Attention, Balance and Coordination E-Book

Sally Goddard Blythe

• Herausgeber: John Wiley & Sons
• Kategorie: Geisteswissenschaft
• Sprache: Englisch

Seitenzahl: 674

Veröffentlichungsjahr: 2011

Beschreibung

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 in development and their effects on learning, behaviour and beyond - also covers adult neurological dysfunctions anxiety and agoraphobia * Builds on an ABC 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 with guidance on how to use and interpret it

Leseprobe

Contents

ABOUT THE AUTHOR

CONTRIBUTORS

PREFACE

ACKNOWLEDGEMENTS

CHAPTER 1 WINDOWS ON THE BRAIN

INTRODUCTION

DEVELOPMENTAL READINESS FOR EDUCATION

WHAT IS NEURO-DEVELOPMENTAL DELAY?

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

PRIMITIVE AND POSTURAL REFLEXES – THE MEDICAL MODEL

NEUROLOGICAL DYSFUNCTION IN SPECIFIC LEARNING DIFFICULTIES

DIAGNOSTIC CRITERIA, SIGNS, AND SYMPTOMS OF SPECIFIC LEARNING DIFFICULTIES

DYSLEXIA – SIGNS AND SYMPTOMS

DCD (DYSPRAXIA)

ATTENTION DEFICIT DISORDER (ADD)

UNDERACHIEVEMENT

THE SENSORY-MOTOR CONNECTION

THEORIES OF MOTOR CONTROL

REFERENCES

CHAPTER 2 THE SIGNIFICANCE OF PRIMITIVE AND POSTURAL REFLEXES

WHAT ARE PRIMITIVE AND POSTURAL REFLEXES?

WHAT CAN PRIMITIVE AND POSTURAL REFLEXES TELL US?

THE DEVELOPING BRAIN

THE EMERGENCE OF SPINAL REFLEXES

REFLEXES MEDIATED AT THE SPINAL LEVEL

REFLEXES MEDIATED IN THE BRAINSTEM

REFLEXES AS REFLECTIONS OF HIERARCHICAL DEVELOPMENT

AREAS OF THE BRAIN INVOLVED IN THE MEDIATION OF PRIMITIVE AND POSTURAL REFLEXES

THE MULTISENSORY REFLEX – THE MORO REFLEX

CHARACTERISTICS OF THE FEAR PARALYSIS REFLEX

MORO REFLEX ACTIVATORS

FUNCTIONS OF THE MORO REFLEX

PHYSIOLOGICAL RESPONSE TO THE MORO REFLEX

IMPLICATIONS OF A RETAINED MORO REFLEX

SYMPTOMS OF SCOTOPIC SENSITIVITY SYNDROME (SSS)

GENERAL SYMPTOMS ASSOCIATED WITH A RETAINED MORO REFLEX

BEHAVIOURAL OUTCOMES ASSOCIATED WITH A RETAINED MORO REFLEX

REFERENCES

CHAPTER 3 PRIMITIVE REFLEXES OF POSITION

TONIC LABYRINTHINE REFLEX (TLR)

DEVELOPMENT OF HEAD CONTROL

WHY IS HEAD CONTROL SO IMPORTANT?

THE TONIC LABYRINTHINE REFLEX (TLR) AND EARLY FEEDING

ASYMMETRICAL TONIC NECK REFLEX (ATNR)

SYMMETRICAL TONIC NECK REFLEX (STNR)

REFERENCES

CHAPTER 4 PRIMITIVE TACTILE REFLEXES

PALMAR GRASP REFLEX

PLANTAR REFLEX

ROOTING REFLEX

SUCKLING AND SUCKING REFLEXES

THE SPINAL GALANT REFLEX

REFERENCES

CHAPTER 5 POSTURAL REFLEXES

HEAD RIGHTING REFLEXES

RIGHTING, PLACING, AND EQUILIBRIUM REACTIONS

PARACHUTE REFLEX

REFERENCES

CHAPTER 6 USE OF THE INPP SCREENING QUESTIONNAIRE

THE INPP SCREENING QUESTIONNAIRE FOR CHILDREN

HOW TO USE THE INPP QUESTIONNAIRE

REFERENCES

CHAPTER 7 POST-NATAL FACTORS USING THE INPP QUESTIONNAIRE

SCHOOLING

SCORING THE INPP QUESTIONNAIRE

RESEARCH INTO THE RELIABILITY OF THE INPP QUESTIONNAIRE

REFERENCES

CHAPTER 8 THE DEVELOPMENT OF THE VESTIBULAR-CEREBELLAR THEORY

ORIGINS

DEVELOPMENT OF BALANCE

CEREBELLUM AND BALANCE

SIGNIFICANCE OF VESTIBULAR DYSFUNCTION

SYMPTOMS OF VESTIBULAR PROBLEMS64

REFERENCES

CHAPTER 9 THE EFFECTS OF NEURO-DEVELOPMENTAL DELAY IN ADULTS AND IN ADOLESCENTS

PROBLEMS IN HIGHER EDUCATION

VESTIBULAR CONNECTIONS TO THE RETICULAR ACTIVATING SYSTEM (RAS)

ADOLESCENT AND ADULT MANIFESTATIONS OF NDD – A CLINICAL PERSPECTIVE

REFERENCES

CHAPTER 10 DEVELOPMENT OF THE INPP METHOD – FROM THEORY TO FACT

REFERENCES

CHAPTER 11 OTHER FACTORS IN SPECIFIC LEARNING DIFFICULTIES

UNRAVELLING THE THREADS

USE OF PHYSICAL TESTS TO ASSESS NEUROLOGICAL READINESS IN SCHOOLS

APPLICATION OF THE INPP METHOD

THE NEURO-EDUCATOR

ATTENTION, BALANCE, AND COORDINATION

REFERENCES

APPENDIX 1 SCREENING FOR NEUROLOGICAL DYSFUNCTION IN THE SPECIFIC LEARNING DIFFICULTY CHILD

ABSTRACT

INTRODUCTION

EARLY IDENTIFICATION

AIM OF THE STUDY

METHOD

ANALYSIS OF THE QUESTIONNAIRE AS A MEANS OF IDENTIFYING SPECIFIC LEARNING DIFFICULTIES

ANALYSIS OF INDIVIDUAL QUESTIONS

RESULTS

DISCUSSION

CONCLUSIONS

REFERENCES

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

This edition first published 2009

© 2009 John Wiley & Sons Ltd, except for appendix I, which is a revised and adapted version of a study published by the College of Occupational Therapists; and appendix II, which is revised and adapted from www.listenhear.co.uk, published by Steven Brown, for which permission has been kindly granted.

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LibraryofCongressCataloging-in-PublicationData

Goddard, Sally, 1957–

Attention, balance, and co-ordination: the A.B.C. of learning success/

Sally Goddard Blythe; with contributions from Lawrence J Beuret and

Peter Blythe.

p. cm.

Includes bibliographical references and index.

ISBN 978-0-470-74098-9 (cloth) – ISBN 978-0-470-51623-2 (pbk.)

1. Reflexes–Handbooks, manuals, etc. 2. Child development–Handbooks, manuals, etc.

3. Developmental disabilities–Physiological aspects–Handbooks, manuals, etc. 4. Learning–Physiological aspects–Handbooks, manuals, etc. I. Beuret, Lawrence J.

II. Blythe, Peter. III. Title.

QP372.G57 2009

612.6′5 – dc22

2008047079

Set in 10 on 12 pt Palatino by SNP Best-set Typesetter Ltd., Hong Kong

Printed in Singapore by Markono Print Media Pte Ltd

ABOUT THE AUTHOR

SallyGoddardBlythe is a Consultant in Neuro-Developmental Education and currently the Director of The Institute for Neuro-Physiological Psychology (INPP) in Chester, England.

She has worked in the area of neuro-development for more than 20 years and is the author of several books and published papers on child development and neuro-developmental factors in specific learning difficulties. Her first book, Reflexes,LearningandBehavior, has provided the basic information for many other professions throughout the world now using reflex assessment. Her subsequent books, TheWellBalancedChild and WhatBabiesandChildrenReallyNeed, examine the importance of physical development for later learning success, health, well-being, and social integration.

She is the author of The INPP Test Battery and Developmental Exercise Programme for Use in Schools – a programme of daily exercises designed to be used in schools with a whole class of children over one academic year – this programme has been the subject of published research initially involving 810 children across schools in the UK. The aim of the programme is to provide teachers with a method to enable them to identify physical readiness for learning and how to use a physical intervention programme designed to encourage physical readiness for learning in children of all ages.

CONTRIBUTORS

PeterBlythe,PhD was formerly a Senior Lecturer in Applied Psychology/Education at the College of Education in Lancashire. In 1969, he became aware that many children with average to above-average intelligence who have specific learning difficulties in the classroom still had a cluster of primitive reflexes that should not be present above the first year of life and underdeveloped postural reflexes, which are necessary to support all aspects of education. These developmental ‘signposts’ of maturity in the functioning of the central nervous system were connected to inability to demonstrate their intelligence in an acceptable academic way.

In 1975, he established The Institute for Neuro-Physiological Psychology (INPP) where he developed protocols of assessment and effective remedial intervention. He was the Director of INPP until 2000.

The INPP in Chester is the international training centre for professionals seeking access to The INPP Method.

LawrenceJ.Beuret,MD graduated from the Loyola Stritch School of Medicine in Chicago, Illinois. During a fellowship at the Mayo Clinic, he observed a high incidence of learning disabilities in the adolescent psychiatric population. Following two years as an emergency room physician, he entered a private practice in the treatment of psychosomatic and post-traumatic stress disorders (PTSD). In 1985, he trained in Chester, England with Dr Peter Blythe in the INPP treatment techniques for neuro-developmental delay (NDD). In the course of his practice, he has extended the diagnostic and treatment techniques of INPP to include pre-school ages, as well as adolescents and adults with reading and learning difficulties. He is currently active in developing courses for therapists in the recognition and treatment of subconscious aspects of PTSD. His medical practice is in the Chicago suburb of Palatine.

PREFACE

In my years of practice, I have continued to hear a similar story told by parents several times a week. The story is of families who have struggled, usually for several years, to find help for their child but to no avail, despite the fact that they, the school, teachers, and often other professional agencies have been aware that a problem exists for several years. It is all so depressingly familiar.

The story begins something like this. A happy child starts school just prior to his or her fifth birthday. The child may have had a series of minor problems in the early years, such as difficulty with feeding, sleeping, frequent ear, nose, or throat infections, or delay in achieving some developmental milestones such as learning to talk and learning to walk, but these early signs are rarely considered as possible precursors to the problems that may arise in the classroom in the years to come. Because medicine as a profession tends to be focused on the treatment of immediate, short-term outcomes, the longer-term sequelae of these developmental indicators do not re-enter their ken. The early warning signs that were evident in developmental records simply become buried in the system when the handover of responsibility for the developmental progress of the young child is transferred from health visitor and doctor to education at the time of school entry.

Towards the end of the first year of schooling, the teacher may inform the parents that their child is having problems either in relation to difficulties with reading and fine motor skills, or, more often at this stage, problems with attention, ability to sit still, compliance, and social skills. These are often viewed as being primarily behavioural problems requiring behavioural management, but in the developmentally delayed child, the behaviours are usually symptomatic of physical immaturity which is affecting posture, the ability to sit still, the development of freedom from distractibility, control impulsivity, and the ability to read and to react appropriately to the body language of others. It is at this stage that the special needs team may be brought in to provide additional support. Specialist teaching in smaller groups helps as long as it is ongoing but does not necessarily sustain itself over time.

It may take a further two to three years of education before the child is referred to an educational psychologist for formal evaluation of cognitive strengths, weaknesses, and IQ. Generally, a child must be at least two years behind his or her chronological age in reading before referral to an educational psychologist takes place with subsequent recommendations being made for specific support in the educational setting. In severe cases, referral back to the medical profession may be made with recommendations that further investigations should be carried out to see if a diagnosis of developmental coordination disorder (formerly dyspraxia) or attention deficit (hyperactivity) disorder is relevant. By this time, the child is at least eight years of age, and three years of formal education have already passed without anyone investigating whether there might be a physical or neurological basis to the child’s educational difficulties. Even when the child is referred on for occupational therapy or physiotherapy, there is often a wait of several months for assessment and follow-up remedial intervention. Therapy is often carried out in a group setting for a finite period of time, and, while undoubtedly the child benefits from therapy, therapy either does not continue for long enough or is not carried out on a sufficiently regular basis (i.e. daily) to effect change not only in physical coordination but also in cognitive performance.

In effect, these children who are not ‘bad enough’ to qualify for a medical diagnosis, but who are nevertheless delayed in aspects of neurological development, simply fall through the net of services which should be in place to identify their difficulties at an early stage and to provide effective remedial assistance. Teachers recognize the symptoms but struggle to identify the cause or howtohelp, because the physical development of the child does not constitute a major part of teacher training at the time of writing. I have been increasingly reminded of this when delivering training in The Institute for Neuro-Physiological Psychology (INPP) Method to probationary teachers in the UK. When asked, at the beginning of the lecture, how much time students spent in their training on physical infant development, not one hand in the group goes up. A few hands may be raised at the mention of Piagetian stages of development, but only the early years specialists have a good understanding of the importance of sensory-motor development to support later cognitive skills. A child’s learning throughout education is rooted in its own physical development from conception. Mastery of balance, posture, coordination, and adequate vision and hearing are crucial to learning success but do not form a part of statutory assessments when a child starts school. In my view, this constitutes a major deficit in the current education system.

The INPP was originally set up by Peter Blythe in 1975 to research into the effects of central nervous system dysfunction in specific learning difficulties (and adults with anxiety, agoraphobia, and panic disorder that have failed to respond to intervention or therapies of choice), and to devise effective methods of assessment and subsequent remedial intervention. Although the clinical assessment and supervision of remedial programmes for individual cases remain as the main focus of INPP’s work some 30 years later, the INPP also provides training to allied professions in the administration of school-based programmes and ongoing research. As the scope of the work carried out at the INPP has broadened, it has become increasingly apparent that there are gaps between the professional services which should be in place to provide help for individuals experiencing a range of problems linked to developmental delay, also sometimes referred to as central nervous system immaturity or neurological dysfunction.

This book is an attempt to bring together a body of knowledge and to make it available to all professions that are involved, in one way or another, in helping to treat the symptoms of specific learning difficulties and emotional problems. For this reason, different parts of the book are aimed at different readerships. Chapter 1 examines the links between the symptoms of specific learning difficulties and underlying physical dysfunctions. The connections between these two are relevant to the professions of education, psychology, and medicine. The chapters on the role of reflexes in development may be familiar ground for those working within the field of medicine, but the impact of aberrant reflexes on subsequent learning and behaviour is often new ground for doctors, teachers, and psychologists. The effect of aberrant reflexes and vestibular dysfunction in secondary neuroses is relevant to psychiatrists, while the general concept of a neuro-developmental basis for learning difficulties and emotional problems is of interest to parents, teachers, doctors, psychologists, and to anyone involved in planning and implementing educational policy in the future. The application of The INPP Method is to the resolution of educational, emotional, and behavioural problems for which there is an underlying physical cause.

While modern technology has advanced our understanding of a wide range of diseases and the prevention of disease, and has increasingly enabled scientists to look into the functioning of the brain, technology cannot yet reveal everything. Just as gaps exist between professional domains in the investigation and treatment of subclinical disorders, so gaps also exist between what modern scanning equipment, posturography, etc. can detect, and what old-fashioned, less sophisticated methods of assessing the nervous system can show. In many cases, advanced technology does not detect a specific area of abnormality, but simple tests carried out to assess static balance, proprioception, and oculomotor functioning reveal that functional abnormalities are present. These will affect performance on a wide range of skills.

Additionally, findings obtained from clinical practice or field observation are frequently treated as the ‘poor relations’ of research, and can take many years to be accepted in academic circles or to become integrated into general professional practice. In this sense, what is taught to the next generation of professionals as students in universities today are the tried and tested clinical techniques of yesterday, not the developments of the present. This statement should not be misinterpreted to mean that rigorous attention to the scientific method is not an essential part of research and clinical practice; it is, but the scientific methodology also has limitations, and there is a danger that each individual profession becomes so specialized and focused on the minutiae of its own disciplines that it loses the ability to see the bigger picture. Children’s difficulties do not exist in specialist departments; they exist within the context of the whole child.

The techniques used by the INPP cross a number of professional boundaries: The diagnostictechniques and scoring systems are based on tests originally developed by mainstream medicine. This means that if the same tests were carried out by a doctor, physiotherapist, or occupational therapist, they would find identical results. However, the methods of intervention used at the INPP are different from conventional methods used by physiotherapists or by those occupational therapists trained in the techniques of sensory integration; finally, the application of physical tests and physical remediation programmes is to problems of an educational or psychological nature.

The purpose of this book was to bring together the different professional domains and to reach a common understanding of therolethatphysicalfactorscanplay in learning and in emotional problems.

It is not within the scope of a book to provide training in The INPP Method, rather to offer a solid basis to the underlying theories and current research so that professionals can work more closely together for the benefit of children and patients.

Sally Goddard Blythe

March 2008

ACKNOWLEDGEMENTS

Hawthorn Press for permission to include sections relating to The Institute for Neuro-Physiological Psychology Questionnaire originally published in WhatBabiesandChildren ReallyNeed–HowMothersandFathersCanNurtureChildren’sGrowthforHealthandWellbeing and examples of children’s drawings originally published in TheWellBalancedChild.

Paul Madaule, Director of The Listening Centre in Toronto, Canada for permission to include TheListeningCheckList in Chapter 11.

Svea Gold for permission to include an extract from ‘Using the Head Righting Reflex to Check for Warning Symptoms That Something Is Wrong with the Child’s “Gaze Control” and How to Proceed from There’, and for having the faith to publish my first book, ATeacher’sWindowintotheChild’sMind, from which all my subsequent books have grown, and for her tireless curiosity and hard work in seeking to understand and to resolve the problems of children struggling to learn.

Peter Blythe and TheBritishJournalofOccupationalTherapy for permission to include The INPP Questionnaire for Children and research based upon the use of the questionnaire instrument.

Dr Harold Levinson for information and advice.

Peter Blythe and Dr Lawrence Beuret for their invaluable contributions to this book.

Sheila Dobie OBE, Dr Kjeld Johansen, Dr Lutz E Koch, and Dr Heiner Biedermann for developing and sharing their work.

For parents and colleagues who have donated pictures from their personal collections of their own children as babies and in the childhood years.

For many other people whose ideas, research and scholarship over many years have provided the information on which this book is based, and also those people whose contributions through discussion and the sharing of information have been silently woven in to the fabric of knowledge which has supported the development of The INPP Method over many years.

To everyone at Wiley-Blackwell involved in the editing, picture sourcing and production of the book.

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.