occupational therapy school tools

As a SENCO I have had almost ten years of collaborative work with the London Children’s Practice. Over the years, they have been able to provide my various schools with a reliable and professional team of speech therapists (and occupational therapists). They find me the speech therapist who is able to do the required hours, and in addition to teaching the pupils they are also able to do some screening of other pupils who perhaps do not require a full assessment. They also provide INSET training and regular reports for the school and parents. The speech therapists and I always encourage the school staff to go and observe the lessons from which they learn a lot about the individual needs of each child. The LCP makes my life so much easier and I hope to still be working with them in another ten years’ time.

SENCO, Rokeby School

What should I do if I want to expand the current SEN provision?

Funding for SEN provision in maintained schools generally comes from:

  • Additional Support Funding (ASF)
  • Top-up Funding

If you need to provide support for a greater number of pupils with SEN than anticipated, then the school can request additional funding from the LA.

Funding for SEN provision in independent schools generally comes from:

  • The School budget
  • Directly from parents
How do I start the EHC process?

The parent of a student under 16 can request an EHC needs assessment by writing to the Director of Education or Head of Children’s Services of their Local Authority (LA). The school can assist with this process through provision of a letter supporting the parental application or this can also be completed on behalf of the parent by the school.

This application must show that:

  • The child potentially has a special educational need (SEN)
  • The provision to meet this need will need to be made through an EHC Plan

By law, the LA must respond to this request within six weeks, so keep a copy of the letter and make a note of the deadline for this response. If the application has been refused, the parent can consider appealing to the Special Educational Needs and Disability Tribunal.

When should I consider an EHC needs assessment?

It’s a good idea to request an EHC needs assessment when:

  • A child’s learning difficulty is impacting their ability to access the curriculum or is holding them back at school
  • It is felt that the school is not able to provide adequate support to meet the child’s needs
What type of assessment should I recommend?

Speech and Language Therapist

  • Any difficulties above
  • Any difficulties related to speech sounds, language, understanding, attention, play, social skills, communication.

Occupational Therapist

Does the child display any of the following?

  • Difficulty sitting still
  • Slouching/slumping in seat
  • Needs lots of breaks
  • Poor focus in class
  • Difficulties with handwriting/pencil grip
  • Poor organisation skills
  • Difficulty with physical activities such as climbing, kicking a ball and jumping
  • Clumsiness

Educational Psychologist

  • Poor reading, writing and spelling
  • Specific difficulties with Maths or Numeracy
  • Obvious discrepancy between verbal and non-verbal skills
  • Overall lack of confidence in academic ability
  • Memory difficultiesAny other learning difficulties
  • Difficulties with concentration/focus
What do speech and language difficulties look like in the classroom?

Some commons signs of children with attention, receptive language, or expressive langauge difficulties are:

  • Slouching in seat
  • Fidgeting/difficulty sitting still
  • Distracted, may seem as though they are not listening
  • Do not follow long instructions
  • Difficulty expressing ideas
  • Difficult to understand speech
  • Gets ‘stuck’ on words
  • May not readily answer questions in class
  • Passive and quiet
  • Frustration
  • Low self esteem
  • Lacking confidence in their peer relationships
  • Poor social skills
Where can we access training for teachers?

The London Children’s Practice carry out inset training sessions for both state and private schools around London. These can be tailor-made to your individual schools requirements, for example Autism in the Classroom, Selective Mutism, General Speech Language and Communication Needs in the Classroom. Otherwise your local Speech and Language Therapist or Occupational Therapist may be able to deliver staff training.

Do you have any advice for behaviour management for children with SEN?

Always ensure that you understand the underlying reason for the child’s behaviour. For example are they seeking some sensory input? Are they unable to communicate a need or want and are therefore frustrated? Are they looking for adult attention? etc. Once the reason is understood, try to meet the need (for example a means of communicating something, an outlet for their sensory need) then see if the behaviour decreases. Always ensure that you refer on to the appropriate professionals to support the child around behaviour management, for example SLT, OT, Clinical Psychologist, etc.

Do you have any resources for transition from primary to secondary school?

There is a new resource which is now available called Autistic Spectrum Disorder And The Transition to Secondary School by Marianna Murin, Josselyn Hellriegel & Will Mandy . It comes highly recommended and is an easy to use and practical resource. It is essential that students with ASD have a transition programme in place prior to their move to secondary school. This helps to decrease anxiety and to ensure that all staff and students involved have the necessary information and tools to help make this big change run as smoothly as possible for these students.

How often should we use exclusion pull out model?

It is important that children feel included and part of the class, so we would always recommend a real focus on this. This should be done by differentiating the curriculum for each child thus allowing them to take part in each lesson. However, each child is different and there may be some times where a child is unable to access the curriculum, for example in PE if the hall is too noisy or if they do not have the physical abilities to join in. In such circumstances, we would recommend they carry out another focused activity.

Which resources can we access to set up social skills groups?

‘Talkabout’ for school aged and ‘Talkabout for Teens’ by Alex Kelly is a resource that we often use for social skills groups. It includes initial student assessments and interviews in order to pinpoint which areas of social communcation the student finds most challenging. The sessions can then be tailored to the students in the group, and includes lots of group activities and ideas.We would also recommend the ‘I Am Special’ programme by Peter Vermeulen.

We would also recommend the ‘I Am Special’ programme by Peter Vermeulen.

What do we do to help a child who cannot get dressed independently for P.E?

Children struggling with dressing skills may have an underlying difficulty with motor co-ordination particularly if they are significantly behind their peers. An occupational therapy assessment would be recommended for these children. They can be supported to develop skills through a backward chaining approach where the adult starts off the dressing and then the child finishes it off (e.g. adult helps child step feet into trousers and child pulls them up).

How can I help a child who struggles with using scissors?

Children struggling with scissor skills can be prompted to always place their thumbs on top of both hands and to point their scissors forward when cutting. Children often need prompts to adjust the position of their supporting hand in order to make it easier to cut a shape. Adapted scissors can be recommended by an occupational therapist.

How can I help a child who struggles with handwriting?

Children struggling with handwriting should be prompted to use a dynamic (where they move their fingers) tripod grasp. This can be encouraged with a cross guard ultra grip or large ultra grip (Available from task master online). Some children may also need a writing slope to support their wrist position. Children struggling with the positioning of their letters on the line can be encouraged to use sky, grass, soil paper. Occupational Therapy assessment and intervention can provide recommendations for specific input to help children develop their handwriting and assessment of underlying causes of difficulties.

What equipment is important to buy for children with sensory or fine motor needs and where can we buy it?

Equipment such as a junior move ‘n’ sit cushion is recommended for children who struggle to sit still at their desks. This should be partially inflated so that it is a wedge shape, this will help to promote a good sitting position as well as reduce fidgeting. A gym ball which is a similar height to the child’s knee can be used for children to sit at their desks (with close supervision) in order that they can move while sitting (they should be sitting in a posture with their knees and feet at a 90 degree angle). Scissors such as long loop scissors or mini easy grip scissors can be used to help develop children’s scissor skills. Theraputty is excellent for children to fidget with while they are listening- a 454g pot is a recommended size as a general guide, young children would need yellow (soft) putty), infants would need red (medium-soft) putty and juniors and above would need green (medium) putty. Please note that theraputty also develops hand strength and cannot be substituted for Play Doh. Other fidgets include items such as tangles and stretchy men. Websites such as Amazon and the complete care shop can be used to buy this equipment.

Where can we access SLT/OT resources for the classroom?

LCP can provide specific advice and classroom resources if you need these. Some equipment (suggested below) can be good to purchase for OT needs.

Is it ok to allow breaks for SEN children and not others?

Yes, it’s important for children with SEN to have regular movement breaks, particularly if they are often a fidgety child, this will help their general level of attention. It’s more advisable to fit as many proprioceptive activities into the day for the whole class as possible (e.g. Animal walks or posture preparation before any writing activity) – this will help everyone’s attention and concentration.

How can teachers support a child who cannot sit still/fidgets in class?

Children who struggle to sit still in class may have difficulties with their sense of body awareness or proprioception. Proprioception is our sense of where our body is in space, proprioceptors in our joints send signals to our brain about the position of our body. Regular proprioceptive activities that allow a child to experience pressure through their joints helps to improve their body awareness and therefore reduce fidgeting. Proprioception is also a sensory regulator and therefore will help with general attention and concentration. Activity ideas include walking like an animal (e.g. like a bear or a crab with hands and feet on the floor and bottom in the air) pushing the wall and counting to ten (making sure feet are on the floor, body straight and elbows bent), posture preparation (e.g. pushing hands together and counting to ten, pulling hands apart and counting to ten, giving self a big hug and counting to ten). Some children may need the use of a fidget toy to help them reach the level of sensory input they need in order to be able to attend and concentrate, children should be allowed to use these when teachers are giving the input (ideas for purchase are below).

Paediatric Feeding Clinic

The London Children’s Practice offers a paediatric feeding clinic treating infants and children with a range of feeding and swallowing difficulties. This feeding clinic consists of a multidisciplinary team committed to providing care to children with feeding disorders and their families.

We assess and treat children with:

  • Fussy eating
  • Food refusal behaviours
  • Sensory-based feeding difficulties
  • Difficulty swallowing
  • Difficulty biting or chewing
  • Difficulty managing certain textures (e.g., lumpy or hard foods)
  • Difficulty transitioning to oral feeding, from nasogastric, gastrostomy or jejenostomy feeding.

An initial assessment is carried out by a Speech and Language Therapist and Dietitian, both with expertise in the area of paediatric feeding. From this initial assessment a comprehensive report is generated and a course of therapy agreed on. Paediatric Neurologists, Occupational Therapists and Psychologists are also available for assessment and therapy depending on the needs of the child.


Special Educational Needs, Tribunals and Legal Work

The London Children’s Practice provides a wide range of services related to tribunals and legal work, including expert witness opinion and evidence. These include:

  • Specialist joint and multi-disciplinary assessments
  • Preparation of Statement reports
  • Expert witness attendance
  • Tribunal reports
  • Expert advice and consultation
Holiday Activity Camps

The London Children’s Practice offers activity days throughout periods of school holidays. These camps provide the opportunity for your child to engage in fun and interactive activities whilst in a supportive therapeutic environment. They are designed to support children to develop their speech, language, play and social skills through a combination of structured language communication and sound activities and supported free play.

Evidence shows that many children make better progress in group settings as the skills targeted are consolidated and generalised into more realistic goals.

Additionally, we offer input from Occupational therapists and Art Therapy during holiday camps.

For bookings and any queries please contact:


The Practice offers consultations with parents, guardians, health professionals, members of the legal profession and schools, always striving to adopt a pro-active, problem-solving, child-centric approach. Areas for consultation include:

  • General advice and discussion
  • Learning issues
  • Behaviour and social issues
  • Supporting parents and the extended family
  • Attendance at school reviews, parent’s evenings, etc

We are also able to offer advice on the most appropriate school for your child’s particular needs.

Educational Psychology

Introducing a comprehensive educational psychology service for families and schools
The London Children’s Practice is a multi-disciplinary team of paediatric therapists now working in partnership with consultants and psychologists to provide a comprehensive and integrated service for children. Since its beginnings more than 20 years ago, the practice has steadily grown to become a specialist centre with an international reputation.

Educational psychologists are both psychologists and qualified teachers who undertake specific post graduate training in educational psychology. They have an in-depth understanding of the educational and psychological needs of children and young people both at home and within school. All our educational psychologists are experienced practitioners and all hold chartered status with the British Psychological Society.

Our psychology team offers a full range of services for children and young people of all ages. We can also offer psychology as part of a multi-disciplinary service in partnership with other professionals working at the London Children’s Practice.

Our Educational Psychologists specialise in:

  • Learning difficulties
  • Specific learning difficulties (including dyslexia)
  • Language and Communication
  • Autistic Spectrum Disorders and related social communication disorders
  • Neurodevelopmental disorders such as ADHD
  • Asperger Syndrome
  • Behaviour
  • Medico-legal work, including tribunals
  • Our psychologists are also involved in training and research

When required, our educational psychologists carry out detailed assessments to determine the nature of a child’s difficulties and then suggest a plan of intervention which may involve both parents and school. Where necessary, we can also link to other services provided within London Children’s Practice such as speech and language therapy. In other words as part of the wider multi-disciplinary practice, we are able to provide more than just assessment and our aim is to provide a pro-active individualised intervention service for each child.

We also offer a consultation service to parents and professionals and provide a range of services specifically for schools.

Assessments and Consultations are generally carried out within the practice but home or school based assessments can be offered when the need arises. Email and Telephone Consultations are also available.

Services we offer include:

  • Assessment (including developmental and IQ assessments and/or academic learning assessment)
  • Diagnostic Assessment
  • Assessment and Planning of intervention programmes for overseas families
  • Assessment for Examination Special Arrangements
  • Assessment for and representation at Special Educational Needs Tribunals
  • Medico-legal reports and assessments
  • Attendance at reviews and advice to schools
  • Advice & Intervention for behaviour problems in school and at home
  • Social Skills Training
  • Anger Management Training
  • Individual therapy and counselling
  • Training workshops and Advice to schools
  • Parent and Family workshops
Medical Team

We work closely with a Paediatric Neurologist who carries out multi disciplinary and diagnostic assessments with the practice team.

Occupational Therapy

Occupational therapy (OT) addresses the question ‘Why does this child have difficulties managing his/her daily activities, and what can we do to make it possible for him/her to manage things better so that it has a positive impact on their health and general well-being?’. Our primary goal is to assist children participate in everyday activities.
Our Occupational therapists provide:

  • Assessments;
  • Individual therapy at school, at home and/or in our clinics;
  • Group therapy – ‘Wonderful Writers’ (Handwriting), ‘Little Hands’ (fine motor skills and pre-writing skills), ’Mover and Shakers’ (physiotherapy and occupational therapy), and ‘School Starters’ (speech and language therapy and occupational therapy school readiness);
  • Parent and teacher training, talks and advice;
  • Home and school programmes; and,
  • Medico legal assessment reports.

Children learn best by doing so our therapy sessions are fun and meaningful and provide multi-disciplinary practice skills through a range of different activities such as:

  • Visual fine motor skills – cutting, colouring, drawing, threading, puzzles, etc.
  • Sensory motor skills– posture, balance, throwing and catching, etc.
  • Self-care skills – dressing and undressing, using cutlery, etc.
  • Handwriting
  • Planning and organisational skills

The London Children’s Practice Paediatric Occupational therapists work tirelessly to assist and help children succeed in performing their self-care and school/play activities.

What is Speech and Language Therapy?

Speech and language therapy is concerned with the management of disorders of speech, language, communication and swallowing in children and adults. At the London Children’s Practice we specialise in the provision of speech and language therapy for children up to the age of 18. We work closely with families to fully assess the child’s needs and plan an appropriate intervention programme based on the needs of the child. Our service is provided in the form of assessments, reviews and regular or intensive therapy input.

Group sessions last from one to two hours and some children attend more than once a week. We run several groups that target language, speech sounds, specific language difficulties or social communication difficulties.All groups are run by a speech and language therapist and a speech language therapy assistant.

All London Children’s Practice therapists are fully qualified with many years of experience. All are registered with the Health Professional Council and meet the exacting standards of the Royal College of Speech and Language Therapists (RCSLT).


Speech and Language Therapy assessments usually last an hour, during which a case history will be taken and a range of formal and informal assessments will be used as appropriate. At the end of the session the therapist will feedback assessment findings and discuss future management options which may include referral onto other professionals. A detailed report including strategies and specific recommendations for your child’s therapy needs will then be written and distributed.


Therapy is available on an individual basis or within small groups. Some children may benefit from a combination of both individual and group therapy. School and home based therapy sessions are also provided. Therapy programmes including specific targets and strategies are developed with the child and family. At the London Children’s Practice we keep up to date in new therapy techniques and research in order to provide the best and most effective therapy for our families.

Group sessions last from one to two hours and some children attend more than once a week. Our early years nursery groups are for young children with communication difficulties and provide a structured total communication approach with the focus on language stimulation and functional communication. We also run several other groups that target speech sounds, specific language difficulties or social communication difficulties. We often find that many children make better progress if they receive speech and language therapy within a small group setting as the skills targeted are consolidated in a more realistic environment. All groups are run by a speech and language therapist and a speech language therapy assistant.

Our therapy assistants are also able to provide support to children in clinic, nursery, school placements or at home under the guidance of a qualified therapist. They are able to follow targets set by the child’s therapist in order to help consolidate skills learnt in therapy sessions into different settings.