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Physical & Self-care Difficulties

Last updated 19/01/2023

A child or young person with a physical difficulty may struggle with day-to-day activities and need extra support.

Difficulties can be as a result of:

  • A physical impairment, e.g. cerebral palsy, muscular dystrophy, spina bifida, arthritis, genetic disorder etc.

  • Delayed development of gross and/or fine motor skills due to various reasons, e.g.a specific condition, lack of exposure, hospitalisation, illness, etc. 
  • An injury or illness that causes a short term change to physical functioning.

Support is offered through two services Paediatric Occupational Therapy (OT) and Paediatric Physiotherapy (PT).

Paediatric Occupational Therapy (OT)

Occupational Therapy is concerned with promoting a balanced range of occupations to enhance health and wellbeing.  Occupations refer to everything people do in the course of their daily life.  Within Ealing Community, Paediatric Occupational Therapists work with Children and Young People (CYP) aged 0-18 who have difficulties functioning in daily living activities due to illness, injury, developmental difficulties or neurodisability (e.g. physical disabilities, autism). 

The Ealing Paediatric Occupational Therapy Service is committed to ensure a child and their family are able to function in all aspects of their lives to their maximum potential: self-care (e.g. dressing to go out, eating a meal, using the toilet), productivity / educational attainment (e.g. playing for young children, attending school) and leisure / socialisation (e.g. playing with friends, participating in sports) etc.

Occupational Therapists provide advice and support to parents, carers and other professionals involved and work across a range of settings where different occupations occur (e.g. home, school, clinics etc.).  The unique contribution of Occupational Therapy includes:

  • Improving quality of life for children and families
  • Minimising barriers to activity participation
  • Reducing impact of disability
  • Promoting independence and self-management

When would my child need OT?

When your child experiences difficulties in carrying out normal day to day activities such as:

Self-Care

  • Feeding – child is unable to feed him/herself to an age appropriate level
  • Child cannot hold spoon / fork / knife correctly
  • Dressing – child is unable to dress / undress to an age appropriate level
  • Toileting – child is significantly delayed in toilet training

Participation in Productive Activities (in relation to movement and coordination)

  • Ability to use different tools and items, e.g. crayons, pencils, rulers, scissors, puzzles etc.

Participation in Play and Leisure Activities   

  • Knowing how to explore and play e.g. engagement with toys or play items etc.
  • Doing arts, crafts and having hobbies
  • Games and PE, e.g. accessing climbing frames, ball games etc

 How to Access the OT service

OT come under Ealing Community Services, London North West Healthcare University NHS Trust.  The service is based at Carmelita House and is integrated with other Ealing health, education and social care services to form a part of Ealing Services for Children with Additional Needs (ESCAN). 

Ealing Paediatric Occupational Therapy Service
Carmelita House
21-22 The Mall
Ealing W5 2PJ
0300 1234 544
Email: ealingcommunityreferrals@nhs.net


How to refer

Any parent, carer or professional can refer a child or young person to the service by completing the referral form (downloadable from the right of this page, or by contacting the service); and sending it in with written parental/guardian consent.

Referrals will be accepted for children/young people who have:

  • An Ealing GP, and are aged 0-18 (unless they attend an Ealing special school where we are based, in which case we will take referrals up to the age of 19).
  • A difficulty or difficulties participating in functional tasks in the areas of self-care, productivity and/or leisure.

Paediatric Physiotherapy (PT)

What is Paediatric Physiotherapy?

Physiotherapy is a healthcare profession that promotes the health and wellbeing of all. Physiotherapists are responsible for the assessment and physical management of problems due to accident, injury, ageing, disease or disability. Paediatric physiotherapists have specialist skills as physiotherapists, along with additional expert knowledge and experience of child development and childhood disabilities.   

Who do we see?

Children & young people accessing our service are subdivided into two main pathways:

  • Long term conditions, physical disabilities and developmental problems  (0-18 years, 19 in special schools)
  • Musculoskeletal and Orthopaedic conditions (0-18 years)

What do we do?

Therapists provide evidence and experience based intervention options with clear pathways (Specialist intervention). They actively support self-management and empower children, young people and families to self-manage their own needs (Targeted intervention).

Each child/young person will be fully assessed by one of our Physiotherapists at their initial appointment and, together with the family, we will plan what to do next depending on the child/young person’s need and the outcome that is required.

Physiotherapy intervention may include:

  • Provision of an exercise or physical/postural management program
  • Individual or group session with physiotherapist or physiotherapy assistant
  • Provision of specialist equipment (e.g. orthotics, mobility aids and postural management equipment)
  • Review of child or young person's physiotherapy needs and program after an agreed period of time
  • Training of parents/carers/school staff to carry out exercise or physical/postural management programs, and integrate them into the child or young person's daily routine where indicated
  • Liaison with parents/teachers/learning support assistants/nurses and medical staff as appropriate
  • Onwards referral to other services as indicated e.g. wheelchair service, podiatry, other therapy services (i.e. OT/SLT)

Where do we work?

The Ealing Paediatric Physiotherapy Team is based at Carmelita House and is part of the Ealing Services for Children with Additional Needs (ESCAN)

We are a predominantly clinic-based service, but some services are delivered in children's centres, special and mainstream schools, and patients own homes, depending on the child or young persons needs. 

Who else do we work with?

We work as part of the Multidisciplinary ‘team around the child’ with our colleagues in Health, Education and Social Care. Your child may be known to one or more professionals depending on their needs.

Training offered:

We are happy to provide training on request. For example:

  • To referrers regarding our service delivery, referral guidelines and criteria, and to disseminate universal information that may be relevant to their patients (e.g. advice on flat feet and in-toeing for GP's)
  • To individual settings (schools, nurseries etc.) regarding postural management, integrating the principles of physical management, integrating the principles of physical management into the child/young person's day, and how to promote gross motor skill development through universal activities
  • Specific conditions or elements of physiotherapy intervention 

Referrals:

  • We accept referrals for children/young people with an Ealing GP and that live in the Borough of Ealing or within one mile of the Borough boundary
  • We accept referrals from GP's, Paediatricians, Consultants, other Health Care Professionals and School Teachers/SENCO's.
  • Referrals are accepted by email to wlm-tr.ealingcommunity.referrals@nhs.net

For more information, visit Physiotherapy :: West London NHS Trust


Ealing Paediatric Physiotherapy Service
Ealing Service’s for Children with Additional Needs (ESCAN)
Carmelita House
21-22 The Mall
Ealing W5 2PJ

Tel: 0300 12345 44
Email: ealingcommunity.referrals@nhs.net

For more information, visit Physiotherapy :: West London NHS Trust 

 

Specialist Equipment & Services

You may need specialist equipment to help manage your child’s needs and disabilities.

Health professionals such as occupational therapists, speech and language therapists, physiotherapists and specialist community nurses may (as part of an assessment) recommend a particular piece of equipment for your child.

An occupational therapist can also assess the need for specialist equipment and adaptations around your home. This can include minor adaptations such as a hand rails around the house or a calling entry system for those who cannot reach the front door, or major adaptations such as a chairlift, wheelchair access ramps or a level access shower.

When to refer to Ealing Community Paediatric Occupational Therapy

  • The child is between the age of 0 - 16 and full time resident in Ealing
  • The child has ongoing OT needs
The Community Paediatric OT service does NOT cover Children who need one-off Social Care interventions, for example home equipment required after surgery.

The focus of the request for a home assessment by an Occupational Therapist may be:

  1. To consider the need for specialised equipment within the home to enable access and use of facilities, e.g. hoists, bathing equipment;
  2. To consider the need for minor adaptations (<£1000) within the home;
  3. To consider need for major adaptions (>£1000) housing adaptations and/or potential assessment for a Disabled Facilities Grant (DFG) assessment.

Requests for Home Assessments will not be undertaken by Occupational Therapists where the request is in regard to:

  • Assessment of space (e.g. numbers of bedrooms, size of rooms)
  • Assessment of standards of amenities (e.g. suitable heating system, damp)
  • Accessibility of local community facilities

Requests for Home Assessments will not be undertaken by Occupational Therapists for assessment and or provision of equipment and adaptations that are considered to be the reasonable responsibility of parents to ensure the safety of children within the home (such as window restrictors, provision of stair guards or locks on cupboards containing medicines or sharp items).

When to refer to Ealing Social Service Occupational Therapy

(located in Perceval House)

1. For Children 16-18 years of age – a referral needs to be made through ECIRS to Social Service OT (as long as the child is resident in Ealing).

2. Adult (over 18 years) referrals to SSOT can be made via Framework-i.

Telephone no. 0208 825 8000 option 2 or Fax 0208 825 9127

Or email ECIRS@ealing.gov.uk

For home adaptations you can contact Ealing's Repairs and Adaptation Service directly on 020 8825 6070 or housinggrants@ealing.gov.uk

Wheelchairs

Children and young people requiring a wheelchair should make contact with their GP / physiotherapist / occupational therapist who can refer them to AJM Healthcare. 

Parents can also self–refer by contacting AJM Healthcare directly.

Find out more about AJM Healthcare (internal link)

https://northwestlondon.wheelchair.services/

Telephone:  0808 164 2040 

There is a team of professionals who will perform an assessment to provide wheelchairs suitable for numerous physical disabilities.

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