As a result of the difference in knowledge and skills, there will be some children, situations and/or therapy activities that are better carried out by an allied health professional rather than a therapy assistant. These include:
- Children who:
- have medically unstable conditions and require close monitoring
- have complex movement difficulties or complex disabilities
- have significant deformities that require careful handling and facilitation
- have significant behavioural difficulties
- Situations like:
- early in a child’s rehabilitation when they are improving or changing rapidly
- following a specific intervention such as Botox or surgery
- when a child needs to trial a specialised piece of equipment
- Therapy activities that:
- require specialised handling and facilitation of movement
- involve the maintenance of optimal posture and positioning
- require constant or frequent modification and adaptation in response to your child’s efforts and abilities
- on the spot clinical reasoning and problem solving
- are new to the child
- are physically or mentally challenging or taxing, and the therapist wants to push your child’s abilities
- involve the use of specialised equipment that is not yet part of the child’s home therapy routine
This list is not exhaustive, but it can give parents an idea about whether or not the introduction of a support worker or therapy assistant might be suitable for their child at a specific point in time.
What is the difference between a support worker and a therapy or allied health assistant?
The national register for training in Australia (training.gov.au, in: HLT42512 – Certificate IV in Allied Health Assistance) defines allied health assistants as:
‘Workers who provide therapeutic and program related support to allied health professionals. The worker is required to conduct therapeutic and program related activities under the guidance of an allied health professional. Supervision may be direct, indirect or remote and must occur within organisation requirements. The worker is required to identify client circumstances that need additional input from the allied health professional.’
The Australian Physiotherapy Association (APA), Occupational Therapy Australia (OTA), and Speech Pathology Australia (SPA) all recognise Allied Health Assistants (AHA’s) or therapy assistants as being those support workers that:
- hold a Certificate IV in Allied Health Assistance, and/or
- who are directly employed and supervised by a registered allied health professional
As a result of this employment arrangement, it would be expected that therapy assistants receive ongoing training, supervision and support from the allied health professional to ensure that the work they perform is to a certain standard. This means that the types of tasks and activities that a therapy assistant can do may include some activities that require a higher level of knowledge and skill than what another support worker might be able to do. In addition, therapy assistants are usually covered under the allied health professional’s or allied health business’s professional indemnity and public liability insurance.
Why might it be useful to have a support worker or allied health/therapy assistant helping with my child’s therapy program?
The benefits of having a support worker or therapy assistant helping with your child’s therapy program can include:
- Support workers and therapy assistants are cheaper – by having a support worker or therapy assistant complete a home program with your child, your child may be able to do more therapeutic activities with their funding.
- Support workers or therapy assistants can take the load off you as a parent – parents of children with disabilities already have a lot on their plate; by engaging a support worker or therapy assistant to do your child’s home program with them, you might be able to free up some of your own time for work, household tasks, spending time with your other children, etc.
- Your child may respond better to and work harder with a support worker or therapy assistant than a parent – some children (most children???) may behave better and try harder when they are doing exercises for a support worker or therapy assistant, than if they were doing the same activities or exercises with their parents.
What activities can a support worker or allied health/therapy assistant do?
The types of activities a support worker or therapy assistant can undertake will vary. Whether a support worker or therapy assistant can help to implement a child’s therapy program will depend upon:
- the child’s and family’s needs
- the nature of the therapy activities and the knowledge and skill level required
- the support worker/allied health assistants’ level of competence, training and experience, in general and in the specific therapy activities
- the relationship that exists between the support worker/allied health assistant and the allied health professional, and
- the level of training and supervision able to be provided to the support worker/allied health assistant by the allied health professional
Ultimately, the allied health professional holds legal responsibility for the safe and effective delivery of the therapy program to the child (ie: the physiotherapist is responsible for the delivery of all physiotherapy services for a child) – subsequently, it is up to the allied health professional to determine if a support worker/therapy assistant can safely and effectively carry out each activity within the program for each child.
How can we ensure the therapy assistant or support worker is performing the activity to an appropriate standard?
Support workers or therapy assistants require a satisfactory level of training and supervision in your child’s needs and the appropriate activities and exercises for them to carry out prior to commencing therapy with your child. The amount and type of training and supervision required will vary depending on the support worker’s/therapy assistant’s knowledge, skills and competence, the environment, the type of activities, the child’s needs, and the phase of treatment the child is currently in.
Once the support worker or therapy assistant is trained and competent in the activities, then there must be some way for the allied health professional to be able to monitor and adjust the program if necessary, and there needs to be clear and open ways for the allied health professional, support worker/therapy assistant and family to communicate to ensure the program continues to be implemented in a safe and effective way, and to ensure any issues are addressed appropriately and in an appropriate time-frame. This ensures that the program is being implemented effectively so that your child receives the maximum possible gains from completing the program with the support worker/therapy assistant, that any funding is being used efficiently and effectively, and that your child’s safety is maintained.