Langtry ASD unit admits children with a diagnosis of Autistic Spectrum Disorder. The children are usually aged between 2 and 4 years of age and can be admitted from other mainstream nursery provisions, although it is often their first educational provision.
The occupational therapy service aims to provide children who attend Langtry ASD unit with as comprehensive a service as possible within the confines of the service’s staffing levels, geographic boundaries, priorities and strategies, any unforeseen time restrains and/or conditions that may interfere with service provisions and in accordance with the goals and aims of Camden PCT. With this framework in mind, the service delivery to the autism unit has been designed as follows:
Occupational therapy service provision
- Provision of therapeutic equipment
- Documentation and reports
- Consultation and liaison with teaching staff
- Individual/group interventions
- Annual reviews
- Provision of occupational therapy activity programmes
- Interventions run by teacher or designated LSAs – e.g. sensory diet, pre-writing and other tabletop activities, practice of gross motor tasks
- Attending other relevant meetings (MDRs, Transition Meetings, etc)
- Home visiting
Half a day per fortnight (but this can be delivered flexibly), to include:
- Individual assessments (interventions, observations etc)
- Consultation with staff, carers, parents
- Attendance at relevant meetings
- Administration time (report writing, management of equipment related issues, liaison with other services etc.)
- Home visits
Areas of functional skills into which the occupational therapist is able to provide input include:
- Use of recommended equipment
- Development of fine and gross motor skills
- Sensory processing difficulties
- Self help skills (e.g. eating, dressing, toileting, participation in daily routines in the nursery)
- Accessing play
- Participation in appropriate learning activities
The occupational therapist works within a multidisciplinary team consisting of the child, their parents/family, unit teacher, special support assistants, speech and language therapist and MOSAIC professionals, who all work together closely to address the needs of the child in as holistic a way as possible.
Areas of service provision
The occupational therapy service will accept referrals for any child attending the unit who has difficulties or dysfunction in the following areas:
- Physical function, fine and gross motor skills
- Sensorimotor development
- Play development
- Perceptual and cognitive function
- Daily living skills
- Sensory integration
- Development of pre-writing and handwriting skills and use of other tools in the classroom
All pupils starting at Langtry ASD unit may be referred to occupational therapy by parents, carers, teachers, school doctor, school nurse or another therapist, although most of the time these children are known to the MOSAIC team already so a transfer of care may be required from the MOSAIC OT to the unit OT. Referrals/requests for occupational therapy assessment and/or treatment should be made directly to the therapist working at the unit.
The occupational therapist aims to provide a high standard of occupational therapy assessment to children referred to OT services in the school. Occupational therapists routinely use standardised assessment and structured/informal observation techniques as part of their assessment procedures. The assessment procedures will vary from child to child, depending on the nature of difficulties and the reason for referral – for instance, more than one session may be required to assess the equipment needs of a child, or several observations may take place to ascertain their difficulties with using playground equipment. If appropriate, a report will be written following assessment and it will be discussed with both the child’s parents and teachers where possible.
Provision of Therapeutic Equipment
The occupational therapist will be responsible for assessing and identifying children’s equipment needs, in conjunction with other therapists and staff (e.g. seating equipment, slanted desktop, technology needs etc). Equipment is obtained through the school budget.
The occupational therapist will be available for consultation regarding equipment.
Documentation and Reports
The occupational therapist will be responsible for maintaining appropriate occupational therapy documentation and files on all children attending Langry ASD unit who receive occupational therapy intervention, according to occupational therapy standards of practice. Reports will be submitted at annual reviews of the child’s progress and setting of functional aims will be done and reviewed every term or following assessment. In most cases, reports will be written with the parent as recipient in mind.
Students may be offered individual or group treatment sessions depending on presenting difficulties and in accordance with therapy time constraints. Joint work with other therapists and staff will be encouraged where appropriate, in order to further joint working and promoting an integrated approach in the child’s care.
Therapists may make use of the following treatment approaches:
- Sensori-integrative therapy
- Compensatory and environmental approaches
- Behaviour management techniques
- Play-based interventions
When appropriate, the occupational therapist will participate in running groups with other team members.
Occupational therapists recognise that, for a large part of the time, the functional context in which children operate is their nursery environment. We are, therefore, committed to working in partnership with school staff in their natural setting as much as possible. We will endeavour to work within the classroom/playground environment, where our input is felt to be most constructive and where advice can be easily replicated by staff in the unit. For example, this may involve the provision of a specific activity programme in the real environment for the child (i.e. toileting area) and following his usual daily routines.
Collaboration and training
We recognise the importance of joint working and are willing to inform and transfer skills to other staff members and carers where appropriate, so as to facilitate this process. This will take place regularly in a number of ways – e.g. discussion and feedback, provision of programmes and ideas, attendance at planning meetings, modelling practice during joint/group sessions, follow-up discussions with parents, carers and teachers to discuss and outline home programmes or involve specific training etc.
This may at times take the form of formal training sessions for either staff or parents of children attending the unit. At times these sessions may be multidisciplinary.
Annual reviews/case discussions
The occupational therapist will endeavour to attend annual reviews of children who receive occupational therapy intervention within the ASD unit, provided it is on a day that is compatible with his/her pre-determined work schedule. A written report will be provided in advance to these meetings.
The occupational therapist will endeavour to attend other case discussions on appropriate children, provided they are held on a day compatible with his/her schedule.
The occupational therapist will make it a priority to attend the multidisciplinary reviews and planning meetings which are held on a regular basis.
Home visits will be carried out as and when the need arises and will be considered on an individual basis. The purpose of these visits will be to assess and monitor equipment needs of the child, to provide advice on home activities, to review previous home programmes and to back up therapy input already being received at school, liaising with and supporting carers at home.
Transition to school or other placements
Occupational therapists are actively involved with transition planning to other educational settings, in conjunction with the unit staff. Areas of involvement may include: preparing the child for the different school experiences, liaison with the new teachers and school staff concerning the child’s needs, assessing and recommending the provision of equipment and setting up of class programmes as appropriate.