A Brief Overview of the History and Principles
of Neurological Reorganization Therapy
By Bette Lamont
Neurological Reorganization and Developmental Movement are two names for a rehabilitation approach to the brain injured that has its roots in the work of Temple Fay, MD, Glen Doman, Carl Delacato, and later, Florence Scott (nee Sharp), RN. Various doctors who have helped advance the work, but whose names are not as strongly associated with this methodology, include Evan Thomas, MD, Edward LeWinn, MD, and Neil Harvey, MD, among others. This treatment method continues with an unbroken record of over 60 years of rehabilitating children and adults with non-progressive brain injuries and learning disabilities.
The work has been found to have a great effect in addressing the problems of autism, developmental disabilities, adoption trauma, ADHD learning disabilities, strokes, and all other non-progressive brain injuries whether acquired before, during, or at any age after birth. The youngest person treated successfully by this method began the program as a newborn. The oldest successfully treated individual of whom we are aware began the program after suffering a stroke at the age of 90.
Believing that most non-progressive brain injuries were irreversible, medicine in the mid twentieth century was content to diagnose and treat brain-injured children and adults on the basis of symptoms with little or no reference to the brain. This perspective discouraged the search for more accurate knowledge about the injured brain. It also prevented attempts to devise and assess treatment programs designed to improve the functioning of an injured brain. There is a great deal of research newly available providing evidence that activating early reflexes can alter the structure and functioning of the brain, but with few exceptions, medical practice has largely ignored the implication of this evidence. Instead, as a rule it has been taken for granted that the treatment of the brain-injured must be symptomatic.
To our knowledge, the first people to take issue with the symptomatic treatment of non-progressive brain injury were those named in the group above. These individuals became dissatisfied with the results of physical therapy and the overuse and wrong use of braces in the management of cerebral-palsied children. In the late 1940s they decided to seek ways of treating the brain injured.
This group of pioneers recognized that phylogenetically and ontogenetically, the human brain comprises a hierarchy of developmental levels with ultimate control in the cerebral cortex. They were aware that, deprived of appropriate sensory input, the brain fails to develop normal functions. From this knowledge they reasoned that it might be possible to organize or reorganize neuronal systems in an injured brain. In order to accomplish this in brain-injured children, they devised treatment programs that recapitulated, as far as this was possible, the sensory and motor experiences they believed were essential for the development of brain functions during infancy.
Principles on Which This
Treatment Is Based
1. The brain is a hierarchy. The human brain develops from the lowest level upwards recapitulating in part the phylogenetic development of the fetus, infant and child.
2. Function determines structure. Genes initially determine structure, but embryonic cells in the development of the embryo differentiate for functional purposes. In the early stages of development, function can determine how the embryonic cells develop. Also, the functional use of nerves and muscles increases the size and efficiency of these structures, while disuse causes atrophy.
3. Sensory input and motor activities are essential for the development of learning as a manifestation of functional neurological organization. Learning is a sensory process that must be reinforced by motor functioning. As stated by Doman and Scott: if input is nonexistent, limited or confused, the sensory pathways will be similarly undeveloped, underdeveloped, or incorrectly developed, and learning will not exist, will be incomplete, or will be incorrect to the same degree.
4. By increasing the duration, frequency, and intensity of sensory and motor activity appropriate for the development of neuro¬logical organization from birth onward, the neurological organization of injured brains can be improved. Treatment programs are therefore based on increased stimulation in six sensory and motor areas: visual competence, auditory competence, tactile competence, mobility, language, and manual skills.
5. To influence the organization or reorganiza¬tion of injured brains, it is necessary to make a fresh start beginning with activities and sensory inputs that have proved beneficial in promoting effective neurological organization from early infancy on. In other words, it is necessary to retrace steps in the normal process of neurological organization going back as far as possible.
The greatest possible unlimited opportunity for bodily movements is essential in the treatment of brain-injured children who have mobility problems. Further, movement activities increase stimulation to injured brains that impact all functions of that brain area. Thus, a child who crawls increases his capacity to accurately perceive pain and develop sophisticated horizontal visual-motor patterns.
The floor best provides opportunities for body movement for brain-injured children and adults. The restrictive effects of lying in a bed or on a couch, or sitting in a wheelchair during most of the day must be avoided in all cases, unless contraindicated by illness. ”The floor is the athletic field of the child.” (Gesell)
Children and adults who are not so physically limited, but suffer from learning disabilities, attention deficit disorder, hyperactivity, and the confusing symptoms of mild brain injuries are equally benefited by the floor and upright work assigned in programs designed by Developmental Movement Consultants.
Centers around the country offer these services both locally and also travel to other cities and countries to provide this new and effective approach to children with challenges.
A list of these providers appears on an accompanying document.
Over the past 20 years variations of Developmental Movement Therapy and new clinical studies have made this work known to more areas if the country. However many clinicians who treat children are unaware if the work of these pioneers.
With thousands of clients having successfully completed a program of Developmental Movement Therapy we have hundreds of testimonials from parents. Attached are excerpts from some of their letters
Brain Injured Children, Evan Thomas
Charles C. Thomas Publishers
Florence Scott, R.N. various lectures
Copyright, Bette Lamont, 2008