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By Suzanne Day
Introduction to the Neurology behind this approach
(giving the brain a “second chance” to address learning and attention inefficiencies)
Learning Disabilities (LD) and the inattentive type of Attention Deficit Disorder (ADD) are hidden conditions which are not evident from the outside like a heart problem. Children with these problems have one or more areas of inefficiency in their processing. Children that manifest the symptoms of LD or ADD confess that they feel stupid and that they carry guilt and shame. Comments or reactions such as “ I just can’t figure out what the teacher is saying, so I just stare and think: am I the only person in the world who is so dumb?” are rolling in their heads. Common labels for these children are “lazy”, “unmotivated”, and too often, “stupid”. Sometimes the labels “Learning Disabled” or “ADD” alleviate depressive feelings and somehow give a reason for the person’s learning problem. However, labels can be a double-edged sword, which can mislead the person and the educator to accept the weaknesses and stop the process of striving to better understand the root causes in order to overcome the limitations.
Pertinent and effective intervention can only be planned, when some of the causes are identified. As a professional I have found that the best way to efficiently increase the learning process and to address the learning and attention difficulties is to look at the causes of the problems in terms of neurodevelopment. This approach has proven to be invaluable in my career. Sally Goddard expresses it well: “A neurodevelopmental approach enables the teacher/therapist/clinician to ‘take the lid off learning disabilities’.” The neurodevelopmental approach looks at the condition of the functions that should be in place from birth to seven years old in the areas of visual, auditory, tactility, mobility, manual dexterity, and language.
The Central Nervous System
When addressing this issue of learning and attention disabilities, the inefficient functions of the central nervous system must be attended to. The central nervous system (CNS) is comprised of the spinal cord and the brain. The different parts of the CNS communicate with electrical impulses, which are transmitted along the nerve cells and are generated by chemical markers called neurotransmitters. Research has identified protein-like markers, which guide the dendrites (the extremities of nerve cells) to their specific destinations. When talking about the electric current in the brain and the chemistry involved to allow this electric current, it is interesting to note that in recent years, through the use of the electron microscope, researchers have discovered that it is not only the proteins around the cells that allow these communications, but glycoproteins or monosaccharides (sugars) that attach to the proteins. An article in Acta Anatomica (161/1-4/98) explains “…there are eight essential monosaccharides which represent an alphabet of biological information similar to amino acids and nucleic acids, but with unsurpassed coding capacities”. We knew that our brain needs glucose to function but we now know that there are seven other essential monosccharides which are involved in efficient cell-to-cell communication.
The Importance of the Brain Stem in Learning
We mainly refer to the cortex (of the brain) when discussing learning and attention difficulties. Yet, other important areas, which we neglect to understand, are the pathways between our senses, the spinal cord, the brain stem, the midbrain, and then the cortex. The brain stem (the medulla and the pons) is one crucial section of the CNS, which is often neglected; it is located between the spinal cord and the mid brain.
The brain stem regulates both motor and sensory processes, consciousness, and the control of perception. The brain stem constitutes bulges of nerve pathways carrying the nerve impulses between the brain and the body. The brain stem houses not only the reticular formation (network of nerves) responsible for vigilance (alertness), but also the nuclei where the main neurotransmitters originate. It is very interesting to note, also, that the twelve pairs of cranial nerves originate from the brain stem. Some of them are motor nerves, like the oculomotor nerves, which pertain to the eyes, some are sensory like the olfactory nerve and some have mixed functions like the trigeminal nerve. Information is transferred from the brain stem to the midbrain and the thalamus. The thalamus is like a telephone switchboard that in turn directs information to different areas of the cortex, except for smell which goes directly to the cortex bypassing the “switchboard”. What happens in the cortex is the result of loops along this pathway from the brain stem to the cortex. We know for example, that reading happens mainly in the left temporal lobe of the cortex, while the quality of one’s attention span depends upon the pre-frontal cortex. The pre-frontal cortex is responsible for higher executive functions like planning, flexibility, and decision-making. Any information from the brain stem that is missed along the way creates processing inefficiencies. For example, if the child has not crawled enough, or not at all, the sensory information coming from his torso going to the thalamus will be lacking and the child’s body image of himself in space will be incomplete.
Give the Brain a “Second Chance” to Improve Learning Skills and Attention Span
Dr. Temple Fay, Glen Doman and Carl Delacato are giants in the field of interventions to improve learning processing and attention span. Their work, starting in the fifties, has clearly shown that an interruption of the natural development of the Central Nervous System (CNS) in a child brings about incomplete brain organization, which prohibits the child from achieving his maximum potential. Working mainly, at first, with brain injured children; they observed that these children could not make the stereotyped movements that a normal child could. They also discovered that by helping these brain injured children make these movements, the children would start doing these movements by themselves. Calling this intervention “patterning” and the process Neurological Reorganization, they framed their discovery in a developmental profile. This developmental profile explains clearly the sequential development of the CNS from birth to seven years old and the simultaneous development of different areas such as vision, auditory, tactility, language, mobility, and manual functions. Following this pattern of sequential development should bring about complete brain organization, and then in turn the child would attain his maximum potential. Unfortunately, children with learning disabilities cannot access their full potential because of the inefficiencies in the neurodevelopment of their CNS.
The Need to Observe what goes “In” the Brain
By observing what and how a child’s brain receives information through their different senses, specific inefficiencies are identified. Too often professional attention is only given to “what is not coming out.” A better approach is to figure out “what is not getting in” in order to understand why it is not coming out and then knowing what to do. The neurodevelopment approach considers how the skin and the muscles as well as how the ears and the eyes are transporting information to the brain. For example, eye convergence is often a problem with children who have learning and attention difficulties. Convergence is the ability of the eyes to work synchronously ( together). When the eyes do not converge, a degree of double vision is experienced, which confuses the child, who will then “squint” in his attempt to eliminate his double vision. Subsequently, reading and writing are difficult. Eye exercises can correct this problem. However, it is only when we understand the connections between the eyes and the brain stem that we can intervene more efficiently. Masao Ito from the University of Tokyo explains how the loops between the functions of the semi circular canals in the inner ear, the cerebellum and the eyes not only affect posture and balance (for example being seasick) but it also affects hearing and speech. Eric Kandell’s Principles of Neural Science explains, “Vestibular and Neck Reflexes stabilize the head and eyes…. Both reflexes produce coordinated effects on the muscles of the arms, legs and neck. Movements of the head also evoke vestibular-ocular reflexes that stabilize visual images on the retina.” (p. 600)
The Importance of the Cross-Pattern in Movements
Another problem with learning and attention inefficiencies is the difficulty a child has when doing multi-tasks (more than one thing). Often these children have not developed an efficient cross pattern movement and are lacking the speed needed in their processing. The speed of processing is generated by the production of myelin on the nerve cells. The myelin grows as the nerve influx passes through the same pathways. The largest fiber bundle in the brain and the richest in myelin is the corpus callosum, which connects the two hemispheres of the brain. People, who have learning difficulties lack development in this area. Developmental exercises like crawling and creeping can be used to stimulate these functions. Understanding how the child’s brain receives the information allows, in subsequent steps, to concentrate on how he processes the information, stores and utilizes it.
Sensory Functions and Attention Span
Research states that up to 70% of children with attention problems have learning disabilities. Attention problems present a wide range of symptoms. One of the frequent symptoms is a weak tactile function, also known as a delay in sensory integration. Children who experience sensory distortion often display learning difficulties. Each of the senses has a specific function in the learning process that channels the information to the brain. When facing behaviour problems such as, impulsivity, hyperactivity, aggressiveness, and reduced attention span, investigating the sensory system broadens our perspective and increases our efficiency in treating the symptoms as we recognize the root causes.
The “Hyper” and the “Hypo” Dysfunctions
The sensory system can have one of two types of sensory dysfunctions: “hyper” which leads to an oversensitive reaction to information and the “hypo”, which yields an undersensitive state. Sally Goddard from the Institute for Neuro-Physiological Psychology in England explains “ Where there is arousal, internal excitation and muscle tension increase. Where there is prolonged muscle tension eventually there is fatigue. Fatigue will reduce performance, so that in order to maintain the same level of performance and make up for the lack of efficiency, there will need to be an increased level of arousal. Thus a vicious circle is created.”
Examples of these Dysfunctions
A few examples of children with these difficulties are children who always ask to have the tags from the back of their clothes removed; they are hyper sensitive to surface touch. Children who are seen as “very tough” to pain when at the dentist, or children complaining of ear infections only when the eardrum bursts, would be considered hypo sensitive to deeper touch. These children are hypo tactile to deeper touch and can rarely keep still. They often need to feel pressure and consequently will move, lean on or over things, and can be aggressive toward other children. The surface and the deep touch sensation are processed in two different parts of the brain, when one is “on” the other is “off”. The good news is that something can be done to balance the brain’s perception.
Another example is the child who is sensitive to sunlight and fluorescent lighting; s/he would be considered hyper-visual. A delay in the closing of the retina keeps this child in a state of inner “alert” in relation to light. The hypo sensory visual child will have difficulty in keeping order in his room even though his mind would be able to perceive complex three-dimensional designs.
Also, children who are hypersensitive to noises will be easily distracted in a large group or to any sharp sound. Hyper-auditory children have difficulty concentrating because they do not adequately filter noises. They will often disconnect from the environment if they are forced to stay in a situation with auditory overload. A better understanding of these individual limitations help parents and educators to be more patient in disciplining this type of child instead of punishing him for not meeting certain behavioural standards. The child needs help in developing a more balanced perception in order to meet social demands with less energy.
Neurodevelomental and Sensory Integration Activities: the Treatment
When the brain seems to misinterpret the information brought in from the senses and the muscles, the objective of treatment is to normalize the brain’s perception of the information coming from the sensory and motor input. The treatment, through specific and targeted repetition of appropriate activities, aims the stimulation at the functions of the Central Nervous System (CNS) responsible for efficient learning processes. Svea Gold, who first witnessed amazing changes in her child, has spent thirty years trying to understand through the exponential brain research how this change was possible. She summarizes beautifully: “It (the program of activities) makes children go through the same movements which the early reflexes would have dictated their little bodies to make, these same movements will create chemicals at the junction of the muscle and the axons and the chemical markers will make sure that the messages go to the exact part of the brain that nature intended them to go… we allow the brain to repair itself.” Indeed, we are wonderfully designed.
Example of the Benefit of such a Program
I have used this approach for the past ten years after seeing amazing results with our own son. I have since designed hundreds of neurodevelopmental programs and have witnessed along with the parents of these children, similar results. One of the tests that I have used to measure a child’s progress is the ‘Draw a Person’ test: the child is asked to draw a picture of himself. The drawing reflects how he feels about himself.
Notice the addition of the arms, hands and ears, which suggests that he has grown in his perception of these body parts. The mother commented how talkative he had become and how willing he was to sit still and put effort into his reading.
Changes in the Brain Waves Patterns
Over the past few years, since I was trained in the use of the Quantitative EEG (QEGG) I have had the privilege and the excitement of measuring the changes in brain wave patterns of children after they have been following a neurodevelopmental program, for only a few months. Learning and attention difficulties are characterized by a larger production of theta waves which are the slow waves responsible for the “tune out” mind set. The faster beta waves are responsible for the “problem solving” mind set. After a few months of doing neurodevelopment activities, the QEGG measurement usually shows a reduction in the production of theta waves leading to a more balanced and normal ratio between the theta (slow) and the beta (faster) waves.
Below is an example shown on a bargraph. From right to left we have the frequency of the waves, the slower waves being at zero and the faster being twenty. The blue line shows the pattern of this child when he first came in for attention problems and difficulties with math. The ratio between the slow waves and the faster waves is 4.1. A ratio above 2.7 is significant of an attention problem. This child was scoring an average of 60 % in math and yet had no problems understanding concepts. After a few months of doing the neurodevelopmental activities at home, while taking glyconutrients, he showed a marked improvement in producing fewer theta waves, 4-8 hertz. The ratio between the slow waves (theta) and the faster waves (beta) was then 3.1. The post-test results are shown in the pink lines. The mother described her child as being more attentive. She was also delighted that he was achieving 90% on his math tests. (A remarkable change in such a short period)
Copyright 2005 Suzanne Day, Neuropsychologist member of l'Ordre des psychologues du Québec
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Resources
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A Light in the Tunnel, by Elizabeth Harms (306-872-4904)
How to Multiply your Baby;s Intelligence, Glenn Doman
What to do about your Brain-Injured Child, Glen Doman
A New Start for the Child with Reading Problems, Carl H. Delacato
The Ultimate Stranger, The Autistic Child, Carl H. Delacato
If Kids Just Came with Instruction Sheets, Svea J. Gold
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