Children’s Community Therapies

Who are we?

Children’s Therapies is an integrated service consisting of Occupational Therapists, Physiotherapists, and Speech and Language Therapists.

Where do we work?

We work in the place or places where the child can best be seen. This may be:

• Mainstream primary and secondary schools
• Nurseries / Early Years settings
• Children’s centres
• Special schools
• Child development centres
• Alternative educational provision e.g. Pupil Referral Units
• Hospitals
• Health Centres
• In the family’s home

To speak to a therapist you can ring The Lyng Health Centre on 0121 612 2345 and they will get a therapist in your area to contact you.

To make a referral please see the ‘how to refer’ section.

How do we work?

Our Therapists work directly with children to:

• Assess the child’s s needs.
• Carry out regular work with the child to help them to improve or maintain their skills in particular areas of development.

We also work indirectly with children to:

• Collect information regarding their development, discuss concerns and goals with parents/carers.
• Share information with educational staff and other medical professionals to ascertain everyone’s concerns and plans for the child.
• Train parents/ carers and staff to deliver programmes of work to help the child develop or maintain their skills.
• Deliver training courses for parents or professionals involved in a child’s development.

Training others is a big part of our role.  A child’s development is a shared responsibility amongst all those working with the child, not just the therapist!

For more information about disabled access for this service, please click here.

Speech and Language Therapy

Speech and Language Therapists work with children who may have difficulties with:

Speech Sounds
A speech difficulty is when children cannot say the right sounds for their age, or their talking is difficult to understand.  When children learn to talk, they use easier sounds first – like ‘m’, ‘b’ or ‘d’. Later on they begin to use the harder ones –  like  ‘s’, ‘f’, ‘k’ or ‘sh’.  All children will simplify words if they’re not yet able to use the correct sounds but sometimes children find it especially difficult to learn new sounds.

Language
Language is split into two parts: understanding things and expressing things. Children with language difficulties may not be using words at all, or only using single words. They may confuse words or struggle to make sentences. Depending on their age, they may find it difficult to understand what people are saying to them.

Stammering
Stammering or stuttering is when children know what they want to say but struggle to get their words out. For example they may repeat words, repeat the sounds in a word, lengthen the sounds in a word or struggle to get the word out at all.

Many children under five will experience some stammering, though most of them will grow out of it. Young children are often not aware of their difficulties and it is best not to draw their attention to it, instead keep easy eye contact and allow them plenty of time to talk.  Stammering doesn’t always happen when you expect it, so don’t worry if the Speech Therapist doesn’t hear it during an assessment.

Feeding difficulties
Swallowing uses the same muscles as those for speaking which is why speech and language therapists may be able to help babies or children with swallowing problems.  The therapist’s role is to assess the safety of a child’s swallow. We see children from 0-19 who have eating and drinking difficulties that could be caused by:
• Neurological Conditions – Downs syndrome or cerebral palsy
• Physical difficulties – cleft palate
• Other medical conditions – heart or breathing problems
• Being born prematurely

We don’t see children who are fussy or faddy eaters. You can get advice about children who ‘can eat but won’t eat’ from your health visitor, GP or local children’s centre.

Voice
Children may have a problem if the quality, pitch or volume of their voice are not appropriate for their age, sex, size or culture. For example:
• A hoarse or breathy quality to their voice.
• Sounding as if they are straining their voice.
• Sounding unusually deep or high pitched for their age or size.
• Sounding too quiet and breathy, making it difficult for them to be understood.

There may be several reasons for these problems and any medical problems should be investigated before a speech and language therapist becomes involved.  Therefore it is important that children are seen by a GP or ENT consultant (Ear, Nose and Throat) first, who can refer to us if necessary.

If children show any of the following signs, please talk to your GP:
• A continual hoarseness in their voice for more than 10 days
• Repeated episodes of a hoarse voice or voice loss (i.e. more than twice a year)
• A change in the child’s voice
• Deterioration of the child’s voice after sustained use (e.g. at the end of a school day)

Physiotherapy

Physiotherapists work with children who may have difficulties with mobility, muscle weakness, balance, or development

Physiotherapists work with children who may have difficulties with:

Mobility
Concerns about your child’s mobility, which may include:

Falling over
Difficulty in climbing up and down the stairs
Difficulty getting up from floor
Changes in walking ability (getting less good at walking over time)
Abnormal walking pattern (can be indicated by significant wearing and tearing of part of footwear)
Toe walking

Muscle weakness
Concerns about your child’s strength, which may include:

Frequent falls
Difficulty in climbing up and down stairs
Difficulty getting up from floor
Struggling with PE activities
Increased level of fatigue or increased amount of rest required

Balance
Concerns about your child’s balance, they may include:

Falling over
Difficulties in jumping, hopping and/or balancing on one leg
Struggling with PE

Development:
Concerns about your child’s development, which may include:

not kicking both legs equally
appearing to be floppy
legs and/or arms feeling stiff
not being able to hold their head up well at the age of 4 months
not being able to roll at 9 months old
not sitting at 10 months old
not walking at 18 months old
strongly favouring one side of the body more than the other
not being able to move in and/or out of position(s)
demonstrating reduced active movements

Occupational Therapy

Occupational Therapists work with children and young people who have a physical disability which affects participation in the everyday activities s/he either wants, needs or is expected to take part in.  The difficulties may impact upon play, leisure and/or access to education.  Physical conditions that might affect the child include cerebral palsy and dyspraxia.

Occupational therapists look at children’s performance under three headings:

• self-care (looking at eating and drinking, dressing and personal hygiene)
• leisure and play (hobbies & leisure time)
• school and work productivity (access to the curriculum & class room activities)

Interventions

If difficulties are highlighted the therapist will discuss appropriate treatment options available, which may include:

• Developing skills
• Using specific therapy techniques/interventions from a range of approaches
  • to encourage development of normal movement patterns
  • to prevent a deterioration in the child’s posture or loss of range of movement
  • to help children to organise themselves within activities, attend to tasks and develop their co-ordination
• Adapting the task (or activity) to enable children to participate as fully as possible
• Adapting the environment through the use of specialist equipment

• Brushing Teeth
• Ball Skills
• Using Cutlery
• Cycling

ADL’s

• Buttons and zips
• Toileting
• Tying laces
  

Bilateral Upper Limbs

• Developing Bilateral Skills
• Upper limb and hand strength

Classroom Skills

• Multi-sensory approach
  • Multi-sensory approach activity record
• Organisation for secondary school
• Scissors 
  • Activity Sheet – Scissor skills

Hypermobility

• Hypermobility Advice Sheet

Sensory Detective and Environment

• Sensory Environment
  • Sensory Detective Screening Tool
  • Sensory Detective State of Arousal

Sensory Processing

• Chewy Tube Fact Sheet
• Proprioception – Overview and Activities
• Sensory-Motor Preference Checklist
• Sensory Processing Resource List
• Tactile – Over Responsive
• Tactile – Under Responsive
• Vestibular – Overview and Activities
• Weighted Backpack

Sleep Hygiene

• Top Tips For Sleep Hygiene

Visual Perception

• Visual Perception (General Guide)
• Visual Perception For Early Years

How to refer

If you would like to make an appointment for a child to see an Occupational Therapist, Physiotherapist or Speech and Language Therapist please call the FASTA line (Faster Access to Sandwell Therapy Assessment): 0121 612 2010.  Referrals may be instigated by professionals but parents must make the phone call to make the appointment.

FASTA Opening times are:

Monday to Wednesday: 8.30am-12.30pm and 1.30-4pm
Thursday 9am-12.30pm and 1.30-3.30pm
(Please note the service is closed for lunch between 12.30-1.30pm)

During school holidays:
Monday to Wednesday: 8.30am-12.30pm
Thursday: 9am-12pm

You will be asked to give the child’s details and briefly explain your concerns. You will then be offered a choice of clinic; the first appointment will be arranged over the telephone and confirmed by letter and/or SMS text.

What to expect at the child’s first appointment

• The therapist will see the child in clinic for the first assessment.
• The therapist will talk to parents to discuss concerns they may have and find out some background information. (Sometimes it be helpful to bring the child’s red book)
• The therapist will then assess the child either indirectly through observations, or directly with the child through face to face assessment.
• The therapist will then feedback what the assessment findings are
• Finally the therapist will give recommendations and set targets for parent and the child to carry out at home as necessary.
• Parents will have an opportunity to ask questions and talk about any worries.  The appointment should last no longer than an hour.

After the appointment your child might be:

• Discharged- if there are no further concerns
• Reviewed in clinic, nursery, school or home.
• Placed on a list for therapy in clinic

Professionals

If you have concerns about a child’s movement abilities, communication skills or swallowing we recommend the following pathway:

1. Offer advice to the parents/ implement strategies at nursery / school to help develop the child’s skills first.
   2. Review the situation
   3. If progress is achieved, update/ continue with the advice/ strategies
   4. If no progress has been achieved consider the child’s other skills: does he/ she have global developmental delay or a specific difficulty?
   5. If the child has a specific difficulty speak to the family about your concerns and explain that you think that Occupational Therapy / Physiotherapy / Speech and Language Therapy may be able to help them/ their child.
   6. Give the Mum/ Dad/ Carer the FASTA hotline number – 0121 612 2010 (see above for opening times).  Provide a reminder of the phone number by giving parents/ carers a compliments slip or business card.

If you are unsure of whether to refer, contact the Lyng Centre for advice on 0121 612 2345 and ask to speak to a therapist

Social Media

For all our latest updates and tweets please see our Twitter page and don’t forget to us!

Awards

Beacon Service Award – Sandwell Children’s Therapy Service, Beacon Service of Sandwell and West Birmingham NHS Trust– Innovation implemented with impact

SWB NHS Trust Staff Awards 2014

Justin and Denise collecting their awards!

Innovation Award: presented to an individual or team that has pushed the boundaries of research, technology or clinical practice.

Justin Drew – Symbols 2 Write-An app to develop children’s narrative skills and literacy through symbol supported text.

Denise Charnock – TaSSeLs -a resource pack to promote effective tactile communication with children & young people who have profound and complex learning disabilities

SWB NHS Trust Staff Awards 2015

Clinical Team of the Year for Children – The Children’s Therapy Team won the Trust’s award for the great work they have done over the last year.

The Children’s Therapy Team collecting their award at the Staff Awards 2015

Links:

Below are some useful links you may be interested in. They include some general speech and language advice and activities you could do.

• thecommunicationtrust.org.uk – This website has lots of resources including downloadable booklets on a wide range of speech, language and communication difficulties and short films about ways to help your child at different age.
• afasicengland.org.uk – Afasic is the UK charity representing children and young people with speech, language and communication. The website has a range of information including simple advice sheets.
• talkingpoint.org.uk – This website has lots of useful information including information about speech and language development.
• rcslt.org– The RCSLT is the professional body for speech and language therapists in the UK; providing leadership and setting professional standards
• wordsforlife.org.uk – This website is great for activities to help your child’s language development for ages 0-11 years old.
• stammering.org and  stammeringcentre.org– Useful stammering website
• ican.org.uk
• nhsggc.org.uk/kids  – Kids Independently Developing Skills (KIDS) resources.

For more links to different agencies that offer support in such areas as Holidays and Respite, Equipment, Activities and Sports Groups, Charities and Support Groups and Bereavement Charities click here

Additional Services

In addition to our regular therapy services we also offer:

Training:

Makaton training

ELKLAN training

WellComm training

If you are interested in purchasing training or going on a training course please contact the Children’s Therapies admin team 0121 612 2345.

Enhanced therapy services :  Would you like to buy in more speech and language therapy?  See our information leaflet, in the patient information tab, for more information.