Introduction
A neonatal physiotherapist aims to support the development of babies who may be at increased risk of having movement or developmental difficulties. This may be as a result of prematurity, difficulties before, during or after birth, problems affecting joints or muscles or any other disorders that may affect how they move.
Following discharge, neonatal and paediatric physiotherapists are an integral part of the multidisciplinary team involved with the enhanced developmental surveillance and support process and pathway (also known as neuro-developmental follow-up). Starting on the unit, this enhanced developmental surveillance and support should continue until the child is two or four years of age.
Physiotherapists are key professionals involved in assessment and treatment through specific handling and play activities. They must possess advanced clinical competences. More broadly, they will also require sensitivity to the environment and social needs of the child and his or her family. Having knowledge and understanding of the typical and atypical developmental trajectory of the preterm infant and high-risk term age infant is a critical learning experience for all therapists who assess and treat these young infants whether community or hospital based.
Generally, neonatal and infant assessment should aim to:
- Evaluate age appropriate developmental progress
- Involve and empower parents/carers through effective communication and support
- Detect early signs of a neurological problem
- Identify likely origin / cause/ type disorder
- Estimate severity and prognosis
- Plan further investigations & treatment
Neonatal chest physiotherapy is a highly specialised area of respiratory care. Very little evidence supports the use of physiotherapy techniques, therefore detailed understanding of the literature and professional consensus is required in order to apply treatment techniques judiciously and safely to preterm infants, which differ in vulnerability and physiology from their term counterparts. The physiotherapist should approach assessment of the infant with a thorough understanding of the pathophysiology of the premature baby. This enables the physiotherapist to accurately identify respiratory problems that have the potential to be addressed by physiotherapy approaches and treatments.
How to become a neonatal physiotherapist
To become a neonatal physiotherapist, you firstly require a university degree in Physiotherapy. As the nature of neonatal practice is specialised, most neonatal physiotherapist positions will start at a band 7 – highly specialist level and will require a background in paediatric practice and knowledge of infant/early childhood development. Increasingly, there are opportunities for Band 6 level positions, in units where supervision is available from a more experienced Band 7 or 8 therapist. There are currently many neonatal physiotherapist education and training opportunities led by the Association of Paediatric Chartered Physiotherapists (APCP) and Health Education England to support physiotherapists to transition to a neonatal physiotherapist role.
Progression opportunities
The clinical area of neonates is ever-expanding for physiotherapists. There are opportunities to move into Clinical Specialist Band 8 roles, both in the clinical and strategic spheres. Physiotherapists have skills that transfer well into leadership roles within Trusts, local ODNs and in strategic roles to be key voices in the development of services for infants and families at a national level. Neonatal physiotherapists may also choose to pursue an academic career or work simultaneously as clinicians and researchers.
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