Children's Therapy Services - Occupational Therapy - St Mary's Hospital, Kettering

Our specialised therapists work within the patients’ home, school and in the wider community. We help with self-care, like eating, drinking, using the toilet, dressing and personal safety, as well as play and leisure and school participation, using classroom equipment and understanding the curriculum.

About the service

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About the service

Children's Occupational Therapists (OTs) support children and young people to be independent and maintain their skills.

We are child-centred in our approach while working closely with the family and the team around the family.

We understand that each child and young person is different and has unique desires and dreams. Our role is to support them to reach their full potential through the changes that come with growing up.

As OTs we pride ourselves on our problem-solving approach to enable children and young people to identify and overcome any barriers to participating in day-to-day life.

We may make suggestions for:

The child – helping to develop skills for everyday tasks by providing advice, strategies or a programme of support

The environment – for example, table height or the type of seat used when handwriting

The task  breaking down the steps or suggesting special equipment, such as lightweight, ergonomically designed cutlery or self-opening scissors

Make a referral

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Make a referral

The Children's Occupational Therapy service accepts referrals from:

  • GP
  • Healthcare professional (e.g. health visitor, school nurse)
  • Education
  • Social care
  • Voluntary sector

Please note that we cannot accept referrals from parents or carers.

Referrals can be made via the Referral Management Centre (RMC).

For children and young people referred via the motor coordination pathway, we require a completed Children's Occupational Therapy School Questionnaire[pdf] 630KB attached to the RMC referral. Referrals cannot be accepted without a completed questionnaire.

Referral criteria

  1. Children / young people aged 0-19 years
  2. Consent from the person with parental responsibility
  3. Pre-school child or in full-time statutory education
  4. Registered with a Northamptonshire GP
  5. Children / young people with complex, severe or enduring physical and/or developmental condition that is significantly affecting their ability to achieve their potential in terms of activities of daily living

If a child is not registered with a Northamptonshire GP, even if they are resident within Northamptonshire or go to a Northamptonshire school, an extra-contractual referral agreement may be required, so please liaise directly with the service for advice.

Looked-after children placed in Northamptonshire, or Northamptonshire children placed elsewhere, may be seen where practically possible, so please liaise directly with the service for advice.

If the primary occupational therapy concern is related to their learning disability, please liaise with Children’s Occupational Therapy service and the Children's Community Team for People with Learning Disabilities (CTPLD) to clarify.

What information is needed when you make a referral?

  • Child and family details
  • Parental consent
  • The nature of the problem with examples of difficulties
  • How long the problem has been apparent
  • What has been done so far to address the issue(s). For school-age children, please attach any relevant EHCP
  • How the problem is impacting on the child or young person in their environment

Exclusion criteria

  • GP outside of Northamptonshire
  • Young people aged over 19

What will happen next?

  • Referrals will be reviewed by the children and young people's Referral Management Centre (RMC) via an initial clinical screening
  • The RMC will contact the referrer, Parents/Carers or School if further information is required
  • For those referrals not accepted into the service, the referrer should expect a letter
  • Parents / carers / young people accepted into the service will receive a letter or telephone call from Children’s Occupational Therapy service with an appointment

Services we do not provide

Services we do not provide

Services not provided by Children's Occupational Therapy

Wheelchairs

Children's Occupational Therapy does not provide wheelchairs.

For more information about eligibility for a wheelchair, please visit the Blatchford Northamptonshire Orthotic and Wheelchair Services NHS Clinic website or download the Blatchford Northamptonshire Wheelchair Service Q&A leaflet.

Sensory assessments

Children's Occupational Therapy is not commissioned to provide sensory assessment.

Sensory assessment would need to be accessed via independent sector healthcare providers.

For more information about accredited sensor assessment providers, please visit the Royal College of Occupational Therapists website.

Sensory-based advice and support for neurodiverse children

Children's Occupational Therapy will offer sensory-based advice to neurotypical children who have significant difficulties with everyday functional skills.

For neurodiverse children, and children who are on the pathway for autism spectrum disorder or ADHD, there is a countywide agreement in place for SEND support services to provide this support.

Major housing adaptations

For all major housing adaptations (for example, extensions, wetrooms, permanent ramping) a referral to Community Occupational Therapy is required.

Hand therapy and splints

Children's Occupational Therapy does not prescribe splints. Splints can be accessed via Hand Therapy services or via Blatchford Northamptonshire Orthotic and Wheelchair Services NHS Clinic.

Car seats

Children's Occupational Therapy does not assess for or provide children's car seats.

For more information about national car seat laws, please read the government guidance.

If your child requires a specialist car seat because of their condition, there are centres that can offer assessments, including:

Often specialist car seats come with a high price tag. For those families who cannot self-fund, there are many charities that you can apply to for funding support, including:

Buggies and pushchairs

Children's Occupational Therapy does not offer advice on or prescribe buggies or pushchairs.

There are various showrooms around the UK that offer the ability to trial buggies, including the Mobility Aids Centre.

Buggy companies will often offer an assessment of their products at your home if you reach out to them.

Specialist buggies often come with a high price tag. For those families who cannot self-fund there are many charities that you can apply to for funding support, including:

Seating for learning

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Seating for learning

It is important for all children to sit properly when writing. Being seated properly gives a child good stable posture to develop their fine motor skills and handwriting. A well supported trunk is essential for good shoulder control.

Children who have difficulty with their movement can find it very difficult to sit comfortably or with stability. It is even more important for these children to get their posture right to help them develop their handwriting.

The ideal sitting position

A child should be able to sit with their bottom at the back of the chair with approximately two fingers' width between the back of their knees and the edge of the seat.

The child should be able to place both feet flat on the ground and be sitting up straight, creating the “90°, 90°, 90°” posture. The desk needs to be at the child’s elbow level with forearm flat on the table.

A child seated at a classroom table demonstrating the ideal 90 90 90 seating position with a straight back and upper and lower legs at right angles

An illustration of the ideal “90°, 90°, 90°” sitting position

Basic seating checklist

  • Is the child's bottom back in the chair?
  • Are the child's feet touching the floor?
  • Is the child able to sit upright without support?
  • Is the child about to sit long enough for them to engage in activity?
  • Are there arm rests to the chair?
  • Is the desk or chair roughly at elbow height when the child is sitting at it in their chair?
  • Is the child propping themself up when in a seated position?
  • Does the child spend a lot of time fidgeting?
  • Is the child's body weight evenly distributed?

Solutions

Once the problem has been identified, it is worth trying out the following:

  • A different sized chair or table to see whether this helps improve the child’s posture
  • A small foot stool if a smaller chair cannot be identified to support the child’s feet and improve their stability
  • A small cushion behind the child’s back if the chair depth is too great
  • Checking that appropriate footwear is worn, fits properly and provides good support
  • Ensuring glasses are worn if needed for short-distance vision (writing, reading and other tabletop tasks)
  • Providing opportunities for the child to practise some core strengthening exercises, such as bridging, high kneeling / side sitting, balancing on a therapy ball, animal walks
  • Providing opportunities for regular changes of position and movement breaks during long periods of sitting
  • Encouraging the child to review their posture regularly, particularly at the beginning of a task. This can be a verbal or visual prompt (such as a photo of them sitting with good posture)

Equipment to support good posture

Please note that the products and organisations listed here are provided for illustrative purposes only. NHFT and the Children's Occupational Therapy Service have no affiliation with any of the companies mentioned and alternative suppliers are widely available.

Chairs and tables

Writing slopes and wedge cushions

For children who lean over a table, the following posture aids may be helpful to try:

Inflatable cushions

Inflatable cushions create instability (a wobble) encouraging the core muscles to work, imrpoving posture and core stability.

The wedge shape tilts the pelvis forward to reduce stress on the lower back and prevents slouching.

The wobble effect also makes sensory-seeking children focus on how they sit, reducing fidgeting and helping to improve focus on the task in hand.