Children's Occupational Therapy

Community 

Children on a community caseload are those with a defined physical disability or developmental delay who will require longer-term input to support skill development and postural and equipment needs. While children with very complex needs will remain on a community caseload for the duration of their childhood, most children will have episodic occupational therapy input. This may include targeted programmes tailored to the child's needs. These might be implemented at home and nursery or school. Once therapy goals are met, they may be discharged but can be re-referred at a later date.   

Outpatients 

Children on an outpatient caseload have less complex physical needs. Most commonly these children have fine motor difficulties such as handwriting, tying shoelaces or using cutlery.

After the referral is triaged, an initial telephone call consultation may take place with parents to clarify the child's difficulties and agree on what matters the most to both the child and parent. In the clinic appointment, the occupational therapist will assess the child's difficulties. After the appointment, the occupational therapist will write up an individualised report with advice and recommendations which is sent to the family, referrer and school. Depending on the child's needs, they may be discharged, be offered up to 4 therapy sessions with an OT or OT assistant, or be offered a review appointment.

Developmental Coordination Disorder (DCD) clinic

DCD clinic is part of a diagnostic pathway for children who may meet the criteria for a diagnosis for developmental coordination disorder (gross and fine motor difficulties). This requires involvement from a medical doctor and therapist. In the therapy assessment, children receive a thorough two-hour standardised assessment of both fine and gross motor skills. This assessment is undertaken by both an occupational therapist and a physiotherapist. 

Following assessment and a written report, families and schools are invited to a feedback session to discuss the therapy recommendations. The report is shared with the medical referrer and the child is discharged from our therapy services.

Online training

We offer regular online training workshops for parents and education staff. These include workshops on practical strategies to manage sensory processing difficulties in daily life and handwriting for schools.

Upper limb Clinic

Children with a diagnosis of cerebral palsy hemiplegia are invited to an annual (or 6 monthly if under 6) clinic appointment to measure their upper limb ranges of movement. This informs our interventions and therapy recommendations and allows us to monitor ranges of movement to highlight any change. We will liaise with orthopaedics if there are any areas for concern. They may consider medical intervention to support function or reduce pain. 

Children referred to Occupational Therapy must be:

• Aged 0-18 (For young people in the transition process.  We will discuss and agree on the most appropriate arrangements for service provision.)
• Registered with a North Derbyshire GP
• Have consent for a referral from a person with parental responsibility, and/or from the young person where appropriate. 

We accept referrals for:

• Assessment of and advice for fine motor difficulties affecting age-appropriate participation or independence in daily living activities (e.g. buttons and fastenings), school activities (e.g. mark making and handwriting, tool use) and play.
• Assessment, advice and provision of specialist equipment for children with postural needs (i.e. specialist seating).
• Assessment, advice and provision of adapted equipment (if relevant) for daily living tasks (e.g. bathing, toileting, dressing, using cutlery).
• Early support and positioning advice for young children and babies presenting with delayed development.

Depending on the complexity of a child’s diagnosis or presentation they will be supported through different pathways. This will affect the setting where a child is seen and the length of time they are kept on a caseload (see services offered above).

Please email completed referral forms to: crhft.childrens.therapies@nhs.net.

*Please take the time to read the relevant referral criteria below before making a referral. If you have any queries about whether the referral you want to make is appropriate, please ring us to discuss before making the referral.

Referrals we cannot accept:

Referrals will not be accepted for children whose:

• Self-care skill level, fine motor or functional skills are in line with their overall developmental level or their chronological age
• Difficulties arise primarily from behavioural or sensory issues (i.e. request for sensory assessments or behaviour management strategies)

Referrals for wheelchairs should be made directly to AJM Healthcare who are the providers for Derbyshire Wheelchair Services. Visit the Derbyshire Wheelchair Service website for more information.

Referrals for structural adaptations in the home environment are provided by Occupational Therapists working in social care (i.e. for provision of level access shower, stair lift, downstairs bedroom). If you have any queries you will need to self-refer to Social Care OT via Starting Point.

Referral form for Health and Medical Professionals

SENCos can now refer directly to Children’s Occupational Therapy about difficulties observed within the school setting, which impact a child’s ability to develop and participate in daily school activities e.g.

• Difficulty with mark–making, drawing, or handwriting.
• Difficulty using tools in the classroom, e.g. scissors, food technology, design and technology.
• Dressing difficulties at school (as appropriate for age), e.g. when changing for PE, toileting or playtime).
• Difficulty managing equipment and using cutlery at dinner time (as appropriate for age).
• Difficulty managing self-care tasks at school, e.g. washing hands and bottom wiping.

Referrals we cannot accept:

Referrals will not be accepted for children whose:

• We cannot accept referrals from SENCOs for specialist postural equipment. 
• Self-care skill level, fine motor or functional skills are in line with their overall developmental level or their chronological age
• Difficulties arise primarily from behavioural or sensory issues (i.e. request for sensory assessments or behaviour management strategies)

Referrals for wheelchairs should be made directly to AJM Healthcare who are the providers for Derbyshire Wheelchair Services. Visit the Derbyshire Wheelchair Service website for more information.

Referrals for structural adaptations in the home environment are provided by Occupational Therapists working in social care (i.e. for provision of level access shower, stair lift, downstairs bedroom). If you have any queries you will need to self-refer to Social Care OT via Starting Point.

Please read further information about SENCo referrals before making a referral.

Referral forms and information

• SENco Referral Supporting Information
• Special School Referral Supporting Information
• Referral form for SENCo and Special School

Many Children who have previously received input from Occupational Therapy for extended periods of time on a community caseload, can now be re-referred to occupational therapy by parents or carers.

Parents of children who have accessed services as outpatients are welcome to seek a re-referral for their child via any relevant health professional but cannot make a self-referral for their child at this time.

*Parents of eligible children will have been notified of their child’s discharge report.  

Parents can self-refer after a minimum of 6 months since discharge from the previous episode of care, to give time to consolidate any intervention and advice given, unless there has been a significant change in circumstances such as transition to a new school setting, moving home or new functional challenges.

Reasons parents may wish to re-refer to Occupational Therapy:

• Difficulty drawing, mark-making or handwriting
• Difficulties with dressing, as appropriate for age
• Difficulty managing equipment and using cutlery at dinner time (as appropriate for age)
• Difficulty making a snack
• Difficulty managing self-care tasks (e.g. bottom wiping, washing hair and body)
• Minor equipment to improve transfers and access to bathing and toileting facilities
• Changes in seating/postural needs at school or home

Please read further information about parent re-referrals before making a referral.

Referral forms and information

• Supporting Information 
• Parental/Carer Referral form

Referrals from medical doctors only (e.g. paediatrician, GP or school doctor).

DCD can be regarded as an umbrella term which covers motor coordination difficulties (gross and fine motor) and can include dyspraxia (difficulties with planning, organising and carrying out functional activities).

The DCD clinic is a joint physiotherapy and occupational therapy assessment which is part of the diagnostic pathway. Only medical doctors can refer to the DCD service. Following standardised assessment, they will be provided with a report and information which should be used as evidence to aid or eliminate a diagnosis of DCD.

Referrals will only be accepted if children meet the criteria for assessment in the DCD service (see information pack) and the correct process and paperwork are used (see below DCD referral form and parent and school questionnaires).

Please read the DCD supporting information pack prior to making a referral.

Referral Forms

For referrals to be accepted, all three forms below need to be completed and enclosed.

• DCD Referral Form
• School Questionnaire 
• Parent Questionnaire

DCD clinic is a one-off assessment as part of a diagnostic process. A referral can be made to children’s occupational therapy using the blue form after a minimum of 6-9 months for new functional challenges at home or school.

_{*Please note that our school training is for schools in the North Derbyshire area. Our services cover North Derbyshire (including High Peak, Buxton, Chesterfield, Bolsover, Alfreton, Clay Cross, Matlock, Dronfield and Shirebrook).}

_{Pre-Writing Training (online)} 

Aiming to support school staff by considering what foundation skills are important and exploring activities that can be used to support the development of physical pre-writing skills.

TBC

^{Primary Writers Training (online)} 

Aiming to support school staff by considering different types of handwriting difficulties that may be seen in a primary classroom and exploring practical strategies that can be used to support and improve physical writing skills. 

TBC

DCD (Developmental Coordination Disorder) and Dyspraxia in Schools

Face-to-face training aimed at staff working in mainstream school settings. The training will outline what DCD and dyspraxia mean and the kind of difficulties they might have at school. It will explore strategies for school staff supporting children with DCD or dyspraxia to learn and take part in physical and practical subjects. There is one training session for Primary School Staff and one for Secondary School staff. Please click on the relevant link below to sign up:

Primary Schools- further dates TBC

Secondary Schools- further dates TBC

This video gives an introduction to children's different senses and considers how they use these to function in daily life. The video gives a basic understanding of sensory processing and suggests general strategies to help support a child's sensory processing needs.  

For professionals

There is a Derbyshire Local Area Approach to meeting children and young people's sensory processing needs (SPN).  All professionals who work with children and young people in Derbyshire can access training and resources to help identify and address SPN in their setting.  This video is a presentation that gives further information about this, in particular the Sensory Processing Needs Toolkit.