Q:
Are you willing to share your answers to EHCP section C? If yes, please make sure you remove personal data, such as names.
SEND Kids
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25 Mar 2021
A: SenseCheck
- 8 Yes
- 0 No
- 1 Other
- 17 Jan 2022
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Yes
Simple
PART C – HEALTH NEEDS
[EHCP: Amended Final Following Appeal Hearing and 1st Tier SENDIST Decision]
What are [child]’s Health Needs?
[child] suffers from chronic constipation, which at times can cause him a lot of discomfort. When he is constipated, he is less willing to eat and his mood is affected. It is also possible that his pacing up and down is an attempt to ease his pain.
Blood tests have shown that [child] has intolerance to certain foods. He has seen a dietician and is currently on a casein free diet.
[child] suffers from constipation which is currently controlled with Movicol.
- 19 May 2021
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Yes
Other
Section C: My Health Needs
[child] is reported to get nasally congested and has a habit of snoring. He had a few episodes of croup around the age of 5.
[child] has a genetic condition [chromosomal detail deleted] which is associated with cognitive difficulties and speech & language difficulties.
[child] displays atypical social behaviours, as well as ticks such as snorting and clicking his jaw, and he is overwhelmed with noise. - 13 May 2021
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Other
Other
Other ...:
[removed at request of parent]
- 07 May 2021
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Yes
Other
- [child] has a diagnosis of Down’s Syndrome for which he requires regular health checks.
- [child] has a fluctuating hearing loss and needs regular hearing checks at the ENT hospital.
- [child]‘s vision is impaired and he needs regular ophthalmology checks.
- [child]’s speech is unclear and he needs regular speech therapy.
- [child] suffers from low muscle tone and needs regular occupational and physiotherapy.
- [child] suffers from psoriasis and other skin conditions and requires regular dermatology checks. - 30 Apr 2021
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Yes
Other
SECTION C: Health
The Young Person's health needs which are related to their SEN or to a disability
5. Health and Wellbeing
[child] has a rare chromosomal disorder, [xxx], moderate-severe learning disability, difficulty with gross and fine motor skills, trance-like absences (non-epileptic) and chronic constipation. [child] also has scoliosis, kyphosis and lordosis. He leans to the left, which is worsening as he gets older. His medical conditions affect [child]'s participation in his education, activities and ability to develop independence.
[child] is going through puberty relatively late and his scoliosis is being made worse by his pubertal growth spurt. The relatively late puberty will also affect the time at which [child] stops growing, which may impact decisions around surgical management of his scoliosis. [child] has used a lycra suit in the past, and now has a thoracic lumbar brace to support his scoliosis and to try and slow the progression. He wears the brace at all times, except when participating in PE, swimming or horse riding (23 hours a day).
[child] is monitored by the paediatric physiotherapists and has Ground Reaction Ankle Foot Orthosis (GRAFOs) to wear at school and to supplement the Ankle-Foot Orthoses (AFOs) and a raise in his shoes to assist with disordered gait in his lower limbs. [child] is assisted to do exercises to stretch tight hamstrings and ankle plantar flexors. [child] has knee flexion deformities on both legs and it is thought that his walking is deteriorating. However, testing suggests gait has not deteriorated as much as could be expected.
Physiotherapy advice suggests that [child] should have time daily in a standing position and also do some work in standing. The reason for this being to achieve a more upright position and an active position up against gravity. This may have a positive effect on his scoliosis and muscle strength.
[child] has nocturnal enuresis and takes Desmopressin although this is less successful now than it was when initially started. His treatment plan includes monitoring fluid intake - to be maximised during the day and stopped 1 - 2 hours before bedtime - and ongoing support around constipation and further urodynamic studies assess the function of the bladder and urethra. Although a renal ultrasound showed nephrocalcinosis, but no stone and no evidence of obstruction.
In August 2017, [child] was able to demonstrate a 'safe swallow', although anecdotal evidence from the school in early 2018 suggests this may not have been maintained. [child] has dysphagia guidelines at school which are followed at each mealtime. [child] is able to feed himself although he needs prompts to eat at slow pace. [child] has specialist cutlery (Caring Cutlery) and a specialist plate with a scoop side to enable him to scoop up more easily. At school, he receives hand-over-hand support to cut his food which requires complying with the dysphagia guidelines devised by the school SALT team.
[child]'s constipation is managed with daily medication, although he does have a bowel movement every day so is not considered to be appropriate for a further referral to gastroenterology at this time.
[child] takes:
• Movicol (10mg sachet) x1.5 sachets at bedtime
• Desmopressin 120mcg x2 tablets at bedtime
[child]'s mother reports that she has observed different episodes where [child] will stare without associations, or become ridged and tense. However, [child] has had EEGs in 2012 and 2017 which have both been normal. He has been referred for a mobile EEG.
[child] has been prescribed glasses, but he chooses not to wear them. However, his eyesight is not sufficiently poor that glasses are wholly necessary. He has been discharged from ophthalmology and his eyesight should be monitored by a high street optician.
[child] has hyperplastic teeth; he has an inability to visit a high street dentist as he needs to have a general anaesthetics for all treatment.
[child]'s learning disabilities combine with the result that he is unable to understand medical issues and treatment. He is not able to understand pain or communicate his feelings about or around pain. He requires support from adults who will help him to communicate and interpret his needs and he requires doctors and nursing staff experienced in treating learning difficulties. [child] has a Health Care Plan in school for dysphagia and his physical needs are met by a Physical Care Plan which all staff should be aware of. - 28 Apr 2021
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Yes
Other
C
Health needs and how these affect learning
- [child] has subtle dysmorphic features and microcephaly
- [child] had several investigations performed and has been seen by Geneticists, Paediatric Neurology, Metabolic Medicine and further genetic tests have been recently requested. So far, an underlying diagnosis is not conclusive however and his MRI brain scan has indicated bilateral perisylvian polymicrogyria and some cerebellar hypoplasia with generalised under-development of the cerebral white matter disease. This is associated with his speech and learning difficulties and difficulties in the areas of motor planning.
- [child] is known to 100,000 Genomes Project.
- [child] required patching and has been recommended to wear glasses for the correction of a squint. - 28 Apr 2021
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Yes
Other
C: My Health Care Needs
[child] is reliant on adults to support his access to self-care activities.
[child] sits in his specialist seating system for meal times and requires assistance with feeding to cut up food
[child] requires assistance of one to transfer him between some positions and in and out of his specialist equipment.
[In my EHCP section C is listed with sections E & G.]
Mobility
[child] demonstrates an ability to roll between front and back
Reach toys out of his base of support by shifting his weight and leaning sideways or forwards.
Stand through half kneeling with handhold of an adult.
Take steps with double handhold of an adult.
Take steps using a kaye walker with moderate support from an adult.
[child] is working towards:
Developing the ability to move around on the floor through crawling or commando crawling.
Developing the ability to pull himself to stand at a supporting surface e.g. sofa.
Taking steps with improved control to require less adult support and improve independence.
Transfers/Moving and Handling
[child] demonstrates an ability:
To complete a standing transfer with the assistance of one adult.
Transition between lying and sitting independently
Step into a standing frame and turn around with assistance of two people to secure the straps.
[child] is working towards:
Transitioning from sitting to kneeling up to a supportive surface independently.
Transitioning from kneeling to standing by pulling to stand with supervision or minimal assistance.
Requiring less support to transfer into his standing frame.
Postural Needs
[child] demonstrates an ability to:
Sit independently on the floor.
Access a floor sitter daily wearing leg gaiters to achieve a hamstring stretch.
Sit upright in specialist seating
Stand in Meerkat standing frame with low level hip support for 60 mins each day wearing boots.
[child] is working towards developing:
Postural control to improve his ability to stand upright in standing frame for a longer time period.
PE/ Outdoor Play
[child] demonstrates an ability to:
Participate in physical activities that have been modified to his ability level e.g. outdoor play on a trike.
[child] is working towards:
Being able to join in with adapted PE and physical activities with adult
supervision. - 28 Apr 2021
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Yes
Other
C: Health needs
[child] has Autism and therefore he has difficulties in the area of his social interaction, social communication, understanding the world around him. He presents with self-directed behaviour wanting things done on his terms and difficulties with responding to other people’s needs. This is impacting on his ability to access the curriculum. He needs to be supported in order to develop his social interaction and peer relationships as well as to communication. He would benefit from being taught in a suitably differentiated curriculum with Autism Specific Strategies.
[child] is in good physical health and does not have any significant health issues. He is not on any regular medication. His immunisations are up-to-date.
Vision:
Father reports no concerns about his vision.
Hearing:
There are no concerns reported by his hearing. He had hearing test earlier this year which was normal.
Physical examination:
[child] resisted physical examination and therefore this was not carried out. There were no obvious dysmorphic or unusual facial features.
Growth:
It was not possible to obtain growth parameters as [child] did not engage. Father reported his height measured last week was 121 cm (50th -75th centile). - 25 Mar 2021
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Yes
Simple
[child] has been diagnosed with Kabuki Syndrome and he is showing delays in his development.
[child] has a moderate to mild upsloping hearing loss [Hospital]. He wears two hearing aids.
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