Part 2: What Is the Neuro-Developmental Treatment (NDT) Approach?

NDT is a problem-solving approach used by physical therapists, occupational therapists, and speech and language pathologists to improve the abilities of child and adults with nervous system pathologies face during their daily lives. It is not a prescribed series of techniques, but a dynamic approach to planning and implementing treatment.

NDT has evolved over time through clinical experience, questioning, and integration of discoveries made within the areas of motor learning, motor development and motor control. It considers the whole person and understands that psychological, emotional, cognitive, perceptual and physical factors will contribute to a person’s functional abilities.

“The main problem of patients with lesions of the upper motor neurone is abnormal coordination of movement patterns. Problems of the strength and activity of individual muscles and muscle groups we see as secondary to that of the coordination of their action.” (B. Bobath, 1990, p. xiii)

NDT has recognized from its inception that problems with postural control and movement are the primary problems in people with CP or stroke. Secondary effects of muscles and joints can occur because ineffective patterns of movement are repeated over and over. Therefore, NDT focuses on the active use of overall movement patterns that are efficient, self-initiated, and have variety, in order to facilitate brain plasticity and neural recovery to improve coordination of movement.

NDT is a hands-on approach that uses touch to guide movement, provide boundaries to active movement, and elongates shortened areas of the body that are limiting alignment and as a result are limiting activation. This approach is dynamic throughout a treatment session and strategies are modified based on the person’s response and level of success in achieving the goal set for that session. Opportunities for home practice are essential for functional changes to occur and built into the child’s daily routine.

NDT certification is an education process that PTs, OTs, and SLPs can participate in over a 3-week period to work with adults or an 8-week period to work with children. The education process involves classroom learning, lab activities between participants, and supervised sessions treating children or adults with neuropathology. To find an NDT certified professional there is a directory here. If you are already working with a therapist, ask them about NDT. Find out if this is an approach they use and why or why not. NDT is an approach used so commonly that patients and families may not be aware of the framework the therapist is utilizing.