Sally Goddard Blythe is International Director of The Institute for Neuro-Physiological Psychology (INPP) in Chester, UK. She is the author of seven books on child development, including Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Programme (Wiley-Blackwell, 2012), The Genius of Natural Childhood (2011), and Attention, Balance and Coordination: The A.B.C. of Learning Success (Wiley-Blackwell, 2009).

• Foreword xDr Arthur PaynterAcknowledgements xiii1 Identifying Signs of Neuromotor Immaturity in Children and Adults 11.1 Introduction 11.2 How to use this Manual 21.3 Overview 31.4 Relationship between Neuromotor Immaturity and Learning Outcomes 4Literature review 41.5 Neuromotor Immaturity in Adolescents 61.6 Relevance of the INPP Screening Test to Health Practitioners 81.7 What is the INPP Method? 8Why assess posture and balance? 9Why carry out assessments for balance? 9What is the significance of static balance and dynamic balance to learning? 10What is the significance of postural control to learning? 10What is the link between primitive reflexes, balance and postural control? 111.8 How Does the Vestibular System Work? 111.9 Primitive Reflexes 12Why have these four reflexes been selected for evaluation? 121.10 What Evidence is there that Intervention in the Form of Movement Programmes Aimed at the Level of Primitive Reflexes Improves Reflex Status and Educational Outcomes? 181.11 What was known about Exercises to Inhibit Primitive Reflexes? When was the INPP Method Developed? What has been your Personal Experience Since then? 191.12 What is the Difference between the INPP Method, Sensory Integration (SI), Vojta Therapy, Bobath Therapy and Others Working with Primitive Reflexes? What are the Criteria for Referral to a Particular Therapy? 20The INPP method 20Sensory Integration (SI) therapy 21Vojta therapy 22Bobath therapy 261.13 What are the Top Five Medical Diagnoses Where Referral to INPP Should Routinely be considered After Checking the Reflexes by Clinicians? 271.14 Screening Tests 27How to use the screening test 28References 282 Screening Test for Use with Children 322.1 General Instructions 322.2 Scoring 322.3 Tests 33The Romberg test 34One-leg stand or Unipedal Stance Test (UPST) 37Tests for ‘soft signs’ of neurological dysfunction: The Tandem and Fog walks 39The Tandem walk 40The Fog walk (1963) (walking on the outsides of the feet) 42Finger and thumb opposition test 442.4 Tests for Primitive Reflexes 46Asymmetrical Tonic Neck Reflex (ATNR) 46Test procedure: Ayres quadruped test for the ATNR 47Adapted Hoff–Schilder test for the ATNR (from seven years of age) 48The Symmetrical Tonic Neck Reflex (STNR) 50Tonic Labyrinthine Reflex (TLR): Erect test 52The Moro reflex 542.5 Sample Score Sheets 562.6 Sample Observation Sheets 572.7 Interpreting the Scores 58Children 58References 593 Neuromotor Immaturity in Adults 613.1 The Role of the Vestibular System and Its Connections 613.2 Historical Background to Links between Vestibular–Cerebellar Dysfunction and Anxiety, Agoraphobia and Panic Disorder 643.3 Vestibular Dysfunction: Cause or Effect? 683.4 Rationale for a Somatogenic/Psychosomatic Basis to Some Anxiety Disorders 683.5 Postural Righting Reactions 71Labyrinthine Head Righting Reflexes (LHRRs) 713.6 The Moro Reflex: A Trigger for Panic? 723.7 How to Use the INPP Screening Test 743.8 The INPP Adult Screening Questionnaire 763.9 Interpreting the INPP Adult Screening Questionnaire 79References 804 INPP Screening Test for Signs of Neuromotor Immaturity in Adults 834.1 General Instructions 834.2 Scoring 834.3 Screening Tests for Use with Adults 834.4 Tests for Balance and ‘Soft Signs’ of Neurological Dysfunction (ND) 844.5 Tests for Balance and Proprioception 86The Romberg test 86The Mann test (advanced Romberg test) 89The tandem walk 91The Fog walk (1963) (walking on the outsides of the feet) 934.6 Tests for Primitive Reflexes 95Asymmetrical Tonic Neck Reflex (ATNR) 95Ayres quadruped test for the ATNR 96Asymmetrical Tonic Neck Reflex adapted Hoff–Schilder (erect) test 97The Symmetrical Tonic Neck Reflex (STNR) 99Tonic Labyrinthine Reflex (TLR): Erect test 101Moro reflex 103Erect (drag) test for the Moro reflex 1054.7 Adult screening test 1074.8 Interpreting the scores 109References 110Resources 111Index 121

"This book is a good starting point for clinicians for assessing neuromotor immaturities. It will help you to understand the current neurological status of your patient and the need for further assessment, therapy or referral." Pregnancy and Paediatrics Faculty of the Royal College of Chiropractors Newsletter, February 2015

Sally Goddard Blythe is International Director of The Institute for Neuro-Physiological Psychology (INPP) in Chester, UK. She is the author of seven books on child development, including Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Programme (Wiley-Blackwell, 2012), The Genius of Natural Childhood (2011), and Attention, Balance and Coordination: The A.B.C. of Learning Success (Wiley-Blackwell, 2009).

• Foreword xDr Arthur PaynterAcknowledgements xiii1 Identifying Signs of Neuromotor Immaturity in Children and Adults 11.1 Introduction 11.2 How to use this Manual 21.3 Overview 31.4 Relationship between Neuromotor Immaturity and Learning Outcomes 4Literature review 41.5 Neuromotor Immaturity in Adolescents 61.6 Relevance of the INPP Screening Test to Health Practitioners 81.7 What is the INPP Method? 8Why assess posture and balance? 9Why carry out assessments for balance? 9What is the significance of static balance and dynamic balance to learning? 10What is the significance of postural control to learning? 10What is the link between primitive reflexes, balance and postural control? 111.8 How Does the Vestibular System Work? 111.9 Primitive Reflexes 12Why have these four reflexes been selected for evaluation? 121.10 What Evidence is there that Intervention in the Form of Movement Programmes Aimed at the Level of Primitive Reflexes Improves Reflex Status and Educational Outcomes? 181.11 What was known about Exercises to Inhibit Primitive Reflexes? When was the INPP Method Developed? What has been your Personal Experience Since then? 191.12 What is the Difference between the INPP Method, Sensory Integration (SI), Vojta Therapy, Bobath Therapy and Others Working with Primitive Reflexes? What are the Criteria for Referral to a Particular Therapy? 20The INPP method 20Sensory Integration (SI) therapy 21Vojta therapy 22Bobath therapy 261.13 What are the Top Five Medical Diagnoses Where Referral to INPP Should Routinely be considered After Checking the Reflexes by Clinicians? 271.14 Screening Tests 27How to use the screening test 28References 282 Screening Test for Use with Children 322.1 General Instructions 322.2 Scoring 322.3 Tests 33The Romberg test 34One-leg stand or Unipedal Stance Test (UPST) 37Tests for ‘soft signs’ of neurological dysfunction: The Tandem and Fog walks 39The Tandem walk 40The Fog walk (1963) (walking on the outsides of the feet) 42Finger and thumb opposition test 442.4 Tests for Primitive Reflexes 46Asymmetrical Tonic Neck Reflex (ATNR) 46Test procedure: Ayres quadruped test for the ATNR 47Adapted Hoff–Schilder test for the ATNR (from seven years of age) 48The Symmetrical Tonic Neck Reflex (STNR) 50Tonic Labyrinthine Reflex (TLR): Erect test 52The Moro reflex 542.5 Sample Score Sheets 562.6 Sample Observation Sheets 572.7 Interpreting the Scores 58Children 58References 593 Neuromotor Immaturity in Adults 613.1 The Role of the Vestibular System and Its Connections 613.2 Historical Background to Links between Vestibular–Cerebellar Dysfunction and Anxiety, Agoraphobia and Panic Disorder 643.3 Vestibular Dysfunction: Cause or Effect? 683.4 Rationale for a Somatogenic/Psychosomatic Basis to Some Anxiety Disorders 683.5 Postural Righting Reactions 71Labyrinthine Head Righting Reflexes (LHRRs) 713.6 The Moro Reflex: A Trigger for Panic? 723.7 How to Use the INPP Screening Test 743.8 The INPP Adult Screening Questionnaire 763.9 Interpreting the INPP Adult Screening Questionnaire 79References 804 INPP Screening Test for Signs of Neuromotor Immaturity in Adults 834.1 General Instructions 834.2 Scoring 834.3 Screening Tests for Use with Adults 834.4 Tests for Balance and ‘Soft Signs’ of Neurological Dysfunction (ND) 844.5 Tests for Balance and Proprioception 86The Romberg test 86The Mann test (advanced Romberg test) 89The tandem walk 91The Fog walk (1963) (walking on the outsides of the feet) 934.6 Tests for Primitive Reflexes 95Asymmetrical Tonic Neck Reflex (ATNR) 95Ayres quadruped test for the ATNR 96Asymmetrical Tonic Neck Reflex adapted Hoff–Schilder (erect) test 97The Symmetrical Tonic Neck Reflex (STNR) 99Tonic Labyrinthine Reflex (TLR): Erect test 101Moro reflex 103Erect (drag) test for the Moro reflex 1054.7 Adult screening test 1074.8 Interpreting the scores 109References 110Resources 111Index 121

"This book is a good starting point for clinicians for assessing neuromotor immaturities. It will help you to understand the current neurological status of your patient and the need for further assessment, therapy or referral." Pregnancy and Paediatrics Faculty of the Royal College of Chiropractors Newsletter, February 2015

Sally Goddard Blythe is International Director of The Institute for Neuro-Physiological Psychology (INPP) in Chester, UK. She is the author of seven books on child development, including Assessing Neuromotor Readiness for Learning: The INPP Developmental Screening Test and School Intervention Programme (Wiley-Blackwell, 2012), The Genius of Natural Childhood (2011), and Attention, Balance and Coordination: The A.B.C. of Learning Success (Wiley-Blackwell, 2009).

• Foreword xDr Arthur PaynterAcknowledgements xiii1 Identifying Signs of Neuromotor Immaturity in Children and Adults 11.1 Introduction 11.2 How to use this Manual 21.3 Overview 31.4 Relationship between Neuromotor Immaturity and Learning Outcomes 4Literature review 41.5 Neuromotor Immaturity in Adolescents 61.6 Relevance of the INPP Screening Test to Health Practitioners 81.7 What is the INPP Method? 8Why assess posture and balance? 9Why carry out assessments for balance? 9What is the significance of static balance and dynamic balance to learning? 10What is the significance of postural control to learning? 10What is the link between primitive reflexes, balance and postural control? 111.8 How Does the Vestibular System Work? 111.9 Primitive Reflexes 12Why have these four reflexes been selected for evaluation? 121.10 What Evidence is there that Intervention in the Form of Movement Programmes Aimed at the Level of Primitive Reflexes Improves Reflex Status and Educational Outcomes? 181.11 What was known about Exercises to Inhibit Primitive Reflexes? When was the INPP Method Developed? What has been your Personal Experience Since then? 191.12 What is the Difference between the INPP Method, Sensory Integration (SI), Vojta Therapy, Bobath Therapy and Others Working with Primitive Reflexes? What are the Criteria for Referral to a Particular Therapy? 20The INPP method 20Sensory Integration (SI) therapy 21Vojta therapy 22Bobath therapy 261.13 What are the Top Five Medical Diagnoses Where Referral to INPP Should Routinely be considered After Checking the Reflexes by Clinicians? 271.14 Screening Tests 27How to use the screening test 28References 282 Screening Test for Use with Children 322.1 General Instructions 322.2 Scoring 322.3 Tests 33The Romberg test 34One-leg stand or Unipedal Stance Test (UPST) 37Tests for ‘soft signs’ of neurological dysfunction: The Tandem and Fog walks 39The Tandem walk 40The Fog walk (1963) (walking on the outsides of the feet) 42Finger and thumb opposition test 442.4 Tests for Primitive Reflexes 46Asymmetrical Tonic Neck Reflex (ATNR) 46Test procedure: Ayres quadruped test for the ATNR 47Adapted Hoff–Schilder test for the ATNR (from seven years of age) 48The Symmetrical Tonic Neck Reflex (STNR) 50Tonic Labyrinthine Reflex (TLR): Erect test 52The Moro reflex 542.5 Sample Score Sheets 562.6 Sample Observation Sheets 572.7 Interpreting the Scores 58Children 58References 593 Neuromotor Immaturity in Adults 613.1 The Role of the Vestibular System and Its Connections 613.2 Historical Background to Links between Vestibular–Cerebellar Dysfunction and Anxiety, Agoraphobia and Panic Disorder 643.3 Vestibular Dysfunction: Cause or Effect? 683.4 Rationale for a Somatogenic/Psychosomatic Basis to Some Anxiety Disorders 683.5 Postural Righting Reactions 71Labyrinthine Head Righting Reflexes (LHRRs) 713.6 The Moro Reflex: A Trigger for Panic? 723.7 How to Use the INPP Screening Test 743.8 The INPP Adult Screening Questionnaire 763.9 Interpreting the INPP Adult Screening Questionnaire 79References 804 INPP Screening Test for Signs of Neuromotor Immaturity in Adults 834.1 General Instructions 834.2 Scoring 834.3 Screening Tests for Use with Adults 834.4 Tests for Balance and ‘Soft Signs’ of Neurological Dysfunction (ND) 844.5 Tests for Balance and Proprioception 86The Romberg test 86The Mann test (advanced Romberg test) 89The tandem walk 91The Fog walk (1963) (walking on the outsides of the feet) 934.6 Tests for Primitive Reflexes 95Asymmetrical Tonic Neck Reflex (ATNR) 95Ayres quadruped test for the ATNR 96Asymmetrical Tonic Neck Reflex adapted Hoff–Schilder (erect) test 97The Symmetrical Tonic Neck Reflex (STNR) 99Tonic Labyrinthine Reflex (TLR): Erect test 101Moro reflex 103Erect (drag) test for the Moro reflex 1054.7 Adult screening test 1074.8 Interpreting the scores 109References 110Resources 111Index 121

"This book is a good starting point for clinicians for assessing neuromotor immaturities. It will help you to understand the current neurological status of your patient and the need for further assessment, therapy or referral." Pregnancy and Paediatrics Faculty of the Royal College of Chiropractors Newsletter, February 2015