in time to submit evidence, they might come before the tribunal and can help on the day, as you can still say things verbally or you can try to submit late evidence, as soon as you receive it. Can be invaluable evidence.

 

Best of luck

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And I would also include in your Case Statement and documentary evidence that GOSH recommended Clinical Psychology/CAHMS input, and that was not provided by CAHMS. Do you have any correspondence with CAHMS after that appointment? Could you write to them and say that you would like to know why they did not put in place the therapy that GOSH recommended. Is it because they are not an ASD specific service, and if they could not provide that therapy why could they not refer you onto somewhere that could.

 

And that input/therapy is what you would also be looking for in the placement ie. a school that has EP or Clinical Psychology or CAHMS professional working with the school, in school, and seeing the children in school to meet their needs in the educational setting.

 

That was a major part of our appeal. My son had been under ClinPsych and CAHMS, but they did not go into his school, and his school were in denial and kept saying they had no concerns. So I highlighted that in the Case Statement and appeal documents. The LA were also arguing that there were no concerns and they felt I had 'exaggerated' my sons difficulties. Well I had all the correspondence with ClinPsych and CAHMS, which the school had also had but had ignored. That did not go well for the LA/School on the day of the Tribunal as the Panel wanted to know WHY they had not carried out the strategies and approaches recommended and wanted to know what joint planning had taken place etc. There was no communication at all between Education and NHS professionals. This is an important factor to highlight as most independent ASD specific schools do deliver a cohesive therapy involving educational and health professionals.

 

Whatever professional you do decide to use they MUST have experience of writing reports for SEND Tribunals and have experience of attending as expert witnesses. Because you may also need them to attend to back up and explain their report findings and recommendations.

Edited by Sally44

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Unfortunately CAMHS wrote to the GP and told him that my son 'understandably did not want to enter into talking therapies'. And, even more unfortunately I was so stressed out with tribunal goings on, and being let down by advocate who was supposed to be doing working document and missed the deadline, then when it came it was rather dubious....anyway there was so much going on that I did not reply to that letter. However, I did tell the panel what had happened at CAMHS, but I will have to repeat it for this one. I will also write to GP so there is a documentary record. Unfortunately GP not very good, told me his son doesn't like going out after dark ie I should stop being concerned. He also was not willing to make a record of what was going on with school, he said he would put down that he was physically ill! At the time my son was suffering from tummy ache but I suspect that was due to anxiety. I don't know why i didn't argue. He used to be quite pro active but not any more.

 

 

Can you tell me where I should apply for Data protection request?

 

also, Sally - Do you mind me asking who did you take to hearing - was it just the EP?

 

 

thank you all for your advice

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Yes, Sally, thank you. The form has just been taken in. They are allowed 40 days to reply, and unfortunately that is probably too late for my response but it is within the final deadline. Not sure I want to see it really, but I just hope there's something helpful in it.

 

Another question. It's about tribunal deadlines. My LA have about 6 weeks to submit their response. I then have 19 days to reply. Is that about right?

 

thanks

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I would check any deadlines with SEND directly.

 

Regarding who I took with me to the Tribunal. I had my advocate with me from Network81.org, and my independent SALT, EP and OT as well as he Deputy Head of my parental choice of school.

 

My appeal had originally been about parts 2 and 3, and I had intended to just go on my own and get the Statement more specific. But my son deteriorated significantly and developed mental health issues and was out of school for a year. Our appeal date was cancelled twice. It was orignally scheduled for April, but it eventually took place some 6 months later in October.

 

So we were in a bizarre situation where we had the annual review of the Statement we were appealing before we had the actual appeal!

 

So as time went on, I became more sure that he would never return to his former school, and therefore, as he began what should have been year 6 and he was still out of school, I requested a change to the appeal to also include part 4. I had been monitoring the situation from the time we first lodged our appeal.

 

Initially I had only sought an updated OT report, because although his previous Statement had said he should receive an OT programme delivered in school, it had never happened. And when the LA re-assessed his Statement the LA struck out that provision eventhough no OT had said he no longer needed OT therapy. So initially it was just the OT report.

 

I also took my son to see an independent EP that specialised in Dyslexia, because, again, his former Statement said he was likely to be dyslexic and that professional input was needed to determine this, and yet again the school and LA had done nothing to identify this.

 

When the appeal was cancelled the first time I decided to get an updated SALT report. And when it was cancelled the second time I got an EP report.

 

And I had been in contact with all my independent professionals over these 112 months so that they had kept the Appeal date free incase I needed them to attend.

 

As the LA were taking their own EP and the NHS SALT and OT, I had to have my independent professionals to answer queries about their reports and for them to have the opportunity to challenge anything the LA side said.

 

On the day the Panel were brilliant. They sat each set of professionals down at a time: so my EP and the LA EP gave evidence to the Panel, then the LA OT and my OT and the LA SALT and my SALT.

 

That turned out to be very helpful because as the Panel said in their Decision letter; there was no disagreement between the professionals. The only disagreement seemed to come from the NHS SALT who said that his social and communication therapy could be delivered by someone other than a SALT. My SALT said it had to be a SALT because he had fallen further behind and because social communication and interaction would become a greater area of need as he moved into his teenage years. The Panel agreed.

 

And after the Tribunal, and after we had won, I put in an application for costs because due to them cancelling the appeal twice it had caused me to seek further reports, as the SEND Judge had issued an Order that only reports that were less than 6 months old should be in the Core Bundle of documents.

 

And I was fortunate to win that too and get the costs back.

Edited by Sally44

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If you find anything significant that you need to submit, you can submit it on the day. Just make sure you have copies for everyone. The LA may refuse to admit it as evidence, but the Panel will decide if it is relevant or not.

 

On the day before our tribunal I had received a letter from Clincial Psychology confirming a diagnosis of an Anxiety Disorder and OCD for my son. We copied that and took it with us. The LA said they refused to allow it as evidence. The Panel decided it was relevant to the Appeal and they admitted it as evidence. That become a major factor in their Decision as they said it demonstrated that he had deteriorated to such a degree that he now had a diagnosis of an Anxiety Disorder and OCD on top of all his other difficulties.

 

And I think the school SENCO really irritated them because she kept saying my son had made progress. Eventually a member of the Panel asked her "from the evidence before us we have a child that has been out of school for nearly a year and has received no education; he has lost academic skills and has become anxious to the extent that he has a further diagnosis of an Anxiety Disorder and OCD. Can you please be precise and tell the Panel exactly where you think he has made progress?" I could have hugged her.

 

Remember that the Panel are not biased. They look at the evidence on the day. So you must make sure you have your case statement clear and are able to identify the main issues of the appeal.

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