The foundations for almost every aspect of emotional, intellectual, physical and social development are laid in the early years (from conception to 5 years). These foundations are a critical determinant of health and wellbeing and progress throughout the life course. Yet, a recent report by the Institute of Health Equity suggests that nearly half of all five-year-olds in England are not achieving a good level of development in readiness for school. In low income families the proportion of children meeting the milestones, or early learning goals in the areas of communication and language; physical development; and personal, social and emotional development, set out by the Department of Education is as low as 36%.
Physiotherapists working with both adults and children are ideally positioned to help children in meeting these milestones. Firstly, we have the knowledge and skills to facilitate children and/or parents to embed physical exercise and a healthy diet for good health. For example, with good evidence to support the benefits to children of antenatal education on exercise and nutrition, physiotherapists working with pregnant mothers advise or in some cases provide intervention to optimise maternal fitness and physical activity levels during and after pregnancy. Physiotherapists working with adults who have young children link their physical activity goals to helping their children achieve a minimum of three hours of active play every day (for children from 0-5) or help identify parental health and wellbeing issues, such as mental health or social concerns, that may impact on children and signpost to relevant services for early intervention and prevention of problems.
Paediatric physiotherapists are already likely to have seen increasing numbers of otherwise healthy children with poor confidence, control, co-ordination, stamina, and strength in fine and gross motor skills, impacting on their ability to confidently and safely move and function - whether that is handling pencils for writing or independently managing dressing and toileting. While the causes for these are multi-factorial paediatric physiotherapists offer specialist advice and treatment ranging from advice on ‘tummy time’ to provision of graded exercise, motor skills and weight management programmes and, for children with specific physical needs, rehabilitation aimed at physical activity and sport participation.
As the experts in movement, physiotherapists, in conjunction with midwives, health visitors, early years professionals and parents, have a crucial role to play in ensuring all children get the best possible start and fulfil their potential in life – their future depends on it!
Ripal Patel
Chartered Society of Physiotherapist's Professional Adviser and Paediatric Musculoskeletal Physiotherapist
