Background. Primitive reflexes are automatic stereotyped movements, present in the first year of life which assist with birthing and development of motor, sensory and visual systems. Primitive reflexes are superseded by fully developed postural reflexes by 4-years-old. The prolonged presence of primitive reflexes indicates an increased risk of neuromotor immaturity, developmental delay and neuro-behavioural disorders in children. Neuromotor interventions can reduce the presence of primitive reflexes and lead to improvements in motor development, and pro-social behaviour, along with reading, spelling, and writing in school-aged children (Goddard Blythe, 2005; Goddard Blythe, 2023; Konicarova et al., 2013; Marlee, 2008). However, few studies have measured neuromotor interventions in younger children and to the best of our knowledge, there have been no prior studies of this kind in four-year-olds in New Zealand. Accordingly, this thesis aimed to examine aspects of feasibility and acceptability of a neuromotor programme, ‘Moves4LilMinds’ (M4LM), in children aged 4-years-old.

Methods. Using a single-centre, two-arm, single-blinded, pilot randomised controlled trial (RCT) design, 11 children (mean age = 4.2 years) were randomised to the intervention or a general exercise control group. Feasibility of conducting a full-scale trial of the intervention was quantitatively assessed by examining rate of recruitment, acceptance and effectiveness of randomisation, and participant burden. Feasibility of the intervention was quantitatively assessed by programme adherence and safety. Acceptability was qualitatively assessed by semi-structured interviews with parents and teachers.

Results. Findings supported feasibility of participant recruitment (81%), effectiveness of balanced randomisation (Māori/non-Māori, age, sex), acceptance of randomisation (100%), safe delivery (100%) and consistent improvements in teacher intervention adherence across two assessment timepoints. Parent and teacher feedback on intervention acceptability revealed three themes: benefits; challenges; and the importance of teacher initiative when delivering the intervention. Teachers found the intervention acceptable to use in the early childhood centre, with reported improvements in teacher-child relationships, concentration, attention, self-regulation, body/mind connections, and child leadership. Both parents and teachers reported benefits for children’s confidence, focus, behaviour and coordination. Teacher-reported barriers to intervention delivery including remembering the exercises, initial discomfort modelling exercises and staffing challenges. Teacher initiatives to support delivery included reminder sheets, shared leadership and flexibility.

Conclusions. Study findings suggest that a future full-scale trial is likely to be feasible, with changes to the study design to increase participant completion of assessments and intervention delivery. Future studies can draw on the strengths and recommendations of the current study, allowing greater time for intervention delivery and larger sample sizes to enhance design. Future research can harness the opportunity to determine the efficacy of neuromotor intervention programmes for reducing the presence of primitive reflexes in four-year-olds as an intervention pre-primary school. This offers the potential to enhance children’s learning, behaviour and physical development in New Zealand and beyond.