Continuing our celebration of OT Week 2020 we showcase the role of Charlotte Warburton. Charlotte is a paediatric wheelchair therapist at Betsi Cadwaladr University Health Board. She provided an insight into her role through the Posture and Mobility Group (PMG) and appeared in our May/Jun 2020 issue.


Charlotte Warburton - OT Week 2020Working in a wheelchair service is not something I had ever considered prior to taking up my current role, but I have been in the post for almost three years now and haven’t looked back…  Although it did take me two years to feel fully confident, as there is a lot more to wheelchairs than I had realised!

I see children with a wide range of postural and mobility issues, and treat everyone on an individual basis, because the same condition can affect each client differently; there can also be comorbidities, including behavioural or mental health issues. I have found that my therapeutic use of self is key in these situations, as I adapt myself to each client to ensure that the process is as smooth as possible for both the client and their parents or carers.

Within my role, it can be a challenge to manage expectations regarding what the service can provide.  Occasionally clients come in with pictures of what they want, or state they would like the same equipment as another client they know. This is where treating all clients as individuals, and ensuring I have clinical justification for all equipment, is key to providing equipment that meets their needs in an equitable manner. Once the needs, and how the equipment will meet them, are discussed with clients/parents/carers, this usually alleviates any issues regarding expectations.

Occasionally, it is difficult to know which equipment will be most suitable during the actual assessment. However, I really enjoy researching and problem-solving, which these cases allow me to do. Before I started this role, I did question whether issuing wheelchair after wheelchair could become repetitive, but this has not been the case at all – I really have to think about all the different elements of equipment, and use clinical reasoning to justify my choices.  However, I soon learnt that there are often compromises to make when choosing equipment; something which took the perfectionist in me a little time to get used to!

Requests for buggies can be particularly challenging. For example, it is not always age appropriate to issue a buggy; as an occupational therapist I always prefer the option that promotes independence where appropriate and, in my view, a self-propelled wheelchair gives this advantage over a buggy. However, sometimes parents/carers are not ready to accept a wheelchair and will refuse to use it, so this must be taken into account. I would rather provide equipment that will be used, allowing the client to engage in meaningful activities and activities of daily living, than provide equipment that is not used and therefore limits their participation in such activities.

One of the most unexpected challenges was the technical element of the role.  When I was given my toolbox in the first week, I have to admit I didn’t know how to use half of the tools!  But I am pleased to say, I can now make adjustments to equipment, fit hip belts and back rests, and I do also have support from some wonderful technical instructors.

The wheelchair therapist role can be undertaken by an occupational therapist or physiotherapist, therefore, it is important for me to keep my occupational identity.  One way I do this is using occupational terminology throughout my notes, assessments and intervention plans whilst also ensuring my assessments are holistic and client-centred.  I am proud of my profession and want to ensure I stay true to its core philosophies.

I thoroughly enjoy my role within the wheelchair service and would encourage anyone to explore available opportunities within this setting.

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