Does my child need physiotherapy intervention?

  • Premature babies
  • Not reaching developmental milestones
  • Flattened or mis-shaped head (Plagiocephaly)
  • Clumsiness or lack of coordination
  • Floppy or rigid joints
  • Hip dysplasia (clicky hips)
  • Torticollis (looking to one side)
  • Erb’s Palsy or Brachial Plexus Lesion
  • Talipes /Club foot (mis-shaped foot)
  • Abnormal walking pattern (in toeing, out toeing, walking on toes)
  • Poor posture
  • Casting and post fracture rehabilitation
  • Cystic fibrosis and airway clearance


Plagiocephaly refers to a persistent flattened spot on the back or side of the head, and is sometimes referred to as Flat Head Syndrome. Plagiocephaly can be pre-natal, again due to a restricted uterine environment, lack of amniotic fluid, multiple births or increased abdominal or uterine muscle tone.

Children who are left untreated may suffer from one or more of the following associated problems:

  • Open mouth posture
  • Tongue may be pulled to one side
  • Suck/swallow reflex may be affected
  • Shortening of other neck or trunk muscles
  • Facial asymmetry
  • One ear in front of the other
  •  Feeding issues

Developmental Delay

Developmental delay is a broad term used to describe when a toddler or infant’s development is delayed in one or more areas compared to other children.

These different areas of development may include:

  • gross motor development (how children move)
  • fine motor development (how children manipulate objects and use their hands)
  • speech and language development (how children communicate, understand and use language)
  • cognitive/intellectual development: how children understand, think and learn
  • social and emotional development: how children relate with others and develop increasing independence.

Parents may become aware of delay when the child does not achieve milestones at the expected age.

Transient developmental delay is common in premature babies. Premature babies may show a delay in the area of sitting, crawling and walking. Early physiotherapy will help to attain milestones so the child can progress on at a normal rate.

Disorders which cause persistent developmental delay are often termed developmental disabilities. Examples are cerebral palsy, muscle disorders, language disorders, autism, emotional problems and disorders of vision and hearing. All these conditions can cause developmental delay.

Developmental Co-ordination Disorder

Developmental coordination disorder (DCD) is a spectrum of issues that affect a child’s ability to acquire or perform skilled movements. Children with difficulty coordinating movement can have subsequent trouble with many tasks required routinely in school/ preschool.

If not treated early children with DCD can develop avoidance behaviours or fail to participate, leading to a cycle of inactivity, frustration and low self-esteem. In Australia as many as one in ten children experience these issues. Accurate diagnosis of DCD enables the Physiotherapist to employ strategies that will aid in the healthy physical and mental development of these children.

Is your child achieving the appropriate developmental milestones for their age?

  • Rolling at 4 months
  • Sitting at 6 months
  • Crawling at 9 months
  • Pulling to Stand 10 months
  • Walking at 12 months

There are many factors that may delay your child’s development including the personality of your child, premature birth, neurological and musculoskeletal conditions. The aim of the physiotherapist is to identify any issues that may be causing these delays. Physiotherapy sessions are based on each infants needs and are integrated into family life for a realistic outcome.

The following conditions relate to infants not achieving milestones. If diagnosed early these conditions have dramatic improvement with physiotherapy interventions.

  • Torticollis (Tight Neck muscles)
  • Plagiocephaly (Flat head)
  • Developmental Co-ordination Disorder
  • Talipes
  • Developmental dysplasia of the hips (Clicky hips)
  • Developmental Delay


Torticollis is the tightness of a newborns neck muscle, called the sternocleidomastoid muscle (SCM). This is a muscle that runs on both sides of the neck from the back of the ears to the collarbone. Tightness of the SCM on one side will make it difficult for a baby to turn their neck.

Torticollis can be caused by restricted uterine environment, abnormal positioning (such as being in the breech position) or the use of forceps or vacuum devices during delivery. Torticollis is relatively common in newborns. Boys and girls are equally likely to develop the head tilt. It can be present at birth or take up to 3 months to develop.

If detected early torticollis is treated effectively with stretches and strengthening.

Your child may require an intervention for torticollis if:

  • their head is tilted in one direction (this can be difficult to see in very young infants)
  • they prefer looking at you over one shoulder instead of turning to follow you with his or her eyes
  • when breastfeeding they will only feed on one side (or prefers one breast only)
  • when turning to look at you they become frustrated or are unable turn his or her head completely

If not detected early infants with Torticollis will also develop a flat head (positional plagiocephaly) on one or both sides, due to laying in one direction all the time. Or they might develop a small neck lump or bump, due to the tense neck muscle.


If diagnosed before 6 months of age this condition is usually successfully treated with physiotherapy. Treatment may involve stretching exercises, serial casting and orthotic devices. Positional Talipes is caused by packaging in the uterus and is common with larger babies. Positional Talipes is usually effectively treated conservatively (this means without surgery) if detected early. Congential Talipes has a lower success rate with conservative treatment and it is likely that your child will require a specialist opinion to determine if an operation is required..

Assistive Devices

If your child requires an assistive device the physiotherapist will perform an Assessment to determine the most suitable equipment.

Ongoing therapy sessions will involve monitoring the effect of the device, ensuring infant comfort and adjusting the fit as required.