F.E.A.S.T's Around The Dinner Table forum

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KLB
S has expressed an interest in going back to school and although I would love for this to happen I don't want to send him in if he's not really ready. He's been off school since the beginning of the school year in September. I wanted to ask for opinions on what things need to be in place before this......

i.e. 
What does the ED kid need to be able to do/not do (in terms of eating and ED behaviours) before going back? 
Do they need to be weight restored?
What plans need to be put in place? 
Is a phased return better than a full return straight away?
I would appreciate hearing (reading) your experiences.........
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tina72
Big question in your special case would be how meals/snacks in school can be supervised. It might be ED that wants to go back to school to be able to restrict again. And if additional energy for more movement there and learning could be added. And if school can make sure that he does not exercise there.

If you can solve these problems school could give him a good distraction and social contact. Here it pulled my d back to life to see what normal teenagers are able to do that do not listen to ED.
We started with half days (mornings with supervised snack by the teacher (which was great with that) and lunch at home). No tests at the start - too much stress. She did great and we went to full days after only 2 weeks but no tests for about 2 months. But we took her home for lunch every day and drove her back after that (this was necessary as lunch is the biggest meal here) for the rest of her school time (it was about a year from then). My d was not WR - it was actually 3 weeks after IP when we started. We waited until she ate all meals and snacks without complaint.
We had some friends around before she went and she went directy after holidays. So there was no "do you remember what happened in maths last week" and she was not there.

So if you can solve the food problem I think it is worth a try. Maybe start with 2 lessons between breakfast and snack or two afternoon lessons if possible.
Keep feeding. There is light at the end of the tunnel.
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scaredmom
I like to break it down a bit: with questions for myself so that I cover a lot of bases. I am sure you have a really good feel for what will work for your situation. I will just share how I thought about it. 
1: will he be able to eat at school? Is it feasible for you or a nurse or teacher to supervise? And what does the supervision look like? My d teacher thought she was drinking her smoothies but it was being tossed in the toilet and she pretended. Do they have a cafeteria where the school  provides meals or are you in charge of that?
2: go back to school very slowly half day a few days per week- slow gradual integration. 
3: gym? Considerations about all of that. 
4: proper communication with all teachers and principal of the school about ED and what to do and when. 
5: how will you handle health classes? I Pulled d out of health classes and she did another math project. Just not to trigger her ED brain etc..
6: tests and exam? Which can he do or not?


We have what is called and IEP individual education plan to support kids for different reasons ie more time on assignments or less homework or no gym etc...  for physical and psychological issues as required ( my d friend has had a lot of concussions and so has time in the day just to rest at school without penalty) 
Our two schools that d went to with ED were very accommodating. I did not need a doctor’s note, but i know some do and need everything spelled out. I guess that is just so all is ‘legal’ and documented 

All the best 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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scaredmom
You asked if they need to be WR- my d was not. And my d did go back full time after IP and once I knew she threw away the smoothies I kept her home for two days.
she sat inside at recess while other kids went out to play. That was hard as she did not wish to be centred out for just sitting on a chair in the school yard. She had standing issues at school I had to tell the teacher to be firm to get her to sit. It still was an issue but d did not wish to disobey her teacher. 
When within yourself you find the road, the right road will open.  (Dejan Stojanovic)

Food+more food+time+love+good professional help+ATDT+no exercise+ state not just weight+/- the "right" medicine= healing---> recovery(--->life without ED)
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Mcmum
A good sign that he wants to go back I think!  The difficulty is putting in place supervision to ensure eating happens. My son still finds eating outside the home really difficult and the instinct is to starve still.  Your son needs a lot of calories so the main priority is to get them in. I agree that part time might be best.  We needed to be convinced that our son would be safe at school and also avoid sports at first. 
My main instinct is slowly does it.  How is his mood?  Has he seen friends?  Does he overdo the work?  Do school "get it"??
We started on a short school day and built up. We have to be vigilant as our school can tend to think that things are normal.  They're not! !! All the best xx
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debra18
The other think to add is it seems he needs supervision to remain safe.
 Do you think he would run away or hurt himself in school? My daughter was always in school and had meal supervision in school. It was a necessary distraction for her but she is much younger than your son.
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Ellesmum
Mines only back part time, she was completely off from last May to December I think.  School is completely aware of the situation and we have monthly progress meetings. D can work in their quiet space, she started going to sit in there for an hour a day just quietly reading.  I’d say set nothing in stone, maybe he can go in for say, Friday afternoon to see how it goes.

We have all kind of provisions in place, supervised lunch, an exit card if she needs to leave a room, no teacher will single her out to answer questions, no PE until I say so, food can be kept at school. Why don’t you call a meeting and see what they can provide?  Maybe he can do 2 hours a day or something for a while. 
Ellesmum
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Ronson
Could you drive him to school. Have lunch with him and bring him home from school to reduce activity and ensure he eats.  We brought d home for lunch for a while.  
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edhater
Something I hadn’t thought of with regard to school, because my primary focus was on eating at school, was exercise. I’ll never forget my non-ED D telling me that my RAN D was running the halls and climbing the stairs at school every chance she got. It might be an idea to try to put in place a watchful eye for that, to make sure it isn’t an option for him. 
Food is medicine... one mouthful at a time.
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Foodsupport_AUS
It can be really positive him wanting to return to school. 
Like others mine was not fully weight restored but was well on the way there. I would have sent her earlier if she would have gone. 

The most important for me was working out how to manage 
Meals - leaving no wiggle room for missed meals or snacks- initially I met D at school, later I delivered food to the nurse every day and D had to eat at the nurse's office.
Exercise - I had agreement from the school with no PE or sports or dance classes like Zumba,  and monitoring of exercise at lunch and recess. 
Health classes - they let me know if classes were coming up about weight/health etc. Overall though I don't really think this had a big impact.
Reintegration - my D was out of school for 18 months and went back to the same class as her peers. The school agreed as D was capable and after discussion it was preferred she stayed with her current friends rather than having to make new ones. She returned at year 10. We had agreement for initially limited classes. The only homework she was expected to do was English, science and maths. She was not expected to complete exams initially. She had a designated teacher to whom she was to report if she felt distressed, and who she also reported to if there was a class such as PE or French she was not attending. With that teacher she could read, study, or talk if she needed. The teacher in her case had not designated class, rather she was a teacher who was responsible for helping struggling students of whatever description. We went back part time too but by the end of week one she was back full time. She ended up doing three of a possible seven exams at the end of the year but no mid year ones. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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toothfairy
Hi KLB,
I think of you often.
I was keen to get him back to school to some level of normality.
As my S had spent 4 months in hospital, he was phased from hospital back to school at bmi 19, not weight restored, but a lot better than when he was pulled from school at 16.8 bmi.
First week , one morning
Second week 2 mornings 
Third week 3 mornings
Forth week 5 mornings, and Fifth week 5 mornings and one afternoon etc by two months he was back at school full time.

Here were my rules;-
Nobody was going anywhere until the breakfast that I served was fully eaten,every single crumb.
Breakfast consisted of a full large bowl of Muesli type cereal (Probably approx 3 servings in todays world!) with full fat milk, 2 slices of buttered toast and glass of milk.
That kept him going until lunch.
He needed his school lunch supervised by me for 1.5 years.Even after that I had to put a safety net in place.

The school could not provide any supervision or help whatsoever, but they were fully on board with all our comings and goings and absences etc.

If even a mouthful of the very high calorie lunch that I choose and served to him was not eaten, then he did not go back to school for the afternoon.

Same with dinner and snacks, no school the following day unless every single item was consumed and with no compensatory behaviours.
This became my leverage, and it was powerful. 

I did not allow PE for 2 years He is now 3.5 years into strong recovery and chooses not to do PE himself.

I had several meetings with the school, principal, Teacher year heads etc before he went back, and after he was back.
I spelt his situation out loud and clear and also put it in writing.

I contacted his friends parents and explained as much as possible of his situation.

He was not allowed use a bathroom until a few hours after his breakfast or lunch at school.
He was forbidden to run or power walk around the building. Any breach would result in him being pulled immediately from school.

He missed the best part of the year in school and did not do any exams at the end of that year.

I encouraged school friends to our house for meals and this helped a huge amount to move him along.
The very best of luck
Food is the medicine. Recovery is possible.
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