Developmental Delay
Early intervention from paediatric physiotherapy, occupational therapy and speech pathology supports children with developmental delay to meet milestones and participate fully.
Common symptoms
- Late achievement of motor milestones (sitting, walking)
- Reduced muscle tone (hypotonia)
- Speech or language behind peers
- Difficulty with fine motor or self-care tasks
Common causes
- Genetic syndromes (e.g. Down syndrome)
- Prematurity
- Acquired brain injury
- Idiopathic / cause unknown
When to seek help
Children develop at different speeds, and most variations are normal. But there are some patterns that benefit from a proper assessment rather than waiting another six months to see how things go.
Worth booking in if:
- your child isn’t sitting independently by nine months, or walking by eighteen months
- they have fewer than 50 words at 18 months, or aren’t combining words by age 2
- they can’t be understood by people outside the family by age 3
- they’re struggling with toileting, dressing or feeding well past peers
- they’re losing skills they previously had — at any age
- a paediatrician, GP or teacher has suggested an assessment
Coming in for reassurance is a perfectly good reason. Many of our paediatric assessments end with "your child is developing typically, here’s some context, come back if anything changes."
How we treat developmental delay
Early intervention is one of the best-evidenced things in paediatric allied health. Children who get appropriate, well-timed input often catch up to peers entirely. Others gain skills they wouldn’t have without support. Either way, the earlier the better — and "early" can mean from 18 months.
We work with families, not over them. Most of what changes a child’s development is what happens at home, at preschool, and in everyday play. Our sessions are partly direct work with the child and partly coaching for parents and carers, because the people the child sees daily are the ones who change the trajectory.
What an assessment actually involves
A first paediatric assessment is usually 60 to 90 minutes. We watch how the child plays, how they move, how they communicate, and what they can do across self-care tasks. We use standardised tools where they help — the Bayley Scales, the Movement ABC, language samples — but a lot of useful information comes from the unstructured observation.
You’ll leave with a clear sense of where your child is tracking, where the strengths are, where the gaps are, and what makes sense to do next. That might be ongoing therapy, a one-page home program, a recommendation for a paediatrician review, or simply a "let’s touch base in six months" plan.
When NDIS funding makes sense
For children with significant developmental delay or a confirmed disability, the NDIS can fund physiotherapy, occupational therapy and speech pathology under Early Childhood approaches (for under 9s) or standard pathways thereafter. We can write the supporting reports, and we work with Support Coordinators across Sydney to streamline the funding process.
What good therapy looks like for a toddler
Toddler therapy that looks too much like a lesson usually isn’t working. A good paediatric session looks like play, because play is how small children learn motor skills, language and self-regulation. We bring toys that target the goals we’ve set, we follow the child’s interest, and we coach the parent on small things to embed in the routine at home.
Parents sometimes worry their child isn’t "doing the therapy" properly. They almost always are. A child who tolerates a 45-minute session, engages with novel adults, follows two-step instructions, and bursts out laughing when something works — that child is doing the therapy. The grown-up version of "trying hard" isn’t what we’re measuring.
Working with kindy, daycare and school
A lot of the goals that matter most for kids — using cutlery, queuing for the bag racks, sitting on the mat, climbing the equipment — happen at kindy and school rather than at home. With your consent we visit the educational setting, brief the teacher or educator, and provide a one-page strategy sheet that fits into the way they already work. We don’t expect them to run a therapy session; we give them simple things that help.
Common questions about developmental concerns
Should I wait and see?
"Wait and see" is reasonable for small variations and gets riskier as the gap gets larger. The cost of an early assessment that says "all good" is one appointment. The cost of waiting two years and then needing to catch up is much higher. If you’re wondering, book in.
My GP said it’s probably fine — do I really need a physio?
Often your GP is right, and a single assessment will confirm it. Sometimes the GP is reassuring a worried parent in a 15-minute consult, and a longer paediatric assessment reveals things worth working on. There’s no harm in checking.
Do you do home or school visits?
Yes — home and school visits are sometimes more useful than clinic visits, especially for goals around daily routines, play, or classroom participation.
How long will my child need therapy?
It varies enormously. Some children need short, focused blocks (a term, a school year) and discharge. Others need longer-term support that scales up and down with developmental stages. We review the plan regularly so therapy doesn’t become a default rather than a deliberate choice.
Services we use to treat this
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