A review of Sally Goddard Blythe’s book: Reflexes, Movement Learning and Behaviour

Thanks to Caroline Tosh for this review.

Understanding and helping children and adults with balance, co-ordination, emotional and educational issues

Sally Goddard Blythe is a director of the Institute for Neuro-Physiological Psychology. She researches the relationship between physical development and learning. Her remedial programmes and exercises help transform children’s learning through movement.

This book, originally aimed at learning professionals, is a remarkable resource for osteopaths, especially those who treat any children, and for the parents of children with educational challenges. It also provides a useful insight into how unresolved neuromotor functions may impact on the lives of adults. For the first time it also includes simple tests and remedial strategies suitable not only for osteopaths but also for parents and teachers.

The developing infant brain and nervous system starts life with a range of “primitive reflexes”, known as Moro, palmar, plantar, rooting/sucking, tonic labyrinthine, and spinal Galant reflexes, which are present from in utero and help the neonate with instinctive survival movements. As the nervous system develops with increasing myelination, these early responses are inhibited by a process of “neural pruning” and more mature functions enabling sitting, crawling and eventually standing emerge. Goddard takes the reader from a first chapter on primitive reflexes to a second on postural control and goes on to brain development and the integration of senses.

This also clarifies signs of the kinds of difficulties that can occur with poor sensory integration and how this may affect school readiness; for example, the capacity to sit still, listen, hold a pencil and write with ease, follow a written or printed line, move backwards with confidence and take part in games and dancing. All of these require the integration of posture control, proprioception, tactility and vestibular-occular coordination.

Interestingly Goddard identifies that the Moro reflex links with Autonomic (ANS) function, and that incompletely inhibited Moro can underlie psychological responses to overwhelm. This may persist as a poorly developed CO2 function, in which with startle or stress the lungfield arteries open and can precipitate hyperventilation.

Examples include vestibular related problems when taking part in ball games, motion sickness, physical timidity, difficulty processing information in multisensory environments, and auditory confusion from excess background noise. These can persist as secondary symptoms such as continuing free-floating anxiety, overeactivity, frustration and mood swings, tense muscle tone (body armouring), and hyperactivity followed by extreme fatigue and sensory overwhelm. Many individuals have to “work” at maintaining stability, which then gives way under stress. This could be a key factor for many patients, including sportspeople as well as children. The affected individual may then appear to have “Emotional Control“ problems which are in fact secondary effects of poor neurological integration.

Later chapters give an overview of methods of testing reflexes. This briefer outline is useful for paediatric osteopaths, parents and teachers, and would help to identify if a child needs help with a particular sensory pathway, e.g listening problems. Chapter 6 is full of practical information on what can be done to improve integration, with case studies, neuromotor training, and action songs and dances for home and school. Full assessment and treatment is not recommended until seven years of age, but simpler measures can help younger people.

This thoroughly professional book also gives a history of the understanding of neurodevelopmental reflexes and pioneering research, with published studies on how primitive reflexes affect learning and emotional wellbeing.

A valuable addition to the diagnostic and therapeutic armoury of any osteopath.

---

Caroline Tosh, BSO class of 1977, is a Fellow of the SCCO and has taught in England and abroad. She holds MScOst with special interests in women’s health and adult education. She has contributed to Rachel Brooks’ ‘Three Great Teachers of Osteopathy’.