Neuro Developmental Delay

Neuro Developmental Delay is described as an immaturity or lack of normal development within the central nervous system (the brain and the spinal cord). Each full-term baby is born with certain primitive ‘survival’ reflexes (thought to total over 27), that are controlled by their central nervous system. These reflexes produce involuntary movement patterns and responses, and are normally inhibited at specific stages throughout a baby’s first year, enabling them to be replaced by ‘postural reflexes’ in order to develop more advanced muscle control, co-ordination and perceptual skills, and therefore continue to develop in the correct way.

If these reflexes are not inhibited at the appropriate stage, they remain an active component of the nervous system and interfere with the normal development of a child’s movement, balance, hand-eye co-ordination, cognitive functioning, learning and behaviour. This can lead to a child experiencing academic difficulty, reaching their developmental milestones much slower than other children, and may ultimately prevent them from achieving their full potential.

There are many factors that may contribute to Neuro Developmental Delay, from foetal distress during labour, breech presentation, prematurity and gestational diabetes, to genetic makeup, poor nutrition and lack of environmental stimulus.

Examples of primitive reflexes are:

  • Moro Reflex (present up until 3 months post-natally) – this occurs when a baby is held in the supine position (face up), and the head is allowed to drop backwards unsupported. This produces a reflex reaction from the baby whereby they open both arms at the same time, before then closing them again.
  • Stepping Reflex (present up until 6 weeks post-natally) – when a baby is held upright and the bottom of their feet is placed on a firm surface, the baby will automatically perform a stepping reaction with their legs, lifting their feet away from the surface underneath.
  • Atonic Neck Reflex (present from 2 months up until 6 months post-natally) – when a baby is lying on their back and their head is turned to one side, the arm on the same side will extend (straighten), and the opposite side will flex (bend).

Presence of persistent primitive reflexes, beyond their normal time-frame may be a sign that there is something wrong with the normal development of the nervous system, and therefore it is important seek medical assessment if you feel there are abnormalities in your child’s development.

Our Specialist Paediatric Physiotherapy Team is experienced in the physiotherapeutic assessment and management of Neuro Developmental Delay. It’s never too early or too late to ask for professional help or opinion if you are worried about the development of your child.


Please get in touch if you are concerned or you think we may be able to help. We offer a free telephone consultation to chat things through with you if you would rather speak with one of our Paediatric Physiotherapists before making an appointment.

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