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| Feature | No.65 October 2013 |

The Importance of Movement in Early Development – the Foundation of developing Physical Literacy

Sally Goddard Blythe

Abstract

Movement and the acquisition of upright posture have played a major role in the evolution of the human brain. Human movement is not simply the expression of motor intention but is the product of coordinated brain function and is the primary medium through which a child interacts and learns about the world, and its relationship within the world. In the process of interaction sensory integration takes place on which stable perception depends and non-verbal and verbal language is articulated. A growing body of research indicates that immature neuromotor skills are linked to lower educational performance, and examples of the role of movement in developing neuromotor skills in the first year of life are described.

Introduction

Einstein observed that all forms of life share the characteristic of motion. In common with other animate creatures, humans have evolved to move and through movement. In the first year of life, posture, gesture and movement act as a child’s first expressive language (mime) and even sensory experience is the product of stimulation to specialised receptors which respond to different frequencies of motion. Perception (the brain’s interpretation of sensory information) is not based purely upon information derived from individual senses, but is the product of multi-sensory experience integrated, entrained and adapted over time through the medium of movement.

It is no coincidence that development of the infant brain follows a predictable sequence with cortical areas involved in motor control maturing ahead of those involved in sensory development with the association areas being the last to mature, continuing their growth into the twenties and thirties (Spreen et al. 1984) Since Descartes we have become accustomed to believing that thought and consciousness drive human behaviour, but there is an increasing body of evidence to support the theory that areas in the brain involved in motor function are active in advance of conscious awareness (Haggard and Elmer 1999, Haggard et al. 2002).

Wolpert (2009) maintained that,

“We have a brain for one reason and one reason only -- that’s to produce adaptable and complex movements. Movement is the only way we have of affecting the world around us. I believe that to understand movement is to understand the whole brain. And therefore it’s important to remember when you are studying memory, cognition, sensory processing, they’re there for a reason, and that reason is action.”

“We visualise, think and dream in movement” (Berthoz 2000). Movement is the most important function of the brain, facilitating complex and adaptable behaviour. It is the product of sensory feedback, planning and anticipation of the consequences of an action, “projecting on to the world its pre-perception, hypotheses and interpretive schemas”. (Berthoz 2012)

Perception and control of movement are not solely located in the motor area of the cortex but involve communication between many areas. Barton (2012) posited that,

“There is no clear separation between sensory-motor and cognitive specializations underpinning such skills, undermining the notion of executive control as a distinct process. Instead, I argue that cognitive evolution is most effectively understood as the elaboration of specialized systems for embodied adaptive controli”.

In this context, movement is a child’s first language. At birth, the infant has minimal control over its own body, but the child is furnished with a series of reflexes and spontaneous movements to support survival in the first months of life, which also provide rudimentary training for many later more complex skills. In order to become self-reliant, physically, socially and emotionally, the developing child must first learn control of the body. Confidence in the use of the body is its primary pre-school education, which continues to develop and adapt through the remainder of life.

Control of the body begins with development of posture and muscle tone, which act as anti-gravity forces, facilitating not just autonomous movement, but also providing the gravitational security necessary to afford a stable reference point for control of balance, coordination, centres involved in the control of eye movements and spatial orientation. Spatial orientation also supports important aspects of emotional as well as physical stability (Blythe, 1988, Goddard Blythe 2014).

The process of maturation within the central nervous system (CNS) on which these functions depend is hard wired into the healthy infant brain, but to unfold its possibilities, maturation is inter-dependent with physical interaction with the environment and social engagement. Movement opportunity and experience help to form connections within the CNS which provide the basis for a repertoire of expressive techniques (motor vocabulary).

The psychologist and educator G. Stanley Hall observed that the development of the growing child appears to parallel the evolution of the human species. Although the recapitulation theory is now outdated in the literal sense, in the first year of life the human infant does mirror its evolutionary history in terms of the motor and postural skills it acquires and increased connectivity within the neural substrates involved. This is a dual process of maturation and experience.

Kohen-Raz (1996) explained that posture is not only,

“a basic neurophysiological apparatus which ensures physical stability and mobility of the organism against the pull of gravity, but primarily is a central neuropsychological system which embraces a wide range of functional levels, from spinal reflexes to higher mental processes”.

He went on to say that viewed from such a perspective, it is evident that,

“postural control and consciousness, the precondition of all differentiated and complex mental activities, are intimately related”

and that,

“the mental capacity to differentiate between and inner and outer world, the awareness of an autonomous self in the universe, is rooted in the human ability to assume an erect and adaptable posture, a “stance”, a “standpoint”, which serves as a point of reference not just to perceive but to understand the world”.

Relationship between neuromotor function and performance

There is a growing body of evidence which reveals a correlation between maturity in neuromotor skills and educational performance. Neuromotor skills can be evaluated in a number of ways, one method being the assessment of primitive reflexes and postural reactions at key stages in development – the presence or absence of these reflexes at specific times in development - providing recognised signposts of maturity in the functioning of the CNS.

Primitive reflexes emerge in utero, are fully present at birth in the full term infant (40 weeks gestation), and are inhibited in the first six months of post natal life. Examples of primitive reflexes include the rooting, suck, grasping, tonic neck, tonic labyrinthine and Moro reflexes Postural reactions (sometimes referred to as postural reflexes) are reactions to change in position, which develop in the first three and a half years of life and provide a foundation for sub-conscious control of posture, balance and coordination in a gravity based environment. Examples of postural reactions include head–righting, amphibian and segmental rolling reflexes. The continued presence of primitive reflexes beyond the normal time of inhibition, and/or under-developed postural reactions after three and a half years of age provide evidence of immaturity in the functioning of the CNS (Peiper A, 1963, Capute A, 1986).

Retained primitive reflexes are accepted signs of pathology in conditions such as cerebral palsy, and may be disinhibited in the progression of demyelination diseases such as multiple sclerosis and Alzheimer’s disease, but continued primitive reflex activity in the absence of identified pathology has been a ‘grey area’ for many years, with many experts maintaining that residual primitive reflexes cannot persist in the school aged child in the absence of pathology. Despite this prevailing academic view, there is evidence to support the theory that immature primitive and postural reflexes are present in sections of the general school population and are linked to educational under-achievement (McPhillips et al.2000, Goddard Blythe 2001, McPhillips and Sheehy 2004, Goddard Blythe 2005, 2011; Griffin 2012), play a part in aspects of attention deficit hyperactivity disorder (ADHD) (Taylor et al. 2004) and interfere with the motor aspects of speech (Giffhorn and Queiβer 2012).

Studies which have used the The Institute for Neuro-Physiological Psychology (INPP) developmental screening questionnaire (Blythe and McGlown, 1979) – a questionnaire which covers aspects of early development from family history through pregnancy and birth up to school age - have consistently demonstrated a relationship between a cluster of adverse events in the first years of life, early signs of motor delay and later educational under-achievement (Goddard and Hyland 1998, Bharwani S et al. 2013).

An analysis of the developmental history of nearly 15.000 children carried out between 2001 and 2002 as part of The Millennium Cohort Study found that babies who were slow to develop their motor skills relating to sitting unaided, crawling, standing and taking their first walking steps were significantly more likely to be identified as behind in their cognitive development, and also likely to be less well behaved at five years of age (Hansen et al. 2010).

There is also evidence to support the theory that persistent abnormal reflexes and respond to specific physical programmes of remedial intervention (Bender 1976, O’Dell and Cook 1996, McPhillips et al.20001, The North Eastern Education and Library Board Report 2004, North Eastern Education Library (2004), Goddard Blythe 2005, 2011, Giffhorn and Queiβer 2012), indicating that movement plays an important role in the integration of early reflexes, the developmental of postural reactions and the ability to measure and control release of energy, and the speed and choice of direction needed to coordinate actions.

These findings raise questions as to why early motor development and cognitive functioning are inter-dependent, and how movement facilitates integration between the senses and entrains sensory-motor function?

At birth, connections from lower brain centres to the superficial layer of the cortex are only tenuously formed. The neonate is equipped with a series of survival responses to various environmental stimuli which enable him to breathe, to “root” for the breast, to suckle and to grasp. He also has a series of reflex reactions which evoke response to change in position. These innate reflex responses are mediated at the lowest level of the brain – the brainstem – but as connections to higher centres in the brain strengthen during the first weeks, months and years of life, the functional direction and organised control of movement proceeds from the lowest (brainstem) to the highest level of the central nervous system (cortex). “The process of corticalization is characterised by the emergence of behaviours organised at sequentially higher levels in the central nervous system with lower levels being recruited into the service of higher functions as maturation takes place” (Spreen et al.1984).

Children’s motor development is dependent primarily on overall physical maturation, especially skeletal and neuro-muscular development combined with physical interaction with the environment. Children need opportunity for exercise, repetition and practise, not only to develop strength but also control and dexterity. The brain learns by doing and the more an action is repeated the better the brain becomes at anticipating it and sending the right commands with the cerebellum playing a key role in the fine tuning of motor actions and the automisation of rehearsed movement sequences (Ito, 2008). Infants have a natural range of rhythmic motor activities which involve kicking, waving, punching, stretching, rocking, bending and twisting and these rhythmic activities, or primary movements, afford an important transition from uncoordinated activity to coordinated motor behaviour (Thelan E, 1981).

Primary movements occur in the context of opportunity and practice. Opportunity requires the space and time to experience physical activity in all sorts of different ways, from the gross motor movements involved in swinging, rocking, rolling, crawling walking, running and jumping to the fine motor skills needed for feeding, speech and writing. These early movement patterns are later repeated, re-calibrated, and refined as more advanced postural skills are acquired to build a flexible motor vocabulary adaptable to the needs of the environment.

Development of hand-eye coordination in the first weeks of life provides one example of how early reflexes assist in the process.

The visual world of the neonate is very different from the visual-perceptual world of an adult. Focus is blurred and restricted to near distance; the eyes are drawn to outlines and edges rather than central features and are sensitive to contrast. The Asymmetrical Tonic Neck reflex (ATNR), active in the first 4 months of life, is a response to rotation of the head to either side, which elicits extension of the limbs on the jaw side and flexion in the occipital limbs. Rotation of the head also involves movement of the eyes in the same direction as the head, compelling the eyes to follow movement of the extending arm and hand, helping to increase infant’s focusing distance from near point to arm’s length and back again, and from central vision to peripheral vision. (Figs. 1 and 2). Within only a short period of time, the extending arm and hand will come into contact with objects, and through a combination of moving, seeing, proprioceptive feedback and touching, the infant starts to understand the rudiments of space and distance. Only a few months later, the ATNR will be inhibited - as the transition from reflex reaction to increased voluntary control progresses - oculo-motor function and visual perception also mature (Fig. 3).

Figs. 1 and 2 ATNR influencing eye-hand coordination in a neonate

Fig. 3. Infant at 22 weeks able to bring the hand and eyes to the midline to coordinate reaching.

Visual functioning will continue to develop in co-operation with movement activity for many years. Crawling represents another stage in the process, when for the first time vestibular, proprioceptive and visual systems operate together in a new relationship with gravity, with the hand-eye coordination involved taking place at the same visual distance a child will use to read and write a few years later (Fig. 5). Fig. 5. Space, depth and weight bearing are explored from the quadruped position.

Fine motor skills

Development of the pincer grip needed to hold and use a writing implement provides another example. If an object is placed in the palm of a neonate’s hand it will grasp the object by curling its fingers successively around the stimulus, beginning with the middle finger, followed by the ring and little fingers, index finger and thumb (Prechtl 1953) with the thumb usually nestling underneath the index finger (Fig 6).

Fig.6. Palmar grasp reflex in 4 day old baby

The Palmar Reflex remains present in healthy infants up to the fifth month of life gradually being inhibited by the age of one year. By the fifth month, the infant starts to be able to let go of an object, although initially this may occur as much by accident as design. This is the stage when the infant will start to drop toys or food and then whimper in frustration when it cannot retrieve the object itself. Parents quickly tire of the game, but the infant is learning to do something very important. He is learning how to “let go”. This is a precursor to being able to bring the thumb and forefinger together without the whole hand opening or closing. Modification of the palmar reflex occurs in combination with other motor experiences. When placed in the prone position, the action of using the hands to support the weight of the body also helps to moderate sensitivity to touch in the palmar region of the hand and inhibit the grasp response (Figs. 7 and 8).

Figs. 7 and 8. Upper body weight supported using the arms and hands, helps to inhibit the Palmar reflex and develop head, neck and upper body strength

Fig. 7 Hands still under influence
of palmar grasp reflex at 3 months

Fig. 8 Palmar grasp reflex significantly
integrated at 22 weeks

Voluntary release of objects and thumb and forefinger opposition are necessary for many fine motor skills tasks, particularly holding a pencil to write. When a child is learning to write initially he will tend to replicate earlier patterns. He will for example, use a cross-palmar grasp with the whole hand clutching the chalk or pencil and usually with the arm turned inwards. As the arm is not well supported on the writing surface initially the child uses gross rather than fine motor actions to draw or write. A little later, a similar grasp is used but the child notices that he can control the pencil better if he extends his index finger. Eventually he will learn to use a tripod pincer grip with the third finger supporting the pencil, the forearm supported on the surface and the arm turned outwards enabling him to use fine motor actions. This later dexterity relies on successful completion of earlier stages. If a school aged child is still influence by the palmar reflex, manual dexterity will be impaired and may be observed in the type of pencil grip used (Fig. 9).

F ig. 9. Palmar grasp reflex evident in the writing grip of a school aged child

The relatively uncontrolled postures, gestures and attitudes of the infant form the basic motor vocabulary for the most refined and expressive movements utilised in dance, art and musical expression, the physical prowess of the athlete, the creative ideas of the academic and the scientist, and the skill of the craftsman. The difference between these abilities is in the range, release and voluntary control of the movement patterns involved, acquired through maturation, experience and training. While this process begins in infancy, skills continue to be developed over time through experience and practice, a process well recognised in past forms of education at risk of being ignored as children are encouraged to play and to learn with the aid of e-technology through virtual versus physical reality. Physical literacy begins with mastery of the body in space, the physical sense of self and security in space and the development of a rich vocabulary of non-verbal skills as well as supporting verbal expression.

1 McPhillips used exercises based on movements originally devised by Peter Blythe at The Institute for Neuro-Physiological Psychology (INPP) in this study.

References

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Contact

Sally Goddard Blythe MSc
The Institute for Neuro-Physiological Psychology
1, Stanley Street
Chester
CH1 4HL
United Kingdom
Email Sally.blythe@inpp.org.uk

http://www.icsspe.org/