Physical Therapy and Cerebral Palsy

Cerebral Palsy and Other Movement Disorders

Children with cerebral palsy and other movement disorders often get a late start out of the gate when it comes to gross motor development.  They have limitations in their movement that can range in severity from a child who has stiffness in one leg and arm to a child who does not have head control.  

Children with cerebral palsy and other movement disorders often have areas of increased stiffness and often decreased stiffness in their core.  Difficulty moving in positions against gravity and difficulty separating different parts of the body during movement are common.  

Physical Therapy and Cerebral Palsy and Other Movement Disorders

During a physical therapy evaluation a child’s gross motor skills and movement patterns are observed.  The child’s flexibility, strength, and sensory organization will be assessed.

Based on the evaluation findings, physical therapy can include:

  • Strengthening exercises
  • Stretching
  • Balance activities
  • Gait training

The SMILE Approach For Children with Cerebral Palsy & Other Movement Disorders

At Kid PT we are focused on uncovering hidden potential, exploring what children CAN do and we refuse to place a ceiling on a child’s possibilities.  Our approach can help children to skyrocket their skills to the next level by eliminating differences in the body that you may not know are even there, until we show you where to look.   

Kid PT uses the Sensory Motor Integration for Life and Education (SMILE) approach to help children with movement disorders achieve their goals.  The three levels of the SMILE Approach build up the core foundations of movement that some children have not developed on their own.  The three pieces of SMILE work together to ALIGN the body, ACTIVATE the neuromuscular system, and INTEGRATE the sensory-motor systems.  These three pillars work as a sequence of increasing sensory-motor complexity to build a solid foundation for movement. More advanced developmental skills for learning and daily life can then develop with more spontaneity and less intervention.    

Learn More About the SMILE Levels of Intervention


  • Addresses the ability to move in all directions from the inner core out.  A child needs to be able to twist to the left and right, to sit up tall or slump down, and to make each side of the body longer.  All of these movement patterns need to work in combination for balance and motor control to develop.
  • The SMILE Approach assesses a child’s available movement patterns and identifies problem areas.  Releasing these tight spots can make rapid change in a child’s available movement and skills.  This approach gives parents the tools to create and maintain alignment in their child.  Simply by cuddling with your child in certain positions or guiding them to perform certain preferred movement patterns, you can be preparing your child for more success in their motor skills.  As children get older they can be empowered to take over this role and manage their bodies with greater independence.
  • For some children, especially children with developmental delay without a neurologic injury, Level 1 will be all they need.  For other children, they will need to move on to Level 2 and 3 of the SMILE approach.


  • Once a child has the available mobility to achieve a balanced core, many children need additional guidance to learn how to turns those muscles on.  Once a child learns how to combine deep breaths with good posture, they are ready to gain strength, endurance, and motor control in order to use that control all day.
  • Many children with movement challenges have used compensatory patterns since infancy, such as breath holding to keep their balance.  This solution doesn’t work well when the child has to breathe or talk.  A lack of deep breathing skills can affect a child’s balance, can cause constipation, limits turning on the calming system that opposes the fight-or-flight response and can affect visual skill development.
  • The SMILE approach is not your typical core strengthening program!  Typical core strengthening does not focus on the activation of the inner core as preparation for movement.  We focus on quality, not quantity.  The breath and control of posture are integral to this level.


  • The integration  level brings the sensory-motor team online and into daily function.  This is accomplished in different ways depending on the motor abilities.  The goal of Level 3 is to make movement as automatic as possible so that children can focus on higher level skills, whether it is moving through the classroom without bumping into things or learning algebra.
  • Integration is a key for a child to move their movement skills to the next level.  We move through daily life without consciously thinking about how we are moving our bodies.  We can walk while daydreaming without bumping into a street sign and we can sit in a chair without falling off while reading and writing.  This may sound natural for many of us, but children with postural deficits use excessive energy, attention and focus to fulfill all of the expectations they face each day.

By focusing on the building blocks of movement through the S.M.I.L.E. approach, children can build the foundations they need for success in daily life and in school.  Call Kid PT today to learn more how we can help your child unlock their potential.

If you have concerns both in your child’s movement patterns as well as their engagement with you, contact Kid PT here or Call us at 908-543-4390 to arrange a screening.