Date of 1st My Support Plan: 20/05/15 1.2 What’s in my plan? Plan page no. Date completed Part 1: Who I am and what’s in my plan completed by child/young person 1.1 Who I am – the cover of my plan 1 09.12.15 1.2 What’s in my plan – contents page 2 04.01.16 1.3 About me – my views, interests and hopes for the future 3 05.11.15 Part 2: Information gathered by me and my family completed by person and their family 2.1 What my family thinks is important to and for me 4 05.11.15 2.2 Relevant history 5 05.11.15 2.3 My family and significant people in my life 6-7 05.11.15 2.4 Key information for looked after children / young people 7 05.11.15 Part 3: Information about my special educational needs gathered and updated by the educational setting 3.1 Special educational needs (SEN) 8-10 05.11.15 3.2 Educational attainment and progress 11-13 09.11.15 3.3 Special educational provision 14 09.11.15 3.4 Education and learning history 15 09.11.15 Part 4: Information about health and social care needs related to by special educational needs provided by health and social care professionals 4.1 Health needs 15-17 30.11.15 4.2 Health provision 17-19 02.12.15 4.3 Social care needs 20 - 4.4 Statutory social care provision 20 - 4.5 Additional social care provision 20 - Part 5: Information shared and agreed at my meeting completed/finalised by educational setting after review meeting 5.1 My review contribution 21-22 08.11.15 5.2 My family’s review contribution 23 05.11.15 5.3 Contributions from people who support me 24 04.11.15 5.4 Views shared at my meeting 25-26 19.11.15 5.5 Agreed outcomes 27-29 19.11.15 5.6 Agreed actions 30 19.11.15 5.7 Review record 31 19.11.15 Part 6: Relevant advice and information that supports my plan provided by advice-givers 6.1 Additional information 32 09.11.15
Other people you need to know about Name Relationship Additional information Penny Maternal aunt Very close to both aunts. They babysit and are listed to pick up from pre-school. Barbara Paternal aunt People who can provide support and information Name and role Information/support they can provide Contact details Email/address and phone Dr **** ****** Consultant Paediatrician Information and advice about primary health care CDC, York Hospital 01904 726 539 ***** ****** Speech & Language Therapist Advice and strategies to support my speech and language development CDC, York Hospital 726 539 ******** ******, Physiotherapist Advice and strategies to support my physical development CDC, York Hospital 01904 726 539 **** *****, Occupational Therapist Advice and strategies day to day activities, seating etc CDC, York Hospital 01904 726 599 Jo Byers, Portage Home Visitor Home visits, structured teaching strategies to support learning/ play / family support Specialist Early Years Support Team Burnholme Community Hub, Bad Bargain Lane, York. YO31 0GW 01904 555 085 Christine Clarke, Specialist Senior Educational Psychologist (Early Years & Portage) Advice on early development and educational support Specialist Years Support Team Burnholme Community Hub, Bad Bargain Lane, York. YO31 0GW 01904 555 085 Dr ***, Respiratory Information on my respiratory issues Leeds General Infirmary Great George Street, Leeds. LS1 3EX ******** ******** Community Nurse Information and advice on my health Ward 18, York Hospital **** ****** SENCO Puddleduck Day Nursery Information on how Oliver accesses activities at nursery and EYFS 01904 415 144 2.4 Key information for looked after children/young people This section updated on: 08/11/15 Is the child/young person Looked After (by the local authority)? No
Oliver to develop a more efficient pincer grasp to improve his self-feeding and more intricate manipulative play Oliver has an palmer grasp and will occasionally use a lateral pincer grasp **** *****, Senior Children’s OT 08/10/2015 Oliver to develop more fluid and consistent bilateral manual movements to increase his confidence in play and upper limb activities Oliver tends to play with one hand a time, rather than both together. **** *****, Senior Children’s OT 08/10/2015 Oliver to be safe and well supported in sitting, in order that he develops his fine motor and self care skills to the best of his ability. Oliver currently requires a specialist Heathfield with accessories **** *****, Senior Children’s OT 08/10/2015 Oliver to continue to show progression of gross motor skills. To achieve safe independent standing at a low table Oliver has delayed gross motor skills due to reduced muscle strength/ control and reduced core stability ******** ******Senior Physiotherapist 8/10/15 Oliver to develop his mobility skills using a mustang walker – to be able to tolerate the walker for 10 minutes. Oliver unable to take independent he requires support from a walker. ******** ******Senior Physiotherapist 08/10/2015 Name of health professional who has provided this information: ******* ****** Advanced Clinical Specialist Speech & Language Therapist (Dysphagia) Date of contribution: 4th November 2015 Does the child/young person have assessed health needs? Yes What goal/outcome is to be achieved? Assessed health needs Who assessed the need Date assessed 1. Oliver will select identified objects and toys (taken from Vocabulary Building programme) at nursery when requested by an adult. 1. Oliver has significantly delayed receptive language skills. Assessed 11.09.15 using Language Scales PLS4. Receptive skills months with early emerging skills 18-23 months. 1. ******** ********Advanced Clinical Specialist Speech & Language Therapist 1. September 2015
2. Oliver will look at and then post pictures of everyday actions (from starter vocabulary set supplied by SLT) named and signed when prompted by an adult. 2. Oliver has significantly delayed receptive language skills. Assessed 11.09.15 using Pre-School Language Scales PLS4. Receptive skills 12-17 months with early emerging skills months. 2. ******** ********Advanced Clinical Specialist Speech & Language Therapist 2. September 2015 3. Oliver will copy some sounds when modelled naturally in play activities e.g. animal sounds, vehicle noises which are modelled as repeated single sounds e.g. ‘mmmm’, ‘ee’ ‘ah’. 3. Oliver has significantly delayed expressive language skills in association with his diagnosis. Expressive skills assessed using PLS4 early emerging skills months. 3. ******** ********Advanced Clinical Specialist Speech & Language Therapist 3. September 2015 4.2 Health provision This section updated on: 18/11/15 Name of health professional who has provided this information: Dr ****** Paediatrician Date of contribution: 18-11-2015 Does the person have an Individual Health Care Plan? No Health provision recommended to meet assessed need Type of and dates Frequency of Who is responsible for delivery of provision Outcome Children’s Community Nursing team Physiotherapy Dietician SALT OT Orthoptist/Audiology Regular contact As necessary As required As required As required 6 monthly ******* ******* ******** ****** ***** ***** ***** ****** **** ***** ***** *****/ **** **** Ongoing support Provided lycra shorts, Pedro boots, standing frame Fortini milk, Calogen/Maxijul added to feeds Name of health professional who has provided this information: **** *****, Senior Children’s Occupational Therapist and ******** ******Senior Paediatric Physiotherapist