RCOT Specialist Section - Children, Young People and Families

This section contains information tailored for occupational therapy students who either wish to work with children, young people and families in the future or who have an upcoming practice placement in this area. We have added some key reading and resources to look at which will help you develop your understanding, and a description of some of the most common areas that children and young people’s occupational therapists work in.

Student placements

Some students find placements in children’s services daunting. Remember you bring more up-to-date knowledge about many areas including occupational therapy models and frames of references, which may be of interest to your placement department/supervisor. Your core occupational therapy skills are what’s required: interviewing, collaborative goal-setting, task/occupational analysis (of the person, completing the task in the relevant environment), analysis of barriers to successful participation, formulating strategies to support the participation, grading activities, review and outcome measurement. That process, and the skills that underlie putting it into action, are core to any placement  - including within children’s services.

There are however some key differences in this area compared to working with adults:

• A developmental approach: the age of the child affects what should be expected in terms of occupational participation and engagement. The demands placed on them will be different – paying attention at school, participating in PE, sharing, socialising etc. It will be important to be familiar with developmental milestones.
• Who is your client – child? Parent? Family? School? Depending on the service, it could be all of these.

Remember, the occupational therapy process will be followed somewhat in each setting, even if each setting uses it a bit differently (assessment – goal setting – intervention – evaluation).

Key reading and books:

• Occupation-Centred Practice with Children: A Practical Guide for Occupational Therapists edited by Sylvia Rodger and Ann Kennedy-Behr.
• Occupational Therapy for Children and Adolescents by Jane Case-Smith and Jane C. O’Brien.
• Mary Sheridan’s From Birth to Five Years: Children’s Developmental Progress by Ajay Sharma and Helen Cockerill.
• CanChild, a research centre focused on children and youth with disabilities; this website has a wealth of resources.
• Education, Health and Care Plans: there are resources and a video webinar available in the member resources section.

Areas of practice

Occupational therapists for children and young people work in different areas of practice.

Community children services

Each borough or county will have a children’s therapy service, often operating out of a child development centre or hospital. These services provide assessment and intervention for children in the community experiencing difficulties with everyday tasks. Models of service provision vary. Some will offer clinic-based assessments carrying out observation of every day activities as well as standardised tests such as the Movement ABC, Beery VMI, and Bailey. Some will be spend more time in schools (mainstream and special), working with educators to increase inclusion and participation throughout the school day. These services may focus on training school staff.

Some children who are referred to community services will have diagnoses: physical disability such as cerebral palsy, autism spectrum disorder, developmental coordination disorder, a specific syndrome which impacts on learning and development, etc. However, others will be referred due to difficulties with everyday tasks (handwriting, dressing etc) without a clear diagnosis, and parents and schools are looking for input and advice.

Social care

Occupational therapists work to assess and provide equipment and adaptions for independence. They are often employed by local councils and located in children with disability teams. Sometimes services are integrated with the local community health team. Many of the skills learnt in a social care placement are transferable to health teams; as well as assessment, talking to parents and the child/young person, problem-solving the practical elements of measuring marking, assessing toileting equipment, manual handling, seating and access are carried out by health occupational therapists in schools and in some areas in homes. These skills are in demand.

CAMHS

Child and adolescent mental health services are provided in different tiers, with tier 4 being inpatient specialist provision and tier 3 specialist community teams. Occupational therapist roles are usually only within tier 3 and 4. Occupational therapists have a key role in assessing barriers to, and supporting a return to, daily occupations. Many occupational therapists working in community CAMHS services have generic posts – that is to say that their job title might not be occupational therapist but mental health practitioner or CAMHS practitioner.

Special-education schools

Special education schools may directly employ their own therapists or may have a contract for occupational therapy input from the local NHS team. There are different types of special schools which may be maintained state schools, non-maintained or independent schools. These schools may specialise in certain conditions such as learning disabilities, autism spectrum disorders, physical disability etc. Work in these schools can range from equipment provision and review to providing programmes for school staff to follow or direct hands-on input. Look at the Partnering for Change model which has resources and guidelines for tiered-based working with schools. 

Mainstream schools

Mainstream schools increasingly employ occupational therapists, some of whom are in private practice while others are bought in from the local NHS team. The school might determine how they want an occupational therapist to spend their time, which might be in class or extracting children for assessment and intervention. It is worth being aware of development and research in school-based occupational therapy but also in professional practice as a whole, in terms of the evidence base. Look at the Partnering for Change model which has resources and guidelines for tiered-based working with schools. 

Tertiary centres

Tertiary centres offer assessment and recommendation regarding specific areas of need, for example Augmentative and Alternative Communication (AAC) and Assistive Technology (AT) seating. Some are aligned to establishments offering interventions, for example the Wolfson Centre at Great Ormond Street. Occupational therapists also work within rehabilitation in acute settings and in rehabilitation centres/units  

Tertiary acute settings

Many of the larger teaching hospitals have occupational therapists on their wards and in outpatient clinics, for example Manchester, Great Ormond Street, Evelina etc.

General hospitals

Some general hospitals have occupational therapy posts on the wards; assessing post-illness, surgery or trauma; supporting children and young people in their rehabilitation/recovery; and planning discharge. These posts are unfortunately rare and often discharge support is left to community teams.

Neonatal units

Occupational therapists in these settings work collaboratively with parents, supporting the parent role, developmental care and transitions from hospital to home. RCOT and CYPF have produced practice guidelines for occupational therapists working in neonatal services and early intervention.

Membership to the Specialist Section enables you to network with children's occupational therapists across the UK. It provides opportunities to enhance and share clinical skills and knowledge, vital in offering high standards of professional practice.

Membership means you can have your voice heard by RCOT and other stakeholders, helping in raising professional standards. We have over 600 members, supported by a comprehensive network of UK-wide regional representatives.

Benefits of joining include:

• Access to a national network of occupational therapists working with children and young people in a wide variety of areas of expertise and practice
• Opportunity to receive and contribute to a peer reviewed journal twice a year featuring articles, book reviews, research development and reports
• Potential access to members for recruiting research participants
• Opportunity to apply for a research award
• Advice and guidance when undertaking research with children and young people
• Regional study events and networking opportunities
• Access to practice based clinical forums including CAMHS, acute paediatrics, managers and leaders, neonatal, physical disabilities and autism spectrum disorder (ASD)
• Opportunity to comment or advise on national and local issues, including relevant guidance, policies and legislation
• Reduced registration fees at annual conferences, learning events and study days
• Opportunity to be involved in working parties developing clinical guidelines, position statements and other publications
• Continual professional development and opportunities to develop skills as a member of a regional group, clinical forum or national committee
• Bi-monthly newsletters providing regular features, news and forthcoming events.

For any general enquiries please email: cypfss@outlook.com.