Physiotherapy Services

Physiotherapy is an important part of the support provided by Friends of the Care Project (FOTCP).

Our physiotherapy service supports children with a wide range of developmental, neurological and physical needs through both the Friends Development Centre and our Community Outreach Programme.

We aim to help each child achieve the greatest possible level of movement, comfort, participation and independence.

We recognise that physical development affects many areas of a child's life. A child's ability to sit, stand, move, walk, balance or use equipment can influence their learning, communication, play, self-care, confidence and participation in family and community life.

For this reason, physiotherapy at FOTCP is not provided in isolation. Our physiotherapy team works closely with families, teachers, teaching assistants, nursing staff, Community Outreach staff and other professionals involved in the child's care.

Who We Support

Our physiotherapy service supports children with a wide range of needs, including children with:

• Cerebral palsy
• Spina bifida
• Hydrocephalus
• Global developmental delay
• Neurological conditions
• Muscle weakness
• Delayed gross motor development
• Difficulties with balance or coordination
• Mobility difficulties
• Postural difficulties
• Reduced strength or endurance
• Joint stiffness or reduced range of movement
• Complex physical disabilities
• Developmental conditions affecting movement and participation

Families and professionals may contact us where there are concerns about a child's movement, posture, mobility, physical development or ability to achieve developmental milestones.

Referrals to Physiotherapy

Children may be referred to our physiotherapy service from a range of sources.

Referrals may come from:

• Parents and caregivers
• Doctors and paediatricians
• Hospitals
• Health clinics
• Nurses
• Schools
• Teachers
• Early childhood professionals
• Other therapists
• Healthcare professionals
• Community organisations
• Government services
• FOTCP Community Outreach staff
• The Friends Development Centre

Parents and caregivers can also contact Friends of the Care Project directly if they are concerned about their child's physical development.

We believe early identification is important. If a family or professional has concerns about a child's movement or development, they do not necessarily need to wait for a formal diagnosis before seeking advice.

Assessment

Every child referred to our physiotherapy service is individually assessed by a physiotherapist before treatment begins.

The assessment allows the physiotherapist to build a clear picture of the child's strengths, difficulties and functional needs.

The assessment may consider areas such as:

• Gross motor development
• Muscle strength
• Muscle tone
• Joint movement
• Posture
• Sitting ability
• Standing ability
• Balance
• Walking
• Mobility
• Transfers
• Coordination
• Functional independence
• Positioning
• Equipment needs
• Participation in everyday activities

The physiotherapist will also speak with the child's parent or caregiver about their concerns, priorities and what they would most like their child to achieve.

For children attending the Friends Development Centre, information from teachers, teaching assistants, nursing staff and other members of the team may also form part of the assessment.

Individual Physiotherapy Plans

Following assessment, the physiotherapist develops an individual treatment plan for the child.

This plan is based on the child's specific needs and includes clear, realistic and meaningful goals.

Goals may include:

• Improving head control
• Developing sitting balance
• Improving trunk control
• Supporting standing
• Increasing strength
• Improving balance
• Improving coordination
• Increasing mobility
• Supporting walking
• Improving transfers
• Maintaining joint movement
• Reducing the risk of stiffness
• Improving positioning
• Developing greater independence
• Increasing participation in education, play and family life

No two children are the same, so physiotherapy treatment is based on the individual child rather than only on a diagnosis.

Physiotherapy at the Friends Development Centre

Children attending the Friends Development Centre have access to physiotherapy as part of their wider educational and developmental programme.

Following assessment, the physiotherapist will devise an individual treatment plan based on the child's needs, abilities and agreed goals.

Depending on the child's individual needs, children attending the Development Centre may receive physiotherapy treatment up to three times per week.

The frequency of treatment is determined by the physiotherapist and may vary depending on the child's needs, progress, goals and response to treatment.

Treatment may focus on areas including:

• Mobility
• Strength
• Balance
• Posture
• Sitting and standing
• Walking
• Transfers
• Coordination
• Joint movement
• Positioning
• Functional independence
• Participation in classroom and everyday activities

Physiotherapy at the Development Centre is not limited to formal treatment sessions.

The physiotherapy team works alongside the education team so that appropriate therapeutic recommendations can be incorporated into the child's school day.

This may include:

• Correct positioning
• Supported standing
• Walking practice
• Mobility activities
• Movement opportunities
• Transfer practice
• Use of specialist equipment
• Activities to promote strength and balance

This integrated approach gives children regular opportunities to practise important skills throughout the day.

Working Alongside Education

At FOTCP, education and therapy work together.

The physiotherapy team works closely with teachers and teaching assistants so that physical goals can support the child's wider learning and development.

For example, a child working towards improved sitting balance may practise this during classroom activities.

A child working on standing may be supported to stand during learning or play.

A child developing mobility may be given appropriate opportunities to practise moving safely around the classroom or wider environment.

This approach makes therapy more functional and meaningful and allows children to practise skills more frequently.

Positioning and Postural Support

Correct positioning can make a significant difference to a child's comfort and ability to participate.

For children with physical disabilities, positioning may affect:

• Breathing
• Eating
• Communication
• Vision
• Hand function
• Play
• Learning
• Comfort
• Mobility

The physiotherapy team may therefore provide advice on:

• Classroom seating
• Floor positioning
• Standing
• Wheelchairs
• Supportive chairs
• Transfers
• Handling
• Walking aids
• Mobility equipment
• Other specialist equipment

Where equipment is required, the physiotherapist can help identify the child's functional needs and make appropriate recommendations.

Community Outreach Physiotherapy

Not every child who needs physiotherapy attends the Friends Development Centre.

Our Community Outreach Physiotherapy Service enables us to support children and families within the wider community.

Children referred to Outreach are first assessed by a physiotherapist.

Following that assessment, an individual treatment plan is developed with clear goals based on the child's needs.

Outreach physiotherapy is provided in six-week blocks of treatment.

During each six-week treatment block, the physiotherapist works towards the specific goals identified for that child.

At the end of the six-week block, the child's progress is reviewed.

Some children may only require one six-week block of physiotherapy treatment.

Other children may require additional six-week blocks, depending on their progress, individual needs and response to treatment.

Where continued physiotherapy is appropriate, the physiotherapist will review the child's goals, update the treatment plan and offer a further six-week block of treatment.

This means that some children may be involved with the Outreach Physiotherapy Service for six weeks, while others may receive support for longer.

The length of treatment is determined by the child's individual progress and needs rather than by a fixed number of sessions.

This structured approach allows treatment to remain focused, measurable and responsive to the child.

Early Intervention

Early intervention is an important part of our physiotherapy service.

Babies and young children may be referred where there are concerns about:

• Head control
• Rolling
• Sitting
• Crawling
• Standing
• Walking
• Muscle tone
• Limb movement
• Balance
• Coordination
• Delayed milestones
• Development following premature birth
• Development following illness or neurological injury

Early assessment can help identify areas where support may be beneficial.

Where physiotherapy is recommended, treatment will be based on the individual child's needs and stage of development.

Parents and caregivers are involved from the beginning and are supported to understand how everyday activities can help their child's development.

Working With Parents and Caregivers

Families are a central part of our physiotherapy service.

Parents and caregivers know their child best, and their priorities are taken into account when setting treatment goals.

Where appropriate, families are shown activities, exercises or positioning techniques that can be safely incorporated into the child's everyday routine.

These may include activities during:

• Play
• Bathing
• Dressing
• Floor time
• Sitting
• Standing
• Walking
• Everyday movement around the home

The aim is not to overwhelm families with complicated programmes.

Instead, we aim to provide practical advice that can become part of normal daily life.

This gives children more opportunities to practise important skills between treatment sessions.

Review and Progress

Review is an important part of physiotherapy at FOTCP.

For children receiving Community Outreach physiotherapy, progress is formally reviewed at the end of each six-week block of treatment.

The review considers:

• Progress towards agreed goals
• Changes in movement or function
• Areas that still require support
• Whether goals need to be changed
• Whether further physiotherapy is required
• Whether another six-week treatment block should be offered
• Whether the child can continue through a home programme
• Whether monitoring is more appropriate

For children attending the Friends Development Centre, progress is reviewed regularly and treatment frequency may be adjusted according to the child's needs and response.

Some Development Centre children may receive physiotherapy up to three times each week, where this is considered appropriate by the physiotherapist.

A Team Around the Child

Physiotherapy at Friends of the Care Project forms part of a wider team approach.

Depending on the child's needs, the physiotherapist may work alongside:

• Parents and caregivers
• Teachers
• Teaching assistants
• Nursing staff
• Community Outreach staff
• Other therapists
• Doctors and healthcare professionals
• Other agencies supporting the child

By working together, we can ensure that physical needs are considered alongside education, communication, independence, family life and participation.

Supporting Meaningful Progress

Success looks different for every child.

For one child, progress may mean taking their first independent steps.

For another, it may mean being able to sit more comfortably and safely in class.

For another child, it may mean learning to transfer with less assistance, improving balance, becoming stronger or using mobility equipment more independently.

Our physiotherapy service focuses on what is meaningful for the individual child.

Through assessment, individual treatment planning, regular physiotherapy, six-week Outreach treatment blocks, family support and review, we aim to help each child develop the skills they need to participate as fully as possible in education, family life and their community.

Making a Referral

If you are a parent, caregiver, teacher, doctor, healthcare professional or other professional and would like to discuss a possible physiotherapy referral, please contact Friends of the Care Project.

Our team can provide further information about the referral process and arrange an assessment where appropriate.