Child & Family Development Child & Family Development

July 16, 2021

Neuro-Developmental Treatment (NDT)

Neuro-Developmental Treatment (NDT) & Summer Goals

By: Hannah Josephson, DPT, c/NDT

According to the Neuro-Developmental Treatment Association, NDT is a type of therapy that uses an advanced hand-on therapeutic approach to help improve efficient functional movements with individuals with movement and muscle control challenges. (  This is often used with individuals with neuromuscular dysfunction such as cerebral palsy, stroke, and traumatic brain injury. This hands-on approach can help optimize initiation and strength of the muscles, but also focuses on correct alignment in order to prevent further skeletal or joint impairments and to improve overall balance and gait mechanics. NDT is also known for its focus on the client-family unit, with therapist’s focusing on client-driven goals to improve their activity and participation in their household and community activities. Therapy sessions often have one session goal, which is pre-tested and post-tested within the session. Summer is a great time to focus on specific goals, and utilizing the NDT approach can help maximize your child’s function and alignment to more quickly reach those goals.

Examples of how NDT can help with specific goals are listed below:

  • Your child wants to ride their bike, but often falls towards their unaffected side:
    • NDT techniques can be used to help your child learn how to weight shift onto their affected side, and help to elongate their trunk to allow for more symmetrical balance reactions on the bike.
  • Your child has difficulty undressing because they lose their balance when lifting up one leg:
    • NDT techniques can help create stability and proper alignment at their foot and improve the co-contraction of muscles at their hip and knee to improve the stability when balancing on one leg. NDT also can help your child improve how they receive proprioceptive feedback from their foot and ankle, which will help them become more balanced.
  • Your child slumps when they are sitting or cannot sit independently:
    • NDT techniques can be used along your child’s trunk to facilitate a more neutral spine, and to improve the alignment and base of support at your child’s pelvis. If you sit with your pelvis rocked forward over your “sit bones”, you will improve the activation of your back and abdominal muscles, leading to improved sitting posture and balance. Your child can learn how to be more independent with this by working on rotational activities to improve their stability and contraction of their oblique muscles as well.

All of these goals can be directly addressed in each session, due to NDT clinician’s skills for analyzing specific postures and movements that support or limit each of these activities and functions, and organizing the session to address each impairment and component.

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