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Children's Occupational Therapy Liverpool City Council

The Children’s Occupational Therapy (OT) service is an integrated citywide specialist service in Liverpool. It aims to address the needs of children/young people who have difficulties managing their activities of daily living and developing functional skills such as bathing, showering, toileting, dressing, eating; we call these Occupational Performance Issues (OPIs).

We aim to provide an effective, safe, high quality service to enable children, young people and their families to reach their full potential in activities of daily living at home, school, college and their community. The service operates core hours from 8.30am to 4.00pm, Monday to Friday excluding Bank Holidays, with some staff working flexibly to meet additional need.

We use a client-centred approach to address the functional difficulties experienced by individuals within the context of their own social, cultural, spiritual and physical environment and with regard to their carers.

Therapists work with children and young people who have difficulties carrying out activities that they would be expected to be able to do, based on their age or developmental stage.

The Children’s Occupational Therapy Team provide specialist assessment with the aim of encouraging independence in their activities of daily living. Our service aims to support and enable families to help their children with their functional difficulties in the short and long term.

Following assessment, an intervention is planned around the individual needs of the child and their family/carers. Goals and target outcomes are agreed between the child, their parent/carer and the Occupational Therapist.

These may be achieved by:

  • Specialist advice
  • Specialist therapy programmes –  individual or as part of a group
  • Specialist equipment
  • Specialist adaptations to the environment (home or school)

“What is Occupational Therapy?”

The Children's Occupational Therapy team is a community based service for children and young people who live in Liverpool.  We work across Education, Health and Care sectors to support children from 0 – 18 years of age.  The service aims to promote independence, enable the child or young person to do the things that they want to do and support them to reach their potential.

Occupational Therapy enables people to participate in daily life to improve their health and wellbeing.  Daily life is made up of many activities (or occupations). Occupations for children or young people may include:

  • Self-care - getting ready to go out, eating a meal or using the toilet.
  • Being productive - attending nursery or school.
  • Leisure - playing with friends or doing hobbies.

If your child experiences difficulties in these areas, Occupational Therapy may be able to help.

If you are considering a referral to the Children’s Occupational Therapy Team you can look at our OT flow chart, When to Refer to OT flow chart for more information.

“What is the referral criteria?”

Referral criteria for a sensory-motor assessment:

  • The child or young person must be under 18 years of age and be registered with a Liverpool GP.
  • Children who are under 5 will be supported by the OT service within Alder Hey. For further information about the Alder Hey Occupational Therapy Service and to make a referral please visit their website Alder Hey Occupational Therapy Team.

  • The child or young person must be experiencing a difficulty that significantly and persistently impacts on their ability to participate in activities of daily living.  This may include but is not limited to washing, dressing, feeding and toileting.

Referral criteria for home and/or school environmental assessment:

  • The child or young person must be under 18 years of age and live in the Liverpool city catchment area.
  • The child must have a physical or neurological condition which is significantly and persistently impacting on their ability to access their home and/or school and using essential facilities such as getting in and out of the property or school, accessing a bedroom or bathroom, using a toilet and washing facilities.

If you are considering a referral for support with Sensory Processing Difficulties please go to the Sensory Processing Difficulties sectoin above for details on how to get help.

“My child struggles to do everyday things that their friends or siblings can do.”

If your child is struggling with activities such as dressing themselves, using cutlery or wiping their bottom please read the handouts below.  There are lots of advice and strategies which you can try with your child.  Use the Activity Chart to monitor their progress.  This can be a really useful tool to the therapist if you do refer to OT at a later date.

Dressing skills

Dressing skills for younger children

Toileting skills

Tying laces

Cutlery skills

Pre writing skills


Handwriting: fatigues and pain

Scissor skills

Activity Chart/Log


We have a list of cost effective ways to support your child’s difficulties, and the best places to buy them. Please follow the Sensory Motor Resources List for further information. 

Talk to your child’s school about the support that they receive and what strategies can be put in place there.  If, after trialling the advice and strategies in the above handouts, your child’s difficulties continue, they may benefit from a referral to the Children’s OT Sensory Motor Service.

Parents and carers can refer into the service by completing the online referral form or by calling Careline on 0151 233 3700.  We ask that professionals use the online referral form.

If your child’s difficulties are with gross motor activities such as running, hopping or riding a bike please contact Liverpool Community Physiotherapy for support by calling 0151 438 2090.

If your child’s difficulties are with continence we advise that you speak to your school nurse or health visitor. They will be able to make a referral into the Children’s Community Bladder and Bowel Service if appropriate.

“My child needs support with handwriting.”

If you are concerned about your child’s handwriting e.g. they struggle to hold a pencil, their writing is difficult to read or they feel pain when writing, please speak to their school about these concerns. Ask the school what support and strategies can be put in place to support your child’s difficulties.  There may already be things in place to support your child.  School may suggest things that you can continue at home to help with your child’s progress.

Before Children’s Occupational Therapy can offer support, we first expect their school to carry out activities to help with their handwriting difficulties.  This may include giving handwriting “homework” activities to complete with you at home.

Read through the handouts below, they will help you to notice what parts of handwriting your child finds hard and how you can help them to improve.

Developing Pre Writing Skills

Developing Handwriting

Handwriting – Managing Fatigue and Pain


If you are a teacher or other professional making a referral for handwriting difficulties please ensure that the child’s school has implemented handwriting interventions with the child regularly, aiming for three times per week for at least one term, before referring to the Children’s OT Service.  If little or no progress is made following the school’s intervention then a referral can be made. Please ensure you include details of what you have tried in the OT referral.  We may ask for evidence of the handwriting intervention.  This helps the Therapist to identify the best intervention for the child or young person.

Parents and carers can refer into the service by completing the online referral form or by calling Careline on 0151 233 3700.  We ask that professionals use the online referral form.

“My child really struggles with attention and concentration and/or has ADHD which is impacting significantly on their life.”

If your child struggles to focus and concentrate at school, we suggest that you trial strategies from our Attention and Concentration handout.  Speak to your child’s school to see what they can put in place.  Making small changes to your child’s routine can be easy and can make a big difference to their attention and concentration.  This works best when strategies are being carried out regularly throughout the day both at home and in school.

If you feel that your child’s attention difficulties continue to have a significant negative impact on their learning and participation in daily activities, discuss this with your child's school.  We also recommend that parents contact the Liverpool ADHD Foundation who offer a Skills Building Programme for parents. The child does not need to have a diagnosis. Contact details are below:

ADHD Foundation Website

Tel: 0151 237 2661

If your child has a diagnosis of ADHD, it is important to remember that this is a lifelong condition. The goal of strategies is to help them to participate in daily activities rather than “treat” their ADHD. If you feel that your child’s attention difficulties are having a significant negative impact on them learning and playing, you may consider raising this with the Alder Hey ADHD Service for further advice.

Alder Hey ADHD service has some really useful advice and handouts for parents, young people and schools.

“My child has sensory processing difficulties which are impacting on their participation in everyday activities.”

If your child experiences the following, and this results in a big impact on their life:

  • Difficulties concentrating in school
  • Cannot sit still and fidgets a lot
  • Struggles with food textures, tastes or smells and has a limited diet
  • Has difficulty wearing certain textures or dislikes tags and seams
  • Experiences regular meltdowns
  • Struggles to manage their emotions

This may be an indication that they have Sensory Processing Difficulties. We offer a graduated response to supporting children with SPD.  Support for parents of children with Sensory Processing Difficulties is accessed through Sensory Processing Difficulties Awareness Session and Workshops. 

Please contact Addvanced Solutions via telephone 0151 486 1788 or email to book onto the sessions. These sessions are the first step on the SPD pathway.  If further support is required, this can be offered once parents have attended the sessions and trialled the strategies recommended in the sessions for a minimum of six to eight weeks. 

After parents and school have tried the recommended strategies and more support is required parents can make a referral to request additional support. Parents and School will be offered 2 sensory strategies sessions which will provide more individualised support for the child.

The pathway offers further support after attendance at the awareness session and follow on sensory strategies sessions should this be required.

We also offer training sessions for professionals to enable them to support children with sensory processing difficulties.  Once school staff have attended SPD training we can offer support to schools in implementing strategies and sensory circuits in their school environment.  Schools can contact us by email to  for more information.

Please also check our short videos on understanding and supporting Sensory Processing Difficulties.

Our Sensory Processing Resources list has lots of cost effective ideas for supporting your child’s sensory needs and the best places to buy them.

“What support is available for schools around sensory processing difficulties?”

  • The Children’s OT Service offers training opportunities for school staff.  We are currently planning dates for the new school term.  Please contact for further information.
  • School staff can access a professional consultation for SPD support by completing a referral online. Please contact for further information.
  • If a parent attends a Telephone Consultation for SPD support, the recommendations can be shared with school, with consent from parents.

“I think my child has Dyspraxia (also known as Developmental Coordination Disorder or DCD) how can I get some help?”

Children who experience difficulties with fine motor tasks, such as fastening buttonshandwriting and tying shoe laces, and gross motor difficulties, such as catching a ball and riding a bike, may have an underlying movement difficulty such as Dyspraxia.  Dyspraxia is also known as Developmental Coordination Disorder (DCD).  Other common difficulties include poor organisation and time management skills and difficulties with attention and concentration.

The Children’s OT Service carries out assessments which support the Community Paediatricians when investigating a DCD diagnosis. We also provide strategies to help manage this condition.  If you are concerned that your child may have DCD, parents and carers can refer into the service by completing the online referral form or by contacting Careline on 0151 233 3700.  We ask that professionals use the online referral form.

You may also find it useful to read through the handouts opposite.  They contain advice and strategies to support specific areas of need including handwriting, dressing, tying shoes laces, bottom wiping and using cutlery. 

For further information on DCD please check out the following websites:

NHS Diagnosis, Developmental co-ordination disorder (dyspraxia) in children

Dyspraxia UK, Diagnosis Criteria

Dyspraxia Foundation

“I need advice on car seats or car harnesses.”

The Children’ OT Service does not provide assessments for car seats but the car seat and harness suppliers list may be useful when considering a car seat or specialist harness to use in the car.

“My child has difficulties accessing home or school”

If you feel that your child’s home or school environment is stopping your child from participating in family or school life then an OT assessment might be needed.  These difficulties may be because your child has a physical disability or your child has a reduced understanding of danger.

Difficulties may include:

  • Difficulties getting into the house, moving around and going up and down the stairs.  
  • Being unable to access the bath/shower/toilet.
  • Being unable to sit up independently to watch TV, eat meals and socialise.
  • Concerns that your child is able to escape from the home unsupervised.
  • Concerns that everyday things in your home are putting you, your child or their siblings at risk of injury or harm.
  • Concerns around your child going to a new school.
  • Difficulties moving safely around their school and accessing all parts of the school day such as eating lunch, going to the toilet, doing PE and doing a technology lesson.

We advise that parents who have concerns around safety in the home review our Safety in the Home document.  Please trial the advice and strategies before making a referral the Children’s OT Service.

See also Adaptations and Housing for more advice and informtion.

To make a referral parents and carers can completing the online referral form or by calling Careline on 0151 233 3700. We ask that professionals use the online referral form.

Who to contact

Contact Name
Duty Occupational Therapist
Contact Position
Occupational Therapist

Where to go

Children's Occupational Therapy Team
Cunard Building
Water Street
L3 1AH

Please note, this a postal address only

Time / Date Details

When is it on
A Duty OT is available Monday 8:30am - 4:45pm and Tuesday - Friday 8:30am - 12:30pm (except bank holidays)
Time of day

Other Details


Referral required
Referral Details

If you would like to make a referral into Childrens Occupational Therapy please use the Online Referral Form

Local Offer

Local Offer Age Bands
Primary (5 to 11)
Secondary (11 to 16)
Early Years (0 to 5)
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