This Education Health and Care Plan has been developed solely as a training tool for the purposes of EHC plan training workshops delivered in Spring Term 2016. As such, it does include some good elements but it also has areas for improvement, and therefore cannot be regarded specifically as an example of good practice.

Education, Health

and Care Plan:

AnnaDobson (aged 5 years)

Education, Health and Care (EHC) Plan

This is EHC Plan no. 1 for AnnaDobson (name of child)

Date of Birth:19.02.11

Date plan 1 agreed: 05/12/2014

Date for annual review: 05/12/2015

Gender: Female

Home language: English

Preferred mode of communication: A mixture of sign (Sign Supported English), speech and non-verbal communication

Address:

......

......

(if appropriate) Current educational provision (name, type, phase):

Oakwood Nursery (privately run nursery)

......

AnnaDobson’s parents or person(s) with parental responsibility:

Name(s): Mr. SteveDobson

Relationship to Anna:Father

Address: ......

......

Contact information (tel / email)......

The following have contributed to AnnaDobson’s plan:

Name / Role / position
SteveDobson / Parent
Dipesh Patel / Audiologist
Alison Sweeney / Teacher of the Deaf
Samira Greening / Educational Psychologist
Dr. Marion Vine / Paediatrician
Vilma Purtoing / Social Worker
Thelma Williams / Nursery Manager
Marie Vincent / Speech and language therapist

Table of Contents

Section A. Views, Interests and Aspirations – Getting to know Anna–page 4

  • Hello! My name is Anna– a brief profile of Anna
  • Anna’s strengths and challenges
  • Anna’s story to date
  • How to communicate with Anna
  • Anna’s views and aspirations for the future
  • Anna’s father’s views and aspirations for the future

Section B. Anna’s special educational needs – page 7

  • Sensory
  • Speech, language and communication
  • Social and emotional skills
  • Cognition
  • Educational attainment
  • Self-help and independence skills

Section C. Anna’s health needs related and unrelated to her SEN –page 9

Section D. Anna’s social care needs, related and unrelated to her SEN –page 10

Section E. Desired outcomes for Anna–page 10

  • The desired outcomes for Anna
  • Arrangements for monitoring and reviewing Anna progress
  • Planning for Anna’s transfer to primary school

Section F. Special educational provision required by Anna– page 12

Section G. Health provision required by Anna–page 19

Section H1. Social care provision required under CSDPA 1970 –page 20

Section H2. Any other social care provision required by Anna–page 20

Section I. Name and type of school –page 20

Section J. Personal budget arrangements for Anna–page 21

Section K. Action and information received for Anna’s assessment –page 21

SECTION A - Views, interests and aspirations – Getting to know Anna

Hello! My name is Anna

photo

The above is based on a conversation Annahad with her key worker at nursery.

Anna’s strengths and challenges

The assessments and information gathered indicate that Anna has the following strengths:
  • Anna has good non-verbal communication skills. She is a keen communicator with excellent eye contact, concentration and attention.
  • She is good at solving simple problems through pictures (e.g. picking out the pictures that are the same; picking out the picture that is different from a group of 4 pictures), and using blocks and shapes.She can copy simple patterns and designs made by an adult(i.e. she has above average pictorial reasoning ability and average spatial ability).
  • Anna has the ability to retain and use what she learns to find ways of working out similar problems using trial and error. She is keen to learn, determined, enthusiastic and eager to please.
  • Anna’s ability to run, walk, skip and move her arms issimilar to other children of her age. So is her ability to do more intricate things, such as threading small beads, using scissors and drawing (i.e. Anna’s gross and fine motor skills are age-appropriate).
  • Anna is able to concentrate in ‘good listening conditions’ for an ‘impressive amount of time’ (educational psychologist report).
The assessments and information gathered for this plan also indicate that Anna has the following special educational needs:
  • Auditory neuropathy, resulting in difficulty in understanding speech and in distinguishing one sound from another.
  • Moderate hearing loss in both ears in low and mid frequencies, and profound loss in both ears in the high frequencies.
  • Difficulties in the development of making the right speech sound; in language (both understanding and spoken) and in communication skills (using Sign Supported English).
  • Delayed listening skills.
  • Difficulties in the development of social and emotional skills.Anna experiences difficulties in communication and getting on with other children. She also experiences more difficulties in recognising and expressing her own emotions and feelings.
  • Anna’s understanding and use of words and her ability to think and problem solve using words is currently behind that of most children of her age, although the ability to solve problems using pictures is above average.
General health
Anna’s general heath is currently good, although her father states that she has had some sleep problems in the past 6 months and he has taken Anna to her general practitioner.
Anna’s preferred communication
Anna communicates using a mixture of sign (Sign Supported English), speech (largely single words) and non-verbal communication. She has significant difficulty hearing speech if there is any background noise and responds best when spoken language is supported by sign or other visual clues such as gestures, facial expressions and pictures.

Anna’s story

Anna was born prematurely, at 27 weeks gestation, and spent several weeks in intensive care and then the High Dependency Unit. She had a number of complications, including serious infections and lung problems. She was diagnosed with auditory neuropathy in July 2010. Her hearing loss is thought to have resulted from having antibiotics when she was very ill in hospital.
Anna lives with her father and younger brother and has a good relationship with both. Her paternal grandmother looks after both children when Anna’s father is unable to do so due to work commitments. Anna has regular contact with her mother. Anna has had a social care assessment (section 17) and a care plan accompanying a supervision order is in place.
Anna has attended Oakwood Nursery since the age of two and now attends for 5 full days per week. She is eager to please, ready to learn and willing to take part in activities when she is approached directly or the activity is one she knows well and with which she feels confident.
She seems to want to be part of the group and enjoys mixing with other children and adults. She has a strong personality and adapts well to challenging situations. She is developing early independence skills, such as helping with dressing and undressing and trying to wash her hands.
She wears behind the ear (post-aural) hearing aids and is developing responsibility for them. If they come out she will often give them to an adult and indicate that she needs help to put them back in.

How to communicate with Anna

Anna communicates using a mixture of sign (Sign Supported English), speech (largely single words) and non-verbal communication. She has significant difficulty hearing speech if there is any background noise and responds best when spoken language is supported by sign or other visual clues, such as gestures, facial expressions and pictures.

Anna’s views and aspirations for the future

Anna is not yet able to express feelings and opinions verbally, but has clear ideas about what she wants as she goes about her daily life. She is keen to be independent and has indicated she really likes learning about new things. She also enjoys mixing with others and is keen to develop relationships and friendships with other children. She loves looking at books and magazines. Anna has indicated that she enjoys staying in the new house with her father and brother.

Anna’s father’s views and aspirations for the future

Mr Dobson is keen for Anna to make the most of her ability. He feels that she has the potential to achieve well academically if the difficulties arising from her deafness are fully addressed.
He particularly wants to make sure that she develops her communication skills to the best of her ability as this will give her the best chance of achieving independence and leading a happy adult life. He says that both he and Anna’s grandmother would like to help Anna with her communication but feel they need some help.
Mr Dobson wants Anna to have the best possible start in her new primary school.

SECTION B – Anna’sspecial educational needs

The assessments carried out and information gathered, provide the following more detailed information about Anna’s needs.

Sensory
  • Anna has a hearing loss in both ears. It is a moderate loss in the low-mid frequencies and profound loss in the high frequencies. She has two behind the ears (post-aural) hearing aids, which she wears reliably every day. Without her hearing aids Anna could not follow conversation but may hear some very loud sounds such as drums or a dog barking. With her hearing aids,Anna is able to hear the range of low and mid-frequency speech sounds at conversational voice levels. However, she is not able to detect very high frequency speech sounds such as 'ss', 'sh', 'p' and 't'. Her hearing loss therefore makes it very hard for her to discriminate speech effectively, even when wearing hearing aids. Any background noise makes it harder still and her ability to hear is directly influenced by her listening environment.
  • Auditory Neuropathy Spectrum Disorder affects the quality of sound Anna hears. The degree to which Anna is affected varies from time to time. Speech that is heard is often very distorted. Understanding where there is background noise is much worse than would be anticipated by the level of Anna’s hearing loss alone. Early speech discrimination testing suggests that Anna misses a large amount of information when relying on listening to speech alone. This makes it vital that listening conditions are good (e.g. classrooms with limited background noise and good acoustics) and also that she has visual communication support (including being able to see faces clearly, and use of Signed Supported English).
Speech, language and communication
  • There is a significant delay in Anna’s understanding and use of language. At a chronological age of 4 years, her understanding of spoken language (receptive language) is below the age of 2 years. Her spoken language skills (expressive language) are also below 2 years.
  • Her speech mostly consists of single words, two-word phrases and a few key expressions and she uses about thirty recognisable signs. She uses some signs spontaneously and frequently and other signs emerge when she is prompted and encouraged.
  • Anna is able to produce a range of types of speech sounds. This is a good foundation fordeveloping her ability to speak.
  • She is still in the very early stages of learning to listen. She is beginning to lip-read.
  • Anna will not be able to pick up very much, if any, language, information and learning from overhearing conversations and discussions as other children do.
Social and emotional skills
  • Anna enjoys mixing with others but her delayed language development has often prevented her joining in and so she can behave like a much younger child when she is unable to make her needs known.
  • She sometimes accepts “no” but at other times has a tantrum, during which she becomes subdued and sulks and becomes unresponsive, with a sad look on her face.
  • She is happy with most people but tends to stay near to more familiar people, such as her father or her key worker in the nursery. When she is with other children she tries to dominate them.
  • The nursery reports that Anna sometimes suggests a play activity and that it is evident that she would like to be friends with the other children around her, but she finds it difficult to tell them what she wants to do. When she tries to start a conversation with other children, they do not understand her and so she does not get the response she either wanted or expected.
  • She has an early understanding of good manners with ‘please’ and ‘thank you’. When other people are talking, if she wants to say something she tends to barge in, doing whatever she can to get attention.
Cognition
  • Anna is much stronger in some areas of learning, understanding and problem solving than others. Anna’s verbal ability to understand and solve problems using words is very low. Her verbal comprehension skills (understanding of words) were at the 1st percentile when she was assessed by the educational psychologist in August 2013. This means that she finds it very hard to take part in and learn anything from activities which are presented only through speaking. However, her ability to understand pictures and use them to solve simple tasks (pictorial reasoning ability) was above average (at the 67th percentile).
Educational attainment
The following information is taken from the reports from Anna’s Nursery School.
Reading
  • Within the Early Years Foundation Stage Profile (EYFSP), Anna is at the emerging stage of reading.
  • Although she enjoys listening to stories and looking at the pictures in books, she does not yet realise that the printed words in a book tell the story.
  • She appears to recognise a rhythmic beat in music but this is not yet transferred to rhyme and rhyming activities in language.
  • She is working at a level approximately two years behind her chronological age.
Writing
  • Anna is still at the mark making stage in writing and will make a mark under her drawings but does not say what the marks mean.
  • She is approximately two years behind her chronological age in writing.
Mathematics
  • In number, Anna enjoys counting from 1-5, but is not consistent in her recognition of these numbers in written form.
  • The nursery school staff find it difficult to help Anna understand simple number problems as she is often not sure whether to do an adding or a take away sum to get the answer. The nursery school staff believe this is due to her delayed language.
  • Anna is working 2 to 2.5 years behind her chronological age in number.
  • In shapes, space and measures, Anna enjoys pattern making and recognises a circle, naming it ‘round.’ She can match shapes but not name them.
  • She does not yet have positional language (e.g. behind, in front of) or an understanding of time language (e.g. tomorrow, later).
  • Anna is approximately 2 to 2.5 years behind her chronological age in this aspect.
Self-help and independence skills
  • Anna has made good progress in the area of self-help skills in the last six months, although her skills are slightly delayed. She actively helps with dressing and undressing and co-operates when being washed. She uses the toilet appropriately during the day but always wants an adult to accompany her. She continues to wear nappies at night.
  • She is slowly developing responsibility for her hearing aids. If they come out, she sometimes gives them to an adult and indicates that she needs help to put them back in. She does not yet let an adult know if her hearing aids are not working.

SECTION C - Anna’s health needs related to SEN and unrelated to SEN

Related to SEN
Audiological needs
Anna has a hearing loss that is moderate in both ears at mid to low frequencies and profound in both ears at high frequencies. She also has auditory neuropathy spectrum disorder.
She wears behind the ears (post aural) hearing aids but her hearing levels are described as ‘unstable.’
Unrelated to SEN
Anna has had some difficulty in sleeping for the past six months. On average about four nights per week, she wakens during the night and finds it difficult to get back to sleep, crying and calling out for her father. She can be awake for two or more hours. According to her father, this makes Anna and the rest of the family very tired the next day. School staff have also commented that Anna can arrive at school looking very tired some mornings and ‘does not seem in the mood to learn’.
Anna has a nut allergy.

SECTION D - Anna’s social care needs related to SEN and unrelated to SEN

Related to SEN
No additional social care needs related to her SEN have been identified during this assessment.
Unrelated to SEN
Anna is subject to a supervision order with accompanying care plan (dated 29/10/13)

SECTION E - Desired outcomes for Anna

  1. By the end of Year 2, Anna will be able to make the best use of the hearing she has, aided by appropriate amplification and thereafter there should be maintenance at appropriate levels for her age. This will include developing age-appropriate listening skills and learning to lip-read.
  2. By the end of Year 3, Anna‘s speech, language and communication skills will be at a point where they are, as a minimum, at a level of, or close to, that expected of a child of her chronological age and ability. Thereafter, they will be maintained at these levels or improved.
  3. By the end of Key Stage 1, Anna’s personal, social and emotional development will be age and ability appropriate and will be maintained at that level or higher thereafter.
d.By the end of Year 4, Anna will be achieving, academic outcomes which reflect her true ability once the barriers arising from her auditory neuropathy, deafness and resulting language difficulties are broken down.

Arrangements for monitoring and reviewing Anna’s progress