As a parent, we are striving to provide and support our children so they can flourish. Although we are considering how we are influencing their day-to-day, we are also looking further into the future. How can we help and prepare them for adulthood? This is even more challenging if your child has a diagnosis of Cerebral Palsy. There are so many other elements to their care that you need to consider and make choices about. Treatments or Therapy is one of them and trying to navigate this area can be a minefield.

Iona Novak, Cathy Morgan, Michael Fahey, and their incredible team have produced a guide through their extensive systematic review. If you are not familiar with them, they are leading experts within the field of Cerebral palsy (across the world).  They have done the hard work for us, scouring the literature to determine what evidence supports specific interventions and developed a novel traffic light system to make it clearer. Treatments or interventions are clearly grouped into “Do it” (green), “Probably do it” (Yellow) with a clear cut-off with a “worth it line”. This line highlights that areas below this line are lacking in evidence, or if in red are likely to cause harm. The total opposite of what you are trying to achieve as a parent and clinician.

Evidence for prevention and treatment of CP from Novak et al (2020)
Novak, I., Morgan, C., Fahey, M. et al. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep 20, 3 (2020).

It is great to see that therapy options offered at Auckland Children’s Therapy (Motor and Early Intervention)  are in the “Do it” or  “Probably do it” which supports its effectiveness in helping children with CP. If you would like to know more about any of the interventions mentioned above, we are happy to discuss these and see if these are interventions you can add to your child’s therapy program.



Reference: Novak, I., Morgan, C., Fahey, M. et al. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep 20, 3 (2020).


Tummy-time doesn’t have to be a battle although it can feel like it when your babe is protesting. Starting tummy-time when they are newborns is a great place to start but it can be hard to find when to fit it in. In the first few weeks, it feels like they are sleeping, feeding, pooping, and crying on repeat. The ‘awake and ready to play’ window for tummy time just doesn’t seem to happen. Keep trying but often parents find it easier the older they get. Generally from eight weeks on they have longer ‘awake’ periods. It is also good to try and work out what might be making tummy-time less enjoyable for your baby. This might require an external pair of eyes but things like reflux, neck and shoulder strength or family history of very flexible joints can be factors.

How can we overcome the tummy-time battle?

  1. Set the right expectations. They might only manage 20 or 30 seconds their first few Tummy-time supporttimes before they start getting grizzly.
  2. Alignment helps. Help position their elbows inline or slightly in front of their shoulders and tucked into their side. When they are first learning to push up on their tummy, they often struggle to keep their arms against their side.
  3. Get creative and try different positions. Tummy-time can be over your lap, supermans in the air when you bring them through from their bedroom, lying tummy to tummy on your chest, lying across a big ball (starting semi-upright (way easier for them), after a change on their change mat.
  4. Use distractions and keep it fun. Get down to their eye level, try lying face to face on the mat. Use a mirror to see themselves or crinkly noisy fabric that they can explore.
  5. Practice practice practice. They need to build up their muscle strength and endurance. Roll them off their tummy, keep it playful, after a short rest, try again. Practice a few times in a row.  It is also important to practice tummy-time on the floor or a firm surface (carpet or mat) as this is where they will learn how it feels to have weight through their shoulders, forearms, and tummy it is very different from lying tummy to tummy with you. They will feel little weight shifts that are vital for reaching and crawling development.


Is your child anxious about standing? or walking with their leg turned after their fractured leg has healed? These exercises will help. 

Some young children need a little helping hand to start walking after they get the “all clear” from the doctors. It doesn’t need to take a few weeks of them struggling to walk or need you to continue to carry them around. Unfortunately, not all children are able to be seen by a hospital children’s Physio when their cast has been removed but not to worry.  I have put together a FREE booklet of exercises that you can start with your child to help speed up their progress. Try these exercises if you find they are walking with their foot turned out, finding it hard to bend their knee, or walking like they have a ‘peg leg’. Download a copy here or email us at to get your free copy.

Download FREE booklet here: Lets get playing again!




When your baby is able to sit by themselves and are happily rolling side to side then they are probably ready to learn to sit up. This technique will teach them how to transition in and out of sitting. We start off by practicing the movement with them, this will show them how to shift their weight, what muscles to use and put the steps into sequence. As they get stronger they will need less hands-on and you might only start the movement for them.  It is important that you practice this from each side (side-lying start position) even if your child has a favorite side to roll to. I often recommend to parents whose goal is for their baby’s to be able to sit up and lie down by themselves, to do this after each nappy change.


  1. Encourage baby to roll to their side  e.g. right
  2. Place your right hand under their right shoulder
  3. Place your left hand just above their hip
  4. Gently pull down on their left hip whilst giving support to their trunk with your right hand
  5. Give them time to try and place their right hand on the floor and push up (straighten their arm)

Success- Sitting!



Just like the other muscles in your body, your hands can get tired when over worked and can get cramp. Holding a pen and writing for three hours will definitely put your small hand muscles to the test. Use either exercise putty, Plasticine or firm Play dough to help give your hands the pre exam work out that they need. Do make sure that you give your hands a rest  a few days before your exam, just as you would  before an important running race or sporting competition.  Also consider the weight and thickness of the pen you are planning to use for the exam. 

Place the putty in the hand you write with. When doing the below exercises try to not use your other hand or another surface such as a table to shape it. 

To start

  • roll it out between your fingers to make a Snake  
  • make a ball 
  • lay the snake on a tablepinch the snake using your thumb and a different finger all the way from one end to the other end e.g. thumb and first finger, thumb and second finger.
  • put the snake back in your hand and roll it up to make a snail
  • use your thumb and fingers to flatten it out to make a pancake
  • place the pancake over tented fingers (fingers all touching each other) and open up your fingers to make spider webs

Repeat as many times as your like- aim for your hand to feel tired.  


Our practice philosophy is to promote strength and development through play and exercise. We provide a holistic and comprehensive approach that is backed by clinical experience. We can create a tailored individual program to be implemented at home, childcare or school to help meet your child and family’s goals.

Copyright by Auckland Childrens Physio 2020. All rights reserved.