Assessment and Results
Quantitative Assessment and Neurological Summary Report
Foreseeable deviations in postural reactability in position reactions can be described quantitatively with the number of disturbed segmental patterns. For this, a conceivable optimal quality in the structure of the global pattern, the “ideal pattern”, is taken as a starting point. If the “ideal” in a postural response is not reached, then we describe this postural response as "not ideally” realised.
A disturbed segmental pattern by itself is enough to cause this. There can be various reasons for such a deviation. However, the probability of potential pathological disturbance increases with the total number of disturbed segmental patterns. The higher the number of disturbed segmental patterns, the higher also the probability that this will be reflected in several (or all) postural responses.
The CNS is then only imperfectly able to enter into the innate “stock” of sufficient patterns of movement and posture with the afferences that have accumulated in the postural response. For this reason, we speak of a “disturbance in central coordination” (DCC).
Pragmatically speaking, for the purposes of therapy we can distinguish between:
- Mildest DCC 1–3 abnormal postural responses
- Mild DCC 4–5 abnormal postural responses
- Moderately serious DCC 6–7 abnormal postural responses
- Serious DCC 7 abnormal postural responses and additional serious dystonia
To assess the prognosis of a DCC, the neonatal reflex (so-called primitive reflex) dynamic must be taken into consideration. The term “DCC” is therefore not synonymous with “cerebral palsy” or “threat of cerebral palsy”. Outside the period in which neonatal reflexes are normally observed, the term “DCC”, which is noncommittal for individual prognosis, is to be specified. One should then distinguish between postural deficiencies, the threat of cerebral palsy and actual cerebral palsy.
The classification criterion “DCC”, important for the structure of the postural responses, is not a nosological diagnosis.