Physical Therapy and Down Syndrome

Down Syndrome

Children with Down syndrome or Trisomy 21, have differences in their gross motor development.  They typically have have low tone, loose ligaments and decreased strength, which can make it more difficult for them to learn gross motor skills.  They are often extremely flexible in their arms and legs and less flexible in their core, leading to compensations in their movement patterns.  Children with Down Syndrome will often benefit from orthotics to increase the stability of their feet and ankles.  It is sometimes necessary for an infant with Down Syndrome to have needed heart surgery in infancy due to congenital heart defects.  Children who have gone through surgery are especially at risk of having core imbalances due to immobilization after surgery and also due to scar tissue.

Physical Therapy and Children with Down Syndrome

Physical therapy for children with Down Syndrome focusses on improving their quality of movement.  In the long term this will improve how the child walks and keeps up with their peers.  Many children with Down Syndrome benefit from specialty clothing and orthotics, such as Hip Helpers (, abdominal binders, theratogs ( and Sure Step orthotics (  Pre-walkers, beginning at the age of independent sitting, can benefit from a Treadmill Program to help walking skills develop at a quicker pace and with better quality.

The SMILE Approach for Children with Down Syndrome

Therapists at Kid PT have the same expectations for children with Down Syndrome as we do any other child.  We do not place limits on our expectations and encourage parents to do the same. We use the Sensory Motor Integration for Life and Education (SMILE) approach to help children with Down Syndrome to achieve their goals.  The unique focus at Kid PT for children with Down Syndrome works to eliminate barriers that can take impact a child’s movement abilities and propels them forward.

Learn More About the SMILE Levels of Intervention


  • A child with low tone and excessive flexibility in some of their body, often also has tightness, restrictions and asymmetries in their core, where the foundations of postural control need to develop. Freeing up these imbalances, opens up more possibilities of movement to develop.  Children with Down Syndrome often have tightness in the front of their bodies, making it more difficult to sit up tall and to develop quality upright posture when walking.


  • Babies on the Treadmill!  An exciting area of research has emerged to help babies with Down Syndrome learn to walk.  Children with Down Syndrome learn to walk at an average of 2 years of age compared to children without Down Syndrome, who learn to walk at an average of 1 year of age.  Treadmill training aims at earlier walking in order for greater cognitive, social, and language gains, and to improve the long term quality of walking.  
  • To read and watch video of one family’s experience with their son on the treadmill click hereTo read details on how it is done click here.To read a research article on the topic click here. To visit us and try out the treadmill call us at (908) 543-4390.

By focusing on the building blocks of movement through the SMILE approach, children can build the foundations they need for success in daily life and in school.  Call us today to arrange a visit.

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.