IAS services

1. As a Parent Career of a Child/Young Person with Additional Needs, have you heard of the following short breaks services/holiday clubs? (Please select all that apply)?
A) FUN (Families United Network)?

YESNONOT SURE

B) FOBE (Friends of Bright Eyes)?

YESNONOT SURE

C) CYCD (Centre for Youth & community Development)?

YESNONOT SURE

D) CHUMS Friendship Scheme

YESNONOT SURE

E) SNOOSC (Special Needs Out of School Club)

YESNONOT SURE

F) L.O.A.F (Loads of Autistic Fun)?

YESNONOT SURE

G) Hart Hill Adventure Playground?

YESNONOT SURE

H) Access 2Sport?

YESNONOT SURE

I) Baylands Equestrian Centre?

YESNONOT SURE

J) Access Disability Project?

YESNONOT SURE

K) Tokko Youth Space?

YESNONOT SURE

L) Wanted Fun? (project run by Autism Beds)

YESNONOT SURE

2. Have you Used any of the services in question 1?

YES - Go to Q3NO - Go to Q4

3. If you have used these services*, then please say which ones you have used:

FUN (Families United Network )FOBE (Friends of Bright Eyes)CYCD (Centre for Youth & community Development)CHUMS Friendship SchemeSNOOSC (Special Needs Out of School ClubL.O.A.F (Loads of Autistic Fun)Hart Hill Adventure PlaygroundAccess2SportBaylands Horse riding CentreAccess Disability ProjectTokko Youth SpaceWanted Fun (project run by Autism Beds)

*Services listed have been taken from Short Break Statement 2019

4. If you have NOT heard of any of the Short Break Services mentioned, and would like to know more information, then please use the following link:

Link: Download
Download: 54, Size: 1.2 MB, Date: 21 Jan. 2019

5. If in question 3, you have indicated that you have used the short break services, please tell us more for each service you have used:
Service 1.
a. Please state the name of the service you have used here:

b. How easy was it (or not) for you to book a place to access this service?

Easy to book a placeit was Difficult to book a place

Please say why below):

c. Please say how (if at all) accessing this service has supported you and your child/young person with additional needs:

d. Were the activities accessible and available at a time that was suitable for your child/young person?

YESNONOT SURE

Please share suggestions on what could potentially be improved below:

Service 2.
a. Please state the name of the service you have used here:

b. How easy was it (or not) for you to book a place to access this service?

Easy to book a placeit was Difficult to book a place

Please say why below):

c. Please say how (if at all) accessing this service has supported you and your child/young person with additional needs:

d. Were the activities accessible and available at a time that was suitable for your child/young person?

YESNONOT SURE

Please share suggestions on what could potentially be improved below:

Service 3.
a. Please state the name of the service you have used here:

b. How easy was it (or not) for you to book a place to access this service?

Easy to book a placeit was Difficult to book a place

Please say why below):

c. Please say how (if at all) accessing this service has supported you and your child/young person with additional needs:

d. Were the activities accessible and available at a time that was suitable for your child/young person?

YESNONOT SURE

Please share suggestions on what could potentially be improved below:

6. To ensure that a range of services on offer aim to meet most of our children / young peoples’ needs please tick the box below that best describes the primary need of your child / young person:
Child 1
"Age"

"Year of Birth”

ASDADHDDyslexia/DyspraxiaEmotional/Mental Health DifficultiesGlobal Development DelayHearing ImpairmentProfound & Multiple Learning Difficulties (PMLD)Moderate Learning DifficultiesSevere Learning DifficultiesPhysical DisabilitySpeech & Language ImpairmentVisual ImpairmentSensory Processing DisorderOTHER- Please state below

Child 2
"Age"

"Year of Birth”

ASDADHDDyslexia/DyspraxiaEmotional/Mental Health DifficultiesGlobal Development DelayHearing ImpairmentProfound & Multiple Learning Difficulties (PMLD)Moderate Learning DifficultiesSevere Learning DifficultiesPhysical DisabilitySpeech & Language ImpairmentVisual ImpairmentSensory Processing DisorderOTHER- Please state below

Child 3
"Age"

"Year of Birth”

ASDADHDDyslexia/DyspraxiaEmotional/Mental Health DifficultiesGlobal Development DelayHearing ImpairmentProfound & Multiple Learning Difficulties (PMLD)Moderate Learning DifficultiesSevere Learning DifficultiesPhysical DisabilitySpeech & Language ImpairmentVisual ImpairmentSensory Processing DisorderOTHER- Please state below

7. Your (Parent Carer’s) ethnic background: please tick one box, this data will help us understand our reach – and what more we can do to engage / reach out to seldom heard families in Luton
a. White

BritishIrishWhite European - Please state belowWhite Other - Please state below

b. Mixed

White & Black CaribbeanWhite & Black AfricanWhite & AsianOther - Please state below

c. Asian or Asian British

IndianPakistaniChineseBangladeshiOther - Please state below

d. Black or Black British

CaribbeanAfricanOther - Please state below

e. Travellers

GipsyTravellerIrish Traveller

f. Any other Ethnic Group: please specify

g. Prefer not to say which ethnic background:

I prefer not to say

8. Your home post code or Ward if known

9.Any additional comments you would like to make – that you feel may help improve access to Short Break services

Thank you for taking the time to reply.