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Local Offer

Children’s Community Occupational Therapy Services

Occupational Therapy

Community Health Services

Children’s Community Occupational Therapy Services

Core Offer

1. Children’s Occupational Therapy

Access to the service is based on a referral form from a health or social care professional, or educational setting; indicating a child’s functional needs regardless of diagnosis. These referrals are triaged on the eligibility criteria set out in the current Operational Policy. On acceptance, these are divided into the following main care pathways:

  • Children with severe or profound physical and learning difficulties with or without sensory impairment: For example a child with Cerebral Palsy with four limb involvement (Spastic Quadriplegia) with or without visual and hearing impairment
  • Children with moderate to mild physical difficulties: For example, a child with one sided involvement usually with upper, lower limb, sensory and visual impairment
  • Children with specific learning difficulties or developmental delay who present with specific functional difficulties. This excludes children whose function is in line with their overall development.
  • Children with co-ordination or motor planning difficulties which affect their ability to participate in everyday tasks.
  • Children with social and communication difficulties; who present with sensory difficulties which impact on their function.

The child’s needs are met either as part of a multi-disciplinary or uni-disciplinary team approach. Assessment and intervention may take place in the Child Development Centre, at home or within the educational setting. The interventions are delivered within time limited periods determined following clinical assessment, in line with the current Operational Policy. 

Core offer for individual child regardless of diagnosis, care pathway or educational setting

  • Referral triage
  • Assessment*and identification of needs
  • Care Planning, programme and recommendations to promote functional development
  • Time limited intervention package which may include:
    • Providing advice to support functional development of child in partnership with parent/ carer or education staff. This may be communicated via face-to-face, telephone or written communication.
    • Training, demonstration and up skilling carer/staff on delivering individualised programmes
    • Direct blocks of therapy either in 1:1 setting or groups
    • Transition support from hospital to home, into early years settings, as well as primary and secondary education settings
    • Assessment and recommendation for specialist aids and equipment in line with the current Operational Policy
  • Written contribution to the EHC assessment and IEP process if the child is on an active caseload or has been active within the previous 6 months

The duration and time of intervention is variable and will be dependent on the nature of the child’s needs and type of training/support that the carer requires in order to carry out recommendations by the therapist.

OT References

Social Care- Occupational Therapy for Children and Young People and families Social Care- Occupational Therapy for Children and Young People and families http://www.cot.co.uk/position-statements/social-care-occupational-therapy-children-young-people-and-families-0

Supporting Children with DCD (Forsyth 2007)

WHO “Intentional classification of Function – guidance on considering child participation and function, http://www.who.int/classifications/icf/en/

NSF Standard 8, http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4094479

Additional core offer for Children with Complex Physical Disabilities and/ or Postural Management Needs:-

  • Handover of recommended activities/advice to parent/ carer and educational staff for example: face-to-face, telephone or written.
  • Review of postural management needs of individual children/ young people in line with the Operational Policy.
  • Safe moving and handling risk assessment and recommendations for individual children, in relation to specific therapeutic activities, within educational settings.
  • Assessment and review of upper limb needs and orthotic prescription
  • Environment access assessments of local educational settings for individual children in line with the current Operational Policy.
  • Feeding assessment as part of established multidisciplinary team.
  • Referrals and liaison with the Guys and St Thomas’ Wheelchair Service
  • Referrals and liaison with the Guys and St Thomas’ Assistive Technology
  • Key working for children, who are not yet in educational provision, as and when appropriate

*The type of assessment administered would vary according to nature of needs identified in referral could include specialist occupational performance assessments, feeding assessment, environmental assessment, play development and learning abilities.

Services which fall outside the core offer

Over the years there have been ad hoc unfunded arrangements to support children to access the education curriculum but this is unsustainable as it falls outside of the service specification. Examples of such interventions are:

  • Bespoke training that support access to educational curriculum for children that do not have a referral to the service or known medical diagnosis including:
    • - Visual Motor Integration skills, Handwriting and Visual Perceptual Skills
    • - Development of school specific resource packs
    • - Specialist training for the implementation of groups/ enhanced environments within educational settings
  • Interventions to support Transition to Adulthood, independent living skills including Self Care, Money Management, Cooking, Equipment Use, Travel training etc
  • EHC for child that is closed or not known to the service
  • Attendance to IEP annual review meetings

OT Reference

Using technology to develop curriculums http://mail.cot.co.uk/exchweb/bin/redir.asp?URL=http://:www.thechildrenstrust.org.uk/page.asp

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