Neuro Developmental Delay (NDD)
What is NDD?
Neuro Developmental Delay is the retention of a cluster of primitive reflexes above the age of one as well as the absence or underdevelopment of postural reflexes above the age of three and a half years. When primitive reflexes are still present in a child beyond the age of one and postural reflexes are absent or underdeveloped beyond the age of three and a half, that is an indication of immaturity within the central nervous system. The reflexes are said to be abnormal.
"Abnormal reflexes have also been documented as playing a part in specific learning difficulties and immature behavior." (Fiorentino 1970, Bobath & Bobath 1975, Ayres 1972/3, Bender 1976, Blythe, McGlown 1979, Goddard 1994/96, Wilkinson 1994, Goddard Blythe, 1998 )
Primitive reflexes are automatic movements that are not cortically controlled. They begin in the womb and continue up through 6 months to one year of life. Pediatricians commonly test for these reflexes when assessing a newborn’s neurological health. Postural reflexes are automatic movements that begin after birth and should be in place by the age of three-and-a-half and remain for life. When these reflexes do not inhibit or are not stimulated, as they should in normal development, it can be an indication of problems with the vestibular system and/or immature development of the central nervous system.
Many of the symptom of Neuro Developmental Delay at the brain stem level are also symptoms of some diagnosis such as ADHD, ADD, Oppositional Defiant Disorder (ODD), Dyslexia, Dysgraphia, Dyscalculia, Sensory processing disorder, Auditory Processing disorder, etc. Most of the shared symptoms are a result of dysfunction or immaturity in the Central Nervous System.
Why the Brain Stem?
An insecure Foundation may compromise later development
The stability and success of a building is directly related to its foundation, a secure and strong foundation results in a secure and strong building.
The process of constructing a building is strategic and purposeful. When constructing a building, the builder first lays the foundation, then puts up the walls, the doors and the windows and finally, the roof top. A strong foundation results in a solid building, in the same way, a faulty foundation will result in an unstable building.
A faulty foundation cannot be seen on the outside, however, certain "symptoms" can be observed in the building to alert us that there is trouble. Some of the symptoms of a faulty foundation are doors and/or windows that will not open or close properly, cracks on the wall, etc. If the home owner concentrates on only fixing the doors and windows or cracked walls without addressing the root cause of the problem, namely the foundation, the problem will persists. The only way the problem will be taken care of is if the foundation is fixed.
Generally speaking, the development of the central nervous system can be likened to the construction of a house. What the foundation is to a building, the brain stem is to the central nervous system. Just like a building is constructed in a systematic way : foundation, structure and roof, so the central nervous system develops in a strategic way, first the brain stem which is responsible for involuntary movements, then the midbrain and cerebellum which is responsible for voluntary reflexes, posture and balance, then comes the Cortex where reasoning, learning and logic takes place.
The brain stem has many functions, it is crucial for survival. It is responsible for the neurons that controls heart beat, blood pressure, breathing,
swallowing, laughing or sneezing. It is from the brain stem that involuntary movements are stimulated while the child is still in the womb. As the child grows and develops, these involuntary movements should begin a gradual withdrawal in phases and voluntary movements should take over. In normal child development, the withdrawal of the involuntary movement of the brain stem help stimulate development of body awareness, eye movements, the sensory system, motor movements, etc. all of which lead to age-appropriate behavior, helping the child reach their full potential.
When older children exhibit delays in eye movement, speech, auditory processing, sensory, behavior and / or learning, it may that they are functioning in many areas at the brain stem level - the foundation. In some children, their immune and / or digestive system may be delayed in development and as such may have difficulties with eating, sleeping or breathing.
At ABC Foundations, each child is assessed to determine their lowest point of dysfunction, once that point has been identified, a customized program is put together for the child based on their individual needs. This is what sets up apart from some of the other programs out there.
Most other programs usually focus their remediation on the higher levels of the brain (cerebellum and cortex). These programs are usually beneficial to the child that has no immaturity at the brain stem level. For children with immaturity at the brain stem level, any remediation that does begin at the foundation level (brain stem) will yield little or no results.
Delay at the brain stem
Does My Child need NDD Therapy?
Parents usually seek help for their children when they notice symptoms of delay such as immature behavior, failure to understanding social cues, reading comprehension difficulties, problems with hand / eye coordination or sensory issues such sensitivity to light, sound, etc. During the visit, I let the parents know that we are not going to worry about the symptoms for now. We DO NOT ignore them, but we "put them on a shelf" for a while. Instead of focusing on the symptoms, I conduct a comprehensive assessment to help find out the root cause of the symptoms.
During the assessment, I asses different brain and body systems such as the the visual system, balance and coordination, the motor systems, reflexes and more. These brain and body systems are what provide the foundation of learning for the child. In order for the child to achieve learning success, all these systems need to be functioning properly.
From the comprehensive assessment, I am able to determine the point of breakdown in these systems, and as such able to put a customized program together specific to that child that will target the problems at root cause.
If you have a child who is struggling academically or socially, the key to finding the right solution is in trying to find out the root cause of the problem instead of focusing on the symptoms.