Dynamic Movement Intervention (DMI) is a specialized therapeutic technique used by physical and occupational therapists to treat children experiencing delays in gross motor skill development. This hands-on approach aims to improve automatic postural responses and encourage progress toward achieving developmental milestones like sitting, crawling, and walking. DMI incorporates current research in neurorehabilitation to provoke a desired active motor response from the child. Developed in Canada, the method is now utilized globally to address motor impairments in pediatric populations.
The Core Principles of DMI
The fundamental mechanism behind Dynamic Movement Intervention is neuroplasticity, the brain’s ability to reorganize itself by forming new neural connections in response to experience and practice. DMI capitalizes on this natural ability in young children to strengthen existing motor pathways and create new ones through repetitive, specific movement patterns. The therapy stimulates the central nervous system with exercises that challenge the child’s balance and postural control.
A core component of the exercises challenges the child’s body against gravity, providing strong sensory information that requires an active response for postural stabilization. The therapist continuously adjusts the support level, gradually decreasing it to encourage greater independence and strength. This progression provokes an active motor response just beyond the child’s current capability, forcing the brain to adapt and engage new movement strategies.
The therapy places significant emphasis on achieving optimal anatomical alignment and stimulating postural control, often called proximal stability. Ensuring the child’s trunk and joints are correctly positioned promotes normalized movement patterns and helps integrate primitive reflexes. This focus on proper alignment and functional movement leads to improvements in muscle control, balance, and overall coordination.
Conditions and Candidates for DMI
Dynamic Movement Intervention is designed for children struggling to achieve motor milestones due to neurological or developmental conditions. It is often recommended for children with diagnoses such as Cerebral Palsy, where muscle control is affected by brain injury. Children with genetic disorders, including Down Syndrome and chromosomal abnormalities that cause low muscle tone (hypotonia), are also common candidates.
The approach is also beneficial for children experiencing global developmental delay, spinal cord lesions, or acquired brain injuries. Because of its reliance on neuroplasticity, DMI can be used across a broad range of functional levels, from infants as young as three months old to older children. The primary determining factor for candidacy is the presence of a motor delay, regardless of the child’s cognitive level or the extent of neurological damage.
What to Expect During a DMI Session
A DMI session uses a series of structured, purposeful exercises tailored to the child’s developmental needs and goals. The therapist identifies areas of deficit to guide the treatment plan, selecting exercises that challenge the child’s neurological system at their highest level of skill. The environment typically uses minimal equipment, such as specialized tables, boxes, or the floor, to focus the child’s attention on the required movement.
During the session, the therapist guides the movement, using dynamic handling techniques to provide precise, minimal support necessary to provoke an active response from the child. This involves manipulating the child into positions that encourage a novel, more typical movement pattern. Exercises are executed with intense focus in short bursts, with each specific movement pattern typically repeated about five times before moving to the next challenge.
The exercises themselves target the acquisition of functional milestones, such as developing the strength and control needed for rolling, transitioning from sitting to standing, or taking steps toward independent walking. Sessions are often intense, sometimes delivered in multi-day “intensives,” and are highly individualized to ensure the continuous increase in challenge needed for progress. To sustain momentum, the therapist provides a home program, teaching parents or caregivers specific exercises to practice between sessions, reinforcing the new motor pathways established during therapy.