It’s difficult when parents of children with profound impairments have unrealistic expectations of what physio can achieve. Parents sometimes say “why are you fiddling around with that when I want them to learn to walk?” It’s important to set small steps with parents and children so that they understand the small steps along the way to achieving longer-term goals. If they don’t have that, they think ‘what’s the point in coming here?’ We need to agree the stepping-stones along the way.