Pediatric Physical Therapy FAQs

When should I bring my baby into physical therapy?

If your child demonstrates any of the following behaviors and issues, they could potentially benefit from physical therapy:

  • Only moving by scooting on their bottom
  • Having trouble with tummy time
  • Experiencing clicking or popping in their hips
  • Moving asymmetrically (including their head movements)
  • Developing flat spots on their head

What are some common diagnoses you treat?
Here are some of the common conditions we treat at Little Steps:


  • Hypotonia refers to low muscle tone through a child’s body. This can affect a child’s endurance, stability, the way they move, ability to meet their milestones on time, and ability to explore their environment effectively.
  • Treatment strategies include the following:
    • Functional activities
    • Limit external equipment use
    • Orthotic management
    • Muscle strengthening
    • Postural facilitation


  • Torticollis is tightness through one or more muscles in the neck that causes a baby’s head to turn to one side and tilt to the side. This affects the way that a baby can move, play, and interact with their environment.
  • What causes torticollis?
    • Congenital torticollis can develop in utero and the baby can be born with tightness in their neck. Positional Torticollis is caused by a child’s preference to turn toward one side in their environment that leads to muscle tightness in their neck.
  • What are some ways that you can treat this condition?
    • Using the environment to encourage turning the head both ways
    • Positioning
    • Handling techniques
    • Strengthening

Abnormal gait

  • Gait refers to the walking pattern that your child uses. An abnormal gait can include a range of variances in your child’s walking pattern, including asymmetries or insufficiencies that can affect your child’s ability to walk safely.

When should I be concerned about my child’s toe walking?

  • If a child persistently walks on their toes (more than 25% of the time) it can be a red flag that they have decreased stability through their ankles, sensory sensitivity, or other concerns.
    • Treatment strategies include the following:
      1. Stretching
      2. Sensory input
      3. Shoe modifications
      4. Body awareness activities
      5. Hip and abdominal strengthening

What is the difference between muscle tone and muscle strength?

  • Muscle tone has to do with the resting tension of the muscle and the connection from the brain to the muscle. Muscle strength has to do with how fast and hard the muscle can contract.

Is my child getting stronger while they play using equipment like jumparoos and walkers?

  • Equipment can change the way that children use their muscles while they are in upright positions, causing muscle imbalances and delays in gross motor skills. Children also can’t see their feet while in this equipment, and they are not able to explore their environment as effectively or safely. We recommend limiting time spent in external equipment to no more than 30 minutes per day total.

Why is crawling important?

  • It is the first time that the two sides of the brain work together, leading to bilateral coordination skills. It has been linked to reading and handwriting skills. It also helps with postural strengthening.

What are the milestones that my child should be meeting?

Here are some key milestones for physical development:

  • Rolling – 4-5 months
  • Sitting- 6-7 months
  • Crawling – 9-12 months
  • Pulling to stand – 9-12 months
  • Walking – 12-18 months (The average age is now 15 months, and delayed walking is considered any point after 18 months)

Why is tummy time important? How long should my child do tummy time each day?

  • The American Academy of Pediatrics states that 50% of an infant’s awake time should be spent in tummy time. It is important to develop their strength through their neck, shoulder and core muscles in order to develop their gross motor skills.

What does W sitting mean and is it an issue?

  • W sitting refers to a sitting position when a child sits with their lower half of their body in a W, or when their knees are pointing inward together and their feet are by their hips. W sitting can lead to tightness throughout hip muscles, muscle imbalances, and poor alignment throughout their body.

My pediatrician recommended a helmet. When is the best time to get a helmet? What are some things to watch for with helmet care?

  • The best time to intervene is from 4-6 months old, although improvements can still occur at later ages. This varies for each child.
    • Watch for skin redness that persists for more than 30 minutes.I If this occurs, schedule an appointment with your orthotist to adjust the helmet. Leave helmet off until you see your orthoptist.
    • Make sure to wash the helmet every day.