Elisabeth is an occupational medicine specialist, who helps people with neurodevelopmental disorders at her clinic in the south of France. She is also a Montessori classroom director for children aged 3 to 6, and for special needs children. Birgit is a general practitioner from Germany, who also specializes in neurodevelopmental disorders. She has completed diplomas in homeopathy, TCM nutrition, and other body therapies, focusing on therapies that have a neuro-integrative approach. Both are also trainers of Brighter Minds, a program for cognitive development in children.

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Elisabeth Bouderlique and Birgit Dürr

Neuro-development in children - part 1

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<h4>
 DR. ELISABETH BOUDERLIQUE
 and
 DR. BIRGIT DÜRR
 have specialized in behavioral disorders in children from a
 neurodevelopmental perspective. They were interviewed by
 PURNIMA RAMAKRISHNA for World Mental Health Day,
 October 2020, and in part 2 they explore
 reflexes, the brain hemispheres, and creating rhythm in the brain.
</h4>

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 BD:The two most
 important aspects of supporting the development of the brain are integrating
 primitive reflexes through motor exercises and stimulating the underdeveloped
 hemisphere, mainly with sensory stimulation.



 If there is no damage or pathology in the brain, if it is an electrical
 imbalance, it can be corrected. And when the imbalance in the brain is
 corrected, all of the other imbalances are most often corrected as well.


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 <img alt="" class="lazyload has-img-center"
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 Q: Primitive reflexes. Can you tell us more about their role in
 brain
 development?



 EB: Primitive
 reflexes are automatic, stereotypical movements essential for the development
 in the womb and during the baby’s first months. They are part of a normal
 pediatrician’s examination. These primitive reflexes develop in the brainstem
 before birth and contribute to the development of the nervous system. They
 help the baby to come out of the birth canal and are the foundation necessary
 for the baby’s development. They are essential for survival during the first
 weeks of life. These reflexes allow the baby to interact with the world and
 thus contribute to the development of their brain. Most of these primitive
 reflexes are integrated (meaning we don’t see them anymore) during the first
 year of life, as a more complex part of the brain takes control.


The most common primitive reflexes are:

Fear Paralysis Reflex

<ul>
 <li>Tonic Labyrinthine Reflex</li>
 <li>Asymmetric Tonic Neck Reflex</li>
 <li>Moro Reflex</li>
 <li>Spinal Galant</li>
 <li>Symmetric Tonic Neck Reflex</li>
 <li>Babinski Reflex</li>
 <li>Palmar Grasp</li>
 <li>Rooting /Sucking</li>
 <li>Snout Reflex</li>
</ul>


 These reflexes, which persist beyond the first year of life, are called
 “persistent primitive reflexes.” They can affect normal neurological
 development, and therefore be the cause of a multitude of symptoms, including
 learning difficulties and behavioral issues. There are simple exercises that
 can help to integrate them.



 I will give you one example, because most people know the Moro Reflex. If you
 make a loud noise, the baby will suddenly open their arms and close them
 again. If this reflex persists for too long, it becomes the root of many
 symptoms, such as impulsive behavior, hypersensitivity to light, sound or
 sudden movement, dislike of change, difficulty with new or stimulating
 experiences, chronic anxiety, uncontrollable flushing when embarrassed or
 nervous, mood swings, and aggressive outbursts. This reflex can persist even
 in an adult, so it is important to look for these primitive reflexes.



 I won’t go into too much detail about brain development, but it’s important to
 remember that the brain develops from the bottom up, meaning from the
 brainstem to the cortex, and then the cortex regulates everything from top to
 bottom. So, it’s important to help the brain develop from the bottom up, by
 integrating the primitive reflexes which are located in the brainstem.


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 <img alt="" class="lazyload mw-100"
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 Q: Can you tell us more about the hemispheres?



 BD: That’s a good
 question, because to understand what is happening in the brain of a child with
 neurodevelopmental issues, we have to understand the different functions or
 tasks of the two hemispheres.



 The right hemisphere is online first. It sees the big picture. It is there to
 protect us. It is cautious. The right brain is responsible for non-verbal
 communication, which is at the core of socialization. It forms relationships.
 It is able to read between the lines. The right hemisphere learns
 subconsciously, implicitly. We don’t form conscious memories in the first
 three years of life. That’s what we call “childhood amnesia.” It is
 responsible for reading comprehension and mathematical reasoning. It deals
 also with gross motor skills. It is responsible for long-term, non-rewarded,
 sustained attention, like a hunter waiting for hours for his prey. It also
 deals with withdrawal behavior and negative emotions, such as fear, guilt, and
 shame. The right hemisphere will down-regulate our immune system.



 The left hemisphere sees details, like the individual trees in a forest. It is
 all about “why.” For example, if you think of a child that is 2 or 3 years
 old, looking at small animals on the ground and asking, “Why this?” It deals
 with fine motor skills. It is the logical, sequential brain, looking for
 patterns. It is responsible for reading words, spelling, and basic arithmetic.
 The left hemisphere forms conscious memories. It deals with approach behavior
 and emotions, such as anger, surprise, and happiness. It is the hemisphere
 that is naturally impulsive, or even compulsive or obsessive. It is
 responsible for short-term, goal-directed, reward-reinforced attention. Video
 games will stimulate or even overstimulate the left side of the brain.



 As an analogy, imagine a car going downhill. When you remove your foot from
 the brake, the car goes forward by itself. Think of the right hemisphere as
 the brake. If there is not enough “brake,” the left hemisphere will start
 automatically.



 Q: Can you give us a concrete example, so that we can understand
 what
 happens with a child who has ADHD?



 EB: A child
 diagnosed with ADHD usually has underdeveloped, under-integrated networks in
 the right hemisphere. The child will present symptoms related to
 right-hemisphere delay and a left hemisphere that is too strong. The child can
 be hyperactive, obsessive, compulsive, and overly focused on details, not
 paying attention to the big picture. They like to do things over and over
 again. They can have tics – motor tics and vocal tics. A strong left brain
 will be responsible for anger outbursts and hypersensitivity to sound,
 especially high frequency sounds, so you can see the child covering their ears
 when there is too much noise. The symptoms related to a low activity on the
 right hemisphere will be poor, long-term sustained attention, and poor
 non-verbal communication, so they will have difficulty picking up on facial
 emotions and social cues. The child can also have poor mathematical reasoning
 skills, and difficulty comprehending what they are reading. The right brain
 will not play its role of inhibition, so the heart rate can be high, and the
 immune response will be too strong with food sensitivities and environmental
 allergies, for example.



 This imbalance will persist throughout the person’s whole life and this is why
 there are epidemics in these issues in the adult population. A child will not
 grow out of these issues, but may just express them in a different way as an
 adult. The imbalance will still be there. It is not a coincidence that 1 out
 of 5 children have some kind of learning or behavioral issue, and 1 out of 5
 adults have some kind of mental issue.


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 <img alt="" class="lazyload has-img-center"
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 Q: My next question follows on from this. Could you expand on
 the
 connection between a brain imbalance and the effect it has on the overall
 health of a person?



 BD: Almost all
 kids with developmental imbalances not only struggle in school with learning
 and behavior, but suffer from other health issues as well. In this context, it
 is interesting to look at the Adverse Childhood Experiences Study (ACE Study),
 which is one of the largest investigations ever conducted to assess the
 association between childhood exposure to traumatic stressors and health and
 well-being later on in life.



 The story started with a study at an obesity clinic in California in the early
 ’90s. People were there to lose weight and after some time 50% of people
 dropped out. The interesting thing was that the people who dropped out were
 the people who had the best results, meaning they were losing weight. So the
 researchers asked why. What they found when they interviewed these people was
 that the majority had experienced abuse in childhood. After that, they
 investigated more than 17,000 patients about their experience of childhood
 trauma. There were about ten adverse childhood experiences (ACEs) that played
 a major role in health later on in life – emotional abuse, physical abuse,
 sexual abuse, physical neglect, emotional neglect, exposure to domestic
 violence, and household mental illness, to mention a few.



 They also found that there was a correlation between the number of ACEs a
 person had experienced and the chance of poor outcomes later in life. When
 they followed people during later life, they saw that they were 400 to 1200%
 more likely to struggle with health-related issues like diabetes, cancer,
 depression, heart disease, autoimmune issues and earlier death.



 So what is the relationship between a child having an ACE and a child with a
 neurological developmental delay? They both have disrupted neurodevelopment.
 When a child is neglected or abused, neurological development is disrupted.
 Whether a child has a delay in neurodevelopment due to an ACE or for the other
 reasons we mentioned before, it always has an impact on social, emotional, and
 cognitive development, and a severe impact on the whole body and overall
 health. This leads to an increased risk of developing chronic diseases.



 To round off the picture of this topic, we would like to read to you from Dr.
 Melillo’s book, Reconnected Kids: The Symphony of the Brain.


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<h5 class="has-text-align-center">
 “We know it is not the instrument which is broken. The
 musicians just
 need more practice and encouragement. We are trying to find the
 networks in the brain which are malfunctioning and we are stimulating
 them so they get back in rhythm with the rest of the brain.”
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 EB: Dr. Melillo
 wrote: “Think of the brain as if it was an orchestra, with thoughts and
 actions as the notes that change moment to moment to create a musical
 composition. When the conductor, which is the brain, directs the musicians,
 which are the neurons, to use their instruments, which are the synapses, to
 create music, which are thoughts and actions, the music begins to play.



 “Sometimes the conductor signals the right side to play louder while he tones
 down the left side. The key to both sides playing beautiful music together is
 that each musician must not only play the right notes but must play them at
 precisely the right time. This ebb and flow must be perfectly timed. A
 musician might miss a beat and subsequently, the two sides will get out of
 harmony.



 “We know it is not the instrument which is broken. The musicians just need
 more practice and encouragement. We are trying to find the networks in the
 brain which are malfunctioning and we are stimulating them so they get back in
 rhythm with the rest of the brain.”



 Q: Thank you Elisabeth and Birgit.



 Watch the full webinar here:
 <a rel="noreferrer noopener" href="https://youtu.be/AvEB65sAHiU"
 target="_blank">https://youtu.be/AvEB65sAHiU</a>


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Elisabeth Bouderlique and Birgit Dürr

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