Occupational Therapy News OTnews May 2020 | Page 39

COVID-19 FEATURE
Lorna Lewis, children’s occupational therapist,
Dudley Children’s Occupational Therapy, Black
Country Healthcare NHS Foundation Trust.
*Name has been changed
RCOT guidance for parents who are socially distancing with
children, available at: www.rcot.co.uk/staying-well-when-social-
distancing.
Establish a daily routine: Routines provide reassuring
structure and purpose for children and families. Include a mix of
learning, creative, physical and relaxation time and schedule time
for ‘electronics’ if this is important for your child. Help your child
make a visual timetable so everyone understands the plan. 
Make time for physical activity: Encourage your child
outside if you can and rediscover garden games such as swing
ball, skipping and tennis. If you can’t get outside suggest your
child makes an indoor obstacle course or follows an online
exercise programme. There are a multitude of free videos and
fitness instructions online provided you have internet access.
Work on personal care skills: Identify self-care tasks that
your child would like to do more independently, for example tying
shoelaces or getting dressed. Look online for ideas about how
to break the task down into manageable parts or for different
This makes it easier to adapt the assessment
process to reflect the child’s energy levels and
concentration and assess in in a much more client
centred way.
Following collaborative goal setting, it was agreed to
initially focus on Alfie’s goals relating to handwriting.
Before the lockdown, interventions to support skills
development in this area would have been delivered by
occupational therapy and school staff. However, as this
is no longer an option, Alfie and his mother identified
that they would be able to use their time at home to
complete these activities.
This way of working requires more intervention
by the occupational therapist to ensure that parents
have the knowledge and skills to deliver interventions
effectively and confidently.
It also requires an investment of time to assemble
supporting materials. However, the benefits of this
appear to include much greater parental confidence
in their ability to support their child and, hopefully, an
ability to transfer this knowledge to other occupational
performance difficulties in the future.
Alfie’s mother was concerned about engaging
him in activities where his interest and expectation of
success was limited. I was able to use occupational
performance coaching and solution-focused
discussion of previously successful strategies, such as
routines with an occupational balance, goal setting and
reward.
This allowed his mother to develop an action plan
for working with Alfie on his occupational goals.
Feedback from both Alfie and his mother about the
experience has been positive. His mother reported
finding the video consultation ‘really helpful’ and noted
that ‘Alfie loved it… you know what kids are like, they
love anything new’.
It is difficult to know exactly what opportunities will
be available for further occupational therapy with Alfie
in the coming weeks and months. In part, this will
depend on service demands and clinician availability as
we adapt further to support the functioning of the wider
NHS.
However, what this case has illustrated are the
opportunities for innovative and effective practice which
become a possibility when we are forced to consider
what is at the heart of our clinical work as occupational
therapists and don’t just deliver a service based on
what has gone before.
approaches to make the task easier.
Develop life skills: Now is a great time for your child to
master useful life, skills such as preparing their lunch, using a
washing machine and changing the sheets on a bed. Involve
other family members in teaching skills (perhaps via video link)
or use online tutorials which ensure that instructions are given
consistently. Older children could complete online courses in first
aid or start to learn another language.
Create a suitable place for your child to study which is
different to their relaxation space: Ideally your child should
have an appropriately sized chair and table, but if they must use
adult furniture make sure they can sit so that their feet can be
firmly planted and their shoulders relaxed when working at the
table.
Teach your child to type: Typing is a valuable skill for
education, social communication and for the workplace. There
are a variety of free and paid-for online typing tutorials available –
choose the one that works best for your child. 
Rediscover creative activities such as playdough, junk
modelling, Lego and origami. 
Spend social time together as a family: Play board games,
watch a film, make a cake, play multiplayer console games
together. Schedule mealtimes and commit to these as adults,
especially if you are working from home. They are a useful time to
connect socially as a family.
Keep in touch: Arrange for your child to spend time each day
talking to friends or family members on the phone or by social
media (with adult supervision where appropriate). Write letters to
older family members and maybe your child will receive one in
return. 
Look after yourself: Being a full-time parent/carer while
managing a household and handling work responsibilities is
challenging. Make sure you eat and sleep well, and include time
for your own rest and leisure in your daily routine.
OTnews May 2020 39