Motor Development as a “Predictor of Interest” – Monika Buerger


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Now here’s, today’s host Dr. Monica Buerger,

All of you, amazing chiropractors out there. Welcome to another ChiroSecure look to the children’s show. Again. I want to thank ChiroSecure for giving us this opportunity to share, um, such incredible information for our profession out there to all of you. Hopefully you’re enjoying a wonderful and peaceful quarantine summer. Um, my name is Dr. Monica Buerger, and I will be your host for today, and I want to bring you up to date, um, as kind of practice, there is so much happening in the world of pediatrics, neurodevelopment, um, neuroscience. So what I want to do is kind of bring all of that together to you and really highlight some key things that we are going to be necessary for us to understand. Um, as we move forward as a profession in the world of pediatrics. So in the world of neurodevelopment and in neuroscience, now they are looking at motor development as a key.

Uh, the term is predictor interest for, uh, later on diagnosis of any, mostly in the regard to autism and psychiatric illnesses. So why is this so important? It is important because as chiropractors, what do we look so much at posture at motor development at movement, um, at mile movement milestones. So let’s dig in and give you some, um, incredible pearls that we really need to be on the forefront to understand what these indicators might mean to the, um, outcome of a child later on getting a label. That, and that’s exactly what we don’t want, right? We want to be that early intervention, um, that helps to mitigate this, uh, train from going off the tracks and from a label later on. So pop quiz for whoever is out there. If you’re out there, you know, give us a shout out, let us know, um, who you are, where you are, and if you have any, so pop quiz, ADHD Tourette’s syndrome, developmental coordination disorder, DCD, this diagnosis is labeled drives me bonkers.

All right. Basically it means poor coordination. Okay. Asthma let’s throw asthma in that one. What else do we have dyslexia? What else do we have? Anxiety? What do all of these have in common? What is a core component? And then we add autism, all of these labels and more, there’s a lot more than this. Any psychiatric disorder can fall under these bullet points as well. So our CA Harvey here wants to know, do you know what the underlying, um, threat is to all of these labels and that is ready, ready, postural, instability, poor posture. All of those labels have an underlying neurological basis in posture. And I think for chiropractors, I know for chiropractors, we need to understand the neurology behind this, the why behind this, the, where where’s our part in this whole, um, labeling early intervention. This all starts actually, when we look at motor development, it actually starts in utero and that fetal development period.

And this is where it’s so important. This is why I wanted to bring this information to you at this particular time in our history. Because last month I did a presentation for you. And if you didn’t catch it, go back on Kira Secure’s Facebook page. I believe they’re still on there. Um, again, they give us the, the incredible opportunity to share this information. This is critical information. So last month I did a presentation for you with regard to prenatal stress and the fundamentals that we need to understand, especially given the, this, uh, this pandemic period that we’re in. So prenatal stress is huge right now. We’ve got a couple new scientific research papers that came out where they looked at moms and their reporting of increased anxiety, depression, et cetera. During this time that is prenatal stress. We know that prenatal stress is the neurobiology.

It is the foundation of health and development about offspring for the rest of their life, including neuromuscular development. So what we need to understand is motor development begins in utero. The first two, um, sensory systems, which is going to be part of our sensory motor loop. Sensory input equals motor output, motor output equals sensory input to the CNS. So two of the key initial sensory systems that begin to develop in utero are the vestibular and the tactile systems. And these are going to, especially the vestibular system is going to be, um, incredibly important in postural stability down the road. So number one message to you, prenatal stress is going to dysregulate this neural developmental access and can compromise neuromuscular development. All right. So what does that mean later on in life? It means that these neuromuscular building blocks, so to speak, these motor building blocks are imperative for, um, for the integrity of CNS, a brain development of whole brain, whole body development.

I’ve connecting the brain to the body and the body to the brain. That is the means by the way we, which navigate life for the rest of our life, socially, emotionally, motor skill wise, um, and academic wise, this connection, there’s a disconnect that’s happening here. This leads us into what I call limbic lock and load mode, limbic drive, which now we’re going to get dysregulation of our immune system of our HPA axis of our home metabolism of our hormones, of our neurotransmitters. And this is the connection between this sensory motor and motor development and the neural basis of disease. So this paper, just again, reconfirms that during times of prenatal stress, fetal and postnatal neuromuscular development can be compromised. So we know in the autism world, in particularly in autism, it’s very much associated with fine and gross motor skill delays. And we know that the better outcome, they looked at this predictor here at two years of age, um, motor development, more, um, healthier motor development had bidet, better predictive outcomes by the age of four.

So if we had Mo better motor skills, by the age of two, we had better predictive outcomes by the age of four, with regard to the label of autism. Now, if you look at your kiddos with add ADHD dyslexia, you start, you should start looking at postural instability, postural control, can they, um, if they have that higher functional capacity to do so, some of our kids on the spectrum, they don’t have that functional capacity. So you can’t test their balance and so forth, but really your children, we can throw scoliosis into this whole loop as well. Your kiddos are higher functioning, older kiddos that come into your practice that have learning attention, behavioral struggles. The golden thing that you can do for them is evaluate their posture, stability, just their posture. Do they have postural slump? Do they have a scoliosis, but can they balance, can you put them on a balance pad and they can hold their balance? Can they stand on one leg? Do they have the ability to control their posture in these postural challenge positions? Um, and if not, this is a key area we want to look at, um,

Address it.

So I just threw this in there. Again, I like to, um, throw a splattering of what I call research from God’s journals. You don’t take it from me, but you look at these different level journals. And, um, this paper talks about the motor abilities, motor functioning as a predictive interest for developmental psychopathology, and mainly they use autism as example. So let’s go back to first year. So we have prenatal stress. We have compromise on neuromuscular development and the postnatal period, um, developmental motor developmental milestones can be compromised. So what should we look for in that first year of life? We should look at least four, four basic motor patterns. Okay. The first one is spinal Mo motor wise. We’re going to develop from our core from our center, our trunk, um, that’s that develops before it branches out to fine motor to distal motor control.

So we have to lay the foundation. We need to ensure that we’re picking up. If these, if they don’t have good core pastoral trunk stability, if they’re not doing tummy time, that’s going to be your key marker right there. If they’re not doing tummy time and developing that, um, core motor component, first, what can happen later on down the road, fine motor can be compromised. What does that look like? I’m going to show you and just a little bit, some things to think about, especially when it comes to the school aged child, that we’re gonna be, uh, we’re going to be getting into that here soon as school begins. And I’ll give you a couple of key tips for little fiddle farts for the school age years, and especially if they’re having to do homeschool. So hold on, we’ll get that. So core spinal, are they doing tummy time later on?

Are they, um, uh, going into reflection and pulling their toes up to their chest? Do they have that control? Do they then go into phase two or step number two? This home allowed this, um, motor development. That is where we’re developing what we call bilateral coordination, both sides of the body, both upper and lower extremities are developing where they’re using them symmetrically and then goes to asymmetrically. So if you see the second picture right here, you’re going to see my pan here. You’re going to see they, um, they start doing this push pattern about four months of age, start pushing up, um, using both arms at this point. And then about six months of age, they’re sitting on their own. They got good core trunk stability. If this is not happening, if you’re not seeing these phases, this is a red flag for you with regard to abberant motor development.

But wait, there’s more, I’m going to show you what that can equal down the road. Um, and how that ties into those different labels that we talked about with Harvey, our cat. So we need to see this. We need to see tummy time. We need to see then phase two. And then phase three is a home Oklahoma lateral. They are using the same arm and leg to push themselves through space. This is the belly crawling. There is a profound amount of the stipular and proprioceptive input happening here. And of course tactile from the feel of the floor. These are incredibly important sensory mechanisms that are coming into the CNS to foster. Now our whole sensory integration and knowing where we are in space. And these don’t happen later on in life. We don’t know where we are in space. We don’t not have mat how to navigate space, how to, how to, um, be upright against gravity. And this is very scary to the individual. And so they may develop these what we call gravitational insecurity. They don’t want to be upright against gravity. They take longer to walk. They start walking and they’re very hesitant. They walk with, um, compromise or maladaptive, gait patterns, maybe toe walking, maybe a wide base Watergate.

It’s not just the gate. That’s going to be a problem. It’s going to lead to an Auburn, abnormal sensory input beating into the CNS. So now we’re just creating more chaos in the brain. And then our fourth phase is this console lateral cross crawl pattern. Now this needs to happen. Um, if we want a good, good whole brain, whole body left brain, right brain left body, right body, all connecting and working together. So booty in the air bear, crawling army crawling. These are not good motor patterns. They mean something to us as chiropractors. They mean abberant abnormal week, whatever you want to refer to brain development. Okay. So we’re going to move forward here. Magic eraser. All right. So then we go to our stages of independent walking. I want you to think stability before mobility core trunk stability, before we can be independent and gain fine motor and mobility.

So stability before mobility. So first we’re in mobile. Then we go to the belly crawling. Then we go to the quadruped crawling, crawling, which we just saw. Then they should get up and start sideways cruising on long furniture, independently, sideways cruising, then forward cruising with supportive system walking and then walking on their own. So these are the fundamental phases. Again, if they don’t have good trunk stability, those steps four, five, and six are going to be compromised. Again, this booty in the air crawling, this is abnormal motor development. This can be due to poor trunk stability, which can lead to a overactive or not integrated reflex. What we call the sympathetic tonic, um, symmetric, tonic, neck reflex as DNR. And this may manifest in later on in that child that sits in the w position that is assigned for us, that that child probably skipped some of these core foundational motor steps.

They’re setting in this w fashion to gain more trunk stability. They have more of a base to sit on, to stabilize their trunk, to get more feedback to the CMS. Okay? So these are motor patterns. We want to be mindful of. They mean something. We want to look for head lag, a floppy baby, a low muscle tone. Baby is red flags. For many reasons, we don’t have time to get into that. Arnold GRE for us, Arnold GRE is one of the things we need to look at. There’s also predictive interest for autism, um, and it can be chronic infectious cells. So like what we call it one in particular ruckus cytomegalovirus. Anyway, by six months of age, we shouldn’t have that head lagging anymore. The, the, the head and shoulders should all be in line. As we do the pull, the set maneuver that head is still lagging.

That is a telltale sign that there is, um, there’s concern, not just motor concern, but CNS developmental concern. So let’s talk about tummy time real quick. Tell me time. I want you to just to start with a couple of key steps, Tommy time being one of them. If we have tethered or restrictions, tongue ties in particular, it can impede this, this tummy time. They won’t want to come up into extension. Of course, if they’re subluxated upper cervical upper threat, look at those thoracics mid to upper thoracics as well. They won’t want to come up. If they have overload. If there was Stabler system where it was compromised in development and in utero development, it could be too much of a load on the vestibular system. The vestibular system gets activated in extension. So that’s telling you that they may have an underdeveloped vestibular system, which is the head honcho.

It really leads the regulation of all incoming sensory input into the brain. This is very, very important. So I want you to look at fostering ways. We can help foster tummy time, but if they’re fighting it, I need you to understand this may be maladaptive neuroplastic, a kickback because of these underdeveloped systems. It’s important. It’s extremely important during the prenatal period that mom is as active as she can be. The vestibular system in particularly gets, um, it, it matures in utero. It gets stimulated by movement of the mom. So two things mom needs not to be a couch. Potato mom needs to be moving more. And we have to ensure that there is enough pelvic room so that there’s not an restraint for that baby to be moving, right? So if their pelvis is subluxated, we got a problem there. One thing that I want you to keep note of is that during this pandemic phase not has not only has anxiety and stress gone up, which is gonna manifest for generations to come.

This is our next epidemic coming down the road. We covered that last one, but they also have reported that about 65% of women have re pregnant mamas have reported that they are physical activity has actually decreased as a result of this pandemic. We need to think in the context of motor development of that, of those offspring, because lack of physical activity, um, is going to possibly impede motor sensory motor development in utero and primary of the vestibular system. The vestibular system is associated with many, many, many issues, anxiety, depression, many psychiatric illnesses as we’ll show here in a little bit. So next thing I want you to concentrate is how do we get tummy time be creative? Um, mirrors are good tools, particularly if you have a little fart fiddle fart that has a plagiocephaly or maybe a torticollis, let’s pretend that this top picture a little fiddle fart has a pledge.

You have separately on the left side, we’d would want them to rotate towards the flat side and get into extension to help stimulate that those muscles on that particular side and, and, and help, um, re restructure that flatten side besides adjusting them and cranium work. So you have a mirror on that side and have that little fiddle fart turned to that side and try to get up and into extension. You can have some mirrors flat on the floor and have like a bolster or something underneath them and have them playing and looking into the floor. You can have them try to get up into extension and looking at themselves in a mirror. These are great ways to, to get help foster that tummy time with some play. And that also is going to help from the social engagement system from happening bagel tone, for, from developing, um, or help it to develop.

Um, the other things that are fine. If you, this, the, as you move into the winter season, you will find out your sporting goods stores or target or Walmart, or wherever the round sleds. If you’re in an area that has snow put little federal fart on a blanket on that and, and drill a hole in it and tie a rope around it and pull them around the house on a little journey, something that there’ll be movement. And tell me me time at the same time you can, right now, if you can find them is the little plastic blowups, swimming pools, little ones, or the little, um, swimming rings. Those are all fun things we can do to help foster more tummy time. And these little fiddle farts, besides the things is putting them over a physio ball, put them on mom’s tummy, all the things that we’ve heard traditionally.

So postural reflexes, if we don’t get a good pastoral system to develop, we default back into our primitive brain and those primitive reflexes to stay active. So we need to understand that if we’re scared in our environment, we have gravitational insecurity. We’re scared, we’re unsecure, unsure of ourselves. We’re going to revert back to our primitive brain and stay in a reactive mode, defensive mode. So what are we going to see the school year’s speech issues? When we have poor proprioception, knowing where we are in space, we, we compensate by using our eyes to help us navigate our world and hold pencils and et cetera. But that’s a lot of extra work on our brain, but we can’t see our tongue. So that’s why they use the mirrors a lot in speech therapy. So poor trunk stability, poor, fine motor development, speech issues, trouble paying attention in school, fidgeting kiddos, what we call developmental coordination disorder.

They literally clumsy. They fall off of stairs, off their bikes all the time. They can’t sit in their chairs. I mean, they’re literally falling out of their chairs at school, poor handwriting skills, learning how to hand write or their handwriting is atrocious. So they’re being pulled out all the time for handwriting, um, reading because of fine eye muscles. I can’t help that, that those eyes scan and track or a convergent of Vern. So catching balls, et cetera, these are all signs that we miss something back in our stability phase and as chiropractors, that’s what we are. That’s what we should be looking for because this is early intervention. If we can adjust them and create better pasture stability of those trunk muscles, this is not going to be an issue down the road. So I’m just going, um, wrap this up with some key points.

Posture, stability is associated with asthma. Like I said, don’t, don’t rely on me. There’s some gods journals right here, here. Our data suggests that balance needs to be validated and asthmatic patients, um, a ADHD and developmental coordination disorder and postural instability, ADHD, and partial disorders, dyslexia, and posture disorders. Here are results demonstrate that posture parameters may discriminate between children with dyslexia and age equivalent controls, Tourette syndrome. And I can go on and on and on my message to you is let’s dig in. Let’s help prevent or minimize prenatal stress, especially what’s happening right now, understand that the roots of, of sensory motor development help support mama, make sure there’s no lumbar pelvic subluxations to help, um, mitigate lack of movement in utero, adjust those little fiddle farts ensure that we’re seeing these motor patterns develop. And if they’re not developing, how, what does that possibly mean for the future?

And how can we intervene? Start with Tommy time, start with some basics. Okay. Um, so how can we explain this to parents? It’s just like a tree. We, the tree needs to have a good, strong, um, uh, trunk, trunk stability to feed the distal parts of the tree for that, for those distal parts to grow, thrive and stay alive. And that includes the brain. If we have poor Strunk, trunk health, everything above it is going to be compromised. So, um, when you enhance the ability of the child, the ability of the child to process their environment, if they have poor motor control, they have average ways. They’re going to be lacking of, um, ability to process their environment where they are in their environment. But if you enhance this experience, you will enhance the overall health and life expression of that child for the rest of their life.

We see this in all these labels, let’s dig in let’s, um, you know, take some extra initiatives to educate yourself on what to look for, how to intervene before it becomes a label before it comes a problem. So I hope you found some pearls in this information. I hope you understand that as chiropractors, we have a profound, profound ability to change the trajectory of development and overall life and health of that fiddle fart, um, for the rest of their life, profound, profound ability. So with that said, I guess I wanna thank ChiroSecure for giving us this platform, given the ability to share our messages. Um, next month, I have a great guest surprise for you. You won’t want miss out the brilliant dr. Christie wick. Who’s going to lead us into, um, some great ways to share our message to the community and build your practice to be even better because now more than ever, we need to be able to, um, be the light, the hope, the truth for families and kiddos across the globe until next month. Thank you very much for joining us and we’ll see you then.

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