Children’s Occupational Therapy: First Steps to getting help

This level of support is for children, young people and families that are experiencing mild or temporary difficulties or are adjusting to life circumstances where getting and acting on advice hasn’t helped to resolve their difficulties or where their difficulties have got worse may benefit from short term evidence based treatments from health services.

Health Occupational Therapy sits within the tier 2 services requiring a referral from a health professional or through the ASD pathway. 

An initial assessment of need, intervention or advice is provided. 

This assessment and advice can feed into MDT work to support the child /young person in different settings. 

Examples of clinics / short term interventions would be: 

Children who have participated in ‘Spark’ groups at school who require specialist health occupational therapy intervention are offered an assessment, a block of four treatment session and a follow-up appointment to review progress. 

Children with a diagnosis of ASD are offered an assessment a block of six treatment session and a follow-up appointment to review progress. 

Children who are presenting with specific functional difficulties are offered an assessment and a maximum of four treatment sessions and a follow-up appointment to review progress. 

Supporting CYPF to understand and manage, what might be a lifelong condition, is integral to the intervention we offer. 

Various Intervention models are offered, depending on the child’s/young person’s needs: 

The Cognitive Orientation to daily Occupational Performance (Co-op approach) supports this. 

The CO-OP approach is a child centred, performance-based, problem-solving approach that enables skill acquisition through the process of strategy use and guided discovery (Polatajko & Mandlich, 2004). It is a top-down approach this means that instead of working on performance components such as manual dexterity, you work on the actual task e.g. using cutlery or tying laces. The approach involves collaboratively setting a goal with the child, analysing the performance and then achieving success with the task using guided discovery. The aim is to guide the child to independently discover and develop their own strategies to carry out the task- as opposed to directly teaching them. 

Sensory Integration - Sensory processing is a neurological process Our brains take in information through our senses and organise it so that we are able to respond appropriately to particular situations and environmental demands. Sensory experiences include touch, movement, body position, vision, smell, taste, sound and the pull of gravity.

Sensory processing skills develops when a child engages in typical childhood activities, for example messy play, using playground equipment.  When sensory processing does not develop as efficiently as it should it can affect activities of daily living, academic achievement, behaviour or social participation. The health occupational therapist assesses how sensory processing difficulties impact on the child’s skills and then works with the CYPF to find identify activities that can develop these skills and strategies to manage specific difficulties. 

The Compensatory approach aims to modify the demand a task places on the person. This may be achieved by teaching different techniques and strategies or may include the provision of assistive equipment and aids.

 The Neuro-Developmental Treatment (NDT) approach is used to analyse and treat posture and movement impairments.  By treating problems of motor coordination, neuromotor and postural control abnormalities, the ultimate goal of NDT is to optimise participation in a person’s life roles.  Occupational therapists are often specifically involved in the facilitation of upper extremity movements such as reaching, grasping, releasing of objects, and in-hand manipulation skills. Therapeutic handling can be also embedded in functional tasks such as self-care or play.

This work can include 1:1 appointment, liaison with MDT medical teams or social care teams to ensure the right level of support and care is in place.

The long term work we offer are;

Work in clinics at Salt Way, at home, in their educational setting including nursery and school.

The physiotherapy offered will be part of a programme of long term care to support children and young people to achieve or maintain postural management, mobility, joint range of movement (this list is not exhaustive).

Children who have an acquired brain injury will required intensive rehab post injury, often jointly with an occupational therapist and therapy assistant.

Children with cerebral palsy who have been funded by the NHS for SDR (selective dorsal rhizotomy) surgery will require extensive rehabilitation in addition to their usual therapy for 24 months.

Children who undergo multi-level orthopaedic surgery as part of their on-going management will require extensive post op rehabilitation with a physiotherapist and therapy assistant.

Children who undergo botulinum toxin treatment will often need increased therapy input to maximise the benefit from the treatment.

At phases of transition, children will need increased input to support their transition for example from pre-school to school and again from children’s to adult care.