Caregivers might seek physical therapy if their child is showing developmental delays, difficulty reaching physical milestones (such as rolling, sitting up, crawling, walking, jumping, running, or riding bikes and scooters), or has been diagnosed with conditions like cerebral palsy, muscular dystrophy, or Down syndrome. It’s also common for children with sports injuries, scoliosis, genetic or neurological disorders to benefit from physical therapy.

In North and South Carolina, no, you do not need a referral to seek PT services due to direct access laws allow patients (including children) to see a physical therapist without a doctor’s referral. This means you can schedule an appointment directly with a pediatric physical therapist, and they can begin an assessment and treatment plan right away.  Some health insurance plans may still require a referral from a pediatrician or primary care doctor to cover the cost of physical therapy.  Check with your insurance provider to confirm if they require a referral for physical therapy services to be covered.

If a child walks on their toes for more than 2-3 months in the first 6 months of walking, is over the age of 2 years, has muscle tightness or pain in their calf, has difficulty with balance or coordination, trips frequently, fatigues when walking, or is unable to walk flat footed with minimal verbal reminders, they may benefit from physical therapy services.  Long term toe walking can cause boney structural and alignment changes that can become more permanent over time as well as lead to weakness in certain muscle groups and overuse of other muscle groups that can affect gross motor skills in other areas of a child’s development.

Many parents report their child is clumsy and it can be difficulty to recognize if this is a part of development and adjusting to a growing body or an area of concern.  A physical therapist can assist a child in learning ways to improve their motor planning abilities and becoming more successful with gross motor learning and performance.

Chronic pain in children and teens is complex and it can be difficult to diagnose the root cause of the pain.  Physical therapists can help a child or teen relearn how to use the affected body part, regain strength, desensitize to touch, and return to their prior level of function at home, school, and in their community.  Chronic pain that does not respond to traditional pain relieving treatments can be part of a condition called Amplified Musculoskeletal Pain Syndrome (AMPS).  Successful treatment of AMPS requires a specialized approach by a medical and therapy team trained in this condition.

Crawling is an important pre-walking milestone because it provide important input to the entire body with long lasting benefits including coordinating the right and left sides of the body, developing trunk and extremity strength and flexibility, developing the arches in the hands, integrating sensory input coming into the body, and providing the ability to see the environment in a different way.