Does your child use both hands on the handrail when climbing up or down the stairs?
Does your child use both hands on the handrail when climbing up or down the stairs?
Children arriving at my therapy studio often come with their siblings. They can watch or sometimes participate. On one such occasion, 6-year-old Nadia (who was undergoing therapy for social communication and speech difficulties) was accompanied by her then 3-year-old sister, rather angelic-looking, Yasmin. While Nadia was the serious one , her sister, in contrast, was chatty and always wore pink and giggled a lot.
“She twisted her body as she tried to grasp the rail with both hands. At times, instead of facing forward”
Mum, so busy, was often running late for Nadia’s weekly sessions. On one such occasion, I waited at the top of the stairs. All my appointments were back-to-back that day; I wanted to check they had arrived. I could hear Nadia complaining, her mum encouraging her to push her forward, and Yasmin trailing behind them. I observed Yasmin had an unusual way of climbing up the stairs. She was using both hands to hold the handrail. I watched Yasmin ascended in a rather clumsy manner. She twisted her body as she tried to grasp the rail with both hands. At times, instead of facing forward, her feet and body pointed towards the (handrail) wall. I noticed she looked more comfortable side-stepping, always with one foot leading and the other following.
“Seeing a child’s gait is very revealing, and I was not surprised by Yasmin’s.”
I observed with curiosity as we all gathered in the studio to start the session. At this point, I enquired with Mum if Yasmin could participate. Nadia was delighted, as she thought she was off the hook; it was far from the truth!
Yasmin's 'job' was to return all the stray therapy balls that Nadia did not catch. As I worked with Nadia, I observed Yasmin from the corner of my eye as she moved running at times to retrieve the balls. Seeing a child's gait is very revealing, and I was not surprised by Yasmin's. She did not move smoothly, there was jerkiness when she moved, sometimes she could not grasp the ball at all and it slipped out of her fingers.
““Mum watched on, she looked at me and pointed at Yasmin and, as if to read my concern, volunteered ’Emergency C-Section Baby.’”
After the ball exercise Nadia and I continued with an exercise where we passed bean bags seated cross-legged on the floor facing one another, and in this instance, Yasmin wanted to join in. As Yasmin's sister had mastered the same exercise, extending it to include another individual was, in fact, beneficial for all. We sat in a triangle, knees close to touching and passed a bag from one person to the next, accepting from the left, moving across from left hand to right, and then passing to the person on the right, into their left hand. With each pass and transfer was slow and consistent rhythm. It was easy for Nadia but very challenging for her younger sister, Yasmin. Yasmin could not move the bag across her midline; she accepted the bag with her left hand and then passed it directly without transferring from her left to right. It was the same when we went in the opposite direction (taking from the right and passing to the left). Yasmin's inability came as no surprise and half expected, and as Mum watched on, she looked at me and pointed at Yasmin and, as if to read my concern, volunteered 'Emergency C-Section Baby.'
Once the family finished the therapy I watched eagerly as they descended the stairs. Going up and down was the same for Yasmin, but now she had a fear of falling down the stairs, and her mum had to help her navigate by holding a hand, allowing one of Yasmin's hands to stay on the handrail, Mum, guided her down slowly.
We need to know where the midline is.
Three invisible midlines divide our bodies. The first runs centrally, dividing left and right; another divides the top and bottom of the body, and the last divides front and back. We are cross wired, the right side of the brain informs the left side of the body, these midlines helps the brain know where to send information (during early development) to inform the various parts and how they can work together and organise themselves around the forces of gravity—the forces of gravity and knowing where our bodies spatially help us move in space-from one-sided movement for breast feeding, progressing to rolling over on to the tummy, starting to crawl, and then to walk and run.
When children have missed a phase of development, or they have various primitive reflexes retained, disruption hampers further motor development, or in some instances, some primitive reflexes just did not emerge due to birth trauma, as in the case of Yasmin, the ability to organise for smooth movement is compromised.
“Yasmin was stuck, and her body was confused about how to move with ease.”
Retained Primitive Reflexes
When I tested Yasmin, she had a whole host of retained reflexes, such as ATNR (asymmetric tonic neck reflex), STNR (symmetric tonic neck reflex), trunk extension, Spinal Galant, Spinal Perez, and the Morro Reflex.
Yasmin was stuck, and her body was confused about how to move with ease. Both sides of her body were not communicating properly. Each side worked in isolation, either on the left or the right. The retained STNR compromised her balance and ability to move her head and eyes. When Yasmin walked up or down the stairs, she was frightened. She did not know how to move alternating feet to keep her gaze ahead and feel the steps beneath her. Yasmin was confused and disoriented. She led with her right foot; when both were on the same step, she would move her right foot again.
Integrating Primitive Reflexes takes six to eighteen months, but it is worth the effort. In this instance, Mum had learned how to do the exercises with her eldest daughter and continued with her youngest without hesitation.
Interestingly, Yasmin was a chatty individual, and it was never apparent to her nursery, parents or even me that this child had challenges. Observing your child and flagging up any motor coordination problems is very important.
Dyslexia? Dyspraxia? ADHD? ASD? Speech & Language? Developmental Delay? Anxiety?
Is every school day a struggle? As a parent, you may feel exhausted and on this journey alone. Each year you see the gap getting wider. You need to do something - change the approach, help your child learn for themselves, find a way to turn this around - to help while you can - do this NOW. the first step is free.
About the Author
Usha Patel is a Neurocognitive Therapist and Director at Raviv Practice London. Parents searching to help their suspected/neurodiverse child can get evidence-based solutions with results in as little as 8 weeks. Those in search of jargon-free help can get started straight away.
