Disabled Children's Social Work Team (CYPDT)

Working across Child in Need, Children who are Looked After, and Child Protection, and working all the way through to 18, we are in the amazing position to see the development and journeys of the young people we work with. I truly believe this is an area of work that everyone should experience. The children and young people we work with are incredible. The world we live in is not built for them; they are expected to conform and fit society expectations and it becomes our duty to support them and their families to design a part of the world that fits. Working with young people with Autism and taking the time to build those relationships takes consistency and perseverance. A young person with complex additional needs will choose the moment that they allow you into their world but once you have earnt that trust, you are the honoured one to experience what they want to share with you. Whether this is sensory play with dried pasta and rice, taking your hand to see the new shiny floors in a classroom, or talking about Stranger Things for the 450th time that visit; it is such a joy to live life alongside these incredible children.

Occupational Therapists in this team see children and young people from 0 to 18 years with a disability which affects their activities of daily living in the home who live within the boundary of Wiltshire Council.

The children and young people may have difficulty with things like:

• getting into or around the home
• sitting independently
• moving on or off the bed, toilet, bath or a chair
• staying safe at home

To find out more visit:

Children's Occupational Therapy in Social Care

Children diagnosed with ADHD or mental health difficulties alone are not eligible for the CYPDT service, however, if alongside other complex diagnoses which meet the criteria as outlined within CYPDT Threshold guidance (August 2021), they are eligible for referral to the CYPDT.

Referral to the team may be made for any disabled child/young person from birth up to age 17 years 6 months who meets the criteria.

Children with disabilities are more likely that other children to experience abuse or neglect and it is imperative that we remain vigilant to the signs of abuse and utilise the Wiltshire Threshold Guidance for all children, including those with a disability.

All threshold decisions for new referrals; including eligibility for support from CYPDT are made by managers within Wiltshire's Integrated Front Door Service (IFD, MASH and Out of Hours). This ensures that families receive a consistent service from us. If threshold is not agreed by CYPDT this should be discussed with the authorising manager in the IFD in the first instance where this can be explored more fully. Should agreements not be made this should be escalated to the IFD team manager for consideration. All requests to review decisions in the front door are logged and reviewed on a regular basis to consider any themes and identify opportunities for learning.

If the Multi Agency Safeguarding Hub (MASH) identify that a child is eligible for support from CYPDT in addition to safeguarding concerns under (s17 and s47) the child will progress to CYPDT for further assessment. This assessment will be holistic and consider the child's needs as well as the concerns for abuse or neglect identified. Strategy Discussions will be held in the MASH and the CYPDT Duty Manager will be invited to attend and responsible for any on-going s47 investigations agreed.

If a safeguarding concern has been raised that effects a sibling group however not all the children meet the CYPDT criteria, then the subsequent s17 assessment or s47 investigation will be progressed by the area team with the support of CYPDT. Should MASH be required to hold a Strategy Discussion the CYPDT, and area team Duty Managers will be invited to ensure that knowledge and expertise is shared and support is appropriately put in place for the child and family.

The team will work with children where the child's disability is the presenting concern for the case to transfer to CYPDT and who fall within the above criteria and where they meet the threshold for children's social care.

For children, young person who do not meet the CYPDT threshold advice and appropriate signposting will be offered.

Where a transfer request is received from another internal team and it appears that the criteria for the CYPDT is likely to be met, a social worker from CYPDT will undertake a joint visit with the allocated worker and a decision made by the Team Manager as to whether the criteria is met for transferring the case. The existing allocated worker will remain responsible for the case until transfer is agreed and arranged.

CYPDT will work with young people up to their 25^th birthday as they prepare for their transition and transfer to adult teams. The social worker will identify a transfer date that can take place anywhere between 18 to 25 years depending on the needs of the young person.

Where the assessment threshold is met, a member of our CYPDT will complete an assessment with the family. This involves talking to the family about their situation to find out what they are worried about and what needs to change.

After the assessment, we will agree on what kind of care and support is required. For example, this could include:

• Advice and information about universal and targeted services
• signpost/ referral to local support organisations
• direct payments
• Family key worker support regarding sleep, understanding and responding to behaviours, developing routines and communication
• short breaks, social activities, and overnight residential short breaks

If the CYPDT cannot offer any specialist support because the assessment shows the child or family is not eligible for specialist disability services, the assessment will always include other organisations that could help.

One way of looking at it, is that children and young people who have profound and multiple learning disabilities (PMLD) the most in need/impaired, cognitive functioning will be reliant on adults for all aspects of life: Severe learning disability (SLD): has significant needs including significant cognitive impairment, requiring support generally with every aspect of their life areas such as personal care and communication, but there will be a continuum in respect of independence.
For children and young people with a moderate learning disability there will be a continuum in terms of independence, they are likely to require a fully differentiated curriculum and adult support, but will be able to access some learning, life and social skills independently.

Unfortunately, there are no clear universally agreed definitions, and no clear cut off points, as the concepts Moderate Learning Disability (MLD) and SLD are by nature continuum based.
In terms of cognitive functioning there are some guidelines about cognitive levels/IQ - the NICE guidelines give figures for the various definitions (IQ: PMLD: <20, SLD: 20-34, MLD: 35-49). However, these are quite contentious.

Indicators include:

• Severe learning disability
• Has an Education, Health and Care Plan (EHCP) for severe learning disabilities, and learning disability with autism
• Attends a school or SEN centre for students with a severe learning disability: example Exeter House, Larkrise, St Nicholas school within Wiltshire
• Requires assistance in most if not all aspects of their physical care and support to engage in social activities substantially beyond that of their peers
• Demonstrates behaviours, some of which may challenge others, which impact on all aspects of the child's or young person's functioning, daily living and may pose a significant risk to themselves and/or others
• Young people with moderate learning disabilities attending a specialist learning disability setting with additional complex needs for example Sliver Wood Larkrise, St Nicholas, Exeter house school
• Full time wheelchair user and/or mobility severely restricted without the provision of specialist equipment, e.g. hoists
• Requires assistance due to a disability in daily activities, in most if not all aspects of their personal care e.g. bathing, toileting, dressing, eating, and/or engaging in social activity substantially beyond that of their peers
• To have a physical disability that requires support/physical input to complete daily tasks activities
• Is registered or eligible to register as blind, hearing impaired with additional complex needs
• Preschool children who are experiencing substantial developmental impairment or delays in more than one area of cognitive and/or sensory development and/or diagnosed as having severe global or severe developmental delay for example some of these children will be referred to or accessing opportunity groups and portage and are likely to have some enhanced health visiting support

• Legislation.gov.uk: Children Act 1989 (opens new window)
• legislation.gov.uk: Children and Families Act 2014 (opens new window)
• GOV.UK: Statutory guidance SEND code of practice: 0 to 25 years (opens new window)
• legislation.gov.uk: Equality Act 2010 (opens new window)
• legislation.gov.uk: Children Act 2004 (opens new window)
• legislation.gov.uk: Chronically Sick and Disabled Persons Act 1970 (opens new window) 
• legislation.gov.uk: Disabled Persons Act 1981 (opens new window)
• legislation.gov.uk: Human Rights Act 1998 (opens new window)
• legislation.gov.uk: Children and Social Work Act 2017 UK Public General Acts2017 c. 16 (opens new window)
• legislation.gov.uk: Carers and Disabled Children Act 2000 (repealed) (opens new window)
• Care Act 2014 (legislation.gov.uk) (opens new window)
• legislation.gov.uk: Mental Capacity Act 2005 (opens new window)