Speech and Language Therapists- best practice guidelines

[Kathryn]

I've been alerted to this recent publication on the website of the professional body for Speech and Language Therapists. It sets out in great detail how SLT's should approach statutory assessments and the tribunal process, and how they should word their reports and recommendations.

 

Essential and very interesting reading if your child is involved with the speech therapy service in any way, especially if you are about to start the statementing process, S&LT is specified in your child's statement, or if you are appealing to SEND about your child's statement and S&LT provision is an issue.

 

 

http://www.rcslt.org/news/send_best_practice

 

It's 36 pages long - be warned!

 

K x

Edited September 24, 2009 by Kathryn

[Sally44]

Thanks Kathryn, i'll have a read of that.

Whilst I remember though, it is important for parents to look at 'case law' regarding any specific issues they may have which has caused them to appeal. As the Statementing process is a legal process there are usually other cases that have set legal precedents. IPSEA have some of them on their website. This means that the same principle has already been looked at previously by another Panel in another case, and every further Panel will tend to go with the same outcome as previously unless the issue is totally new and is seen as a 'test case'.

This can help your case alot. For example quoting past case law as to the definition of what 'education' means can demonstrate to the Panel that 'education' has already been said to be everything needed for a child to gain independence as an adult. Therefore Statements can and should include things like teaching of 'life skills' if the child's needs are such that they don't have or easily acquire life skills and need professional input and support to achieve them.

[Sally44]

I've only read a brief few paragraphs, but I think that this is a document as important as the SEN Code of Practice, because if SALTs adhere to these guidelines many of the problems parents are posting about, which are the remit of SALT, are covered in these guidelines.

 

For example:

 

It talks about identifying the 'needs of the child and not the resources of the service' and that 'the LA must meet any mismatch' between the two.

 

It also talks about 'ALL areas of communication', which must therefore include things like 'the social use of language' which many SALTs do not assess for, which would cover unstructured freetime such as dinnertime/breaktimes when children on the spectrum are particularly vulnerable and have great difficulty.

 

It further says that the assessments should be for the full range of abilities and that it should be 'in a range of contexts' ie. in the classroom and the playground.

 

It also says that SALTs should not go out of their sphere of experience and therefore it might be relevant for parents to specifically request a SALT that does have experience and expertise in both autism and speech disorders. Previously my son had SALTs that had no experience of autism until I requested one that did.

 

3.7.4 says the report should "state how progress is monitored in school". Many times parents have no idea how that is being done, or if it is being done at all.

 

3.7.5 says that the report should explain 'language and communication abilities in relation to other non-verbal abilities.' This is very important because it indicates the potential of a child to learn and progress if their speech/language and social use of language skills are way below other areas of functioning. And i'm thinking specifically about children with Aspergers who maybe academically bright and therefore get no input from SALT eventhough they do have difficulties with language and social use of language.

 

3.7.6 Says the SALT has to explain 'how' the difficulties impact on the child (in the different contexts as well), so explanations about how difficulties with understanding language or literal interpretation might infact on whole class learning. Or how a lack of certain language and social skills might manifest itself in difficulties establishing friendships, and generally joining in with other children at lunchtimes and breaktimes.

 

Basically i'm loving this document. Is this something that parents can use to 'inform' their SALT about what they should be doing? Or to raise issues about areas they feel have not been assessed, or about reports that parents feel the SALT has not fully explained the implications of difficulties and how they would manifest themselves. These guidelines, are they only for SENDIST appeals, or could a parent use this prior to that stage?

 

I'll read further later on.

[Karen A]

Thanks Kathryn interesting reading.

I take note of the number of times the guidelines mention that the neeeds of the child should be the issue rather than the availability of resources.Perhaps some SALTS could pass this wisdom to more LAs especially in the current climate. Karen.

[Athena]

Looks interesting, I will have a read later. SALT assessment that was produced as part of DD's Statementing process is so woolly, you could shear it and knit a jumper with it!

 

Full of weasel words and phrases such as "any or all" of the following interventions....

 

It is pants, really, and we are not talking throngs, but great, huge, greying and fraying Bridget Jones style knickers!

Edited September 25, 2009 by Athena

[Daisydot]

This is a good document. Lets hope SALTS working within Local Authorities are "allowed" to adhere to it and not have their jobs threatened if they say and recommend things the LA dont want them to.

 

The best bit is where it says about the SALT recommendations reflecting the childs communication needs and not available resources.

 

Lets hope it makes a difference.

[Sally44]

The thing I like about this document is that it gives you something to ask SALT about and you know what the guidance has said on that subject. It is going to make it quite difficult for some SALTs if you specifically ask them 'why' they have not done x, y and z as set out in the guidance and ask them to comment on that in writing.

I still cannot understand how children get discharged from SALT when they have a diagnosis. Because to get a diagnosis they have to meet the criteria which includes significant lifelong difficulties with aspects of speech/language and social use of language. So how do they get discharged?

I don't want to sound really negative about SALTs because I have met just as many really brilliant ones as poor ones. But if I were a parent that had a child with a diagnosis that was not having any input from SALT I would be asking them why that was. Did they feel that the diagnosis was wrong? Because if the don't think the diagnosis is wrong, then they also have to agree that they must have significant lifelong difficulties with speech and language and social use of language which is bound to have a significant and lifelong impact on their ability to access both learning and social interaction. So why aren't SALT involved?

I think that as it is guidance, although there is no legal obligation to follow it, they must explain why their professional input does not meet this guidance, which is actually very specific and well written.

In my experience, once you have asked for and got an experienced SALT and have a Statement, they are more than happy to do what is required because they know that any shortfall in their service has to be funded by the LEA.

The difference I think this guidance gives is that previously, if your LEA SALT was not doing what you thought your child needed, the only option you had was to go to appeal and if you could afford it get a private report to support your case. With this guidance it gives you an insight and ammunition into what they themselves recommend 'should' be done and how it should be done.

[Karen A]

The thing I like about this document is that it gives you something to ask SALT about and you know what the guidance has said on that subject. It is going to make it quite difficult for some SALTs if you specifically ask them 'why' they have not done x, y and z as set out in the guidance and ask them to comment on that in writing.

 

As I understand the guidance it is about the information provided.It is not a comitment for SALTS to provide anything .

I still cannot understand how children get discharged from SALT when they have a diagnosis. Because to get a diagnosis they have to meet the criteria which includes significant lifelong difficulties with aspects of speech/language and social use of language. So how do they get discharged?

I don't want to sound really negative about SALTs because I have met just as many really brilliant ones as poor ones. But if I were a parent that had a child with a diagnosis that was not having any input from SALT I would be asking them why that was. Did they feel that the diagnosis was wrong? Because if the don't think the diagnosis is wrong, then they also have to agree that they must have significant lifelong difficulties with speech and language and social use of language which is bound to have a significant and lifelong impact on their ability to access both learning and social interaction. So why aren't SALT involved?

I think that as it is guidance, although there is no legal obligation to follow it, they must explain why their professional input does not meet this guidance, which is actually very specific and well written.

In my experience, once you have asked for and got an experienced SALT and have a Statement, they are more than happy to do what is required because they know that any shortfall in their service has to be funded by the LEA.

The difference I think this guidance gives is that previously, if your LEA SALT was not doing what you thought your child needed, the only option you had was to go to appeal and if you could afford it get a private report to support your case. With this guidance it gives you an insight and ammunition into what they themselves recommend 'should' be done and how it should be done.

 

Hi Sally.I do not want to put a downer on your enthusiam because I do think the document is interesting.However it is worth bearing in mind that it is still guidance.

There is no legal obligation for individual SALTS to take any notice of it at all.Even if they wish to it is a document produced by there own professional body.There is absolutely no comitment for LAs/HAs/Trusts or anyone else to provide any money to support it.

Also it is Best Practice advice so it is more a case that this is what SALTS should be aspireing to do than what they have to do or even may be practically able to do.

I am obviously not a SALT however I was a nurse.I can imagine that if patients had come to me waving RCN guidance and telling me what to do it would not have improved the patient client relationship.

The guidance includes repeated details regarding the need for SALTS to work towards a positive relationship with parents.I think that parents equally have some responsibility to work constructively with professionals.To approach professionals at the outset waving reports produced as guidance by their own professional body is gaurenteed to sey that relationship off to a difficult start even with the most supportive SALT in my opinion.

 

Even if SALTS are willing and able to follow the guidance and so improve the information submitted they still cannot be responsible for what happens with that information if it is disregarded or diputed by LAs.

 

ASD is a lifelong disability however so are all learning disabilities and many medical conditions.The NHS works on the basis that specific needs are treated .There is ceratinly currently no funding available to gaurentee lifelong treatment for every illness or disability that might be lifelong.What is more in the current financial climate in the NHS the situation will get worse before it gets better.

I think you appear to suggest that because an individual has ASD they will always require a certain level of support and this is clearly not the case.Even with Statements which specify SALT there is an annual review process and the provision could be removed if there was an agreement that it is no longer required.

My experience re SALT being able to do what is documented in Statements is also less positive than yours.The SALTs are very willing however the LA do not provide more SALTS if more children with Statements need provision.The SALTS just have to be spread more thinly.

Karen.

Edited September 26, 2009 by Karen A

[Karen A]

I don't want to sound really negative about SALTs because I have met just as many really brilliant ones as poor ones. But if I were a parent that had a child with a diagnosis that was not having any input from SALT I would be asking them why that was. Did they feel that the diagnosis was wrong? Because if the don't think the diagnosis is wrong, then they also have to agree that they must have significant lifelong difficulties with speech and language and social use of language which is bound to have a significant and lifelong impact on their ability to access both learning and social interaction. So why aren't SALT involved?

 

 

I think you might be suggesting a blanket policy on SALT for all children with a diagnosis of ASD.Such a policy would not be legal.

 

[Karen A]

These guidelines, are they only for SENDIST appeals, or could a parent use this prior to that stage?

 

I'll read further later on.

 

The purpose of this document is to provide guidelines on best practice for Speech and Language Therapists who are writing reports for the purpose of a Tribunal hearing

Quoted from original document.

To answer your question IMO.

 

It is great that Kathryn posted this document as it is very useful information for parents to have.

However it was produced as guidance for SALTS . I do not think it was intended that parents would use them explicitly at any stage.

[Sally44]

But you could ask them to clarify in writing why they are not following the guidance.

Regarding blanket policies. I think SALT departments are already operating blanket policies when a SALT department has a set programme they work through regardless of the individual child's diagnosis difficulties and needs. Or when they have a blanket policy of discharging a child because they can talk and can be understood as if the other areas of difficulty are not important or do not impact on social relationships or cause disruptive behaviour in the classroom.

I think that if a child has a diagnosis which includes a speech and language/communication and social use of language difficulties and is not having input from SALT, or has been discharged from SALT, that parents would be well within their rights to ask for the SALT to clarify any concerns they may have which this guidance highlights. It seems from reading it that alot of parents concerns in this area are covered in this guidance. Very often things don't happen until you ask for them, and if you don't know that you can ask for them then you never ask the question. So parents would be justified to ask a SALT if she has assessed in different contexts as their child might perform well on assessments carried out on a one to one basis in a quiet room, but be totally unable to access whole class learning where are many different sound sources, people talking and speech has to be processed quickly with no help to stay focused.

It is important to know whether she has assessed using both verbal and non verbal assessments as this can highlight cognitive ability, speech disorders and dyslexia. I also think it is very important that SALTs explain 'how' a difficulty will impact on the child. This is exactly the problem we had when the SALT said my son had rote learnt language and was echolalic, and then failed to explain to school what that was and how that would impact on whole class learning and learning styles. So that information was never understood or acted on by the school and therefore nothing changed.

And although this is guidance, I think that it would not look good on any SALT or SALT department for them to go to tribunal having not followed it if the parents have put their requests in writing and have evidence of that. I think this document will give alot of insightful information and allow them to ask to the right questions.

[Sally44]

The guidance also talks about the SALT dedicating time for the planning, training, monitoring and reviewing of SALT programmes. This is on top of the time dedicated to be spent on therapy sessions. This is exactly what I had included in my son's Statement which is how the private SALT had constructed her report. Infact this guidance is exactly how her report was written. However the LEA SALT Department did not do any of this. They didn't even go into school. They used to speak to an untrained TA over the phone!

It also says that the SALT should state whether the current school staff and structure and environment enable them to carry out the therapy and achieve the outcomes aimed for.

All very useful stuff to know.

And although SALT is my pet subject and I do bang on about it alot, I am convinced that many, if not most children with a diagnosis do have significant difficulties that no-one is recognising and picking up on simply because they can speak. I am convinced that my own son would have been discharged by SALT if I had not had a private report and gone to tribunal. And the difficulties she found and explained were severe, yet the LEA SALT did not even feel that assessments were necessary because he could talk - yet his performance in school and in the playground were obviously so low that something was going on. How can you consider discharging a child from SALT when their understanding of verbal instructions is on a percentile of 2?

[Karen A]

The guidance also talks about the SALT dedicating time for the planning, training, monitoring and reviewing of SALT programmes. This is on top of the time dedicated to be spent on therapy sessions. This is exactly what I had included in my son's Statement which is how the private SALT had constructed her report. Infact this guidance is exactly how her report was written. However the LEA SALT Department did not do any of this. They didn't even go into school. They used to speak to an untrained TA over the phone!

It also says that the SALT should state whether the current school staff and structure and environment enable them to carry out the therapy and achieve the outcomes aimed for.

All very useful stuff to know.

And although SALT is my pet subject and I do bang on about it alot, I am convinced that many, if not most children with a diagnosis do have significant difficulties that no-one is recognising and picking up on simply because they can speak. I am convinced that my own son would have been discharged by SALT if I had not had a private report and gone to tribunal. And the difficulties she found and explained were severe, yet the LEA SALT did not even feel that assessments were necessary because he could talk - yet his performance in school and in the playground were obviously so low that something was going on. How can you consider discharging a child from SALT when their understanding of verbal instructions is on a percentile of 2?

 

Hi.I do agree that discharging a child as in your situation would not be appropriate.However as a contrast in our case Ben was found following his most recent assessment to be ahead in many areas compared with most children his age.Although he has difficulties with Social Communication these are addressed far more appropriately by an ASD outreach teacher with teaching experience than they would be by a SALT.If I insisted on SALT input regardless of Ben not currently needing input on the basis of an AS diagnosis in practice this would just mean that the seriously limited resources in the borough would be streched further than they are already.Other children with far more significant needs would then not recieve therapy as often.I could never feel that this was fair.

I know children in the borough with Statements of SEN who have little or no speach who recieve little SALT input because there is not enough to go round.How could it ever be ethical for me to insist on SALT input on the basis of a Dx rather on the basis of need ?

 

[Sally44]

Hi.I do agree that discharging a child as in your situation would not be appropriate.However as a contrast in our case Ben was found following his most recent assessment to be ahead in many areas compared with most children his age.Although he has difficulties with Social Communication these are addressed far more appropriately by an ASD outreach teacher with teaching experience than they would be by a SALT.If I insisted on SALT input regardless of Ben not currently needing input on the basis of an AS diagnosis in practice this would just mean that the seriously limited resources in the borough would be streched further than they are already.Other children with far more significant needs would then not recieve therapy as often.I could never feel that this was fair.

I know children in the borough with Statements of SEN who have little or no speach who recieve little SALT input because there is not enough to go round.How could it ever be ethical for me to insist on SALT input on the basis of a Dx rather on the basis of need ?

 

 

If you get input from another professional that has experience in social communication then that is meeting his need. My point is that to get a diagnosis in the first place these difficulties have to be present and have to be lifelong. If another professional other than SALT is covering that area then that is okay. But if no-one is doing that, then those difficulties are not being addressed or supported and skills are not being taught.

[Sally44]

The other point about lack of resources is irrelevant. Because the 'need' should be met and any mismatch between what the service can provide and what is needed is supposed to be met by the LEA. Children that need that amount of input arguably should be statemented to secure that extra funding. But what tends to happen is that due to lack of resources the provison is never put into place, rather than the SALT doing the assessments and acknowledging the need and the LEA stepping up and providing the extra funding.

If the whole process were much more clearer, and open and truthful, then parents would be told that their child had needs that required a statement to secure the funding for them. But as well know, LEAs tend to try to stear parents away from the Statementing process where at all possible and my experience of LEA SALT was that they certainly were not following this guidance.

[Karen A]

But you could ask them to clarify in writing why they are not following the guidance.

Regarding blanket policies. I think SALT departments are already operating blanket policies when a SALT department has a set programme they work through regardless of the individual child's diagnosis difficulties and needs. Or when they have a blanket policy of discharging a child because they can talk and can be understood as if the other areas of difficulty are not important or do not impact on social relationships or cause disruptive behaviour in the classroom.

 

I am sure blanket policies operate in many areas.However according to the COP they are illegal.I cannot agree with a stance that appears to agree with the COP when it is helpful but then adopt a blanket policy on another issue because that is convenient.The whole idea behind the COP is that a Statement should follow a detailed assessment of an individual child's needs.The idea that all children with an ASD dx should always have SALT input because it is a lifelong condition completely contradicts this stance.

I think that a stance that insists that all children with whatever condition that could be regarded as lifelong should always have treatment would have one major outcome......an increased reluctance to conduct assessments.If a condition is not diagnosed or a Statutary Assessment conducted then parents cannot then insist on input from SALT,OT or any other NHS professional.At the end of the day the professionals we are talking about are trained within the NHS.The NHS does not have any requirement for professional input other than clinical need.A professional can discharge a patient at any time.There is no blanket policy on patients being kept on the books indefinitely because they have a lifelong condition.

Also if the logic you appear to be using is followed through all adults with ASD should also have SALT input which clearly is not the situation.

I may be getting a bit passionate myself on this issue.We have a different but similar situation which is painful to say the least.Ben has individual psychotherapy which is not included in the Statement of SEN because psychotherapy is never regarded as an Educational Need.Ben will most probably finish therapy at christmas.As psychotherapy for parents is only available in support of children's work my husband and myself will also loose our main support which has been in place for the last three years.

I cannot say I am happy about the situation.However I have a friend who has a child who would benefit greatly from psychotherapy.Whilst Ben and ourselves have therapy that child and others will remain on the waiting list.

I am sure that Ben might benefit from individual therapy next year.I would continue to accept support for as long as it is offered.However I do not feel it is ethical in the current climate to push the issue.Karen.

 

 

[Karen A]

Sally.

The other point about lack of resources is irrelevant. Because the 'need' should be met and any mismatch between what the service can provide and what is needed is supposed to be met by the LEA

 

Sorry but it is not irrelevant.Which ever party is elected at the next general election the NHS and LAs are facing a funding crisis.There are limited resources.An insistance that funds are provided for one thing will just mean that they are not provided elsewhere.So you might be able to insist that SALT is provided as per a Statement but the LA will just remove funding for other provision such as respite or Social Care.

In my area the reality is that posts are funded for children with Statements.So a number of SALTS are employed in order to support children with ASD in mainstream and specialist provision.A few children with Statements have SALT input quantified but most do not this includes children in Specialist Provision.So the SALT input is shaired amongst all of the children with ASD.If the parents who happen to have tight Staements insist on SALT input some of the children with no speach could get no input at all which cannot be ethical.

In my area the LA does not come up with money to fund more SALT provision each time a Statement is issued.

I am going off topic a bit I know however the reality is that there is no LEA now there is Children's Services with limited budgets which is part of the council.I could insist on provision for Ben as per his Statement.The reality is that in the last year my elder son has had his phone stollen on the bus,my elder son has been chased by a group of eight teenagers who attempted to steal his phone and he thought they might knife him if they got him,my husband has had his wallet stollen,houses in our block have been burgled in the afternoon by men in balaclavas and yesterday I was vebally abused by teenagers whilst going to the shop across the road.

I am taking Ben to school everyday because I hardly feel safe myself so cannot expect him to take a bus and tube.

Yes I could insist on provision as per his Statement.At the moment I would rather have Anti Social Behaviour and crime addressed to be honest.

 

[Karen A]

The other point about lack of resources is irrelevant. Because the 'need' should be met and any mismatch between what the service can provide and what is needed is supposed to be met by the LEA. Children that need that amount of input arguably should be statemented to secure that extra funding. But what tends to happen is that due to lack of resources the provison is never put into place, rather than the SALT doing the assessments and acknowledging the need and the LEA stepping up and providing the extra funding.

If the whole process were much more clearer, and open and truthful, then parents would be told that their child had needs that required a statement to secure the funding for them. But as well know, LEAs tend to try to stear parents away from the Statementing process where at all possible and my experience of LEA SALT was that they certainly were not following this guidance.

 

But surely what you are suggesting is that all children with AS recieve SALT input for the remainder of their life regardless of need on the basis of a diagnosis.

 

If the process was clear and open and truthful then parents would not automatically be told that their child had needs that required a Statement.There are plenty of parents who would like their child to have a Statement because they consider their child has needs that justify having one but others do not agree.Dare I say that some of them take up time and money in making requests that most people would condider unreasonable.

The process can be clear,open and truthful but the answer might still be no.

A blanket yes is the opposite of recommendations being made following a thorough assessment of individual need in consultation with parents which is what the document recommends.

 

Also as I have said the fact that the SALT makes recommendations does not gaurentee that the LA will step up and provide the funding.If that was the case this document would not be needed because everything would be settled at the Statementing Stage and the tribunal would not be needed.

 

It interests me that the document also advises theat independent SALTS work with parents and LAs so that there is some agreement regarding recommendations to panel or tribunal.This guidance also includes them so they should no longer be producing reports for parents by whom they are payed which can hardly amount to an impartial assessment.

I appreciate that I am being a bit outspoken.However I am aware that you do have personal opinions regarding LA/NHS SALTS not being impartial.I think it is only reasonable to point out that private SALTS who are payed by parents are unlikely to produce a report that disregards parents wishes....if they did nobody would use them.

[Karen A]

If you get input from another professional that has experience in social communication then that is meeting his need. My point is that to get a diagnosis in the first place these difficulties have to be present and have to be lifelong. If another professional other than SALT is covering that area then that is okay. But if no-one is doing that, then those difficulties are not being addressed or supported and skills are not being taught.

 

But that is different to what I understood you were saying.I thought you were saying that all children with ASD had a need for SALT input and that children with ASD should never be discharged by a SALT regardless of other input.

 

I still cannot understand how children get discharged from SALT when they have a diagnosis. Because to get a diagnosis they have to meet the criteria which includes significant lifelong difficulties with aspects of speech/language and social use of language. So how do they get discharged?

Edited September 26, 2009 by Karen A

[Sally44]

Sally.

 

 

Sorry but it is not irrelevant.Which ever party is elected at the next general election the NHS and LAs are facing a funding crisis.There are limited resources.An insistance that funds are provided for one thing will just mean that they are not provided elsewhere.So you might be able to insist that SALT is provided as per a Statement but the LA will just remove funding for other provision such as respite or Social Care.

In my area the reality is that posts are funded for children with Statements.So a number of SALTS are employed in order to support children with ASD in mainstream and specialist provision.A few children with Statements have SALT input quantified but most do not this includes children in Specialist Provision.So the SALT input is shaired amongst all of the children with ASD.If the parents who happen to have tight Staements insist on SALT input some of the children with no speach could get no input at all which cannot be ethical.

In my area the LA does not come up with money to fund more SALT provision each time a Statement is issued.

I am going off topic a bit I know however the reality is that there is no LEA now there is Children's Services with limited budgets which is part of the council.I could insist on provision for Ben as per his Statement. My husband has had his wallet stollen,houses in our block have been burgled in the afternoon by men in balaclavas and yesterday I was vebally abused by teenagers whilst going to the shop across the road.

I am taking Ben to school everyday because I hardly feel safe myself so cannot expect him to take a bus and tube.

Yes I could insist on provision as per his Statement.At the moment I would rather have Anti Social Behaviour and crime addressed to be honest.

 

I know that is how it happens. But I am simply stating what the 'legal' position is. I have not made the laws. But it does say in the COP and the guidance that provison is to meet 'need' and that is 'every need' and that any 'shortfall' in provison or resources is to be 'funded by the LEA'. I did not make those rules. Those are the rules. And that is the framework we have to work within. But I agree that that does leave parents sometimes feeling guilty, especially if they have secured provision and they know of other children in the same school who do not have that provision. However I have followed the procedures to get to where I am now - as have you. There are always choices in where the funding goes and parents can only follow the COP etc to ensure that everything goes by the book.

I agree with you that each child is going to need different levels of support and input. But if SALTs were following the guidance as posted then I think that all children with an ASD would initially be assessed by SALT (which should take place at SAP level anyway). And if it were done correctly then the SALT can work with the child as needed. I am now saying to provide SALT regardless. However I am of the opinion that if the guidance were followed that most, if not all, children with an ASD would require on-going input from a SALT. And again, once the SALT input has gone into a school and trained the TAs, then that benefits all the other children. Education and training remains for life.

I don't know about psychotherapy. I know that most LEAs say that OT is not an educational need. But case law says that if there is a difficulty or need that can cause a child to have difficulties accessing education, then that is an educational need. It was on that basis that we argued for OT because without it my son would find it much harder to access learning. And we managed to secure an OT programme with termly reviews. This is proving invaluable as my son is going through bouts of anxiety that are causing him to vomit for hours at a time and OT is going to start working on relaxation.

I don't know if that is an argument that you could use ie. without the therapy your son will find it harder to cope in school and that the withdrawal of this service could result in a deterioration within the school environment which would definately affect his access to learning.

But I think that your 'view' is also bound to be affected by the fact that you worked within the NHS so you are very aware of the resources and funding issues. I don't, and just want the LEA and NHS to fulfill their legal requirements. If the laws are changed then I would be trying to ensure my son secured the provision he needed through the new system. I am not seeking anything over and above what they should be doing.

Our current situation is very good. And for the first time in years I am even hoping at the possibility that my son might be able to go to a mainstream secondary school. That possibility would be entirely due to the amount of input he has received as a result of the Statement. And if that were to happen that would surely mean a huge saving as opposed to a SEN secondary school.

I am not in favour of just throwing money at any problem. But when there is a known difficulty and a proven way of improving functioning then I think it is madness if the child does not have the opportunity to develop and improve their skills and functioning. In the long term it saves money on an overstretched system. If my son is given the opportunity to become an independent adult that lives and works to support himself that is surely a huge financial saving as opposed to an adult that is reliant on benefits and full time adult support.

Edited October 1, 2009 by Kathryn

[Sally44]

Regarding the safety of children on the streets, that is very worrying. Mine aren't at that age yet. I don't know what I would do it the situation was as you describe. You want your children to learn to be independent - but at the same time if things are happening on a regular basis you don't want to put your children in danger. These other children have parents and it makes me so angry that they have raised such children. It must be very frightening for the children themselves. I think children nowadays are much more afraid than we were as children.

[Karen A]

I know that is how it happens. But I am simply stating what the 'legal' position is. I have not made the laws. But it does say in the COP and the guidance that provison is to meet 'need' and that is 'every need' and that any 'shortfall' in provison or resources is to be 'funded by the LEA'. I did not make those rules. Those are the rules. And that is the framework we have to work within. But I agree that that does leave parents sometimes feeling guilty, especially if they have secured provision and they know of other children in the same school who do not have that provision. However I have followed the procedures to get to where I am now - as have you. There are always choices in where the funding goes and parents can only follow the COP etc to ensure that everything goes by the book.

I agree with you that each child is going to need different levels of support and input. But if SALTs were following the guidance as posted then I think that all children with an ASD would initially be assessed by SALT (which should take place at SAP level anyway). And if it were done correctly then the SALT can work with the child as needed. I am now saying to provide SALT regardless. However I am of the opinion that if the guidance were followed that most, if not all, children with an ASD would require on-going input from a SALT. And again, once the SALT input has gone into a school and trained the TAs, then that benefits all the other children. Education and training remains for life.

I don't know about psychotherapy. I know that most LEAs say that OT is not an educational need. But case law says that if there is a difficulty or need that can cause a child to have difficulties accessing education, then that is an educational need. It was on that basis that we argued for OT because without it my son would find it much harder to access learning. And we managed to secure an OT programme with termly reviews. This is proving invaluable as my son is going through bouts of anxiety that are causing him to vomit for hours at a time and OT is going to start working on relaxation.

I don't know if that is an argument that you could use ie. without the therapy your son will find it harder to cope in school and that the withdrawal of this service could result in a deterioration within the school environment which would definately affect his access to learning.

But I think that your 'view' is also bound to be affected by the fact that you worked within the NHS so you are very aware of the resources and funding issues. I don't, and just want the LEA and NHS to fulfill their legal requirements. If the laws are changed then I would be trying to ensure my son secured the provision he needed through the new system. I am not seeking anything over and above what they should be doing.

Our current situation is very good. And for the first time in years I am even hoping at the possibility that my son might be able to go to a mainstream secondary school. That possibility would be entirely due to the amount of input he has received as a result of the Statement. And if that were to happen that would surely mean a huge saving as opposed to a SEN secondary school.

I am not in favour of just throwing money at any problem. But when there is a known difficulty and a proven way of improving functioning then I think it is madness if the child does not have the opportunity to develop and improve their skills and functioning. In the long term it saves money on an overstretched system. If my son is given the opportunity to become an independent adult that lives and works to support himself that is surely a huge financial saving as opposed to an adult that is reliant on benefits and full time adult support.

 

I will not respond in detail because I know I have probably taken this thread off topic and spent more time today than I should have.

All I will say is that there is no legal obligation for the NHS to provide anything unless it is committed to in a statement.

My view incidently is affected by the fact that my husband is too well aware of the resource and funding issues.

As regards the possibility of mainstream secondary school for your son it is a very individual choice.

There are currently two of us that I know of with children at mainstream secondary school.I do not pretend to be impartial.We are currently attempting to cope with DS who is new to secondary school after a tremendous amount of work and MIL who is in hospital.However it is extremely hard work.Ben is extremely bright and accademically at a level with many of his peers.None the less mainstream secondary is the hardest thing we have ever done.If there was an option for specialist provision that was suitable and did not require a residential placement outside London we might well have considered it.We have already had issues with bullying and lack of understanding of Ben's neeeds.That is despite the school being good compared with many.We also have extensive support from CAMHS and months of work went into transition.

Ben has had three years of psychotherapy to enable him to cope as well as he is now and there is still a risk it may not work out and he could be excluded or just refuse to go to school.Sorry if I sound negative however the reality is that the difficulties of obtaining support at primary school are almost insignificant when compared with attempting to obtain appropriate provision in a school of several thousand pupils and at least twenty permanent staff plus supply staff and office staff.Karen.

 

[Karen A]

Regarding the safety of children on the streets, that is very worrying. Mine aren't at that age yet. I don't know what I would do it the situation was as you describe. You want your children to learn to be independent - but at the same time if things are happening on a regular basis you don't want to put your children in danger. These other children have parents and it makes me so angry that they have raised such children. It must be very frightening for the children themselves. I think children nowadays are much more afraid than we were as children.

 

Unfortunately they are not children.They 15-18 and taller than myself.We happen to live in one of the most deprived inner city boroughs in the country because my husband is comitted to his work in the NHS. at the momment.

I don't think children are more afraid than they were in my time but then my brother [age 16] committed suicide in the house we lived in so I my experiences of feeling safe are not within the norm at all.

I know that it is a myth that things now are so much more dangerous than they used to be. It is just that people talk about it.