Children's Occupational Therapy
Role of the Children's Occupational Therapist
Functional performance is defined as those things that we do in every day life e.g. dressing, grooming, washing, toileting, eating, playing, using tools such as scissors, pencils, cutlery etc. Functional performance can be dependent on certain abilities such as organisational skills, problem solving skills and physical skills.
The Occupational Therapist is concerned with analysing the child's ability to perform in everyday contexts such as school and home. Therefore referrals for an Occupational Therapy assessment should indicate a problem in functional performance, for example, the child is unable to dress themselves, cannot use a knife and fork, cannot use a pencil appropriately etc.
Role of the occupational therapist in interventions
- The Occupational Therapist may concentrate on the facilitation of functional performance in every day contexts (performance areas), which are defined as self-care, school and work, and play and leisure. Play, one of the primary tools of the children's Occupational Therapist, is developmentally the earliest form of occupational behaviour; used therapeutically it provides children with opportunities to develop skill and competence in physical, intellectual and social activities.
- The Occupational Therapist may concentrate on the development of underlying skill components (performance components) such as sensory or motor skills or fine motor skills.
- In addition Occupational Therapist will promote good posture and sitting ability through assessment for specialised seating, buggies, wheelchairs etc.
- The Occupational Therapist may emphasise adaptation of the environment (performance context) taking into account family, cultural and physical factors. This may include assessment for equipment across the range of self-care, school and leisure / play activities.
To continue to provide the highest standard of assessment, interventions, advice and support to children, young people, families and carers referred to the children's occupational therapy service.
Aims of service / Philosophy of Care
The children's occupational therapy service aims to provide community based assessment and intervention to children with physical, sensory and cognitive disabilities, both pre-school and school age in the Bailiwick, in order that they may be enabled, through participation in purposeful activity, to reach their optimum level of function and independence in all areas of family and daily life, within the resources available and according to a clearly defined Occupational Therapy priority matrix. This is of value to children, young people, families and Children's services in integrating and maintaining children and young people in their community.
Service statement: Occupational therapists should have and abide by clearly documented procedures and criteria for referral to their service.
The service will be available for children up to the age of 18 living within Bailiwick boundaries where there is a specific occupational dysfunction affecting the child's performance in activities.This may include the following indicators for the provision of service;
- Any child that has a deteriorating condition that will cause regression or loss of developmental progress
- Any child that has the presence of a condition that effects their sensory motor development that will have an impact on their global development
- Any child that has a specific impairment that is the major contributor to the child's occupational difficulties
The following are examples of specific client groups
- Children with cerebral palsy
- Children with profound and multiple disabilities
- Children with syndromes, limb deficiencies, spina bifida, head injuries
- Children with muscular dystrophy and other degenerative conditions
- Children with co-ordination difficulties
Children who have moved into the area will be placed on the waiting list and prioritised according to the priority matrix.
Referrals are accepted from children, parents / carers, and professional or other agencies working with the child.
Professionals / agencies must obtain consent from the child and / or parent / carer prior to referral and this must be documented on the referral.
Method of referral Occupational therapists will:
- Obtain adequate information to make a decision on the appropriateness of the referral.
- Decline the referral if it is judged not to be appropriate or the needs of the client cannot be met by the occupational therapy service.
- Inform referrer if referral is declined stating reasons.
- Inform both client and referring agency if an individual has to be placed on a waiting list.
- Record date of referral to occupational therapy, including the source and date of referral.
Occupational therapists should respond to referrals within a stated time frame, based upon local need, resources and policy.
Standard Time Frames
- New referrals will be acknowledged within 5 working days.
- Upon receipt of referral, if service capacity does not allow the referral to be allocated to an occupational therapist, the child's parents/guardian will receive the documented standard waiting list letter within 5 working days. This will be copied to the referrer if not the parent / carer. This will indicate the approximate waiting time for the service.
Information leaflets about the service will be provided to the child and parent / carer.
Priority timescales to act upon a referral are:
- 1 week
- 4 weeks
- 12 weeks
Where the referral is inappropriate or the client's needs cannot be met, occupational therapists will either transfer it to an alternative service, or provide information about other services.
- Occupational therapists must acknowledge boundaries of competence and experience, only providing services and techniques for which they are qualified by training, and maintained by CPD clinical competence.
- Occupational therapists are required to:
- Gain and record informed consent before a client is referred to another service.
- Inform the original referral source.
- Ensure that the referral is made to a service/client that can best meet the requirements of the individual being referred.
Prioritising of Referrals
Priority of referral will be based on the following matrix:
- URGENT Level 1: (1 week) Includes:
HIGH Level 2: (4 weeks) Includes: STANDARD Level 3: (26 weeks) Includes: i) Critical risk of significant harm to child and/or carer, information gathered indicates an urgent need for a service due to, e.g. moving & handling issues or safety of child/others, which could result in significant harm. i) Risk of harm to child and/or carer, information gathered indicates a need for a service in the near future due to, e.g. moving & handling issues, safety of child/others, which could result in harm. i) Promoting independence and inclusion in life performance area, e.g. self maintenance activities, play or leisure activities, school or work activities. ii) Management of children with complex disabilities where non-provision of a service would impact on their early development. ii) Management of children with complex disabilities. ii) Improving children's performance and inclusion in school activities. iii) Palliative care, (see risk i) indicators) iii) Children with conditions that affect participation in daily activities and increased care needs potentially leading to school/home breakdown. iv) Discharge from hospital iv) Palliative care, (see risk i) indicators) v) Looked after children with disabilities
|Task||Process||Form (location)||Notes/Contact info||Timescale|
|New Referral||OT Children Services manager and OT allocation meeting professional & referral co-ordinator co-ordinate referrals||Form||OT admin officer||New referral should be acknowledged within 5 working days|
|Waiting List||See OT Referral Procedure and priority matrix||Standard letter||OT Update electronic database weekly|
|Referral to Adult Services||To commence Transition Process||At age for children with complex disabilities|
|Referral to visiting wheelchair clinic for consultation||Complete referral form||Use wheelchair clinic referral form|
|Referral for any services or short break, playschemes, Physio, SLT, etc||Contact||See Admin. for confirmation of process.Guernsey Physiotherapy Group require medical referral|
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- Youth Offending
- Children with Disabilities