First of all, what do know about physiotherapy? Most people don’t understand the key role physiotherapy can play in maximizing a child’s health. Here is everything you need to know about physiotherapy and how it can help with your child.
Table of Contents
1. What is Physiotherapy?
2. Why your child might see a physiotherapist
3. Gross Motor Developmental Milestones
4. Gross Motor Developmental Red Flags
A physiotherapist is a health professional who treats pain caused by joint, muscle and nerve problems. Paediatric physiotherapists are physiotherapists who specialise in working with children from birth to late adolescence.
Physiotherapy helps with the development, rehabilitation, and improvement of movement, flexibility, strength and endurance. Therapy program will focus on improving the child’s functional or educational skills.
Therapy sessions may include:
Initial assessment to find out about the child’s needs
Regularly scheduled treatment to work on mobility, strengthening, flexibility exercises or stretching exercises
Home programs given to parents or families to practice at home
The goal of physiotherapy is to help a child function at their maximum capabilities. Physiotherapy can give a disabled child a priceless sense of independence through comprehensive therapy sessions.
Physiotherapy often works together with other therapies, such as occupational therapy or speech therapy. For example, if a child is learning how to write and is slouching at the table, it may be a sign of poor core strength—physiotherapy can help with the core strength while occupational therapy teaches writing.
1. Developmental delay
Child displays a significant delay in meeting milestones (rolling, sitting, crawling or walking)
2. Unusual posture
Child develops unusual walk, gait, foot or spinal posture. Child frequently sits in the W- sitting pose
3. Persistent pain
Child presents ongoing pain, stiffness or inflammation of joints.
4. Recent injury or surgery
The child is recovering from a recent injury or surgery where their movements became stiff or unsmooth
5. Low-tone/floppy
Child is floppy when picked up, unable to hold up their own head whilst lying on their tummy or when supported in the sitting position
6. High-tone/spasticity
The child’s elbow or knee cannot be straightened or always in bending position. Their foot cannot fully step onto the ground due to tightness
7. Reduced sensation
Child experiences reduced sensation in the hands, legs or feet.
A physiotherapist can help your child with:
Gross motor delay
Autism Spectrum Disorder
Global Developmental Delay
Cerebral Palsy
Down Syndrome
Spina Bifida
Brain Injury
Hypotonia/hypertonia
Muscular Dystrophy or other neuromuscular challenges
Torticollis
Other genetic disorders
Children develop at different speeds with developmental milestones such as sitting, crawling, climbing, walking and jumping. All these can be measured on a broad scale to give parents some guidelines.
What are gross motor skills?
Gross motor skills are those which involve whole body movements and require the large muscles of the body to carry out everyday functions, such as standing and walking, running and jumping, go up and down stairs, and sitting upright at the table. In addition, eye-hand coordination skills are also included such as throwing, catching, and kicking balls as well as riding a bike or a scooter and swimming.
The ultimate goal of gross motor development is to gain independent movement.
Why are gross motor skills important?
To perform activities of daily living
· Walking and running
· Playground skills (climbing, jumping, grabbing)
· Sporting skills (catching, kicking, throwing and hitting a ball with a bat)
· Swimming and cycling
To carry out everyday self care skills
· Dressing (when you wear your pants, you need to be able to stand on one leg to put your leg into the pant leg without falling over)
· Climbing stairs to get into a room, at the mall or in class
· Getting into and out of bed
How gross motor skills affect child’s life?
Gross motor abilities have an influence on everyday tasks. For example, without proper upper body support (core strength), a child cannot sustain appropriate table posture. This will indirectly affect their ability to write, draw and cut. When their core strength is weak, they cannot sit for a long time while maintaining an upright posture in class which negatively impacts their academic learning.
Besides that, without proper gross motor skills, a child can easily get hurt while playing with their friends. They will frequently fall down while walking, running and going down hills which all require a fair amount of upper and lower body strength and balance.
Also, gross motor skills have an impact on your stamina to cope with a full day of school which includes moving between classrooms, walking around classroom desks, carrying heavy books, playing on the playground and sitting upright at a desk.
A child will struggle with many day to day functions such as a eating, keeping their toys, and getting on and off the toilet if they do not have fair gross motor skills.
Gross Motor Milestones
1 month
Chin up when lying on tummy
Turns head when lying on the back
2 months
Chest up when lying on tummy
Head bobs when held in sitting position
3 months
When lying on tummy, pushes up to elbows
Rolls to the side
4 months
No head lag when pulled to sitting position
When lying on tummy, pushes up on wrists
Rolls from front to back
5 months
Rolls from back to front
Sits with arms supporting the body
6 months
Sits momentarily propped on hands
Bears weight on one hand when lying on tummy
7 months
Bounces when held
Sits without support
Puts arms out to sides for balance
8 months
Commando crawls
Pulls to sitting/kneeling position
9 months
Walking on hands and feet with bottom in the air
Begins creeping
Pulls to stand
10 months
Creeps well
Moves around furniture using two hands
Stands with one hand held
Walks with two hands held
11 months
Turns body to a sitting position
Move around furniture using one hand
Stands for a few seconds
Walks with one hand held
12 months
Stands well with arms high and legs spread out
Independent steps
13 months
Walks with arms high and out
14 months
Stands without pulling up
Falls by collapse
Walks well
15 month
Stoops to pick up toy
Creeps up stairs
Walks carrying toys
Climbs on furniture
16 months
Stands on one foot with slight support
Walks backwards
Walks up stairs with one hand held
18 months
Creeps down stairs
Runs well
Seats self in small chair
Throws ball while standing
20 months
Squats in play
Carries large objects
Walks downstairs with one hand held
22 months
Walks up stairs holding rail, putting both feet on each step
Kicks ball with demonstration
Walks on one foot on walking board
24 months
Walks down stairs holding rail, both feet on each step
Kicks a ball without demonstration
Throws overhand
28 months
Jumps from bottom step with one foot leading
Walks on toe after demonstration
Walks backward 10 steps
30 months
Walks up stairs with rail, alternating feet
Jumps in place
Stands in both feet on a balance beam
Walks with one foot on a balance beam
33 months
Walks swinging arms opposite of legs
3 years
Balances on one foot for 3 seconds
Goes up stairs, alternating feet, no rail
Pedals tricycle
Walks heel to toe
Catches ball with stiff arms
4 years
Balances on one foot 4 to 8 seconds
Hops on one foot 2 to 3 times
Standing broad jump: 1 to 2 feet
Gallops
Throws ball overhand 10 feet
Catches bouncing ball
5 years
Walks down stairs with rail, alternating feet
Balances on one foot more than 8 seconds
Hops on one foot 15 times
Skips
Running broad jump 2 to 3 feet
Walks backward heel-toe
Jumps backward
The points below shows the warning signs of delayed gross motor skills and development. Once a condition is suspected or diagnosed, early intervention is extremely important. This is because the child’s brain is still growing hence is the best time to teach new skill or to change behavior.
Late intervention can prevent the child from reaching their maximum capabilities due to a smaller window to implement changes or teach new skills.
Gross Motor Delay According to Age
6 months
Not rolling
Not holding head up when lying on tummy
9 months
Not sitting without support
Not creeping or crawling
Does not hold weight well on legs when held by an adult
12 months
Not crawling or bottom shuffling
Not pulling to stand
Not standing holding on to furniture
18 months
Not attempting to walk without support
Not standing independently
2 years
Unable to run
Unable to use stairs holding onto rail
Unable to throw a ball
3 years
Not running well
Cannot walk up and down stairs
Cannot kick a ball
Cannot jump well
4 years
Cannot pedal a tricycle
Cannot catch, throw or kick a ball
Not able to walk, run, climb, jump and use stairs confidently
5 years
Awkward when walking, running, climbing stairs
Ball skills are very different from peers
Unable to hop 5 times on each foot
Red Flags at any age
Not achieving indicated developmental milestones
Strong parental concerns
Significant loss of skills
Difference between right and left sides of body in strength, movement or tone
Loose and floppy movements (low tone) or stiff and tense movements (high tone)
If you have concerns about your child at any age or your child shows any signs of delays stated in the above, please feel free to contact us to speak to a professional.