Physiotherapy

Referrals should be made any time if your child:

• Appears “stiff” or “floppy”
• Abnormal posturing  and/or movement concerns when performing large body movements
• Difficulty coordinating movements to perform lard body movements
• One side of the body moves differently than then other side
• Delayed gross motor development or regression of gross motor skills
• Physical disability diagnosed

• Is unable to lift and hold up their head when lying on their tummy
• Displays limited random movements of their legs or arms or movement appear “stiff” and/or limited “kicking” of legs noted
• Arches neck and back when lying on their back

• Has not achieved the activities listed for 3-month milestones
• Is unable to roll
• Appears “stiff” or “floppy”
• Does not bring hands to feet
• Requires a lot of support to maintain sitting position) 

• Has not achieved the activities listed for 6-month milestones
• Is unable to push and bear weight on straightened arms when they are on their tummy
• Is unable to sit independently hands free
• Is unable to move in and out of positions on the floor (e.g. from lying on floor up to a sitting position)
• Is unable to take weight on legs in supportive standing position
• Does not roll or move on belly to access toys out of reach

*Please note that the inability to crawl is NOT a concern at this age.

• Has not achieved the activities listed for 9-month milestones
• Is unable to move in/out of positions on the floor including rolling.
• Not rolling, crawling or bum scooting.

• Has not achieved the activities listed for 12-month milestones
• Cannot pull up to stand at furniture 
• Is unable to take steps while someone holds their hands
• Has primarily walked for a minimum of 2 months and their walking pattern appears:
  • Awkward and/or one side of body looks different than other side of body
  • Toe walking majority of time
  • Pattern is not improving with experience
  • Falls and no protective responses of arms

• Has not achieved the activities listed for 15-month milestones
• Is not independently walking

• Has not achieved the activities listed for 18 months
• Has difficulty getting from floor to standing hands-free 
• Has poor standing balance
• Is toe walking majority of time with or without shoes and has no sensory concerns identified. If sensory concerns have been identified, they should be referred first to Occupational Therapy (OT).

• Has not achieved the activities listed for 24-month milestones
• Is unable to run or runs “stiffly” and/or uncoordinated
• Avoids stepping up, on or over obstacles (i.e. curb) hands free or independently
• Is tripping or falling consistently that you are worried about their safety (unrelated to impulsivity, vision and/or inattention) and your child is getting injured.
• Please note that falling is a part of typical development. Getting help from a physiotherapist is appropriate if:
• your child is getting injured often
• you need to contain your child or avoid places, so they don’t get injured
• your child was safely walking and suddenly becomes “clumsy”
• Your child has 2 or more of the following risk factors:
  • Is not performing stairs upright with support (i.e. railing, wall hand)
  • Is unable to jump
  • Is unable to catch, throw or kick a ball

• Has not achieved the activities listed for 30-month milestones or
• Has difficulty standing up in the middle of the room hands-free with their heels on the ground
• Has poor standing balance on flat and/or uneven surfaces
• Unable to step up, on or over obstacles hands free/independently without falling.
• Unable to walk up/downstairs, one step at a time handsfree
• Walking pattern is awkward, one side of body looks significantly different than other side

• Has not achieved the activities listed for 3 years of age or
• Leans on furniture, walls or people to maintain balance
• Gross motor skills are significantly impacting being able to play with peers of same age