Paediatric physiotherapy is physiotherapy that specializes in the treatment of children. At the Comox Valley Child Development Association the physiotherapy program sees children from birth to kindergarten age.
What is a Physiotherapist?
A physiotherapist is a health professional who works with people to help them improve what they can physically do.
A paediatric physiotherapist works with parents to promote a child's development in their movement and gross motor skills. Some examples of gross motor skills are: rolling, sitting, crawling, walking, running, jumping, climbing stairs and throwing and catching a ball.
To be a physiotherapist, one must be a graduate of a university program in physiotherapy. In British Columbia, one must also be registered with the College of Physical Therapists of British Columbia.
When do you need a physiotherapist?
Children are often referred to physiotherapy when they have:
1. Neurological Conditions
- Children with conditions such as cerebral palsy, spina bifida, head injuries, brain tumors and developmental delays
- Children at risk for delays such as those born prematurely
2. Orthopedic Conditions
- Children with conditions such as torticollis, spinal deformities, muscular dystrophy, Legg-Perthes Disease and club feet
- Children who have sustained an injury such as brachial plexus injuries, amputations, fractures and dislocations
3. Genetic Conditions
- Children with conditions such as Down Syndrome, haemophilia, juvenile rheumatoid arthritis and other connective tissue diseases
The physiotherapist has a specific role to play when working with children and their families who are described above. However, physiotherapy is only one piece of the puzzle. The physiotherapist also works very closely with other health care professions that may also be involved with the care of your child including:
- Family doctor
- Medical Specialists such as a pediatrician
- Other therapists such as occupational therapists and speech therapists
- Other health professions such as infant development consultants, orthotists and audiologists
What happens after my child is referred to physiotherapy?
The physiotherapist will contact you to make an appointment. At the first appointment they will:
- Conduct a parent interview
- Conduct formal and informal assessments of your child
- Discuss with you any areas of concern that are found
What does physiotherapy consist of?
If any areas of concern are identified that could benefit from physiotherapy, the physiotherapist can use any of the following methods to help with the areas of concern:
- Develop a therapy program. Sometimes the parents can complete this program with periodic visits from the physiotherapist and sometimes the physiotherapist will complete part of the program themselves using specialized skills. A therapy program may include: strengthening exercises, stretches, balance activities, positioning and functional activities. Sometimes these activities are done at the local pool.
- Make equipment suggestions. Sometimes a child can be helped through obtaining specific equipment such as shoe inserts, splints, braces, wheelchairs, etc. The physiotherapist will help you obtain this equipment or refer you to where you can obtain this equipment.
- Help your child be integrated into typical childhood activities. Sometimes a child needs extra help to participate in typical childhood experiences. The physiotherapist will work with supported child care to help daycares and preschools encourage your child to participate fully in their early childhood education experiences. The physiotherapist can also suggest extra-curricular activities that your child would enjoy.
Frequently Asked Questions
Question: My 10-month-old shuffles on his bottom in a sitting position everywhere instead of crawling. I try to put him on his tummy so he will learn to crawl but he just rolls over or sits up immediately. Is this a problem? Are there any long-term consequences of never crawling?
Answer: It sounds like your baby dislikes being on his tummy. Now that he is 10 months old and can easily roll and sit, it is going to be hard to convince him that tummy time is fun. If this is the only reason for his bottom shuffling, then you probably do not need to see a physiotherapist at this time. Instead, try to encourage him to accept being on his tummy. Get lying down on the floor with him and sing his favorite song or do a highly entertaining activity. A minute at a time, a couple times a day, is better than nothing at all. Learning to walk before you crawl is not a huge problem. Later on in life, practice crawling by pretending to be a dog or a cat. Two year olds often like this game. In the meantime, try to strengthen your child's arms and shoulders. This strengthening is one important consequence of crawling. Some ways to help strengthen your child's arms are having tug-of-wars, hanging from a bar at the playground, or having wheelbarrow races. (A wheelbarrow race is when your child is the wheelbarrow, you hold their hips and they walk on their hands).
On the other hand, if you think that the bottom shuffling could be due to any other reason than lack of tummy time, a physiotherapy assessment is a good idea. Also, if your child is doing any other skills in an unusual manner, a physiotherapy assessment is a good idea.
Question: My 3 month old baby always looks to the right. When I put her head to the left, she complains and moves it back to the right again. I'm beginning to wonder if she knows how to turn her neck/head to the left. Should I be concerned?
Answer: A referral for a physiotherapy assessment would be a good idea. Discussing your concerns with your family doctor is another good idea. Young babies do not have full control of their head and their heads are often tilted or turned to one side or the other. However, they should be randomly tilted or turned to either side, not just the same side all the time. It might be nothing or it might be a condition that requires you to do some basic exercises with your daugther. If exercises would be useful, the sooner they are started, the better.
Question: My child is 1 year old today. He knows how to walk but he still crawls more frequently than he walks. I thought a typical child could walk at their first birthday. Should I be concerned?
Answer: No. According to the Alberta Infant Motor scale, 50% of children who are 12 months old use walking as their main method of getting around. By 14 months, 90% of children are using walking as their main method of getting around. Wait a couple of months. Within the next 2 months you will probably see a great improvement. However, if your child seems to be having trouble because they are trying to walk in an unusual manner or one side or part of their body seems to be working better or worse than the rest of their body, a physiotherapy referral now might be a good idea.
Submitted by Dianne Aikman, Registered Physiotherapist
250-338-4288 Ext. 228
