Kent Community Health . Foundation Trust provides Occupational Therapy for children and with specialist seating needs, according to the referral criteria.
Milestone Academy also employs an Occupational Therapist on a consultancy basis, who is able to offer assessment and interventions to support sensory processing disorder, fine motor skills and independent living skills.
How to decide who is NOT an appropriate referral?
- Students without obvious difficulties in sensory, perceptual and motor functions
- When a student is managing activities of daily living regardless of their diagnosis and difficulties.
- Students who present primarily with emotional and behavioural difficulties not related to any underlying dysfunction, such as sensory processing difficulties.
- Students who present with behavioural problems related to parenting skills and stress with family dynamics.
- Where a student’s functional difficulties are expected and in line with their global developmental pathway. In this case there may be limited effect from an occupational therapy therapeutic intervention.
- Students whose functional difficulties are only related to education- based tasks, e.g. dyslexia affecting handwriting and spelling
- Any student for whom a contribution to their Education, Health and Care Plan (EHCP) is sought as the only basis of referral
How to decide if a referral IS appropriate?
Where there is evidence of significant and severe functional impairment, and where this is significantly out of line with the perceived potential of the student
Where difficulties with sensory processing (e.g. sensory seeking behaviour or hyper-sensitivity to external stimuli) and emotional regulation cannot be met via school-led therapy interventions (e.g. SMILE Time, QuickShifts, Zones of Regulation) and/or ASD Lead support, which are creating barriers to functioning in:
- school, and accessing learning and the curriculum
- activities of daily living
- play and leisure.
Where there are clearly identified functional deficits with activities of daily living in the areas of:
- self-care: including independence in self-feeding, self-dressing, toileting and life skills
- access to learning and the curriculum at school
Gross and fine motor deficits, where need cannot be met via school-led therapy interventions (e.g. Clever Fingers, Write Dance, BEAM)
Perceptual functions, e.g. poor visual discrimination and visual spatial
Where there are environmental barriers, either physical or psychological.
Where new information has come to light or there is change of need, especially if identified in an IPN or Annual Review, with regards to any of the above
For any concerns about a student with complex physical needs who requires or needs a review of their specialist postural seating, please speak with the Milestone Physio / OT Therapy Assistant, who will refer to the NHS Community OT Service
For any concerns about a student’s wheelchair or wheelchair accessories, please raise this with their parents, as it is their responsibility to contact the wheelchair service for reviews and/or repairs.
How to refer to Milestone Occupational Therapy
Referral can be made by SMT, Class Teacher, Phase or ASD Lead to Milestone Therapy Lead.
Referrals should be in writing via internal email or triaged through face-to-face discussion with
The following information should be provided, where relevant to the referral:
- Relevant history of the student concerned and description of present needs.
- A description of how any medical or developmental condition is affecting the daily function of the student concerned.
- A description of what the referrer hopes to gain from intervention from the OT service.
- Information about other professionals and agencies involved with the referred student.
What will happen next?
All referrals via email will be acknowledged by the Therapy Lead to the referrer within seven (7) working days, during term time.
Referrals will be reviewed by the Therapy Lead who will contact the referrer if further information is required or if the referral does not fulfil the referral criteria.
Referrals will be prioritized according to need and passed to the Milestone Occupational Therapist
Milestone Occupation Therapy within the Balance System Framework
Specialist (Direct OT Input)
OT advises course of action or prescribes individualized intervention/programme.
- Significant new information which required investigation, AX or re-AX by OT.
- Needs cannot be met through school-led provision Direction intervention by OT
- Requires immediate action or direct intervention by Occupational Therapist when placement or safety is at risk
Targeted and School-Implemented Specialist (Direct <-> Indirect)
Referral to occupational Therapy. School-led intervention to continue until advised to change or cease by OT. Individualised Intervention or strategies needed over and above school-led Universal Interventions.
- Requires investigation, Ax or re-Ax by OT
- Targeted advice, programmes and training delivered by OT. including Sensory Progressing, Zones of regulations and ADL & Eating/Drinking (with SLT)
- Specialist Training by OT with interventions Implemented byu school staff and parents.
- Monitoring and reviewing by OT
Universal ( School-Led)
Students with identified OT related needs. Need can be met through school-led intervention or support. No involvement needed from Occupational Therapist.
- Whole School Training by OT for Clever Fingers and Sensory Processing
- Staff support available from ASD Leads for Sensory/SMILE guidance and monitoring