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Neurophysiology and Neuropsychology of Motor Development.
  1. NEIL GORDON, Retired paediatric neurologist

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    Neurophysiology and Neuropsychology of Motor Development. Edited by Kevin J Connolly and Hans Forssberg. (Pp 378; £60 hardback.) Cambridge University Press, 1997. ISBN 1 898683-10-7.

    This is essentially a text for those involved in research into normal and abnormal motor development in children; in fact it must be considered indispensable to them. The reason for this: a number of leaders in their field give an up-to-date review of the progress made in various aspects of their work, and in a form that would not be available elsewhere. But what of the average reader of this journal? For them it is likely to be used as a reference book when particular problems arise.

    Since the advent of various types of brain scan more is being learnt about the results of abnormal brain development causing epilepsy, and mental and physical disabilities; and those caring for these children do need to know how these abnormalities occur. There is also the problem of the normal and abnormal movements of babies, both before and after birth, which may worry both parents and doctors.

    More attention is now being given to children who seem to have poor balance and are late in starting to walk, have poor coordination, and are clumsy in their movements. But when do you decide that there is cause for concern? Many answers are given. Of particular value to the clinician are the chapters on children with cerebral palsy. These underline how important it is to avoid dogma, and to be flexible in approaches to treatment. The way in which skills are acquired must be of great significance; and enormous resources are devoted to improving these. If such efforts are to be successful, study of normal development, and of ways in which the damaged brain can compensate will be essential; and all carers will benefit from reading the chapter on the “conversations” between experts and parents, which may be the highlight of the book as far as practitioners are concerned.

    Some of the research certainly emphasises the importance of early learning, especially if motor pathways need to be reorganised. The development of grasping may be of most importance to researchers, but it is also necessary for others to understand how an often used test can vary in the way, and the timing, of its development. The dynamic approach to motor development, and to the acquisition of skills, has considerable appeal, stressing as it does the interaction of so many factors. The mass of information in this book may be daunting, but in the past there is no doubt that many theories, and much of the work, has been oversimplified; and the problems that this complexity presents have to be faced.

    One of the purposes of this book is to bridge the gap between different disciplines, and in this it surely succeeds. Another laudable aim is to link scientific work with clinical practice, and this could have been better served if there were a summary at the end of each chapter, or at the end of the book, underlining how this best can be done. This book should reach as wide an audience as possible: and particularly those working with handicapped children will benefit from seeking answers to the questions they will have when faced with the problems of their charges.

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