Assessing Neuromotor Readiness for Learning E-Book

Sally Goddard Blythe

• Herausgeber: John Wiley & Sons
• Sprache: Englisch

Seitenzahl: 192

Veröffentlichungsjahr: 2024

Beschreibung

Updated INPP training manual for determining immature neuromotor skills in children and associated interventions to improve neuromotor ability

The substantially revised and expanded Second Edition of Assessing Neuromotor Readiness for Learning is a long-established INPP training manual that has been consistently proven in practice which includes neuromotor skill tests for children, a developmental movement program, and information about paid online access to INPP video training materials.

The book comprises two main sections: Simple screening tests for use by teachers in schools to investigate whether immature neuromotor skills are a factor in children who are under-performing in literacy, numeracy, and writing or who may be underachieving, as well as a developmental movement program designed to be introduced into schools as a class-based activity, which is carried out under teacher supervision for 10 minutes per day, every day over the course of one academic year.

The manual is not intended to be used as a stand alone assessment for diagnostic purposes, but rather a simple means of screening for physical factors which can underlie specific learning difficulties and underachievement, and which respond to the school intervention program.

Assessing Neuromotor Readiness for Learning includes information on:

• Simple tests to identify signs of difficulty with visual tracking, control of saccadic eye movements, and aberrant reflex response
• Testing gross muscle coordination and balance via the Tandem Walk and walking on the outsides of the feet (the Fog test)
• Assessing visual-auditory-speech recognition of sounds, including individual sounds, sound blends, syllables, and synthesis of the three
• Utilizing various neuromotor tests, including the Romberg test, the one leg stand, crossing the midline, and the finger and thumb opposition test for qualitative purposes.

Assessing Neuromotor Readiness for Learning is an essential guide for teachers who want to identify children who may be under-achieving as a result of immature motor skills, implement the INPP screening test and/or program into their lessons, as well as researchers interested in using the screening test to evaluate children’s neuromotor skills and efficacy of various intervention programs.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

About the Companion Website

1 Introduction

1.1 OVERVIEW

(1)

1.2 RATIONALE FOR SCREENING AND REMEDIATION OF NEUROMOTOR IMMATURITY

1.3 WHAT IS THE INPP?

1.4 THE INPP DEVELOPMENTAL MOVEMENT PROGRAMME FOR SCHOOLS

1.5 WHAT IS NEUROMOTOR IMMATURITY?

1.6 WHAT IS THE SIGNIFICANCE OF PRIMITIVE REFLEXES TO EDUCATION?

1.7 WHAT ARE PRIMITIVE REFLEXES?

1.8 WHAT IS THE SIGNIFICANCE OF NEUROMOTOR MATURITY TO EDUCATION?

1.9 WHAT IS THE PURPOSE OF DEVELOPMENTAL SCREENING TESTS?

1.10 WHY ASSESS POSTURE AND BALANCE?

1.11 WHY CARRY OUT ASSESSMENTS FOR BALANCE?

1.12 WHAT IS THE DIFFERENCE BETWEEN STATIC BALANCE AND DYNAMIC BALANCE?

1.13 WHAT IS THE SIGNIFICANCE OF POSTURAL CONTROL IN LEARNING?

1.14 PRIMITIVE REFLEXES: WHY HAVE THESE THREE REFLEXES BEEN SELECTED FOR EVALUATION?

1.15 WHAT EVIDENCE IS THERE LINKING BALANCE, POSTURE AND REFLEXES TO EDUCATIONAL ACHIEVEMENT?

1.16 WHAT EVIDENCE IS THERE THAT INTERVENTION IN THE FORM OF MOVEMENT PROGRAMMES AIMED AT THE LEVEL OF PRIMITIVE REFLEXES IMPROVES EDUCATIONAL OUTCOMES?

1.17 HOW TO USE THE SCREENING TESTS

REFERENCES

2 Developmental Screening Tests for Use with Children Aged 4–7 Years

2.1 GENERAL INSTRUCTIONS

2.2 NEUROMOTOR TESTS

2.3 TESTS FOR PRIMITIVE REFLEXES

2.4 TESTS FOR VISUAL PERCEPTION AND VISUAL‐MOTOR INTEGRATION

2.5 SCORE SHEETS FOR 4–7 YEAR OLD TEST

2.6 OBSERVATION SHEETS

2.7 INTERPRETING THE SCORES

REFERENCES

3 Developmental Screening Tests for Use with Children from 7 Years of Age

3.1 GENERAL INSTRUCTIONS

3.2 TESTS FOR GROSS MUSCLE COORDINATION AND BALANCE

3.3 TESTS FOR ABERRANT PRIMITIVE REFLEXES

3.4 TESTS FOR OCULOMOTOR FUNCTIONING

3.5 TESTS FOR VISUAL‐SPEECH RECOGNITION

3.6 TESTS FOR VISUAL PERCEPTION AND VISUAL‐MOTOR INTEGRATION

3.7 SCORE SHEETS (7 + TEST)

3.8 OBSERVATION SHEETS (7 + TEST)

3.9 HOW TO INTERPRET THE SCORES

REFERENCES

4 The INPP Developmental Movement Programme

4.1 HOW TO USE THE INPP DEVELOPMENTAL MOVEMENT PROGRAMME

4.2 THE DEVELOPMENTAL MOVEMENT PROGRAMME

4.3 ADDITIONAL OPTIONAL EXERCISES FOR INTEGRATION OF LEFT AND RIGHT

4.4 POSTSCRIPT

REFERENCES

Appendix 1: Resources

A1.1 TEST AND EXERCISE VIDEO CLIPS

A1.2 TRAINING

A1.3 SUPPLEMENTARY RESOURCES

A1.4 OTHER BOOKS BY THE AUTHOR

A1.5 INPP TRAINING COURSES

Appendix 2: Chapter 2 Test Resources

A2.1 TANSLEY STANDARD FIGURES

A2.2 VERTICAL, HORIZONTAL AND DIAGONAL LINES

A2.3 OBSERVATION SHEET FOR CHAPTER 2 TESTS

A2.4 SCORING SHEET FOR CHAPTER 2 TESTS

Appendix 3: Chapter 3 Test Resources

A3.1 TEST FOR FIXATION, CONVERGENCE AND CONTROL OF SACCADES

A3.2 TEST FOR VISUAL INTEGRATION

A3.3 SOUND DISCRIMINATION (INDIVIDUAL SOUNDS, SOUND BLENDS AND SYLLABLES)

A3.4 SOUND SYNTHESIS

A3.5 THE TANSLEY STANDARD VISUAL FIGURES TEST

A3.6 ADAPTED BENDER VISUAL‐GESTALT TEST

A3.7 OBSERVATION SHEETS FOR CHAPTER 3

A3.8 SCORING SHEETS FOR CHAPTER 3

End User License Agreement

List of Tables

Chapter 4

Table 4.1 Guideline for progress through the exercises

List of Illustrations

Chapter 1

Figure 1.1 ATNR in a neonate

Figure 1.2 The ATNR is inhibited at about 6 months

Figure 1.3 The STNR in extension

Figure 1.4 The STNR in flexion

Figure 1.5 Sitting posture typical of an STNR in flexion

Chapter 2

Figure 2.1 Test position for the Romberg test

Figure 2.2 Test position for the one leg stand test

Figure 2.3 Test position for crawling on hands and knees test (quadruped ‘ta...

Figure 2.4 (a) Test position for crossing the midline test (1) (b, c) Test p...

Figure 2.5 (a, b) Test position and procedures for crossing the midline test...

Figure 2.6 (a) Test position for finger and thumb opposition test (b, c) Tes...

Figure 2.7 Test position for the Ayres test for the ATNR

Figure 2.8 Test position for the STNR test – head flexion and extension

Figure 2.9 Test position for the erect test for the TLR

Figure 2.10 Pencil and paper tests based on the Tansley Standard Visual Figu...

Figure 2.11 Pencil and paper tests based on lines (under screening condition...

Chapter 3

Figure 3.1 Test position for the Tandem Walk NB. The toe and heel should mak...

Figure 3.2 Test position for the Fog Walk arms to the sides

Figure 3.3 Test position for the quadruped test for the ATNR

Figure 3.4 Test position for the Hoff–Schilder Test for the ATNR

Figure 3.5 Test position for the STNR

Figure 3.6 Test position for the erect test for the TLR

Figure 3.7 Test for fixation, convergence and control of saccades (Valett) (...

Figure 3.8 Test pattern for visual integration (under screening conditions, ...

Figure 3.9 Sample of the Tansley Standard Figures (under screening condition...

Figure 3.10 First drawing of Tansley Standard Figures

Figure 3.11 Second drawing of Tansley Standard Figures – 3 months later

Figure 3.12 Adapted Bender Gestalt Figure test (ABG test) (under screening c...

Figure 3.13 ABG test before intervention

Figure 3.14 ABG test at 5 months into a 12–18 month individual INPP programm...

Chapter 4

Figure 4.1

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Appendix 2

Figure A2.10 Tansley Standard Figures (for use under screening conditions)

Figure A2.11 (a–c) Vertical, horizontal and diagonal lines (for use under sc...

Appendix 3

Figure A3.7

Figure A3.8 Test pattern for visual integration

Figure A3.9 Tansley Standard Figures in landscape orientation

Figure A3.12 Adapted Bender Gestalt Figure test (ABG test)

Guide

Cover Page

Table of Contents

Title Page

Copyright Page

About the Companion Website

Begin Reading

Appendix 1 Resources

Appendix 2 Chapter 2 Test Resources

Appendix 3 Chapter 3 Test Resources

WILEY END USER LICENSE AGREEMENT

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Assessing Neuromotor Readiness for Learning

The INPP Developmental Screening Test and School Intervention Programme

Second Edition

Sally Goddard Blythe

This second edition first published 2025© 2025 John Wiley & Sons Ltd

Edition HistoryJohn Wiley & Sons, Inc. (1e, 2012)

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Library of Congress Cataloging‐in‐Publication Data Applied For:Paperback ISBN: 9781394337736

Cover Design: WileyCover Image: © Ariel Skelley/Getty Images

About the Companion Website

Assessing Neuromotor Readiness for Learning ‐ The INPP Developmental Screening Test and School Intervention Programme, 2nd Edition is accompanied by a companion website

www.wiley.com/go/blythe/neuromotorreadiness2 

The website includes:

Appendix 2

Appendix 3

1Introduction

▶ 1.1 OVERVIEW(1)

A significant percentage of children in mainstream schools have been found to have immature motor skills and postural instability.(2,3,4) Such neuromotor immaturity is often rooted in the continued presence of a cluster of primitive reflexes (normally present in infants up to 6 months of age, and then replaced over time by postural reactions). Research has shown that there is a direct correlation between immature motor skills and educational achievement. With proper guidance and instruction, teachers and other professionals can be trained to screen for signs of such delay, so that appropriate referrals can be made or physical intervention programmes introduced. This book provides all the tools and guidance needed to identify children with such immaturity, implement a physical programme if appropriate and evaluate outcomes.

There are many motor training and movement programmes available, but the model developed by the Institute for Neuro‐Physiological Psychology (INPP) described in this book is unique in having been evaluated in practice and offering a means of assessing neuromotor status in the pre‐school and school‐aged child both at the beginning and at the end of intervention.

The book is organised in three sections:

The first section offers a series of screening tests for children aged 4–7 years to assess the presence of three reflexes, control of static balance, coordination, visual perception and visual‐motor integration.

The second section provides a similar series of screening tests for children from 7 years of age and above.

The third section details a complete developmental movement programme designed to be used with whole classes or smaller groups of children over the course of one academic year.

This book is supported by additional test materials and observation and score sheets to download available from www.wiley.com/go/blythe/neuromotorreadiness2. and enhanced by INPP video training materials, available for download purchase from https://www.inpp.org.uk/accessnmr.

▶ 1.2 RATIONALE FOR SCREENING AND REMEDIATION OF NEUROMOTOR IMMATURITY

The INPP programme for schools is based on a clinical programme developed at the INPP and it has been used since the 1970s. In 1996, key tests were selected from the INPP full diagnostic assessment and clinical programme and adapted by the author for use with larger groups of children in a school setting.

This adapted series of screening tests is intended to be used by teachers, doctors and other trained professionals involved in child development and education as a screening tool only. It will not provide sufficient detailed information to justify a diagnosis, nor is it intended to replace standard neurological examinations, psychological or educational assessments usually carried out by trained psychologists, remedial specialists, medical and other non‐medical professionals. It will, however, provide tools that enable a teacher to identify children who are under‐achieving as a result of immature neuromotor skills and who are likely to benefit from the INPP programmes or other physical remedial programmes.

The INPP developmental movement programme comprises a series of daily exercises, based on movements normally made by the developing child in the first year of life. These movements must be carried out every day under teacher supervision. One of the major differences between the INPP programme and many other programmes designed to improve coordination and balance, is that the INPP exercises take children back to the very beginning of balance training and postural development.

▶ 1.3 WHAT IS THE INPP?

The Institute for Neuro‐Physiological Psychology was established in 1975 by psychologist Peter Blythe PhD with several aims in mind:

To carry out research into the effects of immaturity in the functioning of the central nervous system (CNS) in children with specific learning difficulties (and adults suffering from anxiety states, agoraphobia and panic disorder).

To develop reliable methods of assessing CNS maturity.

To devise effective remedial intervention programmes.

Children seen at the INPP are examined on an individual basis using a series of standard medical tests to assess a range of physical abilities:

gross muscle coordination and balance;

patterns of motor development;

cerebellar involvement;

dysdiadochokinesia (ability to carry out rapid alternate movements);

aberrant primitive and postural reflexes;

oculomotor functioning (control of eye movements);

visual perception;

visual motor integration (VMI);

audiometric examination and dichotic listening.

The diagnostic assessment findings provide the basis for an individual regime of physical exercises which the child carries out every day at home under parental supervision. The exercises take between 5 and 10 minutes a day over a period of approximately 12 months. The child is reviewed at 6 to 8 weekly intervals to assess progress and adjust the exercises accordingly.

One of the problems with the INPP clinical programme has always been that it involves detailed assessment on a one‐to‐one basis, is costly in terms of professional time and can, therefore, only reach a relatively small number of the children who would benefit from this type of assessment and intervention. It was to overcome this problem that, in 1996, the author selected a reduced number of tests from the INPP diagnostic assessment and compiled the shortened screening tests in this book, which have been designed to be used as a screening device by teachers and other professionals involved in education and child development, to enable them to identify children with signs of neuromotor immaturity.(5)

▶ 1.4 THE INPP DEVELOPMENTAL MOVEMENT PROGRAMME FOR SCHOOLS

As part of the same package, the author also devised a unique developmental movement programme for use in schools. The concept behind the combined screening tests and developmental programme was that teachers could be trained in a 1‐day course how to administer the screening tests, enabling them to identify children with signs of neuromotor immaturity in the classroom and implement effective intervention.

The Developmental Movement Programme is designed to be used with a whole class of children or smaller selected groups for 10 minutes a day, every school day, over the course of one academic year. Teachers do not select specific exercises for individual children but use the developmental movements in sequence, progressing according to the abilities of the class with the slowest child setting the pace.

This programme has been widely used in individual schools throughout the UK, in other European countries and as far afield as South Africa and Mexico. Research carried out on the screening tests and developmental movement programme has consistently shown that:

Neuromotor immaturity is a factor amongst children in mainstream schools.

There is a link between neuromotor immaturity and lower educational performance.

The INPP Developmental Movement Programme is effective in reducing markers of neuromotor immaturity.

When clear signs of neuromotor immaturity (> 25%)

and

educational under‐achievement coexist, children who followed the INPP developmental movement programme showed greater improvements in measures of non‐verbal cognitive performance and reading.

(6)

Small group studies have indicated that children who were under‐achieving by more than a year in reading and who had clear signs of neuromotor immaturity (> 50%) made significantly increased gains in reading at the end of the year having followed the INPP Developmental Movement Programme.

(7)

▶ 1.5 WHAT IS NEUROMOTOR IMMATURITY?

Neuromotor performance describes a complex functional behaviour which results from activation of the central and peripheral nervous systems and involves motor structures which operate through the musculoskeletal system involving multiple inputs from the individual’s internal and external environment. The systems and structures responsible for movement within an individual are constantly evolving throughout the developmental process, but at certain stages in development a child is expected to have attained a certain level of neuromotor performance. Motor milestones and motor performance provide outward signs of functional neuromotor maturity.

Neuromotor immaturity describes the retention of immature patterns of movement control. These may occur as a result of classical neurological signs (pathology) or be reflective of a functional or developmental delay in the pathways involved. The INPP screening tests are aimed at identifying various ‘soft signs’* of neurological dysfunction together with the presence of three primitive reflexes in the school‐aged population. These tests do not point to causation, nor do they predict learning outcomes in individuals, but they can help to identify the presence of obstacles to educational achievement. Furthermore, in many cases, these obstacles can be removed with the use of a specific developmental movement programme.

▶ 1.6 WHAT IS THE SIGNIFICANCE OF PRIMITIVE REFLEXES TO EDUCATION?

Primitive reflexes are included in the INPP screening tests because the presence of primitive reflexes at key stages in development provides acknowledged signposts of maturity in the functioning of the CNS. While doctors, midwives and health visitors are familiar with assessment of the primitive reflexes at birth, and tests for primitive reflexes are repeated at developmental check‐ups in the first 6 months of postnatal life, if development appears to be progressing normally in the first year then these tests are not repeated in the pre‐school or school‐aged child. Capute(8) noted:

While motor milestones – the neurodevelopmental functional end point of the transitioning of the immature and mature primitive reflexes into volitional activity – have been highlighted in predicting future motor function, the primitive reflexes represent the earliest neurodevelopmental markers available for study. By paediatricians becoming familiar with their quantitative and qualitative aspects, coupled with the time of their appearance and suppression, they will have this neuromotor tool available for the early detection of a significant motor handicap. Primitive reflexes have been highlighted since they are available at birth to be clinically evaluated and followed during sequential office visits during the first six months of life, the time during which infants are more closely followed at office visits. Delay or deviancy (non‐sequential appearance) of motor milestones are preceded by an exaggeration or delayed suppression of the primitive reflexes.

Residual primitive reflexes in the school‐aged child are not necessarily the primary cause of difficulties observed in the classroom but, rather, signify immaturity in the functioning of the CNS and associated pathways, which support many higher aspects of learning.

▶ 1.7 WHAT ARE PRIMITIVE REFLEXES?

Primitive reflexes are a group of reflexes that develop during life in the womb, are fully developed at birth in the full‐term baby (40 weeks) and are gradually inhibited and transformed into more mature patterns and postural abilities during the first 6 months of postnatal life. Only one of the primitive reflexes, the Tonic Labyrinthine Reflex (TLR), can remain in a modified form up to 3.5 years of age.