Book Review – Sally Goddard Blythe; Neuromotor Immaturity in Children and Adults.
The author of the book, Sally Goddard Blythe MSc. (Psych) is a Consultant in Neuro-Develpmental Education and Director of The Institute for Neuro-Physiological Psychology (INPP). She has worked at INPP since 1988 and is the author of several books and papers.
As a chiropractor in the Paediatric field with a special interest in child learning and development I have come across Sally's work often. I was delighted to find the announcement of the release of the new book. This book enables practitioners to screen children and adults for neuromotor immaturity.
Although neuromotor immaturity is often not recognised by mainstream doctors as a factor in learning difficulties I find that in practice if these immaturities can be recognised, and rehabilitated then the roadblock to learning is often removed.
So what does this have to do with chiropractic? Posture and balance are important in the learning process. Posture supports and reflects the functional relationship between the brain and the body. Balance is needed for vestibular processing, proprioceptive feedback and visual perception. These aspects of assessment are certainly in the chiropractic remit.
Sally's recent work, “ Neuromotor Immaturity in Children and Adults” provides the clinician with standardised tools to assess these aspects of your patient's status. These tools include the INPP screening test, which includes how to score the tests and four primitive reflex tests (namely ANTR, STNR, TLR and MORO). The book also provides information on how to interpret and score your results. Sore sheets are provided and more can be downloaded from the website.
These tests are easy to perform and provide the practitioner with an insight as to the development of the patient and the integration of their primitive reflexes, ie neuromotor immaturity. In my experience if the primitive reflexes and other soft neurological signs remain active in the older child, the child or adult may then use higher centres of the brain “to cope”. This coping may then make the child/adult more irritable, unable to reach their full potential and or other learning difficulties or behavioural issues.
This book and the tests contained within are not designed to provide the practitioner with a diagnosis of their patient. Rather the tests tells that neuromotor immaturities are likely to be a factor in that patient's presentation. From this point you can refer the patient to an INPP practitioner, to an OT or other professional who can integrate primitive reflexes if you are unable to address this in your practice. I have found that even with just manual therapy alone these primitive reflex, postural and balance issues can sometimes be ameliorated. The screening tests in this book can be revisited throughout the patient's care and the scores noted over time. Although these tests have not been validated in this way, it can still be used as an outcome measure specific to that patient. The screening tests will also help to indicate those patients who should be referred for more specialist assessment and intervention.
The INPP Adult Screening Questionnaire has been included in this book but not the child developmental questionnaire. This is an important omission as before any assessment begins a thorough history should be undertaken. There are two chapters devoted to the developmental questionnaire in Sally's book, “Attention, Balance and Coordination. The ABC of Learning Success.”
This book is a good starting point for clinicians for assessing neuromotor immaturities. It will help you to understand the current neurological status of your patient and the need for further assessment, therapy or referral.