Occupational therapy - Children (Richmond)

Support during coronavirus restrictions

The team are currently delivering both face to face assessment and treatment sessions at Ham clinic, in the home as well as remotely.

We will offer remote sessions for children who are successfully able to access virtual input and for families who would prefer to continue to do so. A range of remote group sessions are also being offered.

The team are visiting all schools and seeing children who are attending both for assessment and to deliver recommendations outlined in their EHC plan.

PPE is worn for all sessions, both in school and in clinic.

For any further queries or clarification regarding the service we are delivering, please contact the service on 020 8891 8190.

Photograph of an occupational therapist helping a child play What is occupational therapy

Occupational therapy provides services for children and young people from 0-18 years who are experiencing functional difficulties at school, home or during play. Therapy aims to enable children to improve their ability to function within their everyday lives and to access the national curriculum more effectively.

We work on things like developing a child’s play, fine motor, self-care and sensory processing. 

Types of assessments:

  • Health assessment clinic:  A health or education professional must refer for assessment into this service using the referral forms. Once the assessment is completed further sessions may be offered in discussion with the parents. For students with EHC Plans, assessments and input will be delivered in school. 
  • School assessment
  • Telephone advice line (020 8891 8190): If parents have concerns about their child, they can log a call with the telephone advice line on the number above. A therapist will return the call to discuss their concerns and complete a referral form with the parent if this is appropriate. The child will then be invited to attend an assessment appointment at clinic.

We assess children at Ham clinic, school, and nursery as well as in the home environment.

Collage of children enjoying occupational therapy

School age and pre-school children

Our team of therapists work across a variety of settings, including schools, nurseries and clinics to provide occupational therapy interventions for children aged between 0-19. We work closely with parents and educational staff to feel supported and confident to implement occupational therapy into day to day activities, as well as offering blocks of therapy sessions to address a specific clinical need. 

Initial assessments for pre-school children are held in clinic, although a follow-up nursery visit is often carried out. Assessments for school aged children with educational based concerns are carried out in schools. Ways of implementing strategies to support the child are discussed with teaching staff.

Groups

We offer a selection of both occupational therapy and multidisciplinary (MDT) groups. MDT Groups include Little Stars and Sunbeams (pre-school MDT group) and Motor Heroes (MDT group for children between 4 and 8 with co-ordination difficulties). 

Occupational therapy specific groups include Handwriting, Visual Perception, Hands Up for School and Messy Play depending on the demand on the service. These groups are held at Ham Clinic. 

Joint assessment

Families can come and meet the team for the first time in a joint assessment.  We offer multidisciplinary assessment clinics at Ham Clinic which are delivered by the paediatrician, occupational therapist, physiotherapist and speech and language therapist as necessary. 

Educational and health care plans (EHCP)

We support children with EHCP plans where occupational therapy is outlined in their EHC plan. This support is offered in school. As part of this service we contribute to new EHC plans for children that are known to our service. The therapist will contact parents to discuss their concerns for children who are going through this process.  

Students and observation opportunities

We can offer student placements for occupational therapy students and observation opportunities for students that are interested in learning more about becoming a paediatric occupational therapist. 

Photograph of the Ham Clinic

Photograph of the Ham Clinic


Sensory-Behavioural Feeding Difficulties 

What is Fussy-Picky Eating?

Most children start to demonstrate fussy or picky eating from around 18 months old.  This is part of normal development and is known as neophobia or a ‘fear of new food’.  Most children continue to eat a variety of food whilst going through this stage and grow out of it by about the age of 5 years.

What is Sensory-Behavioural Feeding Difficulties?

Some children may demonstrate quite significant reluctance to trying new foods and this is often based on the sensory properties of food i.e. they may avoid wet sticky foods like sauces on pasta and prefer only dry, crunchy consistencies such as bread sticks, dry bread or cereal etc.

This is often called a Sensory-Behavioural Feeding Difficulty. The child may prefer foods presented in the same way at each meal (sometimes known as food jagging); and may also have a very limited variety of food in the diet.  

What is Avoidant Restrictive Food Intake Disorder (ARFID)?

ARFID is a significant and extreme sensory-behavioural feeding difficulty. As described in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders-V, 2013), it includes:

An eating or feeding disturbance (e.g. lack of interest in eating or food; avoidance based on the sensory characteristics of food; concern about aversive consequences of eating) shown by persistent failure to meet nutritional or energy needs with one or more of the following:

  • Significant weight loss (not always the case)
  • Significant nutritional deficiency 
  • Dependence on enteral feeding/oral nutritional supplements
  • Marked interference with psychosocial function. 

It does not occur exclusively during the course of anorexia nervosa or bulimia nervosa and there is no evidence of a disturbance in the way in which one’s body weight or shape is experienced. It is not attributed to a co-existing medical condition or disorder’. 

It is important to remember that the child is not being stubborn or difficult about food, but are experiencing a fear or anxiety regarding a certain food or variety of foods.  

Strategies

There are a number of things you can do at home / nursery / school to help with food refusal:

Away From Meal Times:

  • Encourage them to participate in food preparation including helping with food shopping, putting food shopping away, spreading butter on mum's toast, cutting vegetables for the family dinner (with no pressure to eat)
     
  • Messy food play, (away from meal times)  - See advice sheet

During Meal Times:

  • Keep to regular meal and snack times. This helps to regulate the appetite.
     
  • Try to eat as a family whenever possible, even if it is just once per week. This allows your child to see what and how you are eating
     
  • Do not force-feed your child. This sets up a negative situation for both of you. We want eating to be a positive experience. 
     
  • Try to serve the meal at the dining table, rather than plate up in the kitchen, so they can see the whole meal.
     
  • Encourage your child to serve the food to others at the dining table. This is a desensitisation approach and enables them to interact with food from a slight distance. - See 32 Steps to Eating advice sheet.
     
  • Try to offer multi-vitamins each day. These may be available from your Health Visitor or Children's Centre.  
     
  • Try to offer preferred foods that are already 'fortified'. This means that they will get some extra nutrients in their diet.

It is important that you try not to worry.  You really are not alone in this as so many children develop a degree of fussy-picky eating. The key things are to try and follow the guidance outlined above and also monitor their weight.  If you are concerned that they are losing weight, or that they are very lethargic, contact your GP as a referral to a dietitian may be required.

Resources

Food Diary

To help you identify which foods your child mainly eats.  It can also help to highlight which food groups may be missing from their diet.

Love it-Like it-Learning it Meal Planner

This is to help you meal plan and identify which foods to offer to try and expand their diet.

Messy Food Play

Some ideas for playing with food.  This helps the desensitisation process as they are not expected to eat during this activity – the emphasis is on having fun with food!

32 Steps to Eating

This demonstrates the different steps we all need to take before we will eat something

Matching Fun with Food

Another approach to encouraging your child to try something.

NHS Fussy Eaters

Advice with links to understanding challenging behaviours as well as meal planners.

ARFID Awareness UK

This is specifically for children with significant sensory-behavioural feeding difficulties or who may have ARFID.  However, it has a number of resources for all those with challenging eating / limited diets.

www.arfidawarenessuk.org

Infant & Toddler Forum

This has a range of advice sheets on fussy-picky eating and although aimed at younger children, would benefit school-age children also.

Tiny Tastes

This is a reward based programme to help children try different foods.

weightconcern.org.uk

Emotional regulation

Emotional regulation is something we all need to learn to effectively maintain our wellbeing. Young children with speech, language and communication difficulties can have challenges identifying and expressing their emotions using language.

Zones of Regulation by Leah Kuyper’s uses a colour coded system to support students with this.

Zones of Regulation Explained

An advice sheet explaining The Zones of Regulation

Video resource

A video tutorial on Zones of Regulation 

Zones of Regulation Board

This Zones of Regulation Board can be used to show and remind your child of the different zones and the emotions that belong to them

Emotions Choice Board

These emotion cards can be used to support children to identify how they are feeling

Inside Out Zones of Regulation

The Zones of Regulation with Disney’s ‘Inside Out’ Characters

Zones Tools

These cut out ‘Tools’ cards can be used to support students to identify ways they can re-regulate and get into the Green Zone.

The boys have loved this group. All the staff have been great – Thank you.

- Richmond parent

Well organised, structured, good encouragement and good discipline. Gave parents ideas to incorporate into everyday life and weekend activities.

- Richmond parent

Lovely supportive team. I was able to talk openly without judgement.

- Richmond parent

Where can I park?

Ham Clinic
Ashburnham Road
Ham
Surrey
TW10 7NF

  • Free parking available on site for visitors and free road parking nearby.

Teddington Health and Social Care Centre
18 Queens Road
Teddington
TW11 0LR

  • Free parking for visitors for up to 4 hours. Visitors must get a free ticket from the machine and display in car. Free road parking is also available on Queen’s Road just outside Teddington Health and Social Care Centre.


Can I bring siblings?

Siblings are welcome to attend appointments. However, if it is possible to arrange childcare this can make the session easier for parents to talk to the therapist without distractions. 

What should I wear?

For occupational therapy appointments we advise that both parents and children do not wear their best clothes. Please note both parents and children may be required to do exercises, participate in messy play and activities on the floor. 

  • Motor Heroes group – Children will need to wear appropriate clothing to exercise in e.g. shorts and t-shirt.
  • Messy Play group - Please prepare to get messy! We do not advise that you and the child wear your best clothes.  You may want to bring a change of clothes for both you and the child.


Can I communicate by email with the therapist?

Yes, email communication is possible. Parental consent for sharing programmes and documents via email is required


Royal College of Occupational Therapists

The Royal College of Occupational Therapists is the UK's only professional association for OTs.

Children's Centres in Richmond borough

Children’s Centres aim to provide children and their families with the best start in life. There are six centres around the borough of Richmond.

Achieving for Children

Achieving for Children is a social enterprise company created by the Royal Borough of Kingston upon Thames and the London Borough of Richmond upon Thames to provide their children’s services. On 1 August 2017, the Royal Borough of Windsor and Maidenhead became a co-owner of AfC and they now deliver children’s services across all three boroughs. 

Portage

Portage is a home-visiting educational service for pre-school children with SEND and their families. Portage aims to:

  • Work with families to help them develop a quality of life and experience, for themselves and their young children, in which they can learn together, play together, participate and be included in their community in their own right.
  • Play a part in minimising the disabling barriers that confront young children and their families.
  • Support the national and local development of inclusive services for children. 

Local offer

Information on local services and support available for families including children and young people aged 0 - 25 years with special educational needs or disabilities. 

Independent Advice and Support Services

The organisations offer (mostly free) independent advice and support on all SEND matters including the Assessment, Education, Health and Care Planning processes.

Independent Parental Special Education Advice

This website has free resources to help families get the right education for children and young people with all kinds of special educational needs and/or disability (SEND). 

Small Steps. Charity based in Richmond that run conductive education group classes for pre-school children with physical disabilities.   

Skylarks. An independent Richmond-upon-Thames based charity that provides activities and therapies for children with disabilities and additional needs. They also support and provide therapies, courses and information for their whole families.  

Parent Partnership. A local charity providing impartial advice for families of with children special educational needs.

Hounslow Toy Library. is a library where parents can borrow a variety of fun toys to take home which are suitable for all children with disabilities.

Henry's Bleu Moon.  A local parents and carers support network. Bringing together parents and carers of children with SEND. To connect up parents and carers of children with additional needs and create a support network across Richmond and Kingston.

Please see leaflet for more information

Contact a Family. A national charity working to provide information, advice and support to families. They run events for families and children with disabilities, advise on legal or financial support and have a useful database of specific condition support groups. 

Special Kids in the UK. Special Kids in the UK aim to bring families together for friendship, to share information and to support one another via their online forums and regular events throughout the country.

  • Whizz Kids  - provide equipment, support and life skills for disabled children.
  • Companion Cycling in Bushy Park – Based in bushy park this group run inclusive cycling session for all ages and levels of ability
  • Riding for the Disabled Association – A national group for inclusive horse riding.
  • Park Lane stables (RDA) - Their horses and ponies provide invaluable therapy, achievement and enjoyment to people with disabilities in and around London
  • Specialist swimming teachers – Teddington pool are able to offer both accesses to public sessions in for families use their hydrotherapy pool, as well as 1:1 swimming lessons for children with additional needs.
  • Wheelchair basketball – Richmond’s well established and successful wheelchair basketball team - The Knights 
  • Weir Archer Academy - wheelchair racing- based in Kingston, they host regular training opportunities as well as being and involved in local wheelchair racing events
    Contact: info(@)weir-archer-academy.com
  • RISE – hosting regular inclusive sporting events in the Richmond area for children to come along and try a new sport, as well as running a variety of inclusive sports groups from football, yoga, golf, and dancing
  • British Paralympic Association - This website provides details about a huge variety of national inclusive sports opportunities.
  • CP Sport – a national charity that promotes and supports sporting opportunities for people with cerebral palsy
  • English Federation of Disability Sport 
  • Phyz Swimming is a support group that allows parents/carers to use the Hydrotherapy Pool at Teddington Pool

Skylarks

Visit the website for a list of all the events, activities, talks, workshops, clinic & therapies they have coming up. 

Reflections and Redlees Stay and Play Sessions

Drop in stay and play sessions in Feltham and Isleworth for children and young people with special needs and their families. There is a relaxing white room, a ball pool, soft play area and garden for you to enjoy. Sessions run weekly, Sundays and throughout the school holidays. 

Richmond Parent Carer Forum (PCF)

Richmond PCF is offering virtual drop in sessions for parents of children 0-5 years who are concerned about their child’s progress and would like support from other parents.

Tuesdays 10.30-11.30am

  • 27 April 2021
  • 11 May 2021
  • 1 June 2021

Wednesdays 10.30-11.30am

  • 31 March 2021
  • 28 April 2021
  • 19 May 2021

More information and contact details

Action for Kids. Acton for kids is a charity that helps young people with physical and learning disabilities across the country find greater levels of independence and opportunity through the provision of mobility aids, employability training and family support.

Always look on the Bright Side of Life Charitable Trust. Grants to make children smile. The trust awards one off grants to children in need for activities/ items (not household)/trips that children’s families are unable to afford. The child must be disadvantaged due to financial circumstances, disability/ill health or other category. 

Boparan Charitable Trust. The Boparan Charitable Trust aims to help children and young people up to the age of 18, throughout the UK, who are disadvantaged either through poverty, disability or life-limiting conditions.

Bruce Wake Charitable Trust. Equipment for leisure/activities for physically disabled wheelchair users. Applications on behalf of individuals will only be accepted through a charitable organisation or equivalent recognised body.  

Cash for Kids. Cash for Kids is Bauer Radio’s network of local charities, which operate across 22 areas around the UK. Our mission is to respond to the needs of children in our communities, and we aspire to enable all children to live life to the full and achieve their individual potential.  

Cauldwell Children. Offers a range of support to children with disabilities including family support, short breaks equipment, treatment and therapies. You can apply direct and the process is straightforward.  

Children Today. Children today encourage applicants, usually parents, to come to them for funding and other services on a regular basis as their child’s needs change. Hopefully, this will continue as they grow and develop, gaining more independence and an improving quality of life that is also shared by all those around them. They will continue receiving support until the child reaches the age of 25 years.

Cerebra. Cerebra is a unique national charity that strives to improve the lives of children with neurological conditions, through research, information and direct, on-going support.

Disability Grants. Disability Grants is a web resource which has been set up for people with disabilities and for parents/carers of disabled people. There is a wealth of information on this site to help you find suitable funding, including blogs and forums to help you get a heads up from others who have gone through this process.

Dreams Come True. Dreams Come True is a UK children’s charity. Their mission is to enrich the lives of children and young people with serious and life-limiting conditions across the country by making their dreams come true. Over the last 25 years they have fulfilled dreams for more than 5,000 children and young people as well as their friends, family and carers.

Florence Nightingale Aid in Sickness Trust. The Florence Nightingale Aid in Sickness Trust provides life enhancing grants to help people of all ages in need who are ill, convalescent or disabled. 

Family Fund. Will look at any grant request that relates to the needs of a disabled or seriously ill child, young person and their family. If you are raising a disabled or seriously ill child, the family fund may be able to help with a grant for household items, equipment, sensory toys, a family break or something to help with college for 16/17 year olds. You can apply as a parent carer, or agencies can apply on their behalf

Happy Days Children's Charity. The charity supports families with children aged 3-17 who have learning difficulties, physical or mental disabilities, acute, chronic or life limiting illnesses, been abused or neglected, witnessed domestic violence, been bereaved or act as carers for a parent or a sibling. Eligible applicants can apply for the costs of the following activities: Day trips/theatre trips/theatre workshops and group activity holidays.

Just 4 Children. Just 4 Children is passionate about the relief of sickness and prevention of health of children in the UK and Ireland by providing and assisting in the provision of grants to enable them to obtain medical treatment, therapies, living environments, equipment and holidays which would  not otherwise be available to them.

Local funders. There are a number of local funders such as Richmond Parish Lands Charity, Hampton Fuel Allotments and Barnes Workhouse Fund that offer grants to individuals and families particularly in relation to fuel grants, white goods and other household equipment and education. For a full list of the local funders 

Newlife Charity. Newlife is the UK's largest charity funder of children's specialist disability equipment. We also run the UK's only national emergency equipment service, for terminally ill children.  Newlife Nurses support thousands of families, we campaign for policy change and we fund targeted medical research, to improve child health. 
  
The Family Holiday Association (FHA). Supports families on a low income, that have not been on holiday for the past four years and have at least one child between three and 18 years of age can obtain financial support for a break during 2016 and 2017. The FHA can only accept applications from referring agents (such as a teacher, social worker or health visitor, etc) and not directly from families. The website also has a great resource page which lists other charities and trusts that can support holidays and short breaks

The Henry Smith Charity (Richmond).  People experiencing hardship or distress who live in Richmond, Ham, Petersham or Kew. Applications in writing from referring bodies such as citizen advice and social services.

Tree of Hope. Tree of hope is the crowdfunding charity that helps children and young people with a disability or illness by supporting their families to raise the money they need to pay for specialist care that is not freely available through the UK healthcare system.

Turn2us. A fantastic website that offers help and information for anyone experiencing financial hardship or debt problems, or who is looking for funding to support an individual need within the family such as a short break. It has a grant and benefits search engine which can be tailored to meet your requirements including locality, and a phone helpline that is free to call and gives you access to trained staff who can talk you through your options. The service is available to individuals and organisations acting on their behalf. 

Whizz-Kidz. This charity provide equipment, support and life skills for disabled children. Creating independence to live a life of freedom at home, at school and at play and the independence to be themselves.

The occupational therapy team are all based at Ham Clinic.

Tel:
020 8891 8190

General enquiries/administration hub:
020 8973 3480

Address:
Ham Clinic
Ashburnham Road
Ham
Surrey
TW10 7NF

  • Julie Hale - Divisional Manager
  • Claire Schneider - Clinical Service Manager for Children’s Therapies
  • Jo Fargher – Paediatric Occupational Therapist
  • Kim Martinczak- Paediatric Occupational Therapist
  • Lyndsey D’Souza - Paediatric Occupational Therapist
  • Catherine Johnson - Paediatric Occupational Therapist
  • Nicole Gurney - Paediatric Occupational Therapist
  • Charlotte Porter - Paediatric Occupational Therapist
  • Karen Woodley - Paediatric Occupational Therapist
  • Fidelia Prosper - Paediatric Occupational Therapist
  • Sophie Gates - Occupational Therapy Assistant
  • Christian Lacsina - Multi Therapy Assistant

Referrals will only be accepted if the child has a Richmond GP and consent is obtained from the parent or main caregiver. Referrals are accepted from all professionals. Referrals are also accepted for children who have an Education Healthcare plan and a Richmond address but an out of borough GP.

All referrals need to have a clear functional concern describing how the child’s difficulties are affecting them on a day to day basis.  Once a referral is accepted, the child will be seen within an assessment clinic.

Please return the referral to: 
Hounslow & Richmond Community Healthcare NHS Trust
Children’s Therapy Services Admin Hub
Teddington Health & Social Care Centre
18 Queens Road
Teddington
TW11 0LR

Tel:
020 8973 3480
    
Alternatively, referrals can be made electronically via HRCH.Childrens-Therapies@nhs.net if being sent from another nhs.net account.

Please note the following about our non-attendance policy:
In order to minimise the impact of missed appointments, which increase wait times for users of our service, please note the department’s non-attendance policy: 

  • Initial appointments: If you do not attend your booked initial appointment, without contacting the service beforehand, you will be discharged immediately.
  • Follow-up: If you do not attend your follow up appointment, without contacting the service beforehand, you will be given 10 days to contact the department before being discharged.
  • Groups: If you do not attend two consecutive sessions, without contacting the service beforehand, the remaining group appointments will be cancelled and you will be referred back to your therapist.

Clinics operate during office hours. There is an answerphone service for messages to be left; these are picked up on a daily basis.

Staff will endeavour to get back to you as soon as possible. However due to day to day commitments and some staff working part time it may not be possible to get back to you immediately. Every effort is made to get back to you within 48 hours.