Children who have more complex needs and difficulties may require help to learn some of the skills they will need to cope with daily living.
If they need help with communicating they may see a speech and language therapist, for example. Or a physiotherapist can help them with movement skills and mobility. Read more about the types of therapies available below.
Speech and Language Therapists (SLTs) diagnose and treat problems with communicating, speaking clearly and understanding what other people say. Other SLTs specialise in difficulties with chewing and swallowing.
If you think your child has these kinds of difficulties or someone working with your child suggests that they do, you should be referred to the SLT service. The SLT service will provide assessment, diagnosis and management of your child’s difficulties. After an initial assessment, your child may get a block of direct sessions with a speech and language therapist on an individual basis or in a group. Or someone already working with your child, for example a TA at their school or their nursery worker, may get a programme of exercises or activities to use with your child. To make the best progress, your child will need you to do the same at home too.
In either case, the therapeutic programme will always be reviewed by the speech and language therapy service. Be aware that therapy is unlikely to go on forever and may be put in place for a specific period of time.
In Brighton and Hove, speech and language therapy services for children with complex needs are based at the Seaside View Child Development Centre. They work closely with the BHISS Language Support team who help to provide support with speech, language and communication needs in schools.
In East Sussex, speech and language therapy services are provided by the East Sussex Children’s Integrated Therapy Service (CITS) from three locations across the county
Children with more complex issues around swallowing and eating, such as a serious reflux condition, are likely to be treated by dysphagia specialists in hospitals like the Royal Alex, working in conjunction with respiratory and gastro specialists.
Occupational Therapists (OTs) help children develop everyday skills, such as feeding themselves, getting dressed and playing, if these are affected by physical, developmental, sensory disabilities or sensory processing issues.
OTs will assess and treat children at home, at school or pre-school or healthcare clinics or community locations.
After assessment, an OT will write a report that identifies any areas where your child needs help. This might also include advice on exercises, adapting tasks to your child’s ability or equipment. There will be activities you can do at home with your child as well as in school.
If you think your child help with developing everyday skills, speak to their health visitor, nursery or school SENCO. They can refer you to the OT service.
Physiotherapists help with movement skills and physical mobility. They can treat a wide range of conditions, including:
- Co-ordination difficulties
- Developmental delay
- Neurological or neuromuscular disorders such as Cerebral Palsy and Muscular Dystrophy
- Congenital syndromes and metabolic diseases such as Down Syndromeand Rett Syndrome
Physiotherapists may work with your child in community locations or health care clinics, schools and nurseries, or even in your own home, if appropriate.
If your child has mental health, behavioural or emotional difficulties they may benefit from activities like play therapy, cognitive behavioural therapy or counselling. These kinds of therapies will be provided either through school wellbeing staff, community mental health teams or specialists in child and adolescent mental health.
See our page on mental health and wellbeing for more information on psychological therapies.
Making the most of therapies
However good your child’s assessment and therapy sessions are, they’ll make little difference unless you put in regular work at home too. Here’s our tips for making sure your child really benefits from therapeutic input.
- Include your child as much as you can: if possible, encourage them to explain in their own words how they feel. You might be surprised about what’s most important to them and what they would like to be able to do or change.
- Ask questions: whether you are worried that it takes your child longer to pick up new skills or that they are socially awkward, it will help you both to make sense of the problem.
- If you don’t understand, your child won’t either so keep asking: explanations need to be simple and strategies must be straightforward.
- Find out what you can both do at home between appointments. Check that you understand what you will be doing and why. If the advice sounds counter intuitive, ask why it will work. It’s much harder to take a different approach and embrace new ideas if it doesn’t make sense.
- Ask your therapist to give real examples, and show you what they mean
- Get them to rehearse with you and practise until you feel confident
- Make sure you will get a written copy of the recommendations
- Ask for help getting hold of resources or equipment if it might prove tricky
- Get details of useful websites and online resources
- If trialling a new treatment, be sure you both agree how to report unexpected side effects
- Check how your child’s school or nursery can play their part and how you’ll both be kept in the loop.
- Build any exercises or strategies into your daily routine: often you can harness and adapt everyday activities to embrace and practise these new approaches.
- Enjoy yourselves: if you can make it fun somehow, the therapies will be more enjoyable and more effective.
- Take it easy sometimes: remember, not every moment needs to be filled with purposeful activity. Give your child time to relax and play.
- Be realistic: it‘s what happens day in day out that matters most. Until it feels like second nature, doing things and thinking differently can feel like hard work. Any new approaches need practice – lots and lots of it – so don’t expect to see big changes quickly.
- Be kind to yourself. Take a longer view: quiet optimism and patience will make a difference. With practice, we can all be our child’s best therapist