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

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Hendrixt
My 13yrs D had anorexia for 5 months diagnosed a month and now into 5th week of re feeding, accessing FBT through CAMHS in the UK. Two of the 6 meal a day plan fall within school hours, snack and lunch. School agreed for a member of staff to supervise those meals but this arrangement keeps breaking down so D does not eat when she is not supervised. Does anybody have any suggestions on how to get more support - I've written to the Head asking for a meeting. Therapist advises that anorexia does not qualify for a SEN (special educational needs statement)
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Ellesmum
We had a similar problem. Does the school have a nurse or pastoral worker?  

Basically if she can’t be supervised with eating she can’t go to school, we have regular meetings with the school so do organise that, Eva Musby’s website has some school information you could take to the meeting. 

Otherwise can she she come home for lunch, or you go there, or she goes part time.  Tell them they’re stopping her having her vital medicine, and have her therapist contact them too. CAMHs keep in weekly touch with my school and are very good at setting them right.
Ellesmum
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sandie
Hi
i know what a worry this must be. Let me share our experience.
 In first 6 weeks of treatment, when D was theoreticaly eating snack and lunch in school, i realised later that lots was not being eaten and it took me 2 months really to understand that all meals needed supervision. I took her out of school for 6 weeks to refeed her then and did graded return, initially avoiding snack and lunch and then i met her in car for lunch. Over time, she started to eat in school again- not supervised but we have been reasonablyconfident that she has been managing them and is in supportive lunch environment. I am aware that some children need supervision in school for longtime, and I stll worry sometimes about our loophole- especially when there is stress in school like friendship difficulties.
one thing you could try is to set up 3 way appt in school with appropriate teacher and cahmsto look at options for how school cn support. We had 2 or 3 meetings in school like this with head of year and it is really useful to have a link person to approach when more support needed. Good luck.
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Hendrixt
Thanks Ellesmum and sandie- we've already spoke with our CAHMS therapist and she's agreed to intervene if we dont get anywhere - the idea of regular meetings is good then it doesnt slip off the agenda.

Sandie - we ask her to bring home her lunchbox and leave uneaten food in it - promising there will be no criticism if she leaves any. 
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Hendrixt
Hi Jojo. What a massive variation in response to this. Your experience sounds awful. At least my school are trying to meet her needs, it’s just a bit disorganised. Have you looked into getting an EHCP. I thought you had to get a SEN statement for that - our therapist says that she’s never heard of one for an eating disorder 
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tina72
I took my d home for lunch and brought her back afterwards again for the last 1,5 years of school. Here in Germany supervising lunch in school is not possible. Snack was supervised by her teacher who was luckily a former ED patient so knew what to do but that was completely self organised.
If you cannot make sure she is eating snack and lunch in school I would think about leaving her at home for some time x until she is better. Most ED kids are highly intelligent and can stay out of school for some months without any problems.
Keep feeding. There is light at the end of the tunnel.
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Hendrixt
Hi Jojo/Tina,

Last night I wrote a strongly worded letter to the head teacher and today the school contacted me to confirm that they will provide supervision for all meals in the school. Hopefully they can keep to their word 
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tina72
Sounds great. I hope they do not think "supervision" is just sitting aside and do crosswords...make sure that they really watch her eat and report you.
Keep feeding. There is light at the end of the tunnel.
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Hendrixt
Yes Tina. I’m insisting on a meeting with the head to ensure senior teaching staff fully understand what we are trying to achieve 
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tina72
That would be perfect. It is crucial that ED sees that skipping meals and snacks is impossible. And she will not get into low blood sugar that way.
Keep feeding. There is light at the end of the tunnel.
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Hendrixt
Yes thanks Tina. If we are not 100% satisfied that the school will follow this through then we will be going to the school to feed her ourselves and if that does not work we will be taking her out of school. Funny thing is, well not funny really, today the school have successfully got her to eat two meals and she then comes home and refuses to eat her snack and has a massive hour-long meltdown after which we have to give up so this evening we are looking at how we can make up for those last calories, there’s just never ends does it
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scaredmom
Hendrixt,
You are well prepared! I am pleased it is so hard and you are so organized.
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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Hendrixt
Thanks scaredmom it really doesn’t feel like that sometimes. 

Jojo were part way through a tough meal now. Think it’s a combination of school exams, period (I know we’re lucky she’s having one!!) and offering bigger portions as she had a weight loss on Monday at CAHMS - yes and I know I’m only guessing I do think the ED kicks back big style when it’s under pressure 
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Hendrixt
Can’t weigh up the nature of the melt-downs which seem to vary so much. First one today was the snack after school. Ear-piercing screaming, drink thrown across floor, kicked me twice and slapped me. None of the snack eaten. Next meal another stand-off; ate most but left a token small bit. 1hr 20mins of prompting but she never spoke or responded; just smouldering contempt.
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sandie
So glad 2nd meal was calmer. Smouldering contempt easier I think. I find it so hard to cope with the screaming outbursts. Welldone for keeping going with prompting. X
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scaredmom
Hendrixt,
May I suggest if you have not already, please buy plastic plates and cups. Many have lost some nice dishes to ED.
Also ensure that nice furniture is protected or away. We have had some damage to nice fixtures and furniture. I have kept some reminders of the battles that were won (sigh).
Glad the second meal went better.
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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Hendrixt
Yeah scaredmom it’s not going to be long before one hits it’s target - probably my head at this rate. Obviously I hate the rages and violence but what upsets me most is when she’s completely run out of steam and she cries and wails like she used to do when she was a toddler - I’ll never get used to that 
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sandie
It is all terribly upsetting. A random tip- i wish I had been told to hide away sentimental momentos like cards your D made for you when small to avoid them being destroyed during outburst.

It is awful to hear your child wailing in distress. In our experience, that passed with weight-gain. We also had regression to toddler-like behaviour and D needing soothing like a small child. I have had to carry her like a small child and rock her.
What i was totally unprepared for was a period of high distress when she beat herself. It lasted a week or two about 3 months into refeeding. But it passed thank god. I don't know how common this is.
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Mamaroo
I went to her school during recess and lunch. I was allowed to park in the school parking area, so that my d didn't need to sign out and in. She would meet me there and have her snack/ lunch. I needed to do this for many months until she was able to eat recess with her teacher. However I didn't require the teacher to supervise her eating, instead telling my d the scales would tell me whether she has eaten or not.

The outburst you've seen is quite normal, as she can't restrict at school anymore.  Try and not take it so personally, it's just the ED.

Sending you lots of hugs 🤗🤗🤗🤗🤗
D became obsessed with exercise at age 9 and started eating 'healthy' at age 9.5. Restricting couple of months later. IP for 2 weeks at age 10. Slowly refed for months on Ensures alone, followed by swap over with food at a snails pace. WR after a year at age 11 in March 2017. View my recipes on my YouTube channel: https://www.youtube.com/channel/UCKLW6A6sDO3ZDq8npNm8_ww
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Hendrixt

That’s a good tip Sandie. I think the way she cries is a regression as it’s a long time since I heard her cry like that

Hi mamaroo - hugs to you too. I have done feeding in the car park when it wasn’t supervised by a teacher. You have to do what you can. We’ve both come to arrangement with our employers so that we can both be available during all school hours to go to the school to deal with any eventuality and given notice to our employers that we may have to take extended leave or hand in our notice. We’re trying to get the school to do it just so the feeding doesn’t impact too much on her time with her friends. When she eats under a teachers supervision she sits in a classroom with a small group of her friends who all understand the ED and support her. We think she finds it easier to eat with all this distraction as they chat through lunch. We’ve had to put a lot of pressure in the school to facilitate this but we think it’s better for our D to do it this way

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Hendrixt
Sorry about the large case I wrote it in my iPhone. I’ll make sure that doesnt happen again 
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tina72
Eva Musby has collected some tips what support schools could/should offer on her homepage. Maybe worth to print that out and give it to the school.
https://anorexiafamily.com/eating-disorder-policy-guidance-school/
Keep feeding. There is light at the end of the tunnel.
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Hendrixt
Thanks Tina, that’s really kind of you. I used these tips right at the start of discussions with the school when my D was first diagnosed and I found them to be very useful.  Actually, I think I might re-read this guidance before I meet with the school as it’s a few weeks since I’ve read them thanks for reminding me  
 
I’ve had quite a bit of direct communication with Eva over email. Our CAMHS Community eating disorder service recommend that people on FBT read Eva’s  book
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tina72
Eva is great, she also does skype-sessions if that can help you to get started, her book is our "bible" here and she knows the system in UK very well and has great connections there and can really help a lot. I am a big fan 🙂.
Keep feeding. There is light at the end of the tunnel.
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Scarlett81
Hi Hendrixt,

I have a SENCO qualification and I support schools with SEN in the UK. (But I'm on here as a parent of s with AN!)

The SEN Code of Practice has a section for Social, Emotional and Mental Health difficulties, which eating disorders would fit into.  However, it has to be directly impacting on a child's education, and their ability to access learning for it to be classed as SEN.  Schools have to make reasonable adjustments for pupils so that they can access their learning, which can sometimes include pastoral support.  

It's worth talking to your school SENCO to see if the Social, Emotional and Mental Health difficulties caused by the ED are impacting on the ability to learn.  If so, you may be able to make a case for going on the SEN register.

Hope that helps!
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