Effects of MNRI Therapy on Fine Motor Skills in Children With Developmental Delays.

Delay in development is generally determined with a child does not attain developmental milestones as compared to peers from the same population. "Developmental delay" is a general descriptor of a broad phenotype that must then be specified by carefully determining one or more elements linked with the area of disrupted development. Developmental delay is not a diagnosis by itself rather a categorical, illustrative term used in the clinic. Further, the terms often used to specify a developmental delay may vary by country or area of practice. For example, the term "mental retardation is no longer in use with "learning disability" being used in the UK and Intellectual Disability being used in the US to define a group of individuals with a significant delay defined by "performance equal or greater than two standard deviations below the mean on age-appropriate standardized norm-referenced testing" (IQ or intelligent quotient testing). The MNRI (Masgutova Neurosensorimotor Reflex Integration) processes are designed for individuals with neuro-developmental disorders and aimed at the improvement of their sensory-motor integration, motor coordination, and cognitive development. The MNRI therapy program is based on the supposition that impaired reflex circuits can be reconstructed.

A randomized clinical trial will be conducted at Children Complex Hospital in Multan. Non probability convenience sampling technique will be applied on 34 patients who will be allocated through simple random sampling into group A & group B to collect data. Group A will be given Masgutova Neurosensorimotor Reflex Integration therapy (MNRI) and group B will be a control group. The study will be completed within the time duration of six months .Primary Outcome measures of the research will be reflexes and fine motor skills of upper limbs. Data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Inclusion criteria

• Children of 2-6 years of age presenting with development delay.
• Severity of development delay in each domain will be labeled as mild, moderate and severe categories according to Denver Developmental Scale-II .
• Children showing signs of unintegrated primitive reflexes (e.g., Moro, ATNR, STNR, TLR, etc.), which MNRI specifically targets.

Exclusion criteria

• History of orthopedic surgery within the last half a year
• Any other neurological or musculoskeletal disorders that might hamper the study's results (e.g., traumatic brain disorders, muscular dystrophy, and epilepsy).
• Patients with autism and non-cooperative for development assessment.
• Children whose development level was above 8 years of age as Griffith scale measures development age only up to 8 years .