The Association Between Childhood Motor and Cognitive Development

Contemporary research has resulted in increasing awareness regarding the relationship between motor and cognitive development in early childhood.

Historically, it has been assumed that motor control and cognition develop separately. However, it has now been well-documented in the literature that motor and cognitive skills mature along a similar trajectory.1,2 Leisman, Moustafu, and Shafur studied motor and cognitive skills in the context of the development of bipedalism in humans as a conduit for the evolution of the neocortex.3 Piaget posited that children’s cognitive and motor development are closely related, and was the first to investigate how intelligence evolves from contact with the external world.4,5 Mobility is crucial to cognitive functioning, aiding in the formation of neural connections and cortico-differentiation.6 As infants interact with the external environment, the brain reacts to this input. Studies involving neuro-imaging have found that increased physical activity promotes the formation of gray matter in the brain.1

Childhood Motor and Cognitive Development

In children with developmental disabilities, deficits are typically observed in several domains concurrently. For instance, in children born premature, problems can occur in the areas of emotion, socialization, learning, and movement. Research in 5-6 year old children has revealed a symbiosis in the development of cognitive and motor milestones.7,4,8 Furthermore, research on brain structure and function has shown that the cerebellum, a structure formally thought to be solely involved in movement, also plays a role in cognition. In children with Autism, motor development is one of a number of deficits that also include learning and language, possibly associated with anomalies in the

Notwithstanding the diagnosis, many children that are seen at Grace Rehabilitation for gross motor delays, also tend to have social, emotional, language, and learning difficulties. As physical therapists, we can treat impaired movement, which can in turn help facilitate learning in young children. We are involved in the treatment of motor delays in infants, toddlers, and young children, in addition to interventions by other disciplines such as speech and occupational therapy. These disciplines are not mutually exclusive; and often work together to enhance development. Early intervention is critical to making the utmost change in both learning and motor abilities.

Learning begins when these children are seen in the clinic as infants and helped to improve motorically, stimulating cognitive, social, or speech development. Many of these children continue to be treated in the school setting by various disciplines including occupational, speech, and physical therapy, in addition to academic assistance. Learning is multifaceted, and all needed therapy services are mandated in the educational setting for children with disabilities in compliance with The Individuals with Disabilities Education Act (IDEA), which is federal legislation first passed in 1975.

Some of the diagnoses found in children entering physical therapy at various ages may include: Developmental Delay, various genetic syndromes, Autism Spectrum Disorder, Cerebral Palsy, Developmental Coordination Disorder, Sensory Integration Disorder, and a host of others. A variety of developmental skills deficient in these disorders are addressed by physical therapy to enable the child to function on a level more comparable to his or her peers with regard to gross motor function and mobility, enhancing cognitive development. For example, motor skills in the prone position are addressed. If the child is unable to roll over and function in prone, skills such as eye convergence or fine motor skills that begin with weight bearing through the hands may not develop properly. Inadequate prone skills can also be related to speech or feeding issues, because the orofacial muscles are not strengthened and are underdeveloped. If the child can develop postural skills for sitting, this brings with it greater visual awareness and a perspective of the world, as well as interaction with others. Crawling works on bilateral coordination and the ability to explore the environment, and also works on postural tone that can help with fine motor skills needed for activities such as writing. Walking, running, and advanced skills such as jumping jacks, throwing and catching a ball, all improve body awareness and proprioception, fostering visual perceptual skills that are used in activities such as reading. Being able to slide, jump, and swing works on vestibular development and visual following, aiding in social and emotional development and interaction with peers, such as when playing at recess, or visual/perceptual abilities that aide in fine motor skills such as writing.

Motor skills that develop in infancy and beyond are not simply randomly generated in the central nervous system or at the cortical or spinal cord level. While innate reflexes are present at birth, many early movements are purposeful and conscious, engendering learning. When novel motor skills are produced by a child, pre-planning as well as anticipating the outcomes of the movements help to engender cognitive development. Therefore, a delay or deficit in gross motor skills may impact cognitive development. This necessitates the need for intervention throughout childhood in order to ameliorate the effects of motor impairments on other areas of growth such as learning or social development.


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