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Mgr. Marja Volemanová, Dis., marja.volemanova@pedf.cuni.cz doc. PhDr. Lea Květoňová, Ph.D., lea.kvetonova@ pedf.cuni.cz Charles University, Faculty of Education, Department of Special Education, Magdalény Rettigové 4, 116 39 Praha 1. Annotation This study set out to explore the links between specific language impairment (SLI), motor development and literacy acquisition in children. We focus on motor deficits which are mostly common in children with SLI, further we look if SLI can by caused by persisting primary reflexes or if they can make the symptoms of SLI worse. After that we try to find out, if it is possible to predict SLI, already at small kids by an early development assessment and if a specific movement intervention program would be useful to help children with SLI. A significant relationship between motor impairment and speech/language impairments in children was found. Children with developmental speech/language impairments are at higher risk for reading disability than typical peers with no history of speech/language impairment (Schuele, 2004). However, we still not fully understand the causes and biological basis of SLI. Till now, there is no early developmental assessment available, which comprehensively tests both motor development and language skills. Specific movement intervention programs for children with SLI and other developmental challenges are already developed, but we miss fundamental research which shows success rate for children with SLI. There are available several case studies on this topic. Further research shall be conducted to identify children who may need special intervention even before they get the SLI diagnosis, and to search for approaches, which can help to mitigate the impairment. Keywords Specific language impairment (SLI); motor development; literacy acquisition; Neuro-vývojová terapie; persisting primary reflexes. Discussion Schuele (2004) states, that children with oral language impairment, whether or not they have concomitant speech impairment, are at great risk for reading disabilities. The reason is quite simple, if the child has difficulties with coding events in spoken language structures and in understanding spoken language, the same difficulties will appear in writing and reading. We however still not fully understand the causes and biological basis of SLI. As Hill (2001) said: „The only guaranteed conclusion that one can, currently, draw is that the deficits of children with SLI are not specific to language”. A significant relationship between motor impairment and speech/language impairments in children was found and so further research must be done to identify children who may need special intervention in time, and to search for approaches, which can help to mitigate the impairment. Within the context of reading disabilities, children with a history of SLI should be viewed as a subgroup from children with reading disabilities but no history of speech/language impairment, while intervention needs of children with SLI are potentially different from children with reading difficulties alone. Full text at http://pages.pedf.cuni.cz/gramotnost/3-2017/. VOLEMANOVÁ, M.; KVĚTOŇOVÁ, L. (2017) Links between SLI, Motor Development and Literacy Acquisition in Children. Gramotnost, pregramotnost a vzdělávání , ročník 1, číslo 3, 2017. Available at http://pages.pedf.cuni.cz/gramotnost/3-2017/.

Annotation The development of motor skills, primary reflexes, and speech are interconnected. But how exactly? I work daily with children who have persistent primary reflexes. These children often experience difficulties at school (learning disabilities, attention deficits), motor issues (delays in gross motor skills, fine motor skills, graphomotor skills, and coordination), autistic-like symptoms, or speech development problems — the main focus of this article. I am committed to collaborating with speech therapists to provide the most comprehensive approach and care for children with these challenges. The goal of this article is to clearly and concisely explain the links between primary reflexes and the development of motor skills and speech. In the final section, I briefly mention intervention options that (clinical) speech therapists can incorporate into their speech therapy practice. Keywords Psychomotor development, speech development, gross motor skills, fine motor skills, primary reflexes, neuro-developmental therapy, neuro-developmental stimulation Conclusion From the above, it follows that the development of gross and fine motor skills is fundamental for the ability to communicate through speech. According to research conducted by Bilbilaj in 2017, 71.4% of children with delayed speech development also had persistent palmar reflex, TLR (tonic labyrinthine reflex), and sucking and rooting reflexes (Bilbilaj, 2017). It is therefore essential that even (clinical) speech therapists can identify persistent primary reflexes and have basic intervention skills to inhibit these reflexes. Various methods are used worldwide to inhibit primary reflexes. The most well-known include Rhythmic RTM Training, the INPP Method, and the MNRI Method. In the Czech Republic, the most widely used approaches are Neuro-Developmental Stimulation (NVS) and Neuro-Developmental Therapy (NVT) (not to be confused with the term "neurodevelopmental therapy," which sometimes refers to a group of therapies like the Bobath approach or Handle therapy). Neuro-Developmental Therapy (NVT) is a highly individualized therapy that combines the inhibition of primary reflexes with physiotherapy, special education, and sensory integration. NVT is used with children from around 3-4 years of age, but it is also effective in adults. The treatment is based on simple exercises, which often mimic movements triggered by primary reflexes to stimulate proper neural connections in the brain, allowing it to naturally inhibit these reflexes. The activity of persistent primary reflexes is thus naturally suppressed through exercise, thereby eliminating the related problems. Neuro-Developmental Stimulation (NVS) is a program derived from Neuro-Developmental Therapy. NVS is primarily designed for (special needs) teachers, (clinical) speech therapists, and other professionals working with children with learning, behavioral, and communication disorders. The NVS program is adapted to the fact that these professionals may not have education in anatomy or kinesiology. The tests and exercises are structured in such a way that they can be effectively used with larger groups of children. I believe that Neuro-Developmental Therapy and Neuro-Developmental Stimulation can be successfully used, among other things, in the comprehensive rehabilitation of speech disorders. Article Author : PhDr. Marja Volemanová, PhD. The full article is available at: https://casopis.aklcr.cz/magno/lkl/2020/mn1.phpand at https://www.prolekare.cz/casopisy/listy-klinicke-logopedie/2020-1-36/primarni-reflexy-a-jejich-vliv-na-motoriku-a-rec-125607 Reference :VOLEMANOVÁ, M. Primary Reflexes and Their Impact on Motor Skills and Speech. Listy klinické logopedie , 1/2020. ISSN 2570-6179. Available at: https://casopis.aklcr.cz/magno/lkl/2020/mn1.php

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. Published: 9.12.2024

Evidence-based articles, courses and consulting on Neuro-Developmental Stimulation (NDS) and retained primary reflexes for parents and professionals. Enhancing Child Development through Neuro-D evelopm ental S timulation Cortex Academy® Cortex Academy® aims to raise awareness about Neuro-Developmental Stimulation, particularly focusing on symptoms and inhibition of persistent primary reflexes. Cortex Academy® also engages in publishing activities for professionals, parents of children with learning or behavioral issues, and other interested parties. Cortex Academy® covers: Information about child development from infancy to puberty, covering not only persistent primary reflexes and learning disorders but also providing guidance on supporting child development. Additionally, we offer courses and lectures for the general public. Neuro-Developmental Stimulation (NDS) courses: NDS Active Learning, NDS Active Development as well as other courses and lectures for professionals. An online e-shop featuring publications for both professionals and the general public. NDS Active Learning course graduates can purchase tools (such as NDS cards and motivational charts) from the e-shop and extend their subscription to the exclusive website section. Here, they can access updated information to enhance their work with Neuro-Developmental Stimulation. In the Cortex Help section, you can find information and contacts for counseling focused on inhibiting primary reflexes. The list of certified NDS centers includes contacts for other professionals specializing in Neuro-Developmental Stimulation. Where to continue on these pages Choose what information you are interested in: For professionals For parents Consulting E-shop

The advanced NDS course further deepens the understanding of both the theory and practice of neuro-developmental stimulation. The course is two days long and takes place in-person. For professionals Courses and seminars Introductory course NDS online NDS Active Learning course NDS Active Development course Supervision NDS meeting Advanced NDS course Eye movements Neuro Developmental Stimulation Persisting primary reflexes NDS Active Learning NDS Active Development Cortex App Publications Company INVTS s.r.o. Advanced course NDS Active Learning The two-day face- to- face Neuro-Developmental Stimulation Advanced course "NDS Active Learning" is designed to provide a more in-depth understanding of the theory behind Neuro-Developmental Stimulation (NDS) and allow for the practical application of tests, activities, and exercises. The course is conducted in an experiential format, enabling participants to try out everything practically. While the course is primarily intended for educators and other professionals working with children with learning and behavioral disorders (such as speech therapists, occupational therapists, physiotherapists, doctors, psychologists, and so on), anyone who has completed the Introductory course is welcome to take part. Advanced NDS Active Learning course content The course focuses on a deeper understanding of NDS theory, emphasizing the interdependence and interaction of sensorimotor systems, including their hierarchy and mutual influence. Sensorimotor systems, including the tactile, vestibular, and proprioceptive systems are the cornerstones of learning. The course also covers tests for persistent primary reflexes and methods for improving sensory integration through various games and activities. These include exercises to improve balance, touch, proprioception, and differentiation of smell, hearing, and visual perception. Participants will have the opportunity to engage in a detailed analysis and practice of all the exercises included in the NDS methodology. Lecturer: PhDr. Marja Voleman, PhD. The course is conducted face-to-face and lasts for two days. The first day is from 9 a.m. to 5 p.m. and the second day from 8 a.m. to 1 p.m. The participation fee is 124 00 CZK/ 515 Euro (including VAT) (In the event that we organize the course at your premises, we will agree on the price individually). Printed scripts are included in the price of the Advanced course. The minimum number of participants is 12, the maximum is about 25. Participants will receive a certificate of completion of the course. Upcoming Advanced NDS Active Learning courses Advanced course NDS Active Learning© (in czech language) Thu, Jan 15 Horomerice More info Login closed Advanced course NDS Active Learning© (in czech language) Thu, Jan 22 Horomerice More info Sign up Advanced course NDS Active Learning© (in czech language) Thu, Feb 12 Horomerice More info Login closed

The supervisory meetings are intended for graduates of the NDS courses and serve to deepen knowledge, exchange experiences, supplement information, and review NDS exercises. For professionals Courses and seminars Introductory course NDS online NDS Active Learning course NDS Active Development course Supervision NDS meeting Advanced NDS course Eye movements Neuro Developmental Stimulation Persisting primary reflexes NDS Active Learning NDS Active Development Cortex App Publications Company INVTS s.r.o. Advanced NDS Active Learning- Eye Movements In this advanced course, we will focus in detail on primary reflexes, which play a key role in the development of Eye movements. Primary reflexes are essential for stimulating brain development and creating important neural connections, enabling the child to respond appropriately to visual stimuli and laying the foundation for future learning. We will explore how a child learns to coordinate eye muscles to properly fixate, focus, converge, and track objects with their eyes. These skills are fundamental for effective visual information processing. Additionally, we will demonstrate how understanding these processes can assist in working with children with specific needs, such as learning or attention disorders, and why interdisciplinary collaboration is important. The course material is presented through text materials and video lectures, and there are also PDF scripts available that are tailored for online learning. This educational course is designed for professionals from various fields who have already completed the introductory NDS course and the advanced "NDS Active Learning" course, with the aim of providing a comprehensive overview of the developmental aspects of visual perception. The course also includes practical exercises that can be effectively implemented into the "NDS Active Learning" program. Content of the course: The Care System in the Czech Republic A bit of anatomy: the eye, the central section of the sensory system, and the extraocular muscles The most common visual disorders How primary reflexes affect eye movements Visual hygiene "Cookbook" or how and when practice eye movements within the "NDS Active Learning" program Lecturer: PhDr. Marja Volemanová, PhD. Duration: 10 hours Language: Czech The participation fee is 2,600 CZK/105 Euro (including VAT). Participants will receive a certificate of course completion. Enrol now Kurz oční pohyby CZK 2,600 CZK 2,600 Pay by card After clicking the “Select” button, please enter the password “nvsjeradost” and then continue with the registration and payment by credit card. Do you need to order the course by invoice, or do you need to pay in EUR? Please use the button below. After you’ve made the payment, don’t forget to send me a message, as I need to add you to the course manually. If you register via the first link, you’ll get instant access. 😊 Buy the course by invoice Testimonials from course participants Klára Jabůrková Marja, thank you for the wonderful course, I’m putting it into practice right away! It’s great that the children now don’t have to wait so long for the eye-movement warm-ups (after all, it does take some time before we get to inhibiting the ATNR). Dana Stará Thank you for the wonderful course. Once again, it made me realise how amazing the human body is – and how wonderful NDS exercises with children are. Andrea Nezbedová Thank you so much for the amazing course, which connected theory, practice, videos, handouts and tools in a great way. It took me about a month to complete, but I needed time to really experience and process all the information. Have a lovely day. Miroslava Foltýnková Through this course I have deepened my knowledge about eye movements and about how we can support children in improving their reading difficulties. All of this is, of course, within the framework of exercises for inhibiting primary reflexes. The exercises are easy to remember thanks to their names, and the videos help to better understand how to perform each task. Thank you very much for the course. Jana Hunáková Marja, I really liked how the individual parts were put together – text + video. The review questions were great too, nothing complicated, but they kept me alert. Plus the downloadable materials. Thank you. Eva Zikmundová For me as a vision therapist, the course was a great addition – I know many of the exercises in the same or slightly different variations. It was beneficial, with excellent supporting materials. Thank you. Tereza Debnárová The course was a wonderful way to deepen and enrich my work with the new NDS exercises. At first I was a bit worried about the anatomy part, but everything was explained simply and clearly. Thank you for the course – I’m looking forward to more! Best regards, Tereza Michala Bulířová Hello Marja, in September last year I bought this course and have been watching the videos gradually. I enjoyed it, and I have included some of the activities in my therapy sessions, where I focus on sensory integration, or I pass them on to parents so they can do them at home with their children. The course was very useful for me. Thank you. Mgr. Šárka Kučerová I appreciate the clarity and the way the information is interconnected, as well as the illustrative videos with the exercises, which give a clear idea of how to perform them and thus make it possible to complete the course online.

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