Children's occupational therapy and physiotherapy

Paediatric Occupational Therapists are part of the multi-disciplinary medical team that can work with your child to promote their best level of development and achievement in school and at home, in leisure pursuits and in their social skills.

The Occupational Therapist (OT) will assess your child to find out what their needs are, and in what way they can be supported. The assessments used are a mixture of tests which are standardised against the performance of many other children and clinical observations of their performance.

The Occupational Therapist aims to develop independence in every day tasks, which may often mean working alongside our physiotherapy colleagues.

We also work to improve daily living skills such as eating and dressing. Sometimes the Occupational Therapist advises on the use of equipment to make a task easier for your child, and this could be anything from using a special piece of cutlery, to large pieces of equipment such as a bath seat to help get into the bath safely and independently.

If you would like more information about Occupational Therapy with children, visit the website of the Royal College of Occupational Therapists.

Physiotherapy aims to help and treat children and young people with physical problems as well as providing support to their families and carers.

Physiotherapists support and young people who have difficulty with movement and treat short and long-term conditions that impact on physical development, activity and their ability to participate in play, learning and socialising.

Following an assessment, physiotherapy programmes are devised in collaboration with both the child/young person and their family/carer.  Treatment is incorporated into simple everyday activities.  Advice and training are provided so that the family can help and encourage the child to practice their physiotherapy programmes.

We work with the child/young person, their family and Health and Educational colleagues to encourage each child to get the most out of their lives and fully develop their potential, from birth to the time they transition to adult services.

Movement difficulties may be to to a range of conditions, which may include but is not limited to:

• Cerebral Palsy
• Development Delay
• Developmental Co-ordination Disorder
• Neuromuscular Conditions
• Acquired Brain Injury
• Down's Syndrome.

Both qualified Physiotherapists (PTs) and Technical Instructors work within the service.  Initial assessments are always carried out by a qualified PT.  You may receive further assessment and intervention by a PT or Technical Instructor depending on your need. 

If you would like more information about Physiotherapy with children, visit the Association of Paediatric Chartered Physiotherapists website.

The Early Years team are based at the Ronnie Mackeith Centre at Royal Derby Hospital. They see children from 0 to 2 years old. If support is still required beyond this age, a child will normally transfer to the Community Therapy team – details below.

What do the therapists do?

Your therapist will work with you and your child and the wider team, to enable you to help your child achieve their potential at home, school and during play.

They will give you therapy activities to practise at home in addition to the work done in sessions. They rely on you to provide information and feedback about any difficulties or successes in carrying out the advice so that their help can be as effective as possible.

The therapists may suggest and provide equipment to help your child reach their potential.

How often/long will my child need to see the therapist?

This will depend upon the individual needs of your child.

Referrals to the service

Most referrals to the physiotherapist or occupational therapist come from the hospital paediatric consultants, community consultants, health visitors, or other therapists. Once the referral has been received the initial appointment will be offered as soon as possible. The timescales will depend upon the nature of the concern and the demand on the service at the time.

Find details about the referral process on our referrals page. 

Our Community Paediatric Therapy Team works with children from the ages of 2 to 18 years old. Children are seen in various settings including clinics, nurseries, schools and at home. 

In particular the team work closely with mainstream schools and special schools.

Mainstream schools

In mainstream schools, our therapists work with:

• Children and young people who have a physical disability – often your child may have been seen by the Early Years team first (see above). However if you are new to Derby and southern Derbyshire, or if your child has developed difficulties later than the age of five, your assessment with the team may be the first time you have come across occupational therapists and physiotherapists.
  
  You will have the opportunity to discuss short-term and long-term therapy plans, and how often your child is likely to be seen. If your child has splints or other specialist equipment, these will require regular review and update. Although every effort is made to review your child appropriately, we rely on parents and – where able – the young person themselves to let us know if there is a problem with splints, such as them being uncomfortable and not fitting well. Your therapist will make sure you have contact details to keep us updated of any changes.
   
• Children and young people who have coordination difficulties – parents, carers or school staff may identify that a child is having specific difficulties with coordination; difficulties that would not be expected for their age. This may be seen in a variety of ways including problems in PE, handwriting issues, handling small items with care, frequently tripping or falling over, learning to dress, using cutlery or managing the toilet. When progress is a concern, and attempts to manage these difficulties have not been successful, referral to the paediatric therapy team may be appropriate.
  
  Referral is made via a paediatrician (a children's doctor) or school SENCO (special educational needs co-ordinator). Once your child has been allocated a therapist, they will contact you with details of your appointment. You will be asked to come to a clinic, or your child’s school. Occasionally, the therapist will ask to come to see you at home for this initial appointment, if they feel that this is the most appropriate place for your child. For the first appointment, it is necessary that a parent or legal guardian attends with your child as we need to hear about your concerns and needs for your child.
  
  An Occupational Therapist and a Physiotherapist usually work together to assess your child’s development and coordination. Your child will be encouraged to feel at ease, and activities will be graded to ensure that they can achieve most of what is required.  It is a good idea to talk to your child about the assessment beforehand, explaining that we are here to find out what is hard for them, and also find out what they are good at too. We will provide you with advice to help your child overcome their difficulties along with a treatment programme, if appropriate, to be delivered at home and school.  The appointment usually takes 1 – 1 ½ hours.

Children in mainstream schools will, if appropriate, transfer to the Young Adult Team (transition begins at the age of 14)

Special schools

Our therapists provide a specialist health service in the following schools:

• Alfreton Park Community Special School, Alfreton Park, Wingfield Road, Alfreton, Derbyshire DE55 7AL 
• Bennerley Fields School, Statford Street, Ilkeston, Derbyshire, DE7 8QZ 
• Brackenfield Special School, Bracken Road, Long Eaton, Nottingham, NG10, 4DA
• Ivy House School, Moorway Lane, Derby DE23 2FS
• St Andrews School, St Andrews View, Breadsall Hilltop, Derby DE21 4EW
• St Clare's School, Rough Heanor Road, Derby, DE3 9AZ
• St Giles School, Hampshire Road, Derby DE21 6BT. 
• St Martin's School, Bracknell Drive, Derby, DE24 0BR
• Stanton Vale School, Thoresby Rd, Long Eaton, Nottingham, NG10 3NP.

Children in special schools will transfer to the Adult Learning Disability Team (from the age of 19). 

Referrals to the service

Find details about the referral process on our referrals page. 

The Young Adults team works with young people from the age of 14 -16 years old who require further physiotherapy input and support up to the age of 25.

This service is provided to bridge the gap between paediatric and adult services. Our aim is to support you as much as possible throughout your time in the service to promote independence and self-management of your disability. 

How will you support me?

The team will…

• Work with you to help you to achieve the lifestyle you want by encouraging self-management of your health needs
• Help to maintain and improve your physical abilities with an exercise programme
• Helping you to access leisure/sports facilities
• Help you recover after surgery or an injury
• Advise on any equipment necessary to help you to become independent
• Liaise and refer to other professionals and agencies to ensure you receive appropriate support/treatment, such as referrals to orthotics and occupational therapy
• Provide medical advice.

How do you work?

• We are based in the community. We can see you at home, school, college, work or any other agreed place of your choice
• We offer clinic appointments at Royal Derby Hospital and community health centres
• Working as part of a team, we will assess you and provide you with advice and/or treatment to meet your needs
• We work closely with other services to help support you in all areas of your lifestyle including accommodation, independent living, leisure, work and college.                       

Transition into the Young Adults service  

If you are being supported by the Community Paediatric Therapy Team and attend a mainstream school, discussions will begin when you are 14 about what further services you need after leaving school. The transition into the Young Adults team is a gradual process involving joint working between therapists until you are 16 years old.  At the age of 16, your care will transfer over to the Young Adult Team who will continue to support you until you are 25 years old.

Referrals into the service

Referrals are accepted from GPs, Consultants, Paediatricians, Paediatric Therapists and Social Care for young people with a physical disability. For young people with both a physical disability and a learning disability, the Learning Disability Team may be a more appropriate service.

Referrals can be made via either a letter or the service specific referral form.  All sections must be completed and returned to: Community Therapy Team – Admin Team, St Pauls House, Jubilee Business Park, Enterprise Way, Derby, DE21 4BB.

Tel: 0300 123 4586 (Option 2, option 5)