Treatment by Diagnosis

We reduce pain and treat many conditions and diagnoses including:

Neck/Cervical Issues

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Neck Pain

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Cervical Disc Disorder

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Cervical Myelopathy

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Cervical Radiculopathy

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Cervical Stenosis

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Cervical Strain

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Degenerative Disc Disease – DDD of the Cervical/Neck

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Degenerative Joint Disease of the Cervical/ Neck

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Osteoarthritis

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Spondylosis Cervical

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Tension HA Headache

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Whiplash

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Thoracic and Lumbar/Spine Issues

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Herniated Disc

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Low Back Pain – LBP

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Lumbar Disc Disorder

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Lumbar Myelopathy

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Lumbar Strain

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Sciatica

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SIJ Disorder

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Stenosis-lumbar

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Ankylosing Spondylitis

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Degenerative Disc Disease – DDD (general)

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Degenerative Disc Disease – DDD (lumbar)

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Degenerative Disc Disease – DDD (thoracic)

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Degenerative Joint Disease of the Lumbar Spine/Low Back

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Osteoarthritis of the Lumbar Spine/Low Back

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Spondylitis

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Spondylolisthesis

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Spondylosis

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Thoracic Fracture

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Thoracic Disc Disorder

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Thoracic Outlet Syndrome

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Thoracic Pain

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Vertebral Fracture

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Shoulder Issues

AC Separation

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Adhesive Capsulitis

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Bicipital Tendinitis

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Cartilage Tear

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Chronic Dislocation

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Clavical Fracture

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Frozen Shoulder

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Greater Tuberosity Fracture

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Humeral Fracture

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Impingement Syndrome

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Rotator Cuff Syndrome/ RC Syndrome

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Rotator Cuff Tear/ RC Tear

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Rotator Cuff Tendonitis/ RC Tendonitis

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Shoulder Bursitis

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Shoulder Dislocation

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Shoulder Instability

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Shoulder Osteoarthritis – OA

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Shoulder Pain

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Snapping Scapula

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Pelvis, Hip and Thigh(Upper Leg) Issues

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AVN Femoral Head – Avascular Necrosis

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Femoral Neck Fracture

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Hip OA – Osteoarthritis

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Labral Tear

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Femoral Acetabular Impingement – FAI

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Gluteal Bursitis

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Hamstring Tear/Strain

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Adductor Strain

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Femur Fracture

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Pelvic Fracture

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Pelvic Pain

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Psoas Tendinitis

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Trochanteric Bursitis

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Knee Issue

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ACL Tear

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Chondromalacia

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ITB Syndrome – Ilio-Tibial Band

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Knee Contracture

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Knee OA – Osteoarthritis

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Knee Pain

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Lateral Meniscus Tear

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MCL Sprain – Medial Collateral Ligament

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MCL Tear – Medial Collateral Ligament

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Medial Meniscus Tear

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Meniscus Derangement

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Patella Dislocation

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Patella Fracture

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Patellar Tendinitis

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Patella Tendon Rupture

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PCL Tear – Posterior Collateral Ligament

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Pes Anserine Bursitis

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Patello-femoral Pain Syndrome -PFPS, aka. Runner’s Knee

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Quad Strain

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Quad Tendon Rupture

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Tibial Plateau Fracture

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Tibial Stress Fracture

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Foot, Ankle & Lower Leg Issues

Woman doing stretching exercis
Achilles Tendinitis

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Achilles Tendon Rupture

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Ankle Fracture

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Ankle Instability

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Ankle Pain

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Ankle Sprain

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Ankle Tendinitis

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Anterior Talofibular Ligament – ATFL Sprain

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Bimalleolar Fracture

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Calcaneal Fracture

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Calcaneal Spur

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Equinis

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Foot Osteoarthritis -OA

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Foot Pain

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Gastroc Strain

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Hallux Rigidus

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Hallux Valgus

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Lateral Malieolar Fracture

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Leg Pain

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Medial Malleolus Fracture

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Metatarsal Fracture

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Metatarsalgia

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Morton’s Neuroma

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Peroneal Tendinitis

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Pes Plano Valgus

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Plantar Fasciitis

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Post Tib Tendinitis

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Talus Fracture

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Tib-Fib Fracture

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Shin Splints

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Tibial Stress

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Fibula Fracture

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Elbow Issues

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Lateral Epicondylitis

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Medial Epicondylitis

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Ulnar Nerve Injury

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Forearm, Wrist and Hand Issues

Carpal Tunnel

Carpal Tunnel Syndrome or CTS is now so common it’s been called the “occupational disease of the 1990s.” Symptoms include tingling and numbness in the hand, fingers and wrist; pain so intense that it awakens you at night and similar symptoms in the upper arm, elbow, shoulder or neck. As one researcher has written: Faulty innervation caused by spinal joint lesions in one of the main factors in the production of wrist swelling.

Ulnar Fracture

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Radial Fracture

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Colles Fracture

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DeQuervain’s

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Other Diagnosis Issues We Treat

Abnormal Posture

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Contracture of Joint

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Disuse Atrophy

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Fibromyalgia

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Gait Abnormality

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Headache

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Ligament Laxity

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Muscle Spasm

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Myositis/Myalgia

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Necrotizing Fasciitis

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OCD

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Osteopenia

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Osteoporosis

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Osteosarcoma

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Rheumatoid Arthritis RA

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Temporomandibular Joint Disorders -TMJ

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Weakness (generalized)

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Neuro Developmental Delay
Diagnosing Neuro Developmental Delay

A Neuro-developmental assessment will detect the presence of primitive reflexes and balance problems. Detailed tests assess Central Nervous System maturity. Both types of test aid Movement Solutions in the diagnosis of NDD / Neuro-Developmental Delay.

Standard neurological tests will reveal the continued presence of aberrant Primitive and Postural Reflexes.

Individual reflexes affect specific areas of functioning: one reflex can interfere with the control of the hand when writing; another can affect balance and control of eye movements so that the eyes ‘play tricks’ on the brain, making the letters appear to move on the page.

These are the medical facts which form the basis of our work:

  • During life in the womb a group of reflexes called the primitive reflexes emerge.
  • Primitive reflexes should be present at birth in the baby born at full term.
  • Primitive reflexes are inhibited by the developing brain during the first year of life.
  • Primitive reflexes are gradually replaced by Postural reflexes. Postural reflexes develop in the first 3½ years of life to provide the basis for automatic (unconscious) control of balance, posture and voluntary movement.
  • It is an accepted medical fact that retained primitive reflexes beyond the first 6–12 months of post natal life indicate immaturity in the functioning of the Central Nervous System.

Reflexes

At birth, a baby has minimal control over voluntary movement. Reflexes provide stereotyped reactions to certain stimuli in the early weeks but are soon transformed into more advanced motor skills. Early reflexes also provide training for many aspects of later functioning.

  • Primitive & Postural Reflex
  • Abnormal Primitive Reflex
  • Asymmetrical Tonic Neck Reflex
  • Symmetrical Tonic Neck Reflex
  • Spinal Galant Reflex
  • Tonic Labyrinthine Reflex
  • The Moro Reflex
Dyspraxia (developmental coordination disorder)

Coordination Problems

The word Dyspraxia is derived from two sources: Dys comes from Latin, meaning ‘not easy’ or ‘difficulty with’, and praxis from Greek, meaning ‘action’ or ‘exercise’. It is also known as Developmental Coordination Disorder (DCD).

It is a term used to describe difficulty with the execution of controlled voluntary actions. It is a disorder of movement involving impairment of the ability to carry out a skilled activity in the absence of paralysis, ataxia or any other impairment of the primary motor pathways controlling movement. It can be either developmental or acquired.
Diagnosing Dyspraxia

Diagnosis of dyspraxia – or DCD – is usually given by a doctor, a clinical psychologist, physiotherapist or occupational therapist.

Controlled voluntary movement involves many systems, but three main areas are implicated in dyspraxia:

  • The sensory pathways
  • The motor system
  • The central nervous system as a whole

Any one of these areas may be responsible for the presenting dyspraxia symptoms. Identification of the main area at fault is therefore very important if the most effective form of treatment or training is to be given.

Dyspraxia Treatment / Training

A child who has poor sensory awareness will respond well to a remedial approach, which concentrates on training each of the senses to relay information more effectively. This may be done through stimulation of one of the senses e.g. tactile stimulation or auditory training for a child who is hyper- or hypo-sensitive in these areas. Movement programmes are also designed to improve sensory integration.

If a cluster of abnormal primitive and postural reflexes is present, it will interfere with the development of control of balance and motor skills. A reflex stimulation and inhibition programme can help to provide a solid foundation for the improvement of motor skills, and thereby improve balance, coordination and confidence.

Attention Deficit Disorder – ADD

Attention Deficit Disorder (ADD) describes a persistent pattern of inattention more frequent and severe than is typically observed in individuals of a comparable level of development. Diagnosis of ADD should only be given by a medical practitioner or psychologist.

Features of Attention Deficit Disorder (ADD) include:

  • Deficits in attention to detail – particularly in schoolwork
  • Careless, messy work that is inadequately thought through
  • Impersistence – failure to complete tasks and shift from one uncompleted task to another
  • Daydreaming – does not appear to listen or follow conversations or instructions
  • Organisational problems
  • Lack of forward planning
  • Avoidance of tasks that require sustained attention or self application
  • Stimulus bound – distracted by irrelevant stimuli within the environment
  • Unable to stay on a task
  • Difficulty following conversations, frequently interrupts and/or changes the subject midstream

Several of these features must coexist for a diagnosis of Attention Deficit Disorder (ADD).

Attention Deficit Hyperactivity Disorder

What is attention deficit hyperactivity disorder, ADHD, and attention deficit disorder, ADD?

Children who are inattentive, easily distracted, quickly tire of what they are doing. have problems to organise their activities and to control their impulses are considered to suffer from attentive deficit hyperactivity disorder (ADHD).

According to experts this is a genetically conditioned disorder which often causes deficient professional and educational accomplishment and a lifelong handicap. If there are problems of attention without hyperactivity the condition is called ADD. However there is no scientific evidence that ADHD is genetically caused and in the year 2000 the American Paediatric Association concluded that there is no convincing scientific proof that ADHD even has biological causes.

An alternative way of looking at attention disorder.
You can have another angle of approach on attention deficit disorder and how it can be remedied by studying our smallest children. Normal children around the age of one year, who are allowed to move around freely and not forced to sit in baby sitters or car chairs for long periods have a similar behaviour to that of children with ADHD.

They move around, cling and climb and have problems to sit still. They do not follow instructions and have problems to organize their activities and control their impulses and they are easily distracted. However, unlike children who are labelled as suffering from ADHD, normal children all on their own manage to overcome their attention disorder and hyperactivity as they grow older. How are normal children different from children who develop ADHD and what secret knowledge, unknown to the experts, do they have that enables them to prevail over their attention problems?

Anxiety

Anxiety is a fundamental human emotion which, when generally experienced in mild or moderate forms can encourage motivation, protection and adaptation. Overwhelming anxiety, however, disrupts social, occupational and emotional aspects of life and is experienced as distress. Anxiety can manifest itself in three ways:

  • Cognitively: in thoughts
  • Somatically: in physiological and biological processes
  • In feelings – emotions

Physiological feelings of anxiety can be so acute that they overwhelm any attempt by conscious efforts to control them. Ongoing control of actions can be interrupted due to the following somatic changes:

  • Shallow breathing
  • Dry mouth
  • Cold hands and feet
  • Tightness in the chest
  • Sinking in the stomach
  • Rapid pulse
  • Light headedness
  • Dizziness
  • Muscular tenseness

Blythe recognised that adults who were recidivists (those who recovered for a time, then found symptoms returning), and those who failed to respond to various therapies despite a desire to get better, all demonstrated signs of neurological dysfunction relating to immature reflexes, including problems with balance, coordination, perceptual skills and the functioning of the sympathetic division of the autonomic nervous system (responsible for involuntary responses).

If NDD is a factor, correcting the underlying faults can help the sufferer regain cognitive control.

Please note, only some emotional problems are connected to Neuro-developmental Delay.

Dyscalculia - Math Difficulties

Abridged extract from “Attention, balance and coordination – the A,B,C of learning success” by Sally Goddard Blythe, of INPP. Due to be published by Wiley-Blackwell Professional. Autumn 2008.

Dys means difficulty and calculia is derived from the Latin word for calculus meaning small stone. In the original context it refers to the ancient use of pebbles used for counting which later developed into the abacus. This earlier use of stones as “mind tools” or concrete representations of concepts, suggests that physical interaction has been used as an aid to support and precede conceptual understanding of numbers for generations.

Dyscalculia describes developmental lag of 1 year or more in the acquisition of numerical skills, including:

  • Inability to recognise number symbols
  • Mirror writing (directional)
  • Failure to recognise mathematical operations involved in computation or problem solving (procedural sequencing and inter-hemispheric communication)
  • Inability to recall tables (sequencing)
  • Inability to maintain proper order of numbers in calculation (vestibular and/or visuo-spatial)

Dyscalculia is more prevalent in children of lower socio-economic status. Unlike Dyslexia it is equally distributed between the sexes and there is an association between premature birth and later difficulties with number skills. Badian (1983)iproposed 3 types of dyscalculia:

  • Difficulty with computational procedures such as addition, subtraction and multiplication.
  • Attentional sequential dyscalculia for example, multiplication tables and sequencing of procedures.
  • Spatial dyscalculia, describing difficulty handling multi-column arithmetic problems and place values.

Dysfunction in either hemisphere can impair acquisition of numerical skills but appear to be more profound if present in the left hemisphere.Left hemisphere dysfunction has been found to be associated with construction dyspraxia and below average performance on tasks such as The Embedded Figures Testi (figure ground effect), poor auditory and visual discrimination and motor coordination abilities.

Right hemisphere dysfunction in a group of children who showed no signs of structural abnormality on brain scans (MRI or CT) manifested itself as grapho-motor impairments and slow cognitive and motor performance, although reading development was normali. Additional right hemisphere symptoms included: emotional and inter-personal difficulties, difficulty adapting to new situations, difficulty maintaining friendships, tendency to be withdrawn and shy, poor eye contact and difficulties with spatial perception and imagery. Some of this group also had features of ADHD which it was suggested might be a secondary effect of right hemisphere dysfunction and brain stem factors. Many of these symptoms associated with right hemisphere dysfunction can also occur as a result of dysfunction in the vestibular system and associated pathways, which support the processes of visual perception in the right hemisphere.

Risey and Briner (1990) found a relationship between patients with central vertigo and Dyscalculia, which affected their ability to perform certain tasks counting backwards accurately. Patients with vertigo, which is indicative of faulty vestibular functioning, consistently made the same error each time they were asked to perform the task. They recognised the mistake when it was pointed out to them, but could not avoid repeating the same error, each time they were asked to perform the task. They also had difficulties with mental arithmetic and central auditory processing, lower scores for arithmetic and digit span errors on the Wechsler Adult Intelligence Scale (WAIS) and difficulty with backward digit span recall compared to non vertigo patients, suggesting that vestibular dysfunction can affect visual, auditory and mental sequencing processes.

Dyscalculia References

  • Badian NA, 1983. Developmental dyscalculia. In: Mykelbost HR, Ed. Progress in learning disabilities. Grune and Stratton. New York.
  • Shalev RS, Weirtman R, Amir N, 1988. Developmental dyscalculia. Cortex 24:555-61.
  • Manor O, Amir N, Gross Tsur V, 1993. The acquisition of arithmetic in normal children: assessment by a cognitive model of dyscalculia. Developmental Medicine and Child Neurology 35:593-601.
  • Wertmanelad R, Gross-Tsur V, 1995. Developmental dyscalculia and brain laterality. Cortex 31:357-65.
  • Witkin HA, Oltman PK, Raskin E, Karp SA, 1971. Children’s embedded figures test. Consulting Pyschologists Press. Inc. Palo Alto. CA.
  • Manor O, Amir N, 1995. Developmental right hemisphere syndrome: clinical spectrum of the non-verbal learning disability. Journal of Learning Disabilities. 28:80-6.
  • Manor O, Amir N, 1995. Developmental right hemisphere syndrome: clinical spectrum of the non-verbal learning disability. Journal of Learning Disabilities. 28:80-6.
  • RiseyJ, Briner W, 1990. Dyscalculia in patients with vertigo. Journal of Vestibular Research.1:31-37.
Dysgraphia - Writing Difficulties

Dysgraphia sometimes termed agraphia is a specific deficiency in the ability to write not associated with ability to read, or due to intellectual impairment.

There can be a number of different reasons why an individual may have a specific writing problem but in some cases it can result from immaturity in the neurological pathways involved in the coordination of head, arm, hand and eye movements confirmed by the presence of an Asymmetrical Tonic Neck Reflex (ATNR) in the school aged child. The ATNR is a primitive reflex, normally present in the full-term neonate, which should be inhibited by the developing brain in the first 6 months of post natal life.

A retained or residual ATNR in an older individual can result in specific difficulties in learning to write. This is because, when the head turns to follow the direction of the writing hand, the arm and hand want to extend, making it difficult to hold on to the pen, bend the arm and bring the hand back to write on the left side of the page. Most children learn to “accommodate” the problem by compensating in a number of ways: Adjusting posture by pushing the chair back and leaning back into the chair so that the arm is straight while continuing to write; posture may be twisted or the page rotated by as much 90° so that writing is carried out with the arm extended; an awkward or very tight pen grip may be used to try to keep the fingers closed and the pen under control. Irrespective of the strategy used, the physical action of writing does not become automatic. If a physical action fails to become automated, it can interfere with the ability to think and carry out the physical action as the same time.

Beyond the early stages of learning to form letters, most of education requires the ability to think and write at the same time. The effects of a retained ATNR on written work can occur irrespective of intelligence – indeed the more intelligent and orally articulate the child – the more likely they are to be accused of laziness and to be told, ” you could do better if only you tried”; “could do better if only he applied himself” etc. and to under-achieve. If the ATNR is the only aberrant primitive reflex, the child can usually learn to read, (managing to compensate for control of eye movements) but will have a specific handwriting problem. Reading requires control of eye movements (oculo-motor functioning), but writing needs the eyes and hand to work together (visual-motor integration -VMI). Retention of the ATNR in the school aged child can result in specific writing problems in the absence of reading difficulties or other specific learning difficulties – in other words – a specific form of Dysgraphia.

Dyslexia

Dyslexia has been defined as, “a disorder in children who, despite conventional classroom experience, fail to attain the language skills of reading, writing and spelling, commensurate with their intellectual abilities.” – World Federation of Neurology.

More recently, the British Dyslexia Association expanded upon this definition and described as:

“A complex neurological condition, which is constitutional in origin. The symptoms may affect various areas of learning and function and may be described as a specific difficulty in reading, spelling and written language. One or more of these areas may be affected: numeracy, notational skills (music), motor function and organisational skills. However, it is particularly related to mastering written language, although oral language may be affected to some degree.”British Dyslexia Association

Research into Dyslexia

Research into dyslexia has been ongoing since the symptoms of ‘word blindness’ and problems of visual memory were first identified by Ophthalmologist Dr James Hinshelwood in the 1890s. During the last thirty years, research has converged on four main areas of difficulty, of which one or several may be present:

  • Difficulties with automatic balance
  • Immature motor skills
  • Auditory processing problems
  • Abnormal processing of visual information

In 1996, researchers at the University of Sheffield concluded that:

“Children with dyslexia have deficits in phonological skills, speed of processing and motor skills. These deficits are characterised as problems in skill automisation, which are normally masked by the process of conscious compensation.”Fawcett, Nicolson and Dean

When two or more of these symptoms are present, Neuro-Developmental Delay can be an underlying factor.

All academic learning is connected in some way to the functioning of the motor system. Reading is not a purely cognitive task; it requires eye movements. Writing involves hand-eye coordination with the automatic support of the postural system. Posture develops as a child gains control over balance and balance is dependent on a mature reflex system. Immaturity in the development of primitive and postural reflexes can therefore have a direct impact upon motor dependent skills and any academic learning that involves motor skills.

INPP cannot give a diagnosis of dyslexia

Whilst it cannot be said that all children who have been diagnosed as having dyslexia have NDD, NDD is sometimes an underlying factor in children who fail to respond to normal remedial invention

RHYTHMIC MOVEMENT TRAINING IN DYSLEXIA

Common to all children with reading challenges, is their inability to make reading an automatic process in spite of intensive practice. Researchers have proposed various explanations about the causes of such an inability and, according to current research, dyslexia is due to a weakness of the sound aspect of language; a phonological disability. According to many researchers, nothing can be done about it except to intensify the practice of reading.

Visual challenges in dyslexia
However these modern theories contradict the experience Harald Blomberg of helping many children with reading difficulties to become good readers. Most of these children have been diagnosed as dyslexics. Nevertheless, all of them have suffered from moderate to severe visual challenges. When asked about visual symptoms, they have reported:

  • Symptoms such as tiredness, irritation and ocular pain occur
  • Headaches while reading
  • Text becomes blurry
  • Words start to jump or move
  • Skip a line or forget which line they’re reading
  • Total avoidance of reading

Children with reading difficulties do not spontaneously report their visual challenges and teachers and dyslexia researchers may not ask about them. They have been indoctrinated that dyslexia is exclusively a phonological problem and that it has nothing to do with vision. When never asked about their visual challenges, these children are left to believe that it is absolutely normal that they get a headache, irritation of the eyes or that the text becomes blurry or starts to jump when one reads. Consequently, this leads to feelings that there is something wrong with them because they cannot read like other children.

Development of visual skills.
The development of vision and motor abilities is interrelated. Children develop their vision through the inborn programme of innate baby movements:

  • Grasping objects
  • Putting them into one’s mouth
  • Lifting one’s head in a prone position
  • Crawling on one’s stomach
  • Getting up on hands and knees
  • Rocking and crawling on hands and knees

Children who have motor challenges usually do not make these movements adequately, which ultimately may result in vision challenges.

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