Key To Achieving Therapy Service Ltd

17/10/2026

It's easier to debate diagnosis than to confront the complexity of unmet need.

Because once we start looking at the interaction between people, environments, occupations, health, education, employment and social care, we're talking about multiple systems that would need to change together. That's difficult, expensive and politically uncomfortable.

Questioning diagnostic thresholds, eligibility and who should have access to support is a much more manageable conversation.

But there's a difference between reducing demand for services by genuinely improving people's lives and reducing demand by making those services harder to access.

Early intervention is valuable. It cannot become an excuse for neglecting people whose needs have only become apparent later in life, or who have spent decades managing without appropriate support.

15/10/2026

I’ve stopped accepting attendance as evidence that a child is coping. And I’d ask every education and health professional reading this to consider doing the same.

Attendance, compliance, time in the classroom and apparent calmness are all observable. But they don’t necessarily tell us whether a child is learning, coping or participating sustainably.

For some children, the most important information isn’t found in school at all. It’s at home. The disrupted sleep, difficulties eating, withdrawal from things they previously enjoyed, or an entire weekend spent worrying about having to go back.

Distress that doesn’t appear on an attendance register because it doesn’t happen in the building.

We seem to place more weight on what we can observe ourselves than on the wider picture presented by children and families. Yet professional judgement requires us to consider all available information, not just what happens in front of us.

I’m not talking about every child, or every neurodivergent child. But there is a particular group. The group that mask, that require autonomy in learning, that are sociable but social nuance takes a toll, they struggle with arousal and emotional regulation. They can appear to function and experience significant post restraint collapse. I know this group well, and I work with many of them.

I’m increasingly uncomfortable with what I’m seeing in practice in the context of the government’s attendance agenda.

Of course attendance matters. But when securing it comes alongside a deterioration in a child’s sleep, eating, emotional wellbeing and family life, we need to question what we’re actually achieving.

Attendance is frequently framed as a safeguarding priority. And yet, for some children, the pressure to attend may itself be contributing to significant distress and deterioration in their wellbeing.

There’s an uncomfortable irony in that.

When safeguarding is used to justify enforcing attendance, but the enforcement itself may be causing harm, who is responsible for recognising and questioning that harm?

And are we applying the same professional scrutiny to the actions of institutions as we are to the families being expected to comply?

Because the purpose of education surely extends beyond getting children through the school gates.

If a child’s basic needs are not being met, and their wellbeing and capacity to participate in life outside school are deteriorating, we need to question whether attendance is genuinely supporting their learning and development.

Attendance tells us where a child is. It doesn’t tell us whether their needs are being met, whether they’re learning and developing, or whether they’re thriving in their life as a whole.

14/10/2026

"They just never stop! They're into everything, constantly moving from one thing to the next, and I can't seem to keep their attention on anything."

It’s something I hear quite often from parents, teachers and other therapists, particularly when we’re talking about primary school aged children who seem to be constantly on the move.

And often the conversation turns quite quickly to what equipment might help, or what sensory activities we could try.

But for me, there are so many things I’d want to understand before even thinking about what strategies to use, because just seeing a child constantly moving doesn’t tell us why they’re doing it.

I’d want to know how that child is feeling when they arrive. Do they feel safe and comfortable in that environment, with the people around them and with what’s being asked of them? Are they already working incredibly hard just to cope with being there?

Then I’d be thinking about their body. How much effort does it actually take for them to sit or stand still? Are their joints particularly flexible? Do they have to work harder to keep themselves upright? Do they get tired more quickly than we’d expect? Because sometimes moving around is actually easier than trying to stay still.

I’d also want to understand how well they can feel and make sense of their body. Do they have a good sense of where their arms and legs are without having to look? Can they judge how much force to use or how close they are to things? Are they moving because that movement helps them feel more aware of their body, or more steady and in control?

And then there’s us. How quickly are we moving through things? What’s our tone of voice like? Are we calm and comfortable ourselves? How much are we expecting from that child? Because we’re part of their environment too, and how we interact with them can make a huge difference.

I’d also be looking at what we’re asking them to do. Is it something they’re interested in? Does it make sense to them? Is it too easy, too difficult, or simply something they don’t want to do?

And what about the room itself? Is it noisy? Bright? Cluttered? Are there lots of people moving around? Is there too much happening for them to comfortably take it all in?

Often it’s a combination of several things, and that’s where I think we really need to spend time understanding the individual child.

Because once we have a better idea of what’s going on, the things we choose to do can look very different.

One child might need us to slow down, give them time and help them feel more comfortable before expecting them to join in. Another might benefit from climbing, pushing, pulling or moving through an obstacle course because those activities help them feel more aware of their body and how to use it. Another might actually need us to take things away from the room because there’s already far too much going on.

And sometimes the activity we’ve planned simply isn’t interesting or meaningful to that child, so of course they’re off looking for something else!

The same piece of equipment can help one child feel calmer and more organised, while leaving another feeling completely overwhelmed. Which is why I think we need to be careful about recommending sensory activities without understanding what we’re actually trying to help with.

This is the part of occupational therapy I love. Looking at all the different pieces, how a child’s body works, how they’re feeling, the people around them, the environment they’re in and what’s being asked of them. Then trying to work out how all those things might be influencing each other.

Because when a child is constantly moving, I want to understand what that movement is doing for them before I start trying to change it.

05/10/2026

There’s always more to the story than the part everybody sees.

This video is personal.

But the reason I’m sharing it through Key to Achieving is professional too.

I’m Katie.

I’m an Occupational Therapist with more than 22 years’ clinical experience.

I’m also neurodivergent and living with chronic illness.

I’m adventurous and fun loving.
Creative and Ambitious.
Sometimes extremely capable.

And sometimes I’m not okay.

All of those things are true at the same time.

It’s one of the reasons I care so deeply about looking beyond what someone appears able to do.

Can they get through the school day?

Can they go to work?

Can they socialise?

Can they communicate?

Can they complete the task?

Those questions don’t tell us what it costs them.

They don’t tell us what happens afterwards.

And they certainly don’t tell us the whole person.

At Key to Achieving, we’re interested in the person behind what everybody else sees.

What’s happening in their environment?

What demands are being placed upon them?

What are they having to suppress, tolerate or work around?

What conditions help them feel safe enough to participate, connect, explore and be themselves?

Because getting through something and genuinely managing it are not the same thing.

Human beings don’t belong in neat boxes.

Neither should the support we build around them.

11/09/2026

Why are we so invested in making people push harder along established routes, when human intelligence, self-knowledge and genuine persistence might be found in creating another way? We seem far more comfortable asking people to increase their effort than questioning whether the route itself still makes sense.

For people with chronic conditions and disabilities that are fluctuating or largely invisible, capability can easily be mistaken for capacity. Once somebody has been seen working, travelling, dancing or managing well, that visible moment becomes the standard they are expected to sustain.

We reward persistence when it takes a familiar form: working the expected hours, maintaining the expected pace and continuing to do things in ways society already recognises. Changing the method, reducing the load or using support can be interpreted as giving up.

Finding another route may be one of the most intelligent responses available.

When we are in survival, however, it can be difficult to see beyond keeping the existing structure standing. We use our remaining energy trying to cope better with the same life.

I know this because becoming a mum as a neurodivergent woman with chronic illness led me into burnout. I spent years trying to make the old ways work through effort. Now I understand much more about what drains me, what gives me energy and what I need in order to function sustainably.

Self-knowledge is part of finding another way. So is knowing what support will make a genuine difference and where to find it. This is much of what I do in my work: looking beneath the immediate difficulty, making sense of the wider pattern and helping people find routes that work with who they are.

For me, “never give up” now means staying committed to the life I want while allowing the method to change. It means finding ways to be me without continually paying for it with my health.

When disabled people are judged by how much they can produce, how hard they will push and how little support they require, we keep locating the failure in the individual.

What if disabled people haven’t given up? What if society has given up on finding another way?

02/09/2026

02/09/2026

“Coping” tells us almost nothing about what made coping possible. We see the outcome and risk attributing it entirely to the child. My son walked in to his first day at school happily. From the outside the conclusion could simply be, “He coped brilliantly.” But that removes the context. We arrived early deliberately. We reduced the intensity of the transition. He had time to orient and make a connection. The outcome cannot be separated from the conditions around it.

The conditions that enable coping are individual.

This is where the one-size-fits-all argument becomes important. “Arrive fifteen minutes early” isn’t the lesson. For another child, arriving early could potentially make things harder. The lesson is that we need to understand what this particular nervous system needs in this particular environment. We can use evidence, patterns and clinical knowledge, but support still has to be individualised.

That’s a much more sophisticated professional point than “here are five things that help neurodivergent children start school.”

We don’t account for the cost of making coping possible.

Because there are actually two costs we can make invisible.

There is the cost to the child. A child may appear to cope in school while expending enormous effort to do so.

But there is also the cost around the child. The preparation, planning, adjusting, anticipating, regulating, changing work, holding uncertainty and creating the scaffolding that means everybody else gets to see a child who “coped”.

28/08/2026

A huge thank you to this parent for sharing their experience. It means so much to hear how Katie’s support has helped their family better understand their children and secure support that genuinely reflects their needs.💚

If their story feels familiar and you're looking for practical, neuroaffirming OT support for your child, we'd love to hear from you.