Meaning Comes From Movement

Sensory and Movement Differences are both a Cause and a Consequence of ASD

This is the first in a planned series of blogs on a variety of topics around child development with particular importance to practitioners, parents and others who may be interested in the distillation of information from current scientific thinking. This first blog concentrates on Meaning from Movement or the crucial necessity of intentional sensorimotor activity on the perceptual, cognitive and emotional development of the child. Many of the quoted papers are from leading research contributors to a special issue of the journal: Frontiers in Integrative Neuroscience, January 2013, on the subject of “The Movement Perspective”. Others are by leading researchers in the fields of neurobiology, computational neuroscience and developmental psychobiology. They support the role of discovery learning in typical development and suggest the need for a sensorimotor intervention when there is a primary deficit in sensorimotor intentionality.

Walter Solomon MA (Cantab) Parent, Author and Practitioner

September 2015
Click here to view Part 1.

Part 1 Movement is No Longer a Cinderella

In 1985 Geoffrey Waldon began to “set [my] ideas down as a scientific theory, stating my definitions and axioms, and formulating testable hypotheses. In the first instance, I intend to do this in the form of five essays each of which, whilst being in some sense complete of itself, is meant to be read in conjunction with the others”.

His third (uncompleted) essay Movement and Sensibility:  Tolerance and Constraint – The Creation Of Perceptual Pattern – started as follows:

“The present paper [Meaning from Movement] is concerned with the forces which bring into being the highly improbable patterns from which the world of the human observer, indeed the identity of the observer himself, is created and which, despite their individual isolation, is nevertheless shared by all humans as the basis of understanding.”

Piaget had previously written in: The Psychology of the Child  (Basic Books, 1969 p. 28)

“the sensory-motor structures constitute the source of the later operations of thought. This means that intelligence proceeds from action as a whole, in that it transforms objects and reality, and that knowledge whose formation can be traced in the child, is essentially an active and operatory assimilation.”

The Cinderella of Psychology – The Neglect of Motor Control in the Science of Mental Life and Behavior American Psychologist May-June 2005 Vol. 60 No. 4 pp 308-317

David Rosenbaum Ph.D. is Distinguished Professor of Psychology at Pennsylvania State University:-
“The role of movement in the development in the child was substantially ignored until the last twenty or so years. In his paper David Rosenbaum tried to explain the reasons for this neglect. He set out several hypotheses before dismissing or interpreting them.”

The No-Celebrity Hypothesis:   “One possibility is that no famous psychologists have studied motor control. This hypothesis is worth considering because luminaries attract acolytes, and if no psychologists of note have studied movement, it stands to reason that few psychologists, famous or otherwise, have gravitated to this topic.”

The Only-Human Hypothesis:  “Another hypothesis is that psychologists—and especially cognitive psychologists—are mainly interested in human mental life and behavior. Motor control is not very interesting, according to the only-human hypothesis, because the way humans move does not seem very different from the way animals move. Thought and language are what distinguish humans from animals. Consequently, if a cognitive psychology textbook discusses any form of motor control in detail, it is usually speech production.”

The Dumb-Jock Hypothesis:  “Another possible reason for the neglect of motor control in psychology is that motor activity does not appear to reflect much intelligence. According to the dumb-jock hypothesis, one does not have to be highly intelligent, as measured by IQ tests, to move well. Hence motor control is not very interesting.”

The Too-Hard-to-Study Hypothesis:  “Perhaps motor control is the Cinderella of psychology because it is too hard to study. This hypothesis has been publicized by at least two notable contributors to behavioral and neural science. Donald Broadbent (1993), a pioneer in applied and experimental psychology, wrote that motor performance has always been a neglected and deprived area of psychology. There are technical reasons for that; it is much harder to control what a person does than what stimulates them, and therefore harder to produce scientific laws of the type ‘A is followed by B.’ (p. 864)”

The Think-Before-You-Act Hypothesis:  “All the hypotheses considered so far were ones I raised and then dismissed. Now I consider three hypotheses that strike me as more viable. The first is the think-before-you-act hypothesis. The idea is that the core question in cognitive psychology—what is knowledge?—is not one that naturally inspires work on the question, How do people move? Scientific psychology originated in philosophy, many of whose long-standing questions had to do with epistemology: How do people come to know the world? Can people know the world as it really is or only as they imagine it? And so on.

Inheriting these concerns, psychologists were naturally inclined to investigate the topics listed in most cognitive psychology textbooks today: perception, attention, learning, and memory. Reasoning, decision making, and problem solving also fit in because they may illuminate how and what people learn.”

The Baby-With-the-Bathwater Hypothesis:   “I turn now to the penultimate hypothesis concerning psychology’s neglect of action—the baby-with-the-bathwater hypothesis. According to this hypothesis, when mainstream psychology rejected behaviorism—an approach that treated the response as the only admissible source of psychological data—it eschewed response measures more sweepingly than would have occurred otherwise. The study of motor control was guilty by association. Motor behavior was associated with mindlessness, and a mindless response-centered program of research was anathema to psychologists basking in the glow of cognitivism.”

The Neuroscientists-Have-It-Covered Hypothesis:  “The final viable hypothesis about the cause of psychology’s neglect of motor control is that motor control has long been a forte of neuroscience. Why study a topic when another group of researchers handles it well?”

“My aim,” Rosenbaum concludes, – “has been to point out that motor control, which one may argue lies at the heart of the science of mental life and behavior because it joins the two, has had a surprisingly modest presence in psychology. The reasons, I have suggested, are intellectual and economic. Intellectually, psychology grew out of philosophy, where questions of knowing were taken to be quintessential to epistemology. Only recently have psychologists come to appreciate that acting and knowing are inseparable (Carlson, 1997), and only recently have psychologists come to appreciate that purposeful movement helps initiate or sustain perception–action cycles rather than just being a response to input. Economically, psychologists have been inclined to work on problems for which they were especially well equipped. Thus, motor control, long a jewel in the crown of neuroscience, became less attractive than other topics for which psychologists felt they could make more distinctive contributions.

Will psychologists pay more attention to motor control in the future? There are reasons to think they will. One is that the division between neuroscience and psychology is blurring. Neuroscientists are becoming more interested in the insights that psychologists can provide and vice versa. As more neuroscientists identify with psychologists and as more psychologists identify with neuroscientists, motor control is becoming an interdisciplinary topic to which psychologists are being invited.”

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Part 2 The Revival of Movement Studies: Esther Thelen and the Dynamic Systems Approach to Child Development

Esther Thelen (2000) International Journal of Behavioural Development 24: pp. 385-397

Esther Thelen was an expert in the field of developmental psychology. She was President of the Society for Research in Child Development and the International Society for Infant Studies. She was a Fellow of the American Association for the Advancement of Science and American Psychological Society: –

“Movement itself is a form of perception because the proprioceptive and haptic senses are continuously receiving information that is perfectly coupled with information from the external senses such as vision and hearing. Thus movement is an integral part of the ensemble of all our experience”. “After more than two decades of extraordinary theoretical and empirical contributions to our understanding of development, the study of motor systems had declined by 1950 and then lay dormant for nearly 30 years afterwards”. “Piaget’s theory of mental development was entirely grounded in perception-action, later interpreters were more interested in the contents of mind than its sensory-motor origins.”

Linda B. Smith Department of Psychology, Indiana University, Bloomington, IN, USA smith4@indiana.edu

Dr. Linda B Smith is Distinguished Professor and Chancellor’s Professor of Psychological and Brain Sciences at the University of Indiana:-

Traditional theories of intelligence and its development concentrated on symbolic reasoning, paying little attention to the body and to the ways intelligence affects and is affected by the physical world. Esther Thelen (1941–2004) was a maverick who argued against that traditional view for the idea that intelligence is both made in and realized through physical actions on the world. This once singular position is now known as the embodiment hypothesis and has become a major organizing theme in contemporary cognitive science, neuroscience, and development (see, for example, Smith and Gasser 2005).

Thelen, a professor of psychology, first at the University of Missouri and then at Indiana University, was never a traditionalist. She received her BS degree in zoology from the University of Wisconsin and her PhD in biological sciences from the University of Missouri, bringing the methods of whole-organism biology to human infants. Her dissertation focused on patterned movements—movements that repeat themselves over and over in a certain rhythmical way.  Her idea, the seed of her later developed dynamics systems theory, was that shifts in the variability of behaviors marked developmental transitions.

Initially, behavior is highly variable and disorganized; as it becomes organized, it is often highly controlled and inappropriately perseverative; truly skilled action is both stable and adaptively flexible.  Building on these ideas, Thelen founded a program of research on motor development that grew to become a major influence in developmental psychology, cognitive science, and physical therapy.  As a consequence of her field-changing discoveries and theories, she received many of the highest honors the field has to offer, held many national leadership posts, and was continuously funded by the National Institutes of Mental Health since 1987.

 

Thelen, (see Thelen and Smith 1994), envisioned cognition as embedded in, distributed across, and inseparable from the processes of perception and action. Cognition is situated within the same continuous, time-based, and nonlinear processes as those involved in bodily movement, and in the large-scale processes in the nervous system. Action is the Source of Developmental Change. Thelen (1994) asked: How can a learner who does not know what there is to learn manage to learn anyway? This is a more difficult question than might first appear. The issue is whether one needs to pre-specify the learning tasks and the learning goals, whether the baby has to know what needs to be learned in order to learn. Thelen showed us the way out of this quandary by demonstrating how babies can discover both the tasks to be learned and the solution to those tasks through exploration.  Spontaneous movement creates both tasks and opportunities for learning.  Young mammals—including children—spend a lot of time in behavior with no apparent goal.  They move, they jiggle, they run around, they bounce things and throw them, and generally abuse them in ways that seem, to mature minds, to have no good use. Thelen showed us how this sort of behavior is essential to the developmental process. It is our reason for being—to physically interact in a physical world. According to Thelen, the processes that give rise to motor behavior are also the repository of knowledge and the driver of developmental change.

As phenomenon, they also provide the key to the nested dynamics of human development.  The processes that make movement happen over multiple time scales. Neural excitation, for example, happens in milliseconds. Reaction times are of the order of hundreds of milliseconds. People learn skills after hours, days, and months of practice. What we call “developmental change”—transitions from crawling to walking—occurs over weeks, months, and years.

John P. Spencer, Daniela Corbetta, Patricia Buchanan, Melissa Clearfield, Beverly Ulrich and Gregor Schoner: Moving Toward a Grand Theory of Development: In Memory of Esther Thelen.  Child Development, November/December 2006, Volume 77, Number 6, Pages 1521–1538

The authors were colleagues of Esther Thelen who wrote this paper in memory of her after her death at a high point in her career:-

Thelen discovered that actions that were repeated impacted subsequent behavior even if the link between past and present behaviors was not transparent (Thelen & Farish, 1977). This pushed her to focus on process, on how and why these behaviors emerged and changed.  She discovered that these simple, repetitive behaviors not only provide a window for researchers interested in studying motor control, but also pro- vide infants with opportunities to become active participants in their own learning. This theme clearly resonated with researchers studying child development.

From a Classical to a Systems View of Infant Reaching

Before Esther’s work, the development of infant reaching was thought to occur in two phases that all infants traversed in a similar fashion (see Bushnell, 1985, for review). In a first developmental phase beginning at about 3 or 4 months of age, infants’ reaches were characterized by very discontinuous, zigzagging trajectories. In a second phase appearing around 8 months of age, infants began to reach for toys following a more direct path. The classic account of these two developmental phases focused almost entirely on visual control of reaching. During the first phase called the visually guided reaching phase it was assumed that infants’ discontinuous trajectories reflected their continuous effort to monitor and visually control the hand trajectory.

In the second phase called the visually elicited reaching phase infants could look at the target, anticipate an appropriate hand trajectory, and move their hand to the target using a fairly straight path without visual monitoring.  Esther’s work on infant reaching challenged this view of development in two key ways. First, Esther objected to the heavy emphasis on visual control in earlier accounts. By her view, the development of reaching did not reflect changes in a single factor; rather, she saw infant reaching as emergent from the assembly of many components. To reach out and grab an object, infants need to be motivated. They need to be able to localize the object in three-dimensional (3-D) space. They need to understand whether the object is reachable, and they need to transduce the perceived 3-D space into their body space. They need to be able to plan ahead and anticipate how the trajectory will unfold. They need to be able to correct their movements online as their hand approaches the toy. They need to be able to lift and stabilize the arm as they reach while maintaining the stability of the head and the trunk. And, they need to remember what works in context and distinguish this from what does not work.

Although vision is certainly involved in some of these challenges, vision alone cannot account for how infants learn to reach given these many interacting factors. The challenge, then, is to understand how infants manage to assemble all these factors to perform a successful reach.

In addition to showing that infants follow their own unique trajectories, this study of infant reaching revealed that exploration and selection is a key agent of developmental change. To improve over time, each infant experienced and explored a wide range of movements, ultimately leading to the discovery and selection of an optimal way to assemble the many components involved in a reach.

We want to highlight three points about these data. First, goal-oriented reaches were always embedded within a movement context that showed very similar kinematic characteristics. For instance, changes in the velocity of infants’ reaches over the first year paralleled changes in the velocity of infants’ non reaching movements Thus, when infants were more active as reflected in periods of higher average speeds in non reaching movements, reaches were also performed with higher movement speeds.  Likewise, when infants were less active as reflected in periods of lower average speeds, their reaches were also slower.

Second, the graphs illustrate the concepts of exploration and selection. Exploration is reflected in an early phase from reach onset to about 30 – 36 weeks, where all the speed and trajectory parameters fluctuate up and down and show unstable and changing curves. In this phase, infants explored a wide range of movement parameters and movement solutions. They tried fast and slow movements, learning the effect of these varied speeds on their ability to acquire the toy (see Thelen et al., 1996). This exploration generated crucial sensory-motor experience needed to learn to calibrate movements and feel the boundaries of control within the reaching task. This resulted in selection during a second phase from 30 to 36 weeks through the end of the first year. In this phase, movement parameters settled near particular values and showed much more stability over time as infants discovered, for instance, an optimal reaching speed that led to more stable and efficient reaches (Thelen & Corbetta, 1994; Thelen et al., 1996).

The third critical point is that the infants in the study converged on similar movement characteristics at the end of the first year despite their very different starting points at reach onset. For instance, they converged to a similar number of movement units, comparable movement straightness, and similar movement speed when contacting the toy. This reveals that different developmental pathways can lead to similar outcomes (Thelen et al., 1996).

Esther’s work demonstrated that reaches are carved out from the intrinsic dynamics of infants’ self-generated arm movements as they explore a range of movement possibilities and select viable solutions to meet the demands of the task. In this achievement, body and mind come together as infants assemble the many components that make a reach: the bio-mechanics of the body, the details of the specific environment including the perceived location of the toy, the speed and force needed to extend the arms away from the body, the ongoing movement and postural context, and so on.

This integration of body and mind is a fundamental characteristic of all goal- directed actions and creates a bridge to an embodied view of cognition and behavior.  Esther started to think deeply about the connections between her work in motor development and work in other domains of development. She turned naturally to cognition.

Many of the dominant questions in cognitive development stem from Piaget, who asked how children move from the sensorimotor origins of thought to abstract cognition.  Esther questioned the divide between ‘pure’ sensorimotor behavior and cognition. Indeed, in collaboration with Linda Smith, she denied the very existence of this divide. She argued that mental activity is embodied thought is always grounded in perception and action (e.g., Thelen, 2000; Thelen & Smith, 1994). This followed Piaget’s tradition in invoking the importance of the sensorimotor origins of thought. But rather than viewing development as movement toward the abstract and away from perception – action, Esther believed that for infants and adults alike cognition and action are not separate. Instead, cognition is inextricably linked to perception and movement. There is no cognition in the absence of perception and action.

In her Presidential Address to the International Society on Infant Studies in 1998, Esther outlined the importance of these findings: what infants know is always assembled, in the moment, with contributions from memory, attention, and action (Thelen, 2000). Cognition is embodied. Infants’ decision to reach is based on much more than whether or not they have an object concept. Instead, the decision to reach is based on what the infants have just done, their reaching skill, the feel of the body, the salience of the cue, and the perceptual layout of the task. Thus, this reaching task that was assumed to provide a direct window into infants’ abstract concepts is actually a window into the complex interactions among perception, action, and cognition in infancy.

Adam Sheya and Linda B Smith: Development through Sensorimotor Co-ordination: Enactment: Towards a new paradigm for cognitive science 2009 MIT press, Cambridge, MA:

“Piaget (1952) described a pattern of infant activity that he called a secondary circular reaction. A rattle would be placed in a four-month-old infant’s hands. As the infant moved the rattle, it would both come into sight and also make a noise, arousing and agitating the infant and causing more body motions, and thus causing the rattle to move into and out of sight and to make more noise. Infants at this age have very little organized control over hand and eye movement. They cannot yet reach for a rattle and if given one, they do not necessarily shake it. But if the infant accidentally moves it, and sees and hears the consequences, the infant will become captured by the activity—moving and shaking, looking and listening—and incrementally through this repeated action gaining intentional control over the shaking of the rattle. Piaget thought that this pattern of activity—an accidental action that leads to an interesting and arousing outcome and thus more activity and the re-experience of the outcome—to be foundational to development itself. Circular reactions are perception-action loops that create opportunities for learning. In the case of the rattle, the repeated activity teaches how to control one’s body, which actions bring held objects into view, and how sights, sounds and actions correspond.

Edelman (1987) also pointed to the coupling of heterogeneous sensorimotor systems in the creation of cognition. Edelman’s theory starts by recognizing the multimodal nature of the brain at birth; it is—from the start—a complex system made up of many heterogeneous, overlapping, interacting and densely connected subsystems. Like Piaget, Edelman pro-posed that development occurs through activity dependent processes.

Here, we review behavioral evidence from human development, evidence that suggests that transformative change is driven by the sensor-motor co-ordinations of an active agent in a physical world.

In a recent and remarkably inventive demonstration of this approach, Needham, Barrett, and Peterman (2002) fit two to five-month-old infants with Velcro®-covered ‘sticky mittens’. These mittens enabled the infants to grab objects merely by swiping at them, enabling them to precociously coordinate vision and reaching. Infants who were given two weeks of experiences with sticky mittens subsequently showed more sophisticated object exploration even with the mittens off. They looked at objects more and made more visually coordinated swipes at objects than did control infants who had no exploratory experiences with sticky mittens.

Two subsystems—reaching and looking—are coordinated in the sticky-mitten task and in so doing educate each other. But these components are also involved in other co–ordinations, that is, in other tasks that recruit other coalitions of subsystems. Thus, extra experience in the coordination of reaching and looking with sticky mittens ends up not being just about looking and reaching but potentially about other developments, other co-ordinations, generating cascading developmental consequences in other tasks in which some of the same subsystems are involved.

The second example is the development of reaching, Thelen et al.’s (1993) week-by-week study of four infants transition from not-reaching to reaching for visually presented objects. Early in development, the presentation of an enticing toy aroused the infants and elicited all sorts of non-productive actions. These actions were literally all over the place with no clear coherence in form or direction. But by acting, each baby sooner or later made contact with the toy—banging into or brushing against it or swiping it. These moments of contact selected some movements, carving out patterns that are then repeated with increasing frequency. Over weeks, the cycle repeated—arousal, action, and occasional contact. Over cycles, reaches became increasingly stable, more efficient and more effective.

However, the task of reaching is discovered by individual action, and thus, it is specific to the individual. All infants followed the general pattern, but each also had unique subtasks to solve. Some babies at first could hardly lift their arms, but sat placidly watching the world. Other babies were more high-strung and active, flailing and flapping and always moving.

These different babies had to solve very different problems in order to reach out and grasp an object. The flailer needed to become less active and to lower his hands bringing them into midline creating balance. The placid baby needed to be more active, to raise her hands, to lift them up from their usual positions on her side. What is remarkable in the developmental patterns of the children is that each found a solution by following individual action-defined developmental pathways that eventually converged to highly similar movements. Because action defines the task and because action—through the coordination of heterogeneous sensory systems— finds the solution, development is very much an individual and context-dependent matter.

An action in some context creates a task that coordinates multiple sensorimotor systems, and through this coordination, the component systems and their couplings to each other are changed. The next action may form a new consortium of systems, systems that will have been shaped by their participation in previous tasks. Because action creates tasks and transformative change in the components systems, action is a strong organizer of the developmental trajectory itself. Thus, motor development has a strong effect on the ordering of development as a whole.

The developmental course suggests gradual, action-driven discovery. When nine- to ten-month-old infants are given sets of objects containing like kinds, they do not group them. However, they do pick up objects, one in each hand, and bang them together (Forman 1982). By twelve months of age, these manipulations become more systematic and children manipulate like kinds in a like manner (Sugarman 1983). For example, given four cars and four dolls, the child may systematically push each car. Around eighteen months of age, children not only manipulate objects from one category in sequence, but they also systematically manipulate in different ways objects from two different categories, for example, first pushing each car, but patting each doll. This pattern of behavior—called “sequential touching” in the literature—is compelling to adult observers and seems to be, on the part of the child, a comment on the likeness of the individual instances. From these behaviors spatial classification emerges progressively.

Four behavioral tendencies in infancy may be enough to start the developmental progression. The first is that infants reach to objects in which they are interested. The second is that infants have a tendency to repeat just performed motor acts, and in particular to repeat reaches to nearby locations (e.g., Smith et al. 1999). Third, perceptually similar objects may be similarly enticing to infants. Fourth, infants may notice the outcomes of their own actions.”

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Part 3 The Movement Perspective of Atypical Development: The View from Psychobiology

Colwyn Trevarthen and Jonathan Delafield-Butt: Autism as a developmental disorder in intentional movement and affective engagement. Frontiers in Integrative Neuroscience July 2013 Volume 7 Article 49

Colwyn Trevarthen is Emeritus Professor of Child Psychology and Psychobiology at the University of Edinburgh:-

“Research focused on cognitive disorders of perceptual information processing, selective awareness, and representational thinking articulated in language, all of which skills develop after infancy—disregards the developmental foundations of experience in motor coordination, and in the expression of vital states as emotions for regulation of social life.

A primary cause of autism spectrum disorders is an error in early growth of intrinsic motive and motor systems of the brainstem during prenatal ontogenesis.
This interferes with efficient integration of sensory information with motor timing, and is accompanied by disturbance of autonomic functions, disrupting timing and control of prospective sensory perception in movement as well as vital regulation of functions within the body. All these disorders become most obvious in early childhood, when a toddler normally gains many new powers of movement in engagement with the environment, including speech.

Social isolation, socio-emotional and cognitive delay, and language disorder in children and adults with autism are secondary consequences developed within socio-emotional systems as experience-dependent compensations for primary sensory-motor and affective integration errors and poorly regulated motor intentions. These compensations are elaborated mainly by cortical systems that grow after birth.

It appears likely that autism results from disorders of imaginative and sociable playfulness itself, for which the motives and emotions are apparent from birth. Such disorders can be traced back to creative developments of movement and awareness in body and mind before birth (Trevarthen and Delafield-Butt, 2013), to disorders of sensory-motor circular reactions that become the tools for mastery of engagement with the world (Piaget, 1951, 1954) and for the development of shared cultural understanding (Baldwin, 1902).New data from social neuroscience confirm the ‘common sense’ that we are aware of other person’s states of mind by immediate or direct engagement with the Other’s motor intentions, by whatever modality or movement these intentions are expressed, matching them by instantaneous ‘affect attunement’ (Stern, 1993, 2010) to the animation by which we generate intentions of our own Self (Gallese, 2006; Bråten, 2009).

There has been, in the last two decades, a highly significant re- evaluation of the relationship between emotion and cognition, and their functional inseparability in human experience and in communication at all stages of development (Damasio, 2010; Panksepp and Biven, 2012).

Movements of a baby under 2 months old are coordinated and integrated within a rhythmic awareness of a single intentional subjectivity (Trevarthen, 1979, 1984). These movements were described by Prechtl (2001) and Einspieler and Prechtl (2005) as ‘general movements’, which, involve the whole body in a variable sequence of arm, leg, neck, and trunk movements. They wax and wane in intensity, force and speed, and they have a gradual beginning and end. Rotations along the axis of the limbs and slight changes in the direction of movements make them fluent and elegant and create the impression of complexity and variability. If the nervous system is impaired, GMs loose their complex and variable character and become monotonous and poor. (Einspieler and Prechtl, 2005, p. 61).

This natural history of human movement at a stage of development when the sensory-motor environment can only be the properties of an organized body itself appears to support Lashley’s conclusion that propositional thought may depend on, and indeed be derived from, the spontaneous syntactic ordering of movement sequences (Lashley, 1951, p. 122). The fetus has an imaginative ‘motor intelligence’ and can formulate orderly projects without neocortical skills.

Expressions in fetuses, in addition to twisting movements of distress and tentative exploration by touch, give evidence of emotions—of discomfort, curiosity or pleasure, adapted for communication of interests and feelings. In the third trimester, movements of the face visualized by 4D ultrasound develop into complexes that define a ‘cry face gestalt’ or a ‘laughter gestalt,’ expressing emotions that will communicate powerfully immediately after birth in the regulation of parental care (Reissland et al., 2011). Maternal hunger with depletion of energy supply to the fetus drives ‘anxious’ patterns of fetal movement. The mother and the fetus are already affectively connected. These discoveries prompt a revolution in psychological theory and medical ethics. There is a consensus in modern paediatrics that by 24 weeks the fetus should be considered a conscious agent deserving the same standard of sympathetic medical care as adults (Royal College of Obstetricians and Gynaecologists, 2010).

Disorders of movement in children with autism particularly affect expressive movements in communication (Ricks and Wing, 1975; Damasio and Maurer, 1978; Gillberg and Coleman, 1992; Frith and Frith, 1999; Oller et al., 2010). These have lead to an interpretation in terms of a deficit in ‘executive functioning’ (Rumsey, 1985) attributed to a developmental fault in the frontal lobes that manifests itself in the second year. Recent data point to a more basic and probably earlier developing deficit in prospective control of movements (Mari et al., 2003; Rinehart et al., 2006a; Dowd et al., 2012; Gowen and Hamilton, 2013).

Of particular note is an abnormality in the inferior olivary nucleus, a prominent lower brainstem nucleus known to be involved in perceiving and controlling of the timing of movement (Welsh et al., 1995), indicating a likely primary site of disruption underpinning ASD motor deficit (Welsh et al., 2005).

It is the experience of any therapist who works with persons suffering from autism that a conscious care must be taken to ‘stand back’ and allow any impulse the child or adult may show to take its course, indeed shadowing or mirroring it to aid its motivation. This is the principle put into the practice of interactive music therapy (Robarts, 1998; Wigram and Gold, 2006; Nordoff and Robbins, 2007; Wigram and Elefant, 2009; Ockleford, 2013). A more explicit standing back, called ‘asocial,’ is practiced by the method developed by the paediatric neurologist Waldon to assist persons with a wide range of disabilities in acting and thinking. The therapist places him or herself behind the client, holding the arms to guide the hands in performance of tasks to move objects in such a way that a goal or project is completed bringing a sense of satisfaction. This method has proved effective in helping young children overcome the confusion and isolation of autism in a way that makes productive and progressive motor learning possible (Solomon et al., 2012).”

Jonathan Delafield-Butt and Nivedita Gangopadhyay: Sensorimotor Intentionality: The origins of intentionality in prospective agent action. Developmental Review 2013 33 (4) pp. 399-425 smith

Jonathan Delafield-Butt Ph.D.is a Senior Lecturer in Early Years at the University of Strathclyde:-

“An essential property of all animal actions, complex or single, is their prospectivity or future directedness (von Hofsten, 2004). Externally oriented animal action carried out through the activities of its skeletomusculature in movements of the limbs, body, and head are rarely just reactive reflex responses, they are an expensive activity of the animal’s vital energy resources and neuromotor system that work to move the animal forward in space and time to a new point in experience with a new set of possibilities. And to do this economically and with adaptive effect, they must be guided by prospective perceptual control (von Hofsten, 1993). Even a single simple action, like a rotation of the head, must be guided ‘ahead in time’ in order that the forces of momenta generated do not over-turn the head, potentially causing damage, and do not under-turn the head, failing to make effective action. Information originating from the muscles and tendons of the neck integrated with the distance senses of sight and hearing enable the agent to move from ‘where it is’ to ‘where it wants to be’, situated within an environment of possible action (Lee, 2005, 2009). Even the spontaneous actions of new-borns, repeated over and over again, enable exploration of the action systems of one’s developing body, their possibilities, and their consequential effects (Piaget 1953)

However, prospective sensorimotor control is not limited to visuomotor action; it can employ all modalities of sense – sound, touch, and smell being particularly important cues in early life – with their varied spatial and temporal properties (Lee, 2009; Lee, Simmons, Saillant, & Bouffard, 1995). Especially important is proprioceptive control of movements and postural compositions of the body (Witherington et al., 2002).

From the beginning of life post-partum, the infant’s engagement with the world depends on its capacity for prospectively controlling sensorimotor activity, and this capacity increases rapidly over the first months with improved goal-directed motor coordination of tasks such as reach-to-grasp and standing (von Hofsten, 2004, 2005). More complex tasks requiring serial ordering of several actions, such as manual manipulation of objects, begins to develop significantly only once upright posture is established at about ten months (Trevarthen, 1986), and expands in capacity throughout early childhood as memory and action planning begin to enable abstract reasoning (Piaget, 1954), but their prospective orientation is a feature that remains invariant, no matter their degree of immediacy or complexity.

An infant’s intelligence depends on anticipation of the consequences of an action or serially organised project of actions. Abstract intelligence involving complex memories and plans can anticipate more complex and distant futures. In terms of motor logic, the problem of serial organisation is the problem of serial assembly of single action units that each deliver sensory consequences with new sets of action affordances. Developing knowledge of these and capacity to organise simple action units into projects with greater distal reach expands sensorimotor intelligence to guide the action in the present moment for future gain. Thus, sensorimotor intentions are at first simple and proximal, and later become complex with greater distal purpose.

Any intelligence, no matter how well developed, abstract, and imaginative, must always be fed back through a motor logic to generate its effect in the world. Sperry (1952) reminds us ‘the sole product of brain function is motor coordination’ (p. 297). And it is in the serial organisation of motor acts that intentions and intelligences are developed and expressed, ‘‘… all skilled acts seem to involve the same problems of serial ordering, even down to the temporal coordination of muscular contractions in such a movement as reaching and grasping.”

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Part 4 Cascades: Reviewing the evidence that active exploratory movement drives the development cascade

Meghann Lloyd, Megan MacDonald, Catherine Lord (2011) Autism – Motor skills of toddlers with autism spectrum disorder 17(2) pp. 133-146

Catherine Lord, PhD, is the Director of the Center for Autism and the Developing Brain, a joint project of New York-Presbyterian Hospital, Weill Cornell Medical College, and Columbia University College of Physicians and Surgeons, in partnership with New York Collaborates for Autism. She was involved in the development of standardized diagnostic instruments for ASD with colleagues from the United Kingdom and the United States (the Autism Diagnostic Observation Schedule (ADOS), an observational scale; and the Autism Diagnostic Interview—Revised (ADI-R), a parent interview), now considered the gold standard for research diagnoses all over the world: –
“Movement is a primary element of ‘active play’ in young children (Pellegrini and Smith 1998). Active play facilitates the development of motor skills, social skills, an understanding of the world, daily living skills and adaptive behaviour. Fundamental gross motor skills are complex and require co-ordination, motor planning and control” …….. They ‘are commonly explored and discovered during self-directed or self-regulated learning both with and without peers during play’. ‘Motor deficits’ are present very early in development and may become more pronounced with age. All too often motor skills are not considered important enough when verbal, behavioural and social deficits take preference for parents”.

Linda B. Smith American Psychologist: It’s all connected (2013) November pp. 618-629

“Theorists often refer to the far reach of early developments on later ones in terms of the development cascade and they do so most often when talking about atypical development process, how, for example motor deficits cascade into the poor development of social skills,” “What is remarkable in the development patterns observed by Thelen and collaborators (Thelen et al.,1993) is that each infant found a solution by following individual development pathways that eventually converged to highly similar outcomes.”

Marc H Bornstein, Chun-Shin Hahn and Joan T. D. Suwalsky Psychological Science (2013) 24(10) pp. 1907-1917  

Marc H. Bornstein, Ph.D. is Senior Investigator Section on Child and Family Research NICHD, NIH Rockville MD:-

“Motor exploratory competence typifies infants’ everyday interactions with objects and people, and it also appears to serve as a foundation for cognitive functioning in childhood and academic achievement in adolescence.” “Infants who were more motorically mature and who explored more actively at 5 months of age achieved higher academic levels as 14-year-olds”. “The present study focused on motor-exploratory competence in infancy as a cascade catalyst of academic achievement in adolescence. Developmentalists have historically linked infant motor development to the growth of the mind. Gesell (1929) concentrated on the beginnings of prehension and object manipulation in infancy, and Piaget (1970) grasped the fundamental significance of sensorimotor activity as a foundation of knowing. In this large scale, normative, prospective 14-year longitudinal, multivariate, multisource controlled study, we found that motor-exploratory competence in infancy initiates a developmental cascade that affects subsequent levels of child intellectual functioning that, in turn, help to shape academic achievement in adolescence.” “The developmental course suggests gradual, action-driven discovery, typifies infants’ everyday interactions with objects and people, and it also appears to serve as a foundation for cognitive functioning in childhood and academic achievement in adolescence.”

Morton Ann Gernsbacher et al The Journal of Child Psychology and Psychiatry 49:1 2008 pp 43-50

Dr. Morton Ann Gernsbacher is Vilas Research Professor & Sir Frederic Bartlett Professor. She is Past President, Association for Psychological Science:-

“Whereas language is the mental representation of concepts and their relations, speech is – literally – the articulation of language (Gernsbacher, 2004), and speaking fluently requires ‘an intricate orchestration’ of oral-motor mechanisms (Gracco, 1994, p. 4).” “During typical development, oral motor skills are strongly associated with speech fluency” and “are also strongly associated with manual-motor (hand and finger) skills (Corbetta and Thelen 1996: Iverson and Thelen 1999). For example, during middle childhood, fluency in repeating sentences and non-words is associated with fluency in pegboard tasks (Bishop, 2002)”

Karen E.Adolph and Scott R.Robinson Motor Development, Department of Psychology, New York University

Karen E Adoph is Professor of Psychology and Neural Science at New York University, Director of the Infant Action Lab and President, International Congress of Infant Studies:-

“Motor behaviour is often relegated to an early and isolated chapter in books on developmental psychology. But growing evidence shows that motor development can institute a developmental cascade of events that extend beyond mere movement of the body, effecting changes in perceptual, cognitive and social development.” “Despite a recent resurgence of interest in motor development, it still remains a rarity in developmental science. This situation is ironic because motor behaviour is one of the broadest domains of development. All behaviour is motor behaviour.” “Moving before birth is necessary for proper physical development. Fetal movement exercises muscles, flexes joints, stretches skin and circulates amniotic fluid. Without these consequences of movement, physical development does not proceed normally.” “Over the first year infants display a smorgasbord of kicks, stomps, sways, flaps, flails, rocks, rubs, nods, shakes, bounces, bangs, waves and wiggles – totalling 67 documented forms of movement of every body part from tongue to toes. (Pick and Carman 1994; Thelen 1979). Spontaneous movements occur in isolation (e.g. a single leg kick) and in bouts of rhythmic activity (e.g. repetitively flexing and extending the leg). They are frequent, up to several hundred movements per hour and are frequently coordinated across the two sides of the body.” “ Children, like the young of other placental mammals, devote an inordinate amount of their waking lives to spontaneous, seemingly pointless, repetitive, voluntary activity – play. …… Movements are repeated, typically with novel variations.” Play provides a source of physical activity that can promote development of bones and muscles (Pellegrini and Smith 1998) a mechanism for generating variable neural activity and proprioceptive feedback to promote neural plasticity (van Praag, Shubert, Zhao & Gage, 2005).” “Learning to learn entails immense amounts of variable experiences over a very long time. But this presents no real problem for motor development. By 3.5 months of age infants have produced 3-6 million eye movements (Johnson, Amso & Slemmer 2003); at 11-13 months, they spend half of each waking hour interacting with objects (Karasarik, Tamis-LeMonda & Adolph, 2011); at 1-19 months they take 14,000 steps per day (Adolph et al, 2012).” “Now researchers are inundated with evidence that motor experience can facilitate developmental change in perceptual, cognitive and social domains.”

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Part 5 Action-perception coupling: Why movement IS a sensory modality

Maria Brinker and Elizabeth B. Torres Noise from the periphery in autism. Frontiers in integrative Neuroscience July 2013 Vol. 7 Article 34

Prof. Elizabeth B. Torres leads the Sensory-Motor Integration lab at the Psychology Department of the Busch Campus, Rutgers University. She states there are effects in early infancy, before medical diagnosis, especially in motor sequencing, selective or exploratory attention, affective expression and intersubjective engagement with parents. These are followed by retardation of cognitive development and language learning in the second or third year, which lead to a diagnosis of ASD: –

“No two individuals with the autism diagnosis are ever the same—yet many practitioners and parents can recognize signs of ASD very rapidly with the naked eye. What, then, is this phenotype of autism that shows itself across such distinct clinical presentations and heterogeneous developments?
What have often been overlooked are the processes and relevance of continuously accumulating evidence from the fluctuations in our motions. By gaining a probabilistic expectation about the variability itself the system can acquire predictable and reliable ‘motor priors.’  Rather than merely adding ‘noise’ (Faisal et al., 2008), sensory-motor variability can serve as actively sampled and sharpened informative ‘signals’ and as an aid in adaptively reshaping old priors.

We should stress that the absence of reliable ‘motor priors’ in ASD does not give us the causes of autism. However, it helps begin to define the challenges in new inclusive ways, where the affected person is part of the solution. By precisely and objectively quantifying movement sensing in autism, we can begin to develop an operational definition that refines our Understanding and offers tractable routes of behavioral intervention, even when the causes are unknown. This definition will not merely enumerate what is different or deficient in the autistic system relative to what is known in the typical system. It will, instead, harness whatever compensatory-adaptive solution the autistic system has already developed and work with that to help steer their performance toward social-communicative goals.

Performance can then be steered by closing the stochastic sensory-motor feedback loops to selectively co-adapt the autistic system with the type of sensory guidance that recruits, modulates, and enhances central autonomy over the body. This would then allow us to tap into many of the solutions that the autistic system has already self-discovered. Their system can show us the optimal path of least resistance [in a very precise physical sense (Lanczos,1966; Feynman et al., 2006)]: the path that accelerates learning. In this regard our model is by definition inclusive of the individual with ASD.

Understanding and objectively quantifying movement fluctuations as a form of re-afferent kinaesthetic input in neuro-typical infants may lead us to earlier detection of critical aberrancies potentially leading to neurodevelopmental differences with complex downstream regulatory consequences.

It is time that we seek to better understand how the distributed intelligence of our bodies and social environments scaffolds our cortical control functions for self-autonomy. The measurable re-afferent micro-movements can help us track the dynamics of embodied minds and thereby also move autism research, diagnoses and treatments toward a new frontier—one that includes and truly connects us with the most important piece of this puzzle: the individual with autism.”

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Part 6 Listening to movement, including the perspective of autistic adults

Caroline Whyatt and Cathy Craig Sensory-motor problems in Autism: Frontiers in Integrative NeuroScience July 2013 Volume 7 Article 21

Professor Cathy Craig is Head of the Department of Psychology at Queens University Belfast and Director of Research, Perception Action Communication Cluster:-

“We will present sample studies that explore the role of timing and perception-action coupling in children with ASD who experience motor difficulties. These findings will then be discussed in light of the development of coherent movement control and its impact on social and cognitive ability, highlighting the potential role of a Theory of Sensory-motor control in ASD.
If sensory-motor problems are to be considered a fundamental symptom of ASD, the nature of persistent motor problems specific to ASD must be identified.

Although largely taken for granted, perception-action coupling is honed through maturity and experience, and is dependent on the gradual filtering of sensory information to identify sensory invariants to facilitate the establishment of coherent motor control. Delayed sensorimotor skill acquisition in ASD (Teitelbaum et al., 1998; Zwaigenbaum et al., 2005), may therefore suggest specific a fundamental problem with perception-action coupling as a consequence of impaired perceptual attunement. Combined, this evidence implies a fundamental difficultly with sensory-motor development in Autism Spectrum Disorders, which may precede later social and cognitive symptoms. Indeed, sensory-motor difficulties may even underline classical symptoms of ASD such as cognition, socialization, and communication (Leary and Hill, 1996; Von Hofsten, 2007; Haswell et al., 2009). Whilst, a poor internal sense of time in ASD (Boucher, 2001) and variable temporal production may extend to difficulties with the social “dance” such as turn taking and eye contact (Leary and Hill, 1996; Wimpory, 2002). Moreover, growing evidence for substantial links between motor ability and intensity of classical ASD symptoms (Dewey et al., 2007; Freitag et al., 2007; Hilton et al., 2007; Fuentes and Bastian, 2009) further suggest sensory-motor difficulties are potentially a fundamental, core symptom of ASD, which are currently being overlooked.”

Caroline P. Whyatt and Cathy M. Craig: Motor Skills in Children Aged 7-10 Years Diagnosed with Autism Spectrum Disorder Journal of Autism Development Disorders 2012 42: 1799-1809

“Impairment on both the peg-board and balance board tasks also mirror results from Green et al. (2009), who highlight the explicit use of timing in the scoring of both tasks. Test performance on each task is scored according to performance accuracy and age related time limits. The concept of being timed and understanding the principle of achieving maximal temporal performance may not have been understood by the children with ASD, or the children may have been simply indifferent to this test requirement.

Alternatively it may suggest children with autism have an underlying difficulty with complex tasks which require the coupling of both speed and accuracy, indicating impaired perception–action coupling, crucial in the production of coherent, meaningful goal directed movement (von Hofsten 2007), identified in (1954) by Paul Fitts, Fitts Law is now widely accepted as a universal law of movement control, specifying a direct relationship between spatial and temporal characteristics of a movement. This law stipulates that levels of spatial accuracy required in a movement will be directly reflected in the kinematic profile of the movement. However it may be that children with autism have specific difficulties with this, leading to an inevitable trade off in maintaining an artificially low speed to attain high levels of accuracy. Such a trade off would therefore artificially lower performance scores on both the peg-board (ManDex1) and balance board (Balance1) tasks, which are both scored according to speed and accuracy.

This study reports new results that suggest specific motor deficits in children with autism. Teasing apart levels of performance on a standardised test, whilst controlling for facets of IQ by providing two distinct, well-matched groups of typically developing children has helped reveal a comprehensive profile of motor ability specific to autism. Consideration of the pattern of results may indicate significant underlying deficits in perception–action coupling, vital for the production of coherent, controlled movement.

Jodi Robledo, Anne M. Donnellan and Karen Strandt-Conroy: An exploration of sensory and movement differences from the perspective of individuals with autism. Frontiers in Integrative Neuroscience November 2012 Volume 6 Article 107

Anne M. Donnellan Professor Emerita at San Diego University A long time researcher, advocate and teacher, she founded one of the first programs in the English-speaking world for autistic children in San Diego in 1970. For over 20 years, Dr. Donnellan and her students and colleagues have been writing books and articles emphasizing the importance of studying movement differences in order to understand and support autistic people. Today the Special Research Topic in Frontiers on “Autism: The Movement Perspective” strongly supports this view with over 30 scientific research articles from top research institutions world-wide. Dr. Donnellan co-edited the Frontier’s issue and edited the three papers of Dr. Torres and colleagues from Rutgers and Indiana that document and measure those movement differences. She and her colleagues and students have two research papers in the issue as well (Donnellan, Hill & Leary; Robledo, Donnellan & Strandt-Conroy). The collective works of all these researchers are expected to transform autism by shifting the focus of research and treatments to the individual on the spectrum in ways that are more objective as well as more personalized.

“In the absence of a clear understanding of cause or symptoms, many definitions and theories about autism have been developed. Most often the descriptions offered by the professionals pay little attention to the experience of people who live with autism. It leaves out a long and rich history of writing and research which suggests that individuals with a variety of disabilities or disorders may, in fact, be experiencing differences in their sensory, motor, perceptual, and other systems, which confound and confuse the picture (e.g., Kahlbaum, 1874/1973; Bleuler, 1911/1950). Even in the more recent research that studies the body (motor differences) and autism, there is little understanding of the potential affect of these differences on social, communication, and behavioral functioning (see Leary and Donnellan, 2012).

Typically, the word ‘movement’ refers to observable actions, such as posture, muscle tone, head and eye movements, facial expression, vocalization, speech, whole body movements, reaching, gesturing, running, and walking. Here, the use of the word movement is consistent with research that considers internal mental processes of sensory perceptions (touch, taste, smell, vision, hearing, and proprioception), language, thoughts, and emotions as aspects of human movement.

A review of published first-hand accounts of autism and research studies with participants with autism revealed numerous references to sensory and movement differences in the areas of perception, action, emotion, communication, and cognition.

Perceptual differences, such as differences in hearing, vision, smell, taste, proprioception, and synesthesia were all noted in numerous published first-hand accounts (e.g., White and White, 1987; Cesaroni, 1990; Barron and Barron, 1992; Grandin, 1992, 1995; Williams, 1992, 1994; McKean, 1994; Blackman, 1999; Mukhopadhyay, 2000; Rubin, in Biklen, 2005).

First-hand accounts of autism also revealed challenges with controlling, executing, and combining action or movements (Volkmar and Cohen, 1985; Cesaroni, 1990; Grandin, 1992; Williams, 1992, 1994; McKean, 1994; Hale and Hale, 1999; Mukhopadhyay, 2000; Frugone, in Biklen, 2005; Mukhopadhyay, in Biklen, 2005; Goddard and Goddard, 2012). Alberto Frugone described his challenges with action and movements: “Right from the beginning of an action, I was conscious of my inability to access motor planning and I was lost in an unacceptable motor silence” (Frugone, in Biklen, 2005, p. 190).

Charles Hale described his difficulty with actions and movements: I think my movement disorder is most apparent in the fact that I am unable to respond to someone or something, when my intelligence would tell me to respond in an appropriate manner. For instance, when I should be smiling, sometimes I know that I am not smiling but may be even frowning. This causes me a great deal of pain and makes me look as though I am not comprehending when, in fact, I am trying to respond in an appropriate manner.” (Hale and Hale, 1999, p. 32).

Another individual with autism, Therese Jolliffe commented: ‘It [stress] occurs at any time, but always when I know I have to go somewhere stressful. Sometimes the pain is so bad that my whole body becomes stiff and then I am unable to move.’  Jolliffe et al., 1992, p. 14).

It is essential that the exploration of autism include sensory and movement differences and involve the people who experience autism first-hand for a number of reasons: (1) professionals investigating autism from a perspective that separates mind and body may have overlooked sensory and movement differences, and/or their possible effect on behavior; (2) published first-hand accounts of autism suggest that this is a fruitful area for investigation; (3) in studying autism we need to elicit information from one of the most valuable resources—people with the label of autism.

One of the patients in the study Barbara summed it up well: I want to stop doing anything that doesn’t look normal. But if I am feeling really bad inside, I want people to see the distress signals for what they are. I want people to understand I don’t want to hide the urges if I’m feeling really bad. I want people to let me be. I’ve had all kinds of people who thought they were helping me stop doing things. I have been endlessly criticized about how different I looked, criticized about all kinds of tiny differences in my behavior. There’s a point where you say to hell with it, its impossible to please you people…. No one ever tried to really understand what it was like to be me…. I wish they had accepted some of my behaviors I didn’t have any control over. You don’t criticize people with cerebral palsy.

Summary

This review of recent literature on what Anne. M. Donnellan calls:  ‘Sensory and Movement Differences’  demonstrates that these differences are both a cause and a consequence of ASD. In both cases a movement based therapy is a necessary addition to the armamentarium.

VIDEO BIBLIOGRAPHY

Kennedy Krieger Institute sticky mittens video:

Esther Thelen Motor Development – Baby Body Sense

Elizabeth Torres discusses her research – Click here for her Vimeo presentation. Total time 1hr 2 mins

The Rubber Hand Illusion Horizon.  BBC. How sensory coupling works

Elizabeth Torres Video of children on the spectrum and Reinforcement Learning Interface Therapy

Linda B. Smith (Indiana U.) – “Grounding Toddler Learning in Sensory Motor Dynamics”

Karen Adolph The Baby Human – Specificity of Motor Learning

Interview with Prof. Colwyn Trevarthen: Stories of Connection

Interview with Dr Jonathan Delafield Butt: Stories of Connection

Next month’s blog will focus on Neuroplasticity and Neural-Darwinism as brain-based explanatory frameworks for understanding the Waldon Approach.