Miksi soitto ei suju?
Transcription
Miksi soitto ei suju?
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 Concentration problems 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 Concentration problems Taste & Smell Concentration problems Risking limited nutrition Tactile sense Over sensitive tactile sense can cause Concentration problems Social problems Reflex problems (uninhibited primitive reflexes) Concentration problems 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 pirjo.korpilahti@oulu.fi * ** * * ** * * 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