Developmental Motor Delay

Spinal Health in Children

The majority of spinal problems in infants, children and adolescents can easily be traced to un-ideal early motor development. However neurological and developmental origins of spinal problems in children are largely unrecognized by the mainstream of medical profession in the United States and timely diagnostics of developmental delays are virtually nonexistent. In most of the cases motor deficiencies in small children are entirely missed in the course of routine examinations by pediatricians. Consequently the diagnosis is often delayed until the resulting pathology becomes so obvious that it is actually the parents who spot the problem by comparing their child with other children of the same age and bring it to attention of their pediatrician.

Left unattended, motor development problems often result in disabilities that in the long run may greatly impede lives of the affected children. The range of repercussions of these developing disabilities is not confined to future back and joint pain. They greatly influence the overall emotional and physical health of the child.

We should not put an entire blame on the individual pediatricians for not thinking outside the box’. It is a scourge of the medical education in our country that if something is not taught in the medical school it simply does not exist. Even when a motor delay is recognized, the practitioner’s strategy is often limited to the so-called watchful waiting’ approach. Indeed, because of the enormous adaptive capacity of the Central Nervous System in the first years of child’s life, most of the children with motor delays do catch up. This compensatory adaptation however can have its own set of repercussions that will be discussed below.

It is not the well-timed achievement of conventional chronological milestones alone that plays an important role in the normal progress of a child. The qualitative aspect is equally important not only for future motorics (movement and posture) but for the health of the rest of mind and body. Even if the child is meeting general time frame of developmental requirements, the quality of the performance of the tasks that constitute the milestones may be significantly below the required level. Things like improper position of the head or exaggerated protrusion of the shoulder are often overlooked entirely or unwisely disregarded as insignificant glitches that would be corrected over time. Careful observation by trained specialist can reveal however even very subtle qualitative abnormalities in child’s performance of the milestone tasks allowing timely diagnosis and prompt corrective measures.

From the motor development perspective from early on we commonly observe poor coordination and balance, postural deviations, scoliosis, torticollis, poor sensory awareness (the child incorrectly perceives the external environment and relation of his body to the surroundings), poor fine motorics (an ability to grasp and manipulate small objects with the fingers). Later, as the child matures into subsequent age groups, more advanced symptoms and conditions emerge. These may include headaches, dizziness, inability to perform in the sporting and recreational activities due to poor motor coordination, developing back pain, proliferation of athletic injuries and persistent fatigue.
It must be understood that the impairment of motor development always occurs in combination with abnormalities in other functionality ultimately affecting respiratory, urinary and digestive systems. Such children often develop asthma and improper breathing stereotypes, abnormal dental occlusions, bed wetting and unexplained frequent urinations. All these conditions stem from the same source and represent equally important health concerns. However no less important are the effects that inadequate motor development in the infant stage has on behavioral, cognitive and emotional well being of the growing individual.
Inability to maintain concentration, difficulties in learning and below-the-par school performance can all be attributed to the early developmental delays. It is a scientific fact that a human brain has a set capacity for processing the inflow of the external information. This could be illustrated with a simple example of one’s limited ability to perform multiple tasks simultaneously or at least with equal dexterity. One simply can not exercise, eat, read a book, and watch television all at the same time. Either one of the tasks will take precedence over others or all of them will be performed inadequately. Therefore, when the child’s brain is overloaded by compensatory efforts to correct developmental motor deficiencies (abnormal posture, decreased bodily stability, etc.) it cannot adequately process the inflow of other external stimuli including learning material.

Contrary to common belief, these children do not have intellect problems. Constant bombardment of the brain’s processing centers by firing of postural receptors takes away from brain’s ability to process other information. These are the children that cannot sit still and are constantly moving. When such children are constrained to the school desk they are uncomfortable, frequently shifting positions, and always support their heads with an arm. They are difficult to deal with for parents and teachers. When seen by specialists they are often labeled with ADHD (Attention Deficit Hyperactivity Disorder) and prescribed Ritalin as the commonly accepted medical treatment.

We do not imply that ADHD is solely caused by developmental motor deficit or that all children with motor developmental disorders will develop ADHD. It is however our experience supported by recent scientific research, that motor coordination training greatly reduces hyperactivity and increases attention span in children with ADHD by normalizing their body perception, improving spinal/postural stability therefore enhancing the ability of the child’s brain to process sensory information. Furthermore, advanced Motor Coordination Training intervention corrects faulty breathing stereotypes (because they are intimately connected with posture and spinal stability), relaxes muscles as the child’s movement and maintenance of posture becomes more economical. When the child is relaxed he is calmer and therefore his perception and cognitive abilities become keener.

In the majority of cases disturbance of sensory integration called Sensory Processing Disorder (SPD) comes in combination with Developmental Motor Coordination Disorder (DMCD). However most of the time only sensory symptoms come to attention of parents and teachers obscuring the DCMD component of the problem. Often motor delays elude detection whatsoever since later in the development the nervous system compensates and the child catches up with the quantitative motor development requirements.

This compensation however, while appearing satisfactory at the moment’, is not (and cannot be) adequate in our world of ever increasing stresses. As the child grows up, new challenges create continuous pressure on the developing organism requiring further compensatory effort layering on top of the previous one leaving the initial problem unresolved. This produces a snowballing’ effect forcing the Central Nervous System to keep committing its resources in order to maintain the pace with quantitative requirements. Such disproportionate expenditure of compensatory assets by the Central Nervous System combined with accumulation of unresolved qualitative developmental issues result as a rule in various health problems in the adult life, including back pain and other pathological conditions of the locomotor system.

Neither mainstream pediatricians nor the parents are trained to correctly evaluate the child’s qualitative motor performance. When the child begins to walk, even with utmost clumsiness and poor coordination, it becomes less of a concern to the observing adults who are relieved with the child touching an important milestone hoping that eventually the nature will take its course and quality of the performance issues will resolve themselves. Unfortunately this is rarely the case. The lack of coordination and improper movement that resulted from undetected motor delays at the earlier developmental stages will remain affecting the entire future of the individual including academic achievements, career performance and physical and psychological health. All this is indicative that in treating sensory disturbances, motor disorder symptoms should not be overlooked.

See list of symptoms….When in the course of our therapy we address patient’s coordination and motor function we immediately see improvement of the sensory system, improved attention span and decrease in hyperactivity. In our clinical experience addressing motor dysfunction in conjunction with dysfunction of brain’s processing ability brings faster and sounder results. These patients begin to feel better about them, their emotional state stabilizes and their academic performance improves on all levels. Attention, Balance and Coordination are the primary A, B and C upon which all later academic and career success depends.

In clinical practice we frequently,albeit not always, see children with altered perception and motor deficit of developmental origin. It is futile to treat only sensory symptoms when motor in-coordination is present, as it is frequently the case. When we address coordination and motor behavior we immediately see improvement of the sensory system, therefore improving attention and decreasing hyperactivity. In my clinical experience addressing motor dysfunction together with dysfunction of brain’s processing ability brings faster and sounder results.