Attention, Balance and Coordination

The A.B.C. of Learning Success

Sally Goddard Blythe

• Publisher: Wiley
• Year: 2011
• ISBN:
  9781119964148
• Edition: 1
• Topic: Education
• Subtopic: Education Teaching Methods

Attention, Balance and Coordination is the most up-to-date handbook for professionals involved in education and child development, providing a new understanding of the source of specific behavioural problems.

• Written by a respected author of acclaimed titles in this field
• Explains why early reflexes are important, their functions indevelopment and their effects on learning, behaviour andbeyond - also covers adult neurological dysfunctionsanxietyand agoraphobia
• Builds on anABC of Attention, Balance and Coordination to create a unique look across specific learning difficulties, linked by common motor skills challenges resulting from neuro-developmental deficiencies
• Includes the INPP Developmental Screening Questionnaire together withguidance onhow to use and interpret it

CHAPTER 1

WINDOWS ON THE BRAIN

INTRODUCTION

Although all learning ultimately takes place in the brain, it is often forgotten that it is through the body that the brain receives sensory information from the environment and reveals its experience of the environment. Postural control reflects integration of functioning within the central nervous system (CNS) and supports brain–body functioning. Immaturity or conflict in brain–body functioning affects the brain’s ability to assimilate and process information and to express itself in an organized way.

One method of assessing maturity and integrity in the functioning of the CNS is through the examination of primitive and postural reflexes. The presence or absence of primitive and postural reflexes at key stages in development provides ‘windows’ into the functioning of the CNS, enabling the trained professional to identify signs of neurological dysfunction or immaturity.

This book, I hope, will give the reader an understanding of why early reflexes are important, their functions in early development, their effects on learning and behaviour if retained, and the possible effects on other aspects of development such as posture, balance, and motor skills if they are not integrated at the correct time in development.

Reflexes will be described in detail in subsequent chapters.

There is an increasing body of scientific evidence to support the theory that physical skills support academic learning and are involved in emotional regulation and behaviour. Since its foundation in 1975, The Institute for Neuro-Physiological Psychology (INPP) in Chester has been the pioneer in researching the effects of immature primitive and postural reflexes on learning and behaviour, developing protocols for the assessment of abnormal reflexes and related functions, and has devised a specific method of effective remediation (The INPP Method).

Research carried out both independently and by The Institute over the last 30 years has shown that there is a direct link between immature infant reflexes, academic underachievement and increased anxiety in adult life, and that a remedial programme aimed directly at stimulating and integrating primitive and postural reflexes can effect positive change in these areas. This book will outline the underlying theory, mechanisms, developmental markers, and effects of immature reflexes in the older child to assist professionals involved in education and child welfare to recognize the signs of neurological dysfunction and their implications.

The book will also explore interdisciplinary shortcomings endemic in the current system for identifying, assessing, and providing effective remedial intervention for learning and behavioural problems. In this context, the book will propose that there is a need within education for a new profession to bridge the present gaps – a neuro-educator – trained specifically to assess children’s developmental readiness for education.

DEVELOPMENTAL READINESS FOR EDUCATION

Chronological age and intelligence are not the only criteria for learning success. Developmental readiness for formal education is equally important. Developmental testing of motor skills is carried out regularly in the first year of life, but when responsibility for the young child moves from the domain of medicine (midwife, paediatrician, and health visitor) to education at the time of school entry, a child’s developmental readiness in terms of physical development is not assessed as a matter of routine. Once a child enters formal education at rising five years of age in the UK, assessment of physical development only takes place if problems of a medical nature arise. Assessment within the school system tends to focus on the educational problems or the presenting symptoms rather than on the investigation of underlying causes.

The INPP in Chester was set up in 1975 by psychologist Peter Blythe, PhD, with the aim of investigating whether underlying physical factors could play a part in specific learning difficulties and in some phobic disorders. In the 1970s, Peter Blythe and David McGlown devised, first, systems of assessment to identify areas of impaired functioning, and second, physical remediation programmes to correct the underlying dysfunctions. These methods of assessment, which involve examining the neuro-developmental level of the child and the subsequent physical programmes of remedial intervention, are now known as The INPP Method of Developmental Training.

By their very nature, symptoms of specific learning difficulties tend to cross diagnostic boundaries, with different categories sharing a number of symptoms in common (co-morbidity). This is particularly true of many of the symptoms of dyslexia, developmental coordination disorder (DCD), attention deficit disorder (ADD), and some aspects of autistic spectrum disorders. A number of the symptoms shared in common are a direct result of immaturity in the functioning of the CNS and are sometimes referred to as neurological dysfunction or neuro-developmental delay.

WHAT IS NEURO-DEVELOPMENTAL DELAY?

Every normal human baby, born at full term (40 weeks’ gestation) is equipped with a series of primitive reflexes to help it survive the first few weeks and months of life. If one side of the mouth is gently stroked, the neonate will turn its head in the direction of the stimulus and the mouth will open, searching or ‘rooting’ for the breast; if a finger is placed inside the baby’s mouth, it will reflexively start to suck, and if an object is placed in the palm of its hand, it will grip and not be able to let go at will. These primitive reflexes are hard-wired into the brainstem at birth. They are active for the first six months of life, but from the moment of birth, they start a gradual process of inhibition by higher centres in the brain as neurological connections to higher centres develop. As the primitive reflexes are inhibited, the postural reflexes emerge, which gradually take over many of the functions of the primitive reflexes. Postural reflexes take up to three and a half years of age to be fully developed.

Neuro-developmental delay describes the continued presence of a cluster of primitive reflexes in a child above six months of age together with absent or underdeveloped postural reflexes above the age of three and a half years. The presence or absence of primitive and postural reflexes at key stages in development provides evidence of immaturity in the functioning of the CNS and will influence the development and control of posture, balance, and motor skills.

Neuro-developmental delay, sometimes also referred to as neurological dysfunction, is defined by the INPP as (1) the continued presence of a cluster of aberrant primitive reflexes above six months of age and (2) absent or underdeveloped postural reflexes above the age of three and a half years.

WHAT IS THE CONNECTION BETWEEN NEURO-DEVELOPMENTAL DELAY AND SPECIFIC LEARNING DIFFICULTIES?

Successful academic learning relies upon adequate mastery of motor skills: reading, for example, involves development and control of smooth eye movements to send an orderly flow of sequential information to the brain; eye movements are a motor skill. In order to write, a child needs to have developed hand–eye coordination; this is also a motor skill. Sitting still and paying attention require postural control, balance, and orientation, in addition to the involvement of cortical centres implicated in the maintenance of attention; aspects of mathematics require spatial skills and cooperation between the two sides of the cerebral cortex (left and right hemispheres) to cooperate in solving problems in a sequential fashion. Many of these ‘higher’ cognitive processes are rooted neuro-physiologically in systems involved in postural control, and the reflexes play a crucial part in supporting and facilitating stability and flexibility in postural control.

The vestibular system is a system responsible for maintaining balance, posture, and the body’s orientation in space. This system also regulates locomotion and other movements and keeps objects in visual focus as the body moves. The cerebellum is the control centre for balance and movement coordination. As part of the nervous system, it receives two types of input: one locating the body’s position in space and the other indicating whether the muscle is contracted or relaxed. Based on this information, and depending on the desired action (move forward, grasp, etc.), the cerebellum triggers, adjusts, or stops a movement.

Spatial skills develop directly from physical awareness of the body position in space. Secure balance is fundamental to navigation in space because it provides the physical basis for a secure internal reference point from which spatial judgements about the external environment are formed. Dr Harold Levinson described the vestibular-cerebellar system as acting as ‘a compass system. It reflexively tells us spatial relationships such as right and left, up and down, front and back, east and west, north and south’.¹ Research has shown that perception and differentiation of sequences of mobile stimuli, known to be related to vestibular and cerebellar mediation and postural stability, are faulty in children with reading difficulties.² The cerebellum is also linked to the ability to sequence not only motor tasks but also associated cognitive processes.³

Inter-hemispheric functioning, which is essential for problem solving, is reflected in a child’s ability to use the two sides of the body in different ways. In addition to the specific brain centres which are involved in the mediation and control of balance, integration in the use of the two sides of the body both reflects and supports the use of balance, bilateral integration. While many of the areas of the brain are involved in different types of learning, higher cognitive functions rely upon the integrated functioning of lower centres to support and to feed information to the cortex.

Bilateral integration is the ability to carry out movements on one side of the body independently of the other side and the ability to coordinate both sides of the body in many different combinations.

Primitive and postural reflexes at key stages in development provide a ‘window’ into the structural and functional integrity of the hierarchy of the brain. Abnormal primitive and postural reflexes provide diagnostic signs of immaturity in the functioning of the CNS which can interfere with optimal cortical functioning. ‘The central nervous system acts as a coordinating organ for the multitude of incoming sensory stimuli, producing integrated motor responses adequate to the requirements of the environment.’⁴ When the CNS is working well, the cortex is free to concentrate on ‘higher’ functions, being involved in intention and motor planning, but not the detailed mechanics of movement. ‘The cortex knows nothing of muscles, it only knows of movement.’⁵

This is because voluntary movements, particularly those associated with postural adjustment, are largely automatic and function outside of consciousness. The maintenance of posture and equilibrium is carried out by the CNS recruiting lower centres in the brainstem, midbrain, cerebellum, and basal ganglia in the service of the cortex.

PRIMITIVE AND POSTURAL REFLEXES – THE MEDICAL MODEL

It is medically accepted that abnormal reflexes can persist as a direct result of pathology such as in cases of cerebral palsy when damage to higher brain centres prevents the cortex from completely inhibiting the primitive reflexes in the first year of life or from releasing postural reflexes. Primitive reflexes may also reappear as a result of progressive pathology such as in multiple sclerosis when pinhead-sized hardened patches develop and scatter irregularly through the brain and the spinal cord, causing the insulating sheaths of the nerve fibres in the hardened patches to break up and become absorbed, leaving the nerve fibres bare. When this happens, postural reflexes become impaired and the primitive reflexes re-emerge as a direct result of loss of integration within the functioning of the nervous system and loss of control from higher centres. A similar regression of reflex integration can be seen in Alzheimer’s disease, when degeneration within the cerebral cortex results in gradual loss of higher cortical function and the release of primitive reflexes as primitive, protective, survival mechanisms.

The transition from primitive to postural reflex in the first year(s) of life is a gradual one. It occurs as a result of maturation within the CNS, but it is also partly environmentally dependent. While the reflexes are hard-wired into the system at birth, physical interaction with the environment is like the software through which the potential of the nervous system is entrained. In the early months of life, primitive reflex actions provide rudimentary physical training through movement at a time in development before the cortex and connections to the cortex are sufficiently mature to orchestrate a controlled response. In other words, through the feedback or movement experience of early reflex actions, neurological pathways are developed and strengthened. As connections between higher and lower centres become established, primitive reflexes are inhibited to make way for more advanced systems of voluntary movement and postural control.

Structural development of the nervous system takes places as a result of maturation and interaction with the environment. Every species begins life with a common tool kit of genes involved in bodybuilding, but the development of the nervous system in each individual is the product of using the same genes in different ways.

At this stage of development, postural reflexes lay the foundations for automatic reactions needed for the maintenance of posture and balance in a gravity-based environment (preconscious), as well as support the control of voluntary movement. The importanc...

Table of contents

• Cover
• tittle
• copyright
• ABOUT THE AUTHOR
• CONTRIBUTORS
• PREFACE
• ACKNOWLEDGEMENTS
• CHAPTER 1: WINDOWS ON THE BRAIN
• CHAPTER 2: THE SIGNIFICANCE OF PRIMITIVE AND POSTURAL REFLEXES
• CHAPTER 3: PRIMITIVE REFLEXES OF POSITION
• CHAPTER 4: PRIMITIVE TACTILE REFLEXES
• CHAPTER 5: POSTURAL REFLEXES
• CHAPTER 6: USE OF THE INPP SCREENING QUESTIONNAIRE
• CHAPTER 7: POST-NATAL FACTORS USING THE INPP QUESTIONNAIRE
• CHAPTER 8: THE DEVELOPMENT OF THE VESTIBULAR-CEREBELLAR THEORY
• CHAPTER 9: THE EFFECTS OF NEURO-DEVELOPMENTAL DELAY IN ADULTS AND IN ADOLESCENTS
• CHAPTER 10: DEVELOPMENT OF THE INPP METHOD – FROM THEORY TO FACT
• CHAPTER 11: OTHER FACTORS IN SPECIFIC LEARNING DIFFICULTIES
• APPENDIX 1: SCREENING FOR NEUROLOGICAL DYSFUNCTION IN THE SPECIFIC LEARNING DIFFICULTY CHILD
• APPENDIX 2: FREQUENCY RANGE OF VOCALS AND MUSICAL INSTRUMENTS
• GLOSSARY OF TERMS
• BIBLIOGRAPHY
• INDEX
• Also by Sally Goddard Blythe What Babies and Children Really Need