Problems that may require Pediatric Physiotherapy differ depending on the age of the child and are, thus, divided into the following categories:
- Low muscle tone, complete lack of movement
- High muscle tone, excessive stretching
- Plagiocephaly (asymmetric face)
- Torticollis (asymmetric posture)
- Deviations from expected development: Not rolling, no (eye) contact, difficulty changing posture
- Inability to crawl (In combination with displays of frustration and excessive crying)
- Swallowing problems (with prematurity or dysmaturity, for example due to tube feeding)
- Development problems relating to prematurity or dysmaturity (motory and sensory)
- Injury to the brachial plexus
- Pathology: e.g. Down’s Syndrome, movement restlessness, sensory dysfunction or learning difficulties.
- Motor restlessness, inability to sit still
- Problems with motor development, inertia or fatigue
- Clumsy motor skills such as tripping (usually notable during physical activity/education)
- Deviations from expected development: Problems walking (also, possibly, up stairs or backwards), jumping, hopping or playing hopscotch.
- Pathology: All slow motor or sensory development
From 5+ (Until the end of Primary School)
- Fine motor skill disorders: visible when playing, drawing, cutting, using cutlery and with basic writing. As school progresses (or by Dutch Group 5), issues with writing quickly.
- Gross motor skill disorders: sumbling, awkward/clumsy movements (visible during physical education), quickly becoming tired when walking, persistently walking on tiptoes
- Disturbing movements in arms, legs or face (mouth)
- General motor restlessness (ADHD or suspected ADHD), coordination or concentration problems.
- Problems with posture: limp posture, abnormalities in the spinal thorax
- Pre- and post-operation orthopedics
- Pathology: Involving all motor development disorders
- Down’s Syndrome, spina bifida, achondroplasia, rheumatic disorders, learning difficulties, autism.
- Respiratory diseases
- Neuromuscular diseases
- Diseases relating to muscle tone regulation, myopathie
- Connective tissue disorders
- Respiratory problems: Cystic Fibrosis, Asthma, COPD
- Incontinence (not bedwetting)
- Obesity, low load bearing capacity
Plagiocephaly (Flattening of the Skull)
Plagiocephaly is a condition that we regularly encounter and, thus, we will talk about it specifically. Babies can develop a flattened skull during the first few months due to repeated pressure on one part of their head, usually due to preferring a specific posture. In this posture, the baby spends too much time lying in one direction or on its back. This has become more common since it has been advised to allow babies to sleep on their backs to prevent Sudden Infant Death Syndrome (or ‘cot death’). Unfortunately, during these first months the baby’s skull is very malleable and this can lead to plagiocephaly.
If the flattening is too large, a specialist will be consulted to assess whether or not further therapy (usually involving corrective headbands or helmets) is necessary. Usually this takes place when the baby is around five or six months old if it turns out that the flattening is not acceptable to the parents.
Usually further helmet therapy is not necessary, and the flattening can be remedied through advice on the handling, posture and the sleep position of the baby. Thus, the therapy consists of instructions and demonstrations in the practice or, if desired, in you home.
We will also examine your baby’s motor development as favouring a certain posture can lead to further issues relating to normal motor development. Here, too, advice from us plays an important role.
The paediatric physiotherapist will assess the degree of flattening, and whether this has consequences for the facial shape relating to, for example, asymmetrical position of cheeks, ears and eyes.