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Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
1. How does an Occupational Therapist make a difference for a child?
What does a children’s Occupational Therapist do?
We provide information, advice, and access to specialist equipment and recommend
ways to adapt the home and or short break setting and school for disabled children. We
also use strategies and activities to develop skills directly with the child, and to promote
independence and safe management by the parents / carers. This can include: moving
and handling, all activities of daily living, and by provision of safety adaptations, and
access to basic facilities such as the bedroom, bathroom and toilet.
Which children do we work with?
Occupational therapists work with children from age 0 –19 currently, with a range of
needs from children with severe physical and / or learning disabilities to those with
complex health care difficulties, including children with sensory difficulties. Our aim is to
enable each child to achieve just how much they can do for themselves, and to enable
parents / carers to manage them safely within their home, short break, or educational
setting.
For example, a child with cerebral palsy may be able to use a computer if he can be
supported correctly in his chair, and then learn to use a head switch to communicate. We
can also provide practical solutions for children with specific physical problems. We aim
to increase children’s independence, confidence and provide opportunities for them to
achieve their potential. “Occupational Therapists work with people of all ages, helping
them to carry out the activities that they need or want to do in order to lead healthy and
fulfilling lives” College of Occupational Therapists, 2005.
Occupational Therapists differ from other health care professionals. Our focus is not so
much on the problem itself but on how it affects a child’s ability to do normal every day
activities. For children this could mean helping them to be independent when they are
getting dressed, feeding themselves, using the bath and toilet and carrying out practical
activities at school.
For parents / carers this could mean helping their child to be independent, enabling their
development and supporting them to care for their child at home, including sleeping,
sitting and getting around.
How do we work with children?

We aim to build up a good relationship with the child and family. We liaise with and
gather information from relevant people who are involved with the child.
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
During assessment, we clarify what the child and family want to be able to do, and
what is a priority and of highest need / risk to them, in their daily activities. We use
different methods to identify what the child’s skills and difficulties are. This can take
place in a variety of settings such as home, short break settings, school, or nursery.

We work with the child and family to problem solve and make a plan of action.
The plan of action may involve;
- providing advice and information to children, parents and schools
- developing the child’s skills individually, or on occasions in groups
- using equipment to enable independence; and
- making the child’s environments more accessible
How to refer to children’s Occupation Therapy
We operate an open referral system, so accept referrals form professionals such as
schools, physiotherapists and allied health care professionals, nurses, Consultants and
parents.
We also liaise with the NHS OT service, which is generally involved with pre-school
children at home and then in the education setting when they reach school age. We
accept transfers of care from this service when children commence school to consider
their home needs.
Case study
Jack
Jack is the second child of three children. From early on his parents noticed that he had
trouble with tripping and falling frequently, toileting himself independently, dressing and
eating. When Jack started school, his teacher also noticed that he was finding it difficult to
mobilize especially on stairs, and toilet himself independently, organise himself and was
having problems with writing. As time went on, Jack became more reluctant to go to
school and was often tearful and upset at home. Jack’s parents talked to their GP about
this and Jack was subsequently diagnosed with Cerebral Palsy, which affected the
muscle strength and co-ordination in his legs and lower back.
Jack was referred by his GP to a children’s Occupational Therapist. After assessing
Jack’s ability to carry out these activities both at home and at school, and following
discussions with Jack, his parents and classroom teacher, Occupational Therapy
sessions were planned and carried out and recommendations made. The Occupational
Therapist developed a toileting strategy which included the fitting of grab rails to support
him to be independent, and a handrail to the steps both at his home and school to
increase his stability when mobilizing. The Occupational Therapist showed Jack’s
teachers some suitable activities for him to do at school and discussed strategies that
would help Jack to organise himself. Jack also attended a handwriting group with other
children who were experiencing similar difficulties.
A year later, Jack is much more independent. He is able to toilet himself independently,
is falling much less frequently when mobilising, is able to dress himself after PE and is
beginning to write more clearly. His confidence is returning and he joins in playground
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games with his friends. Jack seems happier with what he is able to achieve both at home
and school.
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
2.
Your first appointment:
What will happen in your child’s first appointment with an Occupational
Therapist?
1. After making a referral you will have received information about whether you will
need to wait for an appointment. You will also have been advised about how we
share information and given us consent to do so.
2. When an appointment is available, an Occupational Therapist will contact you.
If your child needs to be seen in the home initially (which is usually the case), your
Occupational Therapist will contact you to arrange a convenient time and you will
have an appointment confirmed either by telephone or letter.
3. The initial visit and assessment will be approximately 1 – 1.5 hours long and it will be
necessary for your child to be present.
4. You will need to stay with your child throughout the assessment.
5. During your first appointment your Occupational Therapist will need to find out
information about you and your child.
This may involve questions regarding your child’s developmental progress, how they
carry out daily activities and how they are managing at school. It would be useful for
your Occupational Therapist to see any recent reports at the first appointment (e.g.
School, Physiotherapy and Educational Psychology reports).
6. Your Occupational Therapist may explore your child’s abilities and level of
independence and safety in a range of activities.
(See later in this leaflet for the areas addressed by Occupational Therapists.) It would
be helpful if your child is dressed in loose comfortable clothing if possible and any
existing equipment used at home to be available.
7. At the end of the assessment your Occupational Therapist will agree an action plan
with you and your child. This action plan may involve: Further specific assessment, e.g. Moving and Handling or seating
 Ongoing therapy individually to e.g. to develop strategies with activities of daily
living
 Further home visits
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

A School visit
No further action
8. The outcome of the assessment will be written down and sent to you with the agreed
action plan. Copies will be sent to the referrer if requested, and others involved with
your child, with your permission.
Examples of areas addressed by Occupational Therapists
Posture
Your occupational therapist can assess a child’s posture and whether or not specialist
seating or other equipment might be required. A specialist chair can provide and
maintain good sitting balance. In turn this helps to prevent physical problems as well as
maximising concentration to a task, e.g. feeding, and the development of fine motor
skills.
Fine Motor Skills
Your child may be finding it difficult to hold and control a pencil for writing, to cut with
scissors, manage eating with standard cutlery or to manage buttons or zips. The
Occupational Therapist can provide adaptive equipment or recommend activities
designed to improve the child’s ability.
Gross Motor Skills
Your child may find it difficult to walk, hop, skip, jump or throw/catch a ball. Coordinating movements to get dressed independently might be difficult and the
Occupational Therapist can recommend strategies to help.
Your Occupational
Therapist can also make recommendations for adaptations which may increase
independence, provide access and maximise safety especially within the home.
Activities of daily living
Your child might have difficulty using the toilet or bath safely and independently. A
young person may need to be more independent in the kitchen. Equipment and
adaptations to the environment could help. There may be ways your Occupational
Therapist can help you to teach your child to carry out these activities more
independently.
Caring for your child
You may need help to care for your child at home. Your Occupational Therapist may
provide advice and strategies or equipment to help you carry out tasks, or to increase
safety in the case of behavioural / learning difficulties. These might include going in and
out of your home or car, moving from the bed to the toilet, moving and handling, helping
your child have a bath or the use of Assistive Technology to enable you to supervise
your child within the home.
Children’s Occupational Therapy Service
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This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
3.
Adaptations at home and school for children with disabilities:
What is an adaptation?
An adaptation is a permanent change to a child’s home and / or school. Many are minor
changes such as grab rails or small steps; some may be major changes such as the
fitting of a stair lift or converting a bathroom, which require careful planning.
Minor adaptations
Occupational Therapists will make recommendations on minor adaptations. These will
require the agreement of whoever owns the property.
Major adaptations
These are normally only considered after all other options have been looked at with the
Occupational Therapist, such as using equipment or changing the use of the space in the
home or school. This is because a major adaptation is a big decision, which can involve
disruptions and may take time to complete.
Who can have an adaptation?
There is a range of legislation that requires local authorities to provide adaptations for
children with disabilities. Your child needs to be assessed by an Occupational Therapist
from Children’s Services to ensure they are eligible for an adaptation, and that any
recommendations are “necessary and appropriate” for your child. This assessment is
likely to be with an Occupational Therapist. The assessment will define what your child
needs at home or school and what the adaptation should achieve for your child, family or
school.
How do I know if my child is eligible for an adaptation?
For any adaptations your main permanent place of residence for your child’s school must
be within Rochdale Metropolitan Borough Council and your child must be disabled.
Disability can be defined by various legislation, including the Disability Discrimination Act
1995 and the Children’s Act 2000.
If you and your Occupational Therapist have agreed that a major adaptation may be a
solution at home, then the Occupational Therapist will advise the housing department
(Rochdale Home Improvement Agency – RHIA) if the adaptation is “necessary and
appropriate” for your child’s needs.
The housing department (RHIA) will then decide if the proposal is “reasonable and
practicable” both for the property and in terms of cost and if you are eligible for a Disabled
Facilities Grant (DFG).
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How are adaptations paid for?
If your child is eligible, minor adaptations are provided by children’s services – (Children
with Disabilities Services). There are different ways to fund major adaptations. Your
Occupational Therapist will advise you and begin the processes with you.
At home
A Disabled Persons Facilities Grant (DFG) will usually be required for major adaptations
at home. The DFG is administered by the housing department (Rochdale Home
Improvement Agency – RHIA.
Rochdale Metropolitan Borough Council’s RHIA, following advice from your occupational
Therapist is available to help you with DFG applications. Other financial help may be
available through your Occupational Therapist from Children’s Services through
alternative funding; this may apply for example if you foster a child with disabilities. The
Family Fund Trust may also be able to assist.
At school
With your Occupational Therapist makes any recommendations for your child within their
school, the school may then be able to seek financial assistance from the local authority.
How will an adaptation happen?
Minor adaptations at home can be carried out for you via our building technicians in the
RHIA
Your Occupational Therapist will keep you informed about the progress of your individual
case. If a major adaptation is agreed for your home, the RHIA can manage the adaptation
for you with your agreement. This is then funded by Rochdale Metropolitan Borough
Council.
If your Occupational Therapist has agreed with you that a major adaptation at school may
be a solution, they will liaise with the local authority to support you and the school in
enabling these changes to happen.
For all adaptations but especially major work, it is helpful to have as much notice as
possible. Therefore we would encourage both you and your child’s school to work with us
to plan ahead to meet your needs if we can.
The majority of major adaptations in homes should be completed within one year;
however your Occupational Therapist and the RHIA will keep you informed of progress,
as unforeseen works can occur.
Disabled Facilities Grant Process
Below is a basic outline of the DFG process, (this may however vary slightly depending
on the adaptation requirements):
1. Client / parent enquiry to local authority Children’s Social Care Services or Housing
(RHIA) department, leading to referral to Occupational Therapy service.
2. Assessment of need of the disabled child by an Occupational Therapist.
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3. Agreed statement of need presented to RHIA detailing recommendations as
“necessary and appropriate”.
4. Confirmation of eligibility and prioritisation according to risks
5. Financial issues considered.
6. Initial drawing of technical plans and schedule of works drafted.
7. Obtaining building quotations via the RHIA RMBC tendering process.
8. Obtaining planning permission (if required) and building regulations permission.
9. Grant application made.
10. Grant approval awarded.
11. Building works commence, dependent on identified builder availability.
12. Payment of contractors via RHIA, and evaluation by RHIA & the Occupational
Therapist to ensure that the disabled child’s needs are met.
Further information about legislation:
Delivering Housing Adaptations for Disabled People: A Good Practice Guide
ODPM Publications, PO
Box 236, Wetherby
LS23 7NB
Tel 0870 1226 236
www.communities.gov.uk/ - search for “delivering housing adaptations for disabled
people”
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
4.
Equipment & aids for children with learning & physical disabilities
“Occupational Therapists work with people of all ages, helping them to carry out the
activities that they need or want to do in order to lead healthy and fulfilling lives.”
(College of Occupational Therapists, 2005)
One of the ways a children’s Occupational Therapist can help a child carry out their daily
occupations is by recommending the use of specialist equipment. For some children,
having the right equipment can enhance their ability to be more independent in their
daily activities.
Caring for a disabled child can also be made easier with the use of certain equipment,
aids and / or adaptations to the home. There is a wide range of equipment available and
some of it is very expensive. This leaflet provides information about how equipment is
provided for children with learning difficulties and disabilities who live in Rochdale
Metropolitan Borough Council.
Who provides what?
 If your child has a disability that is temporary or mild then the Occupational Therapist
on Duty can provide on specialist suppliers and other services that may be able to
help. They can also provide advice on charities that may be able to help to buy
equipment that statutory services do not provide such as for leisure activities.
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

If your child requires equipment to facilitate a hospital discharge, for a temporary
impairment, e.g. following a broken leg, then the Health Occupational Therapy
Service will make recommendations and identify and provide the equipment
necessary for this. The Occupational Therapist on Duty can provide their contact
details, however most local hospital are already aware of these local arrangements
and will in most cases refer to them directly in the first instance, this also applies for
nursing equipment and wheelchairs.
If your child has a permanent and substantial disability that is impacting on their
ability to carry out their daily activities at home or at school, they may be eligible for
an assessment from a Children’s Occupational therapist. (See leaflet – How does an
occupational therapist make a difference to a child?)
The action plan that is made with the child and family might include a
recommendation to use certain specialist equipment. This might include specialist
chairs, hoists, bathing, toileting or feeding equipment. Physiotherapists also work
closely with Occupational Therapists and can provide mobility, standing and sleeping
aids.
 We can support and provide access to advice and the provision of a range of other
equipment such as IT, car seat providers, trikes and bikes and toys.
What happens after the assessment by the Occupational Therapist?
The Occupational Therapist will work with the child and family to identify their needs and
possible solutions. The Occupational Therapist can then make arrangements to try the
equipment out in the environment it will be used in, for example at home or school.
When the Occupational Therapist, child and family have agreed on the best option, the
Occupational Therapist will request funding from Children’s Services with a written
report; urgent needs can be addressed within 24-48 hours.
Once the needs and provision have been approved, the Occupational Therapist will
place the order through the children with disabilities equipment service. The children
with disabilities equipment service (which is currently delivered via Rosscare, will deliver
the equipment within the specified timeframe recommended by the Occupational
Therapist if it is standard stock, but it may take longer if it is ordered specially.
If the equipment cannot be provided, Children’s Services will ensure the family are given
the reasons why and alternatives to explore. The equipment service or Occupational
Therapist will ensure the equipment is delivered and set up correctly for the child and
provide advice and instruction on its use and care.
Is there a charge?
Equipment for children is loaned free of charge for as long as it is needed. The
appropriateness and fit of the equipment will be reviewed by the Occupational Therapy
Service on a regular basis, the frequency of this recommended by your child’s
Occupational Therapist. Any essential maintenance or checks of electrical or lifting
equipment, and most repairs are carried out by the local authorities’ designated
providers and you will be notified of these arrangements if necessary. All we ask is that
the items are kept in good working order and in a clean condition. If there is a problem
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with an item then simply contact the community equipment service (see contact
information on the stickers placed on the equipment) and they will deal with it as quickly
as possible.
Contact information
Children's Occupational Therapy Service
Services for Children & Young People with Disabilities
Floor 4,
Number One Riverside,
Smith Street,
Rochdale.
OL16 1XU.
Tel: 01706 925900 Fax: 08451904240
Children’s Occupational Therapy Service
This information relates specifically to the service provided from:
Rochdale Metropolitan Borough Council
5.
Professional standards and outcomes for disabled children:
Enjoying and achieving
Children’s Occupational Therapists:
 provide support for children, young people and their carers in developing
independence in personal care, leisure and school skills, thereby enabling their
enjoyment and ability to achieve in life
 provide advice, information and training for early years settings to promote the
development of early skills for independence in daily activities
 provide advice about equipment and adapting environments to enable children with
disabilities to access a range of educational and recreational activities
 enable a disabled child to join in with able bodied children by adapting
environments, teaching alternative activity techniques or providing adapted
equipment
Making a positive contribution
Children’s Occupational Therapists:
 encourage children and young people to be independent and value their own
strengths and abilities
 support children, families and schools to enable access to the full curriculum
 provide a range of interventions to support children and young people with learning
difficulties and disabilities to develop school and work skills
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The ‘specialist section for children, young people and their families’ can be found using
the COT website
College of Occupational Therapists
106-114 Borough High Street
Southwark, London SE1 1LB
Tel: 020 7357 6480
www.cot.org.uk