Play-based Paediatrics Allied Health Services

23/09/2025

A hole in the wall is not at all uncommon in Australian homes. Plasterboard is so fragile. It is however a sign that parents of children with special needs know all too well. Whether your child has a diagnosis of ASD and pathological demand avoidance, oppositional defiant disorder or ADHD and too many other combinations to mention, broken gyprock can be a secret tell that parents caring for similar children can understand too well. We are all often way too tired or burnt out to fix it or get someone to fix it as it is often the least important of many tasks in our overloaded in tray. We’re often just in “survival” mode. We do however feel self conscious about it and often avoid having visitors over so they don’t see it. This also leads us to further isolation, which of course makes things worse, as we lose our support networks and social contact and a valuable means to release tension and relax.

Almost the same is true of the messy house. We are trained to be house proud and the idea of people seeing our messy house is horrifying. The truth is however that in the majority of houses caring for a child with special needs, some housework tasks don’t make the daily priority list and remain undone. We should not feel ashamed of our unfolded washing, our tables covered in junk or even the overflowed recycle bin. These are signs that we have our priorities right and that we are deploying our biggest energies to caring for our child. If there is insufficient time left over to polish the bench tops then the world will have to deal with that. We have to be aware of changing our own behaviour and try to still have friends over regardless. If you can’t get past society’s expectations of the tidy house then consider meeting friends in a park or cafe.
Don’t be afraid to discuss your fears with your friends as you will almost always find them more understanding than you may have thought. Remember that to be the best carer you can be, you have to make time and care of yourself. Remember that we, as parents, are the life raft.


PS - these are the photos my wife would let me post….. meaning our actual house is like a bomb zone.

21/09/2025

As a dedicated paediatric physiotherapist, I’ve seen many children living with cerebral palsy benefit from hydrotherapy.
Supported through the NDIS, hydrotherapy is a fantastic tool that supports physical well-being facilitating muscle movements through the support and warmth of the muscles that would otherwise often be painful. The children also love the goals they can achieve within their own limitations.
Here are some of the key benefits:

1. Weightless Movement - The buoyancy of water supports the body, reducing strain on muscles and joints. This allows children to move more freely, improving mobility and increasing muscle strength without the pressure of gravity.

2. Muscle Relaxation: Warm water helps to relax tight muscles, making stretching and movement more effective. This can significantly reduce spasticity and improve comfort levels.

3. Enhanced Mobility: The resistance of water provides a gentle and supportive environment to build strength and encourage better motor function, enhancing day-to-day mobility.

4. Boosted Confidence: Success in the water can translate to improved self-esteem. Children gain confidence as they achieve new milestones in a safe and fun setting.

5. Sensory Benefits: Hydrotherapy provides a multi-sensory experience, which can help children adapt to different sensory stimuli, enhancing their sensory processing abilities.

By incorporating hydrotherapy into therapy plans, we create a dynamic and enjoyable way to support our young clients on their journey to greater independence and improved quality of life.

For more information on how hydrotherapy can benefit your child and how to access services through the NDIS, feel free to reach out.

Hydrotherapy can offer immense benefits to children with cerebral palsy that are fun, pain free and will increase their ability to engage in life.

01/05/2025

Thought I’d share this. It refers to all
parents of children with special needs, mums or dads sharing the journey of seeking help for their children as best they can….. that feeling of exhaustion and that what your doing is never enough is not at all uncommon…. .

I see you taking your kid to therapy while your friends take their kids to football or ballet.

I see you sneak out of the conversation when all your friends boast about achievements and exam notes.

I see you juggle events and meetings.

I see you sitting on the computer for hours investigating what your child needs.

I see you make a bad face when people complain about what looks like nonsense.

I see you disappear little by little but you keep going beyond for your family.

I see you pull strength from weakness with a force you didn't even dream you had.

I see you showing respect for teachers, therapists and medical professionals who help your child and help you.

Watching you wake up early in the morning to do it all again after another chaotic night.

I see you when you're on the edge of the precipice struggling to live.

I know you feel invisible, like no one notices.
But I want you to know that I see you.

I see you push forward always. I see you choose to do everything you can to give your child the best care at home, school, therapy and the doctors.
What you do matters. It's worth the struggle.

On those days when you wonder if you can make it one more minute, I want you to know I see you.

I want you to know that you are beautiful.
I want you to know it's worth it. I want you to know that you are not alone. I want you to know that love is the most important thing, and that you are the best at it.

And in those days when you see an improvement, those moments when hard work has its reward, and you can taste success, I'll see you then too.
And I'm proud of you.

Whatever day today.....you're doing it right.

And I see you. ❤

✒ Alethea Mshar

📷 John Walker / Flickr

16/02/2025

When you look at this video I want you to see kids having an egg and spoon race over some obstacles having some fun. That is also what I want them to experience. What I won’t ever tell them is that we are working on
- balance
- core stability
- motor planning
- fine motor skills
- gross motor skills
- retained primitive reflexes
- motor-sensory coordination
- hand-eye coordination
- proprioception

: and often many more goals based on my initial assessments.

To deliberately work on these skills in isolation with boring repetitive exercises would ruin the experience for the kids and reduce compliance and engagement. Not to mention that integration of skills together achieves much more in less time.
Play-based paediatric physio may, at face value, look like we’re just having a whole lot of fun playing games.. but we’re building strength and skills that will improve endurance, strength and capacity and ,most importantly, self esteem in our kids for their futures.
The smiles at the end are the most important part.

16/02/2025

As a paediatric physiotherapist, I work with many children who live with a wide range of disabilities. My goal is to help each child master motor milestones, from taking their first steps to developing motor planning skills, balance, coordination, address any retained primitive reflexes and improve core strength. I also assist with painful contractures and general joint support and strengthening.

I tailor my approach to each child's unique personality, interests, and needs, using everything from land-based play to hydrotherapy. The key is to make therapy as enjoyable as possible. A parent recently told me that my ability to connect with her son would determine whether I'd be invited back. I completely understood her point. For years, I've believed that the relationship between the therapist and the child is crucial when choosing who to entrust with your child's therapy. If the child isn't having fun or relating to the therapist, they won't give their best effort and may even dread physiotherapy.

My challenge is to design a program that meets their goals while keeping it fun. The child should only be aware that we played games and had fun, not realising that they were actually working towards their therapy goals.

In this way, we replace therapy with fun, giving our children the chance to just be children.

I currently have had some availability come up for certain areas, so if you're interested, feel free message, call or email me. Playbasedpaediatrics@outlook.com or 0418772542. I’m happy to discuss how the various forms of therapy I use (land-based (home, school, kindy); or hydrotherapy may benefit your child.

09/02/2025

If you say the words Cerebral Palsy to a member of the general public everyone will have an idea fixed about what they think that means. Understandably most people are very aware of the very obvious high tone versions of the disorder as these are very visible and obvious when encountered. What most people don’t realise is the amazing variation that is seen. In fact no two cases that I have seen have ever been the same.

Some people with severe Cerebral Palsy have profound disability and need lifelong care while others have much more subtle signs and may simply have trouble with precision or balance. Sometimes parents don’t even realise that their child has CP as it can be challenging to diagnose especially when you are not expecting it.

Often the only clue is that the symptoms don’t completely fit the current diagnosis
Apart from helping parents to identify this possibility my job is to help the client to minimise the effects and to maximise their capacity to participate in life. I always feel that my responsibility is to ensure that this is done in an enjoyable playful way so that therapy sessions are not a drag.

09/02/2025

As a paediatric physiotherapist, I work with a lot of children living with cerebral palsy. No child with CP is the same, and they all have differing needs and goals. I tailor my therapies to help them achieve their goals in a way they find fun, whether it’s hydrotherapy or land-based activities. The same goal can be achieved multiple ways depending on what your child is interested in or finds fun or comfortable. Feel free to call or message me if you’d like more information about how we can achieve this.

09/02/2025

The importance of understanding each child.
As a parent of a child living with a disability, it can be very difficult to see our children’s disability misunderstood by those around them including friends, teachers, family and even doctors and therapists. In reality, parents are usually those best equipped to understand their child and their needs and where disability affects behaviour.

Every child is different, and every diagnosis has a spectrum of presenting signs. By definition, the concept of diagnosis tends to stipulate a specific set of symptoms, but does not consider that some of these will affect the child more or less… and also a particular diagnoses rarely exists in isolation of others creating more variation. When combined with their own individual personality, this often presents as very different things in different children. For instance, Autism has a widely varying presentation with certain core features however there is a very strongly held social “stereotype” around what these are. These are not only rarely true, but also potentially damaging, when people “pigeon hole” how they think your child “is” based solely on their idea of what that diagnoses means.
Autism is also rarely an isolated diagnosis without additional co-diagnoses such as sensory, speech, motor planning or body tone issues.

One condition in which this can be particularly distressing and misunderstood is PDA or pathological demand disorder, which is seen in some children with ASD. The behaviour of affected children, is often mistaken, for bad behaviour. It has far less to do with discipline and far more to do with anxiety and feeling completely overwhelmed, yet schools, daycare and even therapists can respond to the children in such a way as to imply more discipline is the only solution. This is not only painful (by heightening the anxiety) for children, but also parents who are doing their best and the right thing for their children, but are constantly castigated for not showing a firm hand.

There are many ways to approach these conditions in children that achieve results whilst reducing additional anguish and negative interactions.
If the root drivers of various behavioural traits seen in children are understood, they can be supported better with less anguish and ultimately better results.

As a therapist, it is absolutely essential to understand the underlying drivers of conditions I work with. Listening to parents is also esssential, and trusting their knowledge and experience built by parenting their child for many years. If your therapist refuses to listen, point out the years of experience you have, then feel free to change to someone who will listen. After all, no one knows your child more than you do.

08/02/2025

If I am doing my job well, you should look at my physiotherapy sessions and think that this is “just a series of fun games and activities”. After watching my own son with complex disabilities struggling with a rather clinical and regimented approach to physiotherapy that he just disengaged from, I vowed that my approach to my clients would be very different. Whilst that is what I want your child to experience in a session, each activity is chosen based on their goals and after assessing their strengths. Even the assessment will be a series of games. Through play and exercise I can help children work on gross motor skills,fine motor skills, core strength, balance and gaining practical skills for life like riding a bike or swimming. Improving these skills can lead to additional gains like improved concentration in school or independence in dressing or bathing. Do not hesitate to contact me if you would like to discuss how play based physiotherapy might help your child.

08/02/2025

As a dedicated paediatric physiotherapist, I’ve seen many children living with cerebral palsy benefit from hydrotherapy.
Supported through the NDIS, hydrotherapy is a fantastic tool that supports physical well-being facilitating muscle movements through the support and warmth of the muscles that would otherwise often be painful. The children also love the goals they can achieve within their own limitations.
Here are some of the key benefits:

1. Weightless Movement - The buoyancy of water supports the body, reducing strain on muscles and joints. This allows children to move more freely, improving mobility and increasing muscle strength without the pressure of gravity.

2. Muscle Relaxation: Warm water helps to relax tight muscles, making stretching and movement more effective. This can significantly reduce spasticity and improve comfort levels.

3. Enhanced Mobility: The resistance of water provides a gentle and supportive environment to build strength and encourage better motor function, enhancing day-to-day mobility.

4. Boosted Confidence: Success in the water can translate to improved self-esteem. Children gain confidence as they achieve new milestones in a safe and fun setting.

5. Sensory Benefits: Hydrotherapy provides a multi-sensory experience, which can help children adapt to different sensory stimuli, enhancing their sensory processing abilities.

By incorporating hydrotherapy into therapy plans, we create a dynamic and enjoyable way to support our young clients on their journey to greater independence and improved quality of life.

For more information on how hydrotherapy can benefit your child and how to access services through the NDIS, feel free to reach out.

Hydrotherapy can offer immense benefits to children with cerebral palsy that are fun, pain free and will increase their ability to engage in life.

05/01/2025

Kids with poor upper body and core tone go on to develop problems with so many other day to day activities from fatigue and balance to longer term posture issues and joint discomfort. Core strengthening excercises could potentially be hard, repetitive and arduous, however being a parent of a child with complex disabilities, I’ve seen him struggle through testing, assessments and even daily tasks and refuse to see more of his life taken up with things he just has to endure and doesn’t find fun.
Play-based Physiotherapy aims to present effective excercises in a play-based situation focusing on activities that each child finds fun without feeling like “therapy”. Because the same outcome can be achieved using many differing techniques, it allows me to choose the options your child enjoys most. These can be anything from hydrotherapy ,outdoor exploring and balancing activities, obstacle courses and indoor activities including swiss ball activities for plank exercises made fun by combining memory and other games with each roll.

25/12/2024