Within the Early Years pathway, we work with babies and pre-school children 0-4yrs. We see a variety of children who may or may not have a medical diagnosis, this can include:

  • Those with a delay in their motor development, such as being late to crawl or walk.

  • Concerns with regards the way they walk, such as intoeing or out toeing or being flat footed. 

  • Children with more complex needs such as Cerebral Palsy and Down’s syndrome.

It is important to remember your baby is unique and will develop in their own way as all babies develop at different rates. They are not only growing physically but learning all about the world around them.  All sorts of different things will influence and affect how your child develops and it is really important to remember that no two children are the same.  Your Paediatric Physiotherapist will advise you on lots of different positions and play activities to help your child develop the skills they need. We will work through the milestones in stages, for example we will work on tummy time before expecting them to crawl and work on standing before we expect them to walk as this helps them to learn the important skills and build up their muscle strength ready to conquer the next challenge.  Little and often throughout the day, at times when they are not hungry or due a nap is the trick. Click here for a poster to help: Don't Delay the Play

Our information is intended to provide some useful guidance around the expected ages the average baby will achieve their early development milestones.  Also highlighted are some suggestions and advice around positions and activities that will support you to encourage the development of your baby’s gross and fine motor skills as well as their communication and interaction.

Click below for guidance on typical development.

Physical activity guidelines for children (under 5 years)

Being physically active every day is important for the healthy growth and development of babies, toddlers and pre-schoolers.

For this age group, activity of any intensity should be encouraged, including light activity and more energetic physical activity.

NHS Website

Physical activity ideas for under 5's


All movement counts. The more the better.


  • tummy time
  • playing with blocks and other objects
  • messy play
  • jumping
  • walking
  • dancing
  • swimming
  • playground activities
  • climbing
  • skipping
  • active play, like hide and seek
  • throwing and catching
  • scooting
  • riding a bike
  • outdoor activities

Common early years conditions

Below you can find out more about these common concerns seen in babies, toddlers and young children. 

Flat feet, tip toe walking, in-toeing, knock knees and bow legs are all part of a child's normal development which they grow out of during early childhood. 

Click below for further advice. If you are still concerned after reading these or following our advice, please see our getting more help page. 

When to seek advice:


Please seek medical advice if your baby:


  • Keeps their head turned to one direction when awake and/ or asleep
  • Develops a flattened area on their head
  • Has a lump/ swelling on one side of their neck
  • Is moving one limb less than the others
  • Keeps their thumbs tucked into their palms or their hands fisted
  • Has a leg length difference
  • Feet have a fixed position or limited movement
  • Is not meeting their developmental milestones as expected
  • Have stiff leg(s) and/or arm(s)
  • Feels floppy 
  • Has jerky or atypical movements


You should also seek advice if you have any of the following concerns regarding your child’s development:


  • Age two: Not able to walk independently Not able to walk up and down stairs holding on
  • Age three: Not able to walk up and down stairs independently Not able to run or jump
  • Age four: Not able to walk, run, climb, jump and use stairs confidently. Not able to catch, throw or kick a ball


CSP Website