Significant People – Parental Responsibility Relationship to child: Mother First Name: Family Name: Home Address: Sheffield Postcode: S20 Contact Phone Number: address: @googlemail.com Language Support Requirements: None Relationship to Father First Name: Family Name: Home Address: Postcode: S20 Contact Phone Number: Email address: @googlemail.com Language Support Requirements: None Significant People – Who else is important to the child Relationship to child: First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements: Relationship to
First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements: Relationship to child: First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements: Details of Educational Setting Name of setting: Date of admission: 1.9.15 Address: National curriculum year: Y3 Details of previous setting: Xxx school , Primary Inclusion Centre Professionals Providing Support Job ADHD Nurse Name: Contact Address: Ryegate Children’s Hospital Postcode: Contact Phone Number: address:
Parent’s View Our history and background: L has been diagnosed with ASD and ADHD at Ryegate Children’s Hospital. Parents did not want to medicate L for his ADHD initially but felt it would be worth trying after his difficulties at school. He has trialled some different medications for his ADHD with some having quite adverse effects on him. He is currently on Equasym XL and takes 30mg a day. L was permanently excluded from xxx School in June 2015. He attended the Primary Inclusion Centre until the end of the school year which was a supportive environment in terms of his learning, but parents felt that L linked with other children who were not a positive influence on him. They would not like L to attend the Primary Inclusion Centre again for this reason. Important information you need to know our child: L has previously been managed Team Teach techniques which he is now very wary of. If he thinks that he is going to be ‘held’ he will display fight or flight type behaviours. L is very sensitive to noise. This can make him very anxious. What our is good at: L is a bright child. Lego! L loves building things with Lego and usually doesn’t need to refer to the instructions to help him. What our needs help with Relationships with peers. L does not understand how other people may be feeling or how to build and maintain relationships. Managing his strong feelings – in school L is sometimes aggressive or abusive when he is feeling anxious or angry. How you can best support and communicate with our child See One Page Profile above.
Outcomes No. Desired Outcome By When? Steps to achieving outcome Progress reviewed Date 1 L will close the gap between his current levels and his chronological age in reading, spelling, writing and times tables. July ‘17 Assessment of current attainment in these areas. Support in class to access learning and maintain focus. Daily phonics lesson. Weekly spelling focus. 2 L will increase his self-esteem and confidence levels as evidenced by him having a more positive approach to activities. July ‘16 Advice from Ryegate psychologists via xxx. Positive reinforcement. Work against Boxall Profile targets. Nurture type support. 3 L will be able to identify more emotions than happy or sad, both in himself and others. Dec ‘16 Support and advice from ASD team/Speech Therapist. Visual support around different emotions. 1:1 or small group support to work through programme. 4 L will be able to form letters more accurately when writing (fine skills) and will be able to use a knife and fork and ride a bike (gross motor skills) March ‘16 motor skills programme – pre and post assessments. Support during PE lessons. Swimming/Karate activities. Teodorescu Perceptuo Motor Programme. Motor skills support from Ryegate. 5 L will develop strategies to manage his strong feelings. July ‘17 Support from Psychologists at Ryegate. Social stories, weekly art therapy session, PHP implementation, adult support in school to role model/support/ teach strategies for managing behaviour, medication reviews.
Contact Phone Number: Email address: Language Support Requirements: None Relationship to child: Grandmother’s partner First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements: None Significant People – Who else is important to the child Relationship to child: Mother First Name: Family Name: Home Address: Postcode: Contact Number: address: Language Support Requirements: Relationship to child: Father First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements:
Relationship to child: Aunty First Name: Family Name: Home Address: Postcode: Contact Number: Email address: Language Support Requirements: Details of Educational Setting Name of setting: Date of admission: Address: National curriculum year: Y7 Details of previous setting: Professionals Providing Support Job Title: Social Worker Name: Contact Address: Postcode: Contact Number: Email address: Type of Support Provided Input into My Plan, ongoing support for the family. Job Title: Westfield FOS Inclusion Support Leader Name: Contact Address: Postcode: Contact Phone Number:
Email address: Type of Support Provided Previous SENCo support from primary school. Learning assessments. Ongoing support for the family. Professionals Providing Support – continued Job Title: SENCo Name: Contact Address: Postcode: Contact Phone Number: Email address: Type of Support Provided Ongoing SENCo support in school. Job Title: Clinical Psychologist – Name: Contact Address: Postcode: Contact Phone Number: Email address: Type of Support Provided CAMHS – complex cases team support Job Title: Educational Psychologist Name: Contact Address: Postcode: Contact Phone Number: Email address:
What the child is good at: What the needs Help with: Any confirmed diagnoses: Sheffield Support Grid Level Reports/Attachments Name of Report From: Date: – complex cases panel Educational Psychologist Learning Support Service Families Together FACT Team – Social worker Social Care Needs and Strengths Does the child have any identified social care needs related to their SEN? Yes X No Is a Child Protection Plan in place? Yes No X Is a Child in Need Plan in place? Yes No X
1. Personal Details First Name: Middle name: Family Name: Date of Birth: I like to be known as: Looked child? Home Address: Postcode: Contact Phone Number: Gender: UPN: NHS Number (if relevant): Languages Spoken: 2. Significant People – Parental Responsibility Relationship to First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements: Relationship to child: First Name: Family Name: Home Address: Postcode: Contact Phone Number: Email address: Language Support Requirements:
2a. Significant People – Who else is important to the child Relationship to child: First Name: Family Name: Home Address: Postcode: Contact Number: Email address: Language Support Requirements: Relationship to child: First Name: Family Name: Home Address: Postcode: Contact Number: Email address: Language Support Requirements: Relationship to child: Name: Family Name: Home Address: Postcode: Contact Phone Number: address: Language Support Requirements:
Job Title: Name: Contact Address: Postcode: Contact Phone Number: Type of Support Provided Job Title: Name: Contact Address: Postcode: Contact Phone Number: Type of Support Provided Job Title: Name: Contact Address: Postcode: Contact Phone Number: Type of Support Provided
Sheffield Support Grid Category: 1A Communication and Interaction - Speech and Language Y Grid Level: 1B Communication and Interaction - Social Communication Y Grid Level: Cognition and Learning: Yes No What the child is good at: What the child needs help with: Any confirmed diagnoses: Sheffield Support Grid Category: 2A Cognition and Learning - Learning Y Grid Level: 2B Cognition and Learning - Specific Learning Difficulties Y Grid Level: Social, Emotional, and Mental Health: Yes No What the is good at: What the child needs help with: Any confirmed diagnoses: Sheffield Support Grid Category: 3A Social Emotional and Mental Health - Emotional Regulation Y Grid Level: 3B Social Emotional and Mental Health - Mental Health Y Grid Level: