The Person, environment, occupation (PEO) model is used in Surrey to focus on the child/young person’s skills, interest and motivations, the occupations they want or need to do and the environment in which they take place. These three areas all directly impact on participation in daily life.
Occupational therapy is most effective when offered in the environment where the child/young person carries out their daily life activities e.g. home, nursery or school.
Therapy approaches are most effective when the occupations and activities the child/young person’s is motivated and interested in are the main focus. They should be included in their daily routines to maximising frequency.
Occupational Therapists support sensory needs which impact daily life. We support families, educational settings, children and young people to manage sensory needs through; adapting the environment, modify the activity, develop an understanding of sensory needs and use strategies for the child/young person to self-manage.
These approaches are recommended in the literature. For example, changing the sensory environment to enable the child/young person to participate in the activity, i.e. alter the temperature, reduce visual clutter, noise level, and lighting in the environment, (College of Occupational Therapists 2015.)
Supporting the parent/carer to manage sensory needs and to improve participation of children/young people in their chosen occupations through using coaching principles has shown evidence of effectiveness (Dunn et al 2012; Graham et al 2015.) The service does not provide Ayres Sensory Integration Therapy (ASI), therapy in a clinic setting which uses equipment including swings. There is not enough evidence at this present time to validate use. Instead we provide therapy linked to occupations and environments with the intention to manage (not change) the sensory needs of a child/young person (College of Occupational Therapists 2015.)
For more information on the evidence and approaches available to support sensory needs, visit the Council for Disabled Children website.
Current best practice identifies up-skilling those working in closest proximity to the child/young person. Occupational therapists work in partnership with parents, nurseries, schools and other professionals all working towards shared goals.
We use a family-centred approach where children and families are at the centre of goal setting as this is well evidenced. (Novak et al 2019).