Identifying health needs
Parents and young people will be involved with any decision to refer to a specialist service:
The SEND Code of Practice says:
Where assessment indicates that support from specialist services is required, it is important that children and young people receive it as quickly as possible...The Local Offer should set out clearly what support is available from different services and how it may be accessed. (6.60)
Colleges should ensure they have access to external specialist services and expertise. These can include, for example, educational psychologists, Child and Adolescent Mental Health Services (CAMHS), specialist teachers and support services, supported employment services and therapists. (7.23)
For children with complex needs identified at birth, after an injury or illness, or through their early years, you will likely have health professionals already working with you. They will let you know if they believe your child has Special Educational Needs, and can also guide you to other sources of support and information.
Health professionals have a duty to notify the local authority when they identify a child under compulsory school age as having (or probably having) SEN or a disability.
However you might be the person who notices differences around development or behaviour, this can often happen when a child starts nursery or school for example.
You can talk to their keyworker or Teacher about your observations, discuss what support might be needed, and decide next steps together.
You can also see your child's GP and together you might talk about whether to make a referral to a specialist service or paediatrician.
See also SEN Support which explains the cycle of support in schools, 'assess, plan, do review.'
If your child continues to make less than expected progress, the setting may talk to you about a referral to a specialist health service, such as a school nurse or a speech and language therapist. Settings can make a referral into some health services, but not all - the Local Offer will give you information about services and how to access them.
Read more about specific conditions on the NHS Health A-Z
Take a look at the Council for Disabled Children factsheet 'Levels of care in the NHS (PDF)'
Where a setting, the local authority or health professional are unsure how to support your child, they might suggest you consent to a referral to a specialist service for advice, so they can better understand your child's needs.
You should have the opportunity to speak with or meet any specialist that sees your child. They will explain their role, any observations or assessments they will carry out and what will happen next.
It is normal to feel unsure about what to do or even overwhelmed, as a parent you will hear lots of advice and sometimes this can be confusing or even conflicting. You might disagree with your partner about what to do, or feel worried about your child being labelled with a diagnosis.
Taking the step towards seeking diagnosis can often be a relief to both parent and child, who might be feeling different but not understanding why. However it is your personal choice and there is no right or wrong, some things to consider...
- What does my child say, do they notice they are different and how is this affecting them?
- What are the alternatives, ie. can we support my child without a diagnosis? (talk to school, GP and any other professionals involved)
- What will be the impact of going ahead with a referral Vs not, eg. will a diagnosis mean we can access support
Some parents decide to request a referral and then wait and see - using the waiting time (which can be lengthy) as additional time to decide.
In education settings, support for SEN is not dependent on a medical diagnosis.
It can be helpful ahead of an appointment to make notes about your observations and anything you want to raise - it can be hard thinking of examples on the spot so having bullet-point notes can make sure you get everything across that you want to. Sometimes the setting will be happy to bullet-point their observations for you too.
Some parents use examples given by activity or club leaders, such as a Scout or Brownie leader, who has experience of observing your child in a different context. Information from other people who know your child can be really helpful to share.
It is likely you will find it emotional talking about your child's difficulties or receiving a diagnosis, and you may want to take someone with you - your partner or a close family friend for example.
Think about whether you would like some time with the health professional without your child present. You can find out in advance whether there is someone available to look after your child in the waiting area for a few minutes.
You can take notes of key information, though usually you will be sent a letter including what was discussed.
Before you leave - check what happens next and when you will hear.
Regardless of the service you have been referred to, there will likely be some assessment, some examples include...
- considering the referral against the service criteria
- information gathering from family and professionals involved
- observations in school, clinic or at home
- diagnostic tools - such as questionnaires
- assessments carried out with your child
- Your child (and sometimes you) may be offered support or therapy from health services
- You may receive a diagnosis for your child. It is important to share this information with the education setting.
You could feel really emotional if your child gets a diagnosis and coming to terms with this may take some time, your child will also feel this way too and may deal with it differently to you.
You might find it helpful to explore national charities offering advice around specific conditions, or local support groups. We have some listed in our helpful contacts leaflet (PDF).
This guide might be useful if you are going through the process of assessment for Autism 'NICE Assessment and diagnosis of autism - what to expect (for under 19's)'
See our next section for information about how health and education work together to support children and young people with SEN or disabilities.
If you are unhappy with:
- the diagnosis,
- the assessment carried out,
- services or provision offered...
...see our page 'raising concerns (about health services or provision)' for information about what you can do.
Designated Clinical Officers (DCO's) are the point of contact for local authorities, schools and colleges seeking health advice on children and young people who may have SEN or disabilities. They can support schools with their duties under the ‘Supporting Pupils with Medical Conditions’ guidance.
See also our information about medical needs and education.
Watch our video presentation exploring how children with medical conditions may be supported in education.
Health professionals (for example school or specialist nurses and therapists) may work directly with your child/young person and advise or train settings to manage health conditions such as epilepsy and diabetes, or with techniques such as tube feeding, in schools.
The SEND Code of Practice 2015 says:
Schools have a notional SEN budget and many schools will commission services (such as speech and language therapy, pastoral care and counselling services) to support pupils...The school’s governing body must ensure that arrangements are in place in schools to support pupils at school with medical conditions and should ensure that school leaders consult health and social care professionals, pupils and parents to make sure that the needs of children with medical conditions are effectively supported. (3.66)
...should ensure they have access to external specialist services and expertise. These can include, for example, educational psychologists, Child and Adolescent Mental Health Services (CAMHS), specialist teachers and support services, supported employment services and therapists. (7.23)
Individual Healthcare Plans (not to be confused with Education, Health and Care or EHC plans!)
You can discuss with school and health professionals whether a plan would be appropriate for your child:
- An individual plan is particularly helpful for children with long term complex health needs.
- An Individual healthcare plan will help a setting to effectively plan what your child needs, and can provide reassurance about the support plan ie. who will do what, and when.
- You will be able to share your views and those of your child. Let the school know of any changes to your childs needs so the plan can be amended
- This plan can also include your child's Special Educational Needs (where an EHC plan is not in place).
- Though school will be responsible for finalising and maintaining the plan, health, social care or other professionals should be involved in the process.
- The guidance for schools includes a helpful flowchart of what the process should look like:
- Advice and example templates (Health conditions in schools alliance)
Following assessment a medical practitioner may suggest medication for your child to help with their mood or behaviour. Sometimes parents initiate discussing medication as a last resort, where all ideas to support their child have been exhausted.
Your views are really important as you know your child best. If they are able to understand it will be important to talk to them too.
What if I disagree with my child being medicated?
The first step would be to fully understand why the medical practitioner is recommending medication, and to share your concerns with them.
You may have another view for example, you feel their behaviours are responses to their difficulties managing in their current school environment and you want to explore other options first.
Take your time to find out as much as you can about the medication, it's positive effects as well as any side-effects, and what difference it might make for your child.
For children and young people with a learning disability and/or Autism: NHS STOMP-STAMP leaflet. This campaign aims to stop the over-medication of these vulnerable groups.