My child needs to see an Occupational Therapist – what questions should I ask?

If your child has a brain injury, their rehabilitation can mean a lifetime of receiving different therapies. If a recovery is possible, it can take years.

The aim of rehabilitation is ultimately to give your child the best possible chance of making improvements.

Occupational therapy (OT) aims to support your child to perform everyday activities, some they may have lost the ability to do completely and some they may need help to improve.  It is about trying to give your child as much independence as possible.

“Occupation” doesn’t always mean work in the sense of employment – it means any activity you undertake and enjoy.  Being able to do what we enjoy most and what we need to do, gives value to our lives and promotes health and wellbeing.

OT for a child can vary greatly.  It could mean helping them to structure tasks like teeth cleaning and dressing, or assisting with their integration at school and progress towards being an adult.

An OT may need to consider and assess a wide range of your child’s abilities to enable them to advise on the best rehabilitation plan.  That can range from planning to sensory skills, coordination and balance.

How do I know if the OT is the right one for my child?

 It is really important to know that the OT is the right one for your child and that they have the right skills and experience to provide the best support possible.

The questions you need to ask may well differ depending on whether the referral to that OT is being done privately (you are paying for it or it is being funded by a policy of insurance) or whether it is a statutory referral (via the NHS).

Private referral – questions to ask:

• Are you registered with the HCPC (Health & Care Professionals Council)?  You can check this yourself on hcpc-uk.org
• Do they have appropriate insurance in place?
• Can you see a copy of their CV to determine what their qualifications are and whether they have the necessary skills to meet your child’s needs? What specific training and experience do they have to meet your child’s diagnosis?
• How connected are they locally?  Will they be able to signpost you to other providers and services as necessary?
• What are their estimated costs and what does this cover?
• Are they able to access clinical supervision?
• Are they associated with any specialist organisations such as BABICM (British Association of Brain Injury and Complex Case Management)
• How do they maintain an up to date CV?
• Are there any other service users you can talk to (other recommendations)?
• What is their timescale for providing a date for an assessment and then for implementing any treatment recommended?

Statutory referral:

• Please refer to the NHS Choices Framework for information on your entitlement to NHS services (gov.uk) or speak to your GP.
• What are their qualifications?
• How quickly can the assessment be arranged and what are the waiting times to start active treatment?

Once you are satisfied your child is seeing the right OT with the relevant skills and experience to meet their needs, you will want to ensure you have the right information about the rehabilitation therapy choices they are recommending.  You may want to consider these issues / asking these questions:

• Are they prepared to work with you and your child to set SMART goals (specific, measurable, achievable, relevant and time-based)?
• How will OT help your child meet those goals?
• What can you do with your child outside of OT appointments to optimise their recovery / best manage their condition?
• What evidence is their treatment choice based on and is this the most up to date and reliable?
• How will the OT treatment plan / recommendations be shared with other relevant parties?  Where this is a private referral, you need to understand how they will collaborate with statutory services, your child’s school etc.
• What reliable information can you access online for your child in relation to their condition and what isn’t reliable? (there may be specific websites or organisations they can signpost you to).
• How can OT be integrated into everyday activities both at home and at school.
• How will they share therapy plans with you (e-mail, post, verbal)?
• Where equipment is being recommended:
  • What are the options and cost?
  • What is available via statutory services and are there better / different options available privately?
  • Where equipment may need to be paid for – are there any charitable organisations who can assist?  Can the Cerebra Innovation Centre assist (see below)?

At the moment, it is also essential any OT has appropriate COVID risk assessments and cancellation policies in place and uses appropriate PPE.  You should ask for copies of those policies.

The Cerebra Innovation Centre designs and builds innovative and bespoke products to help disabled children discover the world around them.  They may be able to assist with some equipment needs.

Where the OT goals are aimed specifically at supporting your child at school you should carefully consider obtaining separate, specific and specialist advice in relation to their EHCP (Education, Health and Care Plan) to ensure it meets your child’s current needs.  This can include ensuring they provide the appropriate therapy and equipment for your child at school in addition to meeting their educational needs.  The EHCP is a legally binding document which protects the support your child needs up to the age of 25 years.  It is important to seek specialist advice in relation to the EHCP as appeals need to be pursued within tight timescales.  A specialist education lawyer will also be able to advise you on what your child’s EHCP should include to ensure it meets their full needs.

Questions about negligent treatment:

 These questions can’t cover everything you need to know about your child’s OT, but we hope this will give you a head start on some of the most crucial things to know.

If you are worried your child has an injury because something went wrong in the care either you or they received, investigating whether there is a negligence claim can help you to find answers. This is a detailed process and if the claim is successful the additional resources it provides will ensure your child’s care, aids and equipment and therapy needs are met for life.

Our team will work with you to determine what happened, whether the care provided was substandard and, if it was, the specific care, therapy and equipment needs your child is likely to have  to make it possible for them to achieve their maximum potential.

If you have questions about the care you or your child received and believe mistakes were made, we’re here to help. Contact us today.

 A special thanks to Jenny Webster, case manager at Westcountry Case Management, for her invaluable help with this article.