We were pleased to have Lucy Sharpe, a Physiotherapist from PACE come and speak to us about the service, what they’ve learned so far as a service, and what programmes they have put in place in the way of support for children. She has been a physio for 21 years and joined PACE in 2018.
Intro/Approach
They are a charity offering therapies, specialist education, and family support for SEND. There are two sites, one in Wendover and the other in Aylesbury, which provides SEND provision for more complex motor conditions such as cerebral palsy. They also have commissioned services such as physio and OT at Pebble Brook, Heritage House.
History
30 years ago, Heather Last was an OT with a conductive educational approach from Hungary, teaching children with CP to move their bodies. In 2010 Lindsay Hardy came on board to lead the sensory integration team and expand provision to more children with sensory needs. Then in 2022, post COVID, their provision began supporting more children through the Child and Family Services Project with Bucks Health Trust, supporting those on the waiting list for ASD diagnoses. In 2023 they were supporting more children with autism.
Nine Elements of PACE Child and Family
- Sensory processing – physio will think about bones, muscle, joints. Doesn’t clock it as not seeing whole picture, emotional well being, etc.
- Play and recreation – important for development, engage parents & family. Looking at child in everyday life/function, eating, dressing, school bag, lunch hall.
- Relationships – family, peers, community, communication
- Emotional wellbeing – looking at child and family functioning together.
- Support with settings, or looking for appropriate settings
- Not experts, but try to consider everything.
- Mission – support every bady, child and YP w dev diffs, deivers needs, or neurodiversity. Help family to thrive.
- Changing language to affirming, rather than problems
- Evidence based therapy and care
- Neuro diversity, CP 0-18
- Different association with neuro diversity
- Difficulties accessing mainstream school – handwriting, sensory
- Homeschooled
How do we work
- Individual sessions
- Therapy centre
- at home, school, other ed settings
- Online
- Group sessions
- Liaison w family profs and ed. & LA
- Change remit
- Waiting lists for ASD diagnosis
With the increase in children struggling to access school, parents are looking for alternate support at PACE. Therapists joined who had experience in send, they learned on the job, but there is lots still to learn.
The know the importance of a responsive empathetic admin team, who are the 1st point of contact. Elizabeth Burroughs Practice manager is very good at listening. The teams do take the time to listen and understand and with their knowledge they can signpost.
Preparation
- Assessment video call with parent – build relationship, talk about things they might not want to talk about in front of child, support 1st session
- Supporting children prepare to come to PACE
- Sent photos of setting and therapists
- Send video tour
- Low pressure visit – flexible, some children only make it to the car park.
- C&F therapy: approach
- Play based – don’t want child feeling like they’re having therapy. Weve in therapy into play.
- Child led – respect interests, neurodiv affirming – have an idea of the interests of child. Have room set up.
- Building trust
- Relation building – parent/carer involved in sessions – collaborative
- Problem solving – strategies
SaLT
- Understanding difference in language development
- Analytic language processing learn single words first, then build into sentences
- Natural language Acquisition – learn whole phrases – gestalt – first then break them down.
- Children using repeated phrases a lot – learning language.
- Understanding Gestalt language processing
- Working in chunks – echolalia – rather than building speech word by word
- Stages – GLP typically process through 6 stages
- Fixed scripts, mix, modify, generate spontaneous self constructed sentences
- Implications – influences how comm is supported – strategies
Resources
- Toys – to support child’s interests, branded such as Paw Patrol, Peppa Pig, etc.
- Augmented and Alternative comms
- Low tech and high tech
- suport fr communication assistance
- PoDD –
- Grid
- TD Snap – iPad, symbols
- Opps for convers out of session time
- separate calls can be arranged betw sessiont to give ops for parent of talk to therapists
Benefits
- Focus on child in session
- Parents more able to talk
- Staff training
- Team workshop days
- Respond to feed back, being flexible
- Meaningful goals
- Questionnaire at end of block of therapy
Future
- Support more children and families
- Increase expertise
- Spread work
- Relations with family hubs
- More training to school and nurseries of GLP
- LA commissioning
- Primitive reflex integration – no evidence, hard to get, vriables in terms of children/parents. Some can be useful.