Neurobehavioral Disorders of Childhood
Developmental Functional Neurology
This treatment methodology follows the work of Dr. Robert Melillo and is also known as the Melillo Method. The work is unique in the world of pediatric medicine in that it seeks to build functional balance in the patient within the framework of the developmental trajectory of the nervous system. We do this by combining bottom-up sensory stimulation with top-down cognitive and motor strategies to strengthen the underdeveloped networks of the brain. The work has three core areas of emphasis: primitive reflex integration, coordination and stability and hemispheric stimulation.
Primitive Reflex Integration
Primitive Reflexes are defined as automatic, stereotyped movement, directed from the brain stem and executed without cortical involvement. They are the inborn pathways by which the neonatal nervous system organizes itself and responds to the environment. As higher cortical centers come online, these reflexes withdraw or are replaced by higher order reflexes such as the postural, occulomotor, vestibular reflexes and the maturing motor system. These reflexes don’t disappear forever however, they may return with concussion, dementia or periods of extreme stress and poor health.
Some of the common reflexes found retained in those with neurobehavioral disorders include:
Asymmetric tonic neck reflex
Symmetric tonic neck reflex
Moro reflex
Palmer grasp reflex
Babinski reflex
Tonic labyrinthine reflex
Rooting, sucking and snout reflex
As our nervous system matures, more complex systems and functions are built upon simpler systems. If there is a delay, or a process isn’t robustly developed, higher order functioning will be disrupted. Primitive reflexes represent the foundational processes of the nervous system; when they are present beyond their normal milestone windows, it shows a disruption in the command hierarchy of the nervous system. They act like breaks on the development of the frontal lobes.
Midline stability, balance and coordination
Developing strength, stability and coordination are important not only to mature the motor system and build confidence, but to create the neurological foundations for embodiment. Increasing muscle tone strengthens sensory-motor feedback loops driving proprioception and activating the systems which drive the expression of consciousness. Core strength and stability create the mid-line of the neuro-axis around which the self is organized. An integrated, strong cerebellum creates balance, rhythm and coordination in the motor system, and is equally at play in the balanced functioning of autonomic, immune, limbic and higher cortical centers.
Hemispheric Stimulation
We look at the nervous system from a holistic lens; it must be balanced from bottom to top, front to back and right to Ieft. We can make sense of its development using milestones and functional measures. If a piece is missing or skipped over during development, higher order structures will not function correctly. We see this again and again in the sensory-motor, occulomotor, vestibular and congitive systems. As the brain grows, the left and right hemispheres leap-frog through periods of accelerated growth. If there is delay on one side, it can disrupt the natural inhibitory gaiting that happens across hemispheres. This can lead to extreme imbalances of structure and function; this is called Functional Disconnection Syndrome. For example, diagnostic imaging has shown decreased function and connectivity of right hemisphere brain areas in autism spectrum disorder, ADHA, Tourrette’s Syndrome, OCD, and schizophrenia. Conversely, left brain delays may create imbalances that are expressed as dyslexia, dyscalculia, bipolar disorder, depression, and anxiety. In addition to these behavioral disorders, we see hemispheric imbalance expressed in academic, cognitive, emotional,autonomic and immune profiles.
When a hemisphere imbalance is detected, we work to drive activation, blood flow, and connectivity in that region using bottom-up sensory stimulation with top-down cognitive and motor exercise.