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Developmental Delay


During some forty years of practice and working with child disability I have met and recorded case studies of a significant number of children who despite having been given little or no hope of ever lifting their heads, sitting, walking, or engaging in any kind of voluntary movement, have defied their medical prognosis and come through by virtue of their parent’s love, patience and perseverance.
Most of these parents have contacted me through despair some twelve months or more following the birth of the baby when their baby’s disabilities have become painfully apparent. In these instances, the disabilities are made obvious by the display of stiffness or floppiness, or the combination of both, which have inhibited their child’s ability for coordinated movement and motor control.
Most often, a clinical diagnosis of any underlying cause can be difficult to assess and can take months to identify. Even with babies that are known to be at risk of motor delay and disability, arranging an appointment with a specialist can take weeks, especially during a holiday period. Following this, a course of treatment then has to be decided upon and further appointments made to see a qualified practitioner, all of which can take months.
Although there may be no cure regarding the initial diagnosis, this early period is a prime time when the symptoms can be alleviated. For parents a crucial time, during which they can begin to practice some elementary steps that will enable them to help their child gain more motor control. Known as ‘brain healing’, the neuroplasticity of the brain that allows the brain to ‘heal’ and it does this, not by trying to repair those ‘circuits’ that are damaged, but in bypassing the injury and forming new ones. Only, ‘movement restores movement’ the consistent practice and repetition of specific movement being what forms these ‘circuits’ and allows the development of a variety of new skills from infancy to adulthood
There is no point in waving a toy in front of a baby or a child whose limbs are too floppy or too stiff to reach out and grasp it. Before motivation of mind becomes effective, a neural pathway for the physical enablement of this movement has to be established. Where this is lacking it can be achieved through the repetition of tiny steps. Reducing each milestone into a series of tiny steps, each tiny step being built upon consistent practice and repetition of the one previous, enables the neurological pathway that can give a child the ability to achieve movement.
With both stiff and floppy baby syndromes there is much that can be accomplished in the weeks following birth before rigidity and limpness become more established and combine with weight gain to make it even more difficult for the child to achieve any of their motor milestones.
Compassion, patience and practice is the way forward and these steps can be practised consistently as ‘Therapeutic Play’. Not something that is done to a child to conform with a ‘timed’ appointment, but that is practised daily, regularly with the enlistment of the parent/s, with a child, without haste, at the best time and in the best place.

© Peter Walker Physical Therapist
‘Therapeutic Play’
A Parents Role in Treatment and
Early Intervention of Infant Disability
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