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Transcription

Behavior problems
or difficulties with
school?
Can rehabilitation help?
What are the characteristics
for good learning ability?

Good concentration
Good memory
Good motor control
Good stress control
Good self-assurance
Good genetic background
How can we attain all these?
Reading books to children when
they are young
Reading and writing exercises
Motor control: doing some sport
early
Do something where concentration
will be exercised
However…
some individuals have difficulties in
e.g. concentration, learning to read
and/or to write, and mathematics
etc.
What’s the matter?
Motivation?
Teacher?
Parents?
Friends?
School?
External reasons =
reasons outside of the
body
Internal reasons = reasons
inside of the body
External reasons such as difficult
family relationships, problems with peers,
teacher, abuse …
Internal reasons as handicaps,
traumas, illnesses (e.g. repeated ear
inflammations at early age), allergies, poor
nutrition, poor development of sensory
system or/and its poor integration
Genetic component often involved
We will now concentrate in
the development of sensory
system & its integration
First year is important for
“normal” development in the
future
After the birth baby’s
movements, such as
turning, creeping, and
crawling are vital for
“normal” development
Final activation of the
sensory system begins
The transformation
process of the early
reflexes begins
The activation of the
language stimulates left
brain hemisphere
The cross lateral
movements integrate left
and right brain
hemispheres to one
effective system
Following years:
The early baby
reflexes inhibited
Motor system
developed, ready to
walk and go, jump
and spring
The language
awareness improves
and the child begins
to use language
The ability to move and
understand verbal
information create
readiness to join group
play and games
School maturity
Ready for life
Sidetracks of the early
development cause many
problems:

Abnormal development of early reflexes
Over sensitiveness of one or multiple senses
Difficulties with balance, motor problems
Auditory discrimination problems
Poor integration of sensory system
Difficulties in concentration and learning
Is also called Neuro Developmental Delay
(NDD)
What are the reasons for this?
Any cause of delay in child’s
development, such as:
Early birth
Difficult birth circumstances
Multiple ear inflammations at young age
Some other illness or traumas
Inadequate support and advice
Poor parenting skills (infants too often in
baby sitters, too much TV or playstation’s
instead of moving etc.)
But
Sometimes babies with normal early
development can have NDD (Neuro
Developmental Delay)
It is possible and these cases must care
as carefully as others
Focusing at the problem
Even if we removed the external reasons
and internal reasons as handicaps and
illnesses, the problematic sensory
system and it’s poor integration prevails
The Orchestra of Senses
The brain is always attempting to reach the best
possible result with the lowest possible activation level
(lowest consumption of blood sugar)
If one ore more senses are working imperfectly, the
whole system suffers =>need of higher activation level
=> problems in concentration and learning
The whole neural system
works for the common target

The activation level of nervous system
The metabolism system
Relevant reactions
Hormone system
The memory of movement and reactions
The stress model
In the following pages we introduce the Stress Model,
where the behavioral, concentration and learning
difficulties are explained with the help of a theoretical
model.
In the model there is an assumption: Imperfect neural
development and integration causes Neural Stress
Terms:
Neural stress= The brain works at high activation level
Rest stress= The lowest stress level in resting
condition
Stress Level for Good Performance = The maximum
stress level where good performance is still possible.
Stress over this limit means that the quality of
performance or/and concentration will be weakened
Low neural stress
STRESS LEVEL
Very high stress =>Problems with concentration, behavior and performance
Stress Level
for Good
Performance
Good Stress
tolerance
Low stress level
Rest stress level
SENSES
Auditory
Visual
Balance
Smell & Taste
Tactile
Reflexes
Picture 1: Well developed sensory system, low neural stress and good stress tolerance, low level of rest stress,
seldom problems with behavior or performance
High neural stress
STRESS
LEVEL
Very high stress =>Problems with concentration, behavior and performance
performance
Maximal
Stress Level
for Good
Performance
High rest stress level => Low Stress tolerance
SENSES
Auditory
Visual
Balance
Smell & Taste
Tactile
Reflexes
Picture 2: Imperfect developed of sensory system. Many senses affect high neural stress => high
level of rest stress => low stress tolerance, when stress rises over Max. stress level problems
appears with ill behavior and/or performance (poor temper, impulsive, aggressive, get tired
easily..)
High stress:

Increased blood pressure
(Over) activated nervous system
Blood sugar burned quickly
Long term effects: increased risk of
certain illnesses and psychological
problems
Concentration problems
Decreased memory
In the real life –
Auditory problems
=>decreased auditory
discrimination
Oversensitive hearing
Sinking hearing curve (high freq. missing)
The pit on the hearing curve (some
frequencies missing) causes abnormal
phonetic structure
Unbalanced hearing, left ear dominance
Problems in hearing correctly=>spelling
mistakes
Poor memory
Difficulties learning to read or a slow reader
Speech problems
With those having ADD, ADHD, mutism,
autism, aphasia, auditory problems are
common
Left ear dominance can also cause Visio
spatial problems
Balance problems
Poor motor control
Poor control of eye muscles can cause
problems with eye movement and slow
reading=>short term memory problems
Often involved in concentration and
learning difficulties
Visual problems
Tires easily (Unnecessary use of
muscles => burns blood sugar)
Slow reading
Decreases memory
Taste & Smell
Risking limited nutrition
Tactile sense
Over sensitive tactile sense can cause
Social problems
Reflex problems
(uninhibited primitive reflexes)

Difficult to sit still, overactive
Poor hand writing
Memory problems (high stress)
Over sensitive
Reading and writing problems
Speech problems
Poor temper, impulsive, sometimes aggressive
(limited stress tolerance)
Integration of brain
Should happen in early years of life.
The brain is highly specified system:
Left hemisphere = logical processing, language
& behavior control
Right hemisphere = Visio-spatial & emotional
If not integrated well enough it causes learning,
concentration, emotional and motor problems
What can be done?
Sensomotor training In kindergarten and
schools
Specific individual physiological assessment
(hearing tests and auditor balance, visual
system, balance mechanism, reflexes …)
Analysis of the early development
Individual intensive training program, done
daily at home with help of parents
Control assessments in about 3 month
intervals, 4-5 assessments within one year
Our segments
Learning and/or concentration difficulties
(Dyslexia, ADD, Non verbal Learning
Difficulties NLD…)
Concentration diff. and hyperactivity (ADHD)
Autism
Aphasia with children (Dysfasia)
Mutism
Handicaps
Neuroses
Asperger
Learning and
concentration difficulties

Increasing problem in the modern world
Increased risk of dropping out of the society
Very expensive to the society
Creates many personal problems, such as:
Lower income, social problems, educational
difficulties and career hindrances in the area
one’s interest …
Therapy often very effective
Concentration difficulties,
hyperactivity
Very difficult to concentrate=>can have many
kind of problems with school or/and social
environment
Medical approach helps sometimes, but does
not solve the problems behind the syndrome
Therapy helps always, however some people
might have neural lesions or other neurological
problems => needs more therapy and the
success rate is uncertain
Autism
Often unbalanced sensory system and/or week
integration of the brain
Often oversensitive auditory system
Often hypo at deep tactile system=> do not feel
pain
Many autistics receive help from the
therapy=>the problem has been at least partly
developmental. It is worth investing resources to
these segments
Even “difficult” cases can be helped
Aphasia with children
(Dysfasia)
Problems in producing and/or
understanding language
Often poor auditory discrimination
We have had very good therapy success
rate => therefore these cases have been
more developmental in origin, rather than
neurological
The research Project in aphasia with
children (dysfasia) in school,
year 2000
A limited study in a school where every
student had a diagnose of aphasia
Age 7-9 year old
7 boys and one girl, where 6 “clear”
aphasia cases
The study was made by dr. Pirjo
Korpilahti (presently prof. in University of
Oulu )
Assessments
The hearing levels were tested with every
child
The balance tests
Developmental assessment: the early
reflexes (primitive reflexes)
At the following pages will show some of
the results of auditory tests in the form of
hearing diagrams
Boy 9 years old
He came 3 times to see us and
made auditory therapy as home
program.
First auditory assessment 2.2.2000
He trained well at home.
Last assessment 29.8.2000:
1. kuulotutkimus 29.12.1999
The boy
1. Assessment 29.12.1999
Control 15.3.2000
He never finished the program
Boy
First assessment 28.12.1999
Well trained.
Last assessment 14.8.2000:
Boy
First and last assessment 14.4.2000
Boy
First assessment 18.5.2000:
Second and last assessment
30.6.2000.
He never finished the program
Findings:
Many had so called “normal” hearing curve
Many of the studied individuals had left ear
dominance (left ear dominance is a risk for
weakened auditory discrimination)
Children who listened therapy tapes attained
better auditory discrimination (no more left ear
dom.)
The result of the study suggest that left ear
dominance is one of the risk factors with
aphasia with children
Auditory problems can be treated with auditory
therapy
Measurements:
Subjects: ADT NON-ADT Controls
6
8
13
1st – 4th grade, Age: 7-10 years
ADT and NON-ADT: LI & dyslexia
Left figure 2. ERP difference wave,
recordings I and II (post-training for the
ADT-group). ADT-group bold line, NONADT dotted line, controls thin
line. (result: At rec. II the normalizations
can be seen, and the bolted line follows
closer normal controls)
The figures are from the poster from the
seminar: The Science of Aphasia,
Acquafredda di Maratea, Italy
14–19 June, 2002, where prof. Pirjo
Korpilahti introduced her research projects.
Address: Pirjo Korpilahti, Department of
Finnish, Saami and Logopedics,
Post Box 1000, 90014 University of
Oulu, Finland [email protected]
*
**
*
*
**
*
*
Figure 3. Changes in auditory
discrimination and naming.
Vowel score max. 32, Consonants max
50 and Boston Naming
Test max 60. In discrimination tests the
accuracy of 98%
normally reached at the age of 7 years.
Statistical difference
from reference values is marked with an
asterix.
(Prof. Pirjo Korpilahdi, The Science of
Aphasia, Acquafredda di Maratea, Italy)
Peter’s case
In the early summer 1997 a mother came to our training centre
with her 4,9 years old boy, Peter. Before that Peter was examined
at the University Hospital of Turku and he had a diagnose of
specific speech and language disorder: difficulties in producing
and understanding language. Here are some comments of
occupational therapist and speech therapist before ADT:
impairment of fine motor skills
handedness not established
restless behaviour
difficulties to follow instructions and to comprehend speech
fluent but deformed speech
distorted phonemic system
(From the study: Neurofunctional Correlates of Auditory Discrimination Training
in a Language Learning Impaired Boy, Pirjo Korpilahti, Alopaeus-Laurinsalo
Nina and Laurinsalo Veli)
The audiogram measured in
the beginning of the ADT
treatment.
The last and final audiogram
measured 8 months after
intensive listening of the
therapeutic music.
His motor and auditory
training were completed.
Before the ADT. An array of
twelve brain maps showing
the MMN activation for
naturally spoken words from
the stimulus onset to 600
ms.
After the ADT. An array
of twelve brain maps
showing the MMN
activation for naturally
spoken words from the
stimulus onset to 600 ms.
Peter AFTER THE THERAPY
The psychologist: “He is lively, popular in the group,
ingenious and good in games and plays. Peter is talkative
and enjoys the attention of adults. He fits well into the
group. Peter is eager to learn new things and is asking a
lot of questions.
In the face to face situation he
understands even quite complicated maters."
The psychologist's conclusion was that Peter was not
suffering of autism. She wrote: "Peter, 5 years 7 months,
a boy, has had (for 1,5 years) a diagnose of specific
speech and language disorder. The non linguistic
performance is now at the good average level and the
linguistic skills reach now up to the average."
AARO, boy 4 years old,
aphasia (dysfasia), used his
“own language”
Only mother could understand him partly
The doctors at the University of Oulu said
to the mother : “the most difficult case
ever”….”will probably have difficulties at
school”
Had very oversensitive auditory system
Nina A-L made assessment to Aaro and she
designed the therapy program
Aaro began to listen the therapy music and
do his balance and motor exercises
In following pictures we see his
development with the help of his drawings,
which all are typical examples of the given
period
Drawings
during the
therapy:
Before
therapy
Therapy
had begun
There
game
pictures
to the
drawings
“Bird”
In the
end of
the
therapy
“Pirate
ship”
Aaro today
Presently at first class
Teacher says that Aaro is one of the best
pupils on the class
Active and talkative
Normal 7 year old boy
Mutism or selective mutism
Can be reflex based (MORO)+ auditory
discrimination problems
Can be strong psychological background
Therapy always worth trying
Handicaps
Neurological based
Difficult to know, what is caused from
neurological abnormalities and what e.g.
from the lack of early movements =>
uninhibited primitive reflexes => motor
problems and poor balance
Needs much more training than
developmental based cases
Neuroses
Cases we have seen had unbalance in the
sensory system
Children have often good development in
sensomotor therapy
Adults have had often years in psychiatric
treatment. Therapy: We have had good
developmental results, however, it takes much
more time than with children (about 2 year) to
get results
Phobias
Research showed, that many have
remaining uninhibited early reflexes
Sensomotor therapy can help
HS 21.11.2006, ”Psychiatric care with children
increased rapidly”
“Psychiatric care with children
increased rapidly”
High neural stress is a risk for
psychological problems
A correlation of increased
sensomotor problems and increased
needs of psychiatric care can be
found
Asperger
Often unbalance in the sensory system
Often oversensitive auditory & tactile
sense
Therapy can help, however, often very
challenging to the therapist, family and
environment
High risk in braking off the therapy
Mixed syndromes
Neuroses
ADHD
Mutism
ADD, Dyslexia, NLD
AUTISM
Aphasia
Handicaps
Special segments
Musicians
Sportsmen
How to recognize the
problem?
Does not hear well or hears incorrectly, often asking,
“What”
Problems in speech and pronouncing
Slow reader, spelling mistakes
Pressing pen, poor handwriting, difficulties in writing
Clumsy child, not good in sports, does not like sports
Difficulties in sitting still, abnormal seating position,
needs to move all the time
Difficult to move fingers quickly (playing instrument)
Very high stress, forgets everything in exams,
even if seemed to know all at home, poor
memory
Impulsive, easily angered, mood swings
Phobia type reactions
New situations can be very difficult
In new situations “freeze”
Very tired after school day
Boys have more language problems but
problems with girls (women) are often “hidden”
GIRLS; if a girl has to use more time in order to
achieve same results as other girls, she might
have learning problems
Motor development
The baby does not creep in
appropriate way => can not creep or
crawl later either
Difficulties with sitting
and/or poor hand
writing / pressing pen
grip
Sensomotor center in
Helsinki
Individual Therapy
Education of therapists (5 weeks lessons
+ practical training)
Education of teachers to use sensomotor
training methods in schools and
kindergarten (2 days course)
Sensomotor group training
(a 2-day teachers’ course)
Children will train every day in school or kindergarten,
10-15 minute / day
Based on balance, visual, reflex, sensory integration and
logical thinking exercises
Children will achieve:
Better concentration
Better ability to learn
Better motor control and self-esteem
Better logical thinking
Normal opportunities in the future
Education of therapists
The theory and practice training will
take 24 days of full lecturing and
working days
In practice it will be cut to 4-5 one
weeks educating weeks
Needs own therapy and practice at
home
Who are behind of these
methods?
Håkan Carlsson,
Sweden
Founder of
Sensomotorisk
Centrum i Mjölby
Kjeld Johansson,
Danmark
Developed Auditory
Discrimination
Training
method we use
Sally Coddard and Peter Blythe,
INPP , UK.
Peter is the man behind the reflex test &
therapy.
Sally begin the
Children’s
Group
training
In U.K.
Dr. Harry
Wachs
The pioneer in
developmental
optometry. Coauthored the book
Thinking Goes to
School and the test
Wachs Analysis of
Cognitive
Structures.
If we don’t build
solid basement of
the child's
development, the
later life will be
like in this picture
Suur-Helsingin
Sensomotorinen Keskus
Taiteentekijäntie 8
00650 Helsinki, Finland
Phone + 358 (0)9 484 644
www.thalamusoy.com
Any Questions?
The theory?
The therapy?
Education?
Practice?
You will find our E-mail addresses from our
web-pages. If you have questions, we will
try to answer as quickly as possible.
Thank you for visiting our
pages
Her are our dogs: Jere, Knalle and Hilda