Netcare on World Disability Awareness Month

The importance of monitoring the first 1000 days

Friday, December 3 2021

Nicky Lasch, a Paediatric Neurodevelopmental Physiotherapist, spoke to Netcare about the importance of early intervention and the profound impact of a nurturing relationship on an infant’s brain development. “The ‘First 1000 Days’ of life is regarded as the brain’s window of opportunity to grow and develop. It is also a time of tremendous potential and enormous vulnerability”. She added that Neuroscience continues to provide us with insights on how nutrition, a healthy relationship between mother and child, and the influence of a stimulating environment can shape a child’s development.

With this ideology, she established her physio practice for the early assessment and treatment of babies and children who present with either cerebral palsy, autism, congenital disorders or syndromes.


What to watch out for in your baby’s development

“It is essential to remember and that all babies develop at a different pace with many factors influencing their development like home stimulation, birth factors, genetics. Although it is normal to compare your baby with others of the same age, skills are developed at vastly different rates, so instead, use a helpful comparison to assist you in understanding your baby’s progress.” She also went on remind us that there is a lenient ‘window period’ during which your baby can achieve their milestones; one baby may learn to sit faster than another, but their ability to play and explore toys may not be as proficient. This phenomenon is referred to as the ‘competition of skills’– it is normal she stressed. “Each baby will achieve milestones in their unique sequence and time.”


Questions to consider if you have concerns

-    Observe your baby’s movement when placed in different positions. Look at the quality and variety of movement.

  • Does one side of your baby’s body move differently from the other side?
  • Does your baby use a variety of movements in their arms and legs, or do they repeat the same movements continuously?
  • Do they tolerate tummy time?
  • Do their muscles and joints feel more ‘stiff’ or more ‘floppy’?

-    How do they respond to being carried, moved in space or travelling in a car seat?
-    Do they like to be cuddled and touched in everyday handling, or do they resist, stiffen and cry?
-    Is your baby interested in toys and their surrounding environment?
-    Do they make eye contact, engage and interact well with you?
-    Do they feed easily and sleep well?
-    Can your baby calm themselves easily, or are they particularly fussy at inappropriate times?
-    Do they respond to sounds and visual stimulation?

“Tune into your baby as you know your baby intimately and better than anyone else.
Remember that it is normal for your baby to have off days. There is only reason to be concerned when this behaviour becomes the ‘norm’ and is coupled with delays in other milestones.”


Who to reach out to if you are worried about your baby’s development

Over the years, she has been able to expand and collaborate with a multidisciplinary team of equally dedicated therapists, They now refer to themselves as SPOT-on! Therapy. “Our core value is ‘individual, child-centred and streamlined care for both the patient and the family.”
With her commitment to empowering parents with tools for early intervention, she co-wrote and developed the Moms & Babes Stimulation Programme in 1999, alongside her friend and colleague, Kate Bailey (OT). their programme equips and supports parents within the community to understand and enhance their baby’s development by teaching them how to detect delays and implement specific handling skills. This programme has had a far-reaching impact on moms and their babies from cities to suburbs and even outlying rural areas.

Nicky’s journey to paediatric health care

Choosing a profession in paediatric health care was neither an incidental nor a random decision, for her, it was a calling. “I chose to enter the field of paediatric neurology as a physiotherapist with a deep intrinsic motivation to help children, alongside the inspiration from a unique childhood friend.”

“Lee and I were 8 and 6 years old, respectively, when she moved in next door. She had Osteogenesis Imperfecta (Brittle bone syndrome) and was severely physically handicapped. However, she more than made up for her physical limitations with her strong outgoing personality, gifted intellect and creativity and was the source of my convictions to pursue and realise a dream of making a difference in the lives of babies and children who are atypical, have special needs, are disabled or have impairments.”

Despite the shortness of her life, Lee made an impact on Nicky. It was with this fervour that she began her career as Paediatric Neurodevelopmental Physiotherapist thirty two years ago and has completed numerous post-graduate qualifications in this specialised field of Neurodevelopmental Therapy and Early Childhood Development. Her passion for working with young children and their families has taken her on a journey of gaining deeper insight and knowledge through valuable patient interactions. “Sharing my experience with fellow professionals by presenting workshops, lecturing and mentoring, has sustained my interest and commitment to this field.” 

“It is a privilege to still find substantial purpose in my career, and I am grateful for the opportunity to work within a minority group in South Africa. It is these babies and children with disabilities, handicaps and challenges who will become the adults of the next generation.”