Specialist occupational therapy services

Occupational therapy helps children participate in their everyday lives and activities to the best of their ability. A child’s occupations are the meaningful, daily activities that they need or want to do, including play and learning, exploration of their environment, self-care (dressing, eating, toileting, hygiene, etc) and schoolwork (handwriting, organising work, cutting, drawing, PE and sports, etc).

Babies and children who have a diagnosis of Down's syndrome experience some delay in all aspects of their development – physical, social, language, play and emotional. They also have some physical features, such as low muscle tone, which may impact on their development and acquisition of skills. Occupational therapy can help your baby or child in these areas.

Assessment

The assessment process may require gathering relevant information from parents/teachers and other key professionals via interviews, telephone calls or email; direct interaction with the child; use of standardised and non-standardised assessments, together with observations in different settings, for example at play, during school activities and undertaking everyday life skills, such as dressing.

Therapy/intervention

The exact nature and amount of therapy provided will depend on the child’s needs. It could be in the form of:

• direct individual or group therapy sessions, with a defined period of time prior to review
• use of home and nursery/school programmes to integrate treatment activities into real life environments
• regular review or monitoring of the child’s progress
• consultation and training for school staff and parents

Our digital assistive technology service supports children and young people who require communication aids and/or technology equipment to facilitate participation in communication, learning and play activities, also including recording work effectively in the classroom.

The service primarily involves an occupational therapist with specialist knowledge of digital assistive technology and equipment, who works with the child’s therapy team, educational professionals, and the child’s family.

Assessment

The specialist occupational therapist will assess the child’s functional difficulties in order to decide what specialist equipment will best meet their needs. Other relevant people involved with the student (for example:ie teacher, therapists, family) will be invited to attend and contribute to this assessment. The assessment will be carried out in the most natural and relevant place for the child (for example, home, school, clinic) and several assessment sessions may be required before a decision is made.

Intervention

The occupational therapist will provide the child’s family or school staff with recommendations for appropriate technology equipment, functional goals, training and support after assessment, short-term equipment loans and, where appropriate, possible referrals to external organisations, such as charities or further specialist organisations. Relevant reviews of interventions will be offered, where appropriate, after assessment and intervention has been provided, to keep the technology provision relevant and up to date for the student.

Useful websites

Help Kidz Learn
BBC Dance Mat Typing
Typing Test
Free Typing Game
Only Typing Games
Learning Games for Kids 

The Royal Free London is not responsible for the content of external websites.

When a baby is born very prematurely it is important to closely monitor your baby’s developmental progress. This follow-up programme is a systematic way of assessing your baby’s development.

The programme is for all babies born at less than 29 weeks gestation or weighing less than 1000 grams.

Your baby will usually be seen around the following times (term equivalent):

• three months corrected age
• six months corrected age
• 12 months corrected age
• 24 months corrected age

You will be invited to bring your child to the children’s outpatient clinic at the Royal Free Hospital to be seen by one of a team of developmental specialists, who will assess your child’s development. The assessments involve playful activities, which will be fun for your child and interesting for you as parents. You will be able to see how your child is progressing and have an opportunity to discuss your child’s development. Some activities for you to do at home may be recommended. A written report will be provided for you and others involved in your child’s care.

The developmental examinations in the follow-up programme will complement your child’s general medical care. The service will liaise your local hospital or your local children’s services to keep appointments to a minimum.

Sensory processing is a subconscious and automatic neurological process that occurs in every person at all stages of life. Our brains take in information through our senses and organises it so that we are able to respond appropriately to particular situations and environmental demands. Sensory experiences include touch, movement, body position, vision, smell, taste, sound and the pull of gravity.

For most people, sensory processing develops during ordinary childhood activities. When a person has good sensory processing skills, they can integrate information automatically and efficiently. But for some people, sensory processing does not develop as efficiently as it should and can affect activities of daily living, academic achievement, behaviour or social participation.

Children can present with different types of sensory difficulties. These include:

Hyper (over) sensitive

• Fear of heights
• Dislike of touch experiences, eg nail cutting, messy play, hair cutting
• Dislike of loud and sudden sounds
• Avoidance of playground equipment (swings and slides)
• Avoidance of certain foods and food textures, colours, temperature, etc.

Hypo (under) sensitive

• Appears to have no fear or doesn’t feel pain
• Seeks movement or touch opportunities (fidgets, rocks, runs about, leans on peers)
• Mouths or chews things
• Poor attention to the environment or people around

Motor Planning (praxis)

• Appears clumsy
• Difficulty creating movement ideas
• Difficulty planning and executing new movements

Poor posture

• Slouches at desk
• Fidgets/difficulty sitting in one position for extended period of time
• Impact on fine motor coordination & ball skills
• Poor balance

Sensory integration provides occupational therapists with a framework for assessing and treating children who present with the difficulties outlined above.

How we work to support your child’s sensory processing needs

• Sensory workshops for parents/schools.
• Supporting students’ self-regulation skills through the Alert Programme and Zones of Regulation Programmes in schools.
• Consultation sessions in school or at home to support increased participation in daily routines and activities.
• Recommendations on environmental adaptations and equipment that can support participation at home and school.
• Training and education sessions in school. 
• Complex sensory needs clinic.
• Sensory processing services for school-aged children and young people in Camden.

The upper limb management clinic aims to optimise upper limb (arm and hand) function and sensory processing skills in children and young people with a range of conditions. It can also help with postural difficulties and shoulder stability. The clinic is run once a month by specialist therapists. 

The service is for children and young people who live in Camden, are aged between 0 and 19, and who:

• have mild/moderate difficulties using their hands for functional activities due to neurological, congenital or orthopaedic reasons
• have sensory processing needs
• are already known to their local occupational therapy or physiotherapy services

The therapists will discuss the concerns identified by the child or young person and their family and advise on management of the concerns. Assessment of the child or young person’s functional abilities will take place through standardised assessments or observations in the clinic or other relevant places (school, home etc.).

Discussion of the treatment approaches available then takes place. These might include issuing neoprene orthotics, splints or Llycra garments, referral to other services or clinics, specific exercises/stretches or other types of management.

Advice related to the orthotic/garments issued will be given, which will include the wearing regime, how to clean it, additional activities, etc. Functional aims will be agreed with the family and child/young person when issuing a new garment.

The purpose of occupational therapy for children and young people with autism is to help the them achieve or maintain their maximum level of independence and to develop practical life skills so that they can participate to their full potential in the home and classroom environment. Interventions will always occur in partnership with the person’s family or teaching team and within naturalistic environments.

Occupational therapists for children and young people with autism in Camden work in:

• autism units/specialist educational provisions, such as the ones at Netley School, Kentish Town School, Langtry Nursery, Gospel Oak, 1A Children’s Centre, and other specialist autism providers
• special schools such as Swiss Cottage School
• mainstream schools in north and south Camden
• Camden nurseries
• Royal Free Hospital and Kentish Town Health Centre

Cerebral palsy affects each child differently. Children with cerebral palsy experience disorders of movement, but may also have difficulties which can influence learning, behaviour, vision/hearing, perception, communication, eating and swallowing. Such difficulties can range from mild to severe and may affect their ability to function at home and at school.

Occupational therapy is aimed at helping the child to achieve or maintain their maximum level of independence and to develop practical life skills so that the child can participate to his/her full potential in the home and classroom environment. 

Following referral and discussion with the child, parents/carers and teachers, specialist assessments and treatments may be offered, such as developmental skills, self-care skills, fine and gross motor skills, visual perception, sensory processing, and specialist equipment and adaptations.

DCD occurs when a delay in the development of motor skills, or difficulty coordinating movements, results in a child being unable to perform everyday tasks. A diagnosis can be made by a doctor who will ensure that the movement problems are not due to any other known physical, neurological or behavioural disorders, and determine whether more than one disorder may be present.

Following referral to the occupational therapy team, a therapist will organise assessment sessions in order to gain a full understanding of the child’s strengths and difficulties. A decision is then made on the most appropriate intervention for the child.