PARENT RESOURCES & FREQUENTLY ASKED QUESTIONS
Welcome to our DMI therapy Parent Resources page. We are happy you are here! This information is designed specifically with parents in mind. Whether you are no to the therapy world or your child has been doing therapy for years - we hope you find answers to your questions.
Dynamic Movement Intervention (DMI) is a therapeutic technique used in physical and occupational therapy to treat children with motor delay by improving automatic postural responses and help each child progress towards developmental milestones (Ie. rolling, sitting, four-point, crawling, standing, walking and transitions). The goal of DMI is to provoke a specified active motor response from the child in response to defined dynamic exercises prescribed by the therapist. (This means that the therapist will present an exercise in order to provoke a specific movement or response from your child.)
This comprehensive intervention reflects current research on neurorehabilitation, technologies and methodologies. DMI stimulates neuroplasticity to help your child’s brain make new and improved connections and develop their motor milestones.
DMI Therapy can benefit your child in a variety of ways.
• Gross motor skills: improving gross motor skills of children from birth by developing automatic motor movement. (Promotes Neurological Maturity)
Parent Translation: Gross motor skills involve larger muscle groups. Your child’s gross motor milestones include the ability to hold his/her head up, roll, sit, crawl, walk, run, transition between positions, etc. Once movement becomes automatic, the brain has completely grasped how to repeat that skill smoothly and utilize it in various scenarios. This allows your child to use that skill well every day.
• Gradual progression: continuously increasing the challenge to encourage the child to respond with greater independence.
Parent Translation: Gradual progression means lessening the support your child requires to do an exercise or activity. For example, standing while supporting at your child’s ankles is less support than at their hips. The less support they are given, the more their brain understands that they can do this skill independently.
• Alignment and Postural Control: all exercises focus on optimal anatomical alignment and stimulate postural control and verticality
Parent Translation: Encouraging your child to activate the appropriate muscles to obtain correct alignment and/or posture. For example: sitting up with a straight back vs. sitting with a curved back.
• Range of Motion: muscle and joint range of motion is achieved by movement (Dynamical and functional stretching).
Parent Translation: DMI provides active stretching in order for your child to maintain or gain better range of motion in areas like ankles, calves, hamstrings, etc. This is done through exercises specifically chosen both during sessions and for your child’s home exercise program. Stretching in this way helps lead to longer lasting changes.
• Balance: improved balance is a common thread through most DMI exercises.
• Functional movements: improving actions and skills that lead to attaining milestones such as rolling, sitting, standing, walking
• Somatosensory Development: The strong sensory information provided by the exercises sends afferent messages to the brain to create specialized synapses that fine tune balance and muscle control and movement.
Parent Translation: Balance requires multiple systems to work harmoniously together. Each time your child is presented with an exercise, they are experiencing some or all of those systems at work. When we do exercises, we are sending messages to the brain to activate those systems either through our hands, their response, or both. Over time, this helps the brain make new connections that help your child fine tune their movements and learn to balance in a gravity dependent world. Balance and movement can then continue to improve.
• Modifying tone, primitive reflexes, and abnormal patterns of movement: DMI strives to provide normalized movement patterns to children with neurological dysfunction to assist with the integration of disruptive primitive reflexes.
Parent Translation: Reflexes are a natural part of development. They help our bodies learn new skills and prepare us for certain movements. Then they get integrated, or slip into the background. Children with neurological damage or delays often don’t integrate some reflexes and therefore experience reflexes for too long. DMI can Help your child move with proper alignment, activating the correct muscles, and thereby help with the integration of disruptive primitive reflexes.
• Global Development: DMI focuses on gross motor skills, however many other skills develop as a byproduct of this intensive intervention.
Parent Translation: As your child gets stronger and is able to move easier, it frees up their brain to focus on other areas (i.e. speech, vision, play skills, learning etc.)
DMI is a good fit for most children and can benefit those that haven’t met many of their milestones. This can include a wide range of delays- those who aren’t rolling yet to kids walking that need help with stairs, more difficult terrain, etc. Regardless of your child’s level of cognition and extent of neurological deficit or damage, affected children benefit from DMI motor intervention because it works to stimulate neuroplasticity in the developing brain.
Children diagnosed with any type of motor delay (big or small) including conditions such as; Down Syndrome, Cerebral palsy, global developmental delay, hypotonia, chromosomal abnormalities/genetic disorders, spinal cord lesions or acquired brain injury may benefit from this form of therapy.
Children with risk factors for delays, such as those who are born prematurely, can also benefit from this therapy. This is due to the strong neuroplastic changes that this treatment stimulates within the developing brain
We have a current list of Registered Practitioners (link to registered practitioners). Our list is updated as new practitioners receive training.
DMI has multiple levels which will be helpful to understand when looking through practitioners:
Introductory Level A – First course
Introductory Level B
Introductory Level C
Intermediate Level A
Intermediate Level B – Final course before pursuing Master/Teacher level
Some DMI Practitioners may offer telehealth. You will need to reach out to practitioners individually to inquire about telehealth services.
Our co-founder and owner of Get Your Baby Moving, Jake Kreindler, offers telehealth services. You can email him Jake by clicking here.
We welcome clinics, schools, and therapy centers to reach out to us to arrange training. This may include virtual courses over zoom or having a teacher travel to their location to give a live course. Please have them email us for a DMI Therapy Training Brochure for all the information.
Other ways to share DMI Therapy with your child's therapy clinic:
- Share your child’s personal experience with DMI
- Share information about what DMI Therapy is and how it can help children with developmental delays
- Share upcoming course dates
DMI is a very powerful and dynamic approach. What sets it apart from more traditional methods is that DMI is constantly working on improving brain function and harnessing the power of neuroplasticity. This is accomplished by using exercises that expose children to gravity, provoke the next set of developmental skills and milestones, and the use of distal and decreased support. Seeing a DMI session performed is usually a new and exciting experience for both the child and their parents.
DMI was first introduced in February 2021 by Jake Kreindler and Jo-Anne Weltman, both Physical Therapists with over 50 years combined clinical experience. To date, hundreds of therapists around the world have been trained, in tandem with our mission to increase accessibility to therapists, families, and children.
While DMI draws some concepts and handling from other methods, it is an evolution (and revolution!) that has shaped this method into a dynamic and effective treatment approach.
Yes. Some kids will cry during therapy. DMI Therapy is hard work. Some children cry about going to school, but as their parent, you would still take them to school because you know that it is what is best for them and their future.
Don’t be afraid to speak up as well. If you think a change could be made to help your child calm down (a quick break, quieter room, dimmer lights, etc.) be open with your practitioner.
After a brief assessment, the therapist will identify areas of deficit, which will guide the treatment. The therapist chooses exercises that will challenge your child’s neurological system to the highest level of skill as well as exercises that develop the core and foundational milestones. Exercises involve movement against gravity, progressively more challenging (distal) support, provocation of desired movements, as well as postural and strength challenges.
During a treatment session, each exercise is repeated around 5 times and the child will complete many different exercises which provide novel and varied sensory and motor challenges. From session to session, exercises may be repeated until the movements become automatic, which results in improved balance and function.
Exercises are conducted on a tabletop or the floor based on the child’s abilities. DMI Therapy works well in conjunction with other therapeutic techniques and therapy equipment. These are often combined in a treatment session to provide better alignment and enhance optimal outcomes.
Dress your child in comfortable clothing. Pants are preferred to protect your child’s legs.
Children should wear supportive shoes (supportive high tops are preferred).
Bring some of your child’s favorite toys, games, books, music or ipad. These items will be used to encourage your child during exercises.
Some practitioners or clinics may provide a home exercise program. This should be a discussion with your practitioner on how comfortable you feel, as a parent, doing exercises at home. If you are comfortable with it, practitioners will walk you through exercises best fit for your child to make sure you are comfortable doing them at home. It is recommended that parents carryover exercises at home, but we understand that may not always be possible.
Orthotics are a tool that can provide alignment to a child’s feet. However, the body has natural tools too. These are known as proprioceptors. They work through movement and tell the spinal cord and brain where our body is in space. The brain responds to the information by adjusting positions at each joint to teach the child to balance. When a joint’s motion is limited, as is the case with orthotics, the proprioceptors cannot fully work. Therefore, an orthotic provides alignment, but takes away the body’s way of learning balance.
While orthotics are sometimes necessary, we choose to perform our DMI sessions without them so the child’s brain and body can fully experience the movements and their proprioceptors can work at the highest levels.
As mentioned above, DMI is relatively new. As we teach more therapists, treat more children, and raise awareness of this wonderful method, the medical community will be well informed and recommend this approach to their patients. You can help raise this awareness by telling your medical providers about DMI and sending them to our website.
Yes, some of our practitioners do offer virtual consults. You will need to reach out to the individual practitioners to see if this is a service they offer. Our co-founder and owner of Get Your Baby Moving, Jake Kreindler, offers telehealth services. You can email him Jake by clicking here.
This varies by practitioner. You will need to reach out to practitioners individually in order to receive more information regarding session fees.
Sometimes. It depends on if the clinic and/or practitioner accept insurance. For example, NAPA Center offers DMI Therapy and they accept insurance. DMI Therapy is considered Physical Therapy or Occupational Therapy depending on the practitioner’s background.
We don’t have research out about DMI Therapy, however, there is research out that support the theories behind DMI Therapy. Research is difficult to do with children because in research a controlled (placebo) group is always required. Parents are less likely to sign their children up for something that may not benefit their child (if they end up in the controlled/placebo group).
However, practitioners see the benefits of DMI Therapy in the patients that they treat. As anecdotal evidence is presented in case studies and research papers, the body of evidence will continue to grow.
A few examples of supporting evidence.
Doidge, N. (2016). The brain’s way of healing: Remarkable discoveries and recoveries from the frontiers of neuroplasticity. Penguin Books.
Edelman, Gerald M. (1987). Neural Darwinism: the theory of neuronal group selection / New York: Basic Books
Gabbard, C and Rodrigues, L. Optimizing Early Brain and Motor Development Through Movement. Early Childhood News. Retrieved from http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?ArticleID=360
Hadders-Algra, M. (2000). The neuronal group selection theory: promising principles for understanding and treating developmental motor disorders. Developmental Medicine and Child Neurology, 42(10), 707-715.
Hannaford, C. (2005). Smart moves: Why learning is not all in your head (Rev. ed.). Salt Lake City, UT: Great River Books.
Johnston, M. V. (2003). Brain plasticity in paediatric neurology. European Journal of Paediatric Neurology, 7(3), 105-113.
Liddle, T. L., & Yorke, L. (2004). Why Motor Skills Matter: Improve Your Child’s Physical Development to Enhance Learning and Self-esteem. Contemporary Books.
Pape, Karen E., Dr., and Jonathan Webb. The Boy Who Could Run but Not Walk: Understanding Neuroplasticity in the Child’s Brain. Toronto: Barlow, 2016.
Prechtl, H. F. R. (1997). Spontaneous Motor Activity as a Diagnostic Tool: Functional Assessment of the Young Nervous System. A Scientific Illustration of Prechtl’s Method. GM Trust.