We provide a children’s occupational therapy service to children and young people from 0 – 16 years old or up to 19 years old if attending a special school.
To access the service, children and young people must be resident, have a GP or attend a school in the Wigan borough.
Referrals to children’s occupational therapy are accepted from health, social and education professionals. Referrals are through a letter or referral form with consent from the family. Families can request any relevant professional to refer on their behalf.
Referrals are triaged and prioritised on receipt and families are asked to opt in to the service. If parents/carers do not respond within 10 working days to our letter, the child is discharged from the service.
All children are seen within an 18 week timeframe from the date of the referral.
There is no cost for the children’s occupational therapy service.
Location of Services
The team is based at Platt Bridge Health Centre and covers the whole of the Ashton, Leigh and Wigan area.
We also have access to Leigh Health Centre and are able to offer some appointments at this site.
In negotiation with families, we can also gain access to other health locations across the borough.
Occupational therapy services are often offered in children’s homes and education settings as this may be a more appropriate environment to ensure that the child’s needs are best met.
Children’s Occupational Therapy
Our team are skilled in the assessment of a child’s everyday activities which may impact of their access and participation in their environment.
We are able to provide analysis and adaptation of activities and recommendations to improve a child’s occupational performance and outcomes across a range of areas.
The children’s occupational therapy service will offer:
- Specialist Assessment of a child’s needs and identification of outcomes and goals for the child
- Advice and Intervention on the basis of assessment of clinical need
- An individual management plan developed and agreed with the young person, parents and carers as appropriate
- Evaluation of outcomes and future plans
- Advice on Transition and Discharge.
The children’s occupational therapy team work with children presenting with a range of physical and pervasive developmental conditions, complex needs and functional difficulties.
Children, young people and their families can access expert knowledge in the following areas:
- Developmental Delay
- Neurological conditions
- Autistic Spectrum Conditions
- Sensory processing
- Motor Co-ordination Difficulties and Developmental Coordination Disorder (DCD)
- Fine Motor skills, including handwriting
- Neuromuscular conditions
- Rehabilitation for children and young people following injury/accident
- Hospital discharge planning.
Once an initial appointment has been agreed, an occupational therapist will complete the assessment of the child’s needs. This initial assessment will be with the child and the parents, in order to ascertain the child’s needs.
This will usually be in the clinic setting. Please inform the service at the time of booking the appointment if this would not be appropriate for the child.
The occupational therapist will use a number of tools for assessment. This may include standardised tests and assessments and non-standardised observations and assessment.
Further assessment may be required and this may occur over a number of sessions. As well as clinic based assessment, further observations in daily life situations, a home visit and/or school visit may be arranged.
Liaison with other professionals and agencies also forms part of the assessment process.
The outcome of the assessment and any recommendations will be explained by the occupational therapist.
As part of the assessment process, the occupational therapist may complete an assessment and recommendation of equipment for school, which will enable a child to access the curriculum and school activities.
This may include specialist seating for use in school. A recommendation for any school equipment is made to the school who are then responsible for purchasing and maintaining the equipment.
Following assessment of the child/young person’s clinical needs, there may be a recommendation for implementation of some intervention for the child.
To support the child, there are a range of different interventions that may be offered from the occupational therapy service. This decision will be based on the assessed clinical need, the identified goals from the child and parents and based on specific clinical pathways and NICE guidance.
Outcomes and goals of intervention will be agreed and negotiated between the occupational therapist, the child and parents.
The main forms of intervention fall into three categories:
Individual direct intervention focusing upon the child/young person’s needs, delivered by an occupational therapist or therapy assistant.
The frequency of direct therapy will be according to the child’s assessed clinical needs and may be in a short block, with a review period at the end.
An individual programme of strategies and advice for parents to implement with the child.
Following assessment and any intervention, goals and outcomes will be evaluated and any further recommendations will be made at this point. Information will be collated and shared in a report format with parents.
With the relevant consent, any reports and information will also be shared with health, education and social care colleagues.
Information from an occupational therapist may be used to help inform diagnosis by the paediatrician.
Occupational Therapist’s may also be requested to contribute to Education, Health and Care (EHC) Plans and annual reviews for children and young people with additional needs.
Once a request is received for contribution to an EHC Plan, the occupational therapist will work within legal timeframes to collate this information, in collaboration with the parents.
This report will be shared with parents, the Local Authoity SEND team and the child’s educational setting.
Moving on – transitions and discharge
Once the child or young person’s occupational therapy needs are met then a child will be discharged from the service. This may be for reasons including:
- Skills are at an optimum level
- Parents and other professionals working with the child are able to implement the advice and strategies to enable increased participation in daily activities
- Difficulties no longer have significant impact upon the child’s development
- Resolution of difficulties with no ongoing needs
- Child moves out of area in terms of home address, GP and school
- A child or family declines input from the service at this time.
The decision to discharge will always be discussed and agreed with the child or young person, their family and other relevant professionals.
A re-referral to the service will be accepted should further occupational therapy needs be identified in the future.
If a young person reaches the maximum criteria age within the service and there are still ongoing occupational therapy needs then a referral to the appropriate adult occupational therapy service will be made. Collaboration and joint appointments where appropriate will be facilitated in order to facilitate the transition to adult services.
In addition to direct and indirect intervention, we also offer training packages for parents and education settings, around specific clinical areas.
Working with Other Professionals
Evidence shows that the best results are achieved when we work with those in daily contact with the child and young person.
This enables those around the child to promote skills to their full potential in a variety of meaningful environments.
For the Occupational Therapy service this means working with a variety of settings and with a variety of other people including parents and professionals.
The aim is to form a partnership with families and professionals to support others to maximise their child’s potential.
Parents are a significant member of the team who hold a unique insight into their child and whose contribution we value.
Occupational Therapist’ss work closely with other health colleagues to provide an integrated approach to management.
This includes other health services across Bridgewater:
- Children’s Physiotherapy Service
- Children’s Speech and Language Therapy Service
- Children’s Early Years Assessment
- Children’s Community Nursing Team
- Children’s Occupational Therapy Service
- Wheelchair Service
- Health Visiting Service
- School Nursing Service
The occupational therapist’s will also work closely with any other health colleagues who are involved in the child’s care, such as the child’s Paediatrician, GP and professionals within the local and tertiary centres.
Close working with partners from education, including nurseries and schools are advocated within the service, in order that we are able to provide the best support and approaches in developing the child’s skills and functioning in their education setting.
We also work alongside colleagues in the local authority, including social services occupational therapists and social care.