Children’s physiotherapists are state registered and are usually employed by the NHS via health trusts.
Many, though, are employed direct by schools, particularly non-maintained special schools. They can work with children from birth to the age at which they leave school. They work in a great variety of different locations such as:
- hospital maternity wards and special care baby units
- hospital children’s wards and outpatient clinics
- specialist children’s hospitals
- child development centres
- local health centres
- schools – including special schools or units, mainstream nurseries and schools, residential schools and independent schools
- children’s own homes.
There is a wide range of children’s conditions that may need physiotherapy, including:
- respiratory conditions at birth in pre-term and term babies
- respiratory conditions such as cystic fibrosis in infants and children
- neurological conditions such as cerebral palsy, hydrocephalus and head injuries
- syndromes affecting development
- developmental delay/visual and hearing impairment
- learning disabilities
- coordination problems such as dyspraxia
- chronic conditions affecting the joints, such as juvenile idiopathic or rheumatoid arthritis
- progressive illnesses such as muscular dystrophy
- terminal and non-terminal illnesses such as cancer
- injuries such as burns
- congenital skeletal conditions
- limb deficiencies
- orthopaedic problems including post-operative trauma.
What a physiotherapist actually provides will depend on the particular needs of individual children but it is likely to include such things as:
- hands-on treatment on a regular basis
- programmes of exercise which can be implemented by parents, teaching assistants or others
- programmes of movement to prevent the development of deformity and maintain a range of movement and functional ability
- the identification, supply and monitoring of appliances, aids, seating, standing frames, wheelchairs and so on, usually in conjunction with the occupational therapist
- advice to nurseries and schools concerning access to the environment, mobility, special seating or equipment, the use of splints, access to physical education, and ways of involving the child or adapting activities to allow him or her to achieve success in practical subjects
- encouragement towards maximum independence
- referral to other health care professionals such as the occupational therapist or speech and language therapist
- written advice for any statutory assessment of special educational needs
- written reports for, and attendance at, reviews.
Physiotherapists work with children in the most appropriate way. This might be:
- individual sessions – particularly for post-trauma or post-operation rehabilitation, chest conditions, developmental or neurological problems
- group sessions – particularly for coordination problems such as dyspraxia
- through others – such as parents and learning support staff in schools.