CHAPTER 1
Early intervention in movement and learning
PART 1
Making the case
When Trevarthen (1977) and other researchers into child development made the hugely important claim that 50 per cent of all learning happens in the first five years, the case for early intervention could not be denied. A huge expansion in the demand for early childcare was matched by arrangements to ensure that the best possible learning environment was provided; the 5â14 curriculum in Scotland was extended to encompass 3-year-olds and funding was directed into the early years sector. Programmes that sought to compensate for any kind of disadvantage, e.g. illness, restricted experiences, special needs or unstable or disadvantaged backgrounds, were initiated in many regions. This was so that all children could begin their primary school education on the same playing field, as it were.
While this intensive teaching resulted in many children making remarkable and sustained progress, for some the effect didnât seem to endure and after an initial advantage, some still trailed behind the others who had not had the benefit of the intervention programme. This finding raised a number of issues. Many questions were asked, for example: âWere these very young children not ready for the very different kind of learning to which they had been exposed? Was the content of what they were to learn â in some cases learning to write numbers and recognise letters â too bound by the teachersâ sense of the curriculum that was to come? Would it have been better taking the children into a carefully structured environment and encouraging them to learn through play? Or was it the cultural shift that was too great? Were the home/school differences such that new school learning was dissipated or seen as inappropriate by the people and the experiences the children had at home? If so, how could these obstacles be overcome?
These kinds of questions are still critically important when claims in 2003 assert that the earlier children have âexperiencesâ the greater the impact on learning they will make. If proven, this âhas implications for drawing the 0â3-year-olds into the larger picture of the educational processâ (Winkley, 2003). Doubts about whether such young children can be ready to absorb learning have been offset by the resurgence of the importance of critical learning periods and suggestions that if learning doesnât happen at the âright timeâ it could be more difficult to assimilate, even be âtoo lateâ and potential could be lost. These âright timesâ are now thought to be when the brain is most open, i.e. before myelination is complete. This is in the period between 0â6 years.
Certainly this claim has been verified with regard to the visual system. Before age 5 every attempt is made to stimulate the childrenâs vision in the knowledge that later, i.e. once the critical time has passed, it will be too late to stimulate a greater degree of vision. More recent findings point out similarities in the timing of emotional development. Over the years much insight has been gained on bonding and attachment in early relationships and the effect these have on the development of confidence and security in the child (Ainsworth, 1972; Bowlby, 1979). Now it is considered that early, positive parent/child relationships stimulate brain development, so there is an intellectual as well as a social/emotional gain. How can this be? Because as the relationship is formed, the parent acts as a container for the babyâs very intense feelings, in times of stress soothing and calming the child so that a pattern of quieter âacceptableâ behaviour is established. The child then is enabled to internalise this template and make future adjustments without help. Moreover, these routines and repetitions help develop âexpectanciesâ which give structure and comfort to the childâs day. With this in place, the children are freed to encompass new learning.
Early movement patterns too, are subject to this âbest time to learnâ. Many, if not most, children with specific learning difficulties have not crawled and later attempts to teach them have largely been unproductive. It would seem that the time to acquire certain movement abilities, e.g. the cross lateral pattern which enables crawling to be achieved, appears to be time specific too. At first glance this would not seem to be a major hurdle because, after all, older children and adults donât crawl â except up stairs and up mountains! But learning to crawl is actually very important, because in so doing children learn about the space around them and discover how far and in what direction objects in their environment are. They learn to balance in a safe position and feel the transfer of weight from four balance points to three. They choose which hand is best to stretch and the first glimmerings of hand dominance are established. It can be seen then that crawling is much more than a movement pattern which has limited use. Children who have not achieved their developmental milestones at the correct time, however, cannot be faced with the idea that it is too late. They have to have extra support in the form of programmes where the teacher replicates the specific stages of early development to âtry to set the neural clock to the correct timeâ (Goddard, 1996). These can be in any aspect of learning, e.g. movement, reading or whatever competence needs help.
The earlier these programmes can be put into place, the better. This is because in these earliest times the brain cells (neurones) adapt to circumstances much more readily than later and so positive inputs from the environment, e.g. teaching, support, practice and praise, can help the part of the brain which functions well to take over from the âdisabledâ part. This is why early intervention programmes with children who have sensory or physical impairments have been so successful. There are vast implications here for children who are not referred to specialists until it is too late for any remedial programme to have the fullest impact. In 2003, the scarcity of childrenâs referrals to specialists for diagnosis of possible specific learning difficulties is making this happen â a very worrying state of affairs. In some areas resources will not be provided until a report from a psychologist is provided. While parents are understandably angry, teachers and the psychologists themselves are also frustrated by the delay. Many parents are seeking private help because they recognise the negative effect of waiting. But what about the children whose parents cannot afford this or who consider that the kind of support on offer locally is not appropriate for their child?
What is happening in the neurological development of the brain to make this very early time so important?
For many years there has been argument about the proportional importance of nature and nurture in designating what children could do. Generally the debate concluded by asserting that a blend of genetic and environmental factors was responsible for childrenâs progress, but there remained a suspicion that despite the blend, the genetic factors or âwhat the children brought to learningâ was of paramount importance. In 2003, however, research denies that childrenâs brains are pre-programmed in any major way and claims that they develop substantially through experience. Furthermore, the research shows that the very earliest experiences have the most profound effect on structuring the brain (Winston, 2003).
These findings have huge implications for education in terms of the provision that should be made, the resources that are required and the quality of the teaching necessary to understand what is possible and desirable with very young children. But how are parents and teachers to know if their children are learning and if their rate of progress is what should be expected? A first clue is to observe the childrenâs movement, for this is their first way of demonstrating what they have learned. When they stretch out and grip without fumbling, it can be seen that awareness of their hands and an appreciation of distance and direction has been mastered. When they sit up unsupported, development of the muscles in the back is evident along with a sense of balance, and when they crawl using a cross lateral pattern they are demonstrating both developing co-ordination and rhythm. But even within these activities which are dependent on maturation, i.e. the sequential pattern of changes which are innate and donât depend on teaching, it is not difficult to appreciate how opportunity and experience are necessary to produce skill. Certainly teachers are finding that the movement prowess of children has diminished by not getting out of doors to play. To compensate, many are providing daily movement programmes or even just taking steps to ensure that opportunities to move are built into the daily curriculum. In addition, many authorities are being badgered to put physical education specialists back into all primary (stage 1) schools.
What then is happening as movement skills are learned?
Development of the brain
Learning as a stimulant that structures the brain
Figure 1.1 shows two neurones out of the one hundred billion nerve cells which work together to receive, analyse and act on information from both external, i.e. environmental sources, and internal feelings, i.e. pain, hunger and the different emotions. As different experiences occur, these neurones join into networks that work together as systems to facilitate specific functions such as vision or hearing, movement or paying attention. Now, although these systems are in different parts of the brain, they work together in a dynamic way so that the most effective and efficient learning/movement can occur.
Figure 1.1 Two neurones with axons, dendrites and synapses.
Each neurone has an axon, a long spindle that leads to branching dendrites. These connect to other dendrites over a synapse, i.e. a gap, to approximately one hundred thousand other neurones. Chemicals such as dopamine act as neurotransmitters, passing messages from one cell to the next. The vast number of cells and connections mean that an infinite number of connections can be made and unmade. How does this come about?
The entire surface of the body is connected to the brain with different parts having their own number of neurones. Sensitive areas such as the hands, fingers and genitals have more neuronal connections. They are allocated much more âbrain spaceâ than feet and legs. This means that activities such as playing the piano are good for reinforcing pathways as well as promoting finger awareness and so they promote other fine motor skills. As actions are repeated, the cell groups that have been used team up to reinforce specific pathways. This is done by a chemical change that ensures that a trigger to one cell will fire strongly to the next. This is called Hebbian learning and explains why habitual movements, i.e. those done regularly, can, after some initial practice, be performed almost automatically with little preparation or conscious thought. (Children with dyspraxia and other specific learning difficulties are likely to lack this automaticity.) As these pathways are established, the unused dendrites are discarded. This process is known as âpruning of the dendritic arborâ (Bee, 1999). The commonly used âuse it or lose itâ maxim may indeed be true! What is certain is that new experiences stimulate development of the brain.
Myelination â a sign of maturation of the brain
Myelin is a thin fatty coating that acts as an insulator around the axons, allowing signals to proceed smoothly and quickly to their designated ports. There is a gradual maturing of the brain that continues over thirty years but the âmajority of the maturation has occurred by the age of three to four yearsâ (Winkley, 2003). This is how it is possible to begin to make fairly accurate prognoses about childrenâs progress at this stage.
In the first months after birth there is a huge proliferation of synapse activity â the structures are anticipating experience and learning and getting the brain ready to absorb and retain it. The brain has prepared the paper for the script to be written upon it. All kinds of experiences contribute to this text. Interestingly, as areas become myelinated they mature and become more difficult to adjust. Old sayings such as âYou canât teach an old dog new tricksâ may not be wholly true, but the adjustment may take longer!
Illnesses as well as the natural ageing process affect movement too. In patients with multiple sclerosis, as one example, this myelin sheath is breaking down. When this occurs, messages fire across to other neurones rather than along the correct path. This explains why control over the muscles is gradually lost and movement becomes jerky or flustered and confused before, in severe cases, the capacity to move disappears and the patient becomes wheelchair bound. In Parkinsonâs disease there is a paucity of dopamine and so the synaptic connections do not function well. This is one cause of the âstoppingâ without reason, i.e. the cessation of movement, which is one symptom of the disease. It may also help to explain the tremor that defeats efficient movement.
And so the passage of the messages from the body to different parts of the brain are facilitate...