Mindcraft Therapies Assessment Report (14.08.22) stated: ‘The outcome of this assessment is that Elsa meets the criteria for a diagnosis of Autism Spectrum Condition’. Subsequently, a review of Elsa’s private assessment was undertaken by NHS Practitioners (including Dr Amanda Smith). This confirmed that ‘an ASD diagnosis can be hereby ratified by the NHS’ (correspondence dated 05/09/22). MINDCRAFT Therapies Autism Diagnostic Assessment Report 14/08/22 stated: ‘Elsa presents with long-standing difficulties with social communication and interaction, as well as with intense interests and sensory difficulties. She also presents with high levels of anxiety and demand avoidance behaviour’.
Elsa is not currently attending school and parents report that Elsa ‘has not attended since January 2022, having experienced headaches and high levels of anxiety’ (PCP meeting notes 17/10/22).

Most recent available scores:
Salford Reading (July 2021) Chronological Age: 9.06 Reading Accuracy Age 11.03+ Comprehension Age 12.07+ SWST (September 2021) Spelling Age 12+
NC Levels as of September 2021:
Language Literacy and Communication: 4
Maths: 4+
Science: 4
Y4 Welsh National Test Results:
Non-verbal Standardised Score: 140 Maths Procedural Standardised Score: 126 Maths Reasoning Raw Score: 17

These needs effect Elsa’ learning in the following ways:

1. Behaviour, Emotional and Social Development - Emotional Regulation

Whilst attending school Elsa appeared to be able to regulate her emotions. During her time working with an Emotional Wellbeing worker ‘Elsa engaged and enjoyed 1:1 sessions’ (PCP meeting notes 17.10.22), explaining that she enjoys school, the school council, certain subjects and being with her friends. (EW Report 12/05/22). Similarly, Elsa has appeared happy and content in Carousel sessions (Inspired Learners Nurture Report March 2022). Educational Psychologist report 22/11/22 stated that : ‘Elsa presents as a kind and clever girl who is continuing to develop her understanding and insight of herself’ Inspired Learners Report (01/04/2022) stated: ‘Elsa is able to listen to instructions and follow them. She is independent in most of the activities offered, and where she finds something tricky, she asks for help and takes advice on board.

To conclude we have seen a significant improvement in her confidence levels as her anxiety levels have reduced’. However, Nurture Report May 2022) mentioned the following concerns:

• Limited interaction with peers.
• Non- engagement with school.
• Lack of self-belief, particularly in her own ability.
• Dependence on adult relationships

In addition, family report that Elsa ‘can’t cope’ (PCP meeting notes 17/10/22) when unrealistic expectations are made of her. Similarly, Engagement Service visit notes (15/07/22) state: ‘There is a need to balance Elsa’ level of demands. If Elsa is experiencing increased levels of tolerance, she can accept an increase in demand and if she has a low level of tolerance, she will need a low level of demand. These levels may vary day to day, hour to hour’. Parents report that that this is manifested in headaches, vomiting and diarrhoea and by Elsa feeling unable to attend school and needing significant support and reassurance to attend counselling (PCP meeting notes 17.10.22). EMT Visit notes (15.05/22) stated: ‘EMT discussed what a good day in school would look like and Elsa responded with what would not be happening stating she would definitely not feel sick’

In addition, EW Report (Amanda Smith) 29/04/22 states:
‘Elsa tends to get anxious before coming into school, especially for the sessions with myself but there has never been resistance from her, and she has always turned up on time. Elsa explains in the sessions that she feels a lot better once she is in the school, however when we talk about Elsa taking a walk around school with me and showing me the building, she becomes anxious, and fear comes across her face. She explains she gets scared if someone will see her and ask where she has been because she doesn’t know what the other pupils in her class think of her now. In 2 of the sessions, we have discussed about Elsa showing me around the school and going for a play with her friends, Elsa agrees at the time but then the next session comes, and she has a think about it she becomes anxious and doesn’t want to do it’ Additionally, Educational Psychologist report 22/10/22 stated that:‘Elsa’s identified “Top 5 most like me” were: 1. “I find the school environment overwhelming (i.e., noise, crowds)” and “Sometimes I feel like I don’t belong” – These cards were a joint first choice for Elsa.
2. “I worry about being away from my parents/carers” 3. “I feel worried at school” 4. “I worry that something bad will happen” 5. “I worry about coming into school”
The impact of this is that Elsa is currently unable to attend school and take full advantage of the educational opportunities open to her.

2. Communication and Interaction - Social Communication and Interaction
 
3. Behaviour, Social and Emotional: Learning & Engagement