Postural problems such as kyphosis, hyperlordosis, lateral curvature of the spine, narrow jaw and hips; gait abnormalities such as inwardly or outwardly rotated hips, visible on the feet when walking, as well as toe walking or falling over their own feet; problems with fine and graphomotor skills; insufficient impulse control; acoustic or visual perception disorders; often also problems in speech development that require speech therapy; lack of head control, i.e. the child supports its head when writing or it sinks down so that the nose almost touches the page – all these are symptoms and the list could be extended. In addition, frustration, anxiety, depressive disorders and social problems as well as learning and partial performance disorders can often occur as a result.

Based on these observations, the children can be divided into two different groups: one group consists of children who primarily have too weak muscle tone. These children appear clumsy, awkward and are slower in their movement development. On the other hand, there is the other group of children who are predominantly tense and constantly in motion, show prematurity in movement development and are quite skilled in motor things that can be done quickly. If slowness and accuracy are required at school, it is not uncommon to find problems in the fine motor area.

Early childhood reflexes and postural abnormalities

Both groups of children have a disorder in basic muscle tension, a so-called “central coordination disorder”. The central nervous system was not able to fully mature, which means that the basic muscle tension and head control remain unstable and the early childhood or primitive reflexes can still be triggered. Günther Imhäuser, Anton Hopf and Helmut Rösseler pointed out the connection between early childhood reflexes and postural abnormalities in their book Praktische Orthopädie.

Doris Bartel, founder of rota therapy, writes in this connection: “In order to be able to react to their environment and to have their first experiences, humans are already equipped prenatally with so-called early childhood or primitive reflexes. Each of these reflexes is part of the normal development of the human being and has a certain pattern. Reflexes are stereotypical and react compulsively. If the reflex is triggered, the body must react in a certain pattern. ... Once a reflex has fulfilled its task within a certain time frame, it is replaced and integrated by voluntary movements that take place at a higher level of brain development. If early childhood reflexes remain active for too long, this indicates an immaturity of the central nervous system.” And the doctor and special needs teacher Georg von Arnim writes on this: “... these reflexes therefore occur entirely internally, connecting the head and limbs, but not the body with the world. They are present at birth, but must not persist.”

Too high and too low muscle tone

We are dealing with complex problems here. There is a group of children who have a predominance of weak muscle tone. The affected children have to work much harder to keep up with others. They are exhausted more quickly. These children usually have soft facial features, a frequently open mouth, their tongue seems to lie heavily in the front of their mouth, they slump when sitting and they have a weak handshake. They more often appear dreamy, as if absent. When sitting on the floor, they prefer to sit in an intermediate heel position and show postural abnormalities such as a hunched back or flat feet. Their body coordination is limited and their movements awkward. As the children grow older, they can become overly tense due to the early childhood reflexes that can still be triggered. In addition to the low basic tone, they then show excessive muscular tension as described in the following children.

These children, who belong to the second group, have to keep moving to compensate for the tensions caused by the early childhood reflexes that can still be triggered. They tend to have tension in their hands, in the shoulder-neck area or even in the whole body. The movements are fast, seem choppy, soft flowing movements are only possible with difficulty. They are very sensory and over-sensitive to external stimuli, with difficulty filtering perceptions. We can often observe asymmetries in their appearance, posture and movement. The still triggerable early childhood reflexes interfere with free body coordination as well as the regulations of their forces and can lead to uncontrolled body movements.

In the context of tone dysregulation, both groups show too weak head control. This means that the head cannot naturally be held and moved against gravity independently of all other muscles. In order to compensate for this physiological immaturity, muscles in the body that are not needed with stable basic tension must be additionally tensed. This is usually done by activating the early childhood reflex patterns. In this physiologically immature system, the muscles consume more energy and oxygen than is the case with well-regulated normotonus. This energy is subsequently lacking in the children’s learning and concentrated work, which prevents them from making full use of their intellectual potential. In the classroom, we can observe that they keep their head tilted to one shoulder or prop it up when writing; for others, the nose sinks almost to the page.

The cause of the phenomena mentioned and thus for many school problems is often a motor development that has not been fully completed with early childhood reflexes still active at school age. If the disorder is not too severe, the affected children may be able to compensate for the problems by developing substitute motor skills. In this regard, Markus Peters writes: “There is a failure to observe that delayed motor development can be compensated well physically, but is usually accompanied by the development of substitute motor skills and then leads to learning problems later in school.”

The important question that arises in the context of school teaching is: how can the affected children be specifically helped?

Supporting maturation through rota therapy

First of all, it would be desirable for them to receive targeted therapy to help their motor functions to mature. Rota therapy has proven its worth here. Through neurophysiological rotation exercises, which are individually adapted to age and degree of affectedness, the malfunctions of the substitute motor function – that is the motor function that compensates for the original weakness – can be alleviated or even completely overcome. The therapeutic exercises tie in with the conditions of movement development in the first year of life. The most important impulses are the rotation around the axis of the own body in space and the rotation of the spine in itself. These impulses can initiate maturation of the central nervous system and thus have a regulating effect on muscle tone. Too low or too high body tension can be balanced and head control becomes more stable. This creates the physical conditions for the children to sit calmly and upright and subsequently concentrate better on the subject matter.

However, the daily routine of the affected children is also important for reducing tension. These children especially need a structured daily routine in which they can orient themselves well and stress is avoided. Depending on the activity, it makes sense to provide good seating options to relieve strain on the back. It may be that certain types of sport should be reduced for a while if this activates early childhood reflexes. In addition, it is important to observe whether the child becomes tense during sleep. If this is the case, it should be discussed with the parents what individual possibilities there are to avoid this. The possibilities depend on which reflexes are triggered to a greater extent. For example, it may be helpful to position the child in such a way that a rotation of the spine is possible during sleep. The therapeutic measures are all the more effective the less the reflexes are triggered and the less the children have to resort to substitute motor skills in everyday life.

At school, children can be well supported by a structured workspace situation and an optimal sitting position. Firm chairs with backrests, adjusted in height so that the feet are comfortably positioned on the floor and the knees and hips are bent about 90 degrees, support posture. It should be possible to rest the forearms on the tabletop with the elbow joint bent at 90 degrees. The whole of the body should be well supported while writing and reading. The sheet of paper for writing or the book for reading should ideally lie on an inclined surface and face the child so that the body can remain supported.

All the children mentioned above can only sit up straight for any length of time if their back is supported if they are not to strain themselves or become very restless. Without such support, they would tense their backs too much, which in turn restricts fine motor skills, or they have to move constantly to compensate. If the whole of the back can remain leaning against the rest, it is supported. The children can sit quietly for longer without strain. The head can be held in the longitudinal axis of the body and does not have to be actively held against gravity, as is the case with a forward leaning body. This minimises the involuntary body movements that can occur when raising the eyes to the blackboard and lowering the head to the notebook due to the still triggerable early childhood reflexes.

Experience shows: children who sit quietly can concentrate better, make fewer mistakes, complain less about pain in their hands and necks when writing, can read better and disturb the child sitting next to them less. These experiences of success strengthen motivation and self-confidence. It is always gratifying to experience that the first successes usually occur after only a few weeks and that they keep parents and children motivated to continue with the necessary motor exercises.

About the author: Rosemarie Szemkus is a non-medical practitioner, Rota® therapist and anthroposophical art therapist (BVAKT)®, www.kunst-rota-therapie.de