Neurodevelopment Physiotherapy.
Neurodevelopmental physiotherapy for children focuses on supporting the motor development and functional abilities of children with neurological conditions. Neurodevelopmental physiotherapy aims to enhance the child’s quality of life by improving their movement patterns, strength, coordination, balance, and participation in daily activities. The approach is grounded in the understanding of neuroplasticity—the brain’s ability to reorganise itself by forming new neural connections throughout life, which can be particularly effective in children due to their developing brains.
How we can help
Neurodevelopment in babies and children refers to the growth and maturation of the brain and nervous system. This complex process starts in the womb and continues into early adulthood, with the most critical periods occurring prenatally and in the first few years of life. When seeking neurodevelopmental physiotherapy for a baby, it’s important to find a physiotherapist who specialises in paediatric care.
Adult neurological physiotherapy is completely different from paediatric neurodevelopmental physiotherapy because the former is often about the loss of existing skills and function, while the latter is about understanding and promoting normal development of skills not yet learnt.
Here at Sydney Kids Physio, our Expert Paediatric Physiotherapists have specific training and experience in paediatric neurodevelopmental conditions. We understand both neurodevelopmental processes in typically developing children and maladaptive neurodevelopmental processes in children with special needs.
Treatments we offer
The goals of Neurodevelopmental Physiotherapy are to enhance motor development and function to help children achieve developmental milestones such as sitting, crawling, and walking. Our Expert Paediatric Physiotherapists have vast experience in neurodevelopmental conditions ranging from Prematurity to Cerebral Palsy to Rare Genetic Diseases to Global Developmental Delay. The key foundation to Neurodevelopmental Physiotherapy is accurate assessment and identification of a child’s current ability, strengths, weaknesses, potential as well as barriers towards learning new skills. We have a proven track record of helping children with Special Needs “beat the odds” and learn to walk when Paediatric Specialist Teams have predicted otherwise.
Neurodevelopmental Assessments
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Integrated Listening Systems (iLs)
The Integrated Listening System (iLs) method leverages neuroplasticity, the brain’s ability to change and create new pathways in response to environmental stimulation. iLs programs provide targeted, gentle stimulation to activate and strengthen neural pathways involved in sensory processing. Through repeated multi-sensory input sessions, new neuronal connections are formed. iLs trains brain/body integration in stages, starting with sensory integration and progressing to complex cognitive functions like language, self-expression, and social skills. Each program is customized to meet the individual therapeutic goals of each child.
Harnessed Treadmill Walking Systems
The Harnessed Treadmill Walking System is a body weight-supported treadmill training designed to help young children develop or improve their walking abilities. Research shows it benefits children with cerebral palsy, Down syndrome, and spinal cord injuries by enhancing endurance, motor function, walking speed, gait kinematics, symmetry, and safety. Overall, the system offers a structured, repetitive, and safe method for improving walking ability, leading to greater independence and quality of life.
Orthotic Garment Systems
Orthotic garment systems are dynamic orthoses that provide sensorimotor input to improve postural alignment and stability while allowing active movement training. They are used effectively with physiotherapy to treat conditions such as low muscle tone, decreased core strength, poor trunk control, flexible scoliosis, excessive hip rotation, and knee hyperextension. These garments are worn discreetly under clothing, with wear time gradually increased.
At Sydney Kids Physio, our expert paediatric physiotherapists have over 18 years of experience working with orthotic garment companies to prescribe these systems. We can help you find the best option to improve your child’s posture and function.
Functional Electrical Stimulation
Functional Electrical Stimulation (FES) is a therapeutic technique for children with neurological impairments, aimed at improving motor function and daily activity performance. By applying small electrical pulses to stimulate muscle contractions during activities like sitting, standing, walking, or reaching, FES helps retrain the nervous system to control muscle function. Regular use of FES enhances muscle strength, endurance, posture, and balance, and can reduce muscle spasticity.
At Sydney Kids Physio, expert paediatric physiotherapists use FES to assist children with hypotonia, Erb’s Palsy, Cerebral Palsy, Down Syndrome, and Global Developmental Delay.
Radial Shockwave Therapy
Radial Shockwave Therapy (RSW) is a non-invasive treatment that uses high-energy acoustic waves to reduce pain, promote healing, and decrease spasticity, often seen in conditions like cerebral palsy, stroke, and multiple sclerosis. By targeting affected tissues, RSW can alter muscle and nerve function, reducing muscle stiffness and improving mobility. Studies show it significantly decreases spasticity in both upper and lower limbs, with effects lasting up to 12 weeks post-treatment.
At Sydney Kids Physio, expert paediatric physiotherapists use RSW to reduce muscle tightness and spasticity in children with cerebral palsy, enhancing joint range of motion and aiding in achieving motor milestones like crawling, standing, and walking. This treatment has reduced the need for Ankle Foot Orthosis or Botox injections in many children.
Equipment Prescription
Assistive Technology Devices are specialized tools that support children with disabilities and their caregivers in performing daily activities, enhancing independence, and improving quality of life. These devices can be standard, modified, or custom-made to meet the unique needs of each child.
Types of Assistive Technology Devices:
- Aids for Daily Living: Bath chairs, commodes, toileting systems, continence aids.
- Mobility and Transfer Aids: Supportive strollers, walkers, car seats, wheelchairs, hoists, transfer boards.
- Seating and Standing Aids: Specialized seating systems, pressure-relieving mattresses and cushions, positioning equipment.
The process of equipment prescription includes evaluating a child’s needs, selecting suitable devices, and acquiring them to enhance daily activities, education, and participation. Key considerations include the child’s current and future goals, abilities, environment, and device features.
At Sydney Kids Physio, expert paediatric physiotherapists assist with:
- Equipment trials.
- Funding applications (e.g. NDIS).
- Delivery and fitting of devices.
Serial Casting
Serial casting is a non-surgical treatment used to address toe walking in children, whether idiopathic or related to neurological conditions like cerebral palsy or muscular dystrophy. The process involves gradually lengthening the lower leg muscles and tendons, particularly the Achilles tendon, to improve ankle flexibility and encourage a heel-to-toe walking pattern.
Serial casting involves applying weekly casts from the foot to just below the knee over 8–12 weeks. Each cast progressively increases ankle dorsiflexion, stretching the calf muscles and Achilles tendon to improve walking patterns. When combined with physiotherapy, this method can yield significant results.
At Sydney Kids Physio, experienced paediatric physiotherapists provide expert serial casting and second opinions, often helping families avoid surgery after unsuccessful prior treatments.
Dictus Bands
Dictus bands are lightweight braces that assist ankle dorsiflexion to improve walking and reduce tripping. They are used for children with conditions like idiopathic toe walking or cerebral palsy as part of a broader physiotherapy plan. Combined with treatments such as serial casting and radial shockwave, they help maintain ankle range of motion while allowing flexibility for active participation. At Sydney Kids Physio, they are preferred over AFOs.
Conditions we support
Neurodevelopmental conditions in children affect brain or central nervous system development, caused by factors like genetics, prenatal toxin exposure, infections, and birth complications. Often, the exact cause is unclear. These disorders disrupt typical brain development early in life, influenced by genetic and environmental factors. They impact a child’s social, behavioral, academic, and cognitive functions, with severity varying widely. Early intervention is crucial for helping children reach their full potential. At Sydney Kids Physio, we provide specialized support and interventions tailored to each child’s needs.
Global Developmental Delay
Global Developmental Delay refers to significant delays in two or more areas of development, such as motor skills, speech and language, cognition, social-emotional development, and daily living activities. It is diagnosed when children fail to meet developmental milestones, such as walking independently by 18 months.
The long-term outlook depends on the cause and effectiveness of early interventions. While some children may catch up with therapy, others may develop specific disabilities. Ongoing support and monitoring are essential.
At Sydney Kids Physio, expert paediatric physiotherapists provide early intervention, helping many children with GDD achieve outcomes beyond expectations.
Cerebral Palsy
Cerebral palsy is a group of neurological disorders affecting movement, balance, and posture, caused by abnormal brain development or damage before, during, or shortly after birth, or in early childhood.
Symptoms of Cerebral Palsy can present as high muscle tone or low muscle tone, or stiff muscles with exaggerated reflexes, or lack of coordination, tremors or involuntary movements, delayed motor skills milestones, abnormal walking patterns such toe walking, crouched gait, or scissoring of the legs. Cerebral palsy can be classified based on the movement patterns seen into Spastic Cerebral Palsy, Dyskinetic Cerebral Palsy, Ataxic Cerebral Palsy or Mixed Cerebral Palsy.
While cerebral palsy has no cure, early paediatric physiotherapy can significantly improve independence and quality of life. At Sydney Kids Physio, therapists support children in achieving independent walking, developing broader motor skills, and maintaining musculoskeletal health to prevent complications as they grow.
Down Syndrome
Down syndrome, or trisomy 21, is a genetic disorder caused by an extra copy of chromosome 21. It affects development, leading to distinctive physical features, developmental delays, and potential medical issues.
Children with Down Syndrome have generalized low muscle tone affecting gross motor, fine motor, and speech/language skills. Some children with Down Syndrome may also have intellectual delay, congenital heart defects, gastrointestinal abnormalities, respiratory and hearing issues, thyroid conditions, and increased risk of leukaemia.
While there is no cure, Intensive Early Intervention through physiotherapy, speech therapy, and occupational therapy supports children in reaching their potential. At Sydney Kids Physio, early intervention from 3–4 months has consistently helped children with Down syndrome achieve independent walking by 18 months.
Angelman Syndrome
Angelman syndrome is a rare neurogenetic disorder with an estimated incidence of 1 in 12,000 to 1 in 20,000 live births. It primarily affects the nervous system and is caused by issues with the UBE3A gene on chromosome 15. Only the maternal copy of this gene is active in certain brain areas.
Children with Angelman syndrome tend to have significant developmental delay, severe cognitive impairment, severe limitations in speech, ataxic movement patterns leading to coordination and balance issues. They tend to have a happy and excitable demeanour, frequent smiling, laughter, and hand-flapping movements.
While there is no cure for Angelman syndrome, Intensive Early Intervention Physiotherapy, Speech Therapy, and Occupational Therapy can help children reach their best potential. At Sydney Kids Physio, early intervention has enabled several children with Angelman syndrome to learn to walk independently. The key to successful outcomes is starting intensive therapy as soon as the diagnosis is made.
Erb’s Palsy
Erb’s Palsy, or Erb-Duchenne Palsy, is a condition resulting from injury to the brachial plexus, a network of nerves near the neck that transmits signals to the shoulder, arm, and hand. This injury typically occurs during childbirth and affects about 1-2 in every 1,000 babies.
Causes include birth trauma, excessive force during delivery, especially with large babies or difficult births and shoulder dystocia, where a baby’s shoulder becomes lodged behind the mother’s pelvic bone during delivery.
Early intervention is critical for improving outcomes. Many infants recover within six months with prompt treatment. Paediatric Physiotherapy is the primary treatment to minimize permanent damage and improve function. At Sydney Kids Physio, expert physiotherapists provide intensive early intervention to reduce impairments and prevent adaptive movement patterns in babies with Erb’s Palsy.
Autism
Autism, or Autism Spectrum Disorder (ASD), is a complex developmental condition characterized by challenges in social interaction, communication, and restricted/repetitive behaviors. Key features include lack of social reciprocity, impaired speech and language skills, and restrictive/repetitive behaviors. These issues can lead to social isolation, emotional difficulties, and behavioral challenges. While there is no cure, early intervention is crucial. At Sydney Kids Physio, our expert paediatric physiotherapists provide screening assessments, referrals, and intensive early intervention programs to help children with autism achieve their best potential.
Agenesis Of Corpus Callosum
Agenesis of the corpus callosum (ACC) is a rare congenital condition where the corpus callosum, which connects the brain’s hemispheres, fails to fully develop before birth, affecting brain communication and function. The severity can range from partial to complete absence of the corpus callosum.
Treatment focuses on supportive care and managing symptoms through multidisciplinary interventions such as paediatric physiotherapy, occupational therapy, and speech therapy. Early intervention aims to optimize developmental outcomes and improve quality of life. At Sydney Kids Physio, expert paediatric physiotherapists help children with ACC achieve milestones like independent walking and reach their full potential.
Joubert’s Syndrome
Joubert’s Syndrome is a rare genetic disorder affecting the brainstem and cerebellum, leading to developmental delays, coordination problems, and abnormal breathing patterns. Key features include hypotonia (low muscle tone), ataxia (lack of muscle control), abnormal eye movements, and distinctive facial features. Early diagnosis and intervention are essential for improving outcomes. At Sydney Kids Physio, expert paediatric physiotherapists provide tailored intervention programs to enhance motor skills, coordination, and overall development, helping children with Joubert’s Syndrome reach their full potential through individualized care and support.
Rare Genetic Conditions
Rare genetic conditions in children can cause developmental delays, physical challenges, and health issues, often requiring specialized care and early intervention to improve quality of life and outcomes.
At Sydney Kids Physio, expert paediatric physiotherapists offer comprehensive assessments and tailored intervention programs for children with rare genetic conditions. The approach focuses on enhancing motor skills, strength, coordination, and overall development, helping each child reach their full potential. With years of experience, we provide personalized care and evidence-based practices to support families.
Neurological Scoliosis
Neurological scoliosis is a type of scoliosis caused by neurological conditions such as cerebral palsy, muscular dystrophy, or spinal cord injuries. It leads to abnormal spinal curvature, affecting posture, balance, and mobility. Early intervention is essential for managing this condition.
At Sydney Kids Physio, expert paediatric physiotherapists use a variety of strategies to improve spinal alignment, strength, and functional abilities. Through individualized care, the goal is to enhance the quality of life and development, helping children by preventing the development or progression of neurological scoliosis.
Common neurodevelopmental conditions by age groups
Are you wondering if your child is experiencing developmental delays or neurological challenges more often than their peers?
Or perhaps you are concerned that your child seems to struggle with activities that others their age can easily perform?
Neurodevelopmental conditions in babies and children can vary significantly depending on their age and developmental stage. Understanding these conditions and their age-specific prevalence can help in early identification, timely intervention, and appropriate management to ensure better developmental outcomes for children.
Early detection and intervention by a paediatric physiotherapist can significantly improve outcomes for these conditions.
Newborns may exhibit signs of neurodevelopmental conditions that require specialised care. Global Developmental Delay (GDD) can be noticed if infants are not meeting milestones such as rolling over or holding their head up. Conditions like Erb’s Palsy or brachial nerve injuries can result from birth trauma, affecting arm movement and strength. Early intervention is essential for promoting motor skills and preventing further complications.
Infants between 6 to 18 months may show signs of conditions like cerebral palsy, which affects movement and muscle tone, or Down syndrome, characterized by developmental delays and hypotonia. Angelman syndrome may become apparent with its unique behavioural traits and motor delays. Early physiotherapy can support motor development, enhance strength, and improve coordination.
Toddlers can be diagnosed with neurodevelopmental conditions such as autism, which affects communication and social interaction, or agenesis of the corpus callosum, impacting motor and cognitive development. Joubert’s syndrome, a rare genetic disorder, can present with coordination issues and developmental delays. Physiotherapy plays a critical role in addressing these challenges through targeted interventions.
Preschoolers and early Primary Schoolers may continue to face challenges from conditions diagnosed earlier, such as cerebral palsy, Down syndrome, or autism. Neurological scoliosis can develop in children with neurodevelopmental disorders, affecting their posture and movement. Early physiotherapy can help manage these conditions, promoting better mobility and functional independence.
School-age children with neurodevelopmental conditions like cerebral palsy or Down syndrome may require ongoing physiotherapy to address muscle weakness, coordination issues, and mobility challenges. Rare genetic conditions and brachial nerve injuries may also impact physical abilities. Physiotherapy can enhance strength, coordination, and overall functional capabilities, supporting academic and social participation.
Adolescents with neurodevelopmental conditions such as neurological scoliosis, autism, or rare genetic disorders continue to benefit from specialised physiotherapy. Management of posture, mobility, and coordination remains crucial during these years. Early detection and intervention by a paediatric physiotherapist can significantly improve outcomes, ensuring better quality of life and functional independence for adolescents.
Information for parents
As parents, you know your child best. If you feel and see something happening in your child which makes you worry or concerns you, trust your gut instinct. Even if the medical professionals, friends, family and well wishers say to you that “you are overreacting and paranoid”, it doesn’t hurt to speak to a trained and experienced Paediatric Physiotherapist about your concerns for your child.
Here at Sydney Kids Physio, our Expert Paediatric Physiotherapists have been helping families and children since 2006. We see babies as young as 1 week old, including premature babies who might actually be 0 weeks old for corrected gestational age, to assess their gross motor skills development to make sure that babies aren’t delayed in their gross motor skills because of underlying neurodevelopmental conditions. The most common reasons why babies are delayed include low muscle tone, undiagnosed developmental delay, Cerebral Palsy and rare genetic disorders. Early Intervention Paediatric Physiotherapy can effectively manage and treat these neurodevelopmental conditions to help babies achieve their best potential and prevent secondary complications such as behavioural tantrums due to frustration, muscle contractures and neurological scoliosis.
The common misconceptions we see in the community are parents are told their baby is just small and so they are weak or that their baby is just lazy and they will move when they are ready to move. In reality, Paediatric Physiotherapy can help babies improve their core strength, balance and coordination to help babies learn to roll, sit, crawl and walk by 18 months old.
If you are concerned about your baby’s gross motor skills development, reach out to Sydney Kids Physio to speak to one of our Expert Paediatric Physiotherapists. You don’t need a doctor’s referral to see a Paediatric Physiotherapist in Australia. Take advantage of our 15 minute FREE PHONE CONSULTATION.
We're only ever a phone call away.
Information for specialists
As Paediatric Physiotherapists, we are often working closely with General Practitioners, Paediatricians, Neurologists, Orthopeadic Specialists, Paediatric Occupational Therapists, Speech Pathologists, Dietitians, Feeding Therapists, Psychologists, Behavioural Therapists, Optometrists, Behavioural Optometrists, Orthotists and Podiatrists to help little ones achieve their best potentials.
Unfortunately, there are still many healthcare professionals who are unaware of what Paediatric Physiotherapists can do to help children with neurodevelopmental conditions improve their gross motor skills to achieve their milestone. The common myth that Healthcare professionals have about Physiotherapy is that a child has to be 2 years old before they can be considered to be delayed in their gross motor skills to need Early Intervention Paediatric Physiotherapy. In reality, even premature babies and newborns as young as 1 week old can benefit from Early intervention Paediatric Physiotherapy.
The issue with delays in a child accessing Paediatric Physiotherapy services is the missed opportunities to help a child achieve their gross motor skills milestones within normal chronological age range and at times resulting in a child not being able to walk. Early Intervention in the first 3 years of life takes advantage of brain neuroplasticity to change the developmental trajectory of a child with neurological conditions.A child is never too young to start Paediatric Physiotherapy.
If you are a Medical Professionals seeing a baby who seems to have poor head control, low muscle tone, high muscle tone or is missing their gross motor milestones, it is worthwhile referring them for Neurodevelopmental Physiotherapy to promote their gross motor skills.
Reach out to Sydney Kids Physio to speak to one of our Expert Paediatric Physiotherapists about your concerns about the child you are seeing to find out if we can help improve their gross motor skills to allow them to increase their social participation with their peers and family. Together we can help more children build great foundations for bright futures.
We're only ever a phone call away.
Welcome
The Dream Team
It takes a village to raise a child, and that saying is never more true when you have a child with Special Needs. At Sydney Kids Physio, you can be assured that our team is committed to helping you equip your child with the skills they need to achieve their best potential.
Our Team led by Neesha Gan, an Expert Paediatric Physiotherapist with over 26 years of Physiotherapy experience, lives by our core values to deliver Expert Knowledge with Empathy, Respect and Transparent Communication. We understand that the journey of parenting is a lifelong journey filled with the greatest joys and the deepest sorrows which can be overwhelming and daunting at times. We have walked that journey together with thousands of families, and we believe that working together, we can and must create great foundations for bright futures. We look forward to being a part of your family’s journey.
