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Support for grieving children

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Winston's Wish is the UK's childhood bereavement charity. We support children and their families after the death of someone important.

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We help all those affected by domestic abuse by providing innovative and unique services. We work to ensure that victims are supported to recover and perpetrators are supported to change their behaviour.

Do you need support and advice or safe and secure accommodation?

We offer a confidential support service, simply call or email today:

If you are in an emergency situation

If it is unsafe for you to speak on the phone, after dialling 999 just press 55 for the silent solution.

You can also text 999.

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Hampshire's SEND Local Offer is designed to help you find the very best support for your child or young person including information about education, health, social care, leisure services and access to impartial advice or support.

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You can find information about the help and services available for children and young people (aged 0 to 25 years) with special educational needs and disabilities (SEND) in Hampshire. Explore the information topics below.

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Call to discuss your concerns with a Speech and Language Therapist

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Children’s Therapy Service :: Hampshire and Isle of Wight NHS Foundation Trust

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Our Children’s Therapy team works closely together to support children and young people who need specialist help from one or more of our therapy services. These include Physiotherapy, Occupational Therapy and Speech and Language Therapy.

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Lots of helpful links and support for parents around understanding and managing children's behaviour.

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Hampshire Educational Psychology Support 

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Hampshire Educational Psychology Support 

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A support line for parents to discuss and problem solve with an Educational Psychologist, any issues of concern that their child may be experiencing.

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Advice and support for parents about Special Educational Needs and Disabilities (SEND)

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Do you need some support responding to an EHCP or a Working Document? Join one of our online clinics where we'll guide you through the process.

Impartial Special Educational Needs and Disability Information, Advice and Support (SENDIASS) in Hampshire

Hampshire SENDIASS is an impartial Special Educational Needs and Disability Information, Advice and Support Service (SENDIASS) that aims to make a positive and lasting difference for children and young people with special educational needs and/or disability (SEND) and their parents and carers. We do this by providing timely confidential, impartial information, advice and support through our online resources, at events and workshops, via our helpline service and through individual casework.

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Hampshire SENDIASS is provided by Polaris Children's Services, part of a leading Children's Services Group with over 24 years of experience in supporting children, young people and their families to build brighter futures.

Feedback

Tell us what you think by taking a quick questionnaire!

Get in Touch

If you can't find what you need, feel free to get in touch with us, our opening hours are Monday-Thursday, 9am-5pm, and on Fridays 9am-4pm . Outside of these hours please use the Contact Us Form. We aim to respond to all enquiries within 2 working days.

0808 164 5504

The Local Offer includes information about education, health, social care, preparation for adulthood, leisure services and impartial information advice and support. Hampshire's Local Offer (co produced with parents, carers and young people) aims to help you find your way through the maze of information to reach the best solutions for you/your child.

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Hampshire SENDIASS | Impartial SEND Advice & Support

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Hampshire SENDIASS provide information and support to Children & Young People with special education needs and/or a disabilities.

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A website offering support for parents on a wide range of issues

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Support for parents and carers of children with additional needs (diagnosed or not).

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Hampshire Parent Carer Network (HPCN) offers parents and carers of children and young people aged 0-25 with any additional needs, or disability including mental Health (diagnosed or undiagnosed) the opportunity to tell the Local Authority, Health and other services, what life is really like. email participation@hpcn.org.uk or visit our page.

We Are Hiring!

We are looking for passionate and dedicated individuals to fill two exciting roles for projects we are running:

Bridging the Gap(BTG) Coordinator - BTG Job des.docx

Future in Mind (FIM) Coordinator - FIM Job Des.docx

If you are passionate about making a difference and believe you have the qualifications and experience we are looking for, we encourage you to apply.

Deadline to submit Applications : 28th June 2024

Join us in making a positive impact at HPCN. We look forward to hearing from you!

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Hampshire Parent Carer Network (HPCN) offers parents and carers of children and young people aged 0-25 with any additional needs, or disability including mental Health (diagnosed or undiagnosed) the opportunity to tell the Local Authority, Health and other services, what life is really like. email participation@hpcn.org.uk or visit our page.

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Tips on how to support children who may be experiencing mental health difficulties

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Hampshire Child and Adolescent Mental Health Service is an NHS specialist service, provided by Sussex Partnership NHS Foundation Trust for young people aged 5-18 years and their families who are experiencing difficulties with their mental and emotional health. Many young people experience difficulties with their mental health such as anxiety, low mood, trauma, eating difficulties plus many others which can impact on all aspects of life such as education, home life, hobbies and interests, socialising and having fun.

It is important to know that everyone has mental health and that we can all experience tough times and this can cause our mental health to suffer. CAMHS work with young people, their families and other important organisations (such as schools) to achieve the following:

* Assess and diagnose mental health and neurodevelopmental difficulties
* Identify realistic goals or changes
* Identify and build on strengths
* Improve self-esteem and confidence to cope with difficulties
* Learn emotional coping techniques to help manage difficult or upsetting thoughts, feelings, urges or experiences
* Empower the young person to identify, express and communicate their needs, take responsibility for their health and wellbeing and feel confident in knowing where and how to get additional support if necessary
Hampshire CAMHS Thresholds
We cannot "cure" mental health difficulties or prevent difficulties ever coming back. Lots of things can impact on our mental health, some of which are beyond anyone's control. Instead we work with you to help you learn how to manage your difficulties and in many cases overcoming them is absolutely possible. There may also be some difficulties or experiences which CAMHS are not able to provide support for. In these cases we will help you access appropriate help from other organisations and services such as drug and alcohol services and bereavement services plus many others.

You will need to be willing and committed to attending sessions that are offered as well as trying and practising techniques until you find what works well for you. You will need to be prepared to work with us in this way so that you have the best chance of achieving your goals/recovery.

Overcoming difficulties also depends on how much an individual would like to change. Often change can be scary and many young people feel they don't have the energy or the motivation to change or try different things. If you have made the step of asking for help and attending an assessment and are committed to making changes, we will work with you to help you achieve your goals/recovery.

Anyone can help you get an appointment at Hampshire Specialist CAMHS; you, your parents or carers, your teachers, a health professional (such as a school nurse or GP) or a social worker, using our online referral form which you can complete and submit online. You can also call Hampshire CAMHS on 0300 304 0050 (Monday - Friday, 9am-5pm).

If you are experiencing difficulties, it is really important to talk to those around you so that they can support you with these and with getting the right help and support.

We would recommend talking to CAMHS before making a referral so that we can offer advice and guidance and to decide whether CAMHS is the right service to meet your needs. CAMHS may also be able to offer recommendations about other services, organisations and things that may be helpful.

If after receiving a referral it is agreed that it would be helpful for CAMHS to offer an appointment, you will be given a date as soon as possible. Please be aware that there may be a wait for an appointment. If you feel that things are becoming more difficult or more urgent whilst you are waiting for appointment, please contact the Single Point of Access for CAMHS on 0300 304 0050 to let us know.

* At your first appointment we'll start with introductions and outline what will happen during the appointment. Your first appointment may be by telephone or face to face
* We'll ask you to fill in some questionnaires. These help us to understand your strengths and any difficulties you might be experiencing
* Your clinician will also talk to you about confidentiality and consent to share information
* The aim of your first appointment is to find out what your goals are and what you would like to be different
* By the end of the appointment we will decide together the best way forward in order to help you reach your goals/recovery
* If you have any questions, worries or concerns please speak to your clinician - we're all here to listen and to help, your initial appointment is a chance to discuss what is currently going on for you.

We have a leaflet entitled 'About your CAMHS appointment' which you can download here.

This leaflet clearly explains what to do if you have difficulties getting to appointments, it may address other questions you may have and also explains our appointment policy.

We understand that there are lots of reasons why you might not want information shared with your young person's school. We will want to understand those reasons so that we can make sure you still receive the help and support you might need.

There are some situations when we will need to share information with others. If your young person or someone they know are being harmed or are at risk of harm, we have a duty to protect anyone from harm so we will find a way together to share information in an appropriate way. We will include you in all discussions as much as possible when sharing information is involved.

If you are worried about information being shared please speak to your clinician about this so you can agree a way forward together.

* Following your first appointment, if it is agreed that CAMHS can help you a number of things may happen
* You may be offered a group to attend. We know that for some that groups with other people experiencing similar difficulties are the best support. These will be run by our experienced clinicians
* You may be offered a further period of assessment and intervention by one of our clinicians. They will contact you to arrange this.

This will depend on many factors including the type of difficulties you are experiencing and your goals. There will be regular reviews of how things are progressing and discussions with you and your family about the care we provide. At CAMHS we aim to empower young people to learn and develop skills to help themselves cope and work towards their goals.

Sessions usually last between 50 minutes and one hour. Some sessions are longer depending on the therapy approach being used. You can use as much or as little of your session time as you want.

No, not everyone that comes to CAMHS is prescribed medication. Medication can be helpful for some young people depending on what difficulties they are experiencing. If you have any questions or worries about medication, you can ask your clinician.

You might also find useful information and guidance about psychiatric medication on this website: www.headmeds.org.uk

If there is an emergency and you or someone else is at risk of serious harm, call 999 immediately and tell anyone else who may be near you so they can help.

If your young person is in crisis and you do not know what to do, click here.

If it is not an emergency, encourage your young person to find someone to talk to; a parent/ carer or family member, friend or partner, or call the helpline. If you already see someone at CAMHS, you can call after the weekend or the next day to speak with them or someone else in the team.

We know that when people finish their work with us and are discharged (closed) from our service, people can worry that they might not cope. It is important that if you are working with CAMHS that you complete a relapse prevention plan before you finish. It is important to keep this and follow the plan if you are struggling.

You can use the self-help pages of this website to remind yourself of the top tips to help you cope and access extra self-help information and advice. The most important thing to do is to let a parent/carer, teacher or trusted adult know that you are struggling so that they can support you.

Young people can sometimes be re-referred to CAMHS if this is agreed this would be the most helpful thing to do.

Yes!
* Specialist Eating Disorder Team
This team covers the whole of Hampshire and works with young people who have eating disorders and difficulties and their families. Our aim is to see young people as quickly as possible and provide specialist treatment. The team also provides information and guidance for anyone who might be concerned about an eating difficulty. The Specialist Eating Disorder Team can be contacted Monday-Friday 9-5pm on 0300 304 0062.
* i2i (Urgent Assessment and Home Treatment Team)
Our i2i team provide specialist intensive assessment and treatment to young people who are experiencing crisis or who require extra care to try to prevent crises from happening. This service can only be accessed by young people already coming to CAMHS and who have been referred by their CAMHS worker. The team provide urgent assessments and help develop care plans with you, your family, the CAMHS team, school and other agencies (where needed) that aim to keep young people as safe as possible.
* Learning Disability Care
Hampshire CAMHS also offer their services to children and young people with a learning disability, making sure that young people with a learning disability who also have a mental health difficulty can get the help and support they need. Every team in Hampshire CAMHS has a specialist learning disability CAMHS worker who can offer a range of approaches depending on each person's needs. One of the main approaches used is Positive Behaviour Support. This is an approach to support children and young people when they have behaviours that can be challenging.

We work together to find out why a behaviour may occur, including triggers and outcomes. This helps us to think of strategies to help a young person manage their feelings and helps parents or carers to respond in helpful ways.

Further information can be found at: www.challengingbehaviour.org.uk
* Youth Offending Team and Forensic CAMHS
The Youth Offending Team (YOT) is a service provided by Children's Services for young people who are involved in the Criminal Justice System. CAMHS provides specialist assessments and ways to help young people who have been involved in crime and are working with YOT. These CAMHS clinicians work within the YOT teams and alongside the YOT workers.

Forensic CAMHS is a specialist service for young people who experience a mental health difficulty and who may pose a risk to themselves or others. CAMHS workers in this team provide training, and advice and consultation to other professionals as well as specialist assessments and work with the young person and their family. The Clinicians in this team work closely with children's services, schools, the Police and other relevant organisations to ensure the health, wellbeing and safety of the young person and those around them

What do certain words mean? Read our Glossary.

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It's normal for children and young people to feel worried about something that's happening at school - for example, when starting a new school or during exams. Sometimes, however, school can become challenging, stressful or distressing over a much longer period of time.

If your child is feeling anxious about school, or not able to go, it can be exhausting for both of you. Mornings in particular can become really stressful for the whole family, as you try to juggle your child's feelings alongside the need to get them to school and get on with your other responsibilities such as work. Even if you manage to get your child to the school gate, you might know how difficult they're going to find the day - or know that you'll be facing the same problem tomorrow morning.

If you're in this situation, we've got advice to help you explore what's going on with your child, make changes at school that can help, and find the support you need if your child can't go to school.

Young people can feel anxious about school for lots of different reasons. They might be worried about making friends or fitting in, find schoolwork or lessons confusing, feel pressured to learn in a certain way or find their relationships with teachers difficult.

Sometimes, going through difficult experiences outside of school - such as bereavement, an illness in the family or being a young carer - can also make it harder for a child to feel settled at school.

For some young people, the school environment isn't right for them, and trying to fit into it can create a huge amount of stress. This might be the case if they are struggling with their mental health, or have a neurodiverse condition or Special Educational Need (SEN) such as autism, ADHD, dyslexia or dyspraxia. This can make the school environment anxiety-provoking and exhausting, especially if their condition or need is undiagnosed or not being well supported.

Young people might show they're feeling anxious about school by:

not wanting to get up and get ready

saying they can't go

worrying a lot about small issues, such as having the right equipment for a lesson

feeling sick, or having stomach aches or headaches

not sleeping well

not doing schoolwork, or their grades dropping

being angry or upset, or acting out - at school or at home

withdrawing - seeming low, quiet or depressed

It's often difficult for your child to articulate the problem. They may be in a heightened state of stress and not know why or feel able to explain. Your child probably wants to feel able to be in school, just as much as you want them to be there. In many cases it just doesn't feel possible.

Sometimes it can be difficult to work out what's making your child feel anxious, and the first step is often helping them to identify exactly what's worrying them. Once you understand the problem, you'll be in a much better position to make changes that can help.

Young people can find it hard to explain what's causing their feelings, and might not be able to answer direct questions like 'what's going on?' Using an anxiety iceberg can help to open up the conversation - giving you a more relaxed way of exploring together what's causing their anxiety.

Watch our video to find out how to make an anxiety iceberg with your child.

If you're making an anxiety iceberg with younger children, you might want to draw images on the iceberg, or encourage them to write simple words. With older children and teenagers, you can ask them to write key words and phrases on the iceberg, or do this as a mind map, with 'school' in the middle and all the things they're finding difficult around the outside.

Through this exercise, you might identify worries such as arriving at school, finding the environment noisy or overwhelming, finding lessons confusing, feeling lonely through the day, or feeling uncomfortable during specific subjects.

Once you understand what's going on for your child, you can use their anxiety iceberg or mind map to communicate with the school and ask for specific changes.

Follow these steps to start a conversation with the school:

Here are some examples of things you can ask the school for:

Remember that even though this situation can be really tough for you and your child, it's a good idea to maintain a positive relationship with the school. Recognise the support they're offering and any changes they're making. This will help you work together to make things better for your child.

Building a relationship with the attendance team at my son's school was hugely helpful, we were talking with them each day.

If your child isn't going to school at the moment, it might feel incredibly stressful and tiring. You might be worried about when they will be able to get back to school or the impact on their education. Or you might feel overwhelmed because you're juggling this alongside work and other family commitments. Things are probably feeling tough for your child too.

During this time, it's important to keep working with teachers and other staff to try strategies that can help your child get back to school. Keep encouraging them to take achievable steps towards attending too. When the right support is in place, it's often easier for a young person to get back into their usual routine if they can return to school as quickly as possible.

If your child's anxiety about school has built up to the point where they can't go, it's a good idea to get them some professional mental health or SEN support. Find out how to do this further down the page.

Alongside requesting professional help, try to:

The school's SEN and attendance policies should be on their website. Knowing what these are can support you during meetings with the school.

This can help if your child is unable to go to school for a longer period of time and you need to ask for more support, including provision of alternative full-time education.

Encourage your child to get up, do some studying and stop for lunch at the same times they would if they were in school. This will make adapting back to school easier. Explain to your child that if they cannot go to school, they will need to study at home - at least until alternative arrangements are put in place. Ask the school to help you facilitate tasks and activities your child can do and use online resources such as BBC Bitesize.

Not going to school could leave your child feeling really isolated. Make sure they stay connected to the outside world by seeing friends and family, doing activities they enjoy and getting outside for walks and exercise.

Speaking to friends online can be really important if your child is feeling isolated at home. Sometimes, however, you might notice that your child is spending lots of time gaming or on their phone, and that this is getting in the way of important daily activities like spending quality time with family, learning, or sleeping and eating well. If this is becoming a problem, have a look at our guide to gaming or guide to social media for more information and advice.

Local authorities must provide alternative education if a child of compulsory school age is unable to attend school over a longer period of time. If your child cannot attend school because of a mental or physical health issue, the local authority should provide an alternative as soon as it is clear that they will be away from school for more than 15 days (either consecutively or over time). Find out how to request alternative education.

Getting back to school after weeks or months may feel extremely difficult for your child, but you and the school can help make it more manageable. Here are some things you can do to help:

Set small, achievable targets, such as visiting the building outside school hours or attending one lesson.

Request a home visit from a school staff member so your child can check in while feeling safe, see that the school cares and discuss any strategies that might help them.

Ask for a reduced timetable, with regular reviews to discuss building back up at a manageable rate.

Discuss changing classes or sets if your child thinks this would help.

Focus on qualifications needed for what your child wants to do next, perhaps dropping a less relevant GCSE to reduce stress.

My son wasn't questioned about his absence when he did feel able to pop in for favourite lessons, helping to ease him back into full days of education.

If your child is struggling with anxiety and it's affecting their day-to-day life, learning or relationships, it's a good idea to find some professional support. Speaking to the GP and finding them a counsellor or therapist are two good places to start. You can find more information about GPs, counsellors and other mental health services in our guide to getting support from mental health services.

If there is no other obvious reason for your child's inability to attend school, they may have an undiagnosed Special Educational Need (SEN) such as dyslexia, autism or ADHD.

If you think this is the case:

Speak to the school's SENCO or your GP to ask for a referral for an assessment.

While you are waiting for an assessment, you can also ask the SENCO to refer your child for support from other professionals, such as an Educational Psychologist or Speech and Language Therapist. These professionals can identify specific needs and make recommendations for additional support the school can put in place - even if your child hasn't had a formal diagnosis yet.

SEN support at school
If your child is diagnosed with SEN, extra support and adjustments should be put in place at school to help them attend and learn. This is called SEN support, and should be available within the school's existing resources. Speak to the school's SENCO in the first instance about how the school will support your child.
Education, Health and Care (EHC) plans
If you do not think your child's needs can be met by the school's existing resources, you can ask the local authority to carry out an Education, Health and Care needs assessment (EHC needs assessment). If the local authority decides your child needs additional support, they will then make an Education, Health and Care plan (EHC plan). This outlines how the extra support they need will be provided. Find out more about EHC plans.
Your Local Offer
Your Local Offer is the information, support and services available for young people with SEN, and for their parents and families. You can find out what support is available in your area by going to your local authority's website and searching for their Local Offer.

While we take care to ensure that the organisations we signpost to provide high quality information and advice, we cannot take responsibility for any specific pieces of advice they may offer. We encourage parents and carers to always explore the website of a linked service or organisation to understand who they are and what support they offer before engaging with them.

We have more tips and advice on supporting your child with school, and information about how you can get in touch with our Parents Helpline.
This page was reviewed in December 2022. It was created with parents and carers with lived experience of supporting their child or young person with school anxiety. We will next review the page in 2025. YoungMinds is a proud member of PIF TICK - the UK's quality mark for trusted health information.
Whether you love the page or think something is missing, we appreciate your feedback. It all helps us to support more young people with their mental health.

Please be aware that this form isn't a mental health support service. If your child is in crisis right now and you want to talk to someone urgently, find out who to contact on our urgent help page.

At YoungMinds we take your privacy seriously. If you'd like to read more about how we keep the information we collect safe, take a look at our privacy policy.

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School Anxiety and Refusal | Parent Guide to Support

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If your child is anxious about school, or refusing to go to school at all, read our tips and advice on how you can support their mental health.

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CAMHS supports children with emotional or mental health difficulties, sometimes offering assessment and therapy to help them cope and feel better

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Hampshire Child and Adolescent Mental Health Service is an NHS specialist service, provided by Sussex Partnership NHS Foundation Trust for young people aged 5-18 years and their families who are experiencing difficulties with their mental and emotional health. Many young people experience difficulties with their mental health such as anxiety, low mood, trauma, eating difficulties plus many others which can impact on all aspects of life such as education, home life, hobbies and interests, socialising and having fun.

It is important to know that everyone has mental health and that we can all experience tough times and this can cause our mental health to suffer. CAMHS work with young people, their families and other important organisations (such as schools) to achieve the following:

* Assess and diagnose mental health and neurodevelopmental difficulties
* Identify realistic goals or changes
* Identify and build on strengths
* Improve self-esteem and confidence to cope with difficulties
* Learn emotional coping techniques to help manage difficult or upsetting thoughts, feelings, urges or experiences
* Empower the young person to identify, express and communicate their needs, take responsibility for their health and wellbeing and feel confident in knowing where and how to get additional support if necessary
Hampshire CAMHS Thresholds
We cannot "cure" mental health difficulties or prevent difficulties ever coming back. Lots of things can impact on our mental health, some of which are beyond anyone's control. Instead we work with you to help you learn how to manage your difficulties and in many cases overcoming them is absolutely possible. There may also be some difficulties or experiences which CAMHS are not able to provide support for. In these cases we will help you access appropriate help from other organisations and services such as drug and alcohol services and bereavement services plus many others.

You will need to be willing and committed to attending sessions that are offered as well as trying and practising techniques until you find what works well for you. You will need to be prepared to work with us in this way so that you have the best chance of achieving your goals/recovery.

Overcoming difficulties also depends on how much an individual would like to change. Often change can be scary and many young people feel they don't have the energy or the motivation to change or try different things. If you have made the step of asking for help and attending an assessment and are committed to making changes, we will work with you to help you achieve your goals/recovery.

Anyone can help you get an appointment at Hampshire Specialist CAMHS; you, your parents or carers, your teachers, a health professional (such as a school nurse or GP) or a social worker, using our online referral form which you can complete and submit online. You can also call Hampshire CAMHS on 0300 304 0050 (Monday - Friday, 9am-5pm).

If you are experiencing difficulties, it is really important to talk to those around you so that they can support you with these and with getting the right help and support.

We would recommend talking to CAMHS before making a referral so that we can offer advice and guidance and to decide whether CAMHS is the right service to meet your needs. CAMHS may also be able to offer recommendations about other services, organisations and things that may be helpful.

If after receiving a referral it is agreed that it would be helpful for CAMHS to offer an appointment, you will be given a date as soon as possible. Please be aware that there may be a wait for an appointment. If you feel that things are becoming more difficult or more urgent whilst you are waiting for appointment, please contact the Single Point of Access for CAMHS on 0300 304 0050 to let us know.

* At your first appointment we'll start with introductions and outline what will happen during the appointment. Your first appointment may be by telephone or face to face
* We'll ask you to fill in some questionnaires. These help us to understand your strengths and any difficulties you might be experiencing
* Your clinician will also talk to you about confidentiality and consent to share information
* The aim of your first appointment is to find out what your goals are and what you would like to be different
* By the end of the appointment we will decide together the best way forward in order to help you reach your goals/recovery
* If you have any questions, worries or concerns please speak to your clinician - we're all here to listen and to help, your initial appointment is a chance to discuss what is currently going on for you.

We have a leaflet entitled 'About your CAMHS appointment' which you can download here.

This leaflet clearly explains what to do if you have difficulties getting to appointments, it may address other questions you may have and also explains our appointment policy.

We understand that there are lots of reasons why you might not want information shared with your young person's school. We will want to understand those reasons so that we can make sure you still receive the help and support you might need.

There are some situations when we will need to share information with others. If your young person or someone they know are being harmed or are at risk of harm, we have a duty to protect anyone from harm so we will find a way together to share information in an appropriate way. We will include you in all discussions as much as possible when sharing information is involved.

If you are worried about information being shared please speak to your clinician about this so you can agree a way forward together.

* Following your first appointment, if it is agreed that CAMHS can help you a number of things may happen
* You may be offered a group to attend. We know that for some that groups with other people experiencing similar difficulties are the best support. These will be run by our experienced clinicians
* You may be offered a further period of assessment and intervention by one of our clinicians. They will contact you to arrange this.

This will depend on many factors including the type of difficulties you are experiencing and your goals. There will be regular reviews of how things are progressing and discussions with you and your family about the care we provide. At CAMHS we aim to empower young people to learn and develop skills to help themselves cope and work towards their goals.

Sessions usually last between 50 minutes and one hour. Some sessions are longer depending on the therapy approach being used. You can use as much or as little of your session time as you want.

No, not everyone that comes to CAMHS is prescribed medication. Medication can be helpful for some young people depending on what difficulties they are experiencing. If you have any questions or worries about medication, you can ask your clinician.

You might also find useful information and guidance about psychiatric medication on this website: www.headmeds.org.uk

If there is an emergency and you or someone else is at risk of serious harm, call 999 immediately and tell anyone else who may be near you so they can help.

If your young person is in crisis and you do not know what to do, click here.

If it is not an emergency, encourage your young person to find someone to talk to; a parent/ carer or family member, friend or partner, or call the helpline. If you already see someone at CAMHS, you can call after the weekend or the next day to speak with them or someone else in the team.

We know that when people finish their work with us and are discharged (closed) from our service, people can worry that they might not cope. It is important that if you are working with CAMHS that you complete a relapse prevention plan before you finish. It is important to keep this and follow the plan if you are struggling.

You can use the self-help pages of this website to remind yourself of the top tips to help you cope and access extra self-help information and advice. The most important thing to do is to let a parent/carer, teacher or trusted adult know that you are struggling so that they can support you.

Young people can sometimes be re-referred to CAMHS if this is agreed this would be the most helpful thing to do.

Yes!
* Specialist Eating Disorder Team
This team covers the whole of Hampshire and works with young people who have eating disorders and difficulties and their families. Our aim is to see young people as quickly as possible and provide specialist treatment. The team also provides information and guidance for anyone who might be concerned about an eating difficulty. The Specialist Eating Disorder Team can be contacted Monday-Friday 9-5pm on 0300 304 0062.
* i2i (Urgent Assessment and Home Treatment Team)
Our i2i team provide specialist intensive assessment and treatment to young people who are experiencing crisis or who require extra care to try to prevent crises from happening. This service can only be accessed by young people already coming to CAMHS and who have been referred by their CAMHS worker. The team provide urgent assessments and help develop care plans with you, your family, the CAMHS team, school and other agencies (where needed) that aim to keep young people as safe as possible.
* Learning Disability Care
Hampshire CAMHS also offer their services to children and young people with a learning disability, making sure that young people with a learning disability who also have a mental health difficulty can get the help and support they need. Every team in Hampshire CAMHS has a specialist learning disability CAMHS worker who can offer a range of approaches depending on each person's needs. One of the main approaches used is Positive Behaviour Support. This is an approach to support children and young people when they have behaviours that can be challenging.

We work together to find out why a behaviour may occur, including triggers and outcomes. This helps us to think of strategies to help a young person manage their feelings and helps parents or carers to respond in helpful ways.

Further information can be found at: www.challengingbehaviour.org.uk
* Youth Offending Team and Forensic CAMHS
The Youth Offending Team (YOT) is a service provided by Children's Services for young people who are involved in the Criminal Justice System. CAMHS provides specialist assessments and ways to help young people who have been involved in crime and are working with YOT. These CAMHS clinicians work within the YOT teams and alongside the YOT workers.

Forensic CAMHS is a specialist service for young people who experience a mental health difficulty and who may pose a risk to themselves or others. CAMHS workers in this team provide training, and advice and consultation to other professionals as well as specialist assessments and work with the young person and their family. The Clinicians in this team work closely with children's services, schools, the Police and other relevant organisations to ensure the health, wellbeing and safety of the young person and those around them

What do certain words mean? Read our Glossary.

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A simple explanation for all ages - adults and children.

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What is Neurodiversity (The DERS Guide) ~ Autistamatic

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A positive introduction to Autism - a lovely video to raise awareness among all children.

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Amazing Things Happen - by Alexander Amelines

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A list of books to help children to understand more about Neurodiversity.

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Easy to understand support for a small fee.

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Sometimes learning is simply better on-line...SEND Station is a great destination to explore fresh , practical and great value training for those working with and supporting children with Special Education Needs and Disabilities

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What is dyslexia?

Dyslexic brains process information differently. This results in a pattern of strengths, like problem solving, creative thinking and seeing the big picture. Plus, challenges like spelling, reading, writing and rote learning.

Knowing how to spot, support and empower dyslexic thinking can transform the life of any dyslexic child.

How to spot it

How to support it

How to empower it

Get the facts
Download our simple factsheets.

Watch

Watch our simple videos and learn how to support your child's xtraordinary dyslexic mind.
WATCH HERE

Email

Email your school, education authority, or politician to ask for all teachers to be trained.

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Explain dyslexia to your child

Being dyslexic is a brilliant thing. After all, the inventor of the aeroplane was dyslexic. And the lightbulb! So are many xtraordinary writers, like Roald Dahl and Dav Pilkey, the creator of Captain Underpants. It's important to know that you're dyslexic - it helps you to understand why some things come naturally and others are much harder.

5 FACTS TO EXPLAIN:
Visit our kids page to find out more!

Grab a copy of 'Xtraordinary People' to read together!

This brilliant book will help you understand the 7 'Xtraordinary' strengths that come with dyslexia. It's a brilliant way to explain dyslexia to all kids.

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What is dyslexia? Dyslexic brains process information differently. This results in a pattern of strengths, like problem solving, creative thinking and seeing the big picture. Plus, challenges like spelling, reading, writing and rote learning. Knowing how to spot, support and empower dyslexic thinking can transform the life of any dyslexic child.

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Speech and Language activities for Parents and Teachers

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Speech and Language activities for Parents and Teachers

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Herefordshire and Worcestershire Health and Care NHS Trust

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Herefordshire and Worcestershire Health and Care NHS Trust

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Resources for Children's Speech and Language

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Children's Speech and Language resources to download

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Strategies for supporting Sensory issues

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Strategies for supporting Sensory issues

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Parent Support line for Speech and Language, Physiotherapy and Occupational Therapy

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Parent Support line for Speech and Language, Physiotherapy and Occupational Therapy

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Call to speak about any concerns around your child's development in these areas

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Family Information and Services Hub | Solent NHS Children’s Therapy Service

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Solent NHS provide Physiotherapy, Occupational Therapy and Speech Therapy for children and young people aged 0-19yrs who need specialist help across the whole of Hampshire, Southampton and Portsmouth. For further details please see the advice page linked on this page. If you have any concerns about…

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This report details what provision for children with SEND looks like at our school.

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Our school’s SEND policy explains how we notice when a child needs extra help and how we work with families to support their learning and wellbeing.

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A simple step-by-step guide of how the school decides whether a child has SEND and how parents are included in this process.

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Support for ARFID (Avoidant/Restrictive Food Intake Disorder)

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Support for ARFID (Avoidant/Restrictive Food Intake Disorder)

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Avoidant restrictive food intake disorder, more commonly known as ARFID, is a condition characterised by the person avoiding certain foods

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Fortunately, specific behavioral changes and adjustments to the sleep environment will help most children with insomnia. We've compiled the top tips that are proven to help kids sleep. The recommendations outlined here are best suited for toddlers through early adolescence. Both babies and teens will have specific considerations of their own.

These lists may seem long, but you don't need to implement them all at once. It's better to focus on trying a few small changes, giving them time to work, and then adjusting your approach based on how your child responds.

Keep in mind that every child's sleep needs will vary based on their age, genetics, and cultural differences. Therefore, not all approaches will work equally well for all children, and there can be an element of trial and error. However, your patience will be rewarded in time as your little one learns to fall asleep quickly on their own and keep sleeping soundly through the night.

Sleep hygiene - a collection of habits and behaviors that promote good sleep - is vital for children. Many sleep struggles are caused or made worse by poor sleep hygiene. When practicing sleep hygiene, remember that consistency is key. Sleep strategies take time and repetition to be effective.

Create a Routine: Humans are creatures of habit. A lets your child's body and mind know that it's time to settle down and prepare for sleep. The actual routine can be specific to your child, but it should last around 20 minutes and consist of three to four quiet, soothing activities such as putting on PJs, brushing teeth, a warm bath, and reading. Bedtime routines provide children with a sense of familiarity and comfort, which acts in direct opposition to the uncertainty of insomnia.

Set a Bedtime: A sleep schedule works with your child's natural biological clock to promote dozing off with regularity. Bedtimes are most useful when they're consistent, so try to keep the same bedtime on weekends as on school nights. Altering bedtimes during the weekend will make it more difficult for kids to maintain their normal weekday schedules.

Implement a Screen Curfew: The ubiquity of screens makes this rule hard to implement, but it's well worth it. Mobile devices, TVs, and tablets emit a type of blue light that suppresses melatonin, a hormone that promotes sleep. Children may be to the effects of light from screens. Screen time also stimulates the brain, making it harder to wind down for sleep. Electronic devices should be kept out of the bedroom and ideally not used within one hour of bedtime. Consider using the created by the American Academy of Pediatrics.

Get Exercise: Physical activity is proven to help people of all ages . Most children need at least of exercise per day. Just make sure to avoid vigorous activity within two hours of bedtime. Otherwise, your child may feel wound-up and find it harder to fall asleep.

Avoid Scary or Violent Content: Feeling scared or worried is a common reason kids can't sleep. So it's no wonder that scary or violent movies, TV, video games, and even books in the evening are in children. If your kiddo likes the gory or spooky stuff, save it for the daytime.

Nix Caffeine: This is a no brainer. Caffeine is a stimulant that can both make it harder to fall asleep and reduce the quality of sleep. In addition to the usual suspects like soda, coffee, and energy drinks, watch out for more discreet sources like tea, decaf coffee (which still has trace amounts of caffeine) and chocolate. Even small amounts of caffeine can have a in a little body. Don't let your child consume caffeine , or preferably, avoid it all together.

Don't Sleep With a Pet: While it's tempting for tots to snuggle Fido in bed, a pet's movements and noises during the night can awaken them from a peaceful slumber. Try having your furry family member sleep outside of your child's bedroom for a few nights to see if that helps. To make the transition easier, include saying goodnight to pets in the bedtime routine.

Optimizing your child's bedroom is an integral part of inducing quick and seamless shuteye. People with insomnia are more likely to be distracted by an uncomfortable bedroom National Library of Medicine, Biotech Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. View Source , which makes sleep even harder. These tips can help you create the perfect sleep setup for your little one:

Room Temperature: The body and brain both in preparation for sleep, and this can be disrupted by a stuffy bedroom. To avoid this, try to keep the thermostat around 65 degrees.

Noise: Research suggests that even mild sound disturbances can , even if the sleeper never awakens. Consider noise-blocking curtains to cut down on street noise. You can also use a fan or white noise machine to drown out unpredictable or distracting sounds.

Light Level: Start dimming indoor lights as bedtime approaches, and keep your child's bedroom as dark as possible. This and . If your child is afraid of the dark, a small nightlight is okay.

Soothing smells: Calming scents like can have mild sedative effects. You might try using essential oils, a room diffuser, or dried potpourri sachet to provide a soothing, sleep-inducing smell.

Unfortunately, childhood anxiety is steadily rising Centers for Disease Control and Prevention (CDC) As the nation's health protection agency, CDC saves lives and protects people from health threats. known to disrupt sleep Anxiety and Depression Association of America (ADAA) ADAA's mission focuses on improving quality of life for those with anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research. View Source . Stress is View Source in all ages, so anything that can reduce worrying before bed is helpful. Help your child learn to manage their concerns with these tactics:

Write In a Journal: Encourage your child to get their anxious thoughts out of their head and onto paper. It can also help for them to write about the good things that happened in the day. Focusing on the positive will help children feel more secure.

Mindfulness Exercises: Mindfulness exercises like meditation are proven to . There are many kid-friendly meditations that parents and children can do together. These often consist of simple breathing techniques, body awareness, or guided imagery. Look to books, tapes, and even smartphone apps for ideas.

Create a Worry Time: It's okay to discuss worries, just not at bedtime. Set aside a specific time during the day for your children to discuss their concerns and how to cope with them. This can free children of the need to dwell on worries before bed.

It's normal for even the best little sleepers to awaken from slumber and ask for a parent. When your child cries out for you, it's okay to tend to them. However, you should do so with intention. This is not the time to give in to demands, as doing so can increase stimulation and make it harder to fall asleep. Fulfilling your child's every request can also reinforce an unhelpful pattern of relying on parental assistance for sleep.

Instead, keep the checks short and simple. The point is to provide your child with reassurance that they're safe and cared for, while still fostering their ability to self-soothe and sleep on their own. Some parents may even wait a few seconds before answering a call so that their child has the opportunity to fall back asleep on their own.

If you have any doubt over whether your child's nighttime checks are appropriate, consult your child's doctor for guidance.

If your child continues to have trouble sleeping despite your best efforts, it may be time to check in with their pediatrician. Although uncommon, there can be more serious causes of childhood insomnia, such as childhood sleep apnea or restless leg syndrome.

Any of these reasons are cause to involve a doctor:

Significant daytime sleepiness

Frequent or severe snoring or other abnormal breathing during sleep

Suspected psychological or developmental condition

Considering medications or supplements to aid in sleep

For a couple of weeks before the doctor appointment, it can help to keep a sleep diary. This is a nightly recording of your child's bed time, nap times, sleep length, and activities. A sleep diary helps to identify patterns and possible problems to address.

Learn more about our Editorial Team

References

1. Esparham, A. (2020, January 2). Melatonin and Children's Sleep. HealthyChildren.Org.
https://www.healthychildren.org/English/healthy-living/sleep/Pages/Melatonin-and-Childrens-Sleep.aspx

2. Mindell, J. A., Li, A. M., Sadeh, A., Kwon, R., & Goh, D. Y. (2015). Bedtime routines for young children: a dose-dependent association with sleep outcomes. Sleep, 38(5), 717-722.
https://pubmed.ncbi.nlm.nih.gov/25325483/

3. LeBourgeois, M. K., Hale, L., Chang, A. M., Akacem, L. D., Montgomery-Downs, H. E., & Buxton, O. M. (2017). Digital media and sleep in childhood and adolescence. Pediatrics, 140(Suppl 2), S92-S96.
https://pubmed.ncbi.nlm.nih.gov/29093040/

4. Family Media Use Plan. (n.d.)., Retrieved September 23, 2020, from
https://www.healthychildren.org/English/media/Pages/default.aspx

5. A.D.A.M. Medical Encyclopedia. (2017, August 30). Benefits of Exercise., Retrieved August 30, 2020, from
https://medlineplus.gov/benefitsofexercise.html

6. A.D.A.M. Medical Encyclopedia. (2017, August 30). How Much Exercise Do I Need?., Retrieved August 30, 2020, from
https://medlineplus.gov/howmuchexercisedoineed.html

7. Garrison, M. M., Liekweg, K., & Christakis, D. A. (2011). Media use and child sleep: the impact of content, timing, and environment. Pediatrics, 128(1), 29-35.
https://pubmed.ncbi.nlm.nih.gov/21708803/

8. Temple J. L. (2019). Review: Trends, Safety, and Recommendations for Caffeine Use in Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 58(1), 36-45.
https://linkinghub.elsevier.com/retrieve/pii/S0890856718318847

9. Drake, C., Roehrs, T., Shambroom, J., & Roth, T. (2013). Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(11), 1195-1200.
https://pubmed.ncbi.nlm.nih.gov/24235903/

10. Narisawa H. (2013). Anxiety and its related factors at bedtime are associated with difficulty in falling asleep. The Tohoku journal of experimental medicine, 231(1), 37-43.
https://www.jstage.jst.go.jp/article/tjem/231/1/231_37/_article

11. Harding, E. C., Franks, N. P., & Wisden, W. (2019). The temperature dependence of sleep. Frontiers in Neuroscience, 13, 336.
https://pubmed.ncbi.nlm.nih.gov/31105512/

12. Van Der Werf, Y. D., Altena, E., Schoonheim, M. M., Sanz-Arigita, E. J., Vis, J. C., De Rijke, W., & Van Someren, E. J. (2009). Sleep benefits subsequent hippocampal functioning. Nature neuroscience, 12(2), 122-123.
http://www.nature.com/articles/nn.2253

13. Burgess, H. J., & Molina, T. A. (2014). Home lighting before usual bedtime impacts circadian timing: a field study. Photochemistry and photobiology, 90(3), 723-726.
https://pubmed.ncbi.nlm.nih.gov/24918238/

14. Gooley, J. J., Chamberlain, K., Smith, K. A., Khalsa, S. B., Rajaratnam, S. M., Van Reen, E., Zeitzer, J. M., Czeisler, C. A., & Lockley, S. W. (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. The Journal of Clinical Endocrinology and Metabolism, 96(3), E463-E472.
https://pubmed.ncbi.nlm.nih.gov/21193540/

15. Koulivand, P. H., Khaleghi Ghadiri, M., & Gorji, A. (2013). Lavender and the nervous system. Evidence-based complementary and alternative medicine : eCAM, 2013, 681304.
https://www.hindawi.com/journals/ecam/2013/681304/

16. National Center on Birth Defects and Developmental Disabilities. (2020, June 15). Data and Statistics on Children's Mental Health. Centers for Disease Control and Prevention.
https://www.cdc.gov/childrensmentalhealth/data.html

17. Anxiety and Depression Association of America. (n.d.). Sleep Disorders., Retrieved August 31, 2020, from
https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders

18. Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K. (2014). A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep, 37(9), 1553-1563.
https://pubmed.ncbi.nlm.nih.gov/25142566/

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Sleep Strategies for Children | Sleep Foundation

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Wondering about sleep aids for kids? These proven sleep tips will help children learn to fall asleep quickly and stay asleep.

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Getting your little ones to sleep can be tricky. Here are 10 tips that may help your kids settle into bed.

Sleep is an important part of maintaining good health, but issues with falling asleep aren't just problems that come with adulthood. Kids can have trouble getting enough rest, and when they can't sleep... you can't sleep.

Bedtime can become a battle zone when little ones won't settle in and fall asleep. But there are ways to even the odds of victory. Try using these 10 tips to learn how to fight the battle... and win!

School-age children need between 9 and 11 hours of sleep each night, according to the National Sleep Foundation. But there's a lot of variability in sleep needs and patterns. Most kids have patterns that don't change much, no matter what you do.

Early risers will still rise early even if you put them to bed later, and night owls won't fall asleep until their bodies are ready.

That's why it's important for parents to work with their children in setting a responsible bedtime that allows them to get plenty of sleep and awake on time, says Ashanti Woods, MD, a pediatrician in Baltimore, Maryland.

Set a wake-up time based on how much sleep your child needs and what time they go to bed. Woods recommends creating a wake-up routine as early as the preschool years to help prevent stress for parents down the road.

And remember to be consistent with the schedule. Allowing your child to sleep later on weekends is generous, but could backfire in the long run.

Those extra hours of sleep will make it hard for their body to feel tired at bedtime. But if you can try to make bedtime and wake-up time the same, within an hour or so every day, you'll be making everyone's lives sooooo much easier.

Routines are especially important for infants, toddlers, and preschoolers. Woods recommends that after dinner the remainder of the evening should include light playtime, bath, brushing teeth, a bedtime story, and then bed.

Aim for a routine that is comforting and relaxing, setting the ideal bedtime atmosphere. Before long, your child's body may automatically start to become sleepy at the beginning of the routine.

Melatonin is an important piece of sleep-wake cycles. When melatonin levels are at their highest, most people are sleepy and ready for bed.

Research from 2011 found that blue light from a television screen, phone, or computer monitor can interfere with the production of the hormone melatonin.

Watching TV, playing video games, or scrolling web pages on a phone or computer right before bed keep your child up an extra 30 to 60 minutes, according to this 2017 study.

Make the bedroom a screen-free zone or at least make sure all screens are dark at bedtime. And keep your phone on silent when you're in your child's room - or don't carry it in there at all.

Instead of screen time, Abhinav Singh, MD, director of the Indiana Sleep Center, recommends reading to your child in the evening to allow their brain to rest.

Another hormone that plays a role in sleep is cortisol, also known as the "stress hormone." When cortisol levels are high, your child's body won't be able to shut down and go to sleep.

Keep pre-bedtime activities calm. This can help avoid excess amounts of cortisol in your child's system. "You need to reduce stress to make it easier to fall asleep," says Dr. Sarah Mitchell, chiropractor and sleep consultant.

Soft sheets, room darkening shades, and relative quiet can help your child differentiate between day and night, making it easier to fall asleep.

"Creating a sleep-inducing environment is important because it sets the stage for sleep by reducing distractions," says Mitchell. "When you're calm you are not distracted, and can fall asleep more quickly and with less help."

Your child's sleep cycle isn't just dependent on light (or the lack thereof). It's also sensitive to temperature. Melatonin levels help to regulate the drop of internal body temperature needed to sleep.

However, you can help regulate the external temperature. Don't bundle your child up too much or set the heat too high.

Whitney Roban, PhD, clinical psychologist and sleep specialist, recommends dressing your child in breathable cotton pajamas and keeping the bedroom temperature around 65 to 70°F (18.3 to 21.1°C) at night.

Ghosts and other scary creatures may not actually roam around at night, but instead of dismissing bedtime fears, address them with your child.

If simple reassurance doesn't work, try using a special toy to stand guard at night or spray the room with "monster spray" before bed.

Roban recommends scheduling time during the day to address any fears and avoiding using bedtime for these type of conversations.

"Children are very smart and will quickly learn that they can stall bedtime if they use the time to express their bedtime fears," she says.

Kids can have trouble shutting their brains off for the night. So, instead of increasing that anxiety by insisting that it's time to go to bed ("now!"), consider focusing more on relaxation and keeping your child calm.

Tryteaching your child a deep breathing technique to calm their body. "Breathe in through your nose for 4 seconds, hold for 5 seconds, exhale through your mouth for 6 seconds," says Roban.

Younger children can just practice taking long, deep breaths in and out, she says.

Sometimes, your best-laid plans just don't yield the results that you want. (Hello, welcome to parenthood!)

If your child has trouble falling asleep, has persistent nightmares, snores, or breathes through their mouth, they might have a sleep disorder, says Mitchell.

Always talk to your pediatrician if you have any concerns about your child's sleeping habits. They may recommend a sleep consultant or have other suggestions for you to try so the entire family can get a good night's sleep!

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Bedtime can become a battle when little bodies don't abide by the clock. Here are 10 tips to learn how to win the fight.

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Presenter Rodd helps us learn how lack of sleep affects how our brain works. Rodd is usually very organised but he is staying up too late playing computer games. The children help him realise how badly he is affected by the lack of sleep through playing a memory game. Rodd then goes off for a good night's sleep and returns bright and cheery with a tidy house. He plays another memory game and is able to remember things much more clearly. To play the first game you will need scissors, a pencil sharpener, rubber, apple and a lunchbox. For the second - scissors, a watch, a water bottle, pencil and sock are required.

Throughout this clip, read out the dialogue written on the screen during the sketch as though actually talking with Rodd. There is an opportunity to play a memory game with Rodd. In order to do so, a tray will need to be prepared with scissors as well as a pencil sharpener, rubber, apple and a lunchbox and for the second game: scissors, a watch, a water bottle, pencil and sock are needed. Students could then discuss the importance of a good night's sleep. They could recall what happened to Rodd when he stayed up too late, and share their own experiences of being tired at school. Students could share how they feel when they are tired and consider whether this is a nice feeling. Ask students to draw two contrasting pictures, one in which they have not had a good night's sleep, and one in which they have. These pictures could be shared with the class and students could identify the differences in the pictures.

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Rodd's Bad Day - Sleep is Important! - 1st level Health and wellbeing - BBC Bitesize

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Rodd shows how missing out on a good bedtime routine can affect your everyday life.

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The world’s largest free library of guided meditations.

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With your help, we can keep offering free support to those who need us.

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How Zones is used at Old Basing Infants

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Teaching your child to use the toilet correctly can be a difficult task, whether they are on the autism spectrum or not. But if your child is autistic, the process of developing a toilet routine can take longer, and involve its own particular challenges. This guide provides some useful steps that will hopefully make your toilet training a success.

When to start

Choose a time when you have few engagements and are feeling relatively stress free. Some indicators of a good time to start are:

if your child has begun to become aware of needing to go to the toilet

if you notice changes in their behaviour patterns, such as appearing distracted or fidgeting when they are wet or have soiled

if they let you know when they need changing

if you have observed that your child is aware that they have started/finished weeing or pooing

if your child has shown an interest in using or used the toilet themselves without being prompted

if your child can avoid having a wee or poo accident for one or two hours at a time (ie has improved bladder/bowel control).

Developing a toileting routine

Remember that independent toileting is the ultimate aim and may take many months but there will be many small steps and successes along the way. As well as physical factors associated with toilet training, there are social factors to consider. It is rare for an autistic child to have the social motivation to want to be like mummy/daddy/friend and use the toilet. After using nappies for a number of years, your child might not see the point in starting to use the toilet. It's important to remember that all children are different and they will not all respond to the same teaching techniques.

Children on the autism spectrum often like routine. You can build upon this desire for predictability to develop a successful toilet training routine.

When changing your child's nappy, do this where the toilet is so they can start relating toileting activities to the bathroom.

Your child may behave differently than normal when their routine is changed so let everyone who cares for them know why there could be a change in behaviour. It is often easier not to use a potty as part of toilet training to avoid a possibly difficult change from potty to toilet.

Ensure everyone working with your child starts toilet training at the same time and follows your agreed approach. Send in any equipment to nursery/school which you use at home, for example a toilet seat they may use to make the seat smaller. Also remember to send spare clothes, plastic bags to put any wet clothes in and wet wipes. It is important that you have clear lines of communication during this time so having a home/school book to share concerns and successes is vital.

Observe your child over a few days to see when they do a wee or a poo. Identifying a regular pattern can help you take your child to the toilet with an increased likelihood of them doing a wee or poo. This then leads to positive reinforcement.

Continue to take your child at set times based on your observations. If they wet themselves at another time, take them to the toilet as quickly as possible and try to get them there so some of the wee goes into the toilet. Ignore the wetting and positively reinforce that the wee has gone into the toilet and continue the rest of the toileting routine.

Use a visual sequence beside the toilet to help your child understand what is expected of them, for example: trousers down, pants down, sit on the toilet, wee/poo in the toilet, wipe (you may need to show how many squares of paper to take), pants up, trousers up, flush toilet, wash hands. The sequence can either be in the form of photographs, pictures or the written word - whatever is most suitable and motivating for your child. You may need to create a way of removing or covering over each symbol as the step is completed to show that it is finished and to move on to the next step. There are some examples of visual supports on the Do2Learn website.

Make sure any pictures or instructions are very clear so there is no misunderstanding. For example, if you are teaching your son to stand and wee in the toilet, show an outline drawing of him standing and weeing in the toilet. If you are teaching sitting, show a picture of him sitting and weeing in the toilet.

Show your child a photo or drawing of the toilet and say 'your child's name, toilet', take them into the toilet, follow your visual sequence for undressing and sit your child on the toilet. Even if they do not open their bowel or bladder, continue to follow the visual sequence as if they had.

Use a laminated visual sequence above the sink at eye level for hand washing.

Teach toileting as a whole routine from communicating the need to go to the toilet, using the toilet, to drying hands, rather than just sitting on the toilet.

Keep the sequence of behaviours the same every time. Often when an activity is anticipated, the child is more receptive to it.

Concentrate on tackling one behaviour at a time; it's very difficult to change two behaviours at once.

Decide whether or not and how to praise your child for successfully following the toileting routine. Some children enjoy and respond to social praise ('well done', or a tickle), others respond better to an object. Some children find praise difficult and keeping a calm, structured routine with a preferred activity after toileting may work better.

Dressing and undressing

Dress your child in comfortable clothes they can easily manage themselves such as elasticated waistbands on trousers and skirts or dresses that are not too long.

Motivate your child to wear underwear by buying pants with their favourite cartoon or television programme characters on them.

Use 'backward chaining' to teach new skills. This involves breaking a skill down into smaller steps, teaching the last stage of the sequence first. So if you were teaching your child to pull up his trousers, you would pull them up to his hips and then he would pull them up to his waist. Next time, you would pull them up to just under his hips and he would pull them over his hips and waist. This is a particularly good way of teaching new skills as it raises your child's self-esteem as they have taken the final step of the task themselves to complete the sequence.

Hand washing

Follow the same steps each time: sleeves up, tap on, wet hands, squirt soap, rub hands together, rinse hands, turn off tap, shake hands, dry hands.

Stand behind your child and physically prompt them if necessary, slowly withdrawing.

Avoid using verbal prompts as your child can become dependent on these without you realising. Instead let your child refer to a visual sequence as a reminder.

You may wish to teach your child to use the cold tap only. Beware that if you teach them to use the hot tap independently at home, when they go into other settings and wash their hands, the water may be too hot and could burn them.

Boys - sit or stand?

When deciding whether to teach a boy to sit or stand to urinate, ask yourself the following questions:

Can they distinguish between when they want to wee and poo?

Do they have the co-ordination, focus and control needed to aim?

If they learn by imitation, is there someone they can watch?

If the answer to any of the above is 'yes', then they are probably able to be taught to stand to urinate. To start teaching them to aim, it can be useful to put a piece of cereal (preferably one they don't eat as this could lead to confusion) down the toilet so they have something to aim for and concentrate on. You can also purchase a variety of fun toilet target stickers online.

Bowel control

Bowel control is usually learnt after bladder control. Some children can find bowel movements very frightening and not understand what is happening. It can help to get a book with pictures to explain the digestion process.

Some children find the feel of a full nappy comforting, and may enjoy the sensory feeling of the weight of the nappy. Find alternative ways to replace these feelings so you can continue toilet training. Give your child a means of requesting the activity eg being wrapped in a warm, heavy blanket and fit it into their routine.

Sit your child on the toilet, keep the nappy on but with a hole cut in the bottom, slowly cut away the nappy each time until they are able to go without the nappy at all. To start with, they will still have the feeling of a security around their waist which in turn will enable them to feel relaxed enough to poo on the toilet.

Habit training

Some children are toilet trained through habit. Habit training is effective for children who may: lack awareness, not understand the significance or meaning related to physical sensations, be limited by decreased or absent physical sensations or have unsuccessfully tried toilet training before.

Habit training involves training the body to go at set times. Take your child to the toilet at set times throughout the day, every day.

As before, observe your child to discover the best times to take them to the toilet.

Make sure your child feels relaxed enough to open their bladder/bowels while they sit on the toilet. Having the tap running in the background can help enable your child to wee for example.

Sometimes having a toy to handle - not one which causes excitement - can be useful to both keep your child on the toilet and relax them. Keep certain toys/books for just when they are sitting on the toilet.

If your child lacks awareness or sensation, they may have to be taught a strategy before getting off the toilet, to avoid accidentally weeing on the floor. Encourage them to slowly count to ten out loud when they have finished weeing before allowing them to get up, or give them a sand timer to look at.

To help your child to independently manage their own toileting routine when they are older, you can buy watches which you can set to vibrate at certain times throughout the day. You can then teach your child when the watch vibrates, they are to go to the toilet.

Environment

Ensure the bathroom is a calm, relaxing environment to encourage independence and success with the complete toileting routine.

Remove all distractions which are not associated with toileting to help your child understand what is expected of them while in the toilet.

Make the bathroom as comfortable as possible, adding foot supports, side rails and a smaller toilet seat if necessary.

Encourage independence by ensuring that everything in the bathroom is at the right level for your child eg soap and towels.

Think about your child's sensory needs and make changes to reduce their anxiety. Does the soap smell too strong for them? Does the noise of the extractor fan bother them? Does the water temperature need to be adjusted? Is the lighting too bright?

Make sure your child can sit comfortably on the toilet with hips and knees flexed at a 90 degree angle and have feet flat on a secure object.

Night-time

Once your child is mostly dry during the day you will be able to start night-time toilet training.

Have a set bedtime routine which does not change with weekends or holidays.

Limit the amount your child eats and drinks before bed, having no fluid an hour before bedtime, but ensuring your child has enough fluid throughout the day.

Take your child to the toilet before they go to bed. They then may need to be taken once during the night. You could fit this in with your routine by taking them before you go to bed.

If they are unable to keep dry during the night, you may need to try different times in the night to take them.

Use products to protect bedding.

Schools and early years settings

Admission to school should not be refused simply because a child has difficulties with continence. A school that does this may be at risk of disability discrimination (alternative legislation operates in Northern Ireland).

Further tips

Giving a drink 10 to 15 minutes before toileting can help increase the chances of your child successfully doing a wee on the toilet but avoid giving too much as this creates an unnatural routine.

Decide if you are going to teach your child to shut the door as part of the whole toileting routine or only in certain situations.

Avoid using childlike terms for toileting as your child may find it difficult to change language later in life.

If your child has a fear of flushing the toilet, you may wish to remove this from the visual sequence and leave it until the end of the routine - after your child has dried their hands. They then may need to stand in the doorway while you flush the toilet and gradually stand closer each time until they are able to flush for themselves. Playing calming music to drown out the noise of the flush or explaining with pictures what makes the noise when the toilet is flushed may also help.

When your child is in a car, ensure they have a protector to sit on to stop the car seat from being soiled by accidents. Avoid drinks before long car journeys.

Be aware that some children will hold onto their wee/poo until they have their nappy put on, for example if they know they always have a nappy on before going in the car they may wait until it is put back to release their bowel/bladder.

A range of absorbent pants and swimwear for older children is available.

Once your child is toilet trained at home, you will want to teach them to use toilets when out. When visiting new places, show your child where the toilets are and use the same routine as you do at home. Use the same picture and toy or book they may have for toileting at home.

Some children smear their poo. Read our guide on smearing for strategies to try (link to new guide in behaviour section).

Further information

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Toileting - a guide for parents and carers

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This guide provides some useful steps to help make toilet training an autistic child a success.

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A range of ebooks for younger children in a variety of languages

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NABU BOOKS: READ FREE, MOTHER TONGUE BOOKS ONLINE.

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Available in several languages

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Bringing up your child in more than one language.

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Bringing up your child in more than one language.

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Other languages available - please ask

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Information about Free School Meals in the UK

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Information about Free School Meals in the UK

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Available in a range of languages - please ask

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An eating disorder is a serious mental illness that involves a person developing thoughts, feelings and eating behaviour which can take over a person's life and make them very unwell. Eating disorders can involve eating too much or too little and becoming really unhappy, worried and preoccupied with things such as weight and shape. It's important to remember that lots of people worry about what they look like and from time to time might be unhappy with their weight or shape, but for someone with an eating disorder these thoughts and feelings can have a serious impact on their life. It can impact on physical health, education and general daily living, such as hanging out with friends, spending time with family, going out and taking part in activities.

There is no one cause of an eating disorder. Young people who develop eating difficulties and disorders often tell us that eating or not eating can be a way of coping with feelings of sadness, worry and stress. Sometimes life stressors such as exams, bullying, friendship or family relationship difficulties and bereavement or loss may play a part in how someone copes or feels about themselves. There are also some personal factors such as having low self-esteem, experiencing anxiety or depression, setting high standards and being perfectionistic and identifying as LGBT (Lesbian, Gay, Bisexual or Transsexual) are sometimes associated with people who develop eating disorders. However, experiencing any one of these things does not necessarily mean that someone will develop an eating disorder or difficulty.

There are many different types of eating disorders and all of them are serious. All eating disorders are treatable and a full recovery is possible. It is important to notice that you might be having a difficulty and ask for help and advice as soon as possible.

Here are some signs that there might be a problem and it's time to get help;

Constant thinking or worrying about food, calories, weight gain or your shape. You might notice that it is hard to concentrate on other things.

Reducing your food in order to lose weight and setting yourself strict rules about what you can or cannot eat.

Trying to do other things to lose weight, such as lots of exercise, vomiting taking laxatives (medication to help you go to the toilet) or slimming pills.

You might become tired and more emotional (tearful, irritable).

If you're a girl, your periods might stop.

Other people might start noticing and commenting that they are worried about you

Not everyone who has an eating disorder will experience all the signs and symptoms. Also, if you are experiencing some of these signs and symptoms this does necessarily mean that you have an eating disorder, but it is important to get help and advice.

There are a number of workbooks and self-help materials you might useful:

What's eating you? A Workbook for Teens with Anorexia, Bulimia, and Other Eating Disorders by Tammy Nelson

Getting Over Overeating for Teens: A Workbook to Transform Your Relationship with Food Using CBT, Mindfulness, and Intuitive Eating by Andrea Watcher

Body Image Workbook for Teens: Activities to Help Girls Develop a Healthy Body Image in an Image-Obsessed World by Julia Taylor

Self-Esteem Workbook for Teens: Activities to Help You Build Confidence and Achieve Your Goals by Lisa Scab

What is an eating disorder?

Meet the team at Hampshire Specialist Eating Disorder Service

Is there a link between social media and eating difficulties?

A Glimpse of Hope - credit Hampshire Cultural Trust and ICE Project

Social Media, Food and Me

What Not To Say To Someone With An Eating Disorder

Beat eating disorders: Sufferers - credit Beat

What is an eating disorder?

Meet the team at Hampshire Specialist Eating Disorder Service

Is there a link between social media and eating difficulties?

A Glimpse of Hope - credit Hampshire Cultural Trust and ICE Project

Social Media, Food and Me

What Not To Say To Someone With An Eating Disorder

Beat eating disorders: Sufferers - credit Beat

# data[].attributes.attachment_link.description
An eating disorder is a serious mental illness that involves a person developing thoughts, feelings and eating behaviour which can take over a person's life and make them very unwell. Eating disorders can involve eating too much or too little and becoming really unhappy, worried and preoccupied with things such as weight and shape.

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Online apps to support children with EAL

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Picture book titles that help young children cope with their emotions and deal positively with new experiences, situations and issues.

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Little Parachutes: Picture books to help children

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Little Parachutes helps you to find children’s picture books about your child’s worries, experiences and milestones. Our children’s book reviews library contains hundreds of picture books about sharing, moving house, starting school, potty training and the arrival of a new baby. There are also children’s books about more challenging situations: bereavement, adoption, divorce and serious illness.

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High-quality, downloadable resources (both free and paid for) that support emotional resilience, social skills, and positive mental health in children.

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Resources for Emotional Literacy Support Assistants - ELSA Support

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Emotional literacy support assistants - or ELSAs - are teaching assistants trained to provide emotional and social skills support to children.

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Information for Parents and Carers about Emotionally Based School Avoidance (EBSA) - by the Hampshire Educational Psychology team.