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The child at home does not always reflect the child a teacher may see so it is really important for professionals and families to liaise well. Difficulties with sleeping and eating can impact daily life and may need specialist support. Autism and deafness can affect sibling relationships and family dynamics. There are local and national services which can offer support. The web has various sites and fora which seek to offer practical and emotional support generally to families although not necessarily for a specific dual diagnosis.