Neurodevelopmental Therapy
We use Neurodevelopmental Therapy training to guide all of our clinical decision making on
how babies and young children move their bodies.
Key concept: Distal body parts (hands & fingers, feet & toes, mouth & tongue) move best if the proximal (core) of the body has achieved balanced symmetry. The movement of all body parts is a balance of stability and mobility, controlled weight shifts, and rotation over a stable base of support. Tension or spasticity at far distal body parts reflects tight proximal structures.
Neurodevelopmental Therapy (NDT) is a formalized training approach for pediatric and adult
neurological rehabilitation and a standard for physical, occupational, and speech-language
therapists. Originated in Europe by Berta and Karl Bobath in the 1940s, it offers therapeutic
handling methods to treat cerebral palsy, brain injuries, and other neurological disorders. The
handling techniques are theorized to entrain normal movement patterns. The basics of NDT are
often taught in university therapy programs. Still, the advanced certification in post-graduate
training truly prepares the therapist for a full breadth of palpation and handling skills.
Palpation informs our hands which movements are unavailable for the patient, and then
therapeutic touch contact in handling helps activate movement patterns. Built around concepts of
normalizing posture, body alignments, and weight-shifting needed for transitional movements,
handling methods help the clinician evaluate the balance between antagonist and agonistic
muscle groups. The NDT methods facilitate weight-shifting in various positions and hold core
stability to gain distal extremity ease of movement (arms & hands, legs & feet, eye, and
tongue/lips/jaw).
Oral-motor and feeding therapy is embedded in the NDT approach of recognizing the whole-
body processing of sucking/breathing/swallowing. The NDT perspective on oral motor training
is one of the gold standards for training practitioners for a whole-body approach towards feeding.
Interventions for improving head and postural control, balance reactions, rib cage and breath
support for swallow, and core/proximal stability held for distal body parts (tongue, jaw, lips,
hands) to move smoothly.
The foundation of learning afforded by NDT training is astute listening of the hands move subtly
with the baby/child and where imposed movement is needed. The handling skills of NDT are
excellent preparation for all forms of manual therapy.
