Re: Neuro-Physiological Psychology?

[Guest guest]

Mel Siff writes:

<A visit to the site (of INPP - " The Institute for Neuro-

Physiological Psychology " ) provides no information on the credentials

of the staff involved and only some very vague colleagues of articles

about neural development in children…….

The definitions and information quoted in several cases are taken

from the 1960s and state that these disorders affect children, but

make no mention of any adults who may also be afflicted. The little

information which their website supplies doesn't show much of an

awareness of more recent research, but serves mainly to sell their

courses and books. Did you ever find out what the credentials of the

staff and the organisation really are?>

** I agree that the website could be improved. However, the people at the

institute have over 30 years experience working with children and

adults (yes again no mention of this on their website) with problems

rising from retained primitive reflexes. You are wrong to assume they

are not aware of more recent research, in fact in the UK they are

considered to be at the front end and are involved in a number of

ongoing studies. The results from a recent study conducted within

schools in the UK will be out shortly. Each year they hold a

conference and invite experts from all over the world to give

presentations. The staff are from clinical and educational

backgrounds. As for using the website to sell books I cannot see this

for myself. One book and a few papers for sale does not make a

fortune.

[Their site quoted only one or two studies that all of their staff have ever

done -

and I couldn't find much more on Medscape. If they are so prominent, why

does there appear to be such a dearth of research and controlled clinical

studies

available? If they only have one book and a few papers to sell, that is their

problem

- if they were so well known and productive, then they would have much more to

offer and even one book could make them millions. Mel Siff]

Mel Siff:

<For an organisation with the grandiose and impressive name of The

Institute of Neuro-Physiological Psychology, the existence of such a

sparse and uninformative website which a young teenager could put

together in a few hours by cutting and pasting from existing material

on the web makes one seriously wonder. Much of my Masters brain

research involved years of working contact with neurophysiologists,

neuropsychologists, neurosurgeons and neurologists, and every one of

my colleagues in those disciplines would never display their

capabilities and qualifications in such an impoverished manner.

Maybe they actually do have some highly qualified and experienced

medical staff, but, if that is the case, they should improve their

website dramatically so that it doesn't come across merely as a

marketing enterprise. What convinced you to attend their course?>

** Yes again I have to agree. I have come to know the main

practitioners at the centre well and appreciate that they focus

entirely on helping their clients and improving their methods at the

expense of neglecting the presentation. They certainly cannot be

accused of is being all show and no substance.

As a reader of your list for the past two years I feel confident in

detecting the dreaded Guru. I can assure you that this description

cannot be applied to INPP.

[Why are no credentials or institutional reviews cited? Don't

misunderstand me when I satirise some gurus - most of them really

do manage to produce some genuine results, but they also fail to

report negative results and they far too often quote some rather

dubious " science " . So far INPP is very thin on documented evidence,

so that is why they seem to be teetering on the edge of gurudom:) MCS]

I attended the course on primitive reflexes because after 15 years of

karate I still had balance and co-ordination problems.

After reading about INPP's methods I tried one of their assessments and found I

still had a number of retained primitive reflexes. All the benefits

of balance and martial arts training would be limited whilst

brainstem and mid brain reflexes prevented `normal' balance

functioning. By performing 5 minutes a day of movements that

replicated early developmental stages I gradually began to notice

improvements in my balance. I have also seen a number of children

Improve dramatically following the programme. One thing that I found

fascinating was how eye sight and visual abilities could improve by

performing these movements with the eyes shut! By stimulating the

vestibular it has an effect on the vestibulo-occular reflex (VOR).

[Can you cite any references which show that original INPP methods

produce this improvements and that they are equal or superior to

exisitng methods used by therapists? Many of us have been using

eyes-shut proprioceptive training methods for many decades in

several sports - certainly in the martial arts forms which I learned.

Maybe your instructors in martial arts weren't very eclectic. In fact,

I describe close eye training in Supertraining, but point out that it is

more effective if the eyes are covered rather than closed because the

tensing actions of the eye muscles can disrupt movement. What is really

unique about INPP? Mel Siff]

In addition to the results I witnessed convincing me of the validity

of their work, you could not hope to meet people who are more

dedicated to their work, hence my defence. They are applying clinical

knowledge to actual practise that is going to help people unfortunate

to be labelled with a condition that previously needed to

be 'managed' rather than address the possible causes. Rather than

treat people as dyslexic, dyspraxic or hyperactive etc they assess

their reflex profile and look to address what they find rather than

just what symptoms present themselves.

[it would just be very helpful and far more convincing if there were some

published evidence. That was the main thrust of my letter. Incidentally,

INPP is virtually unknown to experts who work with the disabled here - and

this group has huge problems with balance and coordination. You would

think that if they were so far in front that the world's leaders in disabled

rehab would be relying widely on what they do. mel Siff]

Roy Palmer

Bedford

UK

[Guest guest]

Mel Siff wrote:

<Their site quoted only one or two studies that all of their staff

have ever done and I couldn't find much more on Medscape. If they are

so prominent, why does there appear to be such a dearth of research

and controlled clinical studies available? >

** For many years there have been only two practitioners, and there are two

entries in PubMed :-

Blythe P, McGlown DJ. Minimal-organic brain dysfunction. Functional disorder

of the

central nervous system associated with reflex anomalies.

Blythe P Minimal brain dysfunction and the treatment of psychoneuroses.

As they have trained more practitioners more studies have been

undertaken. However, there have been problems with the trials

undertaken to date that have sufficient numbers to be statistically

significant, this has been a problem for other organisations in the

UK regardless of size and resources. The problem is an ethical one

(when isn't it!) to do with the children needed for the control

group that get no intervention. The trials are a year in duration due to

the nature of the programme and it is not considered ethical to

neglect the education of children with learning difficulties.

Two trials have just been completed (May 2002) that have had the numbers

necessary with the proviso that children in the other groups get the

same programme following the trial. The programme used is a broad

based approach that is usable in the classroom taking 5 minutes a

day and not the individually designed programme based on a child

unique reflex profile. The results are currently being compiled by

the statistician and should be available shortly.

Mel Siff:

<Can you cite any references which show that original INPP methods

produce this improvements and that they are equal or superior to

exisiting methods used by therapists? Many of us have been using

eyes-shut proprioceptive training methods for many decades in

several sports - certainly in the martial arts forms which I learned.

Maybe your instructors in martial arts weren't very eclectic. In fact,

I describe close eye training in Supertraining, but point out that it

is more effective if the eyes are covered rather than closed because

the tensing actions of the eye muscles can disrupt movement. What is

really unique about INPP? >

** As mentioned above the results of a larger trial are about to be

published, we will have to wait and see. I am well aware that eye-

shut proprioceptive training has been around for years – I

performed kata many times with a blindfold for this purpose (INPP

also suggest a blindfold for reasons you mentioned). However, it

wasn't until I started to perform the movements replicating primitive

reflex activity that I noticed improvements in balance and eye

function.

This is the uniqueness of INPP's approach in that it works from

the brainstem up in developmental terms. Sensory or bilateral

integration methods work from the cortex down and may also achieve

comparable results, as INPP will readily acknowledge, yet my

curiosity was aroused by the fundamental differences I noticed by

performing movements simulating 'baby' movements in the womb

and early life.

INPP speculate that these movements automatically activated by the

primitive reflexes act as an early motor development stage. As these

primitive reflexes are inhibited then the postural reflexes can

mature allowing for cortical (conscious) control -- see 'Motor

functions: associated primitive reflex profiles.' Capute AJ, Shapiro

BK, Accardo PJ, Wachtel RC, Ross A, Palmer FB

Mel Siff:

<It would just be very helpful and far more convincing if there were

some published evidence. That was the main thrust of my letter.

Incidentally, INPP is virtually unknown to experts who work with the

disabled here - and this group has huge problems with balance and

coordination. You would think that if they were so far in front that

the world's leaders in disabled rehab would be relying widely on what

they do.>

** INPP's work is mainly with people with specific learning

difficulties (SLD) and not the disabled. In this field I know they

have worked with Prof Lyelle L. Palmer, Professor of Special

Education (Learning Disabilities), College of Education, Winona State

University and also with Prof Orlando Schrager MD PHD, University

Salamanca, Spain. Prof. Schrager is internationally known as an

expert in balance disorders and specific learning difficulties. He

has published many papers and is best known as the co-author

of 'Neuropsychological Fundamentals in Learning

Disabilities'. He presented data on the Assymetrical Tonic Neck

Reaction, posture, movement and balance and their importance for the

child's educative process. They also work closely with centres in

Sweden and Germany.

I agree that until there is hard evidence then we should remain

sceptical of any claims. My own subjective experience of INPPs

methods convinced me that the primitive reflexes are worth assessing

in certain conditions. I hope the recent trials will help to further

their work.

Roy Palmer

Bedford

UK

[Guest guest]

Mel Siff writes:

<As I noted before, there has been almost nothing published on their

approach in several decades. Are there not even a few postgrad

students who could have written some research articles on this

approach - after all, they are supposed to be at the " forefront " ….

These connections with well qualified academics makes it seem even

more curious that there is such a scarcity of research into INPP.

Academics are always on the hunt for any research projects which can

earn them publications , status and funding. Why has none of them

seen fit to inspire postgrad students to undertake joint research

projects in this field? Aren't they inspired to enhance reputations

or departmental balances? Or don't they really see much value in this

work? >

** There have been a number written, I know of a Med. Thesis 'The

relationship of primitive-postural reflexes to learning difficulties

and underachievement' Wilkinson G University of Newcastle 1994

(unpublished) and 'Effects of replicating primary-reflex movements on

specific reading difficulties in children: a randomised, double-

blind, controlled trial.' Mc M, Hepper PG, Mulhern G. School

of Psychology, Queen's University of Belfast, UK. Lancet 2000 Feb

12;355(9203):537-41 Mc was trained by INPP. I believe there

is also a paper being written in Germany for a PhD at present.

[so, it appears as the entire published literature numbers around 4-5 studies

over several decades, which is still a very meagre track record. Mel Siff]

Mel Siff :

<If those changes are so noticeable in healthy skilled adults like

you, who ostensibly have very old, persistent neural programs firmly

in place, why haven't they carried out even one single study on

subjects like you and others who have attended their courses? Any

biomechanics facility has the necessary video and force plate

equipment to monitor and analyse before and after tests on large

groups of subjects.>

** As to why studies involving adults have not been undertaken I do

not know. Up until recent years the focus has been on children with

learning difficulties, however it is an area I am interested in and

would maybe look at setting up a study myself after a few more years

experience.

Mel Siff:

<Note that I am not implying that the methods that they use may not

work, but I am questioning if their collage of methods adds anything

novel or unique to the world of neuromotor training or rehabilitation

or even offers something superior to the use of martial arts or Tai

Chi. The approach that my wife and I prefer is to use science to

optimally select and apply existing methods of physical and mental

conditioning, so, in this case, there is a great deal that one can

take from the science of motor control, neuromotor development

and neurophysiology to add to Tai Chi, martial arts and other

physical activities. Why re-invent the wheel that is already working

fairly well, when you can just perfect the wheel?>

** I was struck by the similarity between a number of the movements

in martial arts and those of the primitive reflexes. I believe there

is tremendous benefit to be gained from the martial arts for all

aspects of motor skill etc. Yet if there is a structural weakness in

the CNS due to aberrant primitive reflex activity then we could be

building a house of cards liable to collapse when under stress.

[structural or functional " weakness " ? Nobody even really knows

the precise cause (if there is only one) of all of the " deficit "

syndromes. Every house of bricks will even fail given the " right "

circumstances. Once again, we have to demand to see some more

research to validate a few of the hypotheses which this group seems

to be applying. Mel Siff]

Mel Siff:

<What is so unique about this? Other existing programs recognise the

synergistic and sometimes idiosyncratic involvement of neural

processes above and below the cortical levels and even in different

cortical regions. In fact, there is a great deal of work now re-

examining beliefs that the cerebellum, for example, carries out the

motor processes which have long been ascribed to it. Nothing works

exclusively from the brainstem up, as has been shown by considerable

research. Motor activity plays a role in both output and input to and

from the CNS and is not simply the effect of preceding input

from the senses. >

**Nothing may work exclusively from the brainstem up but everything

does depend on the control hierarchy. If a response is triggered by

primitive reflex activity in the medulla before the cortex has had

chance to intervene, then it is likely to result in inappropriate

activity.

[This is implying that there is always sequential or vertical processing,

whereas there also happens to be considerable concurrent or parallel

processing involved. This is a little reminiscent of the limited isolationist

approaches used in muscle training and rehabilitation. Mel Siff]

The cerebellum seems to undergoing a radical rethink at the

moment – it is also believed to play roll in rote learning and

applying existing knowledge to new situations (adaptability). Another

organisation in the UK called DDAT is looking at cerebellum

developmental delay as a cause for dyslexia. The uniqueness of INPP's

approach is to perform the actual movements (as closely as possible)

of the primitive reflex activity.

[Reflexes even in their " primitive " state are not immutable, but may

be conditioned by the environmental and internal conditions (we cannot

assume that a child or animal has no perceptual response to inner and

outer stimuli- as was noted in a Scientific American article which I

posted by Melzack a few weeks ago). So, what exactly is a " primitive "

reflex and is it a very constant, unvarying entity? Mel Siff]

For example, the asymmetric tonic reflex (ANTR) is activated by the head

turning, the occiput limbs flex and the opposite extend. The reflex can be

stimulated by performing this movement or inhibited by performing the opposite

action of the limbs.

Mel Siff:

<Nobody has the vaguest clue about the precise reasons why a baby

moves in the womb. Moreover, the movements are not repeatable,

identical and precise - they are chaotic, irregular and

unpredictable, so there is no such thing as standard stereotyped

healthy pre-birth movement. The only disturbing aspect is when ANY

movements are minimal in quality or quantity. >

** Not all baby movements are unpredictable, there are stereotyped

actions that can be elicited by moving the head, for example the ATNR

by moving the head left or right and the tonic labyrinthine reflex

(TLR) by moving the head forward or back. I tried these out on both

my children and was able to plot their development by witnessing the

inhibition of each reflex in chronological order.

[i was referring specifically to movement of the baby in the womb - see

above. Once a baby is born, its environment is very different from that

of the womb, so how can anyone extrapolate concepts about prenatal

movement to the postnatal world. Once the baby is " out here " with us,

the reflexes are being conditioned all the time and can hardly be regarded

as " primitive " or fixed. Mel Siff]

The moro reflex test is standard in the UK for newborns to check the

stage of CNS development. The baby is dropped back a few inches and

if all is well the baby will extend their limbs and head and

momentarily freeze until they resume the flexus habitus position and

scream the place down. The moro is believed to break the intrauterine

reflexes. The intrauterine reflexes are also an indication of the

developmental stage of the CNS in the womb. The first reflexes to

emerge are withdrawal reflexes and the fear paralysis response

visible during invasive tests such the amniocentesis. There is an

interesting paper about SIDS and the FPR – `Fear paralysis--still a

possible cause of crib death' Kaada B. PMID: 7701496

[There are dozens of theories about crib death, but not one has ever

been validated. Mel Siff]

Mel Siff:

<Anyway, ongoing subliminal or " primitive " movements are not unique to

the foetus, but are produced by every living human, even during

sleep. Part of this apparently has to do with ensuring adequate

circulation and motor input to supply a certain amount of stimulation

to the RAS (reticular activating system). To extrapolate beliefs

about foetal movements to adult motor competence requires a lot more

than sheer conjecture. Remember, too, that what you did may have

nothing to do with the movements being similar to " foetal " patterns,

but due to your enhanced awareness and structured educational

approach. Even a contribution from a placebo effect cannot be

ruled out, especially since the training was offered in a situation

with public spectatorship.>

** The primitive reflexes remain dormant in the brainstem and medulla

and can become active during sleep and even as an aid to automatic

balance in sporting movements (Fukuda). But when these reflexes are

not subservient to cortical control then problems can occur as

discovered by the aforementioned studies. However, I do accept your

point that it may have nothing to do with the reflex movement in my

case, but can the same be said for children? The Mc study

mentioned above contained placebo movements in the control group that

did not produce the same results.

[it is extremely difficult to conduct anything vaguely like " double blind "

or controlled studies with infants because they are acutely responsive to

many subtle cues such as body language and vocal intonation of the

researchers. As apparent, you must be very aware of this fact, as is any

animal owner. Also, when a given researcher includes some placebo

item, very often he/she takes unconscious steps to ensure that the

placebo is unlikely to be positive. Mel Siff]

Mel Siff:

<Other movements based upon how your cat or dog moves may have

produced the same or superior results. Indeed, the repertoire of Tai

Chi movements is based heavily on the movements and characteristics

of different adult animals - and studies HAVE shown that they improve

balance and coordination, even in older folk with profoundly impaired

motor capabilities. In other words,there would appear to be more

scientific and practical evidence for Tai Chi as a form of neuromotor

therapy than there is for the 'unique' INPP approach.>

** This is my point, we share a number of primitive reflexes with

animals and the 'ancient wisdom' that devised the movements of the

martial arts. These moves are based on survival methods which

incidentally is also used to describe the primitive reflexes, ie

survival reflexes. Sitting in a rocking chair can also be a good

vestibular stimulation exercise which has also been shown to improve

balance in the elderly.

Has anyone proved Tai Chi can help children with learning difficulties?

Roy Palmer

Bedford

UK