Pediatric Physiotherapy

When to have a child assessed

Parents are often told to wait and see. Sometimes that is right — there is a normal range for when children reach milestones, and being at the later end of it is not automatically a problem. But some patterns warrant assessment rather than waiting.

• Clearly delayed milestones — not sitting, crawling, standing or walking near the expected age.
• A strong preference for one side, or consistently reaching with only one hand.
• A persistent head tilt or preference for turning the head one way (torticollis).
• Walking on tiptoes persistently, or an unusual walking pattern.
• Stiffness or floppiness that seems different from other children of the same age.
• Frequent falls, clumsiness or difficulty keeping up physically at school.
• A diagnosed condition such as cerebral palsy, Down syndrome or a neuromuscular disorder.

How children are treated

Assessment looks at how the child moves rather than only at what they cannot do — the quality of movement, muscle tone, joint range, strength, balance and how they solve movement problems. Where relevant, we ask about birth history, medical diagnoses and how the child manages at home and school.

Treatment is delivered through play. Reaching for a toy positioned deliberately, climbing, crawling through spaces, balance games — these are the exercises, structured so the child practises the specific control they need while enjoying the session. Handling techniques may be used to guide better movement patterns, and stretching or positioning programmes are added where tone or range is a concern.

Parents are part of the treatment

A child might attend the clinic once or twice a week. They are at home the rest of the time, which is where most of the useful repetition has to happen. Parents are shown exactly what to do: how to position the child during play and sleep, how to carry them in a way that encourages symmetry, which activities to encourage, and how to progress as the child improves.

We also try to be realistic. A home programme that assumes an hour of dedicated practice every day will not survive contact with a household. Programmes are built around what can be woven into normal daily routines — feeding, bathing, dressing and play.

Working alongside your child’s doctor

Paediatric physiotherapy sits alongside paediatric and, where relevant, neurological or orthopaedic care. Bring diagnoses, medication details and any reports so the programme fits with the rest of your child’s care, and so we can flag anything that should go back to the treating doctor.