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We are a team of 2 Physiotherapists who see Liverpool children (0-19) with neurodisability and respiratory symptoms. A Physiotherapist or consultant may refer children to our service and we assess and treat them in any location (nursery/school, home, respite). Long term and acute strategies are put into place in order to manage these day to day respiratory symptoms and also help prevent recurrent admissions to hospital. We are now also offering head to toe assessment and prescribing skills as part of the service. The team works closely with the community multidisciplinary team, school staff and also Alder Hey in order to provide a holistic approach for the children.
We treat children and young people who struggle with their gross motor skills (large body movements which use the arms, legs, hands, feet and trunk such as jumping, hopping and skipping). These children are assessed and treated in clinics, at school and in group based situations. Our team works in conjunction with local authority services such as Occupational Therapy as well as with mainstream schools and their SENCos to help facilitate improved skills and long lasting confidence of the children in our care.
We are currently in the process of developing a joint Motor Coordination and Sensory Service with the Liverpool City Council Occupational Therapists to improve our patients’ experience. By doing this we hope to reduce waiting times as well as the number of appointments children and families will have to attend.
Children are referred to us when they appear to have variations in otherwise typical development e.g. in turned feet, flat feet. Children are seen by a highly specialist physiotherapist, who has links with the orthopaedic department in AHH, in Childwall Fiveways or Townsend Medical Centers. The Developmental Variant Clinic offers comprehensive assessment of the child, including developmental history and physical examination. The opportunity for this formal assessment is particularly useful when parents do not feel fully reassured by the advice given by their health visitor or GP. We encourage families to ask questions during this clinic, and will explain the child's presentation at this time.
Following this assessment there are a number of potential outcomes, however, the great majority of children do not need on-going physiotherapy intervention or onward referral. Most families are given advice and reassurance +/- an information leaflet and then discharged. Children may be signposted to other services, usually via their GP. When appropriate children may be given advice and asked to return to be reviewed in clinic. If the child would benefit from physiotherapy intervention their care will be passed to a community physiotherapist.
Some children that we see benefit from wearing splints (orthosis) or from lycra garments (a pressure garment).
If it is thought that a child would benefit from one of these then the child’s physiotherapist will discuss it with the parent/carer and arrange for the child to be assessed by an orthotist, either in Alder Hey or in a community clinic, to decide with the family if a splint/orthosis would help the child and if so what type would be best.
These clinics are held in the special schools and some local Medical Centres.
• There will be an orthotist and possibly a specialist physiotherapist at the clinic to assess the child. The child’s physiotherapist will also be present if necessary.
• The reason for the child needing a splint and the type of splint being suggested will be discussed.
• Measurements or a plaster cast will be taken and an order placed.
• The child will have a fitting when the splint is ready (more than one fitting may be needed).
• At time of issuing the splint full instructions will be given about how and when to put the splint on, how to check if the splint is fitting correctly, what to do if it is causing problems and how to care for the splint.
• The splint may be reviewed by the child’s physiotherapist or by the orthotist in Alder Hey.
Alder Hey Children's Charity