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Operating as part of the Integrated Children’s Additional Needs (ICAN) Service, our mission is to support children and young people with disabilities to participate in everyday activities and situations at home, school and in the community.

We want to help children and young people do the things that are important to them, like leisure activities with friends and family, taking care of themselves and joining in and learning in school. We believe that supporting children and young people to participate in everyday life is an important part of their health and wellbeing.

Who's it for?

We work with children and young people with conditions such as cerebral palsy, autism or developmental co-ordination disorder. However, many of the children and young people we support do not have a medical diagnosis. Our occupational therapy colleagues in Leeds Teaching Hospitals Foundation Trust support children and young people with neuromuscular conditions, juvenile arthritis and brain injuries.

What we offer 

  • We will listen to you and your child about your concerns and what is important to you.

  • We will set goals with you and, if possible, your child about what you both want to achieve. We can also get school involved if that’s important to your goals and concerns.

  • We will talk through your usual daily routines and all the things you do. This helps us to come up with recommendations and an action plan that fits with your day-to-day life.

  • We might watch your child doing things in real life, at home or in school. This helps us to understand what might need to change to help your child achieve his or her goals.

  • We will make a plan about what will happen next to help you and your child achieve the goals.

Your child’s episode of care will be closed when:

  • You and your child have achieved your goals or your plan for working on your goals is in place
  • You no longer want to have occupational therapy input
  • You have not attended appointments or contacted the service

You can contact us again in the future if you need more support. 

Understanding and Managing Sensory Differences

If you are looking for support to understand and manage your child’s sensory differences please follow the links below to access videos, sensory questionnaires and strategies to help:

Referrals

Please view the ICAN referrals page 

School resources

Who is this information for?

Teachers, teaching assistants, parents (for support with homework).

Which students may need support with this?

Students who are at the early stages of pencil skills and students who are learning to form letters
and numbers. This is typically for the student under 7 years old or for older students with a learning
disability.


For children who have mastered forming letters please see our information on:

  • ‘How can I support my students to write with ease’
  • ‘How can I support my students to form letters and present their work’


What can I do and how will this help?

Students need to recognise numbers and letters if they are to form them in a meaningful way. Research recommends a multi sensory teaching method. This involves teaching a letter or number in many different ways with the goal of working towards the student forming their letters. Students should practise using big movements to help understand how letters are formed. Be creative - use a stick in the sand, a finger in shaving foam, or a paint brush and water outside on the ground. Use different and fun ways to help make learning more enjoyable!

Does the student need you to demonstrate the letter formation? 

Draw the shape in the air, or on a whiteboard first, then practise on paper. Research suggests a minimum of 20 practice sessions are needed to develop this skill. Practise little and often.

Does the student need to feel the direction of the letter formation?

Practising tracing over raised letters with the finger can help learn letter formation. Making letters from different textures such as sandpaper, string, or in the groove of a cut out letter or stencil can all be useful.

Does the student need to talk through the letter formation? 

Talking through the direction of the movements as students practise letter shapes, i.e go ‘up around and down’ will help the student to remember. Making up rhymes or words to help remember the formation can be useful.

Does the student need opportunities to recognise and pick out letters? 

Look around the classroom trying to find as many shapes, letters or numbers like the ones they are practising to help them remember the shape.

Does the student need opportunities to develop pencil control? 

Students with early writing skills need time to learn how to control their pencil to make meaningful shapes practising with pre-writing patterns. A programme which builds on this is ‘write from the start’.

Where can I get more information?

To get resources to help students with developing early writing skills check out the following websites or search the
internet for other similar resources. 

For tactile letters visit: www.specialdirect.com

For write from the start visit: www.ldalearning.com

The ‘Write from the start’ programme focuses on early pencil control along with the later part of the book focusing on letter formation.

For squidgy letters visit: www.specialdirect.com

For further advice and guidance on teaching early writing skills see www.canchild.ca and look for pre-printing resources in the DCD (Developmental Co-ordination Disorder) resources.

Contact us for further advice and to tell us what you think of this information:

Children’s Occupational Therapy Service
Integrated Children with Additional
Needs (ICAN)
Leeds Community Healthcare NHS Trust
3rd Floor, Stockdale House
Headingley Office Park
Victoria Road
Leeds LS6 1PF
Tel: 0113 843 3620
Email: central.spa1@nhs.net

Who is this information for?

Teachers, teaching assistants, parents (for support with homework).

Which students may need support with this? 

Students who are still learning to:

  • Form letters
  • Leave spaces between words
  • Write letters the same size
  • Keep their words on the line

What can I do and how will this help?

When students are still learning to write, it takes a lot of effort to remember the letter shape and control the pen / pencil. You may therefore see a dip in the quality of their handwriting when they are needing to complete pieces of independent work. Students will need regular teaching and practice at handwriting. Research suggests a minimum of 20 taught sessions are needed. There are different ways you can support students:

Does the student need extra practice to form letters clearly? 

Students need to practise ‘little and often’ to help them remember how to form letters. Students often benefit from
practising letters within a ‘letter family’. An example of this is the letter ‘c’. Forming this letter can then lead into forming a letter ‘a’ and then the letter ‘d’ and so on. The student is learning to start at the same point each time to help remember how letters are formed. This is also recommended in the National Curriculum guidelines (revised July 2014). Research suggests students 7 years and older benefit from direct teaching and a problem solving* approach to developing handwriting. Examples of this type of approach include: 

  • Grade the task so that you just work on one little bit at a time, i.e one letter from a word, or one stroke of an individual letter. 
  • Ask the student to look at a letter they have formed and one you have formed, and ask questions such as - ’what is different between mine and yours?’
  • If the student is struggling to see how they are going wrong and how you are doing it more effectively - demonstrate forming the letter and make it really obvious how they are going wrong, so they work it out for themselves.
  • Use words or rhymes to help them to visualise the letter or remember a series of steps or rules. It is more powerful if the student comes up with these ideas themselves.

Students under 7 years old and some students with learning difficulties benefit from a more mulit-sensory way of learning. This could be practising letters in sand with a stick to draw with or with their finger using shaving foam. See our information on ‘How can I support my students to develop early writing skills’.

Does the student need help to start at the left hand side of the page? 

Having a dot to help them remember where to start point can be useful. For example a green dot on the left side of the page for ‘go’ and a red dot at the end of the line to stop writing.

Does the student need a finger spacer?

If the student is working on remembering to leave a space between their words, a finger space can be useful.
Examples of finger spacers include using a lolly pop stick, or searching on the internet for downloadable ones to cut
out and laminate.

Does the student need extra visual prompts?

For students who need to practise using capital letters and full stops, having a laminated prompt card with these simple reminders on can be useful so the student can learn to check their work and make the changes.

Does the student need to write on different paper?

For students who need to practise where letters sit on the line, paper with extra lines can help. Practising on paper with extra lines can help students see where ‘tall’ and ‘tail’ letters sit in relation to each other such as ‘d’ and ‘g’.

Where can I get more information?

For more information on supporting students with handwriting in class see the following information on our webpage:

  • How can I support my students to gain pencil control?
  • How can I support my students to sit well in class?

For more resources on letter formation, finger spacers and other visual supports, visit www.sparklebox.co.uk or
www.twinkl.co.uk.

For more information on handwriting and letter families, the Canchild website has lots of useful information within its DCD (Developmental Co-ordination Disorder) resources - www.canchild.ca.

Contact us for further advice and to tell us what you think of this information:

Children’s Occupational Therapy Service
Integrated Children with Additional Needs (ICAN)
Leeds Community Healthcare NHS Trust
3rd Floor, Stockdale House
Headingley Office Park
Victoria Road
Leeds LS6 1PF
Tel: 0113 843 3620
Email: central.spa1@nhs.net

Who is this information for?

Teachers, support workers, parents (for support with homework).

Which students may need support with this?

  • Students who are learning to grip a pen or pencil
  • Students who are learning to press on with the right amount of pressure
  • Students who are learning to write more legibly
  • Students who are learning to write more and finish work
  • Students who want to increase the comfort in their hand when writing

What can I do and how will this help? 

There are lots of small changes that can be made to support students to gain pencil control. Students should have regular practice using some of the suggestions below.

Does the student need a pencil grip or thicker pencil? 

A student may press down hard when writing because of a weak grip. Gripping tightly may help them to control their pen or pencil when writing. This can often make the student’s hand ache and they may need to shake their hand to relieve this feeling. A grip or thicker pencil is often more comfortable to hold, so the student doesn’t have to grip too hard.

Does the student need to use a pen? 

A pen often glides more easily than a pencil when writing. This means the student will need to grip less tightly when writing. Try the student with a thicker pen and one with a built in grip to make holding the pen more comfortable.

Does the student need to use a writing slope? 

A writing slope can help with pen or pencil control by supporting the wrist and forearm. It can also encourage a
more comfortable upright sitting posture. 

Does the student need to record school work on a computer?

If the student needs to record school work, and handwriting is not progressing for them, consider using a computer. It is important to make a plan for practising touch typing, using the computer in lessons and printing off their work. Research suggests students will need 25 - 30 hours of teaching and ongoing practice. 

Does the student need to use other ways to record their school work?

If the student is not progressing with writing and typing following practice, they may need to look at other ways to record their school work. This could include:

  • Using gapped worksheets, if the student’s handwriting is easy to read but writing longer pieces of work is effortful.
  • Using a scribe. Telling someone else what to write is often difficult for children to do. It is important to make a plan to practise this and build it into the school day.

Where can I get more information?

See the following tabs on this webpage:

  • How can I support my students to sit well in class?
  • How can I support my students to develop early writing skills?
  • How can I support my students to form letters and present their work?

To write or to type – That is the question! 

For more information visit the Canchild website which has lots of useful information within its DCD (Developmental Coordination Disorder) resources - www.canchild.ca

Contact us for further advice and to tell us what you think of this information:

Children’s Occupational Therapy Service
Integrated Children with Additional Needs (ICAN)
Leeds Community Healthcare NHS Trust
3rd Floor, Stockdale House
Headingley Office Park
Victoria Road
Leeds LS6 1PF
Tel: 0113 843 3620
Email: central.spa1@nhs.net

Who is this information for?

Teachers, teaching assistants, parents (useful for homework and meal times etc). 

Which students may need support to sit well? 

All students need to sit well. If a student has to concentrate on sitting well this will make it hard to concentrate on their school work at the same time. The following students may need support: 

  • Students with low muscle tone (often seen in children who slump at their desk, or wrap their legs around their chair legs) to increase comfort and stability
  • Students learning to stay focused (can sometimes be seen fidgeting or getting up from their chair)
  • Students learning to write or progress with writing
  • Students using a computer

What can I do and how will this help? 

By making changes to the classroom environment the student will be able to feel more comfortable completing their schoolwork. This will help the student to complete their schoolwork with more ease. The suggestions below will help to increase the student’s comfort, focus and work produced. 

Does the student need their table swapping? 

Students should be able to place their elbows around 90 degrees to the table. A table too high and the student may find it difficult to control a pen or pencil or type on a keyboard. A table too low and the student might slump over the desk, causing a poor posture. A height adjustable table may be needed.

Does the student need their chair swapping? 

Students should be able to place their feet flat on the floor when sitting on their chair (knees and ankles at 90 degree angles). This will enable them to sit comfortably. A chair too high and feet may dangle and the student will focus their attention on trying to balance. A chair too low and they may not be able to reach the table.

Does the student need a footrest? 

If a more appropriate chair is not available and the student’s feet do not touch the floor, place an upturned box or similar under their feet as a rest.

Does the student need to improve their position at the desk? 

Make sure the student’s chair is tucked in close to the table so that their tummy is almost touching the table, and their back is well supported in the chair. This will help to promote a good upright sitting posture.

Does the left handed student need to sit in a different position in the class?

Left handed students should avoid sitting on the right side of the table next to a right handed student as both will be using writing hands next to each other leading to possible bumping of arms and impacting on handwriting. Sit a left handed student on the left side of the table. 

Does the child need to use a move n sit cushion?

Students working hard to sit upright at the table may have low muscle tone. Providing them with a move n sit cushion can help to place them in a more upright position by tilting their pelvis forwards. This gives a better position for completing table top work. 

Also students who need to fidget to help them concentrate and complete work can move around on the air filled cushion. This helps them without distracting other students sat at their table.

Where can I get more information?

For more information on equipment, see the following websites or search for other suppliers: 

Move n sit cushions (available in two sizes): www.specialdirect.com

Height adjustable tables: www.morleys.co.uk

Contact us for further advice and to tell us what you think of this information:

Children’s Occupational Therapy Service
Integrated Children with Additional Needs (ICAN)
Leeds Community Healthcare NHS Trust
3rd Floor, Stockdale House
Headingley Office Park
Victoria Road
Leeds LS6 1PF
Tel: 0113 843 3620
Email: central.spa1@nhs.net

Who is this information for?

Teachers, teaching assistants, parents (for support with homework).

Which students may need support with this?

Students who:

  • Are working towards getting started more promptly with school work
  • Are working towards keeping going with school work
  • ‘Switch off’ and ‘daydream’
  • Are easily distractible
  • Are fidgety

What can I do and how will this help?

Students need the best classroom environment to be able to complete their school work and demonstrate their full potential. For some students changing a teaching environment to meet their learning needs, can help to address the above.

Does the student need fewer visual distractions? 

Most students enjoy lots of pictures in the classroom and use many of the visual aids around them to support their learning. However, it can prove a little ‘too much’ for some students. These students can struggle to select only that which is relevant. Some students can find themselves getting distracted by the resources available and therefore ‘tuning out’ of the lesson. You can support the student by:

  • Placing their desk away from wall displays
  • Having a quiet workstation with built up sides to filter out distractions
  • Thinking about who would be a good working partner to sit with

Does the student need a movement break?

Some students need to do something a little more physical to keep their attention levels up. This is often seen in the fidgety behaviour displayed in the classroom. For example when an adult is feeling tired they may have a coffee as a ‘pick me up’. This boost helps an adult to think and complete a task. Teachers can provide students with appropriate opportunities to boost their alert levels to help them focus and complete their school work. Examples include having the student:

  • Take a note to another teacher
  • Collect in and hand out resources
  • Wipe down tables and tidy up
  • Complete a physical activity out of the classroom such as running or playing with a ball (if an adult is available to support them)

Does the student need to be seated near you? 

This can help you to ensure that when giving out class instructions you know they are focusing and taking in the information.

Does the student need to be asked to repeat the instructions back to you? 

This will help to ensure that the student has both listened and understood the information correctly. 

Does the student need to have the information written down for them? 

Enabling the student to refer back to the information when they have lost their concentration will help them find their place in their work. Providing a list to tick off can be motivating and help students to keep focused. 

Does the student need to use a move n sit cushion? 

If the student needs to move or fidget to keep alert levels up but needs to remain in their seat, this allows a subtle but constant movement. 

Does the student need to have something to fiddle with? 

Some children are able to divide their attention and need to touch something to help keep their attention levels up in order to concentrate. This could be a piece of blue tack or a paperclip for example. 

Does the student need a timer? 

Having a visual support to keep focused such as a sand timer can be motivating and help students to understand the concept of time, i.e. ‘you have five minutes to complete your work’ can be difficult for some students to understand. Seeing the time pass can be motivating to attend to and complete school work.

Where can I get more information?

For more information on equipment for the classroom please see the following websites or search for other suppliers:
Move n sit cushions (available in two sizes): www.specialdirect.com
Fidget pencils available from: www.ldalearning.com
Portable workstations available from: www.specialdirect.com
Timers: www.specialdirect.com

Contact us for further advice and to tell us what you think of this information:

Children’s Occupational Therapy Service
Integrated Children with Additional Needs (ICAN)
Leeds Community Healthcare NHS Trust
3rd Floor, Stockdale House
Headingley Office Park
Victoria Road
Leeds LS6 1PF
Tel: 0113 843 3620
Email: central.spa1@nhs.net

What is it?

The Children’s Community Occupational Therapy Service are offering a free workshop to help address handwriting
and recording difficulties. The workshop aims to: 

  • Enable school staff to feel confident making the right decisions, and choosing the right interventions when addressing handwriting difficulties. (When to use a multi sensory approach, when to use a direct teaching or problem solving approach and when to consider alternative methods of recording.)
  • Allow students to participate fully in school education in terms of documenting their knowledge 
  • Show how the information provided links with the national curriculum and best practice (research and evidence) 
  • Help you create a ‘toolkit’ which can be applied as a whole class approach 
  • Have the opportunity to test things out and ask questions!

Who can attend? 

The workshop is offered to all school staff - teachers, Sencos and support staff. Whilst the workshop may have come about because of a referral to our service regarding a specific student, the workshop is designed to give information and develop skills and confidence in addressing handwriting difficulties with all students in school.

Where will it take place? 

We will deliver this workshop in your school. Multiple staff members can attend the workshop although we suggest you limit this to 8-10 staff. This helps to ensure you get the most out of the session in terms of planning and trying things out, and getting feedback. The workshop will last approximately 60-90mins. 

What do I need to do? 

To book a workshop please contact the service on 0113 843 3620, or email central.spa1@nhs.net If this has come about because of a referral to our service for a specific student, please mention the student’s name when booking the workshop. It would be useful if you could come prepared with some students in mind and samples of their work.

Feedback

  • 100% of people said the strategies from the workshop were useful. 
  • 87% said they’d have the time / resources to implement the strategies.
  • “It was great to meet staff from occupational therapy, and we were able to to ask questions, share ideas and problem solve.”

Tel: 0113 8433620

9:00am - 5:00pm Monday - Friday

Our staff operate a citywide service but operate out of three main health centres:

St. George’s Centre
St. George’s Rd
Middleton
LS10 4UZ

Tel: 0113 8432000

Wortley Beck Health Centre
Lower Ring Rd
Wortley
LS12 5SG

Tel: 0113 8438000

Reginald Centre
263 Chapeltown Rd
LS7 3EX

Tel: 0113 8435700 

Families can come and see us in these health centres or be seen in their own homes and school and nursery settings.

Useful links 

CanChild research centre

Hemihelp for advice on a Hemiplegia

The William Merritt Centre

What to do if you need to speak to someone urgently...