Neurodevelopment and the Developmental Pyramid

One of the most common questions we get asked is “Can you help with _____ symptom”? From our perspective, you can truly fill in that blank with anything: speech, delayed walking, meltdowns, anxiety, constant fidgeting and squirming, OCD, irrational thoughts in behaviors that don’t match, trouble sleeping, night terrors. And if you’ve ever called to ask that question, you’ve heard our answer - “We have to dig deeper and run them through a full neuro evaluation to find the source, because everything is connected.” The hardest thing to explain - to parents, patients, and doctors alike - is that everything within the brain and neurodevelopment is connected. Fortunately, because everything is so interconnected, 99% of the time, our answer to the initial question is a resounding yes!

So let’s break down that hard thing to explain.

Baby’s First Year

When a baby is first born, their brains are actually very simple, both structurally and functionally. There aren’t a lot of connections made, so there’s a lot of room for growth and expansion. Babies basically start off as little bundles of reflexes. These reflexes, called primitive reflexes, are pre-programmed motor milestones that babies develop while in the womb, because they help baby travel through the birth canal and then learn how to use their bodies once they’re born.

These primitive reflexes are set to “integrate”, or go away, on a certain timeline within the first year of life. That same timeline correlates with motor milestones like rolling, crawling, standing, and walking, so that baby can continue to progress and develop as normal. As the uncontrolled motor actions (primitive reflexes) integrate, purposeful motor actions (milestones) pick up the motor coordination and control required to meet those milestones.

Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. Melillo et al. Frontiers in Neurology. July 2022.

All while growing and learning how to move, babies’ brains are developing at the fastest pace our brains develop at in our whole lives. Babies make over a million new neural connections every SECOND during the first few years of life. So as movement drives brain development and expansion, we “unlock” or access new parts of our brains as we learn new skills, making more room and more connections for even more advanced skills. And I hope you caught that -

Movement drives brain development and expansion.

The more babies move, the better likelihood they have of developing properly.

Pyramid of Development

Below is a picture of the pyramid of development. This pyramid is how everything is connected. At the bottom of this pyramid says central nervous system - this is the brain and spinal cord. The bottom of the pyramid is where primitive reflexes live. As you slowly climb up the pyramid, you start to work into greater systems of your body, so this is where kids start to develop a sense of touch, a sense of balance, a sense of proprioception (awareness of where they are in space), and an idea that their body exists separate of other people. Primitive reflexes give you the foundation upon which the rest of your systems develop.

If you notice on the sides of the pyramid, it names the systems that are developing overtime. So sensory systems develop first, then sensorimotor systems like motor planning and bilateral bodily awareness. Then, we create perceptual motor skills like hand-eye coordination, oculomotor control, and attention - these skills tie in multiple regions of the brain and start to connect higher order areas. Then, we build into cognition and intellect, like behavior, emotional regulation, memory, learning, and following instructions.

My favorite analogy to use with this pyramid is a computer. The central nervous system is the motherboard: it’s telling everything how to run. The cognition piece up top is the computer. You don’t just stick a motherboard inside of a laptop and expect it to run. In this same way, you wouldn’t just stick a brain inside of a child and expect them to be able to regulate behavior and emotions. You have to work your way up - that’s why we say that everything is so interconnected.

A True Developmental Evaluation

We use this pyramid of development to dictate how we look at and work with kids. If you call me for help about a child with a behavioral problem, we’re not going to talk about how that makes them feel. That’s a therapist’s job, and while extremely valid and helpful as a tool for working with behavioral issues, that doesn’t tell me where the issues are coming from.

We’re first going to start at the very bottom of this pyramid to see how their brain developed. We look at where something might have gone wrong, or a step that might have been missed, and where we need to intervene. We check for retained primitive reflexes. If those are still there, the brain got stuck somewhere at a point in infancy. There could be a number of reasons why, which we can discuss during an initial evaluation, but the main point is that those need to be integrated and addressed.

Then, we go all the way back through those skipped steps of development to make sure that higher cortical areas (the most dense part of the brain) developed properly. We assess for balance and proprioception. If you have a child that loves to spin and never gets dizzy, their vestibular system likely never developed properly. That doesn’t mean they have parts missing or faulty brain regions. That means that neurologically, those areas never connected together and developed well enough to say, “Hey, we’re dizzy! Stop! Spinning!”

In our (humble) (ish) opinion, this is how everyone should be evaluated. The symptom is great - it tells us that something’s going on. Of course, the most difficult part is finding the source or root cause of the symptom. Functional neurology does just that, and from a brain-based perspective. Reprogram the brain (the motherboard) (do kids still call it a motherboard?), and the child’s system (computer) runs more smoothly.

Age is Really Just a Number (To Us)

Whether we’re assessing a child or an adult, this principle of development applies to all, so everyone gets evaluated pretty similarly. It may seem silly, but when you understand neurology, it makes sense. (Don’t wonder about understanding the neurology - we’ve got that part down for you.)

We see adults with OCD that have retained primitive reflexes, children with autism that have very underdeveloped proprioceptive systems, children with genetic conditions that developmentally got “stuck” at a certain age. We can progress them past their stuck point, but first that comes by identifying exactly where and when they got stuck.

With this approach, we’ve gotten children to walk that were told they’d never be able to, children to speak that were labeled with nonverbal autism, and children to hug their parents for the first time in their entire lives (that one might make us cry more than the rest of them). We’ve gotten adults to stop giving into their compulsions, moms to stop wanting to rip their hair out at an overwhelming amount of noise, and parents to stop having migraines that stop their days or weeks in their tracks.

I hope you enjoyed this crash course in child development, and I hope that it helped you understand yourself or your child a bit more. If you have any questions, or would like any literature pertaining to what you read above, we’re always happy to share! For literature recommendations, please reach out on our social media @synergynwi or email us at office@synergynwi.com. For more information about functional neurology and how we may be able to serve you, please give our office a call at 219-786-9596, or fill out this link here.