Delays accessing OT support in school are harming children, says RCOT
We're calling for every school in the UK to have access to occupational therapy expertise.
Fewer children would be absent from school if the UK government’s proposals for ‘Experts at Hand’ in schools are introduced swiftly and in the right way. Current delays in accessing occupational therapy and other specialist support in schools are causing emotional distress, reduced participation and delayed development. The Royal College of Occupational Therapists (RCOT) has released the findings as part of its Right Support, Right Time campaign and in response to the schools White Paper consultation in England.
RCOT carried out a survey of its members working with children, which lays bare the impact of a lack of support in mainstream school for children with special educational needs and disabilities (SEND). The survey found that the top five areas that are most impacted by delays in accessing occupational therapy for children and young people attending mainstream schools are:
- Emotional distress/anxiety for the young person (90%)
- Reduced participation in learning activities (89%)
- Emotional distress/anxiety for parents/caregivers (88%)
- Delayed development of essential skills such as handwriting and self-care (87%)
- Increased pressure on teachers and other school staff (81%)
In the 2024/25 academic year, the overall absence rate for children with SEND in England was 13.7%, compared to 6.9% for all children. With more inclusive practices in mainstream schools, driven by occupational therapists, this gap could be reduced.
According to RCOT members, the top five benefits and improvements of getting the right support from occupational therapists at the right time are:
- Classroom participation (92%)
- Ability of caregivers/parents to support their child’s needs (90%)
- Behaviour and emotional regulation (86%)
- Capacity of school staff to support children and young people (85%)
- Mental health and wellbeing, e.g. confidence, self-esteem (83%)
More than half of respondents (56%) said they’re unable to provide the level or type of support children in their area need and only around two in five (39%) said their occupational therapy teams are fully staffed. A lack of capacity across services is having wide‑ranging consequences for children’s wellbeing, learning and long‑term prospects.
Genevieve Harman, a parent of a child with additional needs who received occupational therapy from Occupational Therapy Essex, said:
Occupational therapy has made a huge difference to my son’s confidence and independence. He now engages, enjoys learning and is developing skills he once found impossible. Having occupational therapy embedded in school would help children earlier, build strengths day by day and stop them falling behind before their needs are recognised.’
Occupational therapy plays a vital role in helping children participate in the classroom, develop essential life skills and manage emotions, yet nearly nine in ten respondents (89%) said a shortage of occupational therapy capacity is now a major barrier to effective SEND support in their area.
This means more children are missing out on essential support with things like learning how to do up zips, hold a pen, use a knife and fork, or go to the toilet by themselves. Children with sensory differences may not be included in classroom tasks if the lighting or sound levels haven’t been adjusted. And children who struggle with mobility may not be able to get to certain parts of their school. It means children are being left out and aren’t gaining the essential skills they need to help them throughout school and into adulthood and work.
The survey also revealed that nine in 10 (90%) respondents believe earlier occupational therapy could prevent the need for an Education, Health and Care Plan (EHCP), either almost always or sometimes. And over nine in 10 (92%) believe improving access to school‑based occupational therapy could reduce the number of SEND tribunals, supporting both families and overstretched local systems. This shows that having access to occupational therapy in school as early as possible could make a huge difference to families of children with SEND.
Professional Advisor for Children and Young People at the Royal College of Occupational Therapists, Dr Sally Payne, said:
All children have a right to education and are more likely to succeed when they get the right support. Our survey shows just how damaging delays in occupational therapy are for children and young people. Children are being left to struggle without support that could transform their school experience. They’re becoming distressed, disengaged from learning and are being held back in their development while they wait. We know that getting support as early as possible is best, but most respondents told us they cannot see children quickly enough or provide the level of help needed. The schools White Paper has been an excellent opportunity to recognise the importance of having occupational therapists in schools and across neighbourhood teams so children can get the right support at the right time. Now we need to turn those ambitions into a reality. Occupational therapists support everything from handwriting and self‑care to adapting school environments so children can participate and learn. Getting the right support at the right time helps children now, as well as helping to shape their confidence, education and future opportunities. Without the right workforce capacity across the UK, children face avoidable barriers that can follow them into adolescence and adulthood.’
There are currently an estimated 3,000-4,000 occupational therapists in the UK who work with children, not all of them in schools, and there are over 24,000 schools. There’s a desperate need for an increase in the number of occupational therapists and a shift in resources to ensure every school in the UK has access to the support its pupils need.
Kantha Naicker, the Special Educational Needs Co-ordinator (SENCo) at Drapers’ Pyrgo Priory School in Essex, said:
Working with occupational therapists has transformed how our children learn and feel in school. It’s improved their confidence, fine motor skills and emotional regulation, helping them participate fully in lessons. The impact hasn’t just stayed with individual pupils; staff are trained, strategies remain embedded and children are proud of what they can now achieve.’
Occupational therapists work across health, social care, education and private practice with adults and children of all ages who have a wide range of conditions, helping them overcome challenges completing everyday tasks or activities, also known as occupations. In schools, they help create more inclusive and accessible school environments so all children can learn, thrive and enjoy school life. By working in partnership with schools, occupational therapists can identify children’s needs early and provide timely support to stop difficulties from escalating. Taking a proactive approach enables every child to access learning and reach their potential, as children and as adults.
RCOT is calling for every mainstream school across the UK to have access to occupational therapy expertise and to take a whole-school approach to providing support. Occupational therapists need to be involved in the training of teachers, teaching assistants and others who work with children, to help them better understand and support all areas of children's development; the ‘Experts at Hand’ model has the potential to help achieve that. Adopting this whole-school approach and enabling school staff to identify, support and include learners with additional needs will mean occupational therapists have more time to focus on children and young people with higher support needs. To achieve this, investment in the occupational therapy workforce is essential, as well as integrated commissioning of children’s occupational therapy services by local authorities and Integrated Care Boards. There also needs to be better integration across education, health and care to ensure children and young people get the seamless support they need to learn and thrive at school.