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Guide · Pediatric Physiotherapy

Pediatric Assessment

A first session always starts with understanding your child — not with a machine or a therapy package. We look at four areas of development, at how your child actually moves, and at what you have already noticed at home.

Age
0–6 years
Duration
60–90 minutes
Parents
In the room throughout

The four areas we look at

Our assessment follows the same framework the community health posts and clinics use through the Ministry of Health's KPSP developmental screening: gross motor, fine motor, speech and language, and social and self-help skills. We use the framework you already know so the result connects to your child's Buku KIA record rather than standing apart from it.

On top of those four areas, as physiotherapists we add what a questionnaire cannot ask: muscle tone, symmetry, joint range, the quality of the movement pattern, and how a child holds a position against gravity. Two children can both "be sitting" in very different ways — and *how* they sit is what decides the next step.

The session runs through play and observation, not through instructions. We ask you a lot of questions, because you see your child every day and we see them for an hour.

The normal range is far wider than most people think

The worry we hear most often sounds like this: "the neighbour's child is walking and mine is not." The WHO Motor Development Study measured when healthy children across five countries reached six gross motor milestones, and the answer is a very wide range.

Sitting without support: 3.8–9.2 months. Standing with assistance: 4.8–11.4 months. Hands-and-knees crawling: 5.2–13.5 months. Walking with assistance: 5.9–13.7 months. Standing alone: 6.9–16.9 months. Walking alone: 8.2–17.6 months. Those are the 1st to 99th percentiles — meaning a child who first walks at 17 months is still inside the healthy range.

So we never read a single date on its own. Sequence and quality tell us far more: whether skills arrive in order, whether both sides of the body are used evenly, and whether the child keeps progressing. Development that stalls or goes backwards matters much more than development that is a few weeks late.

Preterm babies are assessed using corrected age

A baby born before term is assessed using corrected age, not birth age. Take the child's age and subtract the difference between 40 weeks and the gestational age at birth. A baby born at 34 weeks is corrected by 6 weeks — at 6 months old, they are read as a 4.5-month-old.

This correction is used until around 2 years of age. Skipping it is one of the most common reasons a baby gets labelled "delayed" when their development is exactly on track. That is why we always ask about gestational age and birth weight before assessing anything.

What you take home

At the end we explain what we found in plain language, not in technical terms: what is already strong, what needs help, and whether your child actually needs ongoing therapy — sometimes the answer is no, and that is a perfectly good answer.

You go home with a written summary and a home program that fits into nappy changes, bath time and play. If ongoing therapy is advised, we tell you the goal and when we will reassess, so you can measure progress yourself.

What to get ready before you come

  • Your child's Buku KIA or growth record
  • Gestational age at birth and birth weight
  • A short video of your child moving at home — crawling, pulling to stand, or walking
  • A written list of what worries you, made before you come
  • A change of clothes, nappies, and your child's usual snack
  • Book a time when your child is normally at their best, not just before a nap

Frequently asked questions

My child is 15 months and not walking. Is that late?

By the WHO ranges, walking alone appears between 8.2 and 17.6 months in healthy children, so 15 months is still inside the range. What we look at is not the date but whether your child is moving towards it: pulling to stand, cruising along furniture, willing to take weight. If none of those are present, come for an assessment.

Do I need a doctor’s referral for an assessment?

No. You can book directly. If your child has already been seen by a pediatrician or specialist, bringing those notes helps a great deal — we want to add to the care already underway, not start it over.

Is an assessment the same as a diagnosis?

No. A physiotherapy assessment describes how a child moves and functions, and decides whether movement therapy can help. A medical diagnosis is for a doctor to make. If what we find points that way, we say so plainly and recommend a medical review.

How long before we see a change?

We do not promise a timeframe, because every child and every condition differs. What we do is set one observable goal together — holding a crawling position longer, say — and a date to reassess. If there is no progress by that date, it is the plan we change.

Sources

The figures and recommendations on this page come from the sources below. The links go to third-party sites.

  1. WHO Motor Development Study — windows of achievement for six gross motor milestones
  2. Kemenkes RI — Kuesioner Pra Skrining Perkembangan (KPSP), instrumen SDIDTK

This page is educational and does not replace an examination by a doctor. If your child is unwell, or something does not feel right to you, have them seen first.