Neurodisability services

The Occupational Therapy team provide input into the Neurodisability clinics at Great Ormond Street Hospital (GOSH), working collaboratively as part of the multidisciplinary team. The occupational therapist will discuss your child’s current functional skills and assess their ability to carry out age appropriate self-care and school based tasks. Following the assessment, advice to support your child’s occupational performance is offered to local services to ensure continuity of care.

Developmental and Augmentative Communication Service

The occupational therapists work in conjunction with the multidisciplinary team, carrying out specialist developmental assessment with a focus on communication skills. Advice on ways to support your child to develop communication skills through play and interaction are provided, with the overall aim of increasing participation. In conjunction with other members of the multidisciplinary team, the occupational therapist may see children at home, at school or as outpatients in the hospital.

This service is also a specialist centre for the assessment and provision of Augmentative and Alternative Communication (AAC). In this part of the service, the occupational therapist will assess your child’s physical ability to communicate in alternative ways if speech is difficult; they will consider motor development and ability to physically access both paper-based and high-tech voice output communication devices. Seating and positioning is considered in order to promote your child’s ability to control technology, as is the impact of the environment on both access and overall communication skills. If required, the communication devices provided can be mounted to a child’s wheelchair or other specialist seating by the occupational therapist.

https://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/developmental-and-augmentative-communication-service-daacs

Dysphagia clinic

The Dysphagia clinic provides specialist expertise in the assessment and management of complex feeding and swallowing problems in children. The occupational therapist contributes to this as part of the multidisciplinary team. The level of occupational therapy that your child requires will be identified on a case by case basis, either prior to or following their initial assessment. 

The occupational therapist provides assessment and advice for children who have difficulties with motor skills, positioning and sensory sensitivities that are impacting on their specific difficulties with eating and drinking.

The occupational therapist is available to answer your specific questions and to offer support to local services that may require additional information regarding your child's care.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/dysphagia-service

Developmental epilepsy services

Developmental epilepsy clinic

The occupational therapist in these clinics will offer specialist assessment and advice to help support children with complex epilepsy. Advice is provided in partnership with the other members of the multidisciplinary team treating your child at GOSH.

The occupational therapist may provide advice on daily functioning and development. Advice may be provided regarding mobility, upper limb function and fine motor skills. Advice will be focused on supporting the young person to become more independent in self-care activities, schoolwork and play. It will also focus on the use of appropriate specialist equipment and seating. Advice is also available regarding equipment and environmental modifications to support seizure safety.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/developmental-epilepsy-clinic

Sturge-Weber and Neurocutaneous Service

The occupational therapist in this clinic will offer specialist assessment and advice to help support children with Sturge-Weber Syndrome and other neurocutaneous conditions. Advice is provided in partnership with the other members of the multidisciplinary team treating your child at GOSH.

The occupational therapist will provide assessment and advice regarding your child’s development and current functional skills including self-care, play and managing school work. Monitoring and advice is available for children with movement difficulties including transient hemiplegia.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/sturge-weber-clinic

Developmental vision clinic

The occupational therapist in this clinic contributes to the developmental assessment of your child and offers practical recommendations to help promote your child's functional skills at home or school. They can advise on preventing or overcoming difficulties and enhancing the child’s potential with motor and mobility skills, daily activities, play skills and school related activities such as recording of work.

This clinic operates as a specialist multidisciplinary team for children with visual disorders and impairment.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/developmental-vision-clinic

Movement Disorders


Botulinum Toxin Clinic

The occupational therapist will offer specialist assessment and advice for children referred for Botulinum Toxin Injections, with a focus on functional goal setting as part of their upper limb management. Assessment and advice is provided in partnership with other members of the multi-disciplinary team, including a specialist physiotherapist and a consultant specialising in paediatric neurodisability Assessment and advice will focus on upper limb function, participation in daily living, school and leisure skills and where required, recommendation about splinting and assistive devices.

http://www.gosh.nhs.uk/health-professionals/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/botulinum-toxin-clinic

Selective Dorsal Rhizotomy Service

The occupational therapist will offer specialist assessment and advice to support the admission and discharge planning for children and young people with cerebral palsy who have been accepted for SDR surgery. The occupational therapist will meet with the child and family during the pre-assessment appointment to help plan for the admission, including identifying equipment needs and liaising with community services. During the hospital stay the occupational therapist will work alongside physiotherapy colleagues to plan the discharge home and transition back to school.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/selective-dorsal-rhizotomy-service

Neurospines clinic

An Occupational Therapist is present in this outpatient clinic to provide assessment and advice as needed.

Neurodevelopmental assessment clinic

The Neurodevelopmental Assessment Clinic provides specialist expertise in the assessment and management of children with complex neurodevelopmental disorders, including Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and intellectual disability. The main reasons for referral are diagnosis, second opinion, and requests for associated educational/therapy/behavioural advice. 
The Occupational Therapist will discuss your child’s current functional skills and assess their ability to carry out age appropriate self-care, recreational and school based tasks. The session may also include an assessment of the child’s motor abilities and consideration of possible sensory based difficulties that may be impacting on their occupational performance. Following assessment, advice is provided to support the 

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/neurodevelopmental-assessment-service

Osteogenesis imperfecta service

The occupational therapists are part of the osteogenesis imperfecta multidisciplinary team. They will offer advice and support to infants and children seen within this service. Children may be seen as inpatients, outpatients or on outreach visits. Advice and support may relate to the management of daily activities, such as bathing and play, and to guide the handling and positioning of infants. They can advise on specialist equipment, mobility and seating.

Visits can be made to home, school/nursery to support families and their local teams. The Occupational Therapists provide a quick response service to newly diagnosed infants at hospital or home.

http://www.gosh.nhs.uk/medical-information/clinical-specialties/neurodisability-information-parents-and-visitors/clinics-and-services/osteogenesis-imperfecta-service