How to look for Neurodevelopmental Markers
Neurodevelopmental markers (sometimes called "soft neurologic signs") are signs of immaturity of the central nervous system that are developmentally inappropriate, i.e., they would usually be considered normal in a younger child. Finding one or two of these signs in a normally functioning child is insignificant. However, finding multiple neurodevelopmental markers suggests a delay in the maturation of the nervous system, consistent with the diagnosis of a learning disorder. These can be screened for during a physical exam.
Hand preference is generally established by age 3. Left hand preference, or mixed hand preference are neurodevelopmental markers.
*Screen for hand preference by asking the child to demonstrate how s/he holds a pencil, throws a ball, and hammers in a nail.Overflow movements, or synkinesias, are movements of the opposite hand, or the tongue during stressed movements. They are indicative of incomplete inhibitory pathways.
The inability to inhibit proximal musculature while using distal muscles is a neurologic marker.
*Screen for proximal inhibition by having the child rapidly alternate opening and closing of fists with arms extended, or by rapidly rotating the wrist while holding the arm up and hand above the head.Dystonic posturing is stiffening of the extremities during a stressed gait or rhythmic movements.
*Screen for dystonic posturing by having the child hop in place or heel toe walk.Most children can identify left and right by age 8. The inability to identify left and right when crossing the midline, in a child who can identify left side and right side, is a neurologic marker.
*Screen for L/R confusion by having the child touch his/her left ear with his right hand. Also ask the child to point to the examiners right hand with his/her left hand.