Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Saturday, May 12, 2012

The Myth About Crawling Creeps In Again


You think mistakes have gone away--  then they crop up again as vigorously as weeds in the garden! That’s what I’ve just found at http://stellarcaterpillar.com. This web site has a great name, and no doubt contains some valuable material (like a video of how a baby climbs out of his crib). BUT… it also reiterates the Myth About Crawling.

This myth states that babies must crawl, and do so for some period of time, in order to cause the brain to develop properly. It’s a myth because it doesn’t happen to be true, and unfortunately it’s also a piece of folklore, which by definition goes without critical examination by most of its hearers.

Here’s what the stellarcaterpillar author says: “Sometimes baby learns to pull up to a standing position too soon, before his bones and muscles are strong enough to support him. In this situation, it is best for the parent to take his hands back down to the floor and tell him it is not time to stand, and it is still time to crawl. It is very beneficial for baby to crawl for several weeks before standing up. For many years, experts have researched and shown that crawling is very important for the development of the brain.” This author, a dance therapist, goes on to say that babies try to stand “too soon” because of imitating an older sibling, attending day care where older babies walk, or being put in a jumper “too soon”. (Don’t their parents walk, by the way?) She implies without directly stating it that such babies are at risk for inappropriate brain development if not discouraged from standing and receiving praise for crawling. And I must say that she does not “show her work” as she engages in this confident speculation.

So, what about all this? Let’s look at some important issues. The first one is the idea that actions stimulate the parts of the brain that produce them--  for example, that as I use my right hand to type, I am stimulating the left side of the brain, the side that is doing much to control the right hand’s movements.  (By the way, see my previous post about brain functions for some comments about the right-brain/left-brain distinction.) The logic is this: activity of the left hemisphere causes the right hand to move, therefore the movement of the right  hand causes activity in the LH. To put it more generally, this statement is that if A causes B, B causes A. Does anyone recognize this error of critical thinking? It’s called “affirming the consequent”, and it’s the cause of a lot of mistakes in logic. By this fallacy, if the cow jumped over the moon, the moon also jumped over the cow! Of course there can be situations where two factors are mutually causal, but showing that requires a lot more information than a simple statement.

What’s so concerning about the stellarcaterpillar author’s affirmation of the consequent? Well, there are several erroneous conclusions that can be reached if you start with this mistake. One , the practice of “patterning”, goes back to about 1960 and is still advocated by the Institute for Human Potential in Philadelphia—despite two position statements of the American Academy of Pediatrics rejecting it. “Patterning” is a practice based on the idea that  moving on all fours provides not just stimulation to the brain (see previous paragraph), but a pattern of stimulation that affects the right and left hemispheres simultaneously and therefore is asserted to have a special benefit (for which no systematic evidence has been offered). “Patterning” advocates are best known for claiming that repeatedly moving the limbs and head of a brain-injured person would cause the brain to re-develop normally. They have also claimed that forcing school-age children to crawl would repair a range of problems from cerebral palsy to dyslexia. Not only does “patterning” not accomplish these goals, it costs families a good deal in terms of time, money, and other resources. I don’t doubt that “patterning” believers are sincere, but I do consider them deluded.

Having assumed that crawling benefits brain development, the stellarcaterpillar author has to deal with how a child who wants to stand can be prevented from doing so. She suggests discouragement of standing and praise for crawling--  apparently assuming that infants’ primary motivation is social approval or disapproval, and possibly forgetting how they throw food on the floor in spite of their mothers’ negative responses. In fact, the stellarcaterpillar author has forgotten the insight of infant mental health researchers into the fact that mastery motivation is of critical importance in determining infant and toddler behavior. Babies and young children want to master skills and accomplish things. That’s why they work hard and often seem to lose interest in anything they’ve mastered, why they no sooner walk than they have to try walking backwards. Interfering with the baby’s own developmental goals will be extraordinarily frustrating for baby and parent both, and by the way, if the adult succeeds in making the baby stop trying a new skill, it will not be so easy to reverse the attitude when the parent decides there’s been enough crawling. (ANECDOTE WARNING: Some years ago I was consulted about a baby who was not sitting up unsupported at the typical age. Turned out his family day-care provider didn’t have enough cribs to go around, so she put him to nap in a baby carriage. She stayed near, and if he tried to sit up, she pushed him back down. He learned not to sit, and had to be worked with a good deal before he tried it again.)

A final point about the assumptions made by the stellarcaterpillar author: it’s a big mistake to think that development occurs only because of specific experiences a child has. Many aspects of development simply unfold in the course of maturation and are supported by everyday events that usually go unnoticed by adults. A certain amount of motor development has to do with the baby’s muscle strength and position of the center of gravity. Esther Thelen, the great motor development researcher, showed that Down syndrome babies walked earlier when they had a chance to exercise on a “baby treadmill” and strengthen their muscles. But babies can’t and don’t “walk too early” and harm their brain or bone development, any more than they hurt themselves by “talking too early” or “reading too early”. If they try something they’re not ready to do, they fall down, literally or figuratively.

In the days when rickets was common, legs may have become bowed in the course of early walking. But the belief that brains can be “bowed” in this way is simply modern folklore.



36 comments:

  1. Have you ever read this article? http://www.scientificamerican.com/article.cfm?id=crawling-may-be-unnecessary

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  2. No, I haven't-- thanks for sending it.

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    1. Interesting. I remember all the crawling stuff from years ago. One of my sons walked at 9 months so he certainly did not crawl much. Of my kids, he is the most coordinated, a natural athlete, artist, and has a great career in computer graphics special effects in movies. Not crawling did not impede him in any way.

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  3. What if he had turned out to be clumsy and incompetent? Would that mean that crawling had impeded him?

    Each of us experiences so few children that although it's a lot of fun to think of the examples they give, we have to be awfully careful about concluding anything general from those examples.

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  4. Have there been studies that compare cross-lateral crawling with other forms of early locomotion on brain development, determining that it is NOT significant? When? Where? Who?

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    1. If you mean naturally-occurring differences in locomotion-- e.g., kids who don't crawl but walk early, kids who scoot around rather than crawling-- try Flinchum's old book "Motor Development in Early Childhood". The work summarized there shows normal motor development at age 2,whatever the individual history was (with exceptions I'll mention in a minute), and this is quite a good indication of normal brain development. Mead and Bateson, in their study of Balinese life, showed that Balinese children were at that time carried in someone's arms until they could walk, but all aspects of development were normal.

      Those sources are old, but this stuff has been understood pretty well for a long time. Too bad the man Delacato didn't understand it.

      The exceptions to this have to do with asymmetrical crawls, which are often indications of existing problems of brain functioning. Movement patterns reflect what the brain is doing rather than shaping the brain-- cf. children with cerebral palsy.

      If you're looking for experimental evidence, I can't see how that could be brought about without fitting the child with hopples like a pacing horse-- far outside any ordinary ethical standards.

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  5. I took up crawling as an adult, after 3 months of daily crawling I'm much stronger and more coordinated. My walking gait is much better. My posture is much much better. My core, lats, pelvic floor etc are reflexively engaging and my upper traps are no longer overactive so my shoulders are all the way down now instead of slightly raised all the time, so I feel more relaxed and calm. I also used the crawl position to deliberately train diaphragm breathing as the posture of the position really allows you to take deep breaths from the diaphragm and not "chest breath" by using the shoulder and neck muscles to lift the ribcage. My left shoulder isn't slumped forwards anymore as it was in the past. Crawling has brought it back and set it just in the right position. My shoulders no longer pop and click when i rotate them around as well.

    . My mother said that I crawled very briefly before I started walking. I've also always been physically weak and uncoordinated all through childhood and into adult life. Despite training in martial arts for 10 years, lifting weights, training with kettlebells, etc I was still generally clumsy and weak. All those things helped me improve but I was still never overall coordinataed, only coordinated in the movements I specifically trained. I was still clumsy when I walked despite attempting to retrain my walking deliberately, but now my walking is very crisp and effortless without specifically training my walking pattern, just crawling. 10 years of training while standing up didn't do it.. 3 months of crawling 5-10 minutes a day did. Crawling is important. Try baby crawling for 5 minutes a day to see how it transforms the way you move even as an adult.

    Although just because crawling fixed all these problems, doesn't mean that not crawling means someone will have problems. But it seems to have been the case for me. If 3 months of crawling now has made me more coordinated and stronger than I have ever been, then crawling for a longer period of time when I was a baby probably would have helped me avoid a lot of frustration from being uncoordinated and clumsy. I am now training my clients (personal trainer) with crawling as well, and I am seeing the same results. Improved posture, coordination, etc.

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    1. I don't doubt that crawling or any other unusual mode of locomotion will work muscles differently and has the potential for altering posture and gait.

      BUT the point of my original post was to contradict the claim that crawling shaped brain development. I don't think you're claiming that your brain is different, are you?

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  6. Would you consider that the statements in the article you critique are perhaps not best representative of those who promote crawling.

    First, let's be clear: crawling is done on the stomach, while creeping is on hands and knees.

    Next, I believe you support the fact that each person is different, and each of us can be found on a spectrum from completely comatose to genius. Each person, from birth, has different needs, and gets from point A to point B (literally and figuratively) differently and at different stages. One child may seem not to crawl at all (although isn't it just a bit possible moms and dads don't remember that little Jimmy crawled, if even just a little bit?), and another may crawl a lot.

    I agree that parents shouldn't get freaked out if their child didn't crawl, especially if they are fine or even better than fine. Don't look back unless you have too.

    Some kids learn to ride bicycles without training wheels. others use them. Some kids figure out reading with little or no help. Others are "taught."

    Would you agree that if little Jimmy needs help learning to read, that it would be better to help him, rather than simply letting him figure it out, possible by age 15, possible not at all??

    So, if crawling and creeping (and several other sensory stimulations, etc that the Doman model recommends) help organize some children's brains neurologically, so that they read better, organize information better, learn better and are more physically capable, wouldn't it be worth doing? Or would it be better to let it go?

    And when we are talking about brain-injured children, would you argue it is better to just slap AFOs on them, let them spend their lives in wheel chairs, keep them on meds to seizures, perhaps let them continue to be neurologically blind? Should be just continue to spend tons of taxpayer money on Early Intervention, which amounts to very little progress? Or wouldn't it be better to be proactive and have your child reach best potential.

    I have seen it work with my own eyes. Kids who were told they will never walk...They will never see...They will be on meds for seizures their whole lives...I have seen them walk. They can see (not from crawling per se, but from months of therapy, starting with light reflex stimulation). They have gone from 20 seizures a week to 7 a year and are completely off of medication.

    You say
    "They have also claimed that forcing school-age children to crawl would repair a range of problems from cerebral palsy to dyslexia. Not only does “patterning” not accomplish these goals, it costs families a good deal in terms of time, money, and other resources. I don’t doubt that “patterning” believers are sincere, but I do consider them deluded."

    But I have seen the results, from Autism to Cerebral Palsy. Real time put in and real progress. No study you provide me will take away from the results I have seen.

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  7. (continued comment)

    I think the person who wrote the article you critiqued oversimplified. And you are oversimplifying too.
    I have seen the scathing criticisms of the IAHP and Family Hope Center. They are not giving people false hope, which is very often the criticism. They are giving parents and children specific, simple and actionable plans, while the medical model (the very same model that you are touting) simply holds up their hands at those with Cerebral Palsy, Trisomy 21, etc., and says, "there's nothing we can do...this is it..." And then they act as if the family should accept that and deal with it psychologically...and any attempt to do something not recommended by the status quo of the medical model simply illustrates that the parents are in denial.

    Hello? People once believed the world was flat. They believed the Sun revolved around the Earth.

    The medical model is a Pathology ("this is it, now medicate or operate") model...while the Doman model, and that of the Family Hope center is based on Physiology ("use it or lose it").

    Finally, you say,
    "the practice of “patterning”, goes back to about 1960 and is still advocated by the Institute for Human Potential in Philadelphia—despite two position statements of the American Academy of Pediatrics rejecting it. "

    Wow, so I should take whatever the American Academy of Pediatrics says as some kind of scientific proof? They are just statements; that's not science. Those are just people trying resistant to something that is not within their paradigm...and they are baffled and frustrated when people are fed up with a system that isn't always the best support for (brain injured) children.

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  8. I want to say one final thing Patterning. I'm pretty sure that the studies "disproving" that patterning works only executed patterning a few hours a week for a few weeks.

    That is a very different model from those that recommend several hours a day (depending on the child) for anywhere from a few months to a few years.

    My analogy is this.

    If I wanted to become proficient at piano, or violin, or any instrument, could I do so in 3 weeks, with only a few hours of practice per week?

    Should I conclude that I just can't do it? Or is it possible it required more time per week and more weeks, or months or years (depending on my potential) to gain the fine motor facility necessary...and to gain the muscle memory?

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    1. Dear Jeremy-- I gather from Google that you are a supporter of alternative medicine in general, so I don't suppose you really care whether there is or is not a serious evidence basis for a practice. But, in case that does concern you, perhaps you could cite for me a single thorough case study on the effect of patterning. I don't even ask for a study that controls for the effects of maturation, but I want to see a case study (not an anecdote or testimonial). Have you got one that you can name?

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    2. By the way, the burden of proof is on supporters of patterning, to show that it is safe and effective. It's not actually possible to show that something does not work, but in the absence of evidence that it works, the logical assumption is that it does not.

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    3. JeremyDyen, I would like to know more about IAHP and the criticism that it is receiving please.

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  9. Well, the conversation is very interesting. A psychologist that I've been sending my son to has attributed his inability to comprehend text to not crawling, which I didn't really dismiss due to the plausibility of their being a powerful mind-body connection. Although we haven't started the exercises she recommends, I will be moving forward with them for one simple reason; they cannot do any harm. If all I am requiring of my son is to crawl around on the floor for ten minutes twice a day, and there is the possibility that this could improve his situation, then I'm game. If it doesn't work, then we'll move on.

    As to the studies, I'm not sure how you could even set up a trial for this type of thing. Could a doctor even recommend that a group of parents prevent their children from crawling to discover the long term effects of skipping that stage of development. What sort of ethics board would approve the creation of such a control group, knowing that the experiment is being set up to test the possibility that not crawling retards cognitive development?

    Perhaps I am wrong though. Perhaps such a study has been done by the Nazis or Soviets that I don't know about and this is what you are basing your blog on.

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  10. I might add, that at this point I don't know what the exercises are that are being proposed, I merely posited something ridiculous for the sake of argument.

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    1. I am gobsmacked at the idea that an actual psychologist is making this recommendation in 2014. Are you sure this person is a psychologist, as opposed to a psychotherapist? Not only do I question the person's credentials, if I knew who it was I would file an ethics complaint.

      Certainly, if your son doesn't mind crawling around, and if you don't mind delaying effective treatment, there's no harm in this. If your son finds it humiliating, that's an entirely different matter, and if you are concerned about the educational effects of further delaying reading, that too is a problem.

      Of course you are quite right that there has never been a randomized study in which some children were somehow prevented from crawling. The information we have comes from "natural experiments"-- for example, development in cultures that do not permit babies to crawl (e.g. traditional Bali), and development of children who because of physical handicaps never crawl or walk. In both these situations, reading develops along the lines typical among children who have crawling experience.

      I'll be interested to hear whether the exercises suggested turn out to be much like your "something ridiculous", which is in fact exactly the kind of thing that was recommended by Doman and Delcato way back when.

      As for body-mind-- if he couldn't hit a baseball, would you assume that he should practice reading more and that would help?

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  11. Jean, this whole thing is ridiculous. Crawling doesn't hurt anyone and at the least it offers muscle development. If a parent does it in a way where the kid feels embarrassed then the parent goes about things wrong and likely does many other things to embarrass the kid anyway. Why is there such a strong resistance to an exercise that doesn't take long and is totally safe? If some people feel there is benefit to something safe, free, and not time consuming, then scientific studies aren't the end-all be-all decision maker here. Also you mention controls being children in Bali and those with other physical handicaps. Well, these aren't very good controls because there are so many other variables between them and the kids we're discussing here.

    My son who is now 6, has a very high IQ and is reading at the middle school level, never creeped (off belly) but only crawled awkwardly (on belly). He didn't walk until he was 16 mos. Intellectually he's off the charts. But he couldn't hold a pencil until he was almost 5, couldn't alternate feet walking down stairs, has yet to develop handedness (both hands will draw completely different things at the same time), couldn't throw a ball until just recently, couldn't jump with both feet until he was 5, can't catch a ball, and can't skip or hula hoop or swing. Clearly, while his mind is advanced, he would struggle in school because of difficulty writing, cutting, doing any craft or project work, etc. He can't even coordinate his hands well enough to use a spoon or fork. I have been teaching him about the idea of a helping hand for a year now, but he still refuses. On the side, he is not autistic, but he has always displayed comorbid disorders: chewing, head banging, twirling, poor eye contact, repeating words, difficulty transitioning, mood swings, etc....

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  12. (Cont.)
    A year ago he went to an OT and PT. Standardized tests showed bilateral coordination disorder, sensory processing disorder of the vestibular and proprioceptive systems, and hand-eye issues. At first they thought he may have been dyspraxic. We commenced therapy 2-3x/wk. The therapy largely consisted of creeping, crab walking, and doing those movements while upright (like rock climbing). At that time he couldn't even do jumping jacks. They mentioned he was mildly hypotonic (something my pediatrician never noticed). So I began research to find out why.

    I also took him to a behavioral optometrist who found that while his vision was ok, his eyes weren't working together, causing issues with tracking and depth perception. His left eye was partially suppressed. So again, some type of bilateral coordination issue. So we planned to start vision therapy in several months and he got glasses. Then I took him to a behavioral audiologist who said his hearing was above average, but he struggled with hearing direction because the signals weren't crossing across his brain hemispheres efficiently. So again, issues with the two sides working together. (And none of them knew about the other therapies or diagnoses.)

    Here's what happened. After 4 months of combining occupational therapy with taking Efalex fish oil and having a few chiropractic adjustments (all alternative therapies), he completed what they expected would take him a full year. He tested again and was in the low normal range. So even without any other interventions, the crawling did wonders. By this time, he stopped the twirling, head banging, impulsivity, and repeating words.

    THEN we started vision therapy to get the eyes working together. By that time his vision had improved (due to the other therapy?) so that in a few months he no longer needed vision therapy or glasses (he was tested at Indiana University optometry as confirmation). His eyes were working together and his left eye was no longer suppressed. By this time he could hold a pencil and write some numbers, do jumping jacks, play soccer, alternate feet on stairs, make other milestones, and also exhibited much better balance (he used to fall over with a breeze).

    Then I pushed and pushed the pediatrician to refer him to a metabolic doctor to test for carnitine, as an ALTERNATIVE nutritionist said that he could be low, causing the hypotonia. The metabolic doctor tested him and... He was carnitine insufficient. She said this was causing the hypotonia. So he started supplementing, and now his hypotonia is diminishing. Most of his remaining autistic type behaviors have disappeared.

    Please note that while low carnitine could have been the problem all along, only 4 months of crawling-type therapy made a massive improvement. He enjoyed crawling so much that he still does it. I believe it improved his brain, not just his muscles, because of related changes in his visual coordination and behavior. But mostly, please note that ALL OF HIS IMPROVEMENT has come from alternative therapy. His pediatrician is a great doctor but he did nothing to help.

    You can look down on alternative, holistic therapy all you want, but it changed my son's life when the MD's did nothing. And I do mean multiple MD's as we have 8 in our close family, including his grandparents, and all of them said he was fine and nothing else could be done. He was living and breathing, so he was fine. Except he'd have serious struggles throughout his life and except that carnitine insufficiency can kill kids. Thank God for those crazy wacko alternative health practitioners who possibly saved my son's life!

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    1. Your point is well taken, that parents get to make the decisions about their children's treatment. I'd add that it's their obligation to do this well-- using the maximum available information. That's why I have posted material about the evidence basis (or lack thereof) of patterning and crawling treatments.

      I'm glad your son is doing better, but I must point out that you have no way of knowing whether the improvement was the result of these various alternative treatments, of maturation, or of some other experience. You are attributing the improvement to specific alternative treatments when in fact there is no way for you to know which, if any, of them did anything. I offered some weak comparison groups, but you are offering none at all.

      You mention that at age 5 he could not skip or do jumping jacks. This is hardly surprising, as most boys this age cannot make these coordinated movements. I understand that the other problems you mention are very real, but it does not make much sense to focus on "disabilities" that are characteristic of an age group-- perhaps that's one reason why your pediatrician did not pay much attention.

      By the way, of course all these alternative practitioners explained problems as due to poor communication between hemispheres, without knowing what the others had said. This is the explanation most of them give for everything.

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    2. None of them said he had poor communication between brain hemispheres. That was my own conclusion that I pondered after hearing about his eyes not working together well, his spatial hearing awareness being off, and his bilateral coordination being a struggle. Yes a lot of 5 year olds can't do jumping jacks very well, but he was literally falling on the floor when he tried. He took tests that lasted for days which compared him to the norm of his age group and he was well below average. His pediatrician didn't say anything because he saw the IQ tests and saw my son was growing on his curve and had never had a serious illness or even antibiotics, so in his training, he saw coordination issues as being no cause for concern. Except they led me to find out about his carnitine insufficiency, and he couldn't function well in school. It's one thing to be gifted, but another to be able to actually show what you know.

      The turn-around came in 4 months. True, this wasn't scientific research. It's just my sons story. But let's use our common sense, and look at it like this. In 5 1/2 years, after being in swim lessons for 5 years, and alternating martial arts and gymnastics and soccer, hitting a wall at a very low level in all of them but still going every week and not giving up, my gifted son with no apparent health issues still couldn't alternate feet as he walked downstairs and had to hold onto the handrail to go up or down. He couldn't feed himself with utensils, and showed absolutely zero differentiation between right and left hands. He couldn't pedal a tricycle. He couldn't write a letter or draw a circle, yet he was reading The Chronicles of Narnia. I am a teacher and my mother was an elementary teacher and my grandmother was a preschool teacher. I surrounded him with plenty of fine and gross motor skill stimulation. He also showed clear symptoms of Asperger's, which he didn't have.

      He started the OT in October, and by January, he could do all of the above, with the exception of only showing a slight preference for his left hand. His eyes, as tested by three optometrists total, were suddenly working together and he no longer needed glasses. He could tell which direction sound was coming from whereas he couldn't before.

      I don't need a scientific study to see the obvious. There were no other variables.

      Thank you for your thoughtful response and your well-intentioned work. I just think this article is missing the mark.

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    3. Jean, you need to update yourself on motor milestones and coordination milestones. you will fight to make your point hear until your blue in the face. You do not have me convinced. First....do you even work with children? You said "down syndrome babies.." and you lost me. Ignorant and selfish. These parents are giving you testimony and there is plenty of support and research for crawling and it's benefits. And there are no such things as down syndrome babies......they have names and the correct way to refer to a child or anyone with a different ability or a diagnosis is to say a baby diagnosed with down syndrome. It does not define the baby. Research that!

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    4. Can you be more specific about the empirical support for the benefits of crawling?

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  13. I once took a class in neuroscience and education. They showed how, going on a continuum of course, female brains tend to have stronger connections between brain hemispheres as relates to language, and therefore tend to process language in the context of multiple subjects more efficiently, leading to different learning styles than typical male brains have. Does it not make sense that there are other areas as well in which different people can have developed weaker or stronger connections between hemispheres, thus affecting their skills in that area? Couldn't nature and nurture, outside of biological sex, serve to strengthen those connections (or allow them to remain weak if pre-disposed to be so)? I don't see why this theory doesn't make sense.

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    1. Of course what you say is a possibility-- there are many possibilities/hypotheses. But the fact that you can think of a possible cause doesn't mean that that cause is in operation. You need to have empirical support in order to demonstrate that one thing causes another.

      The kind of information you were given in your education class stressed "learning styles"-- and there is no good support for those,either. You should read Daniel Willingham on this. He wrote some good pieces in American Educator several years ago.

      It's all too easy to let theory outrun evidence, and that's what has happened for both learning styles and interhemispheric connections. But even if it hadn't done this, there would still be no evidence that crawling shapes the brain, rather than vice-versa.

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  14. It was a neuroscience course that taught about topics that could be related to education. It wasn't an education course per se -- I wasn't an education major. It was a neuroscience course at Indiana University, taught by neuroscientists, so what they taught was likely scientifically valid.

    From http://www.medicaldaily.com/brain-facts-know-and-share-men-have-lower-percentage-gray-matter-women-292530:

    "...another team of researchers from the same university analyzed nearly 1,000 scans (428 males and 521 females between the ages of 8 and 22) and this study uncovered differences in brain circuitry across gray and white matter. Specifically, they found the brains of women show more connections running between the left and right hemispheres, while the brains of men show more connections between the front and back regions within each hemisphere. According to the researchers, the “results suggest that male brains are structured to facilitate connectivity between perception and coordinated action, whereas female brains are designed to facilitate communication between analytical and intuitive processing modes.”"

    Considering these differences in relation to my son, whose language skills are great but who had problems with perception and coordinated action (the white matter also relates to sensory input, which he struggled with), it appears his struggle could potentially relate to intra-hemispheric rather than inter-hemispheric weaknesses (white matter rather than gray matter). So if we look into how to strengthen white matter, certain body movements work:

    "Learning involves changes in strength of synapses, the connections between neurons in gray matter. But human brain imaging using magnetic resonance imaging (MRI) has revealed structural changes in white matter after learning complex tasks. This raises the question of whether white matter responds to experience in a manner that affects neuron function under normal circumstances, thereby affecting information processing and performance. There are a few intriguing observations related to this possibility. For example, structural changes in white matter correlate with the number of hours a professional musician practices (1). The greatest changes were seen in parts of the brain that were not yet fully myelinated. Similarly, adult subjects showed increased white matter structural organization in a brain region important for visuo-motor control 6 week after learning to juggle (2). And in a study of adults learning to read, the volume, anatomical organization, and functional connectivity of white matter tracts linking cortical regions important for reading were increased (3). Whether these changes in white matter structure affect neuron function directly by altering transmission of information required for acquiring a skill is not clear. However, the observations do show that learning a new skill is associated with altered white matter structure."
    (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3201847/)...

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  15. (Cont.)
    If juggling and playing piano could strengthen connections in white matter, then creeping, which stimulates both sides of the body as piano and juggling do, in addition to stimulating top-to-bottom halves of the body, could be a strong contender for strengthening white and gray matter as well -- at least in kids for whom creeping is a complex task. For us it may be simple, but while watching my son try to do it at first, I saw just how difficult it can be. Playing piano and juggling were way too far out of his zone, but creeping was something he could grasp at and eventually learn.

    My guess with my son is the low carnitine caused muscle weakness which led him to not creep or even move as much as other babies and toddlers did, which led to under-stimulation and therefore poorer connectivity in certain areas of the brain, which would explain why we saw improvements through therapy even before he started carnitine supplementation.

    Yes, you are right to point out that these are theories, not (at least yet) scientifically proven. But my point is that there is support for these theories, there are intelligent parents and adult patients who strongly believed creeping and related therapies benefitted them, and doing it at home is free, safe, and takes little time. At the very least it strengthens muscles (though with all we know about how movement and sports and play benefit the brain, it's hard to believe there's no mental benefit as well). So for a therapist to say "it's possible these types of coordinated body exercises could benefit you or your child," what's wrong with that? But if a therapist says, "don't pursue any other options, all you need to do is crawl and pay me $3,000," then yes there is a problem. But who does that? Certainly no one I've ever met. This is the issue I have with your article. It attacks something that actually could be beneficial for some patients, when really what needs to be discussed is the language we use when discussing or recommending this potential therapy. As my son's OT said, "you might want to try crawling and crab walking at home too. That might be good for him." But we certainly didn't put a big period after that and close our ears to the rest of the world.

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    1. The difficulty with everything you say here is that the fact that something could happen does not mean that it does happen. In addition, we have the problem that when two things occur together, that in itself does not give evidence that one of them caused the other-- e.g., if better brain functioning and motor activity go together, that does not demonstrate that the activity causes the improved brain functioning.

      So far, the American Academy of Pediatrics has twice passed resolutions rejecting the use of patterning and related exercise routines like crawling. They did this because the evidence does not show that these methods are effective.

      I might also point out that men's and women's brain functions have overlapping distributions, so evidence derived from those does not provide a very good foundation for thinking about how an individual brain works.

      You might also want to read my comments at http://childmyths.blogspot.com/2015/06/why-cant-they-tell-which-patient-will.html, about what needs to be known before this kind of individual decision can be made.

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  16. Ihave a PhD in behavioral neuroscience and I am trying to understand your example of - "The logic is this: activity of the left hemisphere causes the right hand to move, therefore the movement of the right hand causes activity in the LH. To put it more generally, this statement is that if A causes B, B causes A." Now if someone were moving another persons hand...then no there would be limited to no stimulation of the motor cortex. But if a baby is encouraged to move a hand, then yes cortical neurons in the motor area are being stimulated. And there are other complications- if someone is happy they smile, we know this. Motor neurons send an action potential to the orbicularis oris and many other muscles in smiling. However- research has also found that if you smile, your move improves. Their are all sorts of feedback mechanisms.

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  17. Sure, there are plenty of feedback mechanisms, and if people stated that the baby who crawls (or moves in any way) strengthens related neuromuscular connections, I would never deny this. The problem here is that crawling is claimed to change brain connections in ways that correct autism or other developmental problems, or that cure traumatic brain damage-- not only that crawling does this, but that no other movement pattern does. You must see the problem here-- we're not just talking about feedback for a particular neuromuscular connection, which could work well e.g. for a limb with peripheral nerve damage, but about a much broader effect on the brain and cognitive functioning.

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    1. In the article you allude that motor movement does not have an effect on the brain (that is like the moon jumping over the cow!). But, now, here deep in the comments you state that you would "never deny" that movement strengthens neuromuscular connections. So, are you saying that you believe that only the connection between muscle and nerve are strengthened and not the rest of the pathway to the brain? Otherwise, what is your basis for implying that the brain is unchanged by the experience of actively moving? I agree that no movement therapy is a cure for any medical diagnosis such as autism and that it is unethical to claim this. However, I do think you are essentially throwing the baby out with the bathwater in your original statement that the importance of crawling is a myth. You make it seem that anyone who incorporates crawling as an activity in their therapeutic treatment is wrong, even going so far as to say that crawling is "humiliating" and you would report someone who recommends it to the ethics committee without knowing the actuality of that person's whole treatment plan or therapeutic reasoning. When, from what I am gleaning from your above statement, it now appears that you are saying that anyone selling crawling as THE therapeutic treatment to CURE a medical diagnosis is wrong and unethical. If that is actually your position, I would agree, I just wish this was stated much more clearly in your original article.

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    2. If someone has trouble crawling, practicing crawling will help them crawl better. If they crawl poorly because of muscle weakness, crawling may help strengthen muscles and therefore help prepare the person for other movement abilities. But, if they already crawl and walk perfectly well, crawling practice is pointless and certainly will not solve unrelated problems like autism.

      If crawling is not an effective treatment for a problem, why recommend it at all, even as a part of a therapeutic program?

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  18. I am totally loving this blog and do very much agree with your statement of putting evidence over theory! There are so many theories around that seem to make sense (and especially when it comes to child development they are always mixed with so much emotional pressure), but if you ask for evidence you only hear anecdotes. Thanks for your effort!

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  19. I'm coming into this discussion months/years late only because a proponent (employee?) and gushing parent recently sent me a facebook message
    outlining the wondrous claims of the Family Hope Center.

    I immediately smelled the woo, and began searching the net for
    parental reviews and complaints regarding this outfit.

    In doing so, I discovered a very interesting pattern of "anonymous"
    posters all over the net who seem to jump in at a moment's notice to
    defend the FHC as soon as a whiff of suspicion is raised about it. I suspect
    these people (or bots?) are trying to use neuro linguistic programming as well,
    based on some of their tactics. The psychology behind some of their posts is
    very interesting indeed.

    As the parent of two autistic children and one
    who has, in the past been gullible and fallen prey to hope sellers,
    I wouldn't go near the FHC. Any company which cold calls parents off
    the internet to attend its very pricey seminars and treatment plans
    and does so with absolutely no evidence to back it up is of no interest
    to me.

    Let's all remember that this is the internet, and to you and me, it's simply
    words on a page. Anyone can present themselves as a parent who
    had wondrous success with the FHC. Those stories of success can be couched
    in a most seemingly intelligent and persuasive manner. But still, they are just words.
    You will never meet the writer of those words. I not above that still no evidence is forthcoming
    from the poster who valiantly argued her point. She was able to discuss biomedical interventions
    for autism (though carnitine use for autism has now been debunked). Thus, her words may sound
    plausible to the more proactive parents out there. Not this one though. Been there done that.
    Delacato method is bunkum. Left brain right brain is bunkum. Autism has no known etiology.
    If the Family Hope Center had any efficacy the world would be paying attention and they wouldn't
    have to rely on cold calls to faceless parents on the internet. It's laughable.

    It's the oldest trick in the book. Save yourself some money and turn on day time
    television and watch Christian born again tv. It's the same old tired stuff.

    Renee Lamothe
    Mom to 3

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    1. Thanks so much for this example and your comments! Perhaps readers will be open to this opinion from "one who has been there". I would like to point out how easy it can be to describe a mechanism that MIGHT cause an outcome, and imply that the existence of a mechanism is evidence for a treatment.But no, folks, we need evidence that the treatment DOES have the posited effect.

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