Neuro-motor immaturities and their impact on the child’s educational skills

by 12.12.2022

Why do some children develop and learn without apparent problems, while others are slow and do not cope with learning as well as their peers?

The problem, if there is no other definite cause, is in the functioning of the nervous system. Sensory-motor works with children immediately after birth and stimulates the creation of neural connections at the level of the brainstem and cerebellum, which leads to the maturation of the central nervous system (CNS) and the laying of a solid foundation for academic achievement. 

It also helps overcome problems with feeding, reading, visualization, fine motor skills, balance, auditory processing, sequencing skills, and sensory integration that often delay neurodevelopment and sabotage a child’s psycho-emotional growth, and success in nursery and primary school, school, and life as a whole. A new, different approach to learning, setting learning content, and planning classes are needed. We need to introduce learning through experience.


The sensorimotor system encompasses all sensory, motor, and central integration and processing components involved in maintaining joint homeostasis during body movements (functional joint stability). Sensorimotor skills involve the process of receiving sensory messages and eliciting a response. Through our sensory systems (vision, hearing, smell, taste, touch, vestibular, and proprioception), we receive sensory information from our bodies and the environment. It is the connection between the sensory system (nerves) and the motor system (muscles), and the process by which these two systems (sensory and motor) communicate and coordinate with each other (Williams, J. & Holley. PA, 2013).

Almost every sensation occurs in the context of some movement. For example, we usually handle an object to ascertain its shape and material. Knowledge of our movements is critical to this interpretation of somatosensory signals. Likewise, visual cues must also be interpreted about the current position of the head and eyes. 

Auditory signals must also be interpreted concerning the position of the head and ears. Even smell and taste involve motor components (acquired through active smelling and chewing).

Conversely, virtually all motor behaviors are influenced by sensory cues. This is evident in actions that are triggered by sensory stimuli. But even for an action that originates from an internal signal, effective motor planning requires accurate information about the state of the body (Williams, J., 2006/2007).

The position and speed of body movement and the external forces acting on the body are all important variables in the planning and execution of effective motor actions. These skills resulting from sensory-motor integration are developed and perfected during the period of growth – from birth to 7 years of age. During these years, the child mainly feels the stimuli and then moves

his body in a response to these sensations. Its development in all other mental and social functions is based on this foundation, namely, on sensory-motor integration.

In the process of developing sensory motor integration, the child first learns to move and then learns through movement. This involves continuously developing the child’s ability to use their body through purposeful movement. Through this movement, the child learns more about himself as he explores the environment around them

The process consists of three parts:

  1. The sense organ receives a stimulus.
  2. The nerves carry the information to the brain, where it is interpreted.
  3. The brain then determines which reaction to make and passes its instructions to the appropriate group of muscle fibers that carry out the reaction itself.

These two systems work together and if the nerve impulses sent are problematic, the brain will not get the message, and if the

impulse in the motor nerves is interrupted, the muscles will not receive a clear message and will not be able to give the correct response.

Academic ability, behavior, and emotional development rest on the full integration of these two systems. This integration occurs during maturation and is actually sensorimotor integration.


These skills and the order in which they are developed can be critical to a child’s learning. Things like balance, left/right awareness, knowing where their body is in space, etc. can affect a child’s ability to sit still in class and focus, follow the teacher’s instructions, or move around effectively without getting lost, falling, distracted, confused, etc.

Also, the confidence that comes from being in control of his body will allow him to move freely and explore the world around him more deeply. This extra movement will open his mind to more learning and improve his personality and intelligence.

On the other hand, an immature sensory-motor system has the opposite effect on a child’s academic activities as well as his “fine motor skills”. The non-integrated system is most often recognized as dysgraphic, illegible handwriting, impaired balance, and/or the child’s inability to sit still. Even with help, there are cases where the child cannot develop his motor performance to a level comparable to that of his peers. Also, with sensory-motor immaturity, it is noticed that the child needs a longer time to complete written work.

The extra time required to complete assignments can cause criticism that is unwarranted if the teacher or parent is not aware of the child’s problem. Criticizing or encouraging a child to work faster or harder leads to emotional problems – poor self-esteem.

Thus, an emotional component is added to the problem, which can affect the development of adequate social skills.


Observed behaviors that should alert you to a problem:

  • Avoids writing assignments or written works;
  • Difficulty with hand coordination, difficulty hitting a ball, copying from a board;

Clumsiness, hypotension, difficulty running, avoidance of sports, inability to sit/stand still;

  • Has difficulty with orientation, gets confused between left and right, etc.;
  • He has difficulty getting dressed, he does not know which garment to put on first, and is slow;
  • He has not developed dominant foot-hand-eye-ear;

There is difficulty in crossing the mid-frontal-vertical line of the body;

  • Difficulty balancing, hopping or standing on one leg.

As with all mental disabilities, the earlier the sensory-motor integration problem is identified and addressed, the better and longer-term the outcome. In preschool age – from birth to 5 years, intervention and/or prevention should consist of outdoor exercises, such as walking, running, jumping, swinging, and other age-appropriate activities.


The organization of a child’s brain is influenced by early experiences.

During the first three years, the child’s brain creates up to twice as many synapses as in adulthood. Between conception and the third year, the child’s brain undergoes an impressive change. At birth, it already has all the neurons it will ever have. Connections between neurons double in amount during the first year, and by 3 years of age reach 80% of that of

the adult  (Gilmore JH, Lin W, Prasatwa MW, et al., 2007; Owakowski RS, 2006; Farroni T, Massaccesi S, Menon E, et al, 2007).

More importantly, synapses form more rapidly during these years than at any other time. In fact, the brain creates far more of them than it needs: at two or three years old, the brain has up to twice as many synapses as it will have in adulthood (Fig. 1). These excesses are gradually removed during childhood and adolescence, a process sometimes called ‘sharpening (Huttenlocher P. Neural Plasticity, 2002).

Synapse diagram 

Source: Adapted from Corel, JL. The postnatal development of the human cerebral cortex. Cambridge, MA, Harvard University Press, 1975.

The organization of a child’s brain is influenced by early experiences.

Why would the brain create more synapses than it needs, only to discard the excess later? The answer lies in the interaction of genetic and social factors in brain development. Early stages of development are strongly affected by genetic factors; for example, genes guide newly formed neurons to their correct location in the brain and play a role in how they interact (Rutter M., 2002; Skaliora I., 2002). But although they organize the basic wiring of the brain, genes do not design the brain entirely (Kagan J, Herschkowitz N, Herschkowitz E., 2005; Elman JL, Bates EA, Johnson MH, et al., 1996).

Instead, genes allow the brain to refine itself according to the influx of signals it receives from the environment. The child’s senses report the environment and experiences to the brain, and these signals stimulate neural activity. Speech sounds, for example, stimulate activity in language-related areas of the brain. If the amount of sensory input is increased (if more speech is heard), the synapses between neurons in that area will be activated more often.

Repeated use strengthens the synapse. Synapses that are rarely used remain weak and are more likely to be eliminated in the pruning process. Synapse strength contributes to the connectivity and efficacy of networks that support learning, memory, and other cognitive abilities (Johnston MV, Ishida A, Ishida WN, et al., 2009; Mangina CA, Sokolov EN, 2006). Therefore, a child’s experience not only determines what information enters his brain but also affects how the brain processes information.

Genes provide the blueprint for the brain, but epigenetics (the child’s environment and experiences) does the construction. The excess of synapses produced by the child’s brain during the first three years makes the brain particularly responsive to external stimuli. During this period, the brain can “capture” the experience more effectively than later, when the sharpening of synapses is underway (Huttenlocher P., 2002). The brain’s ability to shape itself-called ‘plasticity – allows humans to adapt more efficiently and quickly than we could if only genes determined our neural wiring (Pascual-Leone A, Amedi A, Fregni F, et al., 2005). The process of synthesizing and pruning neural connections, far from being wasteful, is indeed an efficient way to achieve optimal brain development.

From birth to the third year: Stages in early brain development


The remarkable abilities of newborns highlight the extent of prenatal brain development before birth. Newborns can recognize human faces in preference to other objects, and can even distinguish happy from sad expressions. At birth, the child knows its mother’s voice and is able to recognize sounds from the stories the mother read while it was in the womb (Dehaene- Lambertz G, Montavont A, Jobert A, et al., 2009; Farroni T, Massaccesi S, Menon E, et al., 2007).

The brain continues to develop at an incredible rate during the first year. The cerebellum triples in size and motor skills develop rapidly, and the infant’s initially weak and limited vision develops into full binocular vision (Herschkowitz N., 2000; Knickmeyer RC, Gouttard S, Kang C, et al., 2008).

After about three months, the child’s ability to recognize improves dramatically; this coincided with significant growth in the hippocampus, the limbic structure associated with recognition memory. Language neural structures in the frontal and temporal lobes are strengthened during the first year, strongly influenced by the language the child hears. During the first few months, an infant in an English-speaking home can distinguish the sounds of a foreign language (Imada T, Zhang Y, Cheour M, et al., 2006; Kuhl PK., 2000).


The most dramatic changes this year involve the language areas of the brain, which develop more synapses and become more interconnected. These changes correspond to the sudden jump in children’s language abilities-sometimes called the vocabulary explosion that typically occurs during this period. Often a child’s vocabulary can develop between their first and second birthday 

In the second year, there is a significant increase in the rate of myelination of neurons, which helps the brain to perform more complex tasks. Higher cognitive functions develop, for example, self-awareness – the child is now aware of his own emotions and intentions. When he sees his reflection in a mirror, he fully recognizes it as his own. He soon began using his name as well as personal pronouns such as “I” and “Me” (Kagan J, Herschkowitz N, Herschkowitz E. 2005; Herschkowitz N., 2000).


The synaptic density of neuronal synapses in the prefrontal cortex probably peaks in the third year, up to 200% of the age level.

Networks with other areas of the brain continue to be created and strengthened. As a result, complex cognitive abilities are enhanced and consolidated. At this stage, for example, children are better able to use the past to interpret current events. They also have greater cognitive flexibility and a better understanding of the cause and effect of their actions (Kagan J, Herschkowitz N, Herschkowitz E., 2005; Bunge SA, Zelazo PD, 2006).

The earliest messages the brain receives have an important impact. Early brain development underlies human adaptability and resilience, but these qualities come at a price. Because experience has such great potential to affect brain development, children are particularly vulnerable to persistent negative influences during this period. On the other hand, these early years are a window of opportunity for parents, caregivers, and communities: positive early experiences have a huge impact on children’s chances of success and happiness.

As a toddler grows, it’s important for parents to monitor how and if they progress through the successive neurological developmental stages that prepare them for learning. One of these stages that the child begins to develop almost automatically is handedness dominance, i.e. the establishment of a dominant hand, not only, but also a leg, an ear, and an eye. In other words – the preferred use of a hand, eye, or leg entirely on one side of the body over the other. They must be either entirely on the right half of the body or entirely on the left.

As the third year approaches, the child begins to show signs of preferring one arm, one leg over the other, which is preparation for mastering writing skills and sports. But before and during the period of establishing a child’s handedness dominance, several other developmental stages are observed that ultimately prepare the child for writing, reading, problem-solving, creativity, critical thinking, and reasoning. Bilateral (two-sided) integration is one of those important developmental stages that go along with the establishment of dominance.

These stages are often called bilateral periods, and each one helps to create a stronger foundation in a child’s learning and teaching.


It is important for children to establish hand-foot-ear-eye dominance to prevent learning disabilities when they start school learning disabilities are most often due to poor bilateral coordination and mixed dominance, which can prevent a child from eye tracking, reading, listening, and language comprehension (Ayres, AJ, 1974).


Given that laterality /dominance is the dominance of one side of the body, it should not be forgotten that we humans are bilateral because we have two sides of the body. That is why we need bilateral activities and movements for better ‘education Bilateral integration enables the child to use both sides of his body in a coordinated way. This includes hands, eyes, palms, feet, feet, and the brain itself. A child needs to develop bilateral coordination in all parts of the body to perform fine ‘motor skills, gross motor tasks, walking logical thinking, and learning et, the list is quite long. Therefore, we often see a two-year-old child who eats with both hands at the same time writing with a crayon in both hands,

If a child is given opportunities to have extensive sensory and motor experiences as a baby and a toddler, the bain will develop ‘incrementally, consistently, and its bilateral integration will flow smoothly.

After these periods, when it comes to certain functions and tasks, the child will have the chance to establish handedness dominance and the brain will begin to specialize in one side of the brain, preferentially using the hand-foot-ear-eye only on the left OR on the right side of the body (Ayres, AJ, 1974).

Lateralization dominance describes an important change in a child’s brain as it becomes aware of the two sides of their body and their differences and similarities. The brain begins to recognize that perhaps one hand or one leg is better at certain skills than the ‘other Eventually, the child will be forced to choose a dominant leg, eye, ear, and hand for learning, preferably on one side of the ‘body to prevent confusion in the brain. f the child shows signs of mixed dominance will cause learning problems. Since the brain is divided into two hemispheres (right and left), it can be noted that the child uses the right side of the brain more, while itis, less (it is the creative one) and subsequently switches to using the left side of its brain when he grows up to perform more ‘complex learning tasks (logical thinking, reading).


If the child shows signs of mixed dominance, he or she usually alternates using hands, feet, eyes, and ears for different tasks, or switches between different hands, feet, and eyes for different activities. For example, a student may have a dominant left eye but a dominant right hand (opposite dominance).

‘Many children have mixed dominance and seemingly show no signs of learning challenges, but for others, it can create confusion in the brain as far as their learning abilities were concerned. The reasons behind this symptomatology are that the left and right hemispheres of the brain store different information and therefore skills (Blythe, GS, 2002).

For example, visual information comes through the left eye and is stored in the right hemisphere, while all auditory information comes through the right ear and is stored in the left hemisphere of the brain.

What we need to ask is HOW the child receives and interprets different information. Are they visual learners or auditory learners? If possible, establishing dominance on one side of the body will help them retain and receive information better in the classroom.

In her work Reflexes, Learning and Behaviours Selly Godderé-Blye (Blythe, GSA Reeves, Learning and the Behaviour, Fem Ridge Press, Eugene, Oregon 2002) states: The effect of mixed laterality can be the fire to send information to the most effective center of the brain for the specific skin question. In this way, a “competition” between the two centers can appear. This is like having two drivers in the front of the car, both wanting to drive at the same time, both trying to be navigators”


‘When the child is small and dominance is not yet established, parents notice that he constantly crosses the mid-front and vertical line to reach an object and will use his right hand in the left half/body field and vice versa. This means it exercises these neural pathways in the brain, preparing the body and brain to hone motor skills and higher cognitive activities. This is a sign that he is developing his collateral processes, which are also important for the development of bilateral coordination. This means that the two sides of the brain talk to each other before the child is ready for academic knowledge if a child finds it difficult to cross this, the bodily “middle line – dividing the body into left and right” end does not fully pass through the period of crossed laterality (two-handedness),

For example, parents will notice that children may begin to struggle with simple tasks that require bilateral activity, such as holding a sheet of notebook paper with their left hand while writing with the other with their right hand. The child may also show signs of an unsuppressed Asymmetric-Cervical-Tonic Primary Reflex (ACR), which prevents the child from crossing the midline due to the continuous coupling between head and arm movements.


‘What is amazing about bilateral integration and dominance is that the two go hand in hand. In the child’s development, his bilateral integration finally leads to dominance. For example, a toddler may start coloring with both hands, but will eventually choose a preferred right or left hand to color, draw, and write as they grow older.

According to Carol Kranowitz in The Qut-of Syne Child Having Fun, bilateral integration develops as the baby grows and learns to move its limbs and torso. As this happens, sometimes the movements are symmetrical, sometimes they are in opposite directions, and sometimes the movements between the limbs are coordinated, Bilateral integration is done in stages. As a child develops, it can be traced through each stage of bilateral integration in sequential order.

“The five stages of bilateral integration are: Symmetrical Bilateral Integration, Reciprocal Bilateral Integration, Asymmetric Bilateral Integration, Crossing the Milne, and Bilateral Development of Academic Skills,


When a child is developing Symmetrical Bilateral Integration, the two sides of the body mirror each other in their movements.

Each side of the body will accurately mirror the movement or action of the other at the same time. For example, a child may bring both hands to their face at the same time, clap their hands together and swing both legs back and forth at the same time. As they grow older and become more active, you can see them begin to use these symmetrical bilateral skills as they jump rope, use a rolling pin, do bunny hops, pop soap bubbles with both hands, and use certain musical instruments such as bells and drum with both hands at the same time.


In this stage, one side of the body does the exact opposite movement or action of the other side of the body. Crawling and creeping are exact examples of this phase. Swinging one arm forward while the other reaches back is another example.

Other activities that involve reciprocal bi-lateralization in the child may include walking, climbing stairs, riding a bicycle, skipping, checkers, and swimming. These are all rhythmic activities that follow reciprocal movement patterns.


This is a very important end developmentally critical phase of bilateral integration for any child. In it, each side of the body learns to perform a different and separate task, but both sides cooperate for the same activity At this stage, the brain must coordinate two streams of skilled thinking. As the child develops his asymmetric bilateral integration, he will begin to use his skills to color on paper with one hand while the other holds the same sheet; they will use scissors to cut, spread butter on a slice, sir food in a bowl trace shapes with stencils, and string beads. The dominant hand will perform the main task, while the non-dominant hand will stabilize the action.


In the previous stage, the brain achieved the goal of coordinating both sides. And in this phase, the crossing of the midline is already at the level of the limbs and senses. An intersection of the figurative front-vertical line of the body is achieved, dividing it

In every single aspect into left and right. This is the time when every child should start to kick a ball for a long time, kick with the dominant leg in a crossing motion, pick up a pencil, with a transition to the other field of the body, hit a small ball with a club and touch the toes on the steps with the opposite hand,


‘This phase is characterized by the consolidation of all movements and achievements from the previous phases and their Inclusion in action. Academic skills rely on good bilateral integration and skills to cross the three midlines of the body and especially the anterior vertical, Without the ability to smoothly cross that line, the student will struggle with reading and writing,

For example, when a child is reading, the eyes must smoothly follow the entire line of text before moving on to the next line of text. Without well-developed bilateral integration skills a chiles eyes will follow the first few words, then stop end blink barely ‘perceptibly upon reaching the anterior vertical midline of the body, and then continue to finish recognizing the remaining words of that row This pause means that the child cannot instinctively cross the midline with his eyes. It manifests as blinking, skipping ‘of the eyes, uneven tracking in space, and subsequent interruption of thought and attention,

Any type of coloring, writing, or drawing will also be affected if bilateral integration is underdeveloped. If the hand cannot naturally cross the midline, then the brain pauses to re-think the movement, rather than being instinctively able to complete the action it has started (Williams, J. & Holmes, CA, 2004). Asymmetric bilateral skills are also essential for writing, as the non-dominant hand is expected to hold the paper while the dominant hand writes letters and words (Williams, J. & Holmes, CA, 2004). When we begin to understand the stages a child goes through to master complete bilateral integration, we can test their skills to determine how they are progressing. Children are expected to start preschool with certain bilateral skills such as control of large limb movements, going up and down stairs, three-finger pencil grip, holding and carrying a small toy basket, jumping, hopping, and skipping. The finer details of these activities will come later. 


Ideally, by the time a child starts school at around age 7, their movements (motor development) should be automatic and precise, so that each movement is synchronized, smooth, and directed to and from the brain’s control area. It is thought that before motor skills become automatic, the brain actually routes messages coming from the body through the cerebellum – to decide what the best response is and where in the brain the signals should be redirected. This requires more brain effort and energy. Once the movement patterns are automatic, the brain is actually freed up to operate at a higher level of thinking and so learning is more easily achieved. Children who have poor motor development struggle to control themselves while learning (Schriever, M., Sasse, MKK & Williams, J. (2010, revised 2011, 2013). 

Characteristic signs for a child with neuromotor immaturity: 

  1. He doesn’t pay attention in class, he’s distracted. 
  2. He can’t stand still, he’s stuck in a chair. 
  3. He has an incorrect posture in the chair, he lies on the floor. 
  4. Avoids writing assignments, drawings are immature for age. 
  5. There is an incorrect pen grip and illegible handwriting. 
  6. Has inappropriate behavior in a peer environment. 
  7. Avoids sports and active movement. 
  8. Having problems with the toilet. 
  9. There are social problems. 
  10. Has difficulty completing a task. 
  11. Performs a task on inconsistent instructions. 
  12. Often sick (allergies, phobias). 
  13. Lack of motivation. 
  14. Reverses numbers, and letters when typing. 
  15. He doesn’t stop running. 
  16. Crooked, stooped posture, scoliosis. 
  17. Interrupts the teacher, and claps during a conversation. 
  18. He doesn’t feel boundaries and rules. 
  19. Lack of sensitivity to the feelings and needs of others, invades personal space, pushes, shoves reactively and unconsciously. 
  20. Spontaneity in behavior and movement. Often, children with good, even excellent, academic skills also show signs of neuromotor immaturity and can improve their functioning if these are removed.


From everything presented so far, we think it has become clear how strong the connection is between the correct passage of the baby and the child through the natural stages of development, the integration of brain and body, and his subsequent success in school and life. 

We examined the role of epigenetics in this development. This fact places all of us – parents, educators, and society – at the center of the processes related to children’s development. We are the ones who have to provide the right stimulation for the appropriate stage of development of the baby and the child (Williams J., 2015 in press). We are the ones who will ensure the prevention of neuro-motor immaturity and allow the child to enter the classroom ready to learn. In this regard, it is extremely important to emphasize prevention. Parents, educators, and specialists need to be informed about what neurological age and maturity are and why sensory-motor work with children is important. 

The emphasis is on ensuring that children start school with their neurological age matching their chronological age. In the period from birth to three years, the role of the parent is definitely the most important. It is the parent who will provide the simulations leading to the suppression of the primary reflexes and the occurrence of sensory-motor integration (Williams, J, 2007, p. 282-290). 

After the child enters kindergarten or school, the teacher begins to play an exceptional role. It is good for the educator to focus not only on the child’s academic knowledge and development, but also to monitor the children’s neurological age and maturity (Williams, J., & Holmes, CA, 2004/2005). How this maturity is achieved – through movement. Particularly useful in this direction are sensory-motor-perceptual programs that, through a complex of structured exercises, work to achieve optimal integration of brain and body (Williams, J., 2007). • 


  1. Neuro-motor immaturity caused by incorrect sensory-motor integration negatively affects the child’s educational skills. 
  2. Sensory-motor integration supports the child’s cognitive functioning and allows for better adaptability – social, emotional, intellectual, and physical. 

Gergana Borislavova Todorova-Markova, d.p.