Walking for the first time can be one of the most exciting milestones in a child’s early development. As paediatric physiotherapists, we often see parents who are concerned that their child is not walking yet but other children their age are.  

In a child’s first year of life, they are busy learning so many new skills at such a fast rate. Each new skill builds on the previous skill. To be able to walk, your child must have strong muscles, be able to keep their body balanced, be able to coordinate the reciprocal stepping pattern of walking and shift their body weight from one foot to the other. A child develops these skills when they are learning to sit, crawl, pull to stand, squat and cruise along furniture. There are so many ‘inch stones’ that build up to the complex milestone of walking! 

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Some children and their caregivers are not sure what to expect when they walk into a physiotherapy clinic to see a paediatric physiotherapist for the first time. Some even ask, “what can a physiotherapist even do to help my baby/child?!” 

Physiotherapists are experts in the human body and its movements, and this is no exception for paediatric physiotherapists. Paediatric physiotherapists are experts in the human body and the typical development and movement patterns in paediatric clients – ranging from infants to young adults. Children are not just little adults, and it can be important to see a specialised paediatric physiotherapist who is specifically trained to assess, manage and diagnose certain paediatric concerns and conditions – and who can also make physiotherapy fun! 

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17th-23rd September

Have you ever felt unsteady when standing on one leg or walking on an uneven path? If yes, your body’s “postural balance” may be challenged. More often than not, we take our balance for granted, but this complex yet wonderful system is what keeps us steady when we stand, walk, run, and, for some, perform interesting balance tricks like the lady in the picture below.

We, as individuals, move through space without thinking much about how we can maintain an upright position or walk in a straight line. These movements are possible because of our ability to balance automatically.

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Dance is a wonderful athletic activity that allows dancers to express themselves and stay active. Those dedicated to the craft reap a number of amazing health benefits, including developing and maintaining a healthy heart, strong lungs, muscles and bones. In saying this, due to the athletic nature of dance, it can also place intense physical demands on the body that can put one at greater risk of injury. 

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Anterior Cruciate Ligament (ACL) injuries are becoming increasingly more common in Australia, particularly amongst younger populations. An Australian study conducted between 2000-2015 found an increase of 43% (54.0 to 77.4 per 100,000 population) for ACL injury rates, with 74% of all injuries among those aged under 25 years old. Peak ACL injury rates in 2014-15 for men were those between 20-24 years old, and for women between 15-19 years old. However, the most rapid increase was noted for boys and girls between 5-14 years old, exposing how early ACL injury might need to be considered.

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What is Bipolar Affective Disorder?

Bipolar Affective Disorder (BPAD) is a medical diagnosis characterized by wide mood alterations, with periods of both depression and mania that can last several weeks or even months at a time. A person experiencing depression or mania may have intense mood swings and changes in thinking and behaviour.

By definition, Bipolar means sharing two poles (high and low) and Affective Disorder means a disorder having to do with mood i.e. the way you think and feel. In most cases, the high pole is experienced as mania and the low pole experienced as depression.

‘Switching’ from depressive and manic periods can be unpredictable and occur in a short time frame.

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If you were asked to look at this picture and decide which of these positions was classed as a “good” posture, chances are you would probably say the image on the right. The truth is it’s not that simple, and there is a lot of scientific evidence debunking the ideas of good and bad postures.

Common Myths:

  1. Upright = Good and Slouching = Bad.

Let’s start by looking at this idea from an efficiency perspective. If someone is sitting at their desk on their chair which has a backrest, sitting perfectly upright is actually a less mechanically advantageous position to be in as it takes more energy to maintain that position. In contrast, adopting a slightly more slouched position with the back against the backrest is more beneficial as it utilizes less energy to maintain. So if you had to sit at your desk for 8 hours a day, which position sounds better – the one that requires more or less energy to sustain?

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What is Assistive Technology?

The World Health Organisation describes Assistive Technology as products that help to maintain or improve an individual’s functioning and their independence (1).

Assistive Technology supports people to participate in activities that are meaningful and important to them, can improve the safety of the individual using the products and the safety of carers, reduce the need for formal health and support services and long-term care and can increase an individual’s ability to participate within education, work and communities.

Examples of Assistive Technology (left to right):
1. Wheeled walker 2. Elbow crutch 3. Wheelchair
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What is low muscle tone?

Muscle tone is the amount of tension in a muscle. Muscles always have a slight amount of tension (slightly turned on) so that they are always ready to contract when we need to move. Muscle tone is also what helps us hold our bodies upright against gravity when we are sitting and standing and helps us control our movement.

Muscle tone can be thought of as a spectrum; some people have lower muscle tone and some people have higher muscle tone. Low muscle tone, or hypotonia, is when the resting tension of the muscles is reduced. The muscles are often described as ‘floppy’. In most cases, low muscle tone is ‘idiopathic’ meaning the cause is unknown. For a small number of children, low muscle tone is a feature of a neurological or genetic condition. Low muscle tone is also very common in the autistic population.

Image by standret on Freepik
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Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that impacts how an individual thinks, feels, interacts with others, and experiences their environment. Every autistic individual will have a different combination of strengths and challenges.

How common are movement difficulties in autistic children?

It is an outdated thought that ASD does not affect a child’s gross motor skills. Learning new movements relies on being able to process sensory information, understand and respond to verbal and non-verbal communication, and effectively plan, problem-solve and adapt to changes. These are all skills that autistic children typically have difficulty with.

Research has found that 87% of autistic children aged 5-15 years present with movement difficulties (Bhat 2020).

Research is now also suggesting that gross motor delays during early childhood may actually be an early marker for ASD, before more diagnostically specific signs develop, like communication difficulties (Harris 2017).

Gross motor skills play a significant role in social participation for school-aged children as many formal activities (eg. PE class, sports day), informal activities (eg. play at recess and lunch), and out-of-school recreation (eg. social gatherings) often have active components at this age.

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