Physical and self care difficulties

Physical & Self-care Difficulties

A child or young person with a physical difficulty may struggle with day-to-day activities and need extra support.

Difficulties can be as a result of:

  • physical impairment, e.g. cerebral palsy, muscular dystrophy, spina bifida, arthritis, genetic disorder etc.

  • Delayed development of gross and/or fine motor skills due to various reasons, e.g. a specific condition, lack of exposure, hospitalisation, illness, etc. 
  • An injury or illness that causes a short term change to physical functioning.

Support is offered through two services Paediatric Occupational Therapy (OT) and Paediatric Physiotherapy (PT).

Paediatric Occupational Therapy (OT)

Occupational Therapy is concerned with promoting a balanced range of occupations to enhance health and wellbeing.  Occupations refer to everything people do in the course of their daily life.  Within Hounslow, Paediatric Occupational Therapists work with Children and Young People (CYP) aged 0-18 who have difficulties functioning in daily living activities due to illness, injury, developmental difficulties or neurodisability (e.g. physical disabilities, autism). 

The Hounslow Paediatric Occupational Therapy Service is committed to ensure a child and their family are able to function in all aspects of their lives to their maximum potential: self-care (e.g. dressing to go out, eating a meal, using the toilet), productivity / educational attainment (e.g. playing for young children, attending school) and leisure / socialisation (e.g. playing with friends, participating in sports) etc.

Occupational Therapists provide advice and support to parents, carers and other professionals involved and work across a range of settings where different occupations occur (e.g. home, school, clinics etc.).  The unique contribution of Occupational Therapy includes:

  • Improving quality of life for children and families
  • Minimising barriers to activity participation
  • Reducing impact of disability
  • Promoting independence and self-management

When would my child need OT?

When your child experiences difficulties in carrying out normal day to day activities such as:

Self-Care

  • Feeding – child is unable to feed him/herself to an age appropriate level
  • Child cannot hold spoon / fork / knife correctly
  • Dressing – child is unable to dress / undress to an age appropriate level
  • Toileting – child is significantly delayed in toilet training

Participation in Productive Activities (in relation to movement and coordination)

  • Ability to use different tools and items, e.g. crayons, pencils, rulers, scissors, puzzles etc.

Participation in Play and Leisure Activities   

  • Knowing how to explore and play e.g. engagement with toys or play items etc.
  • Doing arts, crafts and having hobbies
  • Games and PE, e.g. accessing climbing frames, ball games etc

How to access the OT service

OT come under Hounslow  and Richmond Community Health NHS Trust.  The service is based at Heart of Hounslow. 

How to refer

Referrals can be made by any healthcare professional so discuss any concerns with the childs GP or health visitor

Further information on the team can be found here

Referrals will be accepted for children/young people who have:

  • A Hounslow GP, and are aged 0-18 

  • A difficulty or difficulties participating in functional tasks in the areas of self-care, productivity and/or leisure.

Paediatric Physiotherapy (PT)

Physiotherapists are responsible for the assessment and physical management of problems due to accident, injury, ageing, disease or disability. Paediatric physiotherapists have additional expert knowledge and experience of child development and childhood disabilities.  

Therapists provide specialist intervention to empower children, young people and families to self-manage their needs.

Each child/young person will be fully assessed by a physiotherapist at their initial appointment and, together with the family, they will work out a plan of what to do next depending on the child/young person’s need and the outcome that is required.


Physiotherapy intervention may include:

  • Provision of an exercise or physical/postural management program

  • Individual or group sessions with physiotherapist or physiotherapy assistant

  • Provision of specialist equipment (e.g. orthotics, mobility aids and postural management equipment)

  • Review of child or young person’s physiotherapy needs and program after an agreed period of time.

  • Training of parents/carers/school staff to carry out exercise or physical/postural management programs, and integrate them into the child or young person’s daily routine where indicated.

  • Liaison with parents/teachers/learning support assistants/nurses and medical staff as appropriate.

  • Referrals to other services as indicated e.g. wheelchair service, podiatry, other therapy services (i.e. OT/SALT)

When would a child need Physiotherapy?

Paediatric Physiotherapy can help children with:

  • Long term conditions, physical disabilities and developmental problems
    (0-18 years, 19 in special schools)

  • Musculoskeletal and orthopaedic conditions (0-16 years)

Examples of when physiotherapy may be needed include delay in development, mobility problems, neuromuscular disorders, neurological conditions, balance and co-ordination difficulties, joint and muscle pain/problems.

How to access the Physiotherapy service

Referrals need to be made by a healthcare professional so talk to your gp or health visitor.

In Hounslow the service is provided by Hounslow and Richmond community healthcare.  Further information on the team can be found here.

Children need to have a Hounslow GP

Specialist Equipment

You may need specialist equipment to help manage your child’s needs and disabilities.

Health professionals such as occupational therapists, speech and language therapists, physiotherapists and specialist community nurses may (as part of an assessment) recommend a particular piece of equipment for your child.

The forms to ask for equipment are in the Downloads section of this page. These are also the forms if your child needs specialist equipment to support their education in school or at nursery.  This also should be included as part of the setting via the EHCP process 

If adaptations are required in your home this will be managed by the housing adaptation team who include a specialist occupational therapy team

The Community Paediatric OT service does NOT cover Children who need one-off Social Care interventions, for example home equipment required after surgery.  That should be managed by the discharge team at the hospital the child is attending.

Wheelchair Service

The Wheelchair Hub provides a comprehensive wheelchair, seating and sleep system service for people with long term mobility problems and associated postural needs. Service users must be registered with an NHS Hounslow GP.  The assessment is holistic and takes into consideration disability, environment, lifestyle and safety factors.  

The service offers assessment to children and adults for provision of manual and powered wheelchairs, specialist children’s' buggies and associated supportive seating to meet postural and pressure care needs. 

The service is an 'open access' service as service users can self-refer or contact therapists for information and advice directly via the telephone or email   

Further information on the service can be found here.