The levels of motor development were deduced from the motor skills observed by Le Metayer in humans, which are innate and not intended to disappear as the child grows older.
These motor acquisitions are disrupted in children with CP, and the role of the physiotherapist is to restore them. 

The main functions to be acquired are : 

• the postural function, omnipresent in the organization of any movement.

• the anti-gravity function, which ensures support, maintenance, recovery

• the locomotion function: automatic running, crawling, turning over

 

For the acquisition of these functions, M. Le Métayer defines 12 levels of motor evolution (NEM) :

• Dorsal decubitus 

• Ventral decubitus: position of the sphinx 

• Turns: back to stomach and stomach to back 

• Reptation 

• Position of the rabbit (kneeling): sitting on his buttocks and held by his hands. 

• On erect knees: without hand support 

• Sitting in beach position (position of the little siren): from rabbit position, sliding of the pool to the side 

• Stable seating 

• Position of the serving knight 

• Squatting: with hand support, then without support 

• Position of the bear: leaning on his hands and feet, the child raises his pelvis upwards. 

• Four legs 

• Passage to the standing position: often from the position of the serving knight 

• Standing with support of both hands 

• Standing with one-handed support 

• Standing without support 

• Walk

During a session, the therapist begins by helping the child to relax all his muscles. Then he tries to stimulate the child's reflexes according to his level of mobility. For example, for a child who does not move at all, he can use a boudin to strengthen his postural function. When learning to walk, the use of splints or gutters to guide the correct placement of the hips is possible.