As children’s physiotherapists and occupational therapists, we have the privilege of working alongside children with cerebral palsy (CP) and their families every day. CP is the most common cause of physical disability in childhood, and while it presents unique challenges, early intervention and a team-based approach can make a life-changing difference.
What is Cerebral Palsy?
Cerebral palsy is a group of conditions that affect how the brain controls muscles and movement. It often results from early injury or changes to the developing brain before, during, or shortly after birth. The way CP presents can vary greatly. Some children may have mild balance difficulties, while others may experience significant differences in movement and coordination.
How is Cerebral Palsy Classified?
The Gross Motor Function Classification System (GMFCS) is a widely used tool for describing the movement abilities of children with cerebral palsy. It is split into five levels, ranging from least to greatest physical support needs. Each level reflects typical sitting, walking, and mobility, helping clinicians, families, and educators understand a child’s physical abilities and plan for therapies or equipment needs.
GMFCS Levels Explained
Level I – Walks Without Limitations
Children can walk, climb stairs, run, and jump just like their peers, but may have slightly reduced speed, balance, or coordination during physical activities.
No assistive mobility devices are needed.
Level II – Walks With Limitations
Able to walk without assistive devices, including indoors and outdoors, and can climb stairs by holding a railing.
May have trouble with uneven surfaces, crowds, or long distances.
Limited ability to run or jump.
Level III – Walks Using a Hand-held Mobility Device
Can walk indoors or short distances outside with a mobility aid (like a walker or crutches).
May use a wheelchair for longer distances or in the community.
Can climb stairs with a railing and support.
Level IV – Self-mobility With Limitations; May Use Power Mobility
Walking ability is limited, even with devices.
Primarily uses a wheelchair (manual or power) for mobility, but may use some walking with support at home or school.
May be able to do standing transfers.
Level V – Transported in a Manual Wheelchair
Has major limitations in movement, including head and trunk control.
Cannot walk or sit independently, even with supportive equipment.
Relies on others for mobility, usually requiring a wheelchair and significant physical assistance.
How do Physio and OT Support Children with CP?
Every child with cerebral palsy is unique, so therapy is always tailored to their strengths, needs, and family goals.
Children’s Physiotherapy focuses on improving mobility, strength, balance, and coordination. Therapy often looks like play-based exercises and strength training to help children achieve milestones such as rolling, sitting, crawling, standing, or walking. Physios also support management of muscle tightness, prevention of contractures, and prescription/adjustment of supportive equipment such as activity chairs, walkers, or wheelchairs.
Children’s Occupational Therapy helps kids succeed in everyday activities including feeding, dressing, play, and school participation. OTs break down complex skills such as using cutlery, drawing, or getting on and off the toilet. They also support children with sensory processing challenges, helping those who are more sensitive to sound, touch, or movement. Adaptive strategies, assistive technology, and home or school modifications can help children feel more confident and independent.
Therapy Beyond the Clinic
Effective therapy is more than just what happens in a session. Our role includes supporting children across all the environments where they live, learn, and play. We work closely with families, teachers, and other health professionals, and provide education and advocacy so families can access the right supports and feel empowered along the way.
Our children’s physio and OT team are here to walk alongside families at every step of that journey. To make an appointment to see either Bec, our children’s Physiotherapist, or Renae, our children’s Occupational Therapist, please contact our reception team.