Physical Therapy

Physical therapy (PT) is evaluation and treatment by a licensed physical therapist, a clinician who diagnoses and manages movement problems in people of all ages.¹ For children it covers gross motor skills: head control, rolling, sitting, crawling, walking, balance, coordination and strength. Every US state now allows you to see a physical therapist without a physician referral in at least some circumstances, though your insurance may still ask for one.² For a child under three, a parent can refer directly to early intervention and the evaluation is free.³

What physical therapy is

Physical therapists are licensed health care providers who evaluate, diagnose and manage movement problems in people of all ages and abilities.¹ For children that means the gross motor skills play and school depend on; for adults it more often means recovering movement after injury, surgery or illness.

A pediatric physical therapist assesses how a child moves and why movement is difficult, then works on motor milestones, posture and core stability, walking, balance and mobility, with positioning, equipment or orthotics where useful. The goal is function and participation: climbing the playground ladder, keeping up with friends, managing the stairs at school. Much of the work looks like play, because a child practices a movement willingly when it gets them something they want.

What physical therapy helps with

PTs work on how a child moves through the world. The condition pages carry the detail and their own sources; this page explains what the therapist does:

• Delayed motor milestones: late rolling, sitting, crawling or walking, which can be part of global developmental delay.
• Torticollis, the head tilt and turn preference in babies; the American Physical Therapy Association’s Academy of Pediatric Physical Therapy publishes a clinical practice guideline for its physical therapy management.¹⁰
• Flat head (plagiocephaly), which can come from a tight neck muscle, as in torticollis, or from how a baby lies; a physical therapist helps work out the cause and the treatment.⁶
• Low muscle tone (hypotonia), where a baby or child seems floppy or tires quickly.
• Toe walking that persists, and W-sitting questions.
• Posture and core stability, including postural difficulties linked to sensory processing, and scoliosis in children and teens.
• Coordination and balance: dyspraxia (developmental coordination disorder) and clumsiness that keeps a child out of sport.
• The motor and mobility needs of cerebral palsy, Down syndrome and other neurological and genetic conditions.

For cerebral palsy, a 2020 review that graded the evidence rated many active approaches effective: goal-directed training, task-specific training, mobility training, strength training, treadmill training and home programs.⁷ Working directly on the activity a child is trying to do is what task-specific and goal-directed training mean in practice.

Who physical therapy helps, by age

From infancy through the teen years. Early on, PT supports head control, rolling, sitting and walking; later, coordination, strength, endurance and sport. Each stage has its own page:

• Physical therapy for infants and toddlers (0 to 3): torticollis, head shape, and the early motor milestones, usually through early intervention.
• Physical therapy for preschoolers (3 to 5): running, jumping, stairs, balance and coordination.
• Physical therapy for school-age children (6 to 12): coordination, strength, endurance and keeping up in sport and on the playground.
• Physical therapy for teenagers (13 to 18): sports injuries, posture, hypermobility and returning to activity.

The role of physical therapy in childhood development covers how motor skills build on each other across these stages.

Physical therapy for specific conditions

Many children see a PT because of a diagnosis that affects movement. Each of these pages sets out what physical therapy works on for that condition and what the evidence says:

• Physical therapy for cerebral palsy
• Physical therapy for Down syndrome
• Physical therapy for developmental delays
• Physical therapy for dyspraxia
• Physical therapy for autism
• Physical therapy for ADHD
• Physical therapy for sensory processing disorder
• Physical therapy for Ehlers-Danlos syndrome

When to consider a physical therapy evaluation

Talk to your child’s doctor about a physical therapy assessment if your child:

• is not sitting without support by 9 months;⁴
• is not walking without holding on to anyone or anything by 18 months;⁴
• is not running, kicking a ball, or walking up a few stairs with or without help by age two;⁴
• as a baby, keeps their head turned to one side or has a flat spot on the head;⁶
• seems unusually floppy or stiff (see hypotonia), walks on their toes most of the time, or falls or tires much more than other children their age.

The CDC milestones are set at the age by which at least three in four children reach them, so that a missed one prompts action rather than waiting.⁵ Loss of a motor skill a child previously had warrants prompt medical evaluation at any age.⁴

What a PT evaluation and a session involve

A physical therapy evaluation combines a developmental and medical history, standardized motor assessments, and observation of how your child moves. For a baby with a flat spot, it also covers how the baby is held, where they sleep and how they are positioned through the day.⁶ Goals are set in functional terms, such as “climbs stairs with alternating feet,” not “improves gross motor skills.”

Sessions for young children are play-based and built around the activities your child is trying to do. Parents are coached to carry the work into daily routines: home programs are among the interventions rated effective for children with cerebral palsy.⁷

How to choose a physical therapist

Every physical therapist must pass a national exam and be licensed in their state, and since 2016 every new US physical therapist has graduated with a Doctor of Physical Therapy (DPT) degree; you will see PT or DPT after the name.¹ Some physical therapists go further and earn board certification in a specialty, and pediatric physical therapy is one of them.⁸ Reasonable questions to ask:

• What is your experience with children like mine, at this age?
• How do you set and measure functional goals?
• How much of each session works directly on the activities my child is trying to do?
• What should we practice at home, and how often?

Physical therapist assistants are also licensed and provide care under a physical therapist’s direction and supervision, so your child may see both.¹

Paying for PT: early intervention, school and insurance

Under three: early intervention runs under Part C of the Individuals with Disabilities Education Act. Parents are named as a referral source, the evaluation is carried out at public expense with no fee to you, and services are delivered in natural settings such as your home wherever appropriate.³

Three and over: under Part B, physical therapy is a related service a school provides, at public expense and without charge, when a child with a disability needs it to benefit from special education.⁹ Request an evaluation in writing, so there is a dated record. Clinic-based PT runs alongside school services, through insurance or privately.

Referrals: all 50 states allow direct access to a physical therapist in some form, so you can go directly to a physical therapist without a referral, though some states attach conditions to treatment and your insurance plan may still require one.² Does insurance cover therapy for kids? covers visit limits and appeals, and telehealth physical therapy is an option for some families; in-home therapy covers PT at home, from early intervention to Medicare home health.

Physical therapy for adults

Physical therapists treat people of all ages,¹ and the principle that runs through the pediatric side runs through the adult side too: recovery is measured in what you can do again. Adults see physical therapists for low back pain, neck pain and sciatica; for frozen shoulder and tendinopathy; after surgery, including hip replacement, knee replacement, back surgery and shoulder surgery; after a stroke or with Parkinson’s disease; for balance and falls in later life; and for return to sport.

After an injury or operation, your surgeon’s weight-bearing instructions set what the therapy can do at first. Orthopedic · Neurologic · Geriatric · Sports · Pain and chronic conditions · All adult therapy

Find a physical therapist near you

The physical therapy directory lists clinics by state and city, with each practice’s own description of what it treats. Start from your state:

Alabama · Alaska · Arizona · Arkansas · California · Colorado · Connecticut · Delaware · District of Columbia · Florida · Georgia · Hawaii · Idaho · Illinois · Indiana · Iowa · Kansas · Kentucky · Louisiana · Maine · Maryland · Massachusetts · Michigan · Minnesota · Mississippi · Missouri · Montana · Nebraska · Nevada · New Hampshire · New Jersey · New Mexico · New York · North Carolina · North Dakota · Ohio · Oklahoma · Oregon · Pennsylvania · Rhode Island · South Carolina · South Dakota · Tennessee · Texas · Utah · Vermont · Virginia · Washington · West Virginia · Wisconsin · Wyoming

Or browse occupational, physical and speech therapy by state together.

Physical, occupational and speech therapy side by side

Physical and occupational therapy are the pair most often confused: both can work on motor skills, but PT starts from the movement and OT from the task. The short version, with the occupational therapy and speech therapy guides for the other two, and a longer comparison of OT and PT:

Sources

1. American Physical Therapy Association. About physical therapists and physical therapist assistants (ChoosePT). Physical therapists “are licensed health care providers. They evaluate, diagnose, and manage health conditions and movement problems in people of all ages and abilities”; “Since 2016, all physical therapists in the United States have graduated from a three-year, post-baccalaureate program and earned a Doctor of Physical Therapy, or DPT, degree” and must pass a national exam to be licensed; physical therapist assistants “also are licensed” and “provide care under a physical therapist’s direction and supervision.” Checked October 6, 2026.
2. American Physical Therapy Association. Direct access advocacy. “As of July 1, 2025, all 50 states, the District of Columbia, and the U.S. Virgin Islands have either provisional or unrestricted direct access to physical therapist services for evaluation and treatment,” though some provisions tied to treatment still apply. Checked October 6, 2026.
3. Individuals with Disabilities Education Act, Part C, 34 CFR Part 303. Parents are named among the “primary referral sources”: §303.303(c)(3). Evaluation and assessment are “required functions that must be carried out at public expense, and for which no fees may be charged to parents”: §303.521(b)(2). Services are provided “to the maximum extent appropriate, in natural environments,” which “may include the home or community settings”: §§303.126 and 303.26. Text as published in the eCFR. Checked October 6, 2026.
4. Centers for Disease Control and Prevention. Learn the Signs. Act Early. Milestone checklists: 9 months (“Sits without support”), 18 months (“Tries to say three or more words besides ‘mama’ or ‘dada’”; “Walks without holding on to anyone or anything”; “Tries to use a spoon”), 2 years (“Says at least two words together, like ‘More milk’”; “Kicks a ball”; “Runs”; “Walks (not climbs) up a few stairs with or without help”), 3 years (“Talks well enough for others to understand, most of the time”), 4 years (“Says sentences with four or more words”; “Unbuttons some buttons”; “Holds crayon or pencil between fingers and thumb (not a fist)”). The overview: “If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early.” Checked October 6, 2026.
5. Zubler JM, Wiggins LD, Macias MM, Whitaker TM, Shaw JS, Squires JK, et al. Evidence-informed milestones for developmental surveillance tools. Pediatrics. 2022;149(3):e2021052138. PMID 35132439. The CDC checklists use “milestones most children (≥75%) would be expected to achieve” by each visit age, in order to “clarify when most children can be expected to reach a milestone (to discourage a wait-and-see approach).”
6. American Physical Therapy Association. Physical therapy guide to flat head syndrome: plagiocephaly, brachycephaly, and dolichocephaly (ChoosePT). A baby with plagiocephaly “may prefer to keep their head turned consistently to one side”; it can result from a tight muscle (as with torticollis); “Physical therapists help determine the cause of the head flattening and the best treatment,” and “The sooner a family sees a physical therapist, the better the chances of improving or preventing further head shape deformities.” Checked October 6, 2026.
7. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, et al. State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Current Neurology and Neuroscience Reports. 2020;20(2):3. doi:10.1007/s11910-020-1022-z (PMID 32086598). Effective allied health interventions include bimanual training, constraint-induced movement therapy, fitness training, goal-directed training, home programs, mobility training, strength training, task-specific training and treadmill training.
8. American Physical Therapy Association. Specialty areas in physical therapy (ChoosePT). “Some PTs earn board certification in a physical therapy specialty”; pediatric physical therapy is one of the listed specialty areas. Checked October 6, 2026.
9. Individuals with Disabilities Education Act, Part B, 34 CFR §300.34(a). Related services are the “developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education,” and include “speech-language pathology and audiology services” and “physical and occupational therapy.” Special education and related services under an IEP are “provided at public expense, under public supervision and direction, and without charge”: §300.17(a). Checked October 6, 2026.
10. Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical therapy management of congenital muscular torticollis: a 2024 evidence-based clinical practice guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy. 2024;36(4):370–421. doi:10.1097/PEP.0000000000001114 (PMID 39356257). Covers screening, referral, physical therapy examination and first-choice interventions for infants with torticollis.
11. American Speech-Language-Hearing Association. Audiology and Speech-Language Pathology Certification. The Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), and the public tool to verify an individual’s certification status. Checked October 6, 2026.
12. National Board for Certification in Occupational Therapy. NBCOT: certifies occupational therapists (OTR) and occupational therapy assistants (COTA), with a public “Verify an OTR/COTA” search. Checked October 6, 2026.

Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your child. If your child has lost skills they previously had, contact their doctor promptly.