Tone Management

We develop an individual plan for every child and family, based on their assessment and your goals, which may include a combination of the following:

Neurodevelopmental Physiotherapy Support
– read more 

• Stretching tight muscles and strengthening weaker ones through therapy activities 
• Therapy be delivered as regular therapy sessions or within 1:1 intensive therapy blocks – read more 
• Use of evidence based Physiotherapy approaches, which incorporate tone management strategies – such as practice of child initiated, goal directed, task specific skills including activities with practice of function. 
• We also deliver body weight supported treadmill training which meets evidence based practice criteria 

Q: Why does the evidence say Physiotherapy should include a combination of Physiotherapy sessions and the use of Assistive Technology (AT), to best manage muscle tone?

A: The evidence tells us that Physiotherapy sessions should be combined with use of Assistive Technology (AT) — not used on their own.

• Repetition and intensity matter
  Children learn movement skills through frequent practice. AT helps increase the “dose” of therapy by supporting good positioning and movement throughout the day.
• Body alignment is essential
  Keeping the body in a supported, midline position helps manage muscle tone. Poor alignment—often caused by weakness or abnormal tone—can reinforce tightness, weakness, and lead to long-term complications like joint contractures.
• Therapy alone isn’t enough
  Even if alignment is improved during therapy sessions, spending long periods in poor positions afterward can undo that progress.
• Assistive technology supports progress all day
  Equipment like supportive seating or standing frames helps maintain good alignment outside therapy, increasing the dose of therapy provided and maximising tone management.
• Better alignment supports better function
  When children are well supported, they can more easily lift their head, use their arms and legs, and engage in daily activities. AT helps make this possible beyond therapy sessions.

Combining physiotherapy and assistive technology ensures children are supported both during therapy and throughout the rest of their day—leading to better outcomes in comfort, movement, and participation.

Q: Why is considering positioning for my child when they are asleep important?
A: Good positioning doesn’t stop when your child goes to sleep. In fact, children are asleep for more than half the day, making sleep an important part of tone management.

• Tone continues during sleep
  Muscle tone can still affect how your child lies at night, often leading to repeated or limited positions.
• Positioning is part of a 24-hour approach
  Supporting your child’s alignment overnight helps reinforce the benefits gained during the day, through good alignment. 
• Early support makes a difference
  Introducing sleep positioning from a young age can help manage tone and prevent long-term issues.
• Start small
  Sleep routines are important for the whole family, so simple steps—like trying positioning during naps—can be a helpful place to begin.

Sleep positioning is a valuable part of your child’s overall care. By supporting alignment both day and night, you can improve comfort, movement, and long-term outcomes. If you’re unsure where to start, speak with your Physiotherapist about safe and practical options for your child.