Dublin South Central
Community Paediatric Service
Bru Chaoimhin Centre
Cork Street
Dublin 8
NOTE: This report is strictly confidential and is for the information of the persons to whom it is
addressed. No responsibility can be accepted if it is made available to any other person.
DUBLIN SOUTH CENTRAL
CONFIDENTIAL AND WITHOUT PREJUDICE
PHYSIOTHERAPY REPORT
Name:
Address:
D.O.B.:
Date of assessment:
Age at assessment:
School:
Date of Report:
Reason for Referral:
X was referred for Assessment of Need by X. His Mum reported on the day of the
Physiotherapy assessment that her main concerns with regard to X physically are

Process of Assessment:
The current assessment was informed by the following sources;
1. Review of all file information;
2. Individual physiotherapy assessment on XX, including parent interview, clinical
observation and the Peabody Developmental Motor Scales – 2nd Edition.
Background Information:
Family Information:
Birth & Medical History:
Developmental Milestones:
Strengths & Interests:
Hearing & Vision:
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Educational History:
Previous Assessment History:
Assessment:
Overall Impression:
X presented as a well behaved shy boy who participated well in the assessment process.
He participated in all aspects of the physiotherapy assessment to the best of his ability.
His eye contact was intermittent and he vocalised only with much encouragement.
Interaction, Co-operation, Completion of Tasks, Comprehension.
Observation:
X has normal posture and no spinal deformities. He presents with a mild calcaneovalgus
foot position however this is within normal developmental parameters.
Muscle Tone:
X presents with normal muscle tone.
Range of Motion:
X’s range of motion at all his joints is within normal parameters.
Right
Left
TA (Knee flexed)
TA (Knee extended)
Knee extension
Popliteal angle
Hip external rotation
Hip internal rotation
Active
90°+
90°+
0°
Active
90°+
90°+
0°
45°
45°
45°
45°
Muscle Power:
1. Shoulder Control
This relates to the muscle strength and joint laxity around the shoulder girdle. It is an
important factor for hand function and a prerequisite for writing function. It was tested
during activities such as maintaining the crab position and crawling. X had no difficulty
during these activities indicating good shoulder control and stability.
2. Pelvic Control
This relates to the muscle strength and joint laxity around the pelvis. It is required for
activities such as standing on one leg, hopping and kicking a ball and was tested in
activities requiring weight bearing through one leg.
X could balance on his right lower limb for Y seconds and his left lower limb for Y seconds.
Age appropriate is Y seconds indicating
3. Active trunk extension
This relates to the muscle strength of the back muscles and is required for trunk control.
Together with shoulder and pelvic control it directly relates to balance. It was tested by
asking the child to hold both arms and legs in the air whilst lying on their tummy. X was
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able to hold an age appropriate extended position for Y seconds which is an age
appropriate time for his age.
4. Active trunk flexion
This relates to the muscle strength of the stomach muscles and is required for trunk
control. It was tested by asking the child to transition from lying to sitting without using
upper limbs for assistance. X required the use of his upper limbs to assist with this
transition which indicates some abdominal weakness. X was also asked to hold a curl up
position and he was only able to maintain this position for Y seconds. This also indicates
some abdominal weakness.
Coordination:
1. Eye/hand co-ordination
This is the ability of the eyes and the hands to work together and is required for activities
such as writing and throwing and catching balls. X was able to throw and catch a ball on
Y/10 occasions with no difficulty. He was also able to bounce and catch a ball to himself
on Y/5 occasions and throw a ball up in the air and catch it on Y/5 occasions indicating an
average ability with more advanced ball skills.
Also comment on directionality, appropriate gradation of force and accuracy.
2. Eye / foot co - ordination
This is the ability of the eyes and the feet to work together and is required for activities
such as kicking balls and walking over rough surfaces. It was tested in kicking ball
activities. X demonstrated an ability to kick a ball well with his right lower limb with good
force and directionality. His demonstrated some difficulty with kicking a ball with his left
lower limb both in kicking force and directionality. X also struggled to trap a ball and
accommodate to directional changes of the activity. This indicates mild eye/foot coordination difficulties.
Spatial Awareness:
This is the ability to judge distances and directions of himself in relation to other objects.
X was able to negotiate the room and all its obstacles with no difficulties.
Midline crossing:
This is the ability to cross a limb from one side of the body to the other and is required
for activities such as writing. X demonstrated no difficulties in this area demonstrating an
ability to walk sideways crossing one foot over the other in both directions.
Directional Awareness:
This is the ability to move in different directions such as forwards, backwards and
sideways. X was observed to move in all directions without difficulty.
Symmetrical Integration:
This is the ability to move both sides of the body simultaneously in identical patterns of
movement. X was able to jump forward with two feet together consecutively 6 times with
no difficulty.
Reciprocal Integration:
This is the ability to move both sides of the body in opposite patterns of movement and is
tested in activities such as crawling, wheelbarrow walking (over a peanut ball), skipping and
walking on a balance beam. X was tested on all these activities and performed well.
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Balance:
Sitting:
 static
 dynamic
Standing:
 static
 dynamic
Right lower limb:
Left Lower limb:
Balance Beam:
Stepping Stones:
Gross Motor:
Supine: X had independent floor mobility including transitioning from supine to prone,
into and out of sitting, rolling and crawling.
Sitting: X demonstrated a variety of sitting postures including long sitting and tailor
sitting and demonstrated a good posture in these positions with no evidence of hamstring
tightness or trunk weakness.
Kneeling: X could attain high kneeling and half kneeling independently. He had no
difficulties maintaining his balance when challenged with the addition of having to throw
and catch a ball.
Standing: X could transition from floor to standing through half kneeling. He
demonstrated good static and dynamic balance when challenged.
Gait: X demonstrates an appropriate gait pattern with even stride length and reciprocal
arm swing. X also demonstrated and ability to walk on his toes for Y steps and walk on
his heels for Y steps.
Running: X demonstrated a co-ordinated running posture. He demonstrated the ability to
stop suddenly within 1-2 steps and turn in the opposite direction.
Stairs: X had no difficulty on stairs and ascended and descended with a reciprocal pattern
whilst holding onto the handrail.
Hopping: X demonstrated an ability to hop on both his right and left legs with no
difficulties.
Jumping: X could jump from side to side, forwards and backwards. His movements were
fluid and co-ordinated.
Bicycle/Tricycle/Scooter/Balance bike:
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X was assessed using the Peabody Developmental Motor Scales – 2nd Edition (PDMS-2).
The PDMS-2 was used to measure X’s gross motor and fine motor ability. Five subtests
were used:
1. Stationary subtest – this measures the child’s ability to maintain control of his
body within its centre of gravity and maintain balance. It includes items such as
sitting, reaching and standing on one foot. X achieved a percentile rank of Y which
means Y% of children this age would be expected to achieve a score to this or
less. This places X in the below average range for this skill area.
2. Locomotion subtest - this measures the child’s ability to control his body when
moving from one place to another. It includes activities such as walking, running,
jumping, standing balance and climbing stairs. X achieved a percentile rank of 1
which means Y% of children this age would be expected to achieve a score to this
or less. This places X in the very poor range for this skill area.
3. Object manipulation subtest – This measures the child’s ability to throw, catch
and kick balls. These are necessary skills for development of visual-motor
integration (hand/foot - eye co-ordination). X achieved a percentile rank of 5
which means Y % of children this age would be expected to achieve a score to this
or less. This places X in the poor range for this skill area.
4. Grasping subtest – this measures a child’s ability to use his or her hands. It
begins with the ability to hold and object with one hand and progresses to actions
involving the controlled use of the fingers of both hands. X achieved a percentile
rank of Y which means that Y% of children this age would be expected to achieve
a score to this or less. This places X in the average range for this skill area.
5. Visual-motor integration subtest – this measures a child’s ability to use his or her
visual perceptual skills to perform complex eye-hand co-ordination tasks, such as
reaching and grasping for an object, building with blocks and copying designs. X
achieved a percentile rank of Y which means that Y% of children this age would be
expected to achieve a score to this or less. This places X in the below average
range for this skill area.
The Gross Motor Quotient (GMQ) measures the child’s gross motor development. This is
the ability to use the large muscle systems to react to environmental changes, assume a
stable posture when not moving, move from place to place, and catch, throw, and kick
balls. The GMQ is derived from the standard scores of the three subsets - Stationary,
Locomotion and Object Manipulation. X scored in the Y percentile which places him in the
very poor ability range for his gross motor skills.
The Fine Motor Quotient (FMQ) measures the child’s fine motor development. This is the
ability to use his or her fingers, hands and to some extent arms to grasp objects, stack
blocks, draw figures and manipulate objects. The FMQ is derived from the standard
scores of the two subsets – Grasping and Visual-motor Integration. X scored in the Y
percentile which places him in the below average range for his fine motor skills.
The Total Motor Quotient comprises the scores of the two composites – the GMQ and the
FMQ and estimates the overall motor abilities of the child. X scored in the Y percentile
which places him in the poor range of abilities for his age.
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Behaviour and Communication during assessment:
X was extremely well behaved during the assessment. He waited patiently between
activities for instruction by the therapist.
Main physical difficulties from a physiotherapy perspective:
1.
Sample
Main difficulties:
1. Difficulties modulating his arousal levels.
2. Significant attention and concentration difficulties.
3. Verbal and social communication difficulties.
4. Poor safety awareness
5. Balance difficulties.
6. Eye-hand & eye-foot co-ordination difficulties.
7. Stair climbing difficulties.
8. Hopping difficulties.
Summary:
Comment on the need for physiotherapy and the most appropriate service provider
Samples
X does not require physiotherapy intervention. His difficulties outlined above can be
improved by implementing a home programme of recommended activities. I have
enclosed these activities along with the report to X’s parents. I have also advised his
Mum to investigate some extra-curricular activities that X may enjoy such as karate and
golf.
X presents with some physical deficits such as balance and eye/hand, eye/foot coordination difficulties. However X possesses the fundamental components required to
achieve these skills. It would appear that his difficulties in other domains such as his
ability to modulate his arousal levels, concentration and attention levels and processing
abilities are impacting on his physical skills.
X would benefit from physiotherapy intervention. This would best be provided via a
multi-disciplinary team approach allowing his needs across all parameters to be
addressed collectively. I have made some recommendations on strategies to implement
in order to improve his performance during gross motor activities.
___________________________
Karen Kinsella
Senior Physiotherapist
Dublin South Central Community Paediatric Service.
Cc. client’s file
Cc. parents of X
Cc. Ms Yvonne Browne, Assessment Officer, Bru Chaoimhin Centre, Cork Street, Dublin
2.
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