OT - a 'person centred' approach
Ria is an OT working mainly with children in Cheshire West and Chester. She’s based in the community ‘Patch’ team with social care professionals from different disciplines.
Anyone can refer a child to occupational therapy, and Ria works very closely with the health paediatric OT team , school and social care colleagues. Some of the children using this service have severe physical, learning, emotional or behavioural needs whilst others might have less-complex needs. Either way, all professionals involved with the family need to take a team approach and a long-term view of supporting them and the child.
Like other OTs Ria’s initial assessment involves the ‘person centred’ approach. Intervention may be the provision of advice and basic equipment such as handrails or toilet/bathing equipment which might improve life at home for a child. In the case of a child who has complex needs and is fully dependent on their parent or carer for all daily living activities it’s especially important to work together to plan for the child’s future and more specialised equipment may be required to support both the child and carers. It can be very difficult and overwhelming for carers of younger children contemplate, where the child will sleep and how will they use the bathroom as they get older and can no longer be carried upstairs, for example. A thorough understanding of the emotional impact of caring for a disabled child is crucial and all families are different; for some it’s very hard to think about the future or have a true understanding of the impact of their child’s disability.
In some instances, a family is eligible for support with major adaptations. This could be a through-floor lift allowing a child who is a wheelchair user to continue to be able to get upstairs and take part in family life or it may be that ground floor facilities are the favourable solution. In some cases it is necessary to consider rehousing to a more suitable property to meet the child’s long term needs and the OT will support with a housing needs assessment report.
Sometimes, a smaller level of support can have a very big impact. Ria says, “In one case a child on the autistic spectrum with severe, complex learning disabilities and behaviour problems and his family were all experiencing very poor, broken sleep because he was attempting to climb out of his cot bed at night and couldn’t be kept safe. Provision of a specialised bed with a soft, enclosed space allowed him to enjoy soothing sensations, keep him safe and therefore improve his rest. The better sleep had a direct positive impact on his behaviour at school, improved his interactions with other people and meant his behaviour and routine were better managed.”
Supporting families and children to achieve what matters to them is at the heart of Ria’s OT approach.