Wednesday, April 23, 2014

Steering Clear for Bicycle Safety - A cautionary tale of retained ATNR in action


Walking in the park near my home the other day, I saw a very young child, maybe about two and a half years old, riding a tricycle as his mom walked alongside him. I was behind this pair, so I had a rear view of the child on the trike, just perfect for seeing the alarming event that unfolded so quickly:

The boy suddenly looked over to the right at a barking dog, and simultaneously steered to the left, almost straight into the oncoming traffic on this busy path. The mother said, “watch where you’re going!” which prompted the boy to look up at her (also to the right), and he kept turning left. A collision with an oncoming jogger was narrowly averted.

An onlooker might wonder, Didn’t he see that jogger coming at him? Didn’t he hear his mother? Didn’t he know how to steer? Was something wrong with the handlebar mechanism?

But I’d been behind this pair long enough to see that the boy could certainly steer the trike: he’d been neatly following the curves in this pathway. He didn’t swerve to the left until he looked to the right. Actually, if what I believe is true, he steered to the left because he looked to the right.

What? Steer to the left because you’re looking to the right? Yes. And all because of a retained infant reflex. Allow me to introduce Asymmetrical Tonic Neck Reflex (ATNR).

A bit about reflexes
During our newborn-to-early-choldhood years, we go through a continuum of “wiring” stages, intended by nature to leave us with ready patterns to call on when the time comes to move with skill and precision in specific ways. Doctors gauge the development of a young child by noting whether these reflexes are maturing appropriately. My book Educate Your Brain has an entire chapter on this topic, called “Wired for Ability.” And the definitive resource is Sally Blythe’s book Reflexes, Learning and Behavior – a window into the child’s mind.

Each reflex is intended to emerge, mature as it’s fully put to use, and then integrate into the overall system of wiring patterns. Then it’s a pattern available to be called on at will, rather than constantly operating on its own.

However – and this is a big However – sometimes this plan goes awry (due to such things as trauma in utero, stressful birthing, C-section or premature birth, infant surgery, illness, etc.) and the reflex continuum may go into what I call “suspended animation.”

When this happens, the physical body matures, but the neural system doesn’t, so the child looks (for example) eight years old, but his neural foundation is much younger – and so are his behaviors and abilities. As he grows, certain reflexes may appear, but not mature and then integrate, leaving him with vestiges of various reflexes, and baffling behaviors that may seem to defy his will to be otherwise. I call this being at the mercy of the “invisible puppeteer.” Perhaps this will be more understandable after I explain this particular reflex. But first, a few words about…

Four Movement Patterns
There are four main movement patterns that our body must learn: 
• spinal reaching: leading with the crown of the head (upright posture, and experiencing our spine as our central axis)
• homologous: moving arms (top of the body) independently from the legs (bottom of the body) 
• homolateral: moving the right arm and leg (right side of the body) independently from the left arm and leg (left side of the body)
• cross-lateral: moving right, left, top, and bottom together, in a coordinated way

Physically speaking, when we are wired for all of these patterns, we’re able to use them separately or in any combination, for skilled, selective, intentional movement. 

Cognitively speaking, each of these movement patterns is related to "wiring" that's happening in the brain, culminating (optimally) in whole-brain integration, so that the mind-body system can call at will on all its cognitive abilities, for success in receiving, processing, and expressing information required for learning: reading, memory, concentration, comprehension, and more. 

Here we’ll focus on the homolateral, or “one-sided,” pattern: being able to use one side of the body on its own, without engaging the other side. 
• Physically, we use this one-sided pattern when we do such things as pivot on one foot, or do something with one hand while the other hand is still, or does something else. 
• Cognitively, we use this pattern when we focus intensely on something that's "left-brained," such as math computation, phonics, or spelling; or "right-brained," such as creating stories or holding awareness of spatial orientation. 

As you can see, all these "one-sided" skills are important! The issue arises when a person is stuck in the homolateral state, and cannot shift from (for example) story writing, to figuring out how to spell an unfamiliar word, and back to story writing again. Cross-lateral integration is needed for that. People with a retained ATNR will, by definition, be stuck in a homolateral state, and won't be able to easily do this kind of shifting. We'll get to solutions later; for now, let's look at how we develop this very necessary one-sided patterning.  

Building Homolateral Patterns through ATNR
Nature has worked out how to develop this “one-side-at-a-time” pattern in the infant, by having it go through the “Asymmetrical Tonic Neck Reflex” (ATNR) period, essentially through about the sixth month after birth.

During this period, when the infant is on her back and turns her head to the left (for example), her left arm and leg automatically extend, and her right arm and leg automatically flex. This is not a choice the baby is making, it is a compulsive movement, driven by the reflex present in her system: Turn head to the left, left arm and leg extend, right arm and leg flex. Automatically. No
Baby in ATNR position
choice. Then, when the infant turns her head to the right, the whole process happens in reverse:
Turn head to the right, right arm and leg extend, and left arm and leg flex. Click here to see a video that shows this in action.

By about the sixth month after birth, this repeated motion will have laid down the wiring that allows the right arm and leg to move independently from the left arm and leg. At this point, its work now done, the reflex should then “integrate,” or “retire.” When this happens, the infant will be able to turn her head in any direction, without automatic movement of her arms and legs.1  

Now – back to the child on the tricycle
The boy I observed that day steered accurately, as long as he was looking straight forward. As soon as he turned his head to the right, his right arm straightened and left arm flexed. When the right hand is on the handlebars, and that arm straightens, it pushes the right handlebar forward, which steers the tricycle to the left.

This is a recipe for disaster. I firmly believe that many bike accidents are the result of retained ATNR at work. Let’s envision a child riding along in the bike lane, between traffic and parked cars. He turns his head to the right to see something interesting or important, and reflexively steers to the left – and out into traffic. Or, he turns his head to the left to watch out for traffic – and steers into the cars parked on the street.

Claire Hocking, the instructor for the first Brain Gym® course I took that deals with resolving retained reflexes, told the story of her own experience with retained ATNR. Through some very scary experiences, she had learned never to turn her head while driving, or she’d steer unpredictably; she made herself always sit with her head tensely forward. Once she discovered that this was because of a retained ATNR, and figured out how to resolve the reflex in her own body, she found that she could turn her head in any direction and still steer straight down the road: her head turning no longer elicited an automatic movement of her arms. This became an entire field of study for her, and now she’s taught thousands of adults around the world to work with her techniques. 

Nature’s resolution for ATNR
In the natural course of things, children move their way through the reflex continuum. At the end of the ATNR stage, the STNR emerges: Symmetrical Tonic Neck Reflex. (I’ve written an article about it, which you can find here.) STNR is the reflex that prompts the baby to rise from a tummy-down position to an all-fours position, in preparation for crawling.

And it’s this stage of crawling, which requires coordinated use of both sides of the brain simultaneously, that supports the development of cross-lateral patterning. Some reflex specialists believe that infant crawling may actually contribute significantly to "retiring" the reflexive ATNR pattern. You see how interrelated all these reflexes are!

Cross-lateral patterning is vitally important for all kinds of academic and coordination tasks. And a child will never be truly cross-lateral if he’s still “stuck” in the ATNR stage.

However, some children never crawl, or crawl for only a limited amount of time, or in an “odd” way. This may be because of more significant reflex issues, a home environment that isn't safe for crawling, or simply because their parents did not put them tummy-down for play. (A baby must experience abundant tummy time to be in the right position for the STNR to kick in and get him up on all fours, so he can eventually crawl.)

If a child has never crawled, it’s possible that he never moved his way from homolateral (ATNR) to natural cross-lateral patterning, where he’s able to call on both brain hemispheres simultaneously.

This may cause numerous challenges as he matures, as he struggles with actions or tasks that require the use of both sides of the body (or both sides of the brain) at the same time: Reading. Tying shoes. Doing “story” problems in math. Spelling while writing a story. Catching a ball with both hands. Running in a coordinated way. Doing anything in the space right in front of him, involving both eyes and one or both hands.

And riding a bike without reflexively steering into traffic or parked cars.

And this is just the beginning.

So – what can you do?
If your child has coordination or learning issues of any kind it’s possible that a good movement-based program will provide the help you’re looking for.

You may find that working with a nearby Licensed Brain Gym® Instructor is a tremendous help; and many have taken specialized training in addressing infant reflex issues. Even without specialized reflexes training, a Brain Gym instructor will be able to guide your child through movements and processes that will support a level of integration that will make life easier for him. And you may be interested to know that one particular Brain Gym process, Dennison Laterality Repatterning, typically has the outcome of supporting the learner in taking on a natural cross-lateral pattern very quickly - sometimes in a single session. 

In my own practice I’ve worked with many people – children and adults alike – who found that an infant reflex was at the core of an issue they were addressing. Once the reflex was resolved, the “issue” was no longer there, as focus, attention, comprehension, or coordination would begin to manifest, once the “invisible puppeteer” for that reflex had been retired.

The Cross Crawl
Something you can do on your own that may very well help in the case of ATNR is the Brain Gym® movement called the Cross Crawl. This movement helps the learner develop the ability to use both sides of the body at the same time, in the same way that infant crawling does. 

It would be good to practice it yourself, first. Standing, raise one knee and bring the opposite elbow over to it. Lower that arm and leg; raise the other knee and connect with its opposite elbow. Repeat this, back and forth, for a minute or so. Once you’re familiar with this pattern, you can invite your child to join you, “just for fun.”

If you see your child exhibiting confusion about how to bring the right arm to the left knee (for example), resist the temptation to “correct” him, at least at first. Allow him to experience the movement, and to compare what he’s doing with what you’re doing; he may very well figure it out on his own (self-noticing and self-correction is always the most powerful form of learning).

If confusion persists, you can begin by “motoring” your child through this movement, perhaps while he’s seated in a chair or lying on the floor. Repetition over time will very likely make this movement smoother and easier. Put on some music, and make it fun! And be sure to do this with your child, in the spirit of play.2

All this said, supporting a child in achieving a smooth Cross Crawl movement does not guarantee that an active ATNR will no longer be an issue. If you believe this reflex is still causing challenges, you may want to seek some support, as I described, above.

I would like to see all children become skilled bike riders, able to enjoy looking at the world around them while still steering straight down the road. Let’s make sure that their mind-body systems are integrated enough for this to be a safe and fun activity!

With all best wishes,

Kathy
Click here for a link to the website for my book
Educate Your Brain
1 - Here I'll (again) express my concern that babies kept for extended periods of time in car seats are not getting the amount of time they need to freely move their body. This may prevent them from fully engaging the reflexes they're supposed to be going through. In my estimation, this practice runs the risk of actually creating learning disabilities. 
2 - And, of course, there are 26 Brain Gym movements, each of which has its own special way of supporting the mind-body system in becoming more integrated. If this interests you, I recommend buying a copy of the book Brain Gym® Teacher’s Edition.

Copyright© 2014 by Kathy Brown. All rights reserved. 
Photo of child on tricycle Copyright© Dreamstime.com  All rights reserved. 
Photos of child in ATNR position and doing the Cross Crawl Copyright© 2012 Laird Brown Photography. All rights reserved. 
Brain Gym® is a registered trademark of Brain Gym® International • Ventura, California • www.braingym.org






Wednesday, March 12, 2014

The Best Start Possible... a very sad addendum, and reader comments


Since the posting of my recent article, The Best Start Possible,” in which I called attention to the potential developmental challenges caused to infants by overuse of car seats outside the car, I’ve received two comments that I’d like to share, and a link to an article about something I truly wish hadn’t happened.

I’ll start with the article. Not long ago a friend shared this link to a tragic story told in the Blackfoot (Idaho) Morning News:


This article arrived in my in-box just a few days after I'd posted my own Blog story. I cried for this infant, who died of airway constriction, from sleeping in an upright position without sufficient support for her head. This is called “positional asphyxia.”

Now, the story goes on. As I began to write this Blog posting, I found I’d mislaid the original link my friend had sent, so I did a Web search. What did I find? I found that article, and many more, all about babies dying when left to sleep in car seats.
I couldn’t open any more than these three links. It was just too sad.

Please spread the word. Babies should sleep horizontally. Babies should sleep horizontally. Babies should sleep horizontally. Babies left to sleep in an upright position can die of positional asphyxia. 

This includes sleeping in baby swings. Please see the journal Pediatrics, from the American Academy of Pediatrics, for their recommendations on infant sleep positions:
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf

Now, I’ll exhale and move on.

I would like to thank the readers of my Blog who posted their own comments in response to my original “The Best Start Possible” posting, about the developmental hazards of overuse of infant car seats. I’m sharing them here with you all.

As a mother of three kids, 2 biological and 1 foster care/almost adopted, I could not agree more. Our 16 month old spent the first 4 months of her life in a car seat before she was removed from her biological caregivers. She has been diagnosed as having a stiff spine which has hindered her speech and motor development. We hope that she will continue to improve in both areas now that she regularly sees a physical therapist and a speech therapist. Parenting this child has required a particular amount of patience and love. I hope others will realize that children need to be able to move and stretch without being strapped down! :)

This child is fortunate to now be in the care of someone who understands her challenges and is in a position to support her with therapy. 

How many children are out there, who are not so fortunate? And, considering all the challenges inherent in this kind of neurological damage, what happens when they hit school age? What kind of learning challenges are educators facing with these children, and are schools equipped to recognize and provide the kind of therapy that these children need? 

Another reader shared this:

I would love to stand on a street corner and hand this [article] out to all the mamas I see carrying "bucket babies.” Hurray to the mom who followed her gut... Have shared with colleagues at a local pediatric outpatient clinic. Maybe they will post in the waiting room!

I know exactly what this correspondent means! I’d like to be right there on that street corner with her!

I cannot make a blanket assumption about every infant I see being carried in a car seat, because I see that child for just a few minutes of its life. I truly hope that, as soon as the caregiver gets where he or she is going, the infant is removed from the car seat and held, or put down on its tummy or back. I wish I believed that this happens all the time.

And consider this: Parents must (unfortunately) assume that anything for sale in the baby equipment store is safe to use. We see babies in these carriers everywhere in our world. Who questions this, let alone makes noise about it?

Perhaps you’d like to join me in envisioning a world where all caregivers know the damage that overuse of car seats can do, and are careful to position babies appropriately and safely for their best development and growth.

And let’s support our vision with action. One way I’m doing this is by writing these postings, and making them available to be shared. Want to stand on a street corner with me?

With warm regards,

Kathy

P.S. I'd love to know your thoughts and experiences on this topic. Please "Post a Comment" below.
Click here for a link to the website for my book
Educate Your Brain

Copyright© 2014 by Kathy Brown. All rights reserved. 

Brain Gym® is a registered trademark of Brain Gym® International, Ventura, California • www.braingym.org


Tuesday, February 4, 2014

The Best Start Possible


On my morning walks I travel through a park where there are a lot of mothers out with their babies, and the other day I saw something that really caught my attention. I saw an infant in a baby carriage. Yes, an actual baby carriage. Not a car seat on a stroller framework, but an old-fashioned baby carriage. I was so impressed, I asked the mother if I could take a photo, and here it is: 

She told me she’d had to go to a lot of trouble to find this particular piece of equipment. She said they’re expensive, and not common. She finally found this one, used, online. She didn’t know why she felt so strongly about getting a baby carriage, as opposed to a car-seat on wheels – she just had a “feeling” that it was the right thing to do.

Let’s explore where this “feeling” might have come from.

First, let me say this very clearly: Car seats are absolutely vital for transporting infants and young children in the car. They're specially designed to save lives in the event of a collision. Don't move an inch without one for your baby. 

Now, back to our exploration of that “feeling.”

Let’s begin with a visualization experience.

Imagine that you’re in a semi-reclining padded chair. Imagine also that your neck is weak, so your head rests within a bolster cushion that keeps it in position. It’s comfortable enough, and you’re cozy enough. Now, imagine that you’ve been in it for an hour. Then another hour. Then another hour. You might be out of it for a little while, then back in it, for another hour. And another hour.

Just thinking about this, how do you feel? What do you notice in your body? What physical or emotional impulses do you have?

Now put yourself in the place of an infant. Realize that, as an infant, your job is to move in many important ways, experiencing your body in space, your limbs in relation to each other and your core, your spine as your central axis, your head in relation to your spine, your ability to move against gravity, and more – much, much more.

Sitting in your recliner chair, how fully and easily can you…
• experience that you have a spine, by flexing and rotating it?
• move your arms and legs, from the shoulder or hip?
• feel the muscles of your midsection activating, as you move the rest of your body?
• experience your body’s ability to shift position and move in space?
• lift and rotate your head?
• follow through on your impulses to move and explore?

Now – imagine yourself lying on a flat surface – a blanket on the floor, or on your bed, on your stomach or your back. How fully and easily can you…
• experience that you have a spine, by flexing and rotating it?
• move your arms and legs, from the shoulder or hip?
• feel the muscles of your midsection activating, as you move the rest of your body?
• experience your body’s ability to shift position and move in space?
• lift and rotate your head?
• follow through on your impulses to move and explore?

It’s very likely that you noticed a difference. Being on a flat surface allows much more freedom in how and where we move. (And it's important to experience that flat surface on both our back and our front. "Tummy time" is a developmental imperative, for reasons I won't go into here - but this article about Symmetrical Tonic Neck Reflex should give you a clue.)

Why does all this matter? Because the ultimate result of whole-body movement is the efficient “wiring” of your mind-body system so you can develop and refine your perceptual apparatus, and (eventually) think and learn easily. Without sufficient movement, infants are likely to have a very challenging time growing into natural, spontaneous learners.

Laura Sobell, infant specialist, has written a wonderful book titled Save Your Baby – Throw Out Your Equipment, where she describes many aspects of modern baby-management equipment and practice that are actually harmful to the developing child, and what to substitute for them. She has told me that she can tell if a child has spent too much time in a car seat, because when she picks him up, his back is stiff, with little flexibility.

She recommends baby carriages over car-seat-strollers. (And especially for newborns she most highly prefers something called an “umbrella stroller” or “sling stroller”, which keeps the baby “flexed, rolled up, and cuddled” while still on its back. She emphasizes, “It is best to keep little babies in the reclined position.”2 She also strongly counsels against carriers in which the newborn is held in a vertical position against your chest; and bouncy-seats, which she says contribute to brain-shaking and are hard on joints and muscles.3 For more information, see her website, www.calmbaby.com. Click the “Save Your Baby” link.)

In general, the experts I’ve heard speak, agree that babies should not be propped in a seated or upright position until they can sit on their own, or helped to stand and walk until they can stand on their own. This whole topic is a big one, and deserves more space than I have here.  

So, limiting physical movement is one reason to be concerned about over-use of portable car seats. And there’s another reason, as well: it limits sensory stimulation through touch.

In her book Smart Moves – Why learning is not all in your head (2005), neurobiologist Carla Hannaford, Ph.D. discusses many aspects of whole-body integration and activation that must be present to build the sensory networks for learning to occur. Consider these statements:

Just the act of being touched increases production of a specific hormone within the brain - Nerve Growth Factor (NGF) - that stimulates axon growth and nerve net development, helps maintain neuronal function and increases synthesis of acetylcholine.

When touch is lacking, children and adults exhibit depressed motor and mental functioning. There may in fact be a connection between lack of touch and lowered acetylcholine levels found in Alzheimer's patients. 

Touch, especially along the back, arms, hands, feet and face of the baby, stimulates growth of the sensory nerve endings involved in motor movements, spatial orientation, visual perception, and the stress response. If these nerve endings are not activated, the RAS (Reticular Activating System) that awakens the neocortex, will not operate fully. This leads to impaired muscular movements, curtailed sensory intake, overreaction to stress, and a variety of other emotional disturbances and learning defects.1   

How much touch do infants receive when they’re carted here and there, for hours at a time, in a portable car seat? Or, rather, How much touch are they missing out on? Traditional means of carrying include holding the baby in your arms, in a sling, and in an infant shawl. All of these provide tremendous tactile stimulation.

You may ask: Is an extra hour in a car seat going to thwart nature’s plan for infant movement and neural development? Of course not. But I believe it’s very healthy for parents to examine how many hours a day their children may be in a portable car seat, simply because of the convenience.  

Consider this. Not long ago I had a conversation with a conscientious young mother about this topic, and she began reflecting on a recent day, when she’d had her baby in the car seat…

• in the car, for her hour-long drive to a friend’s house
• sitting at her feet, for three hours while she helped the friend with her tax accounting
• back in the car, while she drove back to her neighborhood grocery store
• propped atop the grocery cart as she did her shopping, and
• at home, while she took a shower and cooked dinner.

She realized with horror that her infant had been in that car seat for more than eight hours. That’s one-third of that infant’s day. How often did she have days like this, without realizing it? And this was a careful, loving mother. What happens with children of neglectful parents? 

I’ll repeat my earlier comment: car seats are vital to use for transporting infants and young children in a moving vehicle. Now I’ll add that I believe the car seats should remain in the car. I heartily recommend that parents explore alternative means of carrying their child. Just because all this equipment is offered for sale, doesn’t mean it’s developmentally appropriate to use everywhere. It could mean that it’s a goldmine for the manufacturers and stores, that advertise to parents stressed by their role as caregivers to a new baby, who want to do “everything possible” for their child.

Over the years, I’ve worked with a number of learning-challenged children whose parents (I would learn, through casual conversation) had unknowingly over-used portable car seats and other baby-management devices. Now, when I’m out and about, and see young parents with a child in a car seat propped up at their table in a restaurant, or with baby-carrier in hand as they go through the shopping mall, I can’t help but feel concerned. Do I know that any particular child I see this way has spent “too many hours” in a portable car seat, and is destined to need special interventions? Well, no.  

But in this world of mushrooming numbers of children diagnosed with such challenges as ADD and ADHD, and accompanying learning issues, it behooves us to look at what has changed in the world of infant management techniques and equipment, and see if some of those changes may be contributing factors. Looking at what we’re doing, and making developmentally appropriate choices in regard to use of baby-management equipment, is a good place to start. The more we protect our children’s neural development through conscious choices and practices, the better chance they have to grow into spontaneous, joyful learners.

So, to the mother who had that “feeling” about finding a baby carriage for her infant: Well done! I congratulate you for bucking the portable-car-seat trend and following your instincts to find a more developmentally appropriate alternative. May many more follow your example!  

With warm regards,

Kathy
P.S. I'd love to know your thoughts and experiences on this topic. Please "Post a Comment" below!
Click here for a link to the website for my book
Educate Your Brain
Citations
1 - Hannaford, Carla. Smart Moves - Why learning is not all in your head. Salt Lake City, UT: Great River Books, 2005. 44-46. 
Additional note: Each of these three statements quoted from Dr. Hannaford comes with its own citation(s). Please see her original text.
2 - Sobell, Laura. Save Your Baby - Throw Out Your Equipment. Santa Barbara, CA: Whole Family Press. 11.
3 - Sobell, Laura. www.calmbaby.com/saveyourbaby.html

Copyright© 2014 by Kathy Brown. All rights reserved. 
Photo Copyright© 2014 by Kathy Brown. All rights reserved. 

Brain Gym® is a registered trademark of Brain Gym® International, Ventura, California • www.braingym.org

https://www.blogger.com/comment.g?blogID=1819129840505860131&postID=8972997767647853683