My name is Vathana Sackett and I am a specialist children and young peoples physiotherapist seeing clients from 0-23. I work as a private independent physiotherapist in the Bromley and Kent area.

I offer specialised treatment to help each client reach their maximum potential. I have a very practical and creative approach to helping you understand the difficulties experienced and adapting physiotherapy advice into your lifestyle.

Worried about my baby’s flat head

Some babies tend to have a head preference to one side, this is called Plagiocephaly or Torticollis. This preference to look to one side can cause a flat spot on the back of the head because they sleep for so long in one position and the babies skull is so soft. Some families notice the ear can be pushed forward or the head is tipped to one side.

For some children this ongoing posturing if left untreated leaves your baby with a misshaped head which can only really be corrected with a helmet which may cost a couple of thousand of pounds.

The best and simplest way to resolve the situation is to manage it early, before 6 months old.

I would suggest that you try and keep your baby off the flat spot by placing them on the opposite side when they are awake and change their position regularly.
Always approach the baby from their least preferred side – e.g. When holding, feeding, stimulating, have the window and all activity occurring this side.
Lastly try and encourage Tummy time and looking up. Little and often is the trick.
I have recently seen these Tortle hats which are worth trying.

If you feel stuck please feel free to get in contact for further help or to get a personalised assessment.

Special needs i pad apps.

I have some great advice for parents of children with special needs. Over Christmas I purchased an i pad and it has presented me with multiple opportunities to play with my daughter and now consider how to use it in my therapy.
I am treating a patient with very limited hand skills- swiping and whole hand touch. So I have done some homework looking up as many apps for the i pad as possible that will allow her to engage in play with her limited hand skills abilities.
Bellow is the list I have put together identified from the apps blurb, which looks like it could meet the needs of children that have very limited hand skills to help them engage them with cause and effect play.
I will slowly try the apps out and feedback on this site but if any of you have experience please share you opinion.
The i pad presents a fantastic opportunity to develop learning skills and improve easy and engaging interaction for special needs children.
Here are the apps I would recommend.

Kids song machine 2 around the world
Baby’s musical hands
I baby button
Baby rattle toy
Touch trainer, autism and special educational needs
Random touch
Touch switch
Attainment switch
Musical bubbles
Color drops – like a drawing app but loads of stimulation with every mark made
Baby UI
Baby touch shapes
Baby moving shapes
Baby aquarium
Baby bubble touch – great visual stimulation but audio is limited

How to progress your childs throwing skills

Here are a few ideas that you can progress through. It starts from easy to more difficult.

These suggestions will be helpful to children with co ordination difficulties.

  • Popping and catching bubbles can help with hand eye co ordination
  • Start with larger balls then move onto smaller ones
  • Begin by rolling the ball to ensure sucess, then try throwing it
  • Use different textures to keep interest (paper, balloons, tennis balls, bean bags and socks)
  • Start games in a sitting position, then move to standing to make it more difficult
  • Offer the ball to left and right hands to improve co ordination
  • Guide your child’s hand through the movement
  • Cheer at all attempts
  • Have a target – eg you, milk cartons, bucket, hula hoop
  • Move the distance of the target, and also move it to the left or right.
  • Take turns (make it a game)

Tummy time for tots

Physios say playtime on tummy is good for babies’ physical development

Many parents could be holding back their babies’ growth and development by not placing them on their tummies during waking hours, warn paediatric chartered physiotherapists.

Statistics show 19 per cent of mothers with children under 6 months old never put their babies on their fronts to play and only 22 per cent regularly give their babies tummy time (1).

The Association of Paediatric Chartered Physiotherapists (APCP) is calling on more mothers to give their babies the best start in life by placing them on their tummies more often when they are awake to optimise growth and movement development.

Peta Smith, Vice Chair of the Association of Paediatric Chartered Physiotherapists (APCP), says: ‘Since the Department of Health recommended healthy babies should sleep on their backs, physiotherapists have noticed a drop in babies placed on their tummies to play during their waking hours. This can result in a delay in acquiring movement skills.

‘Research shows babies placed on their backs to sleep who were then placed on their front for extra time during the day were able to roll, crawl, sit, pull to stand and eventually walk earlier than those who were mainly placed on their backs.’

Although babies predominantly placed on their backs eventually catch up in their development skills, paediatric physiotherapists say the first few months of life are an important time for babies to start to become aware of their bodies and begin to learn movement.

Peta says: ‘By spending time on their tummies babies learn to move from side to side and this helps them learn to reach and crawl. Not only does tummy time help with coordination, balance and postural control, which is the foundation for all movement skills, it increases babies’ confidence and independence helping them to become motivated to explore their surroundings as they learn to control their bodies.’

Tummy time is an important sequence in baby development. It helps with coordination, balance and postural control, which is the foundation for all movement skills.
Paediatric physiotherapists say placing babies predominantly on their backs during waking hours means they can miss out on some important aspects of movement development. They do not have the opportunity to lift their heads against gravity to explore their immediate environment; experience a delay in learning to take weight on their arms; and often develop intolerance to tummy time. Physiotherapists are urging parents to make tummy time part of a baby’s daily routine and limit their time spent in baby seats, carriers and swings.

Joyce Epstein, Director at the Foundation for the Study of Infant Deaths, says: ‘We support the work paediatric physiotherapists are doing in this important area. Babies who do not sleep on the back have a nine times increased risk of cot death. However, when babies are awake they should spend time on their tummies  – not always flat on the back. This aids their healthy development.’

(1) Foundation for the Study of Infant Deaths (FSID)

CSP Press office June 2006

Don’t Use Baby Walkers

Just under half of all children using walkers will experience an injury 2

 Baby walkers cause delay in normal development 1

Parents believe putting babies in walkers provides two benefits;

To keep them safe and encourage them to walk.


 The use of baby walkers for normal healthy infants are neither necessary nor recommended for a child’s development.

There are two main reasons



Babies walk when they are ready. This will depend on their development, personality, experience and opportunities.

  • Using baby walkers limits the amount of time spent in other positions. The lack of opportunity to practice floor skills like rolling, crawling and kneeling delays walking, as they are missing out on these normal experiences.
  • Walkers interfere with a child’s vision of his feet and body when he moves. Visual feedback is important for a child to learn about his movement.


  • The walker doesn’t encourage normal walking and the child may learn to walk with an abnormal pattern such as “walking on toes” and going backwards. Ultimately this may affect their quality of walking in later life
  • Babies in walkers stand on their toes, because their bones and muscles are not ready to support their weight. 4



Babies can reach things you don’t expect. Especially objects at higher levels. (cookers, plants and ornaments)
  • Babies can not move away from danger when they are in a walker. It is possible the walker can tip, or fall down a height/ stairs.

More than 14,000 children go to hospital each year because of baby walker injuries 2


  • Documented evidence has shown that babies have been injured whilst in baby walkers. They have been banned in Canada and countries in Europe. 4

1 Garrett et al., 2002  Locomotor milestones and babywalkers, British medical Journal

2 NH Depart. Health and Human Services, Childrens Hospital Dartmouth

3 Australian Physiotherapy Association 2002 Press release

4 Jentel 2004 Neonates CD Rom


Don’t be in a rush to see your child walk. All floor skills are important for preparing your child to stand, balance and walk independently.

Place guards in front of dangerous places in the home and let your child move freely. Use a play pen to safely enclose your child whilst you do tasks that take you out of the room.

Remember – nothing takes the place of a watchful eye.

NEVER leave a baby alone

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