ROCHADLE LOCAL OFFER 2014
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
- How does an Occupational Therapist make a difference for a child?
What does a children’sOccupational Therapist do?
We provideinformation, advice,and access to specialistequipment andrecommend ways toadapt the home and or short break setting andschool for disabled children. We also usestrategies and activities to develop skillsdirectly with the child, and to promote independence and safe management by the parents / carers.This can include: moving and handling,all activities of daily living, and by provision of safety adaptations, and access to basic facilities such as the bedroom, bathroom and toilet.
Which children do we work with?
Occupational therapists work with childrenfrom age 0 –19 currently, with a range of needs from children withsevere physical and / or learning disabilities to those with complex health care difficulties, including children with sensory difficulties. Our aim is to enable each childto achieve just how much they can do forthemselves, and to enable parents / carers to manage them safely within their home, short break, or educational setting.
For example, a child with cerebral palsy maybe able to use a computer if he can be supported correctly in his chair, and then learn touse a head switch to communicate. We canalso provide practical solutions for childrenwith specific physical problems. We aim toincrease children’s independence, confidenceand provide opportunities for them to achievetheir potential.“Occupational Therapists work with peopleof all ages, helping them to carry out theactivities that they need or want to do inorder to lead healthy and fulfilling lives”College of Occupational Therapists, 2005.
Occupational Therapists differ from otherhealth care professionals. Ourfocus is not so much on the problem itselfbut on how it affects a child’s ability to do normal every day activities.For children this could mean helping themto be independent when they are gettingdressed, feeding themselves, using the bathand toilet and carrying out practical activitiesat school.
For parents / carers this could mean helpingtheir child to be independent, enabling theirdevelopment and supporting them to carefor their child at home, including sleeping,sitting and getting around.
How do we work with children?
- We aim to build up a good relationship with the child and family. We liaise with and gather information from relevant people who are involved with the child.
- During assessment, we clarify what the child and family want to be able to do, and what is a priority and of highest need / risk to them,in their daily activities. We use different methods to identify what the child’s skills and difficulties are. This can take place in a variety of settings such as home, short break settings, school, or nursery.
- We work with the child and family to problem solve and make a plan of action.
The plan of action may involve;
- providing advice and information to children, parents and schools
- developing the child’s skills individually, or on occasions in groups
- using equipment to enable independence; and
- making the child’s environments more accessible
How to refer to children’s Occupation Therapy
We operate an open referral system, so accept referrals form professionals such as schools, physiotherapists and allied health care professionals, nurses, Consultants and parents.
We also liaise with the NHS OT service, which is generally involved with pre-school children at home and then in the education setting when they reach school age. We accept transfers of care from this service when children commence school to consider their home needs.
Case study
Jack
Jack is the second child of three children. From early on his parents noticed that he had trouble with tripping and falling frequently, toileting himself independently, dressing and eating. When Jack started school, his teacher also noticed that he was finding it difficult to mobilize especially on stairs, and toilet himself independently, organise himself and was having problems with writing. As time went on, Jack became more reluctant to go to school and was often tearful and upset at home. Jack’s parents talked to their GP about this and Jack was subsequently diagnosed with Cerebral Palsy, which affected the muscle strength and co-ordination in his legs and lower back.
Jackwas referred by his GP to a children’s Occupational Therapist. After assessing Jack’s ability to carry out these activities both at home and at school, and following discussions with Jack, his parents and classroom teacher, Occupational Therapy sessions were planned and carried out and recommendations made. The Occupational Therapist developed a toileting strategy which included the fitting of grab rails to support him to be independent, and a handrail to the steps both at his home and school to increase his stability when mobilizing. The Occupational Therapist showed Jack’s teachers some suitable activities for him to do at school and discussed strategies that would help Jack to organise himself. Jack also attended a handwriting group with other children who were experiencing similar difficulties.
A year later, Jack is much more independent. He is able to toilet himself independently, is falling much less frequently when mobilising, is able to dress himself after PE and is beginning to write more clearly. His confidence is returning and he joins in playground games with his friends. Jack seems happier with what he is able to achieve both at home and school.
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
- Your first appointment:
What will happen in your child’s first appointment with an Occupational Therapist?
1.After making a referral you will have received information about whether you will need to wait for an appointment. You will also have been advised about how we share information and given us consent to do so.
2.When an appointment is available, anOccupational Therapist will contact you.
If your child needs to be seen in the home initially (which is usually the case), your Occupational Therapist will contact you to arrange a convenient time and you will have anappointment confirmed either by telephone or letter.
3.The initial visit and assessment will be approximately1 – 1.5 hours long and it will be necessary for your child to be present.
4.You will need to stay with your childthroughout the assessment.
5.During your first appointment yourOccupational Therapist will need to findout information about you and your child.
This may involve questions regarding your child’s developmental progress, how they carry out daily activities and how they are managing at school. It would be useful for your Occupational Therapist to see any recent reports at the first appointment (e.g. School, Physiotherapy and Educational Psychology reports).
6.Your Occupational Therapist may explore yourchild’s abilities and level of independence and safety in a range of activities.
(See later in this leaflet for the areas addressed by Occupational Therapists.) It would be helpful if your child is dressed in loose comfortable clothing if possible and any existing equipment used at home to be available.
7.At the end of the assessment yourOccupational Therapist will agree an actionplan with you and your child. This actionplan may involve:-
- Further specific assessment, e.g. Moving and Handling or seating
- Ongoing therapy individually to e.g. to develop strategies with activities of daily living
- Further home visits
- A School visit
- No further action
8.The outcome of the assessment will be written down and sent to you with the agreed action plan. Copies will be sent to the referrer if requested, and others involved with your child, with your permission.
Examples of areas addressed by Occupational Therapists
Posture
Your occupational therapist can assess a child’s posture and whether or not specialist seating or other equipment might be required. A specialist chair can provide and maintain good sitting balance. In turn this helps to prevent physical problems as well as maximising concentration to a task, e.g. feeding, and the development of fine motor skills.
Fine Motor Skills
Your child may be finding it difficult to hold and control a pencil for writing, to cut with scissors, manage eating with standard cutlery or to manage buttons or zips. The OccupationalTherapist can provide adaptive equipment or recommend activities designed to improve the child’s ability.
Gross Motor Skills
Your child may find it difficult to walk, hop, skip, jump or throw/catch a ball. Co-ordinating movements to get dressed independently might be difficult and the Occupational Therapist can recommend strategies to help. Your Occupational Therapist can also make recommendations for adaptations which may increase independence, provide access and maximise safety especially within the home.
Activities of daily living
Your child might have difficulty using the toilet or bath safely and independently. A young person may need to be more independent in the kitchen. Equipment and adaptations to the environment could help. There may be ways your Occupational Therapist can help you to teach your child to carry out these activities more independently.
Caring for your child
You may need help to care for your child at home. Your Occupational Therapist may provide advice and strategies or equipment to help you carry out tasks, or to increase safety in the case of behavioural / learning difficulties. These might include going in and out of your home or car, moving from the bed to the toilet, moving and handling, helping your child have a bath or the use of Assistive Technology to enable you to supervise your child within the home.
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
- Adaptations at home and school for children with disabilities:
What is an adaptation?
An adaptation is a permanent change to a child’s home and / or school. Many are minor changes such as grab rails or small steps; some may be major changes such as the fitting of a stairlift or converting a bathroom, which require careful planning.
Minor adaptations
Occupational Therapists will make recommendations on minor adaptations. These will require the agreement of whoever owns the property.
Major adaptations
These are normally only considered after all other options have been looked at with the Occupational Therapist, such as using equipment or changing the use of the space in the home or school. This is because a major adaptation is a big decision, which can involve disruptions and may take time to complete.
Who can have an adaptation?
There is a range of legislation that requires local authorities to provide adaptations for children with disabilities. Your child needs to be assessed by an Occupational Therapist from Children’s Services to ensure they are eligible for an adaptation, and that any recommendations are “necessary and appropriate” for your child. This assessment is likely to be with an Occupational Therapist. The assessment will define what your child needs at home or school and what the adaptation should achieve for your child, family or school.
How do I know if my child is eligible for an adaptation?
For any adaptations your main permanent place of residence for your child’s school must be within Rochdale Metropolitan Borough Council and your child must be disabled.
Disability can be defined by various legislation, including the Disability Discrimination Act 1995 and the Children’s Act 2000.
If you and your Occupational Therapist have agreed that a major adaptation may be a solution at home, then theOccupational Therapist will advise the housing department (Rochdale Home Improvement Agency – RHIA) if the adaptation is “necessary and appropriate” for your child’s needs.
The housing department (RHIA) will then decide if the proposal is “reasonable and practicable” both for the property and in terms of cost and if you are eligible for a Disabled Facilities Grant (DFG).
How are adaptations paid for?
If your child is eligible, minor adaptations are provided by children’s services – (Children with Disabilities Services). There are different ways to fund major adaptations. Your Occupational Therapist will advise you and begin the processes with you.
At home
A Disabled Persons Facilities Grant (DFG) will usually be required for major adaptations at home. The DFG is administered by the housing department (Rochdale Home Improvement Agency – RHIA.
Rochdale Metropolitan Borough Council’s RHIA, following advice from your occupational Therapist is available to helpyou with DFG applications. Other financial helpmay be available through your Occupational Therapist from Children’s Services through alternative funding; this mayapply for example if you foster a child with disabilities. The Family Fund Trust may also be able to assist.
At school
With your Occupational Therapist makesany recommendations for your child within their school, the school may then beable to seekfinancial assistance from the local authority.
How will an adaptation happen?
Minor adaptations at home canbe carried out for you via our building technicians in the RHIA
Your Occupational Therapist will keep you informed about the progress of your individual case. If a major adaptation is agreed for your home, the RHIA can manage the adaptation for you with your agreement. This is then funded by Rochdale Metropolitan Borough Council.
If your Occupational Therapist has agreed with you that a major adaptation at school may be a solution, they will liaise with the local authority to support you and the school in enabling these changes to happen.
For all adaptations but especially major work, it is helpful to have as much notice as possible. Therefore we would encourage both you and your child’s school to work with us to plan ahead to meet your needs if we can.
The majority of major adaptations in homes shouldbe completed within one year; however yourOccupational Therapist and the RHIA will keep you informed of progress, as unforeseen works can occur.
Disabled Facilities Grant Process
Below is a basic outline of the DFG process, (this may however vary slightly depending on the adaptation requirements):
- Client / parent enquiry to local authority Children’s Social Care Services orHousing (RHIA) department, leading to referral to Occupational Therapy service.
- Assessment of need of the disabled child by an OccupationalTherapist.
- Agreed statement of need presented toRHIA detailing recommendations as “necessary and appropriate”.
- Confirmation of eligibility andprioritisation according to risks
- Financial issues considered.
- Initial drawing of technical plans and scheduleof works drafted.
- Obtaining building quotations via the RHIA RMBC tendering process.
- Obtaining planning permission (if required) andbuilding regulations permission.
- Grant application made.
- Grant approval awarded.
- Building works commence, dependent on identified builder availability.
- Payment of contractors via RHIA, and evaluationby RHIA & the Occupational Therapist to ensure that the disabled child’s needs are met.
Further information about legislation:
Delivering Housing Adaptations for Disabled People: A Good Practice Guide
ODPM Publications, PO
Box 236, Wetherby
LS23 7NB
Tel 0870 1226 236
- search for “delivering housing adaptations for disabled people”
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
- Equipment & aids for children with learning & physical disabilities
“Occupational Therapists work with people of all ages, helping them to carry out the activities that they need or want to do in order to lead healthy and fulfilling lives.”
(College of Occupational Therapists, 2005)
One of the ways a children’s Occupational Therapist can help a child carry out their daily occupations is by recommending the use ofspecialist equipment. For some children, having the right equipment can enhance their ability to be more independent in their daily activities.
Caring for a disabled child can also be made easier with the use of certain equipment, aids and / or adaptations to the home. There is a wide range of equipment available and some of it is very expensive. This leaflet provides information about how equipment is provided for children with learning difficulties and disabilities who live in Rochdale Metropolitan Borough Council.
Who provides what?
- If your child has a disability that is temporaryor mild then the Occupational Therapist on Duty can provide onspecialist suppliers and other services thatmay be able to help. They can also provide advice on charities thatmay be able to help to buy equipment thatstatutory services do not provide such as forleisure activities.
- If your child requires equipment to facilitate a hospital discharge, for a temporary impairment, e.g. following a broken leg, then the Health Occupational Therapy Service will make recommendations and identify and provide the equipment necessary for this. The Occupational Therapist on Duty can provide their contact details, however most local hospital are already aware of these local arrangements and will in most cases refer to them directly in the first instance, this also applies for nursing equipment and wheelchairs.
- If your child has a permanent and substantialdisability that is impacting on their ability tocarry out their daily activities at home or atschool, they may be eligible for an assessmentfrom a Children’s Occupational therapist. (Seeleaflet – How does an occupational therapistmake a difference to a child?)
The action plan that is made withthe child and family might include a recommendation to use certain specialist equipment. This might include specialist chairs, hoists, bathing, toileting or feeding equipment. Physiotherapists also work closely with Occupational Therapists and can provide mobility, standing and sleeping aids.
- We can support and provide access toadvice and the provision of a range of otherequipment such as IT, car seat providers, trikes and bikes and toys.
What happens after the assessment by the Occupational Therapist?