Paediatric Assessment and Rehabilitation:

As part of this comprehensive process, our occupational therapists will assess and identify the requirements of continuing rehabilitation, through consultation, liaison, observation and assessments. In addition, the Therapist will consult with the child, their family, their educational team, other professionals and their support network. Rehabilitation will be child-focused and goal-directed, to enable the child to fulfil their potential.

Adult Assessment and Rehabilitation:

As part of this comprehensive process, our occupational therapists will assess and identify the requirements of continuing rehabilitation, through consultation, liaison, observation and assessments. Rehabilitation will be goal-directed and will focus on the client establishing skills to maximise their independence and their quality of life.

Our occupational therapists will provide written reports detailing the assessment, recommendations and associated costs. In addition, progress reports can be produced, which detail the client’s rehabilitation programme and progress, according to the goals established.

Rehabilitation for Independence has access to a variety of assessment tools including:-

• Sensory profiling;
• Visual perception;
• Handwriting;
• Life skills;
• Goal planning and activity participation.

These standardised assessments, together with detailed observation through the initial assessment period, help to formulate goals and action plans for future intervention.

Rehabilitation for Independence is a provider of COGMED Working Memory Training. This evidence-based approach is a computer-based training programme, which is designed to improve attention, by increasing working memory capacity, over a 5-week programme. Our staff are trained to support both children and adults through the programme.

Working memory is the cognitive function responsible for keeping information online, manipulating it, and using it in our thinking (typically, for a few seconds). It is necessary for staying focused on a task, blocking-out distractions and keeping us updated and aware of what is going on around us. We use our working memory constantly in daily life; helping us to perform efficiently and effectively in academic, professional and social settings.

The programme can be implemented at home and in schools.

An Education, Health and Care (EHC) Plan is for children and young people who need more support than is available through SEN Support, for example, the involvement of external professionals. EHC plans have now replaced Statements of Special Educational Needs. If your child already has a Statement, they should be transferred to an EHC plan by Spring 2018. EHC Plans will address the broader health and social care needs of your child, rather than their educational needs only. The Plan will also cover your child up to the age of 25. The EHC Plan gives increased autonomy and choice to the client and their family through the use of personal budgets.

Read more about the Government’s special educational needs and disability (SEND) Guide for parents and carers.

Our occupational therapists are highly skilled in reporting on a child’s abilities, difficulties and requirements, which can be used to support the EHC Plan. The Therapist will observe and assess the child’s physical and cognitive abilities and/or difficulties, which impact on their ability to learn and develop. Our occupational therapists can contribute to the EHC Plan; working collaboratively to meet the child’s educational, health and social needs.

It may be that a client’s condition is affecting their ability to undertake everyday tasks; making life more challenging than it needs to be. Our occupational therapists are highly-specialised in assessment, recommendation and review of specialist equipment, which can enable an individual to be more independent and improve their quality of life.

Assessment: Our occupational therapists will visit the client at their home and/or school/college/workplace and undertake a comprehensive assessment of an individual’s requirements. The therapist will establish the client’s and/or their family’s priorities – what could improve their independence? Assessments can be undertaken with specialist companies, to establish the individual’s needs – what works best for them?

Recommendation: Following an assessment, our occupational therapist will provide written recommendations and justifications, detailing the clinical reasoning for and costs of the specialist equipment.

Review: Our occupational therapists will be involved in the delivery and handover of the specialist equipment, to ensure correct and safe use is established. It is good practice to review the use and appropriateness of the specialist equipment, to ensure it continues to meet the client’s needs.

What is 24-hour postural management?

“A postural management programme is a planned approach encompassing all activities and interventions which impact on an individual’s posture and function. Programmes are tailored specifically for each child and may include special seating, night time support, standing supports, active exercise, orthotics, surgical interventions, and individual therapy sessions.”

Developmental Medicine and Child Neurology

RFI provide assessment, advice and recommendations towards a 24-hour positioning management programme. This may be in the form of prescriptive specialised equipment for daytime and sleep systems, for night-time positioning.

Specialised seating will offer an ‘exact fit’ in terms of seat length for leg measurements, lateral support for trunk support and head support for assistance with head control, in order to maintain symmetry, improve environmental opportunities and enhance fine motor function.

Specialist beds will allow for height adjustment and profiling potential so that the client and/or carer can ensure an optimally comfortable position.

At Rehabilitation for Independence, we aim to establish a Postural Management Programme which includes activity, equipment and controlled positioning, which manages an individual’s posture. It is imperative that individuals are positioned correctly, to promote appropriate alignment of the body and joints, encouraging symmetry at all time. Ensuring comfort will encourage individuals to be able to learn, retain information and undertake everyday activities to their full potential.

At Rehabilitation for Independence, we believe that Postural Management is a ‘whole team approach’ with the individual at the centre. We will work closely with families, other professionals (including education) and support networks, to identify the most appropriate approach, taking into consideration every aspect of an individual’s abilities, challenges, social circumstances and environment.

Our occupational therapy team is highly experienced in the assessment of appropriate equipment to manage an individual’s 24-hour postural needs. These needs are reviewed on a regular basis, using appropriate outcome measures. Our occupational therapy staff work with a variety of companies, to ensure that the equipment provided meets the individual’s needs.

In the eventuality of a condition reducing an individual’s potential to access areas in their home; We will make careful consideration and assessment of the existing property regarding environmental modifications.

The assessment will establish if the property can be modified, in order to reduce the environment being disabling. We work closely with architects and planners, in order to establish the best scheme available to the environment. We aim to restore or enable independent living for individuals and their families, with the emphasis being placed upon the maintenance of privacy, confidence, dignity and quality of life.

For example, schemes could include improved external access, the widening of doorways, specialised bathrooms, accessible kitchens, provision of moving and handling equipment and the appropriate landscaping of gardens. Technology which allows complete independence is available in the form of electronic door openings, movement sensitive taps and height-adjustable washbasins.

We provide an individualised solution to a problem in all cases, wherever practicable, with a careful and thorough discussion with clients, families and/or support networks regarding their desires, expectations and ambitions.

Due to injury and/or an increase/decrease in muscle tone, wrist positions can deviate considerably from normal alignment, which will reduce an individual’s potential for performance. We will undertake an assessment of an individual’s hand position and where deemed necessary, will provide hand splints.

ADLS

Hand splints are devices applied externally, to restore or improve functional and structural aspects of the hand and wrist, where increased tone or trauma have resulted in the potential for deformities and have compromised function, in the absence of splinting. We can provide splints, which are purpose-made from thermoplastic material or neoprene or are offered from the pre-fabricated provision. We would consider either of the 2 categories below:

Static splints restrict or remove the potential for movement and are most frequently worn nocturnally, in order to encourage ‘muscle memory’ to develop, where normal positioning is learnt through persistent, assisted positioning.

Dynamic/functional splints allow movement and are designed to improve, reinforce and consolidate the wrist position for function.

We would provide splints in order to

• improve range of movement
• correct, discourage or prevent contractures
• help to enhance the function
• help to correct deformities
• block unwanted deviation of a joint

Our sensory processing forms a foundation for all activities we undertake in our daily lives. The sensory procession is made up of vision, hearing, taste, smell, touch, vestibular and proprioception. If a child is experiencing a disturbance in their processing of sensory information, they will demonstrate difficulties in everyday functioning, for example, their ability to concentrate within the classroom, their ability to balance when dressing, to successfully feed themselves and with their handwriting, to name a few.

The occupational therapists at Rehabilitation for Independence can assess a child’s sensory processing difficulties for example, is the child experiencing too much or too little sensory information, to allow normal functioning? We can provide detailed activity plans (sensory diets) to parents, teaching staff and support networks.

Sensory diet is the approach of a carefully designed programme of activities which are child focused. The activities are tailored to enhance attention, performance and achievement with everyday tasks both at home and school.

As part of an individual’s rehabilitation, our occupational therapists will identify, with the client, the most appropriate educational and/or employment opportunity. Vocational rehabilitation, whether through further education or work, is essential to maximise independence and quality of life. Together with the client, we would aim to integrate them into the community, as fully as possible, by striving to remove any barrier to successful higher learning or employment.

Our therapists can assess any potential establishment/workplace and make recommendations for any reasonable adjustments which may be required, to minimise risk and maximise integration. This may be through equipment provision and/or advice and guidance.

Children with Developmental Coordination Disorder (DCD) can have difficulty in undertaking tasks that involve the coordinated movements of large and small muscle groups. For example, pre-writing and writing exercises, tracing, model making, craft activities, fastening zips and buttons and undertaking gross motor skills such as riding a bike, ball skills, gym work and balance exercises.

Developmental Coordination Disorder is a diagnosis made if children do not demonstrate normal motor coordination, according to expected milestones. This diagnosis is made between the ages of four and 11 and is therefore impacted by school attendance and ability comparisons.

The disorder can lead to a reduction in self-confidence and reluctance to participate in some activities, where comparisons can be made with others within a school setting.

We aim to both increase a child’s confidence and performance accuracy, through a thorough assessment process and the devising of tailored and progressive programmes issued for parents, school and therapist to undertake with the child. We consider it imperative for each child to receive an individualised developmental programme, in order to accommodate the psychological impact of the condition and to ensure a confident and competent individual, at the end of intervention.

We offer a comprehensive assessment, treatment and monitoring process for children with a DCD diagnosis.

We offer psychological assessments and treatment that will support our clients, improve their general health, emotional wellbeing, quality of life, and reduce recovery time. We have developed innovative ways of delivering evidenced based and outcome measured occupational therapy techniques.

Our specialist occupational therapist will conduct mental health and specialist occupational therapy assessments to explore an individual client’s current circumstances. The assessment will include an evaluation of past and present psychological functioning in relation to overall general health and emotional wellbeing. This enables our specialist occupational therapist to identify areas of strength and challenge and to provide strategies to facilitate our client’s holistic recovery, back to meaningful routines and activities of daily living.

Our specialist occupational therapist works collaboratively with the client, their family, and the Multi-disciplinary team (MDT) to identify and prioritise goals, working closely with the client to achieve them.