Irish Times Health Supplement 9th January 2007
Finding a cure when 'something is not quite right'
Clumsiness, bed-wetting and poor social skills could be symptoms of mild neuro developmental delay, writes Alison Healy
When parents go to see a neuro developmental therapist, they often say exactly the same thing, according to therapist Moya Mulroy. "So many times I've heard parents say 'there's nothing wrong with my child, but there's something not quite right'," she says. The "something" could be clumsiness, poor balance, difficulty concentrating, dyslexia, poor social skills or bed-wetting. Neuro developmental therapists see these problems as symptoms of a mild neuro developmental delay.
It's all connected with our primitive reflexes, explains Mulroy, a paediatric nurse. We are all born with primitive reflexes. These can be seen in the way a new baby is easily startled or the way he grips a finger. Normal movements cause these reflexes to be shed within the first six to 12 months to allow more sophisticated brain functions to develop. Some children do not lose these primitive reflexes for various reasons and this may prevent other functions developing. Genetic factors could explain the retention of such reflexes, or illnesses such as multiple ear infections. "If a baby's movement is restricted between the ages of nought and one, that can often lead to some skills being compromised for the rest of time," she says.
Mulroy cautions parents against limiting a baby's movement by strapping them into car seats and buggies or carrying them around for long periods. Instead, lie them on their tummies on the floor at intervals to encourage movement.
Early signs of developmental delay might include a failure to crawl, a difficulty in learning to ride a bike and in tying shoelaces or using cutlery. "Or they could be clumsy in sport. You might see a boy who loves football but never gets picked for the team and can't seem to get it together," she says. Neuro developmental therapy (NDT) can help by using a number of movements that are naturally used by a baby and young child to encourage the nervous system to develop. Children are given a programme of exercises that may include crawling, yoga-type movements and an exercise called "the flower". Trampolining and swimming can also help.
"The brain pathways have been blocked and you need to straighten them out. The flower exercise is a foetal movement which opens up the pathways assisting the speedy transfer of information to the brain. Most of the movements are vestibular, stimulating your inner ear." About 10 per cent of Mulroy's client base has autism. While there are complex factors in this condition, NDT has been known to help, particularly in terms of social behaviour.
NDT is relatively new to Ireland, according to Una Hatch, treasurer of the Irish Association of Neuro Developmental Therapists. The therapy was developed in Chester and was introduced in Ireland in the 1990s. The association was formed last year. Its 37 members around the State typically come from a nursing, psychology or teaching background. Referrals to such therapists are mostly made by resource teachers, psychologists and GPs.
The average cost of the therapy is €1,000-€1,300, spread over a year or 18 months. Hatch says the therapists hope that eventually their work will be recognised by the Departments of Health and Education "so that it could become more accessible for lower income families". "Overall it's about the same as a grind a week but by getting in there early, you might avoid the need for grinds further down the road," according to Hatch.
In the Navan area, the Springboard family support organisation has provided funding for children who need the therapy and foster organisations may receive funding for children in the near future.
For some children, the effects can be instantaneous. This was the case for Bríd Ní Annracháin's son Donncha. He was a chronic bed-wetter. At first she did nothing in the hope that it would eventually stop but when he was seven she decided to take action. "I also noticed Donncha's reading was not coming on as it should be. Now I'm not a holistic medicine type of person at all," she says. "I would be very conventional, but I heard about NDT and I thought it was worth a try." She brought Donncha to a therapist and the first question asked was: "Is he flooding the bed?". "He was. He never stopped doing what babies do. He had never lost the reflex." She doesn't know why this is as he was not ill and never had any trauma in his young life but she does recall that he never crawled and instead began walking at nine months. Ní Annracháin still cannot believe how the therapy worked. "If I hadn't seen it myself, I would have fallen off my chair at the thought that it might work. She put him sitting in a swivel chair with his arms and legs crossed and swivelled it clockwise and anticlockwise. Would you believe it, he was dry that night and never wet again. I couldn't believe it. "After two or three months, I noticed his reading had started improving and his co-ordination. It was an absolutely text book case of someone who was cured and never looked back since."
Oonagh (13) from Meath was diagnosed with a brain tumour when she was nine months old. It was successfully removed but the illness meant that she had to lie down a lot and didn't crawl as soon as other babies. "But she passed all her development milestones and had no serious issues," says her mother, Mary. However, Mary gradually noticed that Oonagh had trouble sleeping at night, lacked confidence and had a nervous disposition. She was doing well at school but needed help with maths. It was during a talk by a resource teacher that Mary first heard about neuro developmental therapy. She contacted neuro developmental therapist and paediatric nurse Moya Mulroy who lived locally.
Oonagh, then 10, began her exercise sessions. A yoga-type exercise known as the flower was a key part of the programme and this was done every day. She also did a type of crawling as well as swimming and trampolining. "The first thing I noticed was that my quiet child had become very opinionated, all in the space of three weeks. Within 10 or 12 weeks, Oonagh had finished with her remedial teacher. Her teacher does continuous assessment with the children and felt she did not need the extra help any longer." She also noticed that Oonagh could walk in a straight line, heel to toe, something she could never do before because of poor balance.
"She's doing better now than we ever thought possible," she says. "Now she's doing honours maths and honours English. She's playing football for the Meath under 14s and she is a great outdoors person. It has certainly turned her life around, but in a very subtle way. "With Oonagh, her problems were very minor but children with something like attention deficit disorder would need a lot more time to get the same results."
A list of registered therapists is available at: www.neurodevelopmentaltherapy.ie
© 2007 The Irish Times
* Some names have been changed to protect the privacy of the participants