What is Physical Therapy?

Physical Therapy works on movement and balance activities, such as rolling, crawling, sitting, walking, running and jumping. Physical Therapists help the child to maneuver throughout their community, classroom or playground.

Physical Therapy addresses strength, endurance, body alignment and positioning, gross motor skills, sensory integration, motor planning, posture, muscle tone, coordination, and balance.

Pediatric Physical Therapy focuses on helping your child reach their developmental milestones for motor skills and sensory processing. Physical Therapy can also address safety awareness, body and environmental awareness.

What are gross motor skills?

Gross motor abilities have an influence on everyday functions. For Gross motor skills are generalized body movements requiring the large muscles in the body. A solid strong core and foundation is required to move with coordination and to later achieve fine motor control needed for self-care.
Gross motor skills are those skills required for sitting, standing, walking, running and jumping. In order to have good gross motor skills, a person must also have good neural communication coordinating the right and left side of the body, as well as hand-eye coordination.
Developing a strong neural foundation needed to coordinate the body starts in early development from head to toe, and from midline orientation to distal control of the extremities. This is one of the reasons that babies organize their oral motor skills before developing other more complex skills.
Having good gross motor skills (or adaptations) are crucial to a child’s ability to move, but also to play and physically play with other children and access their classroom/playground. Gross Motor Skills impact a child’s ability to maintain appropriate sitting posture will affect their ability to participate in fine motor skills, and attend to class instruction, which then impacts on their academic learning. Good endurance allows a child to cope with a full day of school (sitting upright at a desk, moving between classrooms, carrying a heavy school bag). Without fair gross motor skills, a child will struggle with many day-to-day tasks such as eating, packing away their toys, and getting onto and off the toilet.

What are Balance and Coordination Skills?

Balance is the ability to maintain a controlled body position during task performance, whether it is sitting at a table, walking the balance beam or stepping up onto a curb. To function effectively across environments and tasks, we need the ability to maintain controlled positions during both static (still) and dynamic (moving) activities.
Static balance is the ability to hold a stationary position with control (e.g. “Freeze” or “statue” games). Dynamic balance is the ability to remain balanced while engaged in movement (e.g. running or bike riding).

Age appropriate balance and coordination allows the child to be involved in the sports participation with a reasonable degree of success as it aids fluid body movement for physical skill performance. The involvement in sport is helpful in maintaining self-regulation for daily tasks as well as developing a social network and achieving a sense of belonging in a community or social setting. It also helps children develop and maintain appropriate controlled body movement during task performance which, when effective, limits the energy required and minimizes fatigue.
With good balance and coordination there is less likelihood of injury as the child is likely to have appropriate postural responses when needed (e.g. putting hands out to protect themselves when they fall off their bike). The physical attributes of balance and coordination also allow appropriate posture for table top tasks and subsequent success at fine motor tasks.

What are Strength and Endurance?

In general terms, muscle strength is how strong the child is and muscular endurance is how long the child’s muscles can work.

Muscular strength is the ability to exert force against resistance. Exerting force may or may not mean there is movement of the joints or body. It might be that you carry an object in front of you and you contract your biceps, but there is no movement as your arms are neither raising or lowering. This is called an isometric contraction. When the muscles contract and there is movement at a joint, such as a bicep curl, this is called an isotonic contraction.
Muscular endurance is the ability of a muscle or group of muscles to exert force repeatedly. Muscular endurance is similar to muscular strength in that strength is required to initiate movements, but it is the muscle’s endurance capacity that enables it to continue for multiple efforts.
Strength and endurance are important to enable children to perform everyday functions such as fine motor skills (e.g. holding a pencil appropriately, cleaning teeth) and gross motor skills (e.g. carrying heavy school bags, walking, running, skipping, playground skills such as climbing, and sporting skills such as  catching, throwing and hitting a ball with a bat). Muscular endurance helps maintain proper posture all day long.
Improving strength and endurance contributes to a higher metabolism, which increases caloric use both while at work and rest, which in turn reduces the risk of obesity. Another important benefit to note is that when a child has good strength, they are more likely to have stronger tendons, ligaments and general joint health which reduces the risk of serious injury.

A Child May have a need for Physical Therapy if they:

• Fall easily, trip often or can’t ‘recover’ quickly from being off balance.
• Move stiffly and lack fluid body movement (e.g. run like a ‘robot’).
• Avoid physical activity (e.g. playground use, sports participation).
• Are late to reach developmental milestones (e.g. crawling and walking).
• Are slower than their peers to master physical skills (e.g. bike riding, swimming or tree climbing).
• Are less skillful than their peers in refined sports participation (e.g. team sports).
• Push harder, move faster or invade the personal space of others more than they intend to.
• Are fearful of new physical games (e.g. swings) or scared of heights that do not faze their peers.
• Have difficulty getting dressed standing up (e.g. they need to sit down to get put pants as they lose their balance standing on one leg).
• Have trouble navigating some environments (e.g. steps, curbs, uneven ground).
• Tire more quickly than their peers or need to take regular short rest periods during physical activity.

Activities you can do with your child now at home:


Tummy Time (It’s never too late)
Allow sensory play. Let kids get dirty.
Allow for safe “rough play”, such as swinging and wrestling
Get down on their level playing with them.
Go to the local park and play.
Roll, sit, crawl, walk, run on a variety of surfaces. Hard top, grass, sand, etc.
Put pillows on the floor and walk or stand still on them.
Enroll your child in age appropriate sports
Look below for activities per age and do those activities.

What is Torticollis – How can a Physical Therapist help?  CLICK HERE FOR MORE INFORMATION:
What is Bilateral Coordination/Integration?  How can a Physical Therapist help?  CLICK HERE FOR MORE INFORMATION:
What is sensory processing?  How can a Physical Therapist help? CLICK HERE FOR MORE INFORMATION:

gross motor skills checklist

If your child is not meeting or is not meeting the gross motor skills on this checklist, give us a call.

0-4 months
  • Holds head in alignment
  • Tracks an object
  • Moves arms and legs when lying on back
  • Lifts head a little when laying on belly, can prop on elbows
  • Brings hands together when laying on back
  • Props on elbows in prone with neck extension
  • Rolls back to side
  • Grasps rattle when placed in hand
  • Likes looking at a human face more than other things
  • Responds to a smile with a smile
  • Looks into caregiver’s face and eyes with interest
  • Reaches toward and touches toy
  • Hits at dangling objects with hands
5-8 months
  • Sitting using hands for support and starting to sit independently
  • Grabs both feet and holds them when on back
  • Brings feet to mouth
  • Reaches to a toy when playing on belly
  • Props on extended arms when on belly
  • Begins to belly crawl
  • Rolls back to belly
  • Holds and shakes a toy
  • Puts fingers in mouth
  • Smiles at self in front of mirror
  • Maintains sitting for 60 seconds
  • Retrieves a toy in sitting and returns upright
  • Rolls belly to back
  • Rolls back to belly
  • Belly crawls 3 feet forward
9 - 11 months
  • Transfers from sitting to hands and knees position (all fours)
  • Creeps forward on hands and knees
  • Pivots in sitting
  • Walks with hands held
  • Transitions to and from laying to sitting
  • Bounces in standing while holding onto your fingers
  • Lowers to sitting from standing without falling
  • Maintain standing without help for 30+ seconds
  • Stoops and recovers object and then return to standing.
  • Cruising on and between furniture
  • Walks with a push-toy 10 feet 
  • Traps a ball with arms and hands in sitting
12-14 months
  • Maintains kneeling position for 5 seconds
  • Rolls a ball 3 feet forward in sitting
  • Flings a small ball while standing
  • Creeps upstairs on hands and knees
  • Walks 10 feet independently without falling (not walking on toes)
15 - 17 months
  • Creeps downstairs independently
  • Walks upstairs/downstairs with both hands on a rail
  • Lifts foot to contact ball
  • Throws ball overhand without losing balance
  • Walks fast
  • Walks Backward 5 steps
18-23 months
  • Stands heel to toe on a line for 2 seconds
  • Kicks ball 3 feet
  • Throws ball overhand 3 feet
  • Rides on a push toy/bike
  • Runs forward 10 feet
  • Walks sideways 10 feet
  • Walks with one foot on balance beam
23-24 months
  • Jumps forward 4 inches
  • Jumps up 2 inches
  • Jumps down from step
  • Walks up 3 steps without a rail
  • Throws ball underhand 3 feet
  • Kicks ball 3 feet with direction
  • Climbs up a small jungle gym
25-29 months
  • Walks down 3 steps without rail
  • Walks backward for 10 feet
  • Traps to chest a balloon that has been tossed to them.
  • Negotiates age level slide independently 
  • Throws ball 7 feet overhand
  • Walks on a 6-inch balance beam 
  • Walks on tiptoes for 5 feet with hands on hips
  • Runs 30 feet in 6 seconds
  • Kicks ball 6 feet forward using opposing arm and leg movement
30-35 months
  • Stands on one foot for 3 seconds with hands on hips
  • Jumps forward 24 inches
  • Jumps down and land on both feet, off a 24-inch step.
  • Jumps over a 2-inch hurdle
  • Walks on tiptoes for 8 feet with hands on hips
  • Catches ball with arms extended thrown from 5 feet away
3 – 3 ½ years
  • Walks upstairs without a rail using alternating steps
  • Rides a tricycle (uses the peddles)
  • Runs 45 feet in 6 seconds
  • Jumps forward 26 inches
  • Throws an 8-inch ball overhand
  • Throws ball underhand to hit target from 5 feet
  • Stands on one foot with hands on hips for 5 seconds
  • Walks 4 feet on a line with hands on hips
  • Catches large ball hands only 5 feet (not using chest to trap the ball)
3 ½ to 4 years
  • Stands on tiptoes with arms overhead for 3 seconds
  • Walks downstairs without a rail using an alternating pattern
  • Hops forward 6 inches on 1 foot
  • Throws ball overhand to hit target from 5 feet 
  • Stands on one foot for 5 seconds
  • Runs and stops within 2 steps (Can play green light – red light)
  • Walks backwards on a line 4 feet with hands on hips
  • Jumps forward 30 inches
  • Hops 3-5 times on each foot
  • Walks on a 4-inch balance beam with hands on hips
4 – 5 years
  • Stands on tiptoes for 8 seconds
  • Stands on one foot for 6 seconds
  • Walks backwards on a line 5 steps with hands on hips
  • Performs a forward roll (somersault)
  • Gallops 10 feet (one foot in front of the other)
  • Skips 8 feet
  • Throws overhand to hit target from 12 feet away
  • Bounces a ball so it hits floor then wall
  • Catches a 4-inch ball thrown from 5 feet hands only
  • Rides a bicycle with training wheels
  • Rides a 2-wheeled scooter (able to push with one foot)
  • Jumps forward 36 inches
  • Able to jump over a partner turned jump rope
  • Performs a turning jump
  • Hops forward 3 feet on each foot
  • Jumps over 10-inch hurdle
  • Pumps self on swing
5-6 years
  • Stands on one foot for 10 seconds with hands on hips
  • Jumps sideways back and forth over a line 3 cycles
  • Hops 20 feet in 6 seconds
  • Skips 10 feet
  • Able to jump over a self-turned jump rope 5 consecutive times 
  • Performs 5 sit-ups in 30 seconds
  • Performs 8 push-ups in 20 seconds
  • Kicks a ball 12 feet in the air
  • Bounce catches a ball with one hand
  • Takes three consecutive steps on a 2-inch balance beam
  • Able to roller skate – with coordination
  • Able to do the monkey bars
6-7 years
  • Able to Rollerblade, skate, skate board.
  • Swim with a mature overhead stroke.
  • Able to perform 10 repeated jumping jacks
  • Able to participate in coordinated sports/dance activities