Consultant appointments for children with SEN

I had arranged to attend two appointments today with one of the consultant paediatricians at the large local NHS hospital. Some of our young students with mental health needs are still seen by paediatrics as opposed to seeing the specialist CAMHS. I have worked with the consultant previously, revising the care pathways for ADHD and asked her to arrange appointments for these two students ‘back-to-back’.

All was looking great, I was there early and then the first young man arrived with his adoptive mother. His needs are complex, including attachment difficulties associated with an extremely traumatic early childhood, as well as ADHD.

It was important that we made the best use of this appointment; in terms of a medication review, but also with the application for Statutory Assessment. We currently support this young man for the whole of the school day – without this intensive support he is unable to interact with other students without experiencing significant risks.

His mother is very supportive and we now operate a hand-over system, whereby she meets me or another member of staff at the end of each day and we feed back positives either through the meeting or via a regular e-mail. This is working well, but currently is being financially sustained by school resources. A formal assessment of the complex needs this young man has is essential in safeguarding the intensive support he requires. It is going to be a long process, but one that I feel is pulling together nicely at the moment and starting from a real model of good practice with the consultation.

The second appointment was for a young man in Year 8, also with ADHD. He has not yet been able to regulate his medication − mum struggles with it alongside caring for her other children and has missed appointments for the past year. However, I know that medication is a significant part of the support for this young man, as is a ‘joined-up’ approach.

We agreed to medicate in school again, as per the support model that works well in Year 8, but we need the mum’s support with this one. A series of fixed-term exclusions, partly as a result of lengthy periods without the support of his medication, is causing him significant difficulties in certain areas and subjects at school. This again will take some time to settle, but at least we were all in agreement: the support of the medication is a key part of the package for this student, and mum needs our support in maintaining that.