Support Referral Form

Argyll and Bute Council ESO: Gerry Geoghegan Community Services: Education

Request for Support Behaviour Support

School: QIO’s name: Teacher: APT’s name: Head Teacher: Ed Psy’s Name: Pupil’s name: Stage:

What additional needs does the child have? This box should contain any known details about the needs of the child help is being requested for. Information might be drawn from support planning documentation held by the school, reports written by other professionals and recent assessments. Where a child had no support documentation it would be an integral part of the ESO request process to begin to create it and the needs denoted in this box would be based on observation and experience of the child by key staff. What supportive action has the school already taken? This box should contain a note of what the school and class teachers have put in place to assist the child in question. This might include the use of assistant staff, adapted curricula, differentiated material, application of discipline strategies and the use of individualised ways of working to address the child’s needs. Schools should also note the involvement of Area Principal Teachers and other support specialists available to them.

Who else is involved? (underline) Psychological Services Physiotherapy Social Work Medical Services Occupational Therapy HI / VI CAMHS SALT Other What outcomes would you like for the child? This box should contain details of what result you might expect from the involvement of the ESO. This might include assistance in analysing the causes of particular behaviours to better understand a child, help to draw up suitable procedures and protocols to address pupil behaviour issues, information and training to better equip staff to work more effectively with particular children and advice on how to deal with issues arising from particular behaviours as well as any other outcomes school staff wish to suggest.

In order to assist schools to further develop their professional practice in delivering the best outcomes to children with additional needs around behaviour, the ESO Behaviour Support is available to visit schools, talk to staff , observe children in class and help provide specific solutions to difficulties arising from behaviour.

Official Use Only Official Use Only Official Use Only

 Action These boxes at the  School contacted  Visit Report Completed

 Decline bottom are used by the  Visit arranged  Thematic Analysis Completed

 Refer ESO to track progress  Visit Conducted  Information Circulated