Occupational therapy - Children (Hounslow)

Occupational therapy is a type of health care that assists people of all ages who are experiencing physical, sensory or cognitive difficulties. 

Occupational therapy can help these individuals in gaining independence and performing work, leisure and activities of daily living (ADLs) that are meaningful to them.

An occupational therapist supports people with removing barriers that might be impacting on a person engaging in meaningful activities in their day to day lives. This may be through making adaptations to the activity, the environment or supporting skill development within the individual. 

What is paediatric occupational therapy?

Children’s occupational therapists (OTs) work with babies, preschool and school aged children who have physical, developmental or sensory difficulties, to help them with skills that they need to succeed in everyday life.

This may include:

  • Self-care tasks, such as getting dressed, bathing, brushing teeth, using the toilet, using cutlery and eating meals.
  • School skills such as sitting at the table, organising belongings, handwriting, using scissors, focusing.
  • Play skills, including developmental play, ball skills, messy play.
  • Play Skills including ball games, sensory play, using hands and fingers appropriately to operate toys such as twisting or pushing buttons, using play equipment, like in park playgrounds (climbing, balancing etc.) 
  • Sensory processing skills, such as responding to information received by the senses (e.g. loud noises, bright lights, different textures)

Not only does occupational therapy help with general issues such as the ones listed above, we are also able to help with more specific conditions such as:

  • Autism
  • Physical disabilities such as cerebral palsy, genetic syndromes
  • Developmental Coordination Disorder/Dyspraxia

 

Our Team:

Children’s Therapy Clinical Services Manager: Uma Saimaruhan

Team lead – Preschool: Caroline Symonds / Claire Jamieson

Team lead – Mainstream: Claire Jamieson

Team lead – Physical Disabilities, Global Developmental Delay and Complex Needs: Tehmi Stott

Team lead – Specialist Centres and Units: Jocelyn Davies

Business Manager: Samsul Alam

Find out about our teams and current waiting times here:

Who do we see?

The Pre-school team see children from 0 until they start Reception class at school.

If a child is within this age range, without complex physical needs such as cerebral palsy, they can be seen by this team.

Who do we not see?

  • Children who have an EHCP. It is up to the school setting to commission an independent OT to provide input for children with an EHCP.
  • Children who attend a special school. Special schools should have their own resident Occupational Therapist.

What is the pathway?

  • If a child has sensory processing differences, parents will first be asked to watch a virtual workshop on sensory processing and fill in and send back a short questionnaire, prior to their child being placed on the waiting list for assessment.
  • If a child has eating difficulties, parents will first be asked to watch a virtual workshop on eating difficulties and fill in and send back a short questionnaire, prior to their child being placed on the waiting list for assessment within our feeding clinic.
  • Most initial assessments take place at Heart of Hounslow, and follow-up can be arranged virtually, in clinic or at nursery/ preschool as appropriate. 

Current waiting times:

Initial pre-school assessment appointment = Approximately 8 months

Initial feeding assessment appointment = Approximately 3-5 months

Follow up appointment = Approximately up to 3 months

Who do we see?

  • Children from Reception class onwards.
  • Children who attend a mainstream school setting.

Who do we not see?

  • Children who have an EHCP. It is up to the school setting to commission an independent OT to provide input for children with an EHCP.
  • Children who attend a special school. Special schools should have their own resident Occupational Therapist.

What is the pathway?

  • Initial assessment: Depending on the needs of the child, the OT is able to complete an initial assessment in clinic at the Heart of Hounslow; at the child’s school or virtually via video call. Following this initial assessment, the OT will write a goal programme to be implemented at home and at school by the adults in the child’s life. There is a strong focus on the OT working with school staff to support the child with school related needs.
  • Follow up appointment: 3 months after the initial OT appointment, once the Parent or School have been able to try putting in place strategies/recommendations from the goal programme, the Parent or School can call the OT service to request an OT review appointment. This review appointment can be completed virtually, at School or in clinic, depending on the needs of the child.

Current waiting times:

Initial school age assessment appointment = Approximately 12 months

Initial feeding assessment appointment = Approximately 3-5 months

Follow up appointment = Approximately up to 3 months

Who do we see?

  • This team sees children from 0-18 with complex needs that are impacting all functional areas. 
  • Children in this stream commonly have conditions or diagnosis of neurodevelopmental conditions such as SMA or cerebral palsy, traumatic brain injuries, down syndrome or other genetic conditions and neurological upper limb difficulties. 

What is the pathway?

  • OT’s working within this team aim to work holistically to support children and their families withing virtually as well as in the clinic, nursery/school and home settings (as assessed to be suitable). 
  • OT input may include individual or group sessions, liaison and where possible joint working with relevant professionals such as physiotherapy, speech and language therapy, specialist/acute services, SENS Physical disability team, school/nursery SENcO’s, Portage etc. 
  • Children within this stream, up until the age of 5 will be able to access our equipment clinic to be assessed and if appropriate, provided with suitable self-care equipment (e.g. bath aids) and specialist seating (following which a referral to the Hounslow Social Services OT service will be made). 
  • Children from this stream will also be able to access our monthly neuro Upper Limb Clinic in which assessment and if required splinting can be provided (either through fabrication or ordering of ‘off the shelf’ items)

Current waiting times:

Initial assessment appointment = Approximately 6 weeks

Who do we see?

We provide the OT provision under section F within a child’s Education Health and Care plan. We are based in the centres and units around the Hounslow Borough. 

We are not commissioned to see children in mainstream schools with EHCPs and the school needs to commission OT for these children. 

How does our service work?

We provide assessment and reviews as outlined within the child’s EHCP. In every EHCP there are “direct” and “indirect” hours. 

Direct hours make up time spent directly with the child.

Indirect hours make up the time spent on resource creating, administration and liaison with teachers, parents and professionals.

We use a classroom-based model of intervention in our centres and units which means that we do not pull out children to see individually without a staff member such as an LSA or TA present. This is because we believe in therapy being provided throughout the day at school through upskilling of staff and not just in the time spent with the OT. As such, we do not provide 1:1 weekly OT sessions in our service. 

We aim to base our intervention within a Tiered Model of Intervention, in line with RCOT (Royal College of Occupational Therapy) guidance. This model is based on the concepts of Public Health model used in the UK and also the Response to Intervention (RtI) model used in the Educational Systems in North America (National Association of State Directors of Special Education, Inc 2005; AOTA 2009 as cited by Chu, S., 2013). This approach is known in England as the Wave Model, defined as a multi-tier method to address the needs of students with SEN or disabilities within three waves of support: universal, target and specialist (Norwich, 2013; DfE & Skills, 2006 as cited by Riveria and Boyle (2020).

The tiers of input are described below:

  1. Universal level: Services provided to all children, young people, and their families).
  2. Targeted level: Services for children who are at risk of, or already experiencing difficulties. 
  3. Specialist level: Children with complex needs requiring an individual approach.

Occupational Therapists across the service support children and young people with Autism Spectrum Disorder.

Social Communication Pathway

For individual queries on waiting times for assessment for autism, please contact the Social Communication Pathway Coordinators:

Email: hrch.socialcommunicationpathway@nhs.net

Telephone: 020 3771 5983

Useful links

NHS: Help for families of autistic people 

This website has useful tips, advice, and further links from the National Health Service.

National Autistic Society 

For safe, accurate and up to date information on autism, including support, guidance, and advice, as well as information on campaigning for improved rights, services, and opportunities to help create a society that works for autistic people.


How to refer a child to Occupational Therapy

Referrals will only be accepted if the child has a Hounslow GP and consent is obtained from the parent or main caregiver.

Referrals are accepted from a healthcare or education professional.

All referrals need to have a clear functional concern describing how the child’s difficulties are affecting them on a day to day basis.  

Please see referral forms below:

Hounslow OT General Referral Form 

  • To be used by any healthcare professional
  • To be used by professionals from education settings who are referring pre-school children (for school age children please use the form below)
  • Click to access : Hounslow OT General Referral Form

Hounslow OT Education Setting Referral Form 

Referrals are accepted from healthcare or education professionals and should be sent via email to : HRCH.Childrens-Therapies@nhs.net.

Bilateral Coordination

Bilateral Coordination For Kids (ot-mom-learning-activities.com) – a blog explaining what bilateral co-ordination is

Cerebral Palsy

Cerebral Palsy | Conditions | OT for Kids - Children's Occupational Therapy Services – a blog explaining what CP is and exactly how an OT can help

Cutlery Skills

Using Cutlery Information Sheet | NHS GGC

How to Use a Knife and Fork Together | Cutlery | Kids | Learn | Table Manners |Teach - YouTube

Developmental Coordination disorder

https://youtu.be/nzOZnS4xdqo - a YouTube video briefly explaining Developmental Coordination

Occupational Therapy Strategies for Dyspraxic Students (dynamicoccupationaltherapy.com)

Developmental co-ordination disorder (dyspraxia) in children - NHS (www.nhs.uk)

Playground Equipment & Activities for Children with Dyspraxia | Playworld Playworld® Blog

Down Syndrome

Occupational Therapy for Down Syndrome | OccupationalTherapyOT.com - a blog explaining what Down syndrome is and exactly how an OT can help

(2597) OT Role with Down Syndrome - Briefly - YouTube

(2597) Down Syndrome: Occupational Therapy Demonstration – YouTube

So you just had a baby with Down syndrome. Now what? (meganmennes.blogspot.com)

Dressing

Independence with Dressing Skills - The OT Toolbox

Work on Dressing Skills Through Play Activities - Therapy Fun Zone

Executive functioning

Executive Functioning Skills for Kids to Adults - The OT Toolbox – a blog explaining executive functioning

Fine motor skills

The OT's Guide to Fine Motor Skills - The OT Toolbox – a blog explaining what fine motor skills are, examples of it and strategies on how to improve them in your child

Fussy Eating

Dealing With Picky Eaters (ot-mom-learning-activities.com) – a blog explaining how to help with fussy eaters.

Your Kids Table

SOS Approach to Feeding | Feeding Disorders in Children

Gross motor play ideas

Postural control: Why Postural Control is Important? - The Therapy Spot (baltimoretherapyspot.com) – a blog explaining what postural control is and how to improve it in your child

Handwriting

Autism and Handwriting: Strategies for Parents & Teachers (lwtears.com)

Eight Handwriting Strategies for Children with Autism - Autism Parenting Magazine

How to Improve Handwriting with Kids - Tips and Tricks for Parents (growinghandsonkids.com)

Messy play

10 Messy Play Ideas for Hands-On Learning | Famly

Epic Messy Play List that's Sensory-Filled, Inspiring, and Easy! (yourkidstable.com)

Midline crossing

 All About Crossing The Midline (ot-mom-learning-activities.com) – a blog explaining what the midline is and what crossing it means

Neurodiversity affirming podcasts and websites

Home - We chose play, joy every day (affectautism.com) – blog run by a mother of an autistic child

Scissor skills

School Therapy OT Program- Scissor Skills – YouTube

Scissor Skills | NHS GGC

Self care

Practical Solutions - SensorySmarts – strategies to help with toothbrushing, bathing, bedtime, haircutting, clothing, shopping, potty training  

Sensory Processing

How to Explain Sensory Processing Disorder | Sensory Integration Issues | Understood – a blog explaining Sensory Processing Disorder

Sensory Processing Disorder: SPD Explained and Simplified - YouTube – YouTube video generally explaining SPD

Vestibular Input: Sensory Processing Explained (lemonlimeadventures.com) – a blog explaining vestibular input/processing

SENSORY MINIS - VESTIBULAR - YouTube – YouTube video explaining what the Vestibular system is and what happens when it’s not working properly

Proprioceptive Input: Sensory Processing Explained (lemonlimeadventures.com) – a blog explaining proprioceptive input/processing

SENSORY MINIS - PROPRIOCEPTION - YouTube - YouTube video explaining what the Proprioceptive system is and what happens when it’s not working properly

Tactile Input: Sensory Processing Explained (lemonlimeadventures.com) – a blog explaining tactile input/processing

SENSORY MINIS - TOUCH - YouTube - YouTube video explaining what the Tactile system is

Sleep

Better sleep for autistic children: tips | Raising Children Network

Helping your child to sleep | Disability charity Scope UK

Toileting

Top 10 potty training tips | ERIC

Toilet Training (for Parents) - Nemours KidsHealth

Visual Perception

Pediatric Occupational Therapy: What is Visual Perception? – Advanced Orthopedic Newberg Physical Therapy (advancedorthopt.com) – a blog explaining visual perception

Visual Perceptual Skills And Learning (ot-mom-learning-activities.com) – a blog explaining visual perception skills and the different types of visual perception skills