SEN support guide for professionals
Help for all practitioners and providers to identify how conditions can affect children and young people and how to access support with or without a diagnosis.
If you would like to make a suggestion or have a comment about this guide, please email SENDpartnership@lancashire.gov.uk.
7. Level 3 Specialist / intensive support
If despite level 2 support, the child continues to struggle at school or at home, a higher level of support may be required, which requires a specialist, co-ordinated approach to support.
Education establishments must continue to implement Assess, Plan, Do, Review Cycles to assess support needs. The SEND local offer can also provide additional support.
Children who are struggling in the early years and not yet attending nursery may need Portage, which is an educational home-visiting service for pre-school children who have significant special educational needs and disabilities. Schools may feel specialist support is required for older children from the SEND Specialist Teaching Service who are highly skilled and committed specialist teachers who have wide experience across all areas of special educational needs and disability (SEND).
Children and young people may benefit from an Education, Health and Care Needs Assessment EHC plans if their needs are not being met despite level 2 and 3 support. If a EHCNA is being applied for then school can invite the allocated SEND Case Worker from the Inclusion Service to the TAF meeting.
Children who have accessed emotional support via CANW and have an Early Help Assessment in place but need more support may benefit from a referral to CAMHS at Tier (level) 3.
CAMHS support is a service for children, young people and families with significant, severe, complex or persistent emotional, mental health, psychological and/or relationship difficulties Children and Young People’s Psychological Services (Lancashire and South Cumbria NHS Foundation Trust)
This could include:
- Anxiety/Mood disorders
- ADHD/ADD
- Self-Harm
- Eating disorders
- Obsessive Compulsive disorder
- Post traumatic Disorder
- Somatic Disorder
- Psychotic Disorders
- Severe behavioural problems (as part of any of the above).
For children where an undiagnosed neuro-developmental condition is suspected. A referral may be made by an education practitioner (SENDCo) to the neuro-development pathway (via CAMHS) for assessment.
For children struggling with emotionally based school avoidance (EBSA) with no improvement, school representatives should request a problem-solving discussion with the EBSA multi-agency team EBSA guidance and ensure multi-agency support is in place via Early Help Assessment and Family Intensive Support from Child and Family Wellbeing service (See Early Help Level 3)
Vulnerable children and their families with multiple needs or whose needs are more complex, such as children and families may benefit from level 3 early help. This may be for children and young people who:
- Have a disability resulting in complex needs
- Exhibit anti-social or challenging behaviour that increases risk for themselves and others
- Experience neglect
- Emotional/ behaviour difficulties experienced by the child/young person
- Parental conflict or poor family relationships
- Domestic abuse
- Poor parental Mental Health
- Have poor engagement with key services such as school and health
- Are not in education or work long-term
- Families involved in crime/misuse of drugs at a significant level
Prior to requesting services at Level 3 “Intensive Support”, practitioners are expected to have worked together with the child/young person and family to meet their Universal Plus needs using an Early Help Assessment and multi-agency meetings.
Support services available include Children and Family Wellbeing Service Family Intensive Support in the family home and community to prevent escalation of concerns. This support can be requested via a form Requesting support from Children's Services
Family Intensive Support should be focussed on working with families, children and young people. Support for families should not be designed to “rescue” them from situations, but to help them to restore family life with evidence-based interventions that help them to make long term, lasting change that they are in control of.
Level 3 support can include Family group conferences for families facing difficult situations or decisions to ensure the well-being and care of children and young people. The conference gives an opportunity to come together and make safe, reasonable and sensible plans for the children.
Families may also need health care for children with life limiting illness Special Needs School Nursing (Lancashire and South Cumbria NHS Foundation Trust) or services for children with profound and enduring disability Community Learning Disability Service (Lancashire and South Cumbria NHS Foundation Trust). The service is provided by a team of highly skilled qualified nurses and health care assistants working as part of the Children’s Complex Needs Nursing Service alongside the Complex Packages of Care and Children’s Complex Care and Assessment Teams.
Targeted Youth Support (PDF 1.12MB) may be needed for young people and provides one-to-one support with a Targeted Youth Support Worker which can be from 4 to 12 weeks in duration. The support can be in school, college, the community or virtually.
For children who are getting into trouble in their community (anti-social behaviour) or are becoming more aggressive and violent then support can be requested from the police community safety / Early Action team (Lancashire Constabulary - Early Action)