Children who are unwell are entitled to an education that is adjusted to meet their needs.  For some, reasonable adjustments alone are needed (such as leaving the class earlier or arriving later to lessons).  Others need short term targeted support and for some, a more bespoke or specialist arrangement is needed.

Support is provided regardless of the child or young person’s academic ability.  They do not have to be ‘behind’ or ‘delayed’.  All children are entitled to an education that helps them to ‘achieve their best’, no matter what their academic levels are.

Most children in Tier 4 CAMHS will need additional support to achieve their best alongside recovering from their illness.  The Child and Family Act (2014) Part 3 outlines the relevant law.  There are two Department for Education guides that are also relevant:

• Education for children with health needs who cannot attend school – GOV.UK (www.gov.uk)
• Supporting pupils with medical conditions at school – GOV.UK (www.gov.uk)

Each Local Authority has an Information and Advice Service (SENDIASS) to help you through this process.  You can find your local one here.  There is a video with more information about SENDIASS services here.

When working out what support children and young people need, it can be helpful to think about barriers to learning.  These can include:

• barriers to attending school
• barriers to being in lessons when in school
• barriers to learning when in the lessons
• barriers to achieving their best in exams

Most children and young people in Tier 4 settings meet the criteria for disability under the Equality Act (2010) and are entitled to reasonable adjustments to enable them to access an education.   Almost all will have special educational needs (SEN).  There are 2 formal levels of support available.

Support for families on the basics of Education law and who can and can’t requests an EHC assessment, can be found here:  SEND Education, A Family Survival Guide

The SEND Code of Practice explains the responsibilities of schools and the local authority for providing education for children who need additional support to manage in school.  SEN Support in School is explained from page 100.

IPSEA explains more about SEN Support in School: What does SEN Support in school mean? | (IPSEA) Independent Provider of Special Education Advice

This level of support should be reviewed regularly through a method called the graduated approach, which is described here: SEN Support (also known as the ‘graduated approach’) – SEN help (sen-help.org.uk)

At this level, the assessment and support is usually provided by the class teachers and school SENCO.

If your child with SEN is likely to need a higher level of support, they may need an Education, Health and Care Needs Assessment (EHC NA) and provision specified in an Education, Health and Care Plan (EHCP).

Where ‘SEN support in school’ is not sufficient for a child or young person to ‘make use of facilities of a kind generally provided for others of the same age in mainstream school’ or ‘make expected progress’, an EHC NA may be required.

When looking to support children, the team around them will be looking to determine the views of the child or young person and their parents’ / carers’.  For example, do they want to complete A levels, look for vocational courses or something else?  They will also be seeking to understand the ‘barriers to learning’.  The plan will be written with this in mind.

The SEND Code of Practice explains the responsibilities in relation to EHC Needs Assessments and plans from page 141.  There is a 20 week process that starts with the views and aspirations of the child and their parents.  With the aspirations of the child in mind, specialist advice will be sought from an educational psychologist, school and the CAMHS team.  Assessments from others can be requested by the parents or the local authority.

The aim of an EHC NA is to:

• outline their education, health and social care related needs
• outline objectives to be met with the aims of the child in mind
• specify the provision that is needed enable them to overcome barriers, meet their needs, so they can reach their objectives.

IPSEA is a great source for information about EHCPs.  You can find out more about EHC NA here.  There is an EHCP checklist on this page that is an excellent guide to what the plan should contain.

The EHCP is assembled by a local authority case officer.  However, they can only include information in this that originates from specialist advice, letters or reports.  Essentially, an EHCP can only be as comprehensive as the information that the local authority has access to.

If your child’s EHCP does not now reflect their goals or needs, or no longer specifies the provision they need to overcome their barriers to learning then it can be reviewed.  An EHCP should be reviewed every year, but you can request this review is brought forward.

If your child had an EHCP before admission to Tier 4 CAMHS, then it may be appropriate to request and early review of the plan.   In many, if not most, the needs and provision required to meet these needs will need to be updated with new advice from health, social care and education.  They may also need advice from an occupational therapist and speech and language therapist.  There is information here about how to request an early review of an EHCP.

If the needs of your child are now completely different, it may be appropriate to request an new assessment of need leading to a completely new EHCP.  There is information her about requesting a reassessment of needs.   This starts the process off from scratch with the same legal obligations in terms of assessments and timescales as those requesting and EHC NA for the first time.

There are excellent resources on this site for parents and professionals bringing together research, policies and laws with experience from families. Not Fine in School – Families, Information

Anna Freud website has a number of resources produced with the Department for Education here: Attendance and mental wellbeing in schools and colleges : Mentally Healthy Schools.  The school resource may also be valuable for parents and carers School attendance and mental wellbeing | Anna Freud

There is an EBSA toolkit on this page: Guides and Toolkits – SEND and You

Exam access arrangements covers both reasonable adjustments for students with disabilities, and some forms of special considerations (where students are ill at the time of the examinations).  Access arrangements must be applied for by the school well in advance of the assessment date.  The Equality Act 2010 requires awarding organisations to make reasonable adjustments to exams and assessments for disabled students.

Exam officers may apply for special consideration on a candidates behalf if their examination performance can be affected by circumstances out of their control. Special consideration is a post-examination adjustment that compensates candidates who were suffering from a temporary illness or condition or who were otherwise disadvantaged at the time of the examination.  All applications must be made within 7 days of the last examination of the series.