Children's Occupational Therapy

Our Paediatric Occupational Therapy Service provides assessment and intervention for children and young people with significant difficulties participating in and completing daily occupations at home, in an education placement, and in the community.

Our Service may offer an assessment of self-care and daily living occupations (see below for examples), where our Universal Advice offer has been followed, but there has been no improvement.

Occupation Examples:

• Self-care; Washing, bathing, dressing, toileting, teeth & hair brushing, eating
• Productivity e.g., Nursery/School; Use of tools to record information, barriers to accessing the curriculum including Physical Education at nursery/school/college
• Leisure & Play; Play skills, engaging with peers, participation in sport and physical activities, accessing the community

Priorities of the Service

• To support with enabling the child or young person to be safe in accessing self-care and activity of daily living occupations. This may include assessment and provision of specialist equipment and/or referrals for adaptations to the home environment.
• To support with the delivery of a Care Plan for the child or young person with significant needs impacting on their self-care and activity of daily living occupations.
• To work in partnership with the child or young person, their parents/carers and educational setting to meet the child or young person’s individual goals.
• To work in collaboration with other professionals from health, social care, and education.

Who can refer to the service?  

Referrals are accepted from:

• Health Care Professionals (GP, Paediatrician, Speech and Language Therapist, Physiotherapist etc)
• Social Care Teams (Social Worker, Family Support Worker)
• SENCO’S (School or Nursery) or Teacher at Special School
• Physical Disabilities Outreach Team
• Local Authority Learning Support Team

Referrers should complete the referral form in full that is available on Carenotes under the referrals tab or can be downloaded directly from this page - Download our referral form 

Please note ALL referrals should be sent electronically to the OT generic email address:  WHCNHS.PaediatricOT@NHS.net

(If using the referral tab on Carenotes, please email the generic email address to alert the service to this referral).

Who can be referred?  

Child or young person from birth up until their 18 ^th  birthday or up to their 19 ^th  birthday if attending special school (for school needs only):

• With consent from the person with parental responsibility or child or young person themselves if considered to have Gillick competence.
• Those registered with a Worcestershire GP.
• Who have a ‘Looked After’ arrangement with Worcestershire Local Authority and continue to reside in Worcestershire with a Worcestershire GP  OR who have a ‘Looked after’ arrangement with another Local Authority and are placed in Worcestershire with an individual funding agreement. 
• Any child or young person placed in a Worcestershire school with a GP out of county will be considered on an individual basis with liaison with their local NHS service.
• For requests about home equipment or adaptations, this is determined by the County Council of the property where the child or young person resides.
• Children and Young people who have  significant*  OT needs, and universal advice has been tried but has not been successful.

We require examples of significant* difficulties that are impacting on independence, and/or participation in self-care and activities of daily living at home, in education and in the community.

It is important to evidence what support, strategies and advice has been tried and/or is already in place to support the child or young person, and the outcome and impact this has had e.g., Universal information from the website, contact with OT Advice Line.

Referrals we may consider

• Child or young person who requires timely assessment and intervention around safety, equipment and moving and handling to prevent incident and injury. 
• Child or young person with regressive or degenerative conditions who are newly diagnosed or where there has been a significant change in their presentation impacting on self-care and activities of daily living. 
• Child or young person who are palliative and end of life who have lost skills and require timely assessment and intervention to prevent incident and injury.
• Child or young person where there are  significant * concerns regarding home safety and evidence of strategies have been tried but have not been successful resulting in risk to safety, incident, and injury.
• Child or young person with  significant * needs who are unable to access self-care or activity of daily living occupations at home and require an assessment of the home environment.
• Child or young person who have  significant * motor co-ordination difficulties that are impacting on self-care and activity of daily living occupations across home, in education and the community.

We are unable to accept referrals for:

• Reported difficulties that are in line with typical or expected development.
• Concerns regarding self-care or activity of daily living occupations without evidence of these having a  significant * impact on the child or young person.
• Sensory concerns in isolation (where there are no motor concerns) without evidence of the  significant * impact these difficulties are having on self-care and activity of daily living occupations. This includes ARFID (avoidant restricted food intake disorder).  For these concerns, please refer to the OT website for universal advice on sensory processing.

Please note we do not provide Sensory Integration Therapy. 

• Education based difficulties in isolation such as handwriting or use of scissors/tools without evidence of the  significant * impact these difficulties are having on self-care and activity of daily living occupations. For these concerns, School to consider advice from the local Learning Support Team.
• Requests for specific equipment. For example, car seats, restrictive beds.
• Anxiety, emotional or behavioural difficulties. Please refer to other appropriate services such as Family Front Door, Early Help, CAMHS. Please see the local offer website: Social, emotional and mental health | Worcestershire County Council and the Child and young person and Adolescent Mental Health Website: Mental health help to children, young people and their families | School Mental Health (hacw.nhs.uk)
• Requests for Educational, Health and Care Plan (EHCP) assessments without evidence of the  significant*  impact these difficulties are having on self-care and activity of daily living occupations.
• Support with home safety which are related to the home physical environment. We require evidence of strategies that have been tried but have not been successful resulting in risk to safety, incident, and injury before considering a referral.
• Support with re-housing or additional bedrooms/ bathroom facilities. Any professional that knows the child and young person or family well can support with these requests.
• Requests for Developmental Co-ordination Disorder (DCD) assessment where there is no evidence of  significant*  motor co-ordination difficulties that are impacting on self-care and activity of daily living occupations across home, in education and the community. Please see the following link for information about DCD diagnostic criteria: Developmental co-ordination disorder (dyspraxia) in children - Diagnosis - NHS (www.nhs.uk)
• Wheelchair or a specialist buggy as referrals can be made by any Healthcare Professional that knows the child or young person. Please see the following link for the Wheelchair service information: Our Services | Herefordshire and Worcestershire Health and Care NHS Trust (hacw.nhs.uk)

* Significant impact  e.g.

•        Risk of education placement breakdown or not currently attending education placement.
•        Child or young person who is not able to complete self-care and/or activities of daily living occupations.
•        Early life experiences which have had a significant impact on the above.
•        Safeguarding concerns where OT is significantly involved.

What happens next?

•        Referrals received will be triaged according to the clinical prioritisation for the child or young person.
•        Parents/carers and the referrer will be informed of the outcome of the referral following triage.