Children learn to move through thousands of small experiments. They reach, roll, crawl, climb, fall, try again and gradually work out what their bodies can do.

There is also a wide range of normal child development. One child might walk early and avoid climbing. Another might take longer to walk but become confident on playground equipment once they get started.

So how do you know when your child simply needs more time and when a paediatric physiotherapy assessment could be helpful?

The short answer is that you do not need to wait for a crisis, diagnosis or major injury. A paediatric physiotherapist can assess how your child moves, identify what may be making a skill difficult and help them build strength, balance, coordination and confidence through practical, age-appropriate activities.

Key Takeaways

• Paediatric physiotherapy supports babies, children and teenagers with movement, gross motor development, strength, balance, coordination, posture, pain and physical participation.
• It may be worth asking for advice when a child is missing motor milestones, moving differently on one side, falling frequently, tiring easily, avoiding movement or struggling to keep up with everyday activities.
• Physiotherapy for children is not only for sports injuries or broken bones.
• A paediatric physiotherapy assessment looks at the whole child, including development, health history, school, play, daily routines and family goals.
• Sudden weakness, loss of previously acquired skills, severe pain, a new limp or a rapid change in walking should be discussed promptly with a doctor.

 

What Does a Paediatric Physiotherapist Do?

A paediatric physiotherapist assesses and supports movement and physical development in babies, children and teenagers. They can help when movement is delayed, difficult, painful or getting in the way of a child participating comfortably in everyday life.

Depending on the child, paediatric physiotherapy may involve:

• gross motor milestones such as rolling, sitting, crawling and walking
• balance and coordination
• muscle strength and endurance
• low muscle tone
• posture and body awareness
• walking, running, jumping and stair skills
• toe walking or unusual gait patterns
• torticollis and head-shape concerns in babies
• hypermobility
• recovery after injury, illness or surgery
• physical participation for children with developmental, neurological or genetic conditions

Physiotherapists can support children experiencing difficulties with balance, posture, coordination, gross motor skills, weakness, pain and recovery after illness or injury.

For a child, physiotherapy does not look like an adult gym program. It’s very play based. Sessions might involve obstacle courses, balls, stepping games, climbing, jumping, playful strengthening or practising one small part of an activity that feels difficult. The play has a purpose. It gives the physiotherapist a way to build skills while keeping movement enjoyable and achievable for the child.

 

What Are the Signs My Child Might Benefit From Physiotherapy?

Signs that your child may benefit from physiotherapy include delayed motor milestones, frequent falling, difficulty with balance or coordination, unusual walking patterns, pain, fatigue or avoiding physical activities. One sign by itself does not necessarily mean there is a problem, so the overall pattern and its effect on everyday life matter.

You might consider asking for advice if your child:

• is noticeably late reaching movement milestones
• seems much stronger or more coordinated on one side
• frequently trips, falls or bumps into things
• has difficulty with stairs, jumping, running, catching or kicking
• avoids playgrounds, sport, bikes or movement games
• tires much more quickly than children of a similar age
• appears floppy, has low muscle tone or finds upright posture difficult
• complains of recurring pain during or after activity
• walks on their toes a lot
• has very flexible joints and finds it difficult to stabilise their body
• has lost a movement skill they previously used
• feels embarrassed, anxious or left out because movement feels hard

Parents often notice the participation problem before they know the movement term.

Your child might say, “I hate PE,” when the underlying difficulty is balance or coordination. They might avoid the playground because climbing feels unpredictable, or stop joining games because keeping up with other children is difficult.

Those observations are useful information.

If this sounds familiar, you may also find our article about coordination, balance and motor skill delays in children helpful. 

 

What Are Normal Gross Motor Milestones in Children?

Gross motor milestones include skills such as rolling, sitting, crawling, standing, walking, running, jumping and climbing. Children reach these skills across a range of ages, so an individual milestone is only one part of understanding a child’s development.

Healthdirect explains that children develop at their own pace, but missing a developmental milestone beyond the usual age range can be a reason to discuss your child’s development with a doctor or child health nurse. Its developmental milestones guidance was last reviewed in August 2025. 

What can be particularly useful is looking at progress over time. Is your child continuing to gain new movement skills? Are they becoming stronger and more confident? Or does a particular movement seem to remain very difficult despite opportunities to practise?

 

Should I Wait and See If My Child Is Behind With Motor Skills?

Sometimes monitoring a child’s motor development is reasonable, particularly when they are continuing to gain skills and the difference is relatively small. “Wait and see”, however, is more useful when you know what you are waiting for and what would prompt you to seek further advice.

Ask yourself:

• Is my child gaining new movement skills?
• Is the gap getting smaller, staying the same or growing?
• Is movement becoming easier or more frustrating?
• Is this affecting play, school, independence or confidence?
• Is my child avoiding physical activities because they are difficult?
• Are there signs such as pain, weakness, asymmetry or loss of skills?

You do not need to be certain that something is wrong before speaking with a physiotherapist.

A paediatric physiotherapy assessment may provide reassurance that your child is progressing within their own developmental range. Or it may identify a specific difficulty and give you practical ideas about what to do next.

 

Why Does My Child Keep Falling or Seem Clumsy?

Frequent falling or appearing clumsy can sometimes be related to balance, coordination, strength, motor planning or gross motor development. There are many possible reasons, however, so repeated falls are best considered alongside the child’s age, development and other symptoms.

Some children simply move quickly and take risks. For others, you might notice a broader pattern. Perhaps your child struggles to stand on one foot, has difficulty learning to ride a bike, finds ball games hard, bumps into things frequently or takes longer than their peers to learn new movement skills. This does not automatically mean your child has a developmental condition.

It does mean that if falling or poor coordination is happening frequently enough to affect play, sport, school or confidence, a paediatric physiotherapy assessment for balance and coordination may be useful.

 

When Should I Worry About Toe Walking in My Child?

Occasional toe walking can occur in young children, but persistent toe walking may be worth discussing with a health professional. A physiotherapist can look at how your child walks as well as their muscle length, strength, balance, coordination and overall development.

Toe walking can have different explanations.

For some children it becomes a habitual walking pattern. For others, it may occur alongside tight calf muscles, sensory preferences, developmental differences or neurological and musculoskeletal conditions.

The important question is not simply, “Does my child walk on their toes?”

It is whether the toe walking is persistent, becoming more noticeable, happening mostly on one side, causing pain or affecting how your child moves and participates.

 

What Happens During a Paediatric Physiotherapy Assessment?

A paediatric physiotherapy assessment usually starts with a conversation about your child’s development, health history, movement and everyday activities. The physiotherapist then observes relevant movements to understand what your child can do comfortably and what may be making particular activities harder.

They may ask:

• Which movements concern you?
• When did you first notice the difference?
• Is there pain, fatigue or frequent falling?
• What movement skills has your child already developed?
• What do they avoid?
• How do they manage at childcare, school or sport?
• What would your child like to be able to do?
• What would make everyday life easier for your family?

The physical assessment depends on your child’s age.

A physiotherapist might watch a baby reach, roll, sit, crawl or pull to stand. An older child might be asked to walk, run, jump, balance, climb stairs, kick a ball or complete a game. The aim is not to judge whether your child is “good at sport”.

It is to understand how your child moves, where the difficulty might be occurring and what could make movement and participation easier.

 

What Might Paediatric Physiotherapy Treatment Involve?

Paediatric physiotherapy treatment is individualised around the child’s movement needs and functional goals. For many children this means practising useful skills through play, repetition and achievable challenges rather than completing a long list of formal exercises.

Support may include:

• play-based strength and balance activities
• practising a motor skill in smaller steps
• coordination and gross motor activities
• changes to positioning or equipment
• simple exercises to practise at home
• advice about shoes, orthotics or other supports when appropriate
• strategies for school, sport or playground participation
• rehabilitation following injury, illness or surgery
• collaboration with a GP, paediatrician, occupational therapist, exercise physiologist, teacher or another professional

A good home program also has to fit family life.

Three useful activities that happen regularly are usually more practical than a page of exercises that nobody has time to complete.

You can also find some ideas for keeping children moving in our guide to evidence-based school holiday activities recommended by therapists. 

 

What Is the Difference Between Paediatric Physiotherapy, Occupational Therapy and Exercise Physiology?

Physiotherapy, occupational therapy and exercise physiology can all support children, but they usually approach the child from different starting points. There can be overlap, particularly when a child has developmental, motor or physical participation difficulties.

Paediatric physiotherapy commonly focuses on movement development, strength, balance, mobility, gait, posture, gross motor function, pain and rehabilitation.

Occupational therapy focuses on participation in everyday activities. This may include dressing, handwriting, sensory processing, fine motor skills, routines, play and independence.

Exercise physiology uses structured movement and exercise to build health, fitness, strength, endurance and physical function, including for children with disability, chronic health conditions or participation goals.

The right discipline depends on what is making everyday life difficult for your child.

Some children benefit from one professional. Others benefit from a multidisciplinary approach where physiotherapists, occupational therapists, exercise physiologists and other clinicians share information and work towards the same functional goals.

 

Can Physiotherapy Help Children With Autism, ADHD or Developmental Delay?

Yes, some children with autism, ADHD, developmental delay or other neurodevelopmental conditions may benefit from physiotherapy when movement, balance, coordination, strength or physical participation is difficult. Physiotherapy is based on the child’s functional needs rather than simply their diagnosis.

For example, one child might have difficulty with balance and playground activities.

Another may tire quickly or struggle to keep up during PE. Another child may have difficulty planning and learning new movement sequences.

This is also why multidisciplinary care can be useful. Movement might be one part of a broader developmental picture involving communication, attention, sensory needs, learning or emotional regulation.

If you have broader concerns and are unsure where to begin, our article about the assessment process at All About Kids explains how developmental concerns can be explored more comprehensively. 

 

When Should I Speak With a Doctor Before Seeing a Physiotherapist?

Seek medical advice promptly when there is a sudden or significant change in your child’s movement, particularly weakness, loss of skills, severe pain or an inability to walk or put weight through a leg. These symptoms require medical assessment rather than simply monitoring them at home.

Speak with a doctor promptly if your child has:

• sudden weakness or loss of movement skills
• severe or persistent pain
• a new or unexplained limp
• an inability to walk or bear weight
• fever together with difficulty walking
• swelling, redness or a joint that feels hot
• a major change in coordination
• repeated falls together with weakness
• breathing difficulties or unusual fatigue
• a movement change that is rapidly getting worse

The Royal Children’s Hospital Melbourne’s clinical guideline, identifies an acute inability to walk or bear weight as a red flag, and notes that a limp with fever, swelling or reduced joint movement can require urgent assessment. If you are unsure, your GP is a sensible starting point.

 

Does My Child Need a Referral to See a Paediatric Physiotherapist?

Families can often contact a private paediatric physiotherapy clinic directly, although referral and funding requirements vary depending on the pathway being used. If your child has unexplained pain, sudden weakness, loss of skills or another medical concern, speaking with your GP first is appropriate.

Some families also access physiotherapy through NDIS, Medicare-supported pathways, private health insurance or private payment, depending on eligibility and circumstances.

If funding is changing for your family, you might also find our guide What Happens If My Child Loses NDIS Funding? useful. It explains some of the ways children can continue accessing physiotherapy and other allied health supports outside an NDIS plan.

 

Frequently Asked Questions About Paediatric Physiotherapy

What age can a child see a paediatric physiotherapist?

Paediatric physiotherapists can support children from infancy through adolescence, with assessment and treatment adapted to the child’s age, development and individual movement needs.

How do I know if my child needs physiotherapy?

Your child may benefit from physiotherapy if they are missing motor milestones, falling frequently, struggling with balance or coordination, tiring easily, experiencing pain or avoiding physical activities because movement is difficult.

Can a physiotherapist help if my child is late walking?

Yes. A paediatric physiotherapist can assess your child’s gross motor development, strength, balance and movement patterns and help determine whether monitoring, targeted support or further assessment may be useful.

Should I worry if my child falls over a lot?

Occasional falls are a normal part of childhood, but frequent falling may be worth assessing if it occurs alongside poor balance, difficulty learning movement skills, weakness, pain or problems keeping up with everyday activities.

Can paediatric physiotherapy help with toe walking?

Yes. A paediatric physiotherapist can assess persistent toe walking and look at factors such as gait, muscle length, strength, balance, coordination and the effect the walking pattern is having on your child.

What is the difference between a paediatric physiotherapist and an occupational therapist?

A paediatric physiotherapist generally focuses on gross motor development, movement, strength, balance, gait and physical function, while an occupational therapist focuses more broadly on participation in everyday activities, including fine motor, sensory and self-care skills.

Do I need to wait for a diagnosis before seeing a paediatric physiotherapist?

No. You can seek advice because of something you have noticed, such as delayed milestones, frequent falls, toe walking, pain, poor coordination or difficulty participating in physical activities, even if your child does not have a diagnosis.

 

How Can All About Kids Help?

At All About Kids, our paediatric physiotherapists in Brisbane support babies, children and teenagers with movement, gross motor development, balance, coordination, strength, gait and physical participation.

You do not need to arrive knowing the correct clinical term.

Perhaps your baby is taking longer to reach a movement milestone. Perhaps your child avoids climbing, walks on their toes, falls often, tires easily or struggles to keep up in PE.

Start by telling us what you have noticed.

Because All About Kids is a multidisciplinary child-development practice, we can also help when you are unsure whether physiotherapy, occupational therapy, exercise physiology or a broader developmental assessment is the most appropriate place to begin.

Not sure whether your child needs physiotherapy? Submit a booking enquiry and have a chat with our team about what you have noticed. We can help you work out what the most appropriate next step might be for your child.

Submit a booking enquiry

- All About Kids Team

General information only. This article does not replace individual medical or physiotherapy advice.