Developmental Concerns

Developmental physiotherapy focuses on children who are not meeting expected gross motor milestones - sitting, crawling, standing, and walking - or who are moving differently from their peers in ways that may affect their long-term development. Early intervention is the most effective approach: the brain and musculoskeletal system are most responsive to therapy-driven change in the first years of life.

What are gross motor milestones, and when should I be concerned?

Gross motor development follows a broadly predictable sequence, though there is meaningful variation in the timing of individual milestones. As a general guide:

• 2-3 months: head control in supported sitting; pushing up on forearms during tummy time
• 4-5 months: rolling from tummy to back; reaching for objects
• 6-7 months: sitting with minimal support; rolling in both directions
• 8-10 months: sitting independently; beginning to pull to stand; crawling (though some babies skip crawling and go directly to walking)
• 12-18 months: walking independently

These are guidelines, not deadlines. However, if your child is significantly behind multiple milestones, or if you notice movement patterns that are consistently asymmetrical or effortful, early physiotherapy assessment is worthwhile. Acting early is always better than waiting to see if a concern resolves on its own.

What is hypotonia, and what does it mean for my child?

Hypotonia means reduced muscle tone - the resting tension in the muscles. A hypotonic infant or child may feel “floppy”, have difficulty maintaining posture against gravity, tire quickly with physical activity, or be delayed in achieving milestones that require active postural control (sitting, standing). Hypotonia is a description of a finding, not a diagnosis - it can be associated with a range of underlying conditions (Down syndrome, Prader-Willi syndrome, cerebral palsy) or may be idiopathic (no identifiable cause). Physiotherapy targets the functional consequences of hypotonia - improving strength, postural control, and movement quality - regardless of the underlying diagnosis.

What does a session at Goji involve?

Our physiotherapist will take a detailed developmental history - your pregnancy and delivery, your child’s milestones to date, what activities they enjoy, and what you have noticed that concerns you. The assessment includes:

• Developmental screen: structured observation of your child’s movement across the developmental sequence relevant to their age, using standardised approaches
• Muscle tone and strength: assessing postural tone, strength in key muscle groups, and how your child moves between positions
• Reflexes and neurological screen: our physiotherapist will note any reflex findings that warrant further investigation and will refer to a developmental paediatrician if indicated
• Environmental and activity assessment: what positions and activities your child spends time in, and how these might be supporting or limiting their development

Therapy sessions are play-based and child-led where possible. The goal is to make movement rewarding and accessible - not to force a child through exercises. Parent involvement and coaching is central: what happens between sessions, in everyday play and caregiving, drives development more than the weekly session alone.

When should I also see an occupational therapist or speech therapist?

Physiotherapy addresses gross motor function. Occupational therapy (OT) supports fine motor skills, sensory processing, self-care, and play. Speech therapy addresses communication, language, and feeding. Many children with developmental concerns benefit from input from more than one discipline. Our physiotherapist will advise where referral to OT or speech therapy would complement physiotherapy, and can assist with referral if needed.

Frequently asked questions

My baby is 9 months old and not crawling yet. Should I be worried?

Not necessarily. Some babies skip crawling entirely and go directly to pulling to stand and walking. The more important indicators are: Is your baby sitting independently? Are they moving around in some way (rolling, commando crawling, bottom-shuffling)? Are they bearing weight through their legs? If you have concerns about multiple milestones or movement quality, an assessment with our physiotherapist will give you a clearer picture.

My 15-month-old is not walking. When should we seek physiotherapy?

Current guidelines suggest that independent walking by 18 months is within the expected range. If your child is not walking by 15 months, it is reasonable to have an assessment - particularly if they are also behind on other milestones or if you notice low muscle tone, frequent falling, or asymmetric movement. Do not wait until 18 months if you have concerns now.

My child has been referred to early intervention services by their school. Can Goji complement this?

Yes. Goji can work alongside school-based early intervention programmes. Coordination between physiotherapy settings ensures the child’s programme is consistent and that there is no duplication or contradiction between approaches. Our physiotherapist will liaise with the relevant school or centre team where appropriate.

Is early intervention just for children with a diagnosis?

No. Early intervention physiotherapy is appropriate for any child who is showing developmental delays or movement concerns, regardless of whether a formal diagnosis has been made. In fact, early physiotherapy can sometimes prevent a mild delay from becoming a more significant one - without needing a label attached first.

My child is 3 years old and has only just been referred for physio. Is it too late?

No. While the window of greatest neuroplasticity is in the first 3 years, the brain remains responsive to therapeutic input throughout childhood and adolescence. Older children still benefit significantly from physiotherapy. The approach and goals will be adapted to their age and developmental stage.

How often will my child need physiotherapy?

This depends on the degree of delay, the underlying cause, and the effectiveness of the home programme. Many children begin with weekly or fortnightly sessions, progressing to monthly review as they consolidate gains. Our physiotherapist will be able to give you a realistic expectation after the first assessment.