Children's Occupational Therapy

Before considering a referral to the occupational therapy team we would like you try the relevant self-help advice and strategies’ with the child/young person for developing skills in their everyday occupations.

We would advise you to complete the most relevant interactive questionnaires. These are designed to enable you to check the child’s progress at particular stages of development. The results provide you and the child with a downloadable guide for you and the child to work on particular areas of development. 

If you still wish to a make a referral, please read the referral guidance in the drop-down below and complete the referral form. The referral must be made by a healthcare or educational professional and should be completed the person who has the concern and knowledge about the child/young person. For prompts about what information to include in the referral form for occupational therapy, please see the referral form with prompts.

If you would like more information about our service, please contact the therapy team office on 01524 591671.

To access this service the child/young person must be:

• 0 – 18 years old (or up to school leaving age).

And

• Registered with a GP within the catchment area.
• A resident of Lancashire catchment area (For home equipment and adaptation referrals).

A referral to the children’s occupational therapy service should be made when the child / young person, family or other involved professional has a concern regarding the child’s functional ability which significantly impacts on their participation in any of the following areas: play and leisure, self care and independence, school life. The referral must be made by a healthcare or educational professional and should by the person who has the concern and knowledge about the child/young person.

Play and leisure – for example helping a child to take part in their chosen activities such as playing with toys or accessing the environment, community facilities and activities.

Self care and independence – for example helping a child learn to use cutlery or dress themselves. Assessment of the home environment which may include advice about improving access around the home or use of specialist equipment. For older children, also consider age appropriate independence skills, such as preparing a drink and snack, pack a bag for school, carry out household chores and so forth.

School life – for example being able to sit and access table top activities, developing pencil control and tool use, recording writing information and accessing school environment in liaison with educational staff.

The Occupational Therapist will take into account the chronological age of the child/young person, their developmental level, the environment and the readiness for working on change. Please note, a referral for a child who is managing activities of daily living regardless of their diagnosis or a child with behaviour, sensory and emotional difficulties in isolation will not meet the threshold for the occupational therapy service.

The Community Equipment Service is a support service which procures, delivers, collects and recycles items of equipment which have been prescribed by a Therapist or Nurse.
The service is operated by:

Medequip
Unit G4 Leyland Business Park
Centurion Way
Leyland
Lancashire
PR25 3GR

Bathing and Toileting

• Look for a bath with a reclined seat and pommel to prevent your baby slipping down. As sitting balance develops, seats that support around their tummy help your child play in the water.
• If your older child has balance difficulties, use non-slip mats on the floor or sitting down in the shower may be easier for them.
• Children with developmental delay or low muscle tone may struggle with balance and stability. Something to support their feet and something close to hold onto may help them feel safe and supported while on the toilet.

Seating

It is important that your childs posture is supported while sitting to enable them to free up their hands to engage in feeding, play, writing etc. Dining Chairs

• Stable base: there’s the seat depth, height from floor and height of child to the table to consider. A chair with a back rest provides more support than a stool.
• Seat depth: a cushion/pillow placed between your child and the back of the chair reduces the seat depth to prevent the seat cutting into the back of their knees and support the pelvis to reduce pelvic tilt
• Height from floor: most chairs are designed for adult length legs. A stool, upturned storage box, or a cardboard box stuffed with paper can be used for your child to rest their feet on. You can also use a chair with a bar they can rest their feet on, or a child’s dining height chair.
• Height of child to the table: A cushion under their bottom (or even a pile of books) is the first thing to try. A child’s height dining chair ensures they are the right height to the table and have something to rest their feet on. There different ones on the market.

High Chairs

• Footrests- support your child to develop good sitting posture with feet flat on footrest to increase stability and encourage them to sit upright.
• Adjustable backrest- adjust the position in line with your child’s development. As sitting balance develops and core stability improves, gradually adjust backrest to upright position.
• Harness- if it cannot be tightened enough it will not support your child’s position when they are smaller. If the highchair does not have a groin strap/ 3- or 5-point harness or a pommel the child may slide down.
• If your child leans to one side, leans back or you notice their head is not in the middle, use cut up foam noodles, tea towels or unused nappies to support their posture. You can adapt this to buggies and car seats also.

Dressing and Feeding

• Larger sizes are usually easier than smaller. Try big buttons and/or wider button holes. Labels or pictures on clothing may help them learn back and front.
• If a child continues to struggle with dressing, consider adapting clothing e.g. Velcro® shoes, Velcro® on top buttons of shirts, elastic on shirt cuffs, elastic laces, toggles on coats or elastic waistbands.
• Use child size cutlery with thick, easy grip handles that curve inwards and try flat shallow bowls

Pencil Skills

• If your child has an upright pencil grasp, you can try a ‘handiwriter’ or a flexible band around the wrist
• Try different shaped pens/pencil and pencil grips. An ideal pencil grip promotes movement in the fingers, allowing the wrist to relax.
• Try different ink, some pens are more free flowing
• If your child sits with a curved posture or appear ‘slumped’ over their work, the use of a writing slope may help them maintain a functional sitting posture
• Handwriting programmes are available such as Write from the start, Speed Up! And Handwriting without Tears for parents to deliver

We recognise the important of joining in with sensory differences.

For more information regarding supporting children with sensory processing needs in Lancashire and South Cumbria, please visit the Lancashire County Council website where you can find more information regarding service offers as well as recommended tools, advice and strategies.

Children are usually deeply curious – it’s how they learn, grow and develop. They are often curious about the environments surrounding them and how things within them work. We understand that this exploration can be very worrying for parents and caregivers, especially for those children who have additional needs and may find it difficult to understand risks, dangers and personal safety. Some children may also want to express their emotions and behavioural reactions differently.

Consider why your child is displaying unsafe behaviours in the home? Think about the behaviours through your child’s eyes and how you can ensure their safety without reducing any enjoyment in their day. For example, if your child is climbing up at the window to watch the traffic, is there a safe way for them to do this? 

You may feel you require more support to understand your child's behaviours and how to help them manage. This would need to be explored before a referral to the occupational therapy team is considered. You may find further information at:

• Challenging Behaviour Foundation

• Lancashire Healthy Young People and Families Service

• UHMBT pre-school Neurodevelopmental Nursing Team

• LSCFT Learning Disabilities Team