Occupational Therapy

Developmental Coordination Disorder (DCD) 

Developmental Coordination Disorder (DCD), sometimes known as Dyspraxia, is a lifelong condition that affects movement and coordination. It means a child may perform less well than expected in everyday activities for their age and may appear to move more awkwardly or clumsily.

This can make tasks like dressing, bike riding, swimming, or joining in with PE lessons more difficult or frustrating. These differences are not explained by a general medical condition or other developmental disorders. Instead, they reflect how the brain processes and coordinates movement — affecting how a child plans, organises, and carries out physical actions.

Children with DCD may:

• Struggle with fine motor tasks (e.g. handwriting, using cutlery, tying shoelaces, using scissors)
• Find gross motor activities difficult (e.g. catching a ball, hopping, skipping, riding a bike)
• Appear slower than their peers to learn new motor skills
• Experience difficulties with organisation, sequencing, or remembering multi-step instructions
• Sometimes have lower confidence or avoid physical play

Each child presents differently, but strengths often include creativity, verbal reasoning, empathy, and original thinking. Many children with DCD show persistence and resourcefulness, especially when supported in environments that recognise and build on their individual abilities.

Information About Our DCD Assessments

Our DCD assessment is uniquely delivered through a joint model, with both a paediatrician and occupational therapist working together in one coordinated session. Families meet with both professionals at the same time, allowing us to explore medical and functional perspectives side by side. This joined-up approach builds a fuller picture of your child’s strengths and challenges, and provides a clear outcome during the session — without needing to return to a GP, chase further referrals, or wait for separate paediatrician input. The model reflects best-practice guidance from DSM-5 and NICE, which recommend collaborative input from both medical and therapy professionals. 

The Goal of a DCD Assessment

• Identify and describe the child’s motor coordination difficulties
• Differentiate DCD from other possible causes of motor delay (e.g. cerebral palsy, visual impairment)
• Guide intervention, helping families, schools, and health professionals understand how to best support the child’s learning, confidence, and independence
• Provide formal diagnosis, where appropriate, following international guidelines (DSM-5 criteria)

Who is this assessment appropriate for?

Although DCD may be suspected in the pre-school years, it’s not usually possible to make a definite diagnosis before age 5, as younger children may still be developing motor skills at variable rates.

In line with NICE guidelines, we assess children aged 5–17 years, though younger children may be discussed or reviewed if concerns are raised. Adults can be assessed for DCD through our adult clinic.

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Sensory Processing Measure (SPM) 

Children’s Understanding Sensory Needs Assessment

What Is Sensory Processing?

Sensory processing is how children experience and respond to information from their senses — such as touch, sound, movement, and balance. This helps them do everyday things like dressing, eating, playing, learning, and joining in with others.

When sensory processing works differently, children may find it harder to engage in daily tasks, regulate emotions, or participate comfortably in busy environments. These differences can affect how they respond to transitions, interact with others, and manage everyday routines.

Typical Signs and Impact 

Children with sensory processing and integration challenges may experience difficulties that affect their ability to participate meaningfully in everyday life. This may influence:

• Emotional regulation and behaviour — e.g. behaviours of distress triggered by sensory overload, difficulty calming after transitions or unexpected input
• Attention, learning, and classroom engagement — e.g. struggling to focus due to background noise (auditory sensitivity), or needing movement breaks to stay regulated (vestibular input)
• Play, social interaction, and transitions — e.g. avoiding messy play (tactile sensitivity), difficulty joining group games due to unpredictable movement or sound
• Self-care tasks such as dressing, eating, or toileting — e.g. distress with clothing textures, resistance to toothbrushing or hair washing, limited food preferences due to taste or smell sensitivity
• Confidence and participation in community or family activities — e.g. avoiding busy environments due to noise or visual clutter, difficulty with travel or unfamiliar routines

These sensory differences can be subtle or pronounced, and often vary across settings. Our assessment helps identify which sensory systems are involved and how they impact your child’s everyday functioning.

Information About Our Sensory Needs Assessments

Our Understanding Sensory Needs Assessment is delivered by an experienced Occupational Therapist with postgraduate training in sensory integration. We use recognised sensory integration frameworks and evidence-informed tools to build a detailed profile of your child’s sensory processing strengths and challenges.

While the focus is on sensory needs, we understand that sensory processing influences all areas of occupation. That’s why our assessment explores how these differences impact your child’s engagement in self-care, play, learning, social interaction, and emotional wellbeing. Together, we shape practical, strengths-based strategies that reflect your child’s unique sensory profile and support the moments that matter most

What Does the Assessment Involve?

Before the Session

• We will send structured questionnaires to both you and your child’s school to gather insights across home and education settings

• We review any existing reports that you provide from professionals already involved in your child’s care (e.g. speech and language therapists, physiotherapists, educational psychologists)
• We bring together all this input to build a joined-up understanding of your child’s strengths, needs, and everyday experiences

During the Session (Approx. 1.5 Hours, Wallingford)

• A combination of standardised sensory assessments and clinical observations
• Engaging, child-friendly activities will be used to explore sensory preferences and responses through play or age-appropriate tasks
• A collaborative discussion with parents and the child will help contextualise findings, reflect together, and explore practical take-away advice to support participation at home, in school, and in the wider community
• We can also spend time talking separately from your child, should you wish, to allow space for sensitive reflection and planning — we have a calm waiting area with plenty of books and toys to help your child feel comfortable while they wait

After the session:

• You will receive a full written report outlining your child’s sensory profile, clinical findings, and tailored strategies to support occupational performance across settings
• Recommendations can be shared with school, healthcare professionals, or used to inform EHCPs and wider support plans

Please note: this assessment is not designed to replace or fulfil statutory Education, Health and Care Needs Assessments (EHCNAs). However, it can provide valuable insight to inform EHCPs, SEN support plans, and wider decision-making. The process is designed to allow space for collaboration, reflection, and practical planning.

Who is this assessment appropriate for?

This assessment is suitable for children aged 3 years and above who:

• Experience sensory-related challenges at home, school, or in the community
• Are awaiting further assessment or support and need a clearer understanding of sensory needs
• Show emotional, behavioural, or functional differences that may be linked to sensory processing

If you have concerns about a younger child, we welcome you to get in touch — we’re happy to explore whether a tailored approach could meet your child’s needs.

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Ongoing Occupational Therapy (OT) Sessions –  Goal-Based Therapy Blocks

Information for Patients and Families

What Is Occupational Therapy?

Occupational Therapy (OT) helps individuals build the skills needed for everyday life and meaningful activities — including self-care, learning, work, play, and social participation. OT focuses on enabling people to live as independently and confidently as possible by recognising both their strengths and the challenges that may affect participation.

Occupational Therapy supports children, young people, and adults who experience:

• Motor coordination difficulties (e.g. DCD / Dyspraxia)
• Sensory processing differences
• Fine and gross motor delays
• Difficulties with daily living skills (e.g. dressing, eating, handwriting, organisation)
• Emotional regulation challenges linked to sensory or motor needs

Purpose of Occupational Therapy Blocks

Following an initial assessment, individuals may be offered a block of goal-based OT sessions. These blocks aim to:

• Build specific skills such as movement, self-care, handwriting, or organisation
• Develop strategies to support sensory or motor challenges
• Promote confidence and independence across home, work, and community settings
• Support wellbeing by reducing frustration and improving self-esteem
• Collaborate with families or employers to ensure consistent, practical support
• Where relevant, we can tailor provision to meet Section F of an Education, Health and Care Plan (EHCP).

Each therapy block is tailored to the individual’s goals, abilities, and preferred learning style, using evidence-based approaches. Goals are reviewed at the end of the block to determine next steps.

What Happens During Sessions?

Sessions within a therapy block may include:

• Targeted skill development (e.g. core strength, balance, dexterity)
• Task-specific practice (e.g. handwriting, using cutlery, dressing, workplace tasks)
• Sensory-based activities to support regulation and attention
• Strategy work with parents or employers
• Ongoing goal tracking to ensure therapy remains relevant and outcome-focused

Parents are actively encouraged to stay and participate in sessions. This collaborative approach helps ensure strategies carry over into daily life and provides space to discuss practical ideas for home. It also supports shared understanding and consistent implementation across environments.

Sessions may take place in a clinic setting or via telehealth, depending on individual needs.

Frequency and Duration

Therapy blocks are structured to allow focused progress and regular review:

• Weekly or fortnightly sessions over a term or intervention block (typically 6 sessions, 60 minutes each)

At the end of each block, progress is reviewed to establish whether further input is needed, whether initial goals have been met, or whether parents feel confident continuing with agreed strategies.

How Therapy Blocks Can Help?

Goal-based OT blocks can lead to meaningful improvements in:

• Daily independence (e.g. dressing, meal preparation, using tools)
• Motor coordination and endurance
• Sensory regulation and focus
• Confidence and self-awareness
• Participation at home, work, or in the community

Therapy blocks draw on evidence-based approaches, including the Cognitive Orientation to daily Occupational Performance (CO-OP) and Ayres Sensory Integration® (ASI), to support functional outcomes and promote meaningful participation. These approaches are selected and adapted based on individual goals, learning style, and clinical need.

Occupational Therapy blocks can build on the universal support already available through schools and the NHS. They offer a more focused level of input for children who need something additional — for example, to meet a specific goal or where universal strategies are already in place but further support is needed. Each block is shaped around clear, achievable goals, with progress reviewed regularly to ensure input remains purposeful and responsive.

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Occupational Therapy (OT) School Observations  

Information for Parents, Schools, and Referrers

What is an OT School Observation?

An Occupational Therapy school observation involves a therapist visiting the child in their natural learning environment to observe how they manage everyday tasks within the classroom and playground.
It allows the therapist to see how the child’s motor, sensory, and organisational skills affect participation, learning, and social interaction in real time.

This can be a key part of holistic assessment and intervention planning for children who may have:

• Developmental Coordination Disorder (DCD / Dyspraxia)
• Sensory processing differences
• Fine or gross motor skill difficulties
• Attention or regulation challenges
• Difficulties with handwriting, focus, or self-care tasks in school

Purpose of a School Observation

The main aims of a school observation are to:

• Understand how a child’s skills and challenges present in the classroom and playground.
• Identify environmental or task-related factors that may help or hinder participation.
• Assess functional skills such as handwriting, using tools, dressing for PE, organisation, and attention.
• Support collaboration between the therapist, teachers, and parents to ensure consistent support across settings.
• Provide practical recommendations that can be easily integrated into the school day.

School observations are especially useful when the child performs differently in clinic versus classroom settings, helping ensure that intervention plans are realistic and effective.

What Happens During a School Observation

During the observation, the occupational therapist will:

• Watch the child taking part in typical classroom activities (e.g. handwriting, group work, transitions, PE, or playtime).
• Make structured notes on the child’s motor control, posture, sensory regulation, attention, and organisation.
• Consider the impact of noise, seating, lighting, and classroom layout.
• Discuss initial impressions (where appropriate) with the teacher or SENCo.
• Later, prepare a written report summarising findings, strategies, and recommendations.

Outcome and Recommendations

After the observation, the therapist will provide:

• A detailed report outlining the child’s strengths and challenges.
• Practical strategies for the school (e.g. seating adjustments, movement breaks, sensory supports, task simplification).
• Home carryover ideas for parents, to promote consistency.
• Guidance on whether further assessment or OT therapy sessions would be beneficial.

How School Observations Help?

A school observation can:

• Improve understanding of the child’s everyday functional performance
• Strengthen communication between therapists, teachers, and parents
• Inform Education, Health, and Care Plan (EHCP) applications or reviews, although observations are not designed to be EHCP-specific reports. If parents require a report to inform an EHCP or an Education, Health and Care Needs Assessment, please contact the clinic to discuss appropriate options.
• Promote inclusive practices within the classroom
• Enhance the child’s confidence, comfort, and engagement at school