Rare Disease Day: My son has Retinopathy of Prematurity

facebook-profileToday, 28th February is Rare Disease Day. It’s an awareness raising day for the millions of people around the world who are affected by rare conditions. Most suffer from lack of investment in research and drug development because there simply aren’t enough people diagnosed to make it a profitable enterprise for pharmaceutical companies.

Today on Special Needs Jungle is the third of our series of posts about rare diseases as our contribution to raising awareness. You can find links to the others at the end of Deb’s moving article about her beautiful son J, who has a rare eye condition that means he cannot see.

Debs writes:

rosie and jamie 005

My twins were born three months early.  After an emergency arrival into the world, R, my daughter “just got on with it” (as the NICU nurse described it).  However, her brother, J, was not so keen to be here early (he still doesn’t like early starts) and needed more intervention.
As a result of their prematurity, they both developed Retinopathy of Prematurity (ROP).  This is the abnormal development of blood vessels in the retina of the eye and the condition has five stages.  My daughter was diagnosed with borderline stage 1/2.  My son was initially diagnosed with Stage 3 but this quickly developed to  stage 5, which in layman’s terms means his retinas have detached.  He has no vision or light perception.

ROP develops in 16% of all premature births (with this rising to 65% in those with a birth weight < 1250g) however, severe ROP (stage 4 or 5) is very uncommon – less than 500 children per year.

I still vividly remember the night we received the diagnosis.  We were told this was a routine eye examination for premature births (with very little other detail) but as soon as the ophthalmologist was examining my son, I knew by his reaction that something wasn’t quite right.  To check for this condition, the baby has to have their eyes pinned open and I remember just listening to my son cry.

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Children and Families Bill – the missing pieces

senreform2Earlier this month, we shared our Initial Views on the Children and Families Bill.  Since then, we have had chance to look at the Bill in more detail and wanted to share our views and more importantly to discuss “the missing pieces”.

As parents, we know the current system and its failings far too well so we welcomed the introduction of the Green Paper and the excitement of being involved in Pathfinders.  However, the Bill that we have been offered isn’t quite all that we were hoping for.

The reforms offered, “a new approach to special educational needs and disability that makes wide-ranging proposals to respond to the frustrations of children and young people, their families and the professionals who work with them”  and a vision of reforms to, ” improve outcomes for children and young people who are disabled or have SEN, minimise the adversarial nature of the system for families and maximise value for money”.

What we’ve been given in the Children and Families Bill has not quite lived up to the hype.

The good bits:

  • Children, young people and their families are to be true participants in all decisions affecting them
  • A duty for health, social care and education to commission jointly (which theoretically means they will actually speak to each other)
  • Education Health and Care Plans (EHCP) to be available up to the age of 25
  • Academies and Free Schools to have the same SEN requirements as maintained schools
  • Independent Special Schools will be included on the list of schools that parents can request as a placement (although the proviso about ‘efficient use of resources’ is still in there)

What’s missing?

  • Disabled children and young people without SEN.  Despite the Green Paper offering improved outcomes for children and young people who are disabled or have SEN, the Children and Families Bill is only offering the new EHCPs to those with SEN.  This decision shows a real lack of understanding from the DfE about the difficulties that children and young people with “just” a disability (and no SEN) face.  The Children and Families Bill suggests that the needs of these group will be met by the Local Offer.
  • Local Offer – Minimum Standards.  Currently, the DfE are suggesting a “common framework” for the Local Offer.  This could possibly (and will most probably) result in a postcode lottery.  As the Local Offer is being offered as the alternative to EHCPs, there needs to be much clearer legal obligation of minimum standards for Local Authorities.  “Minimum” indicates that something is the very least which could or should happen. “Framework” indicates a skeletal structure designed to support something.
  • There does not appear to be, within the Bill, a “duty to provide” the contents of the Local Offer, just to publish it and that a local authority “may” wish to review it “from time to time”. All a little bit wooly.
  • School Action/School Action +.  There is no mention within the Bill as to how the needs of children currently on SA/SA+ will be met.  Again, if the Local Offer is to be the alternative then this  needs to be much more prescriptive to Local Authorities. The DfE says the replacement structure for the present lower categories of SEN will be defined in the new Code of Practice which is now starting to be drawn up – interestingly by a different team of officials to the one that drafted the bill. Hmmm.
  • No duty on health or social care to provide the services within the EHCP – just an obligation to jointly commission with the local authority. There needs to be an realisation in government that the words “Joint Commissioning” aren’t a new magic spell – a sort of Abracadabra for SEN. Optimistically repeating the “Joint Commissioning” mantra doesn’t mean it’s, as if by magic, just going to happen.
  • No specified time frames from when you apply for an EHCP assessment to when you receive an assessment and more importantly, a EHCP.  Currently, it takes 26 weeks from applying for an Assessment of SEN to actually receiving a Statement of SEN.  This, as a parent, can seem like a lifetime (especially if you only hear about the need for a statement a short time before your child attends school – and yes, this is more common than people like to admit). However, you can see a light at the end of the tunnel with a deadline of 26 weeks.  The new Bill does not provide any defined time scales and this is essential for families. It does say that the regulations may make provision for this – but “may” should really be replaced with “must” as this is a key point.
  • Key worker – throughout the Green Paper, there was mention of a key worker for families.  One person to go to, who would help the families through the jungle but there is no mention of this within the Bill.  This is one of those key features that really excited a lot of families.  The ability to have one person; one person who would repeat your story for you and point you in the right direction to access the support your family needs. This is one aspect of the initial aspirational Green Paper that needs to be clarified – both for families and practitioners. Was this just an absent-minded omission from the Bill or has the DfE decided to quietly sweep this innovative and important role under the carpet? Note to DfE: if it’s the former, someone needs a slapped wrist, if it’s the latter, you’ve been rumbled so put it back in, pronto. Or is this another point for the “regulations”?
  • Time – the current Bill is scheduled for Royal Assent in Spring 2014 (i.e. passed into law) with September 2014 being proposed for when this will come into practice.  How will Local Authorities and PCTs manage to train all the necessary staff in this short time (especially with a 6/7 week school holiday in that time)? Ask any parent and they will say the same: they would far rather wait for another six months so that LAs can get all their recruiting and training in place (not to mention their funding arrangements) than inherit a chaotic mess where no one knows what’s going on, where the money is coming from and half the staff still hanging on to the old adversarial ethos.

While we’re on the subject of culture change, a DfE official did mention to us that he thought re-training to effect culture change should be starting now. I would be really interested to know what funding or provisions or courses there are in existence or planned, to begin this process – which is arguably one of the most important parts of the entire process. Indeed, it might be a little controversial to suggest, but if a root and branch programme of culture change within LA SEN departments had been put into practice to start with, there may have been less need to overhaul the entire system.

The new Children and Families Bill does have the potential to provide children and families with, “A new approach to special educational needs and disability” and to, ” improve outcomes for children and young people who are disabled or have SEN, minimise the adversarial nature of the system for families and maximise value for money” but not without some more thought and considerable tweaking.

Tania & Debs

Rare Disease Day: Son2 has Ehlers Danlos Syndrome

facebook-profileTania writes:

As you will know if you are a regular reader, Son2 has Asperger Syndrome. He also has ADD (no H in there, he doesn’t move much!)

Last year, while researching information for the forthcoming Rare Disease Day for work, I came across a case study on the Rare Disease UK site about a young woman who had struggled with a group of different syndromes, including hypermobility, Raynaud’s Syndrome and POTS (Postural Orthostatic Tachycardia Syndrome).

It was a light bulb moment…

son2eds2Son2 was born with an unstable ‘clicky’ hip that took a long time to heal and as a toddler, he had suffered with Reflex Anoxic Seizures, a frightening condition where shock or pain can cause the heart and breathing to suddenly stop. The sufferer then has a seizure-like episode, with eyes rolling, the skin going grey and then falling into unconsciousness.

In fact, as they are not breathing and their heart is not beating, they are clinically dead. After some seconds, thank God, adrenalin always kicks in, restarting their heart and breathing and they come round.

RAS is caused by an inappropriate response of the vagus nerve triggering a cardiac event. It is a rare heart arrhythmia. The brilliant charity that helps people with RAS and other blackout conditions is called STARS and I was involved with helping them for a long time.

Son2 would have these episodes up to three times a day, usually triggered by anxiety or frustration. By the time he started school, the attacks had diminished into ‘near misses’, where an attack would start but we were usually able to get him to a horizontal position to help minimise the effects and equalise his blood pressure.

It was, as you can imagine, a very distressing time, but as with everything we have encountered as parents, we made it through, just taking every day as it came. Of course we knew nothing, then, of what was to come in the years ahead with both sons’ Asperger’s.

As Son2 grew older, his Raynaud’s would cause his lips to turn blue when he got cold and he began to suffer from joint pain and dizziness. We did not connect the different problems he experienced into one larger whole – why would we, when they were so different? We were worried that his dizzy spells were signalling a return of the RAS, which, if it goes away in childhood, can recur at puberty.

But when I read the case study, everything fell into place. The young woman had eventually been diagnosed with Ehlers Danlos Syndrome. I was convinced this is what Son2 had, so I decided to do some more research and follow it up with my doctor.

My research revealed that EDS has six different types of varying severity and the difficulties experienced within each sub-type can also affect people in different ways. EDS can cause multiple dislocations, joint pain, fatigue, easy bruising and stretchy, fragile skin among many other symptoms.

RareConnectAs my work involves a forum run by RareConnect, and I knew they had an EDS forum, I contacted my colleague there, Rob, who helpfully gave me some numbers and links for EDS information.

As a result, I called up Lara from EDS Support UK who gave me the name of a specialist. I went to my GP for a referral, worried she might think I was an over-protective mother. Luckily, she knows me and trusted my instincts. Although she was no expert in EDS, when I gave her the information I had and the name of the specialist, she was happy to refer us.

Soon after, we went to see Professor Rodney Grahame, who is a world expert in EDS in London. He carried out measurements and a physical examination of Son2 and listened closely to his medical history before agreeing that he did, indeed, have EDS Type III.

edsSon2  already had OT at school and now also has a physiotherapist, we have had a special programme designed for him at our gym (he is 13) and he is waiting to see another specialist paediatrician regarding a further potential issue that Professor Grahame noticed.

We saw the Prof. privately for speed, although he also sees patients on the NHS. All Son2’s other treatments are NHS and so we are on a waiting list.  For the physio, the letter instructed us to wait six weeks from the date of the letter before we could ring up for an appointment!

The EDS RareConnect forum that I mentioned, which is run by EURORDIS, the European Rare Diseases Organisation, has lots of information, research articles and the chance to connect with others. It’s also multi-lingual.

If anything I have described here rings a bell, do check out the links in the article to find out more. It’s quite amazing to me that because of work I was doing to help others, I ended up discovering something about my own son that will make his life better (even potentially longer) and my great thanks go to Rob Pleticha at RareConnect and Lara Bloom at EDS UK for helping me on my way.

Rare Disease Day is on February 28th. You can find the Facebook page here

If your child has been diagnosed with a rare condition, the National Children’s Bureau has an information support sheet. You can download it as a PDF here

Special Needs Jungle has a new LinkedIn group!

LIgroupWe have exciting news!

Special Needs Jungle now has a brand new group on LinkedIn. While there are a couple of other SEN groups there, the Special Needs Jungle group is aimed at anyone on LinkedIn involved with 0-25yrs special needs and disability issues in the UK.

This includes health, education, mental health, social care, childhood illness/rare disease & its implications among other issues. And you are welcome whether you are a practitioner , parent/carer or another individual or professional with an involvement in these areas.

We aim to offer a chance to learn from each other by sharing knowledge, experiences, news, best practice and views you may not have previously considered!

There is so much knowledge available from many different sources and we’d like to offer a place for you to contribute your ideas, views, resources and knowledge.

With so many changes on the way in the wider area of special needs, it makes sense for knowledge to be disseminated and shared as widely as possible.

The group is managed by myself and Debs, so you’re sure to have a warm welcome. We’ll be on the look out for great contributions for the SNJ site as well, so don’t be shy in your suggestions!

Join, share, contribute, make yourselves at home!

If you are a LinkedIn user, you can ask to join here

Early Years Development Journals from NCB

NCB-LogoThe NCB (National Children’s Bureau) website has some brilliant free resources for parents, carers and practitioners available for download.

One is the Early Years Development Journal.

“The new Early Years Developmental Journal is designed for families, practitioners and others to use as a way of recording, celebrating and supporting children’s progress. It is also for people who would like to find out more about children’s development in the early years. It supports key working by helping everyone involved with a child to share what they know and discuss how best to work together to support development and learning.

This Journal is particularly useful if you know or suspect that your child or a child who you are helping is unlikely to progress in the same way or at the same rate as other children – whether or not a particular factor or learning difficulty has been identified and given a name.”

Before you start to use the Journal, you should first read the ‘How to Use’ guide, which you can also download.

There are also specific journals for children who are deaf, visually impaired or have Down’s Syndrome on the same page.

Debs says:

“I was introduced to the Developmental Journal for children with a visual impairment by one of our Consultants.  I was asking how my son’s development compared to other children with VI because I didn’t think it was fair to be comparing his development to a sighted child.  Thankfully, our Consultant was Alison Salt (Consultant Paediatrician – Neurodisability) who was one of the people involved in helping to develop the journal for VI children.

The journal became our bible and it went everywhere with me.  We took it to assessments with Alison Salt, his VI play specialist used it to set targets, we used it with his nursery – it was invaluable as it meant we were all working together with the same information.  We were able to see what my son was able to do, what gaps there were in his development and within the journal for children with VI there are also suggestions on activities.

As a mum of a child with visual impairment, I found it really difficult at the beginning to think outside the box – so many ideas for helping a child to develop are vision based.  Look at the majority of children toys, most of them have buttons that light up to tell you that you chose the right option.

The developmental journal was so useful, it gave us ideas, a true assessment, a mutual reference for all involved and more importantly, it gave us hope.  I really cannot recommend this Developmental Journal enough.  It made me informed and therefore I felt like an equal partner.”

There is so much more on the NCB website from information, training and support, Why not bookmark the NCB website to explore as and when you have the time?

SEN Reforms – The Minister visits

Last Friday a groups of parents from parent-carer forums around the country came together at the Department for Education to talk about how parental involvement in the pathfinder reforms had influenced the process, what was working and what wasn’t.

The parents included myself, Debs (who you will recall runs Kent’s forum) and Angela Kelly, my Surrey Family Voice co-chair.

We talked a lot about the value of what is being called the “co-production” of parents’ voices being valued and listened to and how it must continue after the reforms are put into practice, and preferably, mandated in the Children & Families Bill, or new Code of Practice/regulations.

On hand were DfE officials involved in the bill’s progression and yesterday, Edward Timpson, the minister in charge himself travelled to Disability Challengers in Farnham to meet parents and pathfinder families.

Although, very flatteringly, I had been invited to meet him because of Special Needs Jungle, I was already booked to deliver a half-day social media workshop for a room full of noisy and energetic Stella & Dot independent stylists. It was lots of fun, but I was rather hoarse and brain-dead at the end.

Despite sadly missing my chance to speak to the minister, I knew he was in very good hands with Angela being there, along with other parents.

And Ang, being the good egg she is, has written about the visit here. She did say the Minister had a tear in his eye at missing me too, but I think she was smirking when she said it.

Over to Ang…

The SE7 pathfinder team had an important visit on 14th February. SE7 is a collective group of seven south-east local authorities, parent-carer forums and Voluntary and Community sector organisations, who have come together to trial the reforms proposed in the Children & Families Bill.

On a mild Thursday morning, a collective group of professionals, made up of local authority, voluntary and community sector and parents came together at Disability Challengers in Farnham, Surrey to meet with Parliamentary Under Secretary of State, Edward Timpson. (And yes, I have included Parents in the professional capacity because 1, we are professionals where our children are concerned and 2, we are professional in our capacity as co-producers under the new approach to the SEN reform)

Upon my rather unceremonious and flustered arrival, I was greeted by a room full of familiar and  friendly faces. Co-chairs of West Sussex, Hampshire and Kent parent-carer forums had arrived in a much more timely manner than myself, thank goodness and represented parent participation in a very professional manner.

But most importantly there were young people present and a family who are currently at the Statutory Assessment phase under the current SEN system.  Having young people and families involved in such a key meeting is such a step forward and gives a them a voice, it also enables the people who need to understand this message the opportunity to hear how real people are affected by the current system and what needs to change.

The Minister joined everyone in a circular group and was told about the progress being made so far by all trial areas, while Surrey’s pathfinder manager, Susie Campbell followed with Surrey’s progress regarding the single plan. She explained how Surrey had devised their single plan, focused and the child and their family, and how families and young people had been instrumental in this process. Our draft has gone back and forth until a plan was agreed suitable for testing.

I was then asked what my thoughts were on the single plan and I rather gushingly spilled out how I thought co-production was the only way forward and that by children and families having a voice and being at the heart of the process this would create a culture shift and build relationships with parents/carers and all the authorities.

Mr Timpson spoke with a family about their experience of the current system and the openness of the discussion demonstrated that they were being heard and that a change in the way mainstream schools approach SEN and disability was urgently needed.

There was a very limited discussion about Key Working which, while this was due to time, is something that I feel will have to be further addressed  and  when further trials have been carried out this will be  key area (pardon the pun) to ensure the success of the new approach.

Personal budgets and the Local Offer were next and Co chair of West Sussex spoke of their experiences with personal budgets and how this had enhanced their child’s access to services he actually needed rather than accessing services that were available.

Click to see the Tweet Vine Movie of the card

Click to see the Tweet Vine Movie of the card

I think more time needed to have been spent discussing the Local Offer, as there huge concerns over how this will work and how it will  replace the categories of School Action and School Action Plus and inform parents of services that will be able in cross-boundary areas in a clear transparent timely and effective way

Time seemed to be the main constraint with the meeting as there was a lot to present in such a small amount of time, however that Mr Timpson visited to see what is happening in the trials from the mouths of those involved  demonstrates a willingness to listen learn and understand what is happening with the trials and, if I hadn’t mentioned it before, the importance of co-production!

At the end of the session Mr Timpson was  presented with messages from each SE7 parent-carer forum to the Minister. This was innovatively delivered in a hand made Valentines card.

This was well received and Mr Timpson remarked that it was the most creative lobbying he had ever seen, I therefore feel that because of this, the impact of the messages will resonate for longer and have a greater prospect of successfully informing the change to the SEN and disability reform.

Here’s Family Voice Surrey’s message to the Minister:

Message from Family Voice Surrey- Thank you for listening to and including parents/carers views in the publication of the draft legislation.

Our thoughts are that the new bill needs more clarity. This view is shared by ALL parent carers on our steering group. Statutory protection is necessary for those children and young people who have disabilities that may fall outside of the SEN bracket, these children and young people may have very complex health needs but if they have no special/additional educational requirement then currently they will not be eligible for statutory protection under the single plan.

Family Voice Surrey request that you include:

  • Statutory rights for those aged 0- 5 with an EHCP, ensuring swift and timely access to treatment/equipment to aid the delivery of early intervention
  • A mandatory requirement for children with SEN and Disabilities to receive a level of support from their LA that meet the requirements of their EHCP
  • Minimum national standards for the Local Offer – a specified minimum level of provision that Local Authorities will have a duty to provide to children with education, health and/or social care needs who are not eligible for an EHCP

Pathfinder has shaped co-production and parents and carers are working alongside professionals, practitioners and providers in an unprecedented way and it is working.  Policy and local delivery is being shaped in a pioneering way.   This must continue!

Mandatory requirements for co-production are a central part of the EHCP process, together with the delivery of the Local Offer at a strategic level across all services.

Parent/carer forums have a vital role ensuring that parents receive sufficient support and training to undertake co-production effectively. Recognition is needed for the unique role that parent/carer forums will have in this delivery , with adequate resources provided for this work.

Message from Kent PEPs (Kent parent carer forum)

As a forum we were please to see some of the feedback received from parents/carers has influenced some changes in the draft Children & Families bill, and thank you for listening to our views.

We welcome the changes regarding mediation and the fact it will not become compulsory. We are pleased to see the inclusion of Towards Adulthood as a requirement of the Local Offer and an emphasis on strengthening the participation of young peoples.

However there are still some areas where we have concerns:

  • We are concerned about the lack of inclusion for children & young people who have a disability but not SEN and hope your decision to exclude them will be looked at again, in particular to provide statutory protections for Disabled children & young people who have a specific health/social care need but not severe SEN.
  • There is no indication of a duty to respond to a parents request for assessment within a time limit; will this become clearer when the regulations are published?
  • We would appreciate more detail of the single assessment process, Including how the integrated assessment will work in practice; will this become clearer when the regulations are published?
  • With regards to the Local Offer we urge you to support a standard approach for schools to determine some national minimum standards encompassing what parents/carers can expect from schools, clearly laid out so parents can see how these standards work in practice. This should of course include academies & free schools.
  • We support the call for a national literacy and dyslexia strategy, which includes dyslexia trained teacher in every school, which would support the need to ensure early identification (Dyslexia Action’s Dyslexia Still Matters report).

The pathfinder has certainly increased parent participation and closer working relationships between parents/carers and professionals and we would appreciate support for the vital role parent/carer forums have in ensuring effective co-production continues.

Top Tips for Speech and Language Therapy – Part Two

SpeechblogHere is the second part of top tips for speech and language therapy from Helen & Elizabeth at SpeechBlogUK. If you have any tips that have proved useful, please do share them in the comments!

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Your child’s initial appointment

Your child will probably be seen in a clinic room if they are preschool.  If they are school-aged, they may be seen in school or in clinic – different departments work in different ways.  In a few cases you may get a home visit but these are unusual unless you are seeing an independent therapist.

What to expect

The appointment will probably last around an hour, maybe longer.  If you are in clinic, the therapist is likely to spend a large part of the appointment talking to you about your concerns.  He/she will also play with your child.

If your child is preschool age, they may not do much else and it may look as if they are not doing much.  However, they will be looking at all sorts of things while they are playing, for example, how your child plays, how they communicate, whether they can follow instructions and answer questions, whether they can take turns, how long their attention span is, what they do with the toys…

All of these things will give the therapist useful information about how to help your child.  They will probably like you to join in and interact with your child as well.  Sometimes the SLT may do a more formal “assessment” of your child’s difficulties as well, especially with an older child.  This sounds heavy but will just involve looking at a book full of pictures and asking your child to name things or find particular items.

WARNING:  Your child may not be at their best in the unfamiliar situation, and you may find that your child does not respond to things you are sure that they can do.  If this is the case, tell the therapist.  They will be happy to talk it through with you and work out whether the unfamiliar situation is causing the difficulty or if it’s some other aspect of context that is making the difference.

How to get the most out of your appointment

speechblogboyMake a list of your concerns and take it with you.  You are the person who knows your child best so the therapist will want to hear what you are concerned about (and not) and what you have already done to try and help, if anything.  Think about what you want to convey.  Take with you any other useful information – with a young child, if you have a list of when they did things (crawled, walked etc) in a baby book, you may find it useful to take this with you.

Also, if your child has seen any other professionals (audiology, paediatrician, psychologist etc) take the reports with you.  A school report may be useful to the therapist if you have a school-aged child.  The more information the therapist has, the more likely they are to be able to make an accurate and detailed assessment.   At the end of the appointment, the therapist will give you some feedback about what they have found.

REMEMBER:  If you don’t understand what is being said or the follow-up plan that is suggested, ask.  In all professions, you become immersed in something and it is easy to say something that you think is easy to understand that is confusing to the person you are talking to.  I know the mechanic at the garage certainly does when I take my car in to be fixed!  At all stages, if you are unsure, ask.

What to tell your child

Obviously you will want to tell your child something about where they are going and why.  Keep this low-key.  If your child is quite young, just tell them that you need to go and talk to someone.  He/she will have toys for them to play with, and will probably chat to them too. There is no surer way of ensuring that a child will clam up than telling them that someone is going to listen to how they are talking! You would probably be reluctant to talk too in that situation!  If you have an older child they may be more aware and inquisitive, but still be positive and low-key about it.  Tell them that someone is coming into school to see what some of the children do.  You are one of the children they want to talk to.  They might sit in your classroom and watch for a bit, or they might talk to you on your own and look at some pictures with you.

Follow-up appointments

Similar advice applies for getting the most out of follow-up appointments.  Make a list of what you want to say/ask and take it with you, especially if appointments are infrequent.

WARNING: Be aware that if you have a lot of very specific questions, your therapist may not be able to answer all of them immediately.

If the SLT has given you advice or activities to try, make sure you try the things that have been suggested.  You may start doing the practice and then discover that you are not sure what you are supposed to be doing.  You may run out of ideas to work on a particular thing.  You may have tried for a long time and find that your child is just not making progress.  Talk to your SLT.  Call or email and ask for more ideas or let them know that you are struggling.  Don’t feel that you have to wait until the next appointment, if a brief conversation on the phone would help to clarify something or give fresh ideas.

REMEMBER:  You are the person who knows your child best – make sure you think about what you want to convey each time and what you want to get from the appointment.

Do come and look at our website www.speechbloguk.wordpress.com  for more information as well.  We cover a range of topics for both parents and therapists.  We have several posts with top tips for different topics (first words, generalising sounds, speaking clearly etc), and ideas of things to do, and we’re planning more in the near future.

Top Tips for Speech and Language Therapy – Part One

As is often the case, I come across great resources and services for children with special needs on Twitter. I then cheekily ask them if they’d like to contribute a guest article for Special Needs Jungle and I’m delighted to say, today and tomorrow, we have a two-part article from two Speech and Language Therapists who run SpeechBlogUK.

Helen & Elizabeth have written their top tips when using Speech and Language Therapy services.

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Hi.  We’re Helen and Elizabeth from www.speechbloguk.wordpress.com .

SpeechblogWe’re two speech and language therapists living and working in the south-east of England.  We both have experience of being employed by the NHS and working independently.  We’ve recently started our own blog, and we were thrilled when Tania contacted us about writing a guest post for Special Needs Jungle.  Below is some advice about accessing SLT and making the most of your appointments.

Many children have speech and language problems at some point and this number seems to be rising.  If you have concerns about your child’s development, the most sensible thing to do is seek out a referral to a speech and language therapist.  However, as many of you may be aware, sometimes this can be harder than it sounds.

There are a number of places you can get good, sensible information from, both on development and ideas to help at home.

  • Ican: Ican are the children’s communication charity.  They have some brilliant resources and advice.  They also offer a range of services and support.
  • Afasic Again offer support and advice to parents and have a range of services available.
  • Talking point Has some lovely information and developmental checks and information
  • Mommy Speech Therapy: This is an American blog and has some great advice sheets and ideas

WARNING: be a little careful when searching the Internet. As with all things there is also some misleading information out there.  Try to go to known associations and organisations.

Referrals

pigtail_girlThere are a number of ways to get referred to most NHS speech therapy departments.  There may be local variations but generally:-
– Preschoolers can be referred by a GP, nursery, paediatrician, health visitor OR parents.
– School aged referrals can become a little more complicated. Normally referrals have to come from schools or paediatricians and fewer trusts will accept parental referrals (although it’s always worth trying!). You may also find that your child may need to be referred to other education based services first, before they can be referred on to speech therapy.

You can also access independent speech therapy; however, you have to pay! A few health insurance companies will pay for independent initial assessment, but I have yet to find one that will fund ongoing therapy for developmental issues.

In some circumstances, parents can get help towards the fees from Cerebra.  To ensure the therapist you find is appropriately qualified and insured, use the ASLTIP website www.helpwithtalking.com .  This is the association for independent therapists and, to be a member, you have to prove that you are qualified and keep all memberships/ insurances and skills up to date.  Most independent therapists will happily talk about your concerns over the phone and some offer a free brief consultation – so it’s worth ringing around. You are paying so you want to find someone you can work with.

WARNING. Some schools say they have a speech therapist and they don’t. They may have a TA with some training or some of the local authority education workers who support language, but few mainstream schools have a qualified speech therapist.

REMEMBER: you know your child best.  If you have concerns you should follow up on them, even if it’s just reading up a little.  If you are finding it hard to get your child referred, keep going!

Read the second part of this article on Special Needs Jungle tomorrow.

Ten things I wish, with hindsight, I had known

Debs writes….

As we go through the Special Needs Jungle, we pick up tips, we gain confidence and we often think “I wish I’d known …….. at the beginning”

I wanted to share with you the ten things I wish I had known (or had the confidence to believe) when we entered the Jungle.

  1. When you sit in the room with the practitioners, you are an expert too. You may not be an expert in your child’s diagnosis (yet); you may not be an expert in what services are available for your child but you are an expert in your child. You know your child better than any practitioner. So at your next appointment think “I know my child and I bring this expertise to the meeting.”
  2. 1401629_dancing_girlsIt’s okay to take a friend to an appointment. Not just for support but also to take notes. Someone who, after the meeting, can help you to remember exactly what was said. I have walked out of so many appointments and thought “what was it he said about…….”. They can also be the person who can take your child out of the room when you want to have a discussion you don’t necessarily want your child to hear. Taking a friend is not a sign of weakness or even seen as confrontational, it’s just support when you really need it. Often our friends without children with SEN wonder what they can do to help us – let them help.
  3. It’s okay to feel sorry for yourself sometimes. I really tried to bottle those feelings up and pretend that I was okay, that I was coping when inside I wanted to shout “why me, what did I do”. I would sometimes avoid my friends who didn’t have children with a diagnosis because I wanted to ask “what did you do differently, why do you not have to deal with the same things I deal with”and then I felt guilty for thinking this. But guess what? It’s normal. So many parents of children with SEN go through this, especially at the beginning when you are learning how difficult this system is, this system you are involuntarily dealing with. Don’t bottle it up. When I have a day like this (and I still occasionally do), I stay indoors, I turn off my phone and I cry. Then I get myself back up off the floor and I have stopped feeling guilty for being human.
  4. 1321733_broken_heartSometimes it is going to hurt. When you get a diagnosis, even if it is a diagnosis you have been fighting for because you know the label may help to get the support, it can still hurt. Just because you are expecting it, don’t think it will hurt less. It may not. When I got the diagnosis of hydrocephalus, it was unexpected and it hurt. However, when we went for the diagnosis of ASD, I was expecting it, I knew it was coming and I knew it would help but it still didn’t hurt less when it was confirmed. I can still remember sitting in the car on the return journey and feeling like my world had been turned upside down. I can still remember people saying “what are you upset about, you knew they were going to say this” but do you know what, even though I find this hard to admit, I wanted to be wrong. I wanted them to laugh at me and say “you silly neurotic woman, why would you think he was autistic”. But they didn’t and it really hurt. Then, years after the diagnosis, you will have reality checks and they may hurt. This morning I suddenly had this realisation that I won’t be able to just scribble a note for my son when he’s older. If I have to nip to the shop and maybe he’s in bed, I won’t be able to stick a post-it note to the door saying “nipped to the shop, back in 5”. Yes, I will be able to braille him a note but where do I leave it? I know we will come up with a solution but just this morning, I had a reality check and it hurt.
  5. It is stressful. When you are pregnant with your first child, everyone with children will take great delight in telling you how stressful it is, how this child will change your lives and you may think you understand what they mean – until your child arrives. It’s the same with the system, I can tell you it will be stressful but until you are going through it, it is difficult to understand exactly what I mean. At Kent PEPs last year, we asked parents how they dealt with stress and also, more importantly, how they knew they were stressed. We produced a leaflet for parents with advice and tips from parents in the same position. It’s our most popular download.
  6. Don’t get to crisis point before asking for help. In Kent, we have to go via our Disabled Children’s team to get direct payments and so many parents, who would benefit immensely from this service, refuse to access it because it means involving a social worker. We asked parents recently what would put them off and the main response was “fear of admitting you were finding it hard to cope”. Please don’t wait until you can’t cope before you ask for help. Admitting you are finding it hard is a sign of strength, not weakness.
  7. c&fbillimageI wish I had known more about the law or that there were statutory bodies and charities set up to help parents of children with SEN law. Several websites (including this one) and charities are there to give you advice on SEN law and your local Parent Partnership Service is there to give advice on SEN educational law. There is a huge list of Acts, Conventions and guidance out there to help protect our children but often, you only find out about them when you have already been through months of stress. Even if you do not have the time or ability to read and understand The Equality Act or the new Children and Families Bill, there are others that do. Try to think ahead and find out where you can get help before you need it. .
  8. You will get turned down. I remember the first time I was turned down after applying for support for my eldest son. I had presumed that common sense would prevail and he would get help because he needed it. When I was turned down, I was really shocked. I took it personally, I thought perhaps I hadn’t made it clear, perhaps I had offended someone, perhaps it was me they were saying no to. Having three children with SEN, I soon realised that the system can often be a case of “apply, get turned down, appeal”. I eventually stuck an A4 sheet with these words written in red, yellow and green on my fridge as a reminder that this was not my error, it was down to the system.
  9. You will meet some amazing people. I have met people who inspire me, who motivate me to carry on and people who I feel privileged to have in my life. Most of these people live this, they don’t do it for a living (but there are exceptions). A lot of the parents I know who are involved with their local parent carer forums are amazing to me. Some of these parents have found their way of dealing with the stress, they get involved and try to influence change. Not all parents are ready for this or want to be involved but I am so pleased to be part of the group.
  10. super_hero_flyingI am not Superwoman. If I had to choose one thing I had known at the beginning, this would be it. The hours I spent trying to achieve the un-achievable! Superwoman is a fictional character who does not have children – and definitely not children with SEN. Trying to be everything for everyone all the time is not possible. Spending your days thinking “I should have”, “If only I had”, “I wish” is never going to lead to a good place. Neither does comparing yourself to another parent who is perhaps involved with so many different things that they make you feel like a failure. People deal with things differently, some choose to get involved with forums, some choose to set up support groups, some want to go along to a support group and others just want to avoid support groups like the plague. Whatever works for you is the right thing – for you. You can always get involved or step down from involvement at a later date. You have to take time for you, you have to choose your battles and you have to remember there are only 24 hours in a day. Focus on what you have achieved, not just the things you believe you have failed in. Sometimes, getting through the day without breaking down is an achievement. Celebrate it. Getting dressed can be an achievement, as can making it to an appointment on time. Celebrate the achievements, no matter how small you think they may seem to others. You will know what it took for you to achieve it, so say “well done” and feel good about yourself.

What do you wish you had known? These are my ten things, they may not be yours. More importantly, what achievement are you celebrating today?

Children and Families Bill – initial views

Finally, the wait is over and the Children and Families Bill, which includes the SEN reforms, has been published. Debs spent yesterday poring over it and here are her initial views:

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c&fbillimageJust after 10am yesterday, the Children and Families Bill was released and I started to plough through.  Not only did I  have to read this Bill, I  wanted to compare it to the draft Bill published last September, the Select Committee’s pre-scrutiny recommendations from just before Christmas and the numerous responses.

All of this with a child off school with a chest infection and a husband at home who wanted to chat about decorating the bathroom – oh, and no in-house lawyer on hand to help.

The first thing I looked at was whether the Bill strengthened the involvement and rights of the parent and child (or young person)?  Well, you’ll be pleased to know it has.  There is a whole new clause, right at the beginning of Part 3 of the Bill (the part that deals with SEN), which reads:

In exercising a function under this Part in the case of a child or young person, a local authority in England must have regard to the following matters in particular—

(a) the views, wishes and feelings of the child and his or her parent, or the young person;

(b) the importance of the child and his or her parent, or the young person,participating as fully as possible in decisions relating to the exercise of the function concerned;

(c) the importance of the child and his or her parent, or the young person, being provided with the information and support necessary to enable participation in those decisions;

(d) the need to support the child and his or her parent, or the young person, in order to facilitate the development of the child or young person and to help him or her achieve the best possible educational and other outcomes.

As a parent, I am reading this as “Dear  Local Authority, you have to listen to me and my child(ren), and you have to give us the information we need in order for us to have an informed view”.  Now, there are probably 1001 legal-type people shouting at this post and saying the local authority “must have regard to” is not the same as the local authority “must” and yes, I know there is a difference but I am trying to be positive.

Throughout the Bill, clauses have been added or amended to clarify that parents and young people must be involved and their views listened to.  So thank you Mr T, this is a move in the right direction.

Rights & Duties

My second question was to look at whether there was now a duty for health to provide a service.  In the last Bill, there was a lot of criticism that “joint commissioning” was not enough.  In fact the Education Select Committee believed strengthened duties on health services were critical to the success of the legislation

Well, now in the definition of “Special Education Provision” we have:

21 Special educational provision, health care provision and social care provision

(5) Health care provision or social care provision which is made wholly or mainly for the purposes of the education or training of a child or young person is to be treated as special educational provision (instead of health care provision or social care provision).

This doesn’t put a duty on health but the LA do have a duty to secure the special educational provisions.  There is no clarity however, as to which health care provisions this will actually mean and as there is still no duty on health with respect to the provisions within the EHCP, there are no guarantees.

Next, we considered if the new Bill clarified that parents can apply for a EHCP assessment and the answer is yes.

36 Assessment of education, health and care needs

(1)A request for a local authority in England to secure an EHC needs assessment for a child or young person may be made to the authority by the child’s parent, the young person or a person acting on behalf of a school or post-16 institution.

There appears to be no timescales for the LA to respond within the Bill, but we are constantly being told that the “devil will be in the detail” so this, surely, has to be announced in the draft Regulations which are currently being compiled.

So, on to the next question “is mediation still compulsory” (an oxymoron if ever I heard one)?

And the answer is no.  It’s still an option for families who wish to go down this route before Tribunal but no longer compulsory.

What about disabilities?

So, I started to relax a little now but then had a  big reality check.  One huge (or as my son was said “gi-normous”) omission from the new Bill.  Disability.  Or to be more precise, disability without a special educational need.  If your child has a disability and health and social care needs but does not have a special educational need then I’m sorry but you’re not part of the Plan.

Despite several charities protesting and high profile campaigns, it would appear that the Government will not be providing the same opportunities to some of the children who need them the most.

In the DfE’s case for change, it stated “Disabled children and children with SEN tell us that they can feel frustrated by a lack of the right help at school or from other services”.

In the Green Paper, it said “The vision for reform set out in this Green Paper includes wide ranging proposals to improve outcomes for children and young people who are disabled or have SEN” and “This Green Paper is about all the children and young people in this country who are disabled, or identified as having a special educational need

All of the proposals were clearly for disabled children AND children with SEN, not disabled children with SEN.  So, what has happened?  Every Disabled Child Matters has already commented on this and I will be supporting their campaign to give disabled children the same rights as those with SEN.  When they launched the Green Paper, the DfE set out their cart and made us an offer, they clearly said “disabled children and children with SEN”.  We all hoped  that they were really listening to our families and then they changed the rules without explanation.

If you’re interested in what other groups have to say in response to the publication, I’ve listed all I can find here, if you know of others, let us know.

Children & Families Bill published

logo_dfeThe Children and Families bill, issued in draft form last year, has just been published. Within this bill are the reforms to the way special educational needs are provisioned, including the replacement of the statement with a single Educational, Health and Care plan that will set out all of a child’s needs in one document.

The DfE said:

“Significant reforms to services for vulnerable children and radical proposals to allow parents to choose how they share up to a year’s leave to look after their new-born children have been announced.

The Children and Families Bill, published today, includes reforms to adoption, family justice, an overhaul of Special Educational Needs, reinforcing the role of the Children’s Commissioner and plans to introduce childminders agencies. It also includes the extension of the right to request flexible working to all employees.

The proposed Shared Parental Leave reforms will give parents much greater flexibility about how they ‘mix and match’ care of their child in the first year after birth. They may take the leave in turns or take it together, provided that they take no more than 52 weeks combined in total.

These changes will allow fathers to play a greater role in raising their child, help mothers to go back to work at a time that’s right for them, returning a pool of talent to the workforce. It will also create more flexible workplaces to boost the economy.

Speaking ahead of a keynote speech Children and Families Minister Edward Timpson said:

I am determined that every young person should be able to fulfil their potential regardless of their background. For this to happen we must tackle the disadvantages faced by our most vulnerable children and families. Our measures in the Children and Families Bill do just that.

In this Bill we will overhaul adoption – breaking down barriers for adopters and provide more support to children. We will reform family justice – tackling appalling delays and focussing on the needs of the child. And we will improve services for vulnerable young people – transforming the Special Educational Needs system and better protecting children’s rights.

The Bill will include provisions on the following reforms:

  • Adoption Reform: the Government wants to reform the system so that more children can benefit more quickly from being adopted into a loving home.
  • Children in care: educational achievement for children in care is not improving fast enough. The Bill will require every Council to have a ‘virtual school head’ to champion the education of children in the authority’s care, as if they all attended the same school.
  • Shared parental leave: the Government will move away from the current old-fashioned and inflexible arrangements and create a new, more equal system which allows both parents to keep a strong link to their workplace.
  • Flexible working: the Government wants to remove the cultural expectation that flexible working only has benefits for parents and carers, allowing individuals to manage their work alongside other commitments. This will improve the UK labour market by providing more diverse working patterns.
  • Family Justice: the Government wants to remove delays and ensure that the children’s best interests are at the heart of decision making.
  • Special Educational Needs: the Government is radically reforming the system so that it extends from birth to 25, giving children, young people and their parents greater control and choice in decisions and ensuring needs are properly met.
  • Childcare reform: the Government  is reforming childcare to ensure the whole system focuses on providing safe, high-quality care and early education for children. The Bill introduces childminder agencies which will enable more flexible childminding and removing bureaucracy so that it is easier for schools to offer ‘wrap-around’ care.
  • Children’s Commissioner: the Bill makes the Children’s Commissioner more effective by clarifying his or her independence from Government with a remit to ‘protect and promote children’s rights’.

We’ll be looking at the bill in detail and will bring you views and analysis during the week.

The DfE announcement can be read in full here,

To read the bill and a summary of it, go here

Rare Disease Day: How Dan’s rare disease didn’t stop his mainstream education

facebook-profileRare Disease Day is at the end of February, with the theme ‘Disorders without Borders’. In Europe it’s coordinated by EURORDIS, the European Rare Diseases Organisation.

Many children have special needs because of a rare disease that may present extreme difficulties with being included in mainstream education. Many others, however, whose condition is physical and not a learning disability, simply need support to help them manage the classroom environment on a practical level.

One person such as this is Dan Copeland. I met Dan through my work with DysNet Limb Difference Network. Dan has TAR Syndrome and was only the 18th person recorded in the UK with the disorder. Despite his physical difficulties, Dan, from Liverpool, impressed me with his cheerfulness, humour and can-do attitude.

Dan, now 23, is a student and works part-time as a DJ. Below is the first part of his story, with a link through to the remainder that’s hosted on the RareConnect DysNet rare disease community.

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Dan Copeland

Dan Copeland

My name is Daniel Copeland and I have a very rare syndrome called TAR syndrome which is short for Thrombocytopenia with Absent Radius.

This means I have a low platelet count which causes me to bruise and bleed more frequently and when my blood count is low it causes me to catch viruses more easily than others. I also have no radius bone in my forearm, the rare thing with this is the fact in most genetic cases if the radius is not present then neither is the thumb. But with TAR there is a thumb, although the tendons and ligaments are connected to the ulna bone which causes the wrists of the affected to be turned inwards.
As so little was known about my syndrome as a child, initial diagnoses from knee and hand specialists were not good, telling my parents I would be unable to do basic things from feeding myself to dressing myself. When I was due to start nursery and primary school, the boards were trying to push my parents into sending me to a special school even though all my problems are physical and not educational.
Through my whole educational experience, fitting in was difficult when I started at a new school and college but I quickly integrated into a normal social lifestyle. There were some other disabled children in my school but not many (about six in my school year) so integration with able-bodied children was extra important so as not to become isolated…

Read More of Dan’s story on RareConnect

 

Read our second Rare Disease Day post: My son has Ehlers Danlos Syndrome

Politics and personalities in the SEN jungle

Like me, my co-contributor, Debs Aspland, grew up in the call-a-spade-a-spade, working class, north-west of England.  Also like me, she has far too much to do trying to juggle work and care for her special needs children to have any time for the politics and game-playing that has so often, in the past, made lives difficult for parents trying to cut their way through the special needs jungle.

In this post, our Debs who, you will remember, is Director of Kent’s parent-carer forum, Kent PEPS, explores the different personalities we meet as parents and individuals in our daily lives and how thinking about this – and your own approach – can help you navigate the system to get the best help for your child.

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Any change, even a change for the better, is always accompanied by drawbacks and discomforts.

Arnold Bennett

Any change, even a change for the better, is always accompanied by politics and personalities.

Debs Aspland

True co-production with parents is a goal that came out of Aiming High.  The Department for Education allocate a small grant each year to a Parent-Carer Forum within each local authority, with the remit that they work with health, education, social care and other providers to ensure that the services they provide are the services that families want and need.  Fantastic, what a great way forward!

However, the DfE forgot to tell the health, education, social care and other providers that they had to work with the Parent-Carer Forums.

(more…)

Special Needs Jungle named in The Times “Top 50 Sites To Make You Smarter”

Wowzer!

Special Needs Jungle has been named in the The Times (yes the UK national newspaper) as one of its “Top 50 Websites To Make You Smarter”.

Special Needs Jungle

How amazing is that?

Thanks to Justine Roberts, co-founder of MumsNet, who gave SNJ the ‘thumbs up’ in the ‘parents and teachers’ section of the Top 50.

It means a lot, especially as I’ve recently been diagnosed with  heart rhythm condition, Inappropriate Sinus Tachycardia, which makes day to day life much more difficult as I try to keep up with all my commitments.

This is partly why I’m so pleased that Debs Aspland has come on board to contribute all her knowledge and experience of SEN and coaching and help me take Special Needs Jungle to a new level.

SNJ is, at the moment, voluntary, although if I carry a post about a commercial product, I do ask for a small donation to my boys’ special school.

I’d like to move it to a self-hosted WordPress, but I don’t have the time to make sure it’s done properly, so any advice from savvy readers would be gratefully received!

So, thanks again to The Times and Justine. You’ve made my day!