Occupational therapy reports for school, housing and autism (UK)

An occupational therapy report is a written account of how a person manages the activities that matter to them, what gets in the way, and what would help.

Independent occupational therapists (OTs) in the UK often write three kinds of report. One goes to a school or a local authority for an education, health and care (EHC) needs assessment. One goes to a council housing team to support home adaptations. One describes the sensory and daily living needs of an autistic child or adult for a family, a school or another professional. This guide gives you a common structure, three templates and short fictional examples.

If you want a general outline first, see our occupational therapy assessment report template and outline.

Three reports, three readers

The same assessment can be written up in very different ways. The question to ask before you write is simple. Who will act on this report, and what decision do they have to make?

• School and EHC report. The readers are the SENCO, the local authority EHC team and, sometimes, a tribunal. They need needs, outcomes and provision they can copy into a plan.
• Housing report. The readers are the council housing or grants team, a technical officer or surveyor, and sometimes social services. They need to know what the person cannot do safely at home and which adaptation would solve it.
• Autism-related functional report. The readers are the family, the school and other clinicians. They need a clear picture of sensory processing, self-care, routines and participation, written in plain words.

What HCPC and RCOT expect from any report

If you are registered with the HCPC, its standards of conduct, performance and ethics, effective from 1 September 2024, include standard 10, "Keep records of your work". It says you must keep "full, clear and accurate records" for everyone you provide services to, complete them "promptly and as soon as possible" after the service, and keep them secure "from loss, damage or inappropriate access". Treat a report and the notes behind it as part of that duty.

RCOT's Keeping Records: Guidance for Occupational Therapists (fourth edition, 2018) adds practical rules that apply directly to reports:

• You must be able to record the rationale for any actions or recommendations that follow your assessment.
• Abbreviations should not be used in care records. If you do use an acronym, its meaning must be unambiguous and defined in full.
• Sign legibly, print your name and give your designation.
• Give the date in full, with day, month and year.
• Service users are entitled to access their records on request.

The shared structure

All three reports can use the same core. Add or drop sections depending on the reader.

1. Report details: name, date of birth, date of assessment, date of report, who requested it and why.
2. Reason for referral and the questions the report answers.
3. Consent and who contributed (person, parents, school, other professionals).
4. Background: relevant history, current situation, previous reports read.
5. Assessment methods: observations, settings, standardised assessments with dates, interviews, questionnaires.
6. Findings by area of occupation: self-care, productivity (school or work), leisure, plus the underlying skills (motor, sensory, cognitive, environmental).
7. Impact: what the findings mean for daily life, in the person's own context.
8. Summary of needs.
9. Recommendations: specific, measurable, with who, what, how often and for how long.
10. Review plan.
11. Signature, printed name, designation, HCPC registration number, date.

For more ready-made outlines across professions, see our clinical document templates.

Writing recommendations people can act on

Vague recommendations are a common weakness in OT reports. "Would benefit from sensory support" gives a reader nothing to fund or deliver. A useful recommendation answers five questions.

• What exactly will be provided?
• Who will deliver it, and with what training or supervision?
• How often, and for how long each time?
• Where and when in the day?
• How will progress be measured, and when will it be reviewed?

Fictional example, vague version. "Sam needs help with fine motor skills."

Fictional example, usable version. "Sam will have a 20 minute fine motor programme three times a week, delivered by a teaching assistant trained by the OT, using the activities listed in appendix 2. The OT will review the programme each half term. Target: Sam writes his name legibly on a standard lined page without adult help by the end of the spring term."

Keep the rationale next to each recommendation. One sentence linking it to a finding is enough, and it meets the RCOT point about recording why you recommend something.

Report 1: the school and EHC report

When a local authority carries out an EHC needs assessment, it gathers advice from professionals. Under regulation 12 of the Special Educational Needs and Disability Regulations 2014, an EHC plan must set out, among other sections, the child or young person's special educational needs (section B), the outcomes sought (section E), the special educational provision required (section F) and any health care provision reasonably required (section G). From year 9, provision must also include preparation for adulthood and independent living.

Section F matters most for an OT. Under section 42(2) of the Children and Families Act 2014, "The local authority must secure the specified special educational provision". A clear and quantified recommendation is easier for the local authority to use when it writes section F. A vague one is hard to secure and hard to check.

When a local authority asks a body to co-operate in an EHC needs assessment, that body must comply within 6 weeks of receiving the request, with limited exceptions such as exceptional circumstances or a missed appointment, under regulation 8. If you are an independent OT commissioned by parents, agree a delivery date with them so the report arrives while it can still be used.

Template: school and EHC report

1. Report details and HCPC number
2. Reason for referral and questions asked
3. Consent and contributors (child's views, parents, school staff)
4. Background and previous reports
5. Assessment methods and settings (classroom, playground, home)
6. Findings by school activity: handwriting and recording, dressing for PE, eating at lunch, moving around school, attention and sensory regulation in class
7. Summary of special educational needs (written so it can inform section B)
8. Suggested outcomes (written so they can inform section E)
9. Recommended provision: what, who, how often, how long, review (written so it can inform section F)
10. Health care provision, if any (section G)
11. Preparation for adulthood (from year 9)
12. Signature, designation, date

Fictional example extract. "Need: Amira (age 9) cannot fasten buttons or a zip, so she misses the start of PE each week. Outcome: by July, Amira will change for PE independently within 10 minutes. Provision: 15 minutes of dressing practice twice a week with a teaching assistant, using the graded steps in appendix 1, reviewed by the OT at the end of each term."

Our series article on EHCP professional reports covers this format in more depth for SLTs, OTs and psychologists.

Report 2: the housing and adaptations report

A Disabled Facilities Grant (DFG) helps disabled people make changes to their home. According to GOV.UK, examples include widening doors, installing ramps or grab rails, a stairlift, a level access shower, or building an extension such as a downstairs bedroom. The maximum grant is up to £30,000 in England, up to £36,000 in Wales and up to £25,000 in Northern Ireland. DFGs are not available in Scotland. Some councils may give more. Disabled children under 18 can get a grant without their parents' income being taken into account.

On eligibility, GOV.UK says the council needs to be happy that the work is "necessary and appropriate to meet the disabled person's needs", and reasonable and possible depending on the age and condition of the property. Your report feeds the first test directly.

The government's DFG delivery guidance for local authorities in England (published March 2022) describes the OT role. Key points for independent OTs:

• Some applicants are assessed by a private occupational therapist. A district council must still consult the social services authority in these cases.
• Whichever team makes the initial assessment, the final decision on the grant stays with the local housing authority.
• In complex cases, the guidance recommends that the OT and a technical officer work together, and that the OT recommends the solution in collaboration with the client.
• Adaptations should meet the present and anticipated needs of the disabled person.
• For disabled children, assessments should consider the child's developmental needs, the needs of parents as carers and of other children in the family, and take account of the views of the child and parents.

Write for a council officer and a surveyor. Show the functional problem, the risk it creates, the options you considered and why your preferred option is the one that meets current and future needs.

Template: housing and adaptations report

1. Report details and HCPC number
2. Reason for referral (DFG application, landlord request, hospital discharge)
3. Household and property: tenure, layout, floors, access, bathroom and bedroom location
4. Condition and prognosis in functional terms (stable, progressive, developmental)
5. Assessment methods: home visit, transfers observed, measurements taken
6. Findings by activity: getting in and out, stairs, toileting, bathing, sleeping, kitchen, garden, carer tasks
7. Current risks and what has been tried (equipment, minor adaptations)
8. Options considered, with reasons for and against each
9. Recommended adaptation, with key dimensions and specification points
10. Present and anticipated needs
11. For children: developmental needs, carers, siblings, child's views
12. Signature, designation, date

Fictional example extract. "Mr Okafor (age 67) cannot step over the bath side, even with a board and rail. He has fallen twice in the bathroom since January. A level access shower with a fixed seat and two grab rails would allow him to wash without help. A stairlift was considered but does not address bathing, which is the main risk."

Report 3: the autism-related functional report

Families often ask an OT for a report after an autism assessment, or while they wait for one. Keep to what an OT observes and assesses: sensory processing, self-care, sleep routines, eating, play, school or work participation, and the environment. Do not state or imply a diagnosis. Describe what you saw, in which setting, and how it affects daily life. If a diagnosis exists, quote it with its source and date.

Use plain words, explain any assessment you name and describe the behaviour behind labels such as "sensory seeker".

Template: autism-related functional report

1. Report details and HCPC number
2. Reason for referral and the family's main concerns
3. Existing diagnoses or assessments, quoted with source and date
4. Assessment methods: observations at home, school or clinic, sensory questionnaires, interviews
5. Sensory profile in daily life: noise, touch, movement, food textures, light
6. Self-care: dressing, toileting, washing, eating, sleep
7. Participation: school or work, play and leisure, community outings
8. Strengths and what already helps
9. Impact on the person and the family
10. Recommendations by setting (home, school, community), each specific and reviewable
11. Review plan and signature

Fictional example extract. "Leo (age 6) covers his ears and leaves the dinner hall within five minutes on four out of five observed days. He then eats nothing until home time. Recommendation: Leo eats lunch in a quieter room with up to three peers, five days a week, for one half term. Staff record daily how much he eats. The OT reviews the record at the end of the half term."

Common mistakes to avoid

• Listing test scores without saying what they mean for daily life.
• Writing "would benefit from" instead of a clear recommendation with frequency and duration.
• Using abbreviations a parent or council officer will not know.
• Leaving out the rationale for a recommendation.

Where Delta fits

Delta is an AI assistant for mental health and allied health practitioners, including occupational therapists. It transcribes what is said during a session and prepares a report that you review. You can also dictate observations right after a home visit or session, or add written notes. Delta also drafts assessment reports and letters, which you check, correct and sign. Each draft is added to the client's file, so the follow-up stays in one place. Data is hosted in France with a host certified for health data (HDS, the French health data hosting certification), AI processing including transcription runs on servers in France, the client's name and identifying details are pseudonymised before AI processing, no audio file is kept, data is never used to train models, and data is encrypted in transit and at rest. As with any provider, ask for its data processing agreement before you use it. For a wider view, read our article on AI in occupational therapy.

Sources

• HCPC, Standards of conduct, performance and ethics (effective 1 September 2024)
• RCOT, Keeping Records: Guidance for Occupational Therapists, fourth edition (2018)
• The Special Educational Needs and Disability Regulations 2014, regulation 12
• The Special Educational Needs and Disability Regulations 2014, regulation 8
• Children and Families Act 2014, section 42
• GOV.UK, Disabled Facilities Grants
• GOV.UK, Disabled Facilities Grants: what you'll get
• GOV.UK, Disabled Facilities Grants: eligibility
• GOV.UK, Disabled Facilities Grant (DFG) delivery: guidance for local authorities in England (published 28 March 2022)