JOURNAL OF THE NATIONAL ACADEMY FOR CHILD DEVELOPMENT
1987, Volume 7, No. 1
Learning Disabilities and Organization
Robert J. Doman, Jr.
The term "neurological organization"
means that the brain can take in and store information in
an orderly and "organized" fashion. A child lacking
in complete neurological organization is to some degree neurologically
dysorganized. To a large extent, this is an environmental
or inherited problem as opposed to the organic dysorganization
found in a child suffering from a brain injury.
The first step in detecting neurological
dysorganization is to evaluate the child against the developmental
profile and to have him tested to rule out the possibility
of an organic problem.
NACD's evaluation of these children
begins by determining the organization at the brain level
of the pons. This is ascertained while viewing the child's
ability to crawl on his stomach. The child should be able
to crawl on his stomach in what is termed a "cross pattern"
without receiving specific instruction. Cross-pattern crawling
is forward movement where the child extends his right arm
and pulls up his left leg, pushing and pulling with the right
arm and left leg. He then alternates his movement so that
he is pushing and pulling with the left arm and right leg.
If the child crawls in what is called a homolateral pattern
(which is pushing and pulling with the right arm and right
leg, and then the left arm and left leg) he is exhibiting
a degree of dysorganization at that level. If the child crawls
without a pattern or in a manner where he is extending both
arms forward and pulling both legs up, he is also reflecting
dysorganization in the pons area of the brain.
Advancing to the mid-brain, organization
or dysorganization can be assessed by examining the child's
ability to creep on his hands and knees. Remember, you crawl
before you creep. Crawling is on the stomach, and creeping
is on the hands and knees. The child should also creep in
a cross pattern. Properly, the child's hands should be extended
flat on the floor with fingers pointing forward. Ideally,
the child should be looking forward at the extended hand.
Again, if the child creeps in a homologous (bunny hop) or
a homolateral pattern (right arm and right leg) he is exhibiting
a degree of dysorganization. In assessing your child's ability
to creep, it is necessary that you have him creep at various
speeds, with varied amounts of starting and stopping. A child
properly organized at this level should never go into the
homolateral pattern or homologous pattern.
Progressing up into the lower cortex
area of the brain, you may evaluate organization by viewing
the child's ability to walk. Instruct the child to walk across
the room while he points at his feet, and assess whether he
is walking in a homolateral pattern or a cross pattern. You
may wish to demonstrate to the child what you intend him to
do, then have him mimic your actions. Have the child follow
your instructions while starting and stopping his movement
several times. Any hesitation he displays about which hand
to point is an indication of dysorganization. He should be
pointing opposite hand to opposite foot, and should not walk
in a homolateral pattern. There are many children who lack
this cross-pattern function, and they reflect coordination
problems to a certain extent. Coordinated gross motor action
culminates in a cross pattern whether it's bowling, doing
a basketball lay-up, or throwing a baseball pitch. A child
who lacks complete organization will display a loss of coordination
to some degree. Interestingly, there is the rare child who
is neurologically dysorganized but has good coordination.
Such children generally have other inefficiencies, particularly
mixed dominance.
Neurological organization culminates
at the top cortical level of the brain. This organization
is the establishment of cortical-hemispheric dominance. This
is the establishment of a dominant hemisphere, or side. A
completely organized child should be right-handed, right-footed,
right-eared, and right-eyed, or left-handed, left-footed,
and so on.
To assess your child's dominance, begin
by evaluating the function of his hands. You can find out
if he has a dominant hand, as this will be the hand he writes
with, throws a ball with, etc. These functions should all
be done with the same hand. If a child writes with one hand
and throws a ball with the opposite hand, he obviously is
displaying mixed dominance. Assessment of foot dominance is
essentially done by using the same method, observing which
foot the child kicks with, hops with, etc.
To assess auditory dominance, have
the child put his ear next to the door and attempt to listen
to conversation that is emanating from the other side. Speak
very softly so that the child leans toward you. The child
will turn his head to either the right or left so that the
dominant ear is closest to the source of the sound.
Assessment of visual dominance is
accomplished at what is called near point and far point, using
vision as close as three feet and at a further distance. To
assess the child at a distance, have him point his finger
toward your finger while you extend your arm and point your
finger toward the child. If you sight along your finger to
his finger, you can find out which eye he is using. You may
wish to have him alternate his extended arm from right to
left to double check your findings. Also have the child look
into a telescope or kaleidoscope, as he will invariably use
the dominant eye.
At near point place a one-eighth inch
dot on a piece of paper and put another paper with a one-eighth
inch hole in the center on top. Line up the hole with the
dot so that the child can see the dot by looking through the
hole on the top piece of paper. Have the child grasp the paper
with the hole in both hands and slowly move the paper up to
his eye, watching the dot the entire time. Again, watch which
eye the child brings the paper to, as it will invariably be
the dominant eye.
A completely organized child will have
a dominant hand, foot, ear, and eye, which will be all on
the same side. If the child lacks complete dominance in any
area or does not exhibit dominance on the same side, it's
a reflection of a degree of neurological dysorganization.
If the child lacks a controlling hemisphere
of the brain organization is lacking because the influx of
information to the brain is not occurring correctly. For instance,
a child may take visual information through his right eye
and store it in his left hemisphere. When a child neglects
to take in information from one side and place it in one hemisphere
he is not establishing firm pathways into the brain. The child
cannot efficiently process that information. You might view
the dysorganization as a room filled with filing cabinets.
If he is properly organized all of the files are in alphabetical
order and he can place a piece of information in and extract
it efficiently. A dysorganized child's files are not alphabetized,
and he may absorb the information but when he attempts to
retrieve it he may be unable to do so. These children are
classically the ones who study for a test one night, only
to fail when they go in to take it. They took in the information
but lost it when they attempted to retrieve it. When you place
these children under any type of stress, the system immediately
begins falling apart, and their function diminishes. Often
these children neglect to remember a homework assignment from
the previous night, yet they can remember what color dress
mother wore on Christmas two years previously. These individuals
are not lacking innate intelligence. They just cannot properly
take in information, assimilate it, process it, and bring
it back out again.
The National Academy for Child Development
offers a six-hour parent training seminar on cassette that
explains in detail how children develop neurological organization
and how they learn. The Academy also provides neurological
evaluations for children and programs to improve their neurological
organization. For more information on the tapes and the evaluations,
parents may call.
Reprinted from the Journal
of the National
Academy for Child Development
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