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Children's Occupational Therapy Liverpool City Council

Coronavirus update:

The Children’s Occupational Therapy Team is offering a service to our families during the current Corona Virus Pandemic which is in-line with social distancing advice from the Government. This means that face to face appointments are significantly reduced and will be considered on a case by case basis. All work delivered by the service is being prioritised based on risk of harm to children, young people and their families. A significant amount of our support is currently being provided remotely. Any changes to service delivery will be made in line with Government recommendations. We continue to accept referrals to the service. 

Please note: SPD awareness sessions are being delivered as webinars, to find more information relating to this please see the flyer located in the documents section titled "Addvanced Solutions Online Training" here you can find dates and booking information. 

 

 

If you have any questions about appointments, referrals or support please email chot@liverpool.gov.uk or call Careline on 0151 233 3700. Due to a high level of demand we may be slower than usual to respond to enquiries. All enquiries will be dealt with on a priority basis.

If you have an appointment and you or your child is displaying symptoms of Coronavirus (temperature and/ or new and persistent cough) please do not attend your appointment and contact 0151 233 5989 OR chot@liverpool.gov.uk and we will rearrange your appointment.

Who we are:

The Children's Occupational Therapy (OT) team is a community based service for children and young people who live in Liverpool. We pride ourselves in working across Education, Health and Care sectors to support children from 0 – 18 years of age.  The service aims to promote independence and inclusion at home, nursery, school, or short breaks settings.

The Occupational Therapists assess children aged 0 - 18 who are experiencing functional difficulties with everyday tasks due to a disability or special educational needs.

Difficulties may include:

  • self-care – such as bathing, toileting 
  • independence skills – such as using cutlery, dressing
  • school activities - using scissors, changing for PE classes
  • play activities
  • co-ordination difficulties
  • sensory difficulties

What we do:

Following a referral and assessment the occupational therapist can help to find ways to enable children to participate in activities necessary for life at home, school and play.

Assessment of the home and school environment

If a child is experiencing difficulties with accessing home or school the OT can:

  • assess your child and their home and/or school environments to identify any barriers to your child participating in family and school life.  This includes children with physical disabilities and those with a decreased awareness of danger
  • recommend ways in which the physical environment can be changed to enable your child to move around the home, get to their bedroom and bathroom, use the toilet or bath or access their school setting 
  • make recommendations about equipment that will help you and your child to carry out everyday activities 
  • support your child with transition to a new school setting by providing advice to the new school on how to reduce physical barriers to learning

Assessment of sensory-motor needs

If a child is experiencing difficulties with motor co-ordination and independence skills the OT can arrange an assessment at our clinic base.  Depending on the child’s needs identified at the assessment the family will either be offered advice or a block of therapy sessions.  The OT will discuss what’s important to the child and family and agree on goals to work towards.

The OT will give advice about:

  • Fine motor coordination skills
  • Visual perception
  • Independence skills such as dressing and feeding
  • Developmental activities
  • Use of compensatory aids and equipment to promote independence
  • Upskilling parents and professionals

Clinic base:  appointments are offered at the Royal School for the Blind, Church Rd. North Wavertree, L15 6TQ

If your child is struggling with activities of daily living please see the attached resources that can be tried at home and school without an OT assessment. (Please note: do not complete any of the activities if you have been advised against this by a medical practitioner, for example if the child has been given advice about joint protection.)

How do I request an Occupational Therapy assessment?

For a home or school environmental assessment:

Requests for assessment of the home environment can be made by parents and carers.  The service can be accessed by making a request for an assessment through Careline.  Parents and carers should contact Careline on 0151 233 3700 to make a request by telephone.

Requests for assessment of the home and school environment can be made by education, health and social care professionals.  They should complete the Request for Occupational Therapy Form and forward to Careline.  This can be faxed on 0151 233 3700 or posted to Careline, Venture Place, Sir Thomas Street, Liverpool, Merseyside, L1 6BW.  Parents should be asked for their signed consent before making a request.

Referral criteria for home and/or school environmental assessment:

  • The child or young person must be under 18 years of age and live in the Liverpool city catchment area;
  • The child must have a physical or neurological condition which is significantly and persistently impacting on their ability to access their home and/or school and using essential facilities such as getting in and out of the property or school, accessing a bedroom or bathroom, using a toilet and washing facilities.

For an assessment of sensory-motor needs:

Professionals should complete the Request for Occupational Therapy Form and forward to Careline.  This can be faxed on 0151 233 3700 or posted to Careline, Venture Place, Sir Thomas Street, Liverpool, Merseyside, L1 6BW.  Parents should be asked for their signed consent before making a request.

If you are a parent and feel that an assessment is required for motor co-ordination or self-care please speak to the child’s SENCO, School Nurse, GP, Community Paediatrician or Physiotherapist.  There may be things that can be put in place or tried first before a requesting occupational therapy involvement.  Parents and school should trial general strategies for at least 3 months prior to making a referral.  Please refer to the advice leaflets in the documents section of this page for further ideas and guidance. 

Referral criteria for a sensory-motor assessment:

  • The child or young person must be under 18 years of age and be registered with a Liverpool GP;
  • The child or young person must be experiencing a difficulty that significantly and persistently impacts on their ability to participate in activities of daily living.  This may include but is not limited to washing, dressing, feeding and toileting.

 Please Note:

It is highly recommended that parents attend a Sensory Processing Awareness session before making a request for a sensory-motor assessment if any of the following are a concern for their child:

  • Sensory processing
  • Attention and concentration
  • Behaviour
  • General developmental delay

What happens after a referral has been made?

The referral is triaged to work out if we are the best service to offer help

  • If the referral is accepted then we make a decision about the level of need using our triage tool
  • The timescales to the first assessment are:
  •  Priority referral – we aim to see the child within 9 weeks
  • Routine referral – we aim to see the child within 18 weeks

Please note:  We are currently experiencing high levels of demand for sensory-motor assessments and the waiting times are approximately 25 weeks at the moment.

In Liverpool there are two occupational therapy teams so who do I refer to?

The two occupational therapy teams in Liverpool have different responsibilities. 

The Liverpool City Council OT Team sees all children apart from pre-schoolers who aren’t attending a nursery.

  • The Alder Hey OT Team see in-patients and out-patients in the hospital setting, they also see children under 2 years of age who aren’t in a nursery setting.  

How do I get some advice or find out more about referring to the service?

There is a Duty OT available in office hours Monday to Thursday from 8.30am to 4.45pm and Fridays 8.30am to 4.15pm (excluding Bank Holidays) on 0151 233 5989 or by email to chot@liverpool.gov.uk

If you would like to know more information about Occupational Therapy please visit the RCOT website.

 

What if my child has Sensory Processing Difficulties? 

The Sensory Processing Difficulties (SPD) Offer

For children with sensory processing difficulties a referral is not required to access support. We offer a graduated response in partnership with ADDvanced Solutions.  

  • We advise parents to attend a Sensory Processing Difficulties (SPD) Awareness session with ADDvanced Solutions.  They can be contacted on 0151 486 1788 and at http://www.addvancedsolutions.co.uk  

  • We also offer alternative SPD Awareness sessions for parents where their child is under 5 years of age.  These are held at Children’s Centres across the city.  See attached poster for dates and venues.  Parents need to contact the Children’s Centre to book a place.
  • Once you have attended an SPD Awareness Session they can book onto an SPD Strategy Workshop with one of our Sensory Integration Advanced Practitioner Occupational Therapists.  This is a two and a half hour practical session for parents to learn how to implement the practical strategies which they have learnt about in the previous awareness session. During the workshop you will have the opportunity to try specific strategies, and explore resources which might be helpful for your child. Following this session parents can take the strategies away and try them at home.

  • Parents are advised to try the strategies for three months. Then if they find they aren't working can call the team for advice on 0151 233 5989. Here you may be offered a telephone consultation, where additional strategies may be given.
  • We also offer a two day Understanding SPD and Eating Difficulties course in partnership with ADDvanced Solutions for parents and professionals.  This can be booked directly with them on 0151 486 1788
  • Professional awareness sessions are carried out in partnership with ADDvanced Solutions.  Professionals should contact them directly on 0151 486 1788 to book onto these.

How do I get a Sensory Processing Assessment for my child?

We are unable to routinely offer assessments for all children with SPD.  However, following a telephone consultation with the OT, if your child's needs meet the criteria below the OT may consider making a referral into the SPD service for further support.

Referral criteria:

  • The child or young person is under 18 years of age and is registered with a Liverpool GP;
  • Parents have attended a Sensory Processing Difficulties Awareness Session and a Strategy Workshop.  

  • Parents have tried the strategies advised by the OT for at least three months and the child continues to present with sensory processing difficulties that significantly and persistently impacts activities of daily living and academic achievement AND there is a significant risk of: family breakdown, or exclusion from school, or harm to self or others.

What happens next?

If the referral is accepted the OT will give further advice and strategies and may offer short term targeted support.

 

 

 

“What is Occupational Therapy?”

The Children's Occupational Therapy team is a community based service for children and young people who live in Liverpool.  We work across Education, Health and Care sectors to support children from 0 – 18 years of age.  The service aims to promote independence, to enable the child or young person to do the things that they want to do and support them to reach their potential.

Occupational therapy enables people to participate in daily life to improve their health and wellbeing.  Daily life is made up of many activities (or occupations).  Occupations for children or young people may include:

  • Self-care - getting ready to go out, eating a meal or using the toilet.
  • Being productive - attending nursery or school.
  • Leisure - playing with friends or doing hobbies.

If your child experiences difficulties in these areas, Occupational Therapy may be able to help.

If you are considering a referral to the Children’s Occupational Therapy Team please check out our When to Refer to OT flow chart.

“My child struggles to do everyday things that their friends or siblings can do.”

If your child is struggling with activities such as dressing themselves, using cutlery or wiping their bottom please read the handouts below.  There are lots of advice and strategies which you can try with your child.  Use the Activity Chart to monitor their progress.  This can be a really useful tool to the therapist if you do refer to OT at a later date.

Dressing skills

Dressing skills for younger children

Toileting skills

Tying laces

Cutlery skills

Handwriting

Handwriting fatigues and pain

Pre writing

Scissor skills

Activity Chart/Log

 

Our Sensory Motor Resources List has lots of cost effective ideas for supporting your child’s difficulties and the best places to buy them.

Talk to your child’s school about the support that they receive and what strategies can be put in place there.  If, after trialling the advice and strategies in the above handouts, your child’s difficulties continue, they may benefit from a referral to the Children’s OT Sensory Motor Service.

Parents and carers can refer into the service by completing the online referral form or by calling Careline on 0151 233 3700.  We ask that professionals use the online referral form.

If your child’s difficulties are with gross motor activities such as running, hopping or riding a bike please contact Liverpool Community Physiotherapy for support by calling 0151 438 2090.

If your child’s difficulties are with continence we advise that you speak to your school nurse or health visitor. They will be able to make a referral into the Children’s Community Bladder and Bowel Service if appropriate.

“My child needs support with handwriting.”

If you are concerned about your child’s handwriting e.g. they struggle to hold a pencil, their writing is difficult to read or they feel pain when writing, please speak to their school about these concerns. Ask the school what support and strategies can be put in place to support your child’s difficulties.  There may already be things in place to support your child.  School may suggest things that you can continue at home to help with your child’s progress.

Before Children’s Occupational Therapy can offer support, we first expect their school to carry out activities to help with their handwriting difficulties.  This may include giving handwriting “homework” activities to complete with you at home.

Read through the handouts below, they will help you to notice what parts of handwriting your child finds hard and how you can help them to improve.

<Below will be links to downloads>

Developing Pre Writing Skills

Developing Handwriting

Handwriting – Managing Fatigue and Pain

 

If you are a teacher or other professional making a referral for handwriting difficulties please ensure that the child’s school has implemented handwriting interventions with the child regularly, aiming for three times per week for at least one term, before referring to the Children’s OT Service.  If little or no progress is made following the school’s intervention then a referral can be made. Please ensure you include details of what you have tried in the OT referral.  We may ask for evidence of the handwriting intervention.  This helps the Therapist to identify the best intervention for the child or young person.

Parents and carers can refer into the service by completing the online referral form or by calling Careline on 0151 233 3700.  We ask that professionals use the online referral form.

“My child really struggles with attention and concentration and/or has ADHD which is impacting significantly on their life.”

If your child struggles to focus and concentrate at school, we suggest that you trial strategies from our Attention and Concentration handout.  Speak to your child’s school to see what they can put in place.  Making small changes to your child’s routine can be easy and can make a big difference to their attention and concentration.  This works best when strategies are being carried out regularly throughout the day both at home and in school.

If you feel that your child’s attention difficulties continue to have a significant negative impact on their learning and participation in daily activities, discuss this with your GP.  We also recommend that parents contact the Liverpool ADHD Foundation who offer a Skills Building Programme for parents. The child does not need to have a diagnosis. Contact details are below:

Link: ADHD Foundation Website

Email: itsneverdull@jaynemooremedia.com

Tel: 0151 237 2661

<Link to Understanding and Supporting your child’s ADHD doc from ADHD Foundation>

If your child has a diagnosis of ADHD, it is important to remember that this is a lifelong condition. The goal of strategies is to help them to participate in daily activities rather than “treat” their ADHD. If you feel that your child’s attention difficulties are having a significant negative impact on them learning and playing, you may consider raising this with the Alder Hey ADHD Service for further advice.

Please see link to the Alder Hey ADHD webpage which also has some really useful handouts for parents, young people and schools:

“My child has sensory processing difficulties which are impacting on their participation in everyday activities.”

If your child experiences the following, and this results in a big impact on their life:

  • Difficulties concentrating in school
  • Cannot sit still and fidgets a lot
  • Struggles with food textures, tastes or smells and has a limited diet
  • Has difficulty wearing certain textures or dislikes tags and seams
  • Experiences regular meltdowns
  • Struggles to manage their emotions

This may be an indication that they have Sensory Processing Difficulties.  Support for parents of children with Sensory Processing Difficulties is accessed through Sensory Processing Difficulties Awareness Sessions and Workshops.  

These sessions are being delivered virtually using the platform Zoom.  Please contact Addvanced Solutions via telephone 0151 486 1788 or email info@addvancedsolutions.co.uk to book onto the sessions. You can view Addvanced Solutions confirmed Summer Training Dates here.

The pathway for support is outlined below.

<PICTURE OF THE PATHWAY>

Please note: a referral to the Children’s OT Team for sensory processing difficulties support is not required, and will not be accepted.  Step up for support must come via the pathway above.

Please also check our short videos on understanding and supporting Sensory Processing Difficulties.

Our Sensory Processing Resources list has lots of cost effective ideas for supporting your child’s sensory needs and the best places to buy them.

“What support is available for schools around sensory processing difficulties?”

  • The Children’s OT Service offers training opportunities for school staff.  We are currently planning dates for the new school term.  Please contact chot@liverpool.gov.uk for further information.
  • School staff can request a Telephone Consultation for SPD support.  Please contact chot@liverpool.gov.uk  for further information.
  • If a parent attends a Telephone Consultation for SPD support, the recommendations can be shared with school, with consent from parents.
  • The Children’s OT Service is offering a Sensory Circuit Pilot project with local schools.

“I think my child has Dyspraxia (also known as Developmental Coordination Disorder or DCD) how can I get some help?”

Children who experience difficulties with fine motor tasks, such as fastening buttons, handwriting and tying shoe laces, and gross motor difficulties, such as catching a ball and riding a bike, may have an underlying movement difficulty such as Dyspraxia.  Dyspraxia is also known as Developmental Coordination Disorder (DCD).  Other common difficulties include poor organisation and time management skills and difficulties with attention and concentration.

The Children’s OT Service carries out assessments which support the Community Paediatricians when investigating a DCD diagnosis. We also provide strategies to help manage this condition.  If you are concerned that your child may have DCD, parents and carers can refer into the service by completing the online referral form or by contacting Careline on 0151 233 3700.  We ask that professionals use the online referral form.

You may also find it useful to read through the handouts opposite.  They contain advice and strategies to support specific areas of need including handwriting, dressing, tying shoes laces, bottom wiping and using cutlery. 

For further information on DCD please check out the following websites:

Link: NHS Diagnosis, Developmental co-ordination disorder (dyspraxia) in children

Link: Dyspraxia UK, Diagnosis Criteria

Link: Dyspraxia Foundation

“I need advice on car seats or car harnesses.”

The Children’ OT Service does not provide assessments for car seats but the following information may be useful when considering a car seat or specialist harness to use in the car. Link to car seat info.

“My child has difficulties accessing home or school”

If you feel that your child’s home or school environment is stopping your child from participating in family or school life then an OT assessment might be needed.  These difficulties may be because your child has a physical disability or your child has a reduced understanding of danger.

Difficulties may include:

  • Difficulties getting into the house, moving around and going up and down the stairs.  
  • Being unable to access the bath/shower/toilet.
  • Being unable to sit up independently to watch TV, eat meals and socialise.
  • Concerns that your child is able to escape from the home unsupervised.
  • Concerns that everyday things in your home are putting you, your child or their siblings at risk of injury or harm.
  • Concerns around your child going to a new school.
  • Difficulties moving safely around their school and accessing all parts of the school day such as eating lunch, going to the toilet, doing PE and doing a technology lesson.

We advise that parents who have concerns around safety in the home review our Safety in the Home document.  Please trial the advice and strategies before making a referral the Children’s OT Service.

Further advice on Adaptations and Housing information can be found here. <Housing and adaptations document>

To make a referral parents and carers can completing the online referral form or by calling Careline on 0151 233 3700. We ask that professionals use the online referral form.

“What is the referral criteria?”

Referral criteria for a sensory-motor assessment:

  • The child or young person must be under 18 years of age and be registered with a Liverpool GP.
  • For children who are under 5 the child must be in an education setting i.e. a nursery. Children who are not in an education setting will be supported by Alder Hey OT Team.  Please follow the link: Alder Hey Occupational Therapy Service for more information
  • The child or young person must be experiencing a difficulty that significantly and persistently impacts on their ability to participate in activities of daily living.  This may include but is not limited to washing, dressing, feeding and toileting.

Referral criteria for home and/or school environmental assessment:

  • The child or young person must be under 18 years of age and live in the Liverpool city catchment area.
  • The child must have a physical or neurological condition which is significantly and persistently impacting on their ability to access their home and/or school and using essential facilities such as getting in and out of the property or school, accessing a bedroom or bathroom, using a toilet and washing facilities.

If you are considering a referral for support with Sensory Processing Difficulties please go to the Sensory Processing Difficulties tab above for details on how to get help.

Who to contact

Contact Name
Duty Occupational Therapist
Contact Position
Occupational Therapist
Telephone
E-mail
Chot@liverpool.gov.uk

Where to go

Name
Children's Occupational Therapy Team
Address
Cunard Building
Water Street
Liverpool
Postcode
L3 1AH
Notes

Please note, this a postal address only

Time / Date Details

When is it on
Monday to Thursday 8.30 - 4.45 Friday 8:30 - 4.15 (except bank holidays)
Time of day
Afternoon
Morning

Other Details

Availability

Referral required
Yes
Referral Details

 

 If you would like to make a referral into Childrens Occupational Therapy please visit - Request for Occupational Therapy Form

Local Offer

Local Offer Age Bands
Primary (5 to 11)
Secondary (11 to 16)
Early Years (0 to 5)
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