Integrated Therapy Team
January 2021 marked the beginning of the Integrated Therapy Service at Cleaswell Hill School. The integrated service is designed to complement and enhance the statutory services provide by NHS therapy colleagues, through highly effective communication and collaborative working. Speech and Language Therapists (SaLTs), Occupational Therapists (OTs) and Physiotherapists (PTs) employed by the NHS continue to provide their service into Cleaswell Hill.
Therapists within the Integrated Therapy Team at Cleaswell Hill are employed directly by the school as members of the staff team. Therapy representation on the School Leadership Team ensures a highly integrated approach to school development planning. The integrated team currently includes SaLTs and OTs.
The small integrated therapy team aim to disseminate best practice throughout school. Therapists provide advice and training to school staff regarding developmental difficulties and disabilities, therapeutic approaches and strategies. Therapists and educational staff work collaboratively within an interdisciplinary approach to provide timely and impactful interventions. Interdisciplinary working facilitates a consistent approach, which optimises the child’s understanding, well-being and ability to make progress within different contexts. Where possible, therapeutic approaches are integrated within the curriculum, with qualified therapists providing ongoing support and evaluation. Access to learning, and the generalisation of learning, can be a challenge for children with developmental difficulties and disabilities and the interdisciplinary approach is designed to optimise this.
Integrated Therapy Team Therapists
Juliet Ruddick (Lead Therapist, Highly Specialist Occupational Therapist)
Rachael Howitt (Highly Specialist Speech and Language Therapist)
Joanne Golden (Specialist Occupational Therapist)
Teaching & Therapy Assistants
Teaching and Therapy Assistants are class-based teaching assistants who are allocated additional time for their Therapy Assistant role. Training and supervision is provided by the qualified therapists in order to develop the assistants’ knowledge and skills in therapeutic approaches. Class based assistants work closely with the children and are able to identify and respond to issues as they arise, in close collaboration with qualified therapists and the class team. Their role includes helping to prepare therapy resources and providing therapy programmes to children throughout school within a range of contexts.
Teaching and Therapy Assistants;
Occupational Therapy with Children and Young People
Occupational Therapists (OT) assess and provide intervention for children and young people who have difficulties that affect their ability to perform activities of daily living. OT’s use an holistic approach within therapy, which considers the physical, social, emotional, sensory and cognitive abilities of the young person.
The role of the occupational therapist varies according to the needs of the child. Sometimes the focus will be the provision of equipment to ensure safe moving and handling, bathing and toileting. NHS OT’s are often involved in the provision of equipment. The OT can support the child to progress with skills such as personal care, dressing skills, mealtime skills, classroom tool use, play and leisure.
When assessing a young person the OT carries out observations in a range of contexts and talks to the child, parents/carers, other therapists and educational staff, in order to ascertain their needs and priorities for intervention. Where necessary, the OT will liaise with external professionals, e.g. the child’s paediatrician, nurse, mental health practitioners, with consent. OT assessment can include the completion of standardised assessments (formal assessments that have been designed to measure a child’s abilities compared to other children his or her age), questionnaires and observations within a range of contexts.
The OT may provide a programme of activities to develop component skills within a task e.g. multi-sensory activities to develop a pincer grip in order that the child can do their buttons, pick up small objects and hold a pen. The OT may suggest programmes to support progress with pre-writing, handwriting or technology. It may be necessary for the OT to recommend different techniques or assistive equipment (e.g. specialist pencil grip, angled writing board, ergonomically designed cutlery) to support comfort and improve performance. Where possible, the young person’s goals will drive the direction for therapy, including activities which are purposeful and meaningful to the child. Interventions are carefully broken down into achievable steps, with the aim to improve self-esteem, motivation and a sense of well-being.
Many children with developmental difficulties experience sensory processing issues that affect their ability to manage within daily life. They can be both over-responsive and under-responsive to sensory input. The individual may experience intolerance to clothing textures, smells and noises or be continually ‘on the go’ seeking out movement to the point that it interferes with engagement in purposeful activities. An occupational therapist, with training and experience in sensory processing, is able to conduct a sensory assessment in order to modify the environment and suggest activities to improve sensory and emotional regulation, leading to improved social interactions, independence skills and educational outcomes.
Speech and Language Therapy (SaLT)
Many individuals with developmental conditions and disability experience difficulties with speech, language and communication. These difficulties may be due to a physical issue, which affects non-verbal communication (e.g. finding it hard to lift or turn their head to look at someone) and/or speech production (e.g. being unable to produce words clearly due to muscle tone and coordination issues). Alternatively, a young person may find it difficult to understand what others are saying to them and struggle to communicate their thoughts/needs. The child may find it difficult to find the right words or order the words correctly to make a sentence. Individuals with autism often experience difficulties with social communication and find social situations uncomfortable; they may not understand how to act or what to say within different contexts. Autism is a spectrum condition, some individuals may have a good vocabulary but struggle to understand emotions, which impacts on their ability to make and maintain friendships. Others with autism, developmental delay and/or learning disability can find it impossible to understand the world around them and to communicate their needs effectively. The SaLT strives to support their understanding, ability to communicate, access to learning and well-being.
When working in a school setting, the speech and language therapist supports the class teams to develop total communication environments. Working alongside the OT, the SaLT will provide recommendations regarding the classroom environment e.g. suggesting auditory and visual distractions are minimised, areas are designated to certain activities and routines are consistent and predictable. Within the environment, visual cues are included to improve understanding, including objects of reference, symbols or photographs. Children also have individualised strategies, such as ‘Now and Next’ boards, Picture Exchange and Communication System (PECS) books. Each child’s needs are unique and a wide range of approaches, techniques and strategies are used to optimise progress.
A young person with significant speech difficulties may require a communication aid to augment their speech. Some children have a physical disability, which includes issues with muscle tone which impacts on eating and drinking; a SaLT trained in dysphagia (difficulties with swallowing) will assess the child’s abilities and provide recommendations to support their needs safely, often working alongside medical professionals. At Cleaswell Hill, communication aids and dysphagia are managed by NHS SaLTs.
Within the interdisciplinary approach at Cleaswell Hill, the educational professionals and therapists work together and strive to create the optimal conditions for pupil well-being, progress and achievement in all areas. Collaborative partnerships with parents/carers and external professionals are highly valued, with the aim to improve outcomes in school, home and the community.