Fewer children would be absent from school if the government’s proposed ‘Experts at Hand’ model is introduced swiftly and implemented effectively, according to new findings from the Royal College of Occupational Therapists (RCOT).
The warning comes as part of RCOT’s Right Support, Right Time campaign and its response to the government’s schools White Paper consultation, highlighting how long delays in accessing occupational therapy and specialist support are contributing to emotional distress, reduced participation and delayed development for children with special educational needs and disabilities (SEND).
RCOT surveyed occupational therapists working with children in mainstream schools, revealing the significant impact of insufficient and delayed support.
Respondents identified emotional distress among pupils as the most common consequence, alongside reduced access to learning and growing pressures on families and school staff.
The survey found that delays in occupational therapy are most strongly linked to increased anxiety for young people and parents, lower participation in classroom activities, delayed development of essential skills such as handwriting and self‑care, and mounting pressure on teachers struggling to meet complex needs without specialist input.
The findings come against the backdrop of persistently higher school absence rates for pupils with SEND.
In the 2024/25 academic year, the overall absence rate for children with SEND in England stood at 13.7%, compared to 6.9% for all pupils. RCOT says these figures underline the need for more inclusive practices in mainstream schools, supported by occupational therapists, to keep children engaged in learning and prevent avoidable absence.
Occupational therapists responding to the survey were clear about the benefits of timely intervention.
The majority said that access to the right support at the right time improves classroom participation, helps parents and carers support their children more effectively, strengthens emotional regulation and behaviour, and increases the capacity of school staff to respond to need. Improvements to children’s confidence, self‑esteem and overall mental wellbeing were also highlighted.
However, workforce shortages are severely limiting delivery. More than half of respondents (56%) said they are unable to provide the level or type of support currently needed, and only 39% reported their teams are fully staffed.
Nearly nine in ten respondents (89%) identified a lack of occupational therapy capacity as a major barrier to effective SEND support in their area.
As a result, many children miss out on help with everyday activities that are fundamental to independence and learning, from fastening clothes and using cutlery to writing comfortably or accessing toilets independently. Sensory sensitivities can also go unaddressed, leaving some children excluded from classroom tasks due to noise, lighting or physical layout.
RCOT warned that without early intervention, children risk being left out of education and denied the skills they need not only at school, but later in adulthood and work.
The survey also points to wider system benefits of earlier occupational therapy.
Nine in ten respondents said timely intervention could prevent the need for an Education, Health and Care Plan (EHCP) in some cases, while more than 92% believed better school‑based access to occupational therapy could reduce the number of SEND tribunals, easing strain on families and local authorities alike.
RCOT said that this evidence demonstrates the potential for early therapy support to reduce escalation, conflict and cost across the education and care system.
There are currently an estimated 3,000–4,000 occupational therapists in the UK working with children, not all of whom are based in schools, compared with over 24,000 schools nationwide.
RCOT highlighted that this gap highlights a “desperate need” for workforce expansion and smarter commissioning, ensuring schools can access expertise before difficulties become entrenched.
Dr Sally Payne, Professional Advisor for Children and Young People at the Royal College of Occupational Therapists, 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.”
Occupational therapists work across health, social care, education and private practice, supporting people of all ages to manage everyday tasks and activities.
In schools, they play a key role in creating accessible, inclusive environments where all children can learn and thrive. By working alongside teachers, occupational therapists can identify needs early and adapt classrooms, routines and teaching approaches to support participation.
RCOT is calling for:
- Every mainstream school to have access to occupational therapy expertise
- A whole‑school approach to SEND support
- Occupational therapists to be involved in training teachers and support staff
- Improved integration across education, health and care
Without action, delays will continue to widen inequalities and undermine children’s wellbeing and educational outcomes. With the right support at the right time, RCOT says schools can become environments where every child is included, supported and able to reach their full potential.
Image credit: iStock
