A Special Child in the Family

The Professionals

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Physiotherapists, occupational therapists and speech therapists all work with sick and disabled children to help them overcome their difficulties. If you feel your child would benefit from such help, ask for it as soon as you can for the earlier treatment starts the better.


Physios are probably the best known of the therapists who work with children with special needs. They use exercises to help their patients gain and keep the best possible use of their bodies. They also try to improve breathing, to prevent the development of deformities and to slow down the deterioration caused by some progressive diseases.

Physios usually work in hospitals although some are attached to special schools and clinics. If you think physiotherapy could help your child, ask your doctor to refer you. You will probably have to take your child to see her although some physios visit children at home.

It's worth asking to see a children's physio if one is available. Not only will she be more likely to have had experience of your child's condition but she will also be used to working with uncooperative young patients.

The physio will assess your child's problems and teach you exercises to do with him at home. She may also show you ways to handle your child which will encourage good patterns of movement. If he needs lifting a good deal, ask her to show you how to do this without straining your back. That advice comes from the heart as I hurt my back lifting a profoundly disabled girl we knew. The result was extremely painful and meant I could not carry her or anything else for several months.

If your child receives physio at school, try to learn the exercises so you can continue with them during the holidays. Otherwise he may lose some of his hard won progress which will be very disappointing for everyone, especially him.

There are a variety of ideas among physios about the best way to treat some conditions, especially cerebral palsy. If you believe a different approach would be better for your child, ask your doctor to refer you to a clinic that uses it. Judging by the experience of other parents, you may need to be persistent in your request as doctors and physios are understandably resistant to suggestions that someone else can do better than they can.

Occupational therapy

Occupational therapists (OTs) work with children to increase their ability to cope with the tasks presented by everyday life. Their work not only covers areas like dressing but also less obvious ones like writing skills and difficulties with perception.

They also advise on special equipment to make life easier. In particular, they can assess for and provide wheelchairs and special seats and advise you on how to position and handle your child. This may be important for your child as good handling techniques and seating can prevent or minimise future problems with some conditions, especially cerebral palsy.

Once you are referred to one, she will carry out a complete assessment of your child's abilities and problems. Usually a copy of the assessment is sent to your doctor and sometimes one is given to you as well. The OT then devises a programme of activities to develop his abilities to the full and to give him methods of coping with those tasks his disabilities prevent him doing normally. She doesn't carry out all the training herself. Instead she will teach you activities to do at home and she may encourage staff at his school to do them too.

In some ways the aims of occupational therapists overlap with those of physios as improving your child's ability to feed himself, for example, will probably involve improving his use of his arms and hands. OTs achieve their aims through games and activities rather than formal exercises but, to further fudge the difference, physios working with children often turn their exercises into games to make them more enjoyable.

If you have both a physio and an OT working with your child, they will usually talk together to ensure their treatments complement each other. It is very unlikely that they will give you conflicting advice but, if they do, point this out so they can sort the matter out between them.

You'll find OTs working for your local authority, the health service and for some of the voluntary societies. The local authority ones advise on the provision of special equipment and on necessary adaptations at home or in school but time doesn't usually allow them to carry out treatment schemes with individual clients. You are more likely to receive this type of help from a health service or voluntary society OT.

You can refer yourself to a local authority OT by contacting your local social services department or you can ask your doctor to refer you to a health service one. In both cases, it's worth asking if there is one who specialises in working with children.

Speech therapists

A speech therapist can work with any child with a communication problem even if this is linked to another difficulty like deafness or a learning disability. Because eating involves similar mouth and tongue control to speaking, she can also help if your child has feeding difficulties.

You can be referred to a speech therapist by your GP, consultant, health visitor or school or you can contact one yourself if you prefer. Most of them work in hospitals, clinics or schools although some will visit patients at home. There are also some who work independently but treatment by one of them will normally involve you paying fees.

The main problem parents find with speech therapists is getting one at all. In some areas of the country, speech therapy is a scarce resource which can't stretch to all the children needing it. The result is some children receiving no help and others receiving less than they need.

If you are concerned that your child doesn't see his speech therapist as often as you would like, talk about your worries on your next visit to her. You may be worrying unnecessarily or his treatment could be limited by shortage of resources. Perhaps she could teach you ways to help him at home which would fill the gaps between lessons.