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Understanding Neuro Developmental Delay

Neuro Developmental delay 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 responses still remain active in the system.

Image Babies move around in the uterus and it has long been established that infant reflexes are the dominant form of human movement before birth and in the first few months of life. These reflexive movements are involuntary and are stimulated without involvement of the higher centres in the brain. Some are important to help the baby come through the birth canal in a spontaneous vertex delivery and others help the baby to survive his/her early months of life. Shortly after birth part of the paediatric examination includes testing for the presence of some of those primitive reflexes, in particular those that are necessary for survival. Some of the reflexes tested at this time include the familiar infant suck, rooting and palmar grasp reflexes. If those (and others) reflexes are absent or weak in a full term infant the baby is placed under close observation in the special care baby unit and a neural disorder may be suspected.

Image The developing brain gradually controls these primitive reflexes, and as it does, the baby moves from the involuntary movements to executing planned movements, albeit crude at first. An example of this is when a baby starts to throw an object out of the cot, and will continue to do so as long as someone is prepared to pick it up each time and hand it to him/her. The baby is now losing the automatic hand-grasping reflex (palmar grasp reflex).

There are many other reflexes that should not be present by the end of the baby's first year of life. The term Neuro Developmental Delay may be used where a cluster of the early primitive reflexes are still present above the age of one year or where there is under development of postnatal muscle control above the age of 3 years. The reflexes develop in a sequence and should also be controlled in a sequential pattern.

Thelen (1979) researched the rhythmical and patterned movements of infants in early life and reached the conclusion that these stereotyped movements are developmentally very significant and are precursors of 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 stimulating the brain to cope with the challenges that life will present.

This is particularly relevant when we consider the goals and skills we expect children to gain in school. When they enter primary school we presume that children have the ability to sit and listen attentively, learn to hold a pencil correctly and gradually over the following years learn to write, copy, read with fluency and spell accurately. Quite often children who have difficulty with one or more of these tasks have not passed through the appropriate stages of early development to allow them make the most of their intelligence and reach their potential. Therefore, the path to learning may be wrought with frustration, accusations of not trying and associated stress.
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