understanding the treatment
Brain & Behaviour Enhancement programme is for children who have Neuro-Motor Developmental Immaturity
Neuro-Motor Developmental Immaturity may be described as an immaturity within the central nervous system. In order for the central nervous system to work efficiently all of the other systems must work in harmony with it. Sometimes this does not happen if immature movement patterns (medically known as primitive reflexes) persist in a child long after they should have receded.
FROM THE BEGINNING…
Babies move around in the womb and it has long been established that these involuntary primitive reflexes are the dominant form of human movement before birth and in the first few months of life.
Some of these primitive reflexes are important to help the baby come through the birth canal in a normal delivery and many help the baby to survive in early life.
Shortly after birth, part of the paediatric examination includes testing for the presence of many of the primitive reflexes, such as the automatic hand-grasping reflex, the rooting reflex, the suck reflex and many others.
The developing brain gradually controls these primitive reflexes, and, as it does, the baby moves from involuntary movements to executing more planned movements which become more refined as the baby progresses through his/her early childhood developmental stages. An example of this is the palmar grasp reflex: if someone puts their finger into the palm of a new-born baby’s hand, the baby will grasp it tightly. As the baby grows and develops, s/he loses this automatic hand-grasping reflex over the first few weeks of life.
YEAR 1…
Gradually, over the early months of life the primitive reflexes recede, and the baby develops more mature movement patterns or postural control to allow rolling over, crawling, creeping and eventually walking.
Research suggests that the primitive reflexive movements of infants in early life are developmentally very significant and are precursors to later, more mature motor development. By physically passing through the early stages of sucking, grabbing, crawling and creeping, the baby is playing an active role in the inhibition of the reflexive movements and thus advancing the neural networks in his/her brain.
These early primitive reflexes should be controlled in a sequential pattern, for the most part, by the end of the baby’s first year of life. The term Neuro-Motor Developmental Immaturity may be used where a cluster of primitive reflexes are still present above the age of one, or where there is a delay in the development of more appropriate patterns of movement by the time the child reaches the age of 3 years.
AND BEYOND…
All of this is relevant to future development, especially when we consider the skills expected of children as they grow older. When they begin school, it is expected that children have the ability to: behave appropriately; sit and listen for short periods; hold a pencil correctly; and later learn how to write, copy, read with fluency and spell accurately. Frequently children, who have difficulty with one or more of those tasks, have not passed through the appropriate stages of early development, to allow them to keep up with their peers in school and reach their potential. Therefore, the path to achieving may be wrought with frustration, anxiety, and low self-esteem.
The Brain and Behaviour Enhancement programme gives children a second chance to overcome their early reflexive movement patterns, thus allowing them to reach their full potential.
Examples of immature movement patterns and
how they may affect a school-age child
Immature movement patterns which persist in a child of school age may prevent them from reaching their full potential in academic performance, physical activity, and/or may interfere with their behaviour, emotions or social skills. Outlined below are examples of immature movement patterns, some or all of which may persist in school-age children who have specific challenges. The immature movement patterns outline here are referred to by their medical terms:
- The Asymmetrical Tonic Neck Reflex (ATNR);
- the Tonic Labyrinthine Reflex (TLR);
- the Symmetrical Tonic Neck Reflex (STNR); and
- the Moro Reflex.
1. Asymmetrical Tonic Neck Reflex (ATNR)
This reflex is present before birth and should not be present after about 6-8 months of age, when a baby is awake. Head movement elicits this reflex, which is very strongly present at birth. It is thought to play an active role in the spontaneous vertex delivery of the baby and in his/her survival in the first few months of life. If the ATNR persists in a school-age child particular related challenges may be evident.
Possible symptoms of the presence of the ATNR
- Poor handwriting and sometimes an awkward grip
- Written ideas not reflecting intelligence
- Poor hand-eye coordination
- Dislike of sports or clumsiness when playing
- Losing place on the page when reading unless finger or pencil is placed under the words
- Difficulty distinguishing left from right
2. Tonic Labyrinthine Reflex (TLR)
This reflex is present in a healthy infant at birth and should be fully inhibited by three and a half years of age. The reflex is strongly related to the infant’s muscle tone. As the developing brain gradually inhibits the TLR, the baby starts to lift up his/her head and gains increasing control over his/her muscle movements. If this reflex has not receded in a school-age child particular challenges may be observed.
Possible symptoms of the presence of the TLR
- Skips over words or skips a line when reading
- Tendency to reverse letters or numbers, or confuse with similar shaped letters (b/d, p/q or 6/9)
- Sequencing difficulties
- Postural problems resulting in floppy or stiff muscle tone
- Travel sickness
- Orientation and spatial difficulties
3. Symmetrical Tonic Neck Reflex (STNR)
The STNR reflex is noticeable in a baby just prior to the creeping phase of development. When the baby is on his/her hands and knees on the floor, every time s/he raises the head, there is a tendency to move the bottom back onto the ankles, and each time the baby bends the head, the arms also tend to bend and the upper body goes towards the floor. While this reflex is present the baby will find it very difficult to creep forwards on the hands and knees in a synchronised movement. S/he may creep backwards or shuffle along on his/her bottom. If the STNR has not been inhibited some related challenges may be observed in school or at home.
Possible symptoms of the presence of the STNR
- Leans down over the page when writing
- Squirms on the chair when sitting, may frequently swing on the chair or may sit awkwardly
- Appears clumsy at sports or avoid sports completely
- Difficulty copying down from book or whiteboard
- Messy eating or spillages
- Homework may take a long time
- Poor concentration and/or poor attention to tasks
4. Moro Reflex
In normal development the Moro reflex emerges at about 9 weeks of pregnancy and, in a healthy infant, is expected to persist until the baby is about 2-4 months old. It is a survival reflex that is necessary in the first few months of life to alert a baby’s carer to hunger, discomfort, stress, etcetera. It is one of the important reflexes checked by staff in the maternity hospital shortly after birth. As the Moro reflex recedes the Startle reflex gradually emerges and remains for life in a healthy person. If the Moro reflex persists in a school-age child, its effects may be obvious both at home and at school.
Possible symptoms of a retained Moro reflex
- Child gets stressed easily
- Over-reacts to situations
- May have labile emotions
- Behaviour may be immature
- Is highly sensitive in one or more sensory systems
- Becomes highly excitable at times
- May use up energy quickly and tire easily
