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Article publised in “Nursery World” 3rd March 2010

Child Development

Analysis: Motor skills – Put to the test

Sally Goddard Blythe, 03 March 2010, 00:00am

Developmental testing should be reintroduced for children before and after school entry to improve learning skills, says Sally Goddard Blythe.

Assessing reflexes would help to identify delay in motor skills

Babies with poor motor skills at nine months are also likely to be behind in their cognitive development at this age and less well behaved at age five, the Millenium Cohort Study – involving 15,000 children – has found.(1)

These findings mirror the results of an earlier study, which found a link between immature balance and co-ordination skills at age five and poor reading and writing in primary school.(2)

Physical development is the foundation for learning. Without balance and co-ordination, we could not sit nor stand, have free use of our hands to carry out fine motor tasks, or control the eye movements needed for reading, writing, copying and maths.

Learning success begins with physical development and it is in the first nine months of life that a baby develops the postural abilities that will support gross and fine motor co-ordination for life.

No two children develop at exactly the same rate. But the development of head control, for example, is crucial for learning to sit, stand, walk and provide a stable platform for control of eye movements. Children who are later at developing head control tend to be later at developing other skills. This is where the assessment of primitive and postural reflexes at key stages in development can help identify children whose motor skills are likely to be delayed.


Primitive reflexes emerge during life in the womb, are developed at birth in the full-term baby and are slowly controlled and transformed into more mature postural patterns in the first six months of life. Postural reflexes start to emerge after birth and continue to develop up to three and a half years of age.

Primitive reflexes are tested as a matter of routine at the post-natal assessment and at developmental check-ups in the first six months of life, but are not assessed as part of standard practice thereafter.

It tends to be assumed that if they were sufficiently integrated at six months then no further assessment is required. However, studies carried out on primary school children have shown that traces of primitive reflexes can and do persist into later childhood and that they are linked to under-achievement(3) and behavioural problems(4).

When my eldest son, now 28, was due to start school, every child underwent a developmental assessment by a school doctor, who checked gross and fine motor skills in addition to basic tests for vision and hearing. These tests were phased out a couple of years later, so children with underdeveloped physical skills at school entry simply slipped through the net.

By the time a child enters school, responsibility for the welfare of the child moves from the domain of medicine to education, meaning that subtle problems of a physical nature are not addressed. Neither do health visitors, trained to pick up signs of delay in the early years, follow a child on when they enter school to observe the long-term effects of early delays in motor development.

Reinstating developmental testing of all children, not only in the first year of life but also at later key stages in development, could help to identify children at risk.

This was evident in a study comparing the early developmental history of 72 children who had specific learning difficulties with children of the same age who were performing well at school. The study found that those who were struggling at school had almost twice the incidence of problems occurring in the first 18 months of life (from medical problems during pregnancy and the birth process to being later walkers and talkers).(5)

With regular assessments, suitable physical programmes could then be implemented to improve the motor skills of ‘at risk’ children before and in their first years at school.

Studies carried out in Northern Ireland and elsewhere in the UK between 2001 and 2005 have indicated that in many cases, developmental delay responds to specific training programmes.(6)

Daily developmental movement exercises were introduced into schools. Children in the experimental groups showed statistically significant improvements in measures of balance, co-ordination and infant reflexes compared with control and comparison groups, and greater gains in measures of reading and spelling. Teachers also reported improvements in concentration, behaviour and social skills.

These findings suggest that if we paid more attention to children’s physical development, teaching outcomes could be improved.


1. Hansen K, Joshi H, Dex S, eds (2010) ‘Children of the 21st Century: The first five years’. Policy Press

2. North Eastern Education and Library Board (NEELB) 2004. ‘An evaluation of the pilot INPP movement programme in primary schools in Northern Ireland. Final report’. Prepared by Brainbox Research Ltd for the NEELB.

3. Goddard Blythe 2005. ‘Releasing educational potential through movement: A summary of individual studies carried out using the INPP Test Battery and Developmental Exercise Programme for use in schools with children with special needs’. Child Care in Practice.11/4:415-432

McPhillips M, Sheehy N, ‘Prevalence of persistent primary reflexes and motor problems in children with reading difficulties’ Dyslexia 2004; 10/4: 316-338

4. Marlee R, 2008. ‘Neurological developmental delay research programme, first report’. Report prepared for the Behaviour Support Service, School and Family Support Division, Northumberland County Council

5. Goddard Blythe SA, Hyland D, 1998. ‘Screening for neurological dysfunction in the specific learning difficulty child’. British Journal of Occupational Therapy, October 1998

6. See reference 2

Sally Goddard Blythe is the director of the Institute for Neuro-Physiological Psychology in Chester and author of books on child development including Attention, Balance and Co-ordination: The A,B,C of learning success (WileyBlackwell) and The Well Balanced Child: Movement and early learning (Hawthorn Press)

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