Eating disorders policy and guidance for schools

Thank you so very much, everyone who wrote in comments below, by email, on forums and directly onto the document.

I am working on a new draft right now (Nov 2017). If you’re interested, the current Word file is on

https://1drv.ms/w/s!AkNKehP0Vq2IgQefd2Cqku6CGD-s

When it’s all done I will put the document back on here.

 

17 Replies to “Eating disorders policy and guidance for schools”

  1. It needs an index and summary section. Very detailed, but may need to be simplified in places. Introduction should buy into people or staff who are sceptical, biased or judgemental.
    Some graphics or undisclosed photos may be included.
    Thanks for taking the time and effort.

    1. Eva,
      Thank you so much for all that you do for us all. You are a warrior and we’re very grateful to you. Some points from me:

      1. Your reference to neutral language may need explaining; perhaps give examples of appropriate language, e.g. ‘balanced meal’ rather than ‘healthy/unhealthy diet’

      2. The details surrounding the different types of ED may be a bit wordy; better might be some form of graphic labelling symptoms, rather than lots of text.

      3. Same detail for behaviours and physical signs as point 2 – use of graphics perhaps?

      4. Like the levels of intervention but concerned one-to-one meal supervision from school staff may be too much of an ask (our school has been prickly in this regard re staff resources required to enable this).

      5. The School Trips graphic is brilliant (in fact, I’ve utilised it myself for a school trip).

      1. Louise and Nihan, thank you so much!
        I like your suggestions to reduce the number of words.
        Louise, about your Number 4, I am pretty sure the the one-to-one meal supervision needs to stay in. It’s so useful, and some schools manage it — no idea if they’re a majority or the exception.

  2. Wow this is long and comprehensive. For me the key is supervised lunches and if a student doesnt eat, they cannot continue in lessons. Access to a counsellor immediately could be good. Call the parents. Life stops until you eat should be the message imho. My sons school adopted this attitude and had huge success. My daughters school sisnt supervise lunches, didnt care if pupils didnt eat, were more bothered that they behaved nicely and achieved results. Life stops until you eat.

  3. Eva Musby, I think I love you ?. This will be a fantastic asset in the battle against eating disorders. My daughter ‘s anorexia crept in after the healthy eating programme at school when she was 12. Although I don’t blame the school this policy will greatly increase awareness within teaching staff
    Kind regards and thank you
    Angela

    1. Awww! Yes, my understanding is that these health promotion initiatives have got many of our kids to start restricting. My guess is most schools will not have any idea what could possibly be wrong with “health promotion”.

  4. Eva,
    I think perhaps add some quotes from sufferers who have been supported by school staff and a teacher’s point of view? These would also help to break up the text.

    I was indebted to my child’s school who gave us every support, and which most importantly included lunchtime supervision. This was managed through one of the school’s welfare officers sitting and eating her own packed lunch with my daughter while she ate hers – in a room well away from being observed by other pupils. This enabled my daughter to remain at school and maintain vital links with her friends.

    A huge thank you for all that you are doing to raise awareness. Your website and book have been invaluable!

    1. Thanks for the encouragement to add quotes. It makes everything longer but yes, it might bring things to life.
      What you’ve just written would make an excellent quote. If it’s OK with you I’ll put that in? As “A parent”?

      Anyone who can help, can we gather a few quotes from schools?

  5. This could make such a difference, I feel that something similar should be sent a to all GPs, maybe the parents you are in touch with, could become ED policy champions and try and ensure local schools, CAMHS and GP practices receive copies. I wonder if Early Detection and Signs of ED, should be more towards the start the policy?? With information regarding the particular ED further down in the policy? Thanks Eva for bringing this into the public domain.

    1. It’s a lovely, simple, and very practical suggestion: that parents all over the world can bring education to local schools and doctors with the support of an up-to-date document. All your comments are going to help shape this into that kind of document, thanks!

  6. Hi Eva,
    What a fantastic resource this will be and how very detailed. I did wonder if it might be appropriate to have separate templates for primaries and secondaries as the staff involved are so much more involved with and closer to the children at primary than those at secondary. From our own experience, once the primary staff recognised the problem (which bacame obvious to them on a school residential trip) they were all on board and were able to form a spy network. The dinner ladies reported selling a sandwich and the playground assistants reported seeing it being offered to friends or the janitor finding it in the bin. Parental lunchtime feeding was therefore facilitated and easy. The school nurse made the referral the doctor had refused to do. Secondary, on the other hand, is a very different beast not least because of the scale and complexity involved. No one member of staff has contact throughout the day and pupil behaviours around food are more difficult to confirm. We also experienced PE teachers being awkward when we asked for exercise to be restricted because our child “didn’t look” as if they had AN! I think a policy such as this would help greatly in getting all staff within the school to behave “as one” I.e. Once an ED has been recognised and diagnosed, all staff would be committed to playing their part in any interactions with the child in a constructive way. I agree with earlier comments that the policy is very long and detailed but there is nothing in there which I’d like to see you drop. Therefore I think an index (as already suggested) together with summary would be very beneficial. One further point again harps back to our experience in Scotland where your treatment depends on where you live. This was a few years ago and I hope things have improved since, but you mentioned that in Scotland, there MAY be someone with specialist knowledge in CAMHS. Sadly, that wasn’t the case for us, where out-dated practises and thought streams were initially employed. I know we weren’t alone with this, so if there is still not immediate access to up-to-date specialists, it may be worth recognising this in some way in the section where you talk about what parents are dealing with. Sometimes they are having to fight the system as well as the illness (although I’d like to think that’s not the case any more)….

    1. Thanks so much for checking out this long document, MS. Yes, definitely an index, and no doubt some shortening. I’m not sure about separating primary and secondary because the principles are the same, and I’m not spelling out the details of HOW they can achieve it, which is where primary and secondary would differ. I’ll wait and see what feedback I get from schools.

  7. Coming from someone in the US, school policies vary widely. We have found ours in Michigan to be cooperative with the suggestions we make for our child with ARFID. The document was more lengthy than I have time to read at the moment, but at first glance I thought I’d add to the ARFID description. There are a couple of main ‘groups’ of ARFID patients. More, from what I gather in support groups, are dealing with a form of SED, or selective eating, that escalates beyond fussy eating, to the point of affecting growth. My child is unable to eat any proper quantity of food, also resulting in failure to thrive/grow at all. The main difference between ARFID and other common EDs is the fact that it’s unrelated to body image, and is partly neurological. The thought is that ARFID begins from a traumatic incident, like a bout of the flu or a choking episode. Over time, a child’s brain is ‘rewired’ to think that this is the proper way to eat (avoid the things that made you sick). When they eat foods they don’t believe are safe, or are more than they can consume, they either avoid or get sick. My daughter developed emetephobia (the fear of vomiting) from eating too much food (which may only be 4 oz). I agree that all of the EDs are serious, as they all require support and treatment to avoid malnutrition, failure to thrive and worse. But some of the support tactics for ARFID patients (who often are younger) may vary, since they child has a legitimate phobia that needs to be overcome. Looks like you have put a lot into this, so thank you!

    1. Chris, thanks for describing how ARFID is for your child – I will check what I write on it as I’ve had another comment on it. I’m glad your school cooperated well with your suggestions. Do you think they might give us a few words to quote in the document? I’m planning on making it shorter – the length clearly is an obstacle.

  8. I think there is a lot of great information here that could potentially be useful for a lot of parents. I would like to offer some clarifications and additional information regarding ARFID that I will email to you separately.

    Thank you so much for putting this together.

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