Children’s Services and Adult
Learning Disability Services
Children’s Services and Adult
There are lots of different reasons why you may need to see our team. We have a few different types of clinics that we may invite you to attend, based on your individual needs.
Once a referral has been accepted you will be invited to attend a triage assessment. This will help us to assess your child and determine what input may be required. Firstly, you will have a discussion with the physiotherapist regarding your concerns and then an assessment of your child will be completed.
This assessment may include the physiotherapist assessing your child’s:
It is helpful if your child attends the appointment wearing loose fitting clothes eg PE clothing or shorts and t-shirt.
On arrival you will be provided with consent forms to complete in relation to the care your child receives.
Once a triage assessment has been completed there are a number of outcomes that may be suitable for your child:
Your child may be invited back for a review appointment following an agreed length of time by the physiotherapist
The physiotherapist may provide advice and treatment for you to implement at home before your review appointment
If your child requires ongoing physiotherapy intervention they will be placed on a waiting list and you will be contacted when an appointment is available
The physiotherapist may provide advice and treatment for you to implement at home whilst you are waiting
Your child may not require physiotherapy input, however they may require orthotic intervention and will remain under the orthotic service only
You will need to contact the service when a review of your child’s orthotic intervention is required
Sometimes your child may require a one off visit for them to be seen at their nursery/school
Your child may be placed on the open access service and you will be given a leaflet to explain this. If you still have concerns regarding your child in the future then please contact the service for advice
It may be decided that your child does not require further physiotherapy input and therefore your child will be discharged from the service
CPIP (Cerebral Palsy Integrated Pathway) UK is a follow-up and review programme for children with cerebral palsy or suspected cerebral palsy, allowing early detection of changes in muscles and joints as a result of the condition in order to detect areas of change sooner, to improve earlier management opportunities and reduce the risk of longer term complications.
You will only be invited for this assessment following a diagnosis of cerebral palsy or suspected cerebral palsy. If a child has a condition that presents in a similar way to cerebral palsy, this assessment is sometimes used to monitor those changes. Your consultant or physiotherapist will discuss the assessment and pathway with you first.
The purpose of CPIP UK is to ensure that children with a risk of developing contractures or hip dislocation as a result of spasticity (increased tone) in the muscles are detected early enabling timely intervention.
The goal is that no child should be affected by severe contractures or hip dislocation and that every child should achieve the best possible function possible.
Research has shown that x-rays of the hip taken at the right time in conjunction with a physical assessment can help spot this problem earlier and take steps to reduce the chance of it getting worse.
The CPIP UK review appointment involves the child’s physiotherapist who will make an assessment of the child’s muscle tone, joint motion, ability and function twice a year until the child is aged six.
After that, an annual assessment is made until the child reaches 16 or adulthood if it is felt to be beneficial to review before the child reaches 18.
The assessment is often completed by two therapists and/or assistants. It involves the child’s joints being moved through their normal range and then measured with a goniometer (an angle measure like a protractor).
Parents can be present throughout the assessment. It usually lasts approximately one hour. It is not expected that the child will experience any pain from the assessment but some children may find the stretching of their joints a little uncomfortable. The assessment can be paused at any time to allow your child to move and wriggle.
Please bring your child in a P.E kit or similar clothing to ensure the physiotherapist is able to carry out the assessment easily.
You may also bring a book or tablet to occupy your child whilst the assessment is being completed. They will be asked to lie on their back and/or front for the assessment therefore any activity brought must encourage your child to remain calm and still.
These assessments help the physiotherapist decide how often your child needs to be seen for treatment and what treatment options are best for your child.
Regular assessments and early treatment are combined to improve outcomes.
The assessment works on a traffic light system with colours attributed to different measurements indicating areas that require monitoring, a change of management or consultant review or no concern.
Children with Cerebral Palsy will be asked to attend for a hip x-ray at 2 years of age. If your child is mildly affected by cerebral palsy you can expect one further x-ray aged 6 years. For those more severely affected there will be annual x-rays until age 8 years and then every other year. This is because there is a greater risk of hip dislocation in more severe cases. All children will be invited for a final x-ray at age 16.
The physiotherapist will share assessment details with the other relevant health professionals involved in your child’s care. The common pathway and reporting framework improves sharing of information and understanding of your child’s needs at the time of assessment to ensure the very best outcomes for your child, monitoring change and reviewing management needs as your child grows and develops.
Our team now support the gathering of information about children with cerebral palsy to contribute to research conducted into the management of cerebral palsy. You will be asked for your consent before your child’s assessment results are added to the national data base. The therapist in clinic will offer more information and guidance on this if required when you visit us in the clinic.
Children treated under a similar programme in Sweden experienced significantly fewer hip dislocations. Significantly fewer children from this group developed major contractures and scoliosis through participation in the programme. There was also a decrease in the number of major orthopaedic operations performed for hip dislocation and the co-operation between different specialists involved in the care of children with cerebral palsy improved.
Scotland has this programme in place and it is now being introduced across England.
More information about the CPIP UK pathway can be found here
The Orthotics team work alongside the physiotherapists to assess and manufacture devices which support or correct the function of a limb, the head or body.
Commonly seen orthotics in children’s therapy may include specialist footwear, splints to support or stabilise efficient joint movement, insoles to support foot posture inside shoes, body suits to offer sensory feedback or leg/arm gaiters to support stretching and positioning. Some children may also be offered protective helmets or joint braces from orthotics.
A referral for a new assessment can be made to the orthotic team by your physiotherapist, consultant or GP. Once the referral has bee accepted, the team will contact you to make and appointment.
If you are already known to the service and need a review of your existing orthotics, you can contact the team on 01482 336774 to request a review appointment.
Orthotic clinics are held at a number of bases across Hull and East Yorkshire. You will need to contact the service on 01482 336774 to arrange an appointment at a location that is convenient for you to attend.
Your child will have an initial assessment from a qualified orthotist who will decide if orthotic intervention is required. There are a number of orthotic provisions which can include splints, insoles, or orthotic boots etc.
An assessment will be made to decide which orthotic would best manage the complaint at the time. Orthotic provision will continue to be reviewed as required and can be adjusted and changed as the needs of your child changes with growth or development of different abilities.
If your child’s orthotic provision is causing a red mark on the skin and the skin is not blistered or broken, remove the orthotic and monitor the skin. If the redness disappears within 20 minutes of removing the orthoses then please do not be concerned as this can be normal, however this should be monitored. If the red marks last longer than 20 minutes then you should contact the physiotherapy team for advice and to book an orthotic appointment for a review
If your child’s orthotic provision (splint/insoles/boots etc) are causing a blister on the skin, then remove the orthoses to prevent further pressure on the blister and contact the physiotherapy team for advice and to arrange an orthotic appointment for review.
It is the responsibility of the child’s parents to contact the physiotherapy team to arrange orthotic appointments for reviews.
If your child’s feet have grown and they require a larger shoe size, then it is likely that they will require a review of their orthotic provision.
If your child has a splint you must regularly check that this is fitting well. If the splint looks too tight around the foot, ankle, or leg, or the child’s toes are coming to the end of the splint then you should contact the physiotherapy team to book an orthotic review appointment.
If your child is seen in school or for a review appointment, the physiotherapist may review the orthotic provision at the same time and support you to make a review orthotic appointment.
If you have any concerns about your child’s orthoses, you should contact the physiotherapy team for advice.
Postural Care (also known as Postural Management or Positive Positioning) is a 24-hour programme which is recommended by an occupational therapist and/or physiotherapist for children and young people who are not able to maintain or control a neutral posture.
It aims to protect your child’s body shape during the day and night, encouraging them to grow with the healthiest posture they can achieve.
Everyone who cares for your child needs to understand the programme and be involved in its delivery.
Postural care is a central part of a child’s life at home, school and in leisure. If your child is comfortable with a good posture, they are more likely to achieve greater function.
We will work with each person involved with the care of your child to ensure everybody is following the same postural care plan.
It is important that you and your child let us know when things are not working well so that the best solution can be found for your family.
Good positioning can reduce and sometimes prevent:
Your child will be seen by an occupational therapist and/or physiotherapist for an assessment, this could be at home, school or in a clinic setting. We will ask parents and other carers to attend, as appropriate. We often take photographs to monitor your child’s posture over time, these are stored confidentially and we will only do this with your consent.
Your child may be assessed in lying, sitting and standing positions and we will ask questions to fully understand your concerns and needs. We will work with you and your child to develop an individual postural care plan, ensuring the best positions for lying, sitting and standing.
We may recommend specialist equipment to support your child, this may be required short term, for example whilst your child is still growing and developing. However, sometimes it may be needed long term.
If your child already has equipment in place, this will be reviewed to ensure it is still meeting your child’s needs.
Positioning equipment could be as basic as some rolled up towels, pillows or cuddly toys, but if more specialist equipment is required it could include a specialist seat, standing frame or night time positioning system. Any plan or equipment will be discussed with you and your child, please ask questions throughout.
Your child’s postural needs will be reviewed as required.
Please bring your child in a P.E kit or similar loose fitting clothing to ensure the physiotherapist is able to carry out the assessment easily.
Physiotherapy equipment used to support posture and change of position
The physiotherapy team may decide your child would benefit from use of specialist equipment to support your child’s posture and provide them with a change of position.
Equipment may include:
The following videos have been made by the paediatric physiotherapy and occupational therapy teams in collaboration with experts by experience.
The five individual videos, along with the full-length version, can be accessed at the below links.
Developed by the paediatric physiotherapy and occupational therapy teams in collaboration with experts by experience, the videos explain what postural care is, why it is important, and how it can be effectively supported.
The series covers:
It is important that information about postural care is accessible and easy to understand for everyone who uses our services. By involving parents and carers with lived experience, the content has been designed to be informative, practical and relatable.
The above links are to external websites owned and operated by third parties. These links are not endorsements or recommendations. We have no control over the contents of third party websites, and Humber Teaching NHS Foundation Trust accepts no responsibility for them or for any loss or damage that may arise from your use of them.
Find our more about how to access our service and the referral process below.
Find Out MoreFind out more about our Children's Occupational Therapy service.
Find out more about our Children’s Speech and Language Therapy service.
The Community Team for Learning Disabilities (CTLD) provides specialist health support for adults with learning disabilities whose needs cannot be met through mainstream services.
Find out more about our Health Visiting and School Nursing services in Hull and East Riding.
Find out more about our services from the useful links provided.
