Neuro-developmental stimulation in the work of a special education teacher

Abstract

The aim of the dissertation entitled Neuro-Developmental Stimulation in special education teachers work is to explain a lesser-known phenomenon (persistent primary reflexes and sensory-sensitive integration disorders in children) to determine the prevalence of persistent primary reflexes in pupils from 5 to 8 years and verify effectiveness of the method Neuro-Developmental Stimulation as a possible intervention program for special educators.

The theoretical basis is current knowledge about psychomotorics, primary reflexes, sensory perception and sensory-sensitive integration. The main part of the work is research into the prevalence of persistent primary reflexes. The research group consists 345 pupils from 5 to 8 years of age attending regular kindergartens and primary schools and 26 pupils aged 8 to 11 years attending a primary school established pursuant to Section 16, Paragraph 9 of the Czech Education law. Intervention by the Neuro-Developmental Stimulation method is verified in a case study. The next part of the research maps the experience of special pedagogue teachers and speech therapists with the method Neuro-Developmental Stimulation as an intervention program. The research has a quantitative approach. For data collection, questionnaires were distributed among all special pedagogues and speech therapists who completed Neuro-Developmental Stimulation courses between January 2014 and June 2019.

The research shows that 12.8 % of pupils aged 5 to 8 have at least one primary reflex completely (to grade 4) or at least two reflexes to grade 3. Here we can expect problems with education. Furthermore, research shows that if the primary reflex persists to a large extent, it will not disappear with age. Special intervention is needed. It is clear from the case study that persistent primary reflexes and his associated symptoms can be eliminated or alleviated by using the Neuro-Developmental Stimulation method. Neuro-Developmental Stimulation is perceived very positively by graduates of Neuro-Developmental Stimulation courses as another possible method of working with children with learning or behavioural disorders. Respondents appreciate that Neuro-Developmental Stimulation affects the child comprehensively, throughout its development. According to the questionnaire, the respondents were able to use the Neuro-Developmental Stimulation application mainly to improve gross motor skills and cooperation. Other areas with the most frequent visible improvements were coordination of movements, communication, and focus. It can therefore be stated that Neuro-Developmental Stimulation can be successfully included among special pedagogical methods.

Key words: Neuro-developmental stimulation; primary reflexes; psychomotorics; sensor-sensitive integration; sensory perception

Discussion and recommendations for special education theory and practice

Diagnosis in special education involves a comprehensive, multidimensional process that includes medical, psychological, social, and special education assessment. It is a complex cognitive process essential for determining subsequent support and intervention. Since human development is a dynamic process, a diagnosis should not be regarded as something fixed or unchanging over time (Přinosilová, 2007). The goal of the diagnostic process is to identify specific causes and barriers that the pupil has not yet been able to overcome and, based on this, to propose specific intervention measures (Bartoňová & Vítková, 2016). In practice, the processes of diagnosis and re-education often overlap, as special support is provided based on the diagnosis, and during this process, not only are impaired functions re-educated, but diagnostic knowledge is also refined (Přinosilová, 2007).

When diagnosing many of the main areas of special education diagnosis (gross and fine motor skills, graphomotor skills, drawing, laterality, social development, communication skills, etc.), it is important to focus on key factors such as primary reflexes and sensory-sensitive integration. Persistent primary reflexes and sensory-sensitive integration disorders can cause symptoms related to learning disabilities, behavioral disorders, communication problems, and difficulties with concentration. Specific learning disabilities (SLD) affect a large percentage of the child population. According to Bartoňová (2018), 3–4% of school-age children and youth suffer from learning disabilities. The prevalence of SLD is significantly higher in boys, which is linked to functional differences in the brains of men and women.

A particularly interesting topic for further research could be an attempt to investigate and document the number of children with diagnosed SLD who are also diagnosed with persistent primary reflexes and/or sensory-sensitive integration disorders.

Objective of the dissertation

The aim of this dissertation was to explain a relatively unknown phenomenon (persistent primary reflexes and sensory-sensitive integration disorders in children) and to determine the prevalence of persistent primary reflexes in pupils aged 5 to 8 attending mainstream kindergartens and primary schools. A secondary objective was to verify the effectiveness of a potential intervention approach for special education teachers (Neuro-developmental Stimulation – NDS).

Importance of early intervention

When considering the possible symptoms of individual persistent primary reflexes, it becomes clear that they can significantly affect a child's development and academic performance. Therefore, early detection and intervention aimed at inhibiting these reflexes are essential. Ideally, intervention using NDS should begin before the child enters primary school.

Connection between primary reflexes and sensory-sensitive integration

Primary reflexes and sensory-sensitive integration are two closely related areas that influence different parts of the brain. By combining activities aimed at inhibiting primary reflexes with those aimed at improving sensory-sensitive integration, the intervention becomes more effective.

Differential diagnostics using tests for primary reflexes and sensory integration

Tests for persistent primary reflexes and sensory-sensitive integration can serve as differential diagnostics. It is essential to note that primary reflexes often persist in children with atypical development. Therefore, it is highly likely that children with SLD, attention disorders, autism spectrum disorders (ASD), as well as those with various physical, intellectual, or sensory disabilities, will also have persistent primary reflexes. Persistent primary reflexes can further exacerbate their difficulties, but they may not necessarily be the root cause.

In practice, there is a group of children whose diagnoses have not been correctly established. These are most often children diagnosed with SLD, attention disorders, or autism spectrum disorders. Sometimes, the symptoms caused by persistent primary reflexes or sensory-sensitive integration disorders are very similar to the aforementioned diagnoses. However, the intervention approach should be different. If persistent primary reflexes are detected, efforts should first be made to inhibit these reflexes. Only then is it possible to accurately diagnose SLD or ASD. Inhibiting primary reflexes is therefore one of the possible methods of intervention.

Research on the prevalence of persistent primary reflexes

This dissertation presents quantitative research on the prevalence of persistent primary reflexes in preschool and early school-age children. The quantitative study, which included a research sample of 345 pupils aged 5 to 8, reveals that 12.8% of pupils have significantly persistent primary reflexes, meaning at least one reflex at level 4 or at least two reflexes at level 3. For these pupils, it can be assumed that these reflexes will negatively impact their education. Another 42.8% of pupils had more than two persistent reflexes or at least one reflex at level 2. It is likely that these pupils will face mild difficulties, for example, with (grapho)motor skills, concentration, or learning. However, these difficulties may not be severe enough to be recognized, and these pupils may not be referred for diagnosis. As a result, they may not receive the intervention they need, even though their school performance could be improved.

Preventive intervention in kindergartens

Given these findings, it is worth considering offering Neuro-developmental Stimulation as a preventive program in kindergartens. This idea was also supported by many graduates of the Neuro-developmental Stimulation courses (see appendix).

Structure of the NDS program

Neuro-developmental Stimulation provides a comprehensive methodology for working with children. It can be used by special education teachers as part of both complex diagnostics and intervention. The method combines activities for inhibiting primary reflexes with activities for improving sensory-sensitive integration. The entire program lasts 30 weeks, but it can be extended as needed. The specific method of working with children was described in detail in a case study. Based on the research, it can be concluded that NDS can significantly help prepare children for school.

Survey of NDS course graduates

As part of the second research study, questionnaires were distributed among graduates of the Neuro-developmental Stimulation courses. The quantitative approach yielded a wealth of useful information. A total of 137 graduates (participants of NDS I, NDS II, and sometimes supervision sessions) completed the questionnaire.

Perception of NDS by graduates

The questionnaire reveals that NDS is perceived very positively as an additional method for working with children with learning or behavioral disorders. Most respondents use NDS when working with preschool and early school-age children. They most often work with children individually or in small groups, either in counseling centers or in primary schools. Respondents appreciate that NDS has a comprehensive impact on the child's development as a whole.

Parental involvement and support for other therapies

Another important finding was that NDS requires the cooperation of parents with their child. Respondents also highlighted that NDS supports the child in such a way that other therapies (such as speech therapy) become more effective. Another advantage noted by respondents is that NDS does not require expensive materials (67% of respondents agreed with this statement).

Training and practical feedback from NDS courses

Most of the respondents learned about NDS from colleagues or acquaintances. They attended the course with the intention of incorporating NDS into their work. Over 87% of respondents stated that after completing the courses, they were able to recognize children with persistent primary reflexes. All respondents reported that their approach to children with persistent primary reflexes had changed.

The courses were rated very positively — 68.6% rated them as excellent, and 31.4% rated them as very good. No respondents rated the courses as below average or poor. Respondents particularly appreciated the opportunity to try all activities and exercises themselves and the connection between theory and practice. They also valued the quality of the materials, the clarity of the theoretical explanations, and the availability of additional supervision. Some respondents noted that the volume of new information was too large. About one-fifth of the respondents said they would have liked a more detailed explanation of the child's psychomotor development.

Challenges in using NDS

The biggest challenge in working with NDS, according to respondents, is the lack of time. Some respondents suggested that NDS should be offered in kindergartens and primary schools or even included in the national curriculum (RVP, ŠVP).

Recommendations for special education theory and practice

The findings show that NDS has its place in the work of special education teachers. However, the results of the survey indicate that knowledge about physiological psychomotor development is currently insufficient among special education teachers and speech therapists. Therefore, it would be beneficial to include more information on the child's psychomotor development within the framework of special education studies. For special education teachers to work effectively with children with disabilities, they must first understand the principles of a child's physiological development.

Interdisciplinary cooperation

Another important conclusion from this dissertation is the importance of a comprehensive approach to working with children. Many respondents (97.8%) believe it would be beneficial to raise awareness of NDS among other fields, such as physiotherapy, occupational therapy, and psychology, to improve interdisciplinary cooperation.

Conclusion

The research objectives of the dissertation were met, and the research questions were answered. It can be concluded that NDS is a useful tool in the work of special education teachers. Early detection of difficulties related to persistent primary reflexes and sensory-sensitive integration creates space for effective support of the child's development.

The full thesis can be found at https://is.cuni.cz/webapps/zzp/detail/182844/

VOLEMANOVÁ, M. Neuro-developmental stimulation in the work of a special education teacher (dissertation). Charles University in Prague, Faculty of Education, Department of Special Education, 2020. Available at https://is.cuni.cz/webapps/zzp/detail/182844/

Disclaimer: The information provided in this article is specific to the Czech educational system and may not apply to other countries. Educational systems, policies, and practices vary widely around the world, so please consider this context when interpreting the content.