Depression - a disease of the mind and of the body

New View of Depression:

An Ailment of the

Entire Body

The Wall Street Journal

Scientists are increasingly finding that depression and other psychological disorders can be as much diseases of the body as of the mind.

Shirley Wang on Lunch Break discusses the impact of depression on aging and why people with a history of depression are also known to be at greater risk for cardiovascular disease, diabetes and other aging-related diseases.

People with long-term psychological stress, depression and post-traumatic stress disorder tend to develop earlier and more serious forms of physical illnesses that usually hit people in older age, such as stroke, dementia, heart disease and diabetes. Recent research points to what might be happening on the cellular level that could account for this.

Scientists are finding that the same changes to chromosomes that happen as people age can also be found in people experiencing major stress and depression.

The phenomenon, known as "accelerated aging," is beginning to reshape the field's understanding of stress and depression not merely as psychological conditions but as body-wide illnesses in which mood may be just the most obvious symptom.

"As we learn more…we will begin to think less of depression as a 'mental illness' or even a 'brain disease,' but as a systemic illness," says Owen Wolkowitz, a psychiatry professor at the University of California, San Francisco, who along with colleagues has conducted research in the field.

Gaining a better understanding of the mechanisms that link physical and mental conditions could someday prove helpful in diagnosing and treating psychological illnesses and improving cognition in people with memory problems, Dr. Wolkowitz says.

In an early look at accelerated aging, researchers at Duke University found about 20 years ago that brain scans of older people with depression showed much faster age-related loss of volume in the brain compared with people without depression. The reasons for the accelerated aging appeared to go beyond unhealthy behaviors, like smoking, diet and lack of exercise, researchers said.

Recent efforts to study what is behind accelerated aging on a cellular level have focused on telomeres, a protective covering at the ends of chromosomes that have been recognized as playing an important role in aging. Telomeres get shorter as people age, and shortened telomeres also are related to increased risk of disease and mortality.

In several studies conducted at UCSF, researchers have found shortened telomere length to be associated with depression, childhood trauma and other conditions. A study of 43 adults with chronic post-traumatic stress disorder, whose average age was about 30, and 47 healthy control subjects, found shorter telomere length in the PTSD group that equated to an estimated 4.5 years of accelerated aging, Dr. Wolkowitz says. The study was published last year in Biological Psychiatry.

In separate research, scientists in Sweden found similar results. In a study involving 91 patients with major depression and 451 healthy control subjects, researchers from Umeå University concluded that shortened telomere length was associated with depression and greater perceived life stress. The study was published in Biological Psychiatry in February.

Scientists say more work needs to be done to figure out exactly how severe a psychological experience must be to affect telomere length. Some research suggests that as few as two episodes of major depression may be sufficient to affect cell structure. Other studies indicate that the more bouts of depression a person experiences, the more impact there is on telomere length.

The "holy grail" of this area of work is to try to find the molecular mechanisms by which depression or stress take their toll on the body, says P. Murali Doraiswamy, head of the division of biological psychiatry at Duke University, who isn't involved in telomere work. Such information could help provide clues about how much of age-related disease is due to genetics versus life experience, and whether it can be reversed, he says.

Researchers also want to understand why not all stressed people develop shortened telomeres. Telomere length is thought to be affected by the body's production of certain stress hormones or inflammatory molecules, which are made in greater quantities when people are stressed or depressed. Meanwhile, an enzyme known as telomerase acts to protect against telomere shortening.

Some people appear to have innate biological protective factors, like higher antioxidant level and anti-inflammatory proteins, according to UCSF's Dr. Wolkowitz.

How individuals experience the stress, cope with it and view the world more generally also are thought to relate to telomere length. In 2009, the UCSF researchers found that a personality characteristic, pessimism, correlated with shorter telomeres and increased production of a chemical produced by the immune system related to stress.

In another study, UCSF researchers brought into the lab 50 women and exposed them to standard experimental tasks known to induce stress: giving a speech about their personal strengths and weaknesses and completing a difficult math problem out loud. Some of the women were caregivers for chronically ill children and therefore had presumably more stressful lives. But telomere length didn't seem to depend on whether a woman was one of the caregivers or not. Instead, the telomeres were shorter only in those women who reported greater levels of anxiety about having to perform the experimental tasks—seemingly the ones who tended to get more stressed about life's challenges. The research, led by UCSF postdoctoral fellow Aoife O'Donovan, was published online in March in the journal Brain, Behavior, and Immunity.

Researchers believe it takes months, or even years, for stress or depression to affect telomere length. However, the level of activity of the enzyme telomerase may be affected more quickly. In a pilot study involving 24 patients with prostate cancer, Dean Ornish, founder of the Preventive Medicine Research Institute, a nonprofit research group in Sausalito, Calif., demonstrated that telomerase activity in blood cells increased after three months of changes in the patients' lifestyle, including lowering of cholesterol and psychological distress. Although the study didn't measure telomere length, the researchers suggested that increased telomerase activity in the patients could be signaling greater telomere protection at the cellular level. The study, performed together with UCSF researchers, was published in the Lancet Oncology in 2008.

Heightened telomerase levels have been found in some depressed people who are given an antidepressant. These patients also show improvement in clinical measurements of their depression. Other depressed patients, however, who don't show clinical improvements after being given medication, also didn't experience an increase in levels of the enzyme. The findings are from a small study published in February in Molecular Psychiatry.

After finding that some psychological conditions appear to affect telomere length, researchers at UCSF are trying to find out whether information about what is going on in a patient's cells can be used to change the person's psychology. In an ongoing study, researchers are telling patients how their telomere length, which can be detected through a blood sample, compares with that of an average person of the same age. Researchers are then tracking whether the patients, armed with that information, are more motivated to adopt a healthier lifestyle.

Early Aging

People who have major bouts of depression have an increased risk at a younger age of developing conditions typically associated with getting older. This may be because depression makes cells age prematurely, new research suggests.

•Heart disease

•Atherosclerosis

•Hypertension

•Stroke

•Dementia

•Osteoporosis

•Type 2 diabetes

Source: Owen Wolkowitz, UCSF

Bewuste belewenisse _ Breingebeure of meer?

Uit Dr Wilhelm Jordaan se rubriek in Die Burger van 13 Maart 2012

"Nou die aand in die klas sê-vra ’n nagraadse student: “Al ons gepraat oor vryheid van keuse is praatjies vir die vaak, nè? Dis tog duidelik alles wat jy is, word oplaas deur jou brein bepaal.”

Die student beroep hom op onder andere ’n Duitse breinnavorser, Andreas Bartels, van ’n navorsingsinstituut in Tübingen. Dié reken die liefde, byvoorbeeld, is bloot ’n biologiese meganisme en dat ons binnekort seksuele aantrekkingskrag tussen mense chemies sal kan opwek en reguleer. Proewe met diere bevestig dié moontlikheid, sê Bartels. Wat Bartels beweer, is deel van ’n groeiende “neuro-kultuur” wat reken breinkennis kan nou reeds doeltreffend gebruik word om mense se belewenisse en gedrag te bepaal – volgens breinkarterings wat gegrond is op tegnieke soos MRI-, fMRI-, PET- en CAT-skanderings. Die vertrekpunt is dat jou denke, besluite, emosies en gedrag bloot die som van elektriese en chemiese gebeure in die brein is.

Daar is egter breinnavorsers en -kenners, soos die Amerikaner Richard Restak en die Brit Susan Greenfield, wat teen dié “neuro-kultuur” protesteer en tot versigtigheid maan.

Hulle sê ’n behoorlike neurowetenskap kan nie in die isolasie van laboratoriumproewe geskied nie. Weens die ingewikkelde samehang van liggaam (brein) en gees (bewussyn en belewenis) moet die sosiale, kulturele en sielkundige konteks waarbinne die breingebeure plaasvind, verreken word.

Dié samehang behels byvoorbeeld dat ons bewuste belewenisse – al word dit deur elektrochemiese aktiwiteit en oordragstowwe in die brein bemiddel – méér en ánders as breingebeure is; dat oomblikke van intense bewussyn op sigself die breingebeure wysig en selfs nuwe patrone kan skep. Dit sê ’n mens word mens in die volheid van jou belewenisse; en al word hulle elektrochemies “in stand gehou”, is die belewenisse terselfdertyd méér en ánders as breinaktiwiteit en -prosesse.

Lucille Day, ’n neurochemikus, bioloog én digter, beleef die “meer as” van liefhê as ’n “osmose” tussen man en vrou wat sy “sien gebeur” as sy deur ’n elektronmikroskoop kyk na die eenvoud van senuselle wat “ontmoet”. En dan, op die vlak van belewenis, is daar niks meer te verklaar nie. Al wat is, is die gebabbel van die liefde se vreemde tale. Daaruit kom ’n vers:

“flowing inward, they move/toward each other/and when they finally meet,/melding together, cell by cell,/there is no explanation:/they know who they are./I can almost hear them/yammering in strange tongues.”

Dié “méér en ánders” geld in beginsel ook elke ander kosbare menslike belewenis: ’n spirituele ervaring, ’n oomblik van verwondering, ’n poëtiese insig, die bekoring van ’n woordklank, musiek wat ’n katedraal vul, die gegiggel van kinders wat in bome speel, die aanskouing van skoonheid en ’n vredevolle sterwensoomblik... "

About the anti-anxiety benefits of yoga

Strike a Pose to Reduce Anxiety

By Jennifer Gibson, PharmD, practicing clinical pharmacist and freelance medical writer.

Source: BrainBlogger, a biomedical blog that covers topics from multidimensional biopsychosocial perspectives.

Yoga is a practice almost as old as time itself. It combines mental and physical elements that people today use to enhance spirituality, exercise, decrease stress, and increase well-being. While many practitioners of yoga seem almost mystical and more philosophical than the average bear, a new study proves that you need not be a yogi to achieve the anti-anxiety benefits of yoga.

Research published in the Journal of Alternative and Complementary Medicine reports that practicing yoga postures increased the levels of gamma-aminobutyric acid (GABA) in the brain. (GABA is a neurotransmitter in the central nervous system that is responsible for reduced anxiety, increased relaxation, and enhanced muscle tone.) In this study, healthy subjects with no significant physical or psychiatric illnesses or conditions participated in 60-minute yoga sessions 3 times weekly for 12 weeks. Alternatively, a comparison group participated in a metabolically matched walking program for the same length of time. Subjective mood and anxiety measurements were recorded, and magnetic resonance spectroscopy scans were completed at baseline and at 12 weeks.

Overall, yoga participants experienced greater improvement in mood and decrease in anxiety, compared to the walking group. More objectively, yoga participants showed increased levels of GABA in the brain. Positive correlations were observed between improved mood and decreased anxiety and GABA levels. This appears to be the first time that long-term behavioral interventions have produced increased GABA levels. (A similar pilot study showed that a single yoga session increased GABA levels.) Pharmacological agents are frequently used to increase GABA activity in order to reduce anxiety and improve mood. Yoga, in contrast to pharmacological agents, carries almost no risk of adverse consequences and costs very little, if anything, to practice.

In addition to decreasing anxiety, yoga and other mindfulness-based techniques improve stress, depression, overall well-being, neuroticism, eating habits, energy levels, and pain. Yoga has been prescribed for arthritis and other joint and muscle disorders, with strikingly positive benefits. Yoga also promotes immune function, weight loss, decreased heart rate and blood pressure, and muscle strength. Yoga has even been shown to decrease premature delivery when practiced by women during pregnancy. While other forms of exercise bring about the same benefits, yoga has shown more robust benefits than other activities.

With seemingly all the benefits and none of the risks, yoga should be explored as part of a treatment plan for individuals with mood and anxiety disorders. Or, for anyone wishing to improve well-being. So, grab a yoga mat and strike a pose. Namaste.

References

• Field T (2011). Yoga clinical research review. Complementary therapies in clinical practice, 17 (1), 1-8 PMID: 21168106
• Haaz S, & Bartlett SJ (2011). Yoga for arthritis: a scoping review. Rheumatic diseases clinics of North America, 37 (1), 33-46 PMID: 21220084
• Smith BW, Shelley BM, Dalen J, Wiggins K, Tooley E, & Bernard J (2008). A pilot study comparing the effects of mindfulness-based and cognitive-behavioral stress reduction. Journal of alternative and complementary medicine (New York, N.Y.), 14 (3), 251-8 PMID: 18370583
• Streeter CC, Jensen JE, Perlmutter RM, et al. Yoga Asana sessions increase brain GABA levels: a pilot study. J Altern Complement Med. May 2007;13(4):419-426. PMID: 17532734
• Streeter CC, Whitfield TH, Owen L, Rein T, Karri SK, Yakhkind A, Perlmutter R, Prescot A, Renshaw PF, Ciraulo DA, & Jensen JE (2010). Effects of yoga versus walking on mood, anxiety, and brain GABA levels: a randomized controlled MRS study. Journal of alternative and complementary medicine (New York, N.Y.), 16(11), 1145-52 PMID: 20722471

Somatic markers - how the body affects the mind

Your somatic markers know when to hold ‘em

By Lorimer Moseley in Body In Mind:Research into the role of the brain and mind in chronic pain, 21 March 2011

There is a very large body of data that show that the body affects the mind. That is, bodily processes and responses to stimuli affect our thoughts about those stimuli and our behavioural responses to them. Some of the most intriguing research in this area has been done by Antonio Damasio – most famously the Iowa gambling project [1]. They have primarily investigated people who have damage to their emotional system – ventromedial prefrontal cortex - yet seem to function very well on language and intelligence tests. They do, however, act in a socially inappropriate manner and make stunning judgement errors. One of the earliest studies showed that while healthy volunteers began to choose advantageously before they worked out which strategy was in fact advantageous, patients with damage to their prefrontal lobe chose disadvantageously the whole time – even if they had worked out which strategy was in fact advantageous. The study also showed that normals would have a galvanic skin response, a sign of sympathetic activation, before they realised they were about to make a risky choice. Damasio’s group has done a bunch of studies that underpin their Somatic Marker Hypothesis – “Somatic markers are events or chemicals in your body, detection of which evokes particular feelings or emotions. A note here that, according to Damasio – check out his very readable book ‘The feeling of what happens’, emotions are brain representations of body states. That is, you see a scary looking man approaching you, your sympathetic nervous system is activated, this sends feedback to your brain and your brain registers this feedback and you feel frightened). So, the essence of the somatic marker hypothesis is that when a “negative somatic marker is linked to a particular future outcome it becomes an alarm bell and when a positive somatic marker is linked to a particular future outcome it becomes an incentive” [2].

So, people who have damage to the part of the brain that registers feedback from the somatic markers, don’t ‘read the signals’ from their internal environment. The somatic marker hypothesis argues that this is why they make errors of judgement and do socially inappropriate things – they can’t process the shift in the somatic markers. So, next time you join the poker game, remember what the somatic marker hypothesis says: it is your body that tells you when to hold ‘em, when to fold ‘em, when to walk away and when to run, not Kenny Rogers. So, clearly there is bottom-up influence on cognition – the embodied cognition people talk about this a great deal. We have shown (see here for BiM discussion on ‘Rubber Hand makes your real hand go colder‘ and visual distortion) a top-down effect of cognitive representations on the body [3, 4]. The next blog will raise the stakes even further, albeit rather speculatively…..

1. Bechara, A. (1997). Deciding Advantageously Before Knowing the Advantageous Strategy Science, 275 (5304), 1293-1295 DOI:10.1126/science.275.5304.1293

2. Damasio AR (1996). The somatic marker hypothesis and the possible functions of the prefrontal cortex. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 351 (1346), 1413-20 PMID: 8941953

3. Moseley, G., Olthof, N., Venema, A., Don, S., Wijers, M., Gallace, A., & Spence, C. (2008). Psychologically induced cooling of a specific body part caused by the illusory ownership of an artificial counterpart Proceedings of the National Academy of Sciences, 105 (35), 13169-13173 DOI: 10.1073/pnas.0803768105

4. Moseley, G., Parsons, T., & Spence, C. (2008). Visual distortion of a limb modulates the pain and swelling evoked by movement Current Biology, 18 (22) DOI:10.1016/j.cub.2008.09.031

Ruled by the Body: How Physical Illness Affects the Brain

'Many common ailments and physical conditions can influence the brain, leaving you depressed, anxious or slow-witted.' says Erich Kasten,professor of medical psychology at the University of Lbeck in Germany in an article that appeared in Scientific American on March 3, 2011.

According to Kasten, doctors often forget to ask patients about psychological symptoms. Conversely, psychologists and psychiatrists may treat mental troubles in isolation without looking for a physical cause. But now some doctors and psychologists are reviving the decades-old discipline of somatopsychology, which centers on the effects of physical illness on the brain.

'In Western culture people have long treated body and mind as separate. This dichotomy, popularized by French philosopher René Descartes in the 17th century, is still reflected in medical practice, as the specialists who look after our bodies remain different from those who attend to our psyches. Of course, the division has blurred in recent decades. We now know, after all, that the mind is housed in a physical entity, the brain, which is part of the body. And most people are also aware that psychological problems can produce physical symptoms in the form of psychosomatics; for instance, mental stress can spawn headaches, an upset stomach or even heart problems.

'But fewer people appreciate that the influence also runs in the other direction—that changes in your body can profoundly perturb your mental state,' he says.

Full article available at Scientific American website

You Are What You Touch: How Tool Use Changes the Brain's Representations of the Body

"While we think of our body as a fixed feature of our lives, the brain displays a surprising ability to accept as part of ‘me’ whatever I happen to be touching and using at any given time."

How tools become a part of your body

By Patrick Haggard and Matthew R. Longo

All our experience of the world, and ability to act on it, are channelled through our body. The pioneering computer scientist, Alan Turing, correctly realised the human mind is special not particularly because of its computing power, but because the body provides it with a unique interface to the world. Current research in psychology and neuroscience is probing how the brain represents the body. Recent advances have revealed that body representation is fundamentally multisensory, arising from the combination of many different sensory signals. These include classical “senses,” such as touch and vision, and also much more specific signals, such as the flexion or extension of each muscle, which define the body’s posture in space. This information is integrated to construct a multisensory representation of the current state of the body. Intriguingly, multisensory signals also affect what we perceive our body to be like, for example by making us feel like a rubber hand really is our hand! Our thoughts about what our body is are highly flexible, and track the multisensory inputs that the brain receives.

A common illustration of just how flexible the sense of our body is comes from changes in the brain’s representation of the body due to tool use. Humans, and some other animals, are able to use tools as additions to the body. When we use a long pole to retrieve an object we couldn’t otherwise reach, the pole becomes, in some sense, an extension of our body. Is this merely a poetic way of speaking, or does the brain actually incorporate the tool into its representation of the body? Studies of monkeys learning to use a rake to obtain distant objects show that this may be more than a mere metaphor. Multisensory brain cells respond both to touch on the hand or visual objects appearing near the hand. When the monkeys used the rake, these cells began to respond to objects appearing anywhere along the length of the tool, suggesting the brain represented the rake as actually being part of the hand.

A recent paper in Psychological Science elegantly illustrates the plasticity of body representation, and provides further evidence that representations of the body really do expand to include ‘external’ objects we hold. Thomas Carlson of the University of Maryland and colleagues at Harvard University and Utrecht University in the Netherlands used an unusual subjective experience of the body first reported by Franklin Taylor of Princeton University in 1941. If you look towards your hand in a darkened room and see it illuminated by a bright flash, an afterimage of your hand remains after the flash. If you then move your hand, the afterimage changes, though no actual visual signal is present. The precise effect, like so much of the richness of human sensation, is difficult to catch in words, but is like a fading, or loss of clarity of the hand. This fading is normally explained by the multisensory nature of body representation: when the hand moves, but the afterimage does not, visual information and ‘proprioceptive’ information from muscles no longer agree about where the hand is. The visual impression of the hand fading may be a by-product of this inability to integrate different sensations due to conflict about where they are in space.

Carlson et al used this fading to investigate the limits of the brain’s representation of the body. When participants held an object and then moved their hand after the flash, the object’s afterimage faded as well. Further, if participants reached for the object after the flash, the object still faded. The brain may detect a conflict between the location of the object in the afterimage (on the table) and the location where the object is actually felt (in their hand). Alternatively, the object may be rapidly assimilated into the representation of the body and therefore subject to the same perceptual conflict.

The authors also ran additional tests in which volunteers dropped the object, providing new evidence for a spatial bound on plasticity of body representation. Objects released from a mechanical gripper held in the hand did not fade, while those released directly from the hand’s grasp did fade. These conditions suggest that direct contact with the skin may be an important cue to plastic bodily extension. A critical, though elaborate, test might involve forming an initial afterimage of the hand, gripper and object placed separately on the table, then picking up the gripper, and using this to pick up the object. The authors would predict a fading of the afterimage of the gripper, due to its incorporation in the body representation. However, the object should not be incorporated because it would not be touched directly.

These results elegantly confirm that the human brain maintains a highly flexible representation of the body, despite the tendency in everyday life to think of ourselves as having a fixed personal identity, linked to our body. Two distinctive features of mental body representation emerge. First, from the brain’s perspective, the body is by far the most familiar object in the world: the body, as William James elegantly put it, is “always there.” In these experiments, the mechanical gripper could be treated as part of one’s own body. However, this did not extend to an object held in the gripper, perhaps because this situation wasn’t familiar enough. We speculate that skilled prosthesis users might experience objects grasped in the prosthetic hand as fading, even though first-time users in the present experiment did not. Given the ability to move an object through voluntary action, and sufficient sensory experience of doing so, the capacity to extend the self may be virtually unlimited.

Second, these studies suggest a view of the body as an interface between the brain and the external world. This view has important implications for human psychology generally. The sensorimotor mechanisms of the body are effectively a tool for our voluntary actions to respond to the environment and to change it. While we think of our body as a fixed feature of our lives, the brain displays a surprising ability to accept as part of ‘me’ whatever I happen to be touching and using at any given time.

About the authors:

Patrick Haggard leads a research group at the Institute of Cognitive Neuroscience, University College London. His research interests include the brain's representation of one's own body, and the control of voluntary action. Matthew Longo is a postdoctoral fellow at the Institute of Cognitive Neuroscience, University College London, and soon to be a lecturer at Birkbeck College, University of London. He is interested in how we represent our bodies and how this shapes how we perceive the external world.

Source: Scientific American via Body in Mind

Serotonin cell discoveries mean rethink of depression

If you thought depression was caused by low serotonin levels, think again. It looks as if the brain chemistry of a depressed person is much more complex, with mounting evidence suggesting that too much serotonin in some brain regions is to blame.

Read the full article by Linda Geddes at: NewScientist 22 July 2010 Issue 2770

Source: Neuroscience and Pain Science for Manual Physical Therapists on Face Book

Move it, baby! Can exercises help to avert dyslexia?

Move it, baby! Can exercises help to avert dyslexia?
by Celia Brayfield

When you gaze at your new baby and wonder what destiny has in store, you hope dyslexia won’t be part of the picture, with its possible consequence of alienation. However, parents can act to minimise the possibility.

According to Sally Goddard Blythe, who runs the Institute for Neuro-Physiological Psychology (INPP), a self-funding research and clinical organisation based in Chester, there are factors of family life that interfere with the development of a child’s mind. Her book The Well Balanced Child describes how the infant mind matures and what action parents can take to help it develop.

She argues that the restrictions of a modern childhood, with small homes, baby-seats and reduced opportunities for movement, produces problems. A couch-potato lifestyle can have mental as well as physical consequences. The INPP has 30 years of experience in working with children whose learning difficulties begin in infancy, when they don’t move enough, and in the right way, for their brains to develop the abilities they need to master reading and writing.

“In the first year of life, important connections are being formed between the brain and the body,” Goddard Blythe says. “Balance, co-ordination and eye movements, which a child needs before it can read, all depend on these connections.”

One thing that interferes is a persistence of the reflex reactions of the newborn. These give the baby survival instincts, prompting it to search for the breast, gain control of its body and react to danger. As the baby grows, the movements of crawling suppress the reflexes, which die as the child develops balance.

Babies who don’t crawl or aren’t active enough in their first year retain their newborn reflexes and have to struggle against them. Not only could they have difficulty in reading and writing, but they may also be clumsy and unco-ordinated, have trouble tying shoelaces, riding a bicycle, catching balls and find it hard to do things that involve two skills together – such as copying from a whiteboard.

Immature reflexes may also show up in a child’s feelings and behaviour, because the balance mechanism in the brain also has emotional connections, so children might be hyper-reactive, have trouble concentrating, be easily upset and be overly anxious, fearful or aggressive.

The INPP has developed a ten-minute remedial exercise programme, being tried out in schools. Studies in Cumbria and Derbyshire have indicated that it is twice as effective as traditional exercise and four times better than none at all, in improving reading and writing and behaviour in primary schoolchildren. A study of 670 children — average age eight — in seven schools in Northern Ireland showed improved concentration and a trend towards higher academic achievements.

Every child with learning difficulties is different and has a unique cluster of physical, mental and emotional challenges to overcome. The analysis isn’t a perfect fit, but in some cases it can turn a child’s life around. Of course, it is better to need no remedial exercises. “The process of maturation is hard-wired into our instincts,” says Goddard Blythe. “All children need to develop normally is the opportunity to do the natural thing.”

This means giving a baby ample space and freedom of movement, particularly in the first year. She suggests that from the age of about six weeks a baby should have “tummy time”, when it can lie on its front and wriggle freely. “And don’t make the mistake I made. I was so delighted to have a girl after two boys that I put her in pretty dresses, which aren’t nearly as easy for a baby to move in as Babygros,” she says.

The baby will naturally start doing “push-ups”, raising its head and upper body, and within a few months will start crawling — this is vital for its neurological development.

Because the sense of balance is so important, she suggests a traditional rocking cradle, and for older children those bouncing and swinging games are developmentally vital. They help children to gain mind-body co-ordination. Old-fashioned swings and roundabouts are probably better than adventure playgrounds.

Goddard Blythe’s recommendations include music and singing, reading, conversation, optimum nutrition and family meals. In fact, she concludes, the classic Enid Blyton childhood, with country picnics, nursery rhymes and cod-liver oil, had an awful lot going for it.

The Institute for Neuro-Physiological Psychology; 01244 311414. http://www.inpp.org.uk/

The Well Balanced Child by Sally Goddard Blythe (Hawthorn Press)

Source: Times Online