Pediatric Physiotherapy

What does Pediatric Physiotherapy mean?

Pediatric Physiotherapy is aimed at all children and adolescents from birth until 18 years of age. Some children have delayed or abnormal development, which can be the result of problems with the senses, organs, nervous system or the musculoskeletal system itself.

Each year of development comes with its own attributes and this makes it possible to determine whether a child’s development is delayed or abnormal. The pediatric physiotherapist observes and examines and, if necessary, supplements these observations with information from the referrer (usually a doctor), parents, teachers and others. These are among a wide range of examination methods that contribute to a final diagnosis.

The treatment is aimed at stimulating motor and sensory development, in which the body’s functional capabilities play a central role. During the treatment of children, advice from parents/carers is particularly important.

For disabled children and babies, the treatment will take place at home.

For which problems can Pediatric Physiotherapy be a solution?

Problems that may require Pediatric Physiotherapy differ depending on the age of the child and are, thus, divided into the following categories:

Infant/Baby

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.

Toddlers

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

General

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.