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com

Rhythmic Movement Therapy - Level One

y ADDADAH

On the other hand, babies who are not able to move enough due to low muscle tone or other
circumstances, have very low stimulation of their neocortex and frontal lobes, and become
lazy, hypoactive, disorganized and late developing.

mooQgs S møn*'•• years

Attention Deficit Due to Brain Maturation Relapse

As we have seen, experts believe that ADHD has a genetic origin. An alternative explanation could
be that it is a delayed process of brain maturation. For some reason the child's brain has not
received sufficient stimulation from the senses for the nerve networks to develop and the different
parts of the brain to connect.

This can be caused by many circumstances such as prematurity, brain problems caused during
birth, hereditary factors or diseases. Such factors could cause the baby to skip important steps in
motor development, thereby hindering motor development and brain maturation.

Lack of stimulation from the child's environment, in the tactile or vestibular senses or by
spending a lot of time in baby seats or strollers instead of moving on the floor will prevent the
brain from developing properly.

Similarities between Babies and Children with ADHD

Attention deficit hyperactivity disorder (ADD) is a common characteristic of infants and children
with ADHD. In both groups, there are many signs that the basal ganglia are not functioning properly,
such as difficulties regulating activity level, primitive reflexes, and balance problems. It is also quite
common for children with ADD to have little ability to make simple, smooth, rhythmic movements,
which indicates that the children's abilities are not functioning properly.
C Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDITDAH

The brain's nerve connections have not developed properly. Because the cerebellum is crucially
important for the frontal lobes to function, this impairment may be a major factor in attention and
impulse problems. Many children with ADHD have low muscle tone and a hunched posture, which
causes shallow breathing and insufficient excitation of the neocortex. These children alternate
between hyperactivity and passivity, with hyperactivity being a form of stimulation of the neocortex
through movement.

Rhythmic Movement Therapy

As has been said there are many similarities between babies and children with ADHD. in
behavior asinimmaturityof thebrain.

One has to wonder whether children with ADHD or ADD can improve by imitating the rhythmic
movements that babies make spontaneously. In fact, these movements have been used in Sweden
for more than 25 years.

TMR was developed by Kerstin Linde and is based on the natural rhythmic movements of the baby.
To be effective, these exercises should be done daily for 10-15 minutes. They can be done lying
down, sitting or on all fours.

The rhythmic whole body movements used in therapy are both active and passive. Passive
movements may be elicited by pushing the patient's body rhythmically from the feet with the
patient in the supine position or from the hips towards the head in the fetal position. With the
patient lying face down the bottom may be rocked rhythmically from side to side. In the supine
position the legs may be rocked passively with the aim of bringing the big toes together in the
middle.

These movements can also be done actively. In the supine position with the knees bent, push
off rhythmically from the feet or rotate the legs from the sides to the center so that the big toes
come together. In the prone position, the child rotates his bottom from side to side. Other
active movements include rocking on all fours and crawling.

Although these active and passive movements are valid for all cases, they can, however, be
ineffective. These movements should ideally be performed. In many disabled people, this is of
course impossible and it is a long-term goal to teach them to perform them more and more
accurately.

It is easy to see that these movements produce a great stimulation of several senses. The
head movements stimulate the sense of balance. The rhythmic push through the spine from
the feet or bottom stimulates proprioception in many joints and the internal organs and the
stomach. The rhythmic movements also stimulate the sense of touch of the skin organs
through the friction of the back with the floor.

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADD/ADHD

Effects of Rhythmic Movements on Behavior

Sensory stimulation caused by rhythmic movements in turn stimulates the nervous network of
the brain stem, cerebellum, basal ganglia and neocortex, allowing them to develop. This
improves attention and concentration and decreases impulsivity and hyperactivity.

The rhythmic movements also increase the tone of the extensor muscles of the back and keep the
head in a correct position. Posture, breathing and endurance will improve and the neocortex will
boost stimulation via the brain stem, which will improve attention and concentration.

Synchronous movement therapy will stimulate the cerebellum and nerve parts of the
prefrontal cortex, which will also improve attention and decrease impulsivity.
Rhythmic therapy also stimulates the basal ganglia and helps to mature and integrate primitive
reflexes, which will facilitate children's ability to regulate their activity level and be able to remain
still.

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDITDAH

The Nervous Chassis and Rhythmic Movements

Effect of TMR on the Fish Brain (Nervous System)

The nervous system develops in the fetus and must function properly for the baby to survive at
birth. The nervous system is formed by the brain stem and the midbrain (mesencephalon) and
evolutionarily corresponds to the brain of a fish.
The fish brain receives signals from the senses of balance, touch, kinesthesia and vision and
from the internal organs and responds to the motor organs so that the fish moves in search
of food and avoids danger. Respiration, heart rate and other vital functions also depend on
the fish brain.
As the fetal brain stem and midbrain gradually begin to function during pregnancy, motor
functions also appear. These in the fetus depend on primitive reflexes and are controlled from
the chassis. The fetus moves nimbly in the womb and is able to suck its thumb and play with the
umbilical cord in times of stress. As soon as it is born, the baby loses these abilities and moves
more or less like a fish on land, making slow movements with its head, trunk and upper limbs.
However, in water it is still a good swimmer.

The newborn is faced with the task of reprogramming his kinesthetic sense in order to be able to
control his motor organs and move freely on the ground. This reprogramming is done with the
rhythmic movements of the baby.

Brain Stem and Muscle Tone

All of the senses except smell send sensory signals to specific areas of the brain stem called
nerve nuclei. These nuclei process information from the senses, integrate it with information
from the other senses, and send it to higher levels of the brain. The vestibular nuclei, which
receive signals not only from the balance sense but also from other senses such as touch and
kinesthesia, are particularly important for muscle tone. If there is not enough stimulation of the
brain stem from the touch, kinesthesia, and balance senses, the result will be low muscle tone
of the extensor muscles of the body.
Therefore it is vital touch, hug, rock the baby and let him move freely
in their environment. This stimulation sends signals from the organs of touch, balance and
kinesthesia to the vestibular nuclei. The lack of this stimulation in the baby can produce low
muscle tone and difficulties in lifting the head and chest and moving around, also reducing the
stimulation from the senses of touch, balance and kinesthesia, ending in a vicious cycle.

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDrrDAH

Because of muscle weakness, the child may have trouble holding his or her head up and
standing up straight. The joints and especially the spine of these children are often
hyperflexible. Because of the hunched posture, breathing is shallow. The child may not want
to move and prefers to remain seated.
Many of these children will have attention problems due to a malfunction of the cerebral cortex
and will be diagnosed with ADD when they grow up. The very sensitive spine and joints make it
more difficult for them to breathe and maintain a proper posture.

TNR will gradually normalize muscle tone and joint hyperflexibility.

The Brain Stem and the Reticular Activating System

The central part of the brain stem is made up primarily of a dense network of nerves, the Reticular
Activating System, RAS. This system of nerve cells receives signals from the senses of sight, hearing,
and balance, from the sensory organs of the muscles, joints, and internal organs (the proprioceptive
sense), and from touch, and transmits the information to the cortex. The effect of these signals is to
excite the cortex, which is necessary to maintain attention and alertness. Without such excitation, the
cortex cannot be aware of external events.

Experience with MRT indicates that a consistent loss of sensitivity from the senses of touch,
balance, and proprioception results in a lack of attention and alertness that will be quickly remedied
by rhythmic stimulation. Children with low muscle tone and a slouched posture will develop ADD
without hyperactivity. In extreme cases, children with very low muscle tone who are unable to move
around may gain so little arousal that they are unable to maintain awareness of external stimuli and
instead have daydreams or even hallucinations.

To diencephalon
and cerebrum

Mesencephalon
Substance niya

(;igantoceUular
nucleus of rcticu To cerebellum
formation

Locus ceruleus
Pons

Medull
THC raphe nucleus

To Cord

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDÆDAH

Primitive Reflexes in Babies

The motor activityof the fetus dependsof the primitive reflexes. Thesearemovements
Stereotyped automatic reflexes controlled by the brain stem or midbrain. These reflexes develop at
different stages of pregnancy and may eventually be inhibited by the basal ganglia and integrated
into the overall movements of the baby. By making rhythmic movements of the baby, the baby
inhibits and integrates these reflexes one after the other.

Primitive reflexes are elicited by the most important sensory stimulation from the senses of balance,
touch and kinesthesia. One of the reflexes that develops earliest is the Tonic Labyrinthine Reflex
(TLR). When the fetus's head bends forward, the spine and limbs also bend. Later, at birth, when the
baby tilts its head back, the posterior TLR develops and the baby stretches its body.

When the fetus turns its head from side to side, the kinesthetic receptor organs in the neck will be
stimulated, causing the Tonic Asymmetric Neck Reflex (TACR). This occurs after 18-20 weeks of
gestation, causing the fetus to stretch its arm and leg on the same side as it is turning. The mother
then notices that the baby begins to kick.

The evolution of the Automatic Stepping Reflex in walking can illustrate the role that brain maturity
plays in the development of our motor skills. The fetus begins to make walking movements very
early, even before the brain stem and spinal cord have connected. These stepping movements are
controlled by the spinal cord. At 37 weeks of pregnancy, the Automatic Stepping Reflex develops.
This reflex is controlled from the midbrain level and is active at birth. It can be elicited by holding
the baby under the arms and putting the baby in an upright position, allowing the baby's feet to
touch a smooth surface. The baby then begins to take steps automatically.

When the baby is 3 or 4 months old, this reflex is inhibited and may never be elicited again. When
the baby learns to sit and control his weight, he will transform this reflex into the walking reflex, a
postural reflex controlled by the basal ganglia.

The Importance of the Maturity of Primitive Reflexes

If the baby cannot inhibit his primitive reflexes in time, his motor development will be delayed and
made more difficult, thus hindering the maturation of his brain.

A child whose primitive reflexes have not developed and matured well at birth will have more
difficulty inhibiting them in due time than a baby whose reflexes are fully mature. This is especially
true in cases of premature babies and those born by Caesarean section.
In premature babies, several primitive reflexes have not yet developed at birth. In an incubator,
the baby does not get tactile, kinesthetic and balance stimulation as in the maffiz.
The Dr.Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDITDAH

This will delay the maturation of primitive reflexes. If, on the other hand, the mother carries
the premature child in her arms, he will receive stimulation similar to that of the uterus, which
will produce the maturation and integration of primitive reflexes, improve muscle tone and
help the connection between the different levels of the brain.
Nowadays, many babies are born by Caesarean section, missing the normal process of
childbirth. During the birth process, the baby's primitive reflexes are activated, which is
important for its maturity. Premature babies and babies born by Caesarean section run a
significant risk of maintaining their reflexes in adult life and acquiring motor skills, attention and
concentration problems, and learning problems due to incomplete brain maturation.

Rhythmic Movements to Stimulate the Nervous Chassis

The fetus receives sensory stimulation from the mother's breathing, heart rate, and movements.
This passive stimulation affects the fetus's senses of touch, balance, and proprioception and
stimulates the growth and maturation of nerve cells in the neural tube. All of these stimuli also
provide maturation to other parts of the brain.
In addition, when primitive reflexes are triggered in the fetus, the motor response produces
stimulation in the nervous system. Another source of sensory stimulation is all the movements that
the fetus can make on its own, such as turning its head from side to side, sucking its thumb, playing
with the umbilical cord, etc. Playing with the umbilical cord will cause proprioceptive stimulation,
which has a calming effect on the fetus.
Passive rhythmic movements are especially useful in exciting the nervous system in infants and
also in brain-injured children who are neurologically still at the infant level. Passive rocking in
various ways stimulates the nervous system by improving muscle tone, maturing primitive reflexes,
and stimulating spontaneous movements. Where an infant is developing slowly and does not
progress easily from one stage of development to another, this stimulation may speed up
development, for example in children who cannot lift their head or begin to crawl.
In a severely brain-injured child who has to hold his head to one side, passive acoustic stimulation
may cause him to turn his head to one side as a reflex.

Mobile\Clothes to Stimulate the Nervous Chassis

A Below is a list of movements that can be used to stimulate the chassis in babies, children and adults.
These movements are described further on in the manual.

1. Passive rhythmic stimulation from the feet in a supine position (M6v.1- Pg. 6)
2. Passive stimulation from the knees in the supine position (M6v. 2 - Pg 7)
3. Passive stimulation from the hip in fetal position. (M6v. 3 - Pg 8)
4. Passively roll the buttocks into a prone position. (M6v. 4 - Pg 9)
5. Rotation of the head from side to side. (Mov. 6 - Pg 11)

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADDITDAH

Cerebellum and rhythmic movements

The Function of the Cerebellum

During evolution the cerebellum develops as a bulge in the brain stem with strong connections
to the vestibular and other brain stem nuclei. The cerebellum also has strong connections to the
motor cortex and plays a fundamental role in the coordination of motor activity.

The function of the cerebellum is an extension of the function of the vestibular nuclei, i.e. the
processing and coordination of all kinds of sensory impressions, especially the balance and
kinesthetic senses. Together with the forebrain the cerebellum correlates postural and
kinesthetic information and makes movements smooth, easy and coordinated by correcting
deviations between planned and executed movement.
During the second half of the first year of life, there is rapid growth of the cerebellum
coinciding with the rapid development of the baby's movements. The baby's rhythmic
movements stimulate the maturation of the cerebellar nerve network.

Cerebellar Dysfunction in Learning and Attention Difficulties

Some children may have great difficulty in making simple rhythmic movements in a
coordinated manner. This inability is often not noticeable when the child is moving in an
upright position and so often goes unnoticed. These children may be unable to do these
movements actively. For example, rolling from side to side (movement 8) or actively sliding on
the back (movement 6) may be very difficult for some children to learn. This inability may
indicate a dysfunction of the cerebellum which affects the function of many other parts of the
brain, especially the cortex and many areas of achievement. It may affect attention, planning,
judgment, impulse control and abstract thinking. It may affect eye movements, reading
comprehension, information processing speed, working memory, learning and speech
development.

The large effect of the cerebellum on all these functions can be explained by the strong
connections between the cerebellum and those areas of the neocortex essential for these skills.
These connections exist between the cerebellum and the prefrontal cortex, responsible for
attention, planning, judgment and impulse control; between the cerebellum and the language
areas of Wernicke and Broca; and between the cerebellum and the area of the frontal lobes
responsible for eye tracking movements. When these areas do not have sufficient stimulation
from the cerebellum, their neural networks do not develop properly, which explains their poor
functioning.

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADD/ADHD

The Importance of Improving Cerebellar Function with Rhythmic Therapy

The large impact on attention, concentration, impulse control, abstract thinking, judgment,
and learning that we often see in RMT can be explained by several factors such as enhanced
excitation of the cortex or increased stimulation of different areas of the cortex via the
cerebellum. However, children who have difficulty making smooth, rhythmic movements due
to cerebellar dysfunction do not benefit as much from these movements as children without
such difficulties.

It is therefore all the more important to teach these children to do the movements rhythmically.
Some of them learn quickly in a month or so, but others may need to practice daily for more
than a year to be able to do the movements smoothly, rhythmically and effortlessly. Even then
they will tend to lose the rhythm when they are tired.

The rhythmic movements, performed in an active way, are the most important to remedy
cerebellar dysfunction. In addition, these movements have other effects such as the integration
of primitive reflexes into lifelong postural reflexes, especially in children. These movements also
collaborate in the connection of different parts of the brain, such as stimulating the growth of
neuronal networks essential for the excitation of the cortex and the stimulation of different areas
of the cortex by the cerebellum. All these effects are the main ones to solve attention problems
and learning difficulties.

It takes time to rebuild the brain in this way and therefore continuous, daily stimulation with these
movements is needed for quite some time, usually a year or more to completely resolve attention
problems and learning difficulties.

Movements to Stimulate the Cerebellum

The following are the movementsimportant used to stimulate the cerebellum. The movements are
described below.

1. Sliding on the back (M6v. 7 - Pg 12)

2. Rotation of the legs bringing the big toes together in the centre. (The windshield wiper) (M6v. 8 - Pg
13)
3. Roll your bottom from side to side. (M6v.. 9 - Pg 14)
4. Balance the body longitudinally in a prone position (M6v.10- Pg 15)

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Dr. Harald Blomberg
 Rhythmic Movement Therapy - Level One
TMR and ADD/ADHD

The Reptilian Brain or Basal Ganglia, Integration of Reflexes and

Rhythmic Movements

Functions of the Basal Ganglia

The reptilian brain is the part of the brain that has developed in reptiles. In reptiles this part has
no demonstrable importance for motor development. In reptiles this part of the brain controls
social interaction which is characterized by rituals, routines and submission to a strict
hierarchy.
In human rituals, too, routines and dominance hierarchies are controlled by the reptilian brain, or
basal ganglia, as this part of the human brain is called. But these behaviors are not as important for
humans as they are for reptiles. As often happens during evolution, a new function develops on top
of an old structure. The main task of the basal ganglia in mammals and humans has been modified
to control motor activity in close cooperation with the motor cortex.
Basal Ganglia

Concx Caudate

Nucleus
Putorren , rt;damus

Gobus
Subthalamic SPallidus
•subslantla Hypolholamus

Postural Reflexes

The motor activity of newborns is controlled by primitive reflexes and is outside of voluntary
control. In order to be able to control their organs voluntarily in the gravitational field, the baby must
inhibit its primitive reflexes and develop new lifelong postural reflex patterns that are controlled
from the basal ganglia. When the baby makes its movements, the baby is able to control its organs
voluntarily in the gravitational field.
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Dr. Harald Blomberg