1 Writing outcomes for Education, Health and Care Plans Karina Dancza Professional Advisor- Children & Young People
2 Overview Key points about the legislative changes Sections required within the Education, Health and Care Plans Quiz! What is an aspiration, need, outcome and provision? Importance of a person centred approach Where to start Writing aspirations Writing needs Writing outcomes Writing provision Timeframes for Education, Health and Care Plan advice Additional resources Questions
3 Key points about the legislative changes Involvement of children, young people and parents All relevant duties apply to all statefunded schools and colleges Coordinated assessment; 0-25 Education, Health and Care Plan Local authorities, health and social care to commission services jointly Clear, transparent local offer of services Statutory protections for 16-25s; focus on preparing for adulthood Offer of a personal budget; more choice and control Applies to CYP detained in youth custody
4 Education, Health & Care Plan outline Section A Section B Section C Section D Section E Section F Section G Section H Section I Section J Section K Views, interests and aspirations of the child or young person, and their parents The child or young person s special educational needs (SEN) The child or young person s health needs which relate to their SEN The child or young person s social care needs which relate to SEN The outcomes sought for the child or young person The special educational provision required by the child or young person Any health provision required by the child or young person Social care provision Placement Personal budget (including arrangements for direct payments) Advice and information
5 SORTING THROUGH THE LANGUAGE OF EDUCATION, HEALTH AND CARE PLANS A QUIZ!
6 What is an aspiration? A. An ambition or hope B. A dream C. Breathing in a foreign object D. The same as an outcome E. All of the above F. None of the above (Adapted from Amide, 2015)
7 What is an aspiration? A. An ambition or hope B. A dream C. Breathing in a foreign object D. The same as an outcome E. All of the above F. None of the above
8 What is a need? A. Cerebral palsy B. An adapted chair C. A step in making bread D. Self care: unable to get dressed independently E. All of the above F. None of the above (Adapted from Amide, 2015)
9 What is a need? A. Cerebral palsy B. An adapted chair C. A step in making bread D. Self care: unable to get dressed independently E. All of the above F. None of the above
10 What is an outcome? A. A task an occupational therapist will do such as supplying equipment B. A task an individual will do such as attending a handwriting group C. The benefit or difference made to an individual as a result of a change D. All of the above E. None of the above (Adapted from Amide, 2015)
11 What is an outcome? A. A task an occupational therapist will do such as supplying equipment B. A task an individual will do such as attending a handwriting group C. The benefit or difference made to an individual as a result of a change D. All of the above E. None of the above
12 What is provision? The action of providing or supplying a service or resource. True or false? (Adapted from Amide, 2015)
13 What is provision? The action of providing or supplying a service or resource. True or false?
14 Which is which?? (Adapted from Amide, 2015)
15 Which is which?? Aspiration I want to live independently and get a good job designing computer games Need Moving around the school: Unable to organise belongings and get to classes on time Outcome To independently move around the school by the time I will transition to secondary school Provision Four visits from an occupational therapist in the next 9 months to develop organisational and navigation skills
16 A PERSON CENTRED APPROACH
17 The child/young person and family s views Should be at the heart of the EHCP process. Balancing what is important to a child/young person (to lead a fulfilling life) with what is important for the child/young person (become or stay healthy, happy and safe). (Adapted from Amide, 2015)
18 WHERE TO START
19 Aspirations Information about the views and aspirations of a child or young person should be available from the local authority requesting the occupational therapy advice. Children/young people and parents should not have to re-tell their story to each professional. These aspirations need not be realistic. Unlike outcomes, aspirations have no legal teeth but do need to be detailed on the plan. Can be whatever the child/young person wants. Helps everyone better understand what motivates them. (Adapted from Amide, 2015)
20 Aspirations I want to go to university I want to get a job I want to live independently I want to be a marine biologist I want to be in a relationship
21 Needs For occupational therapists, these should be written as occupational needs. Focus on information about the priority occupations only.
22 Needs Consideration for how these are written. For example: Milla is unable to walk and she has extremely poor fine motor skills which means impacts on all areas of her schooling. OR Moving around the classroom: As Milla is unable to propel her own wheelchair, she required assistance from the teaching assistant to move her wheelchair and position her at her desk. Writing and drawing in class: As Milla is unable to open the clip on her clipboard and slide her paper, she needed assistance from the teaching assistant to perform these task actions.
23 Educational occupations Education setting For example: In the classroom Completing written work for various subjects (including using the computer) Completing craft or maths projects including the use of tools and equipment Playing sport and participating in physical education Following directions for an activity Packing up and tidying a desk In the playground Playing/socialising in the playground at break time Arriving & leaving school Self-care including toileting activities Moving around the educational setting Arriving at school and carrying out the morning school routine Leaving school and getting home Going to the toilet Getting changed for sport Finding the way around the school Lining up to go back into the classroom Mealtime or snack time Participating in breakfast club Eating lunch / school dinner Other school/college participation: Participating in assembly / school concerts/ clubs Going on school trips College of Occupational Therapists, 2014
24 Home occupations At home Personal activities of daily living For example: Waking up and getting out of bed/ going to bed and sleeping Accessing and moving around the house and garden Brushing teeth Using the toilet (including managing menstruation) Having a bath or shower Getting dressed Sexual awareness and sexual activity as appropriate Eating breakfast / lunch / dinner / snack Organising yourself to go out Doing homework Planning what to do and completing homework tasks Household chores Washing the dishes Tidying a bedroom Watering the plants Feeding / grooming / walking pets Play & leisure Playing a game or socialising with a sibling / friend Playing outside / doing sport Reading a book / listening to music College of Occupational Therapists, 2014
25 Community occupations In the community For example: Moving around the community Using the bus or train Walking or cycling in the community Play & leisure Going to the cinema/shopping with friends Playing sport, going swimming or going to the gym Going on holiday Going on a date Attending Scouts / Guides / Brownies or other structured groups Work, appointments & errands Going to appointments or meetings Going to the supermarket / bank / post office Doing a part time job / volunteering College of Occupational Therapists, 2014
26 Needs continued Some services may require needs to be written under the following headings: Communication and interaction Cognition and learning Sensory and/or physical Social, emotional and mental health Behaviour These do not promote occupation-centred practice. If they are, however, required then the occupations could be described under these headings based on the primary reason for the performance issue.
27 Needs continued For example. With Milla, her needs were related primarily to sensory and/or physical for this occupation, so in the report it may look like this: Sensory and/or physical Moving around the classroom: As Milla is unable to propel her own wheelchair, she required assistance from the teaching assistant to move her wheelchair and position her at her desk. Writing and drawing in class: As Milla is unable to open the clip on her clipboard and slide her paper, she needed assistance from the teaching assistant to perform these task actions.
28 Needs continued However. If Milla s needs were primarily related to cognition and learning this occupation, the report it may look like this: Cognition and learning Writing and drawing in class: Milla looked away from her writing frequently which interrupted her completion of the task. Several times Milla needed help from the teaching assistant to keep focused on the task.
29 Outcomes The benefit or difference made to an individual as a result of an intervention. It should be personal and not expressed from a service perspective (SEND definition) These will relate directly to the needs Some key phrases to get you started: By the time I m.. I am able to do/maintain... Consider: What would success look like? How will you know when it has been achieved? (Adapted from Amide, 2015)
30 Example outcomes (end of key stage or 2-3 years) By the end of Year 11, I can read and understand Harry Potter and similar stories (similar to a 9 or 10 year old). I am chatting to other children in my class by the end of Year 8. By the end of the autumn term of Year 7 at secondary mainstream school, I am holding simple conversations with my friends, in the playground. (Adapted from Amide, 2015)
31 Example outcomes and steps towards outcomes E. Outcomes: what this means for the child/young person For Tom to manage his school routine of finding his way around the school and managing his self care independently by the end of year 10. Steps towards outcomes Finding the way around the school: Tom will find his own way to his classrooms, by October Changing for sport: Tom will keep belongings in one place when changing for sport, by November College of Occupational Therapists, 2014
32 Provision E. Outcomes: what this means for the child/young person For Tom to manage his school routine of finding his way around the school and managing his self care independently by the end of year 10. Steps towards outcomes Finding the way around the school: Tom will find his own way to his classrooms, by October Changing for sport: Tom will keep belongings in one place when changing for sport, by November Indicative actions: What will be done and who will do it? The occupational therapist in collaboration with the SENCO and Tom will develop a timetable and map which he can access on his mobile phone to support his navigation around the school. The occupational therapist, class teacher and learning support assistant will work together to establish a routine for Tom and designate a space for him to use when changing. Resources (including frequency) The occupational therapist will visit the school up to four times during the Autumn term to develop the resources in collaboration with the SENCO and Tom. The occupational therapist will collaborate with, and offer advice to the school during the scheduled visits during Autumn term. College of Occupational Therapists, 2014
33 Timeframes Ideally advice or reports used should not be more than 12 months old. If a report is available which is under 12 months old, local authorities should not seek new assessment (providing it is acceptable to the parents/carers, child/young person and school). If a request has been made for a child who is known to an occupational therapy service then the advice needs to be provided within 6 weeks (legislative requirement). If all occupational therapy reports are written with a focus on occupations and outcomes, then responding to EHCP advice requests will be straightforward.
34 Further information Education, health and care plan occupational therapy advice template Examples of aspirations, needs, outcomes and provision Clip from Edward Timpson Ofstead / Care Quality Commission inspections Legal Issues Support for children without EHCPs Integration with the Care Act SEND code of practice Government guides for implementation
35 References Amide F. (2015). Developing Good Education, Health and Care Plans. Presentation for Tri-Borough Champion Training. London. College of Occupational Therapists (2014) Education, Health and Care Plans. London: COT. Available at: Accessed on Department for Education, Department of Health (2015). Special educational needs and disability code of practice: 0 to 25 years Statutory guidance for organisations which work with and support children and young people who have special educational needs or disabilities. Available at: a/file/398815/send_code_of_practice_january_2015.pdf Accessed on
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