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?
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Good concentration
Good memory
Good motor control
Good stress control
Good self-assurance
Good genetic background
How can we attain all these?
ƒ Reading books to children when
they are young
ƒ Reading and writing exercises
ƒ Motor control: doing some sport
early
ƒ Do something where concentration
will be exercised
However…
ƒ some individuals have difficulties in
e.g. concentration, learning to read
and/or to write, and mathematics
etc.
What’s the matter?
ƒ Motivation?
ƒ Teacher?
ƒ Parents?
ƒ Friends?
ƒ School?
External reasons =
reasons outside of the
body
Internal reasons = reasons
inside of the body
ƒ External reasons such as difficult
family relationships, problems with peers,
teacher, abuse …
ƒ 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
ƒ 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
ƒ After the birth baby’s
movements, such as
turning, creeping, and
crawling are vital for
“normal” development
ƒ Final activation of the
sensory system begins
ƒ The transformation
process of the early
reflexes begins
ƒ The activation of the
language stimulates left
brain hemisphere
ƒ The cross lateral
movements integrate left
and right brain
hemispheres to one
effective system
Following years:
ƒ The early baby
reflexes inhibited
ƒ Motor system
developed, ready to
walk and go, jump
and spring
ƒ The language
awareness improves
and the child begins
to use language
ƒ The ability to move and
understand verbal
information create
readiness to join group
play and games
ƒ School maturity
ƒ Ready for life
Sidetracks of the early
development cause many
problems:
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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:
ƒEarly birth
ƒDifficult birth circumstances
ƒMultiple ear inflammations at young age
ƒSome other illness or traumas
ƒInadequate support and advice
ƒPoor parenting skills (infants too often in
baby sitters, too much TV or playstation’s
instead of moving etc.)
But
ƒ Sometimes babies with normal early
development can have NDD (Neuro
Developmental Delay)
ƒ It is possible and these cases must care
as carefully as others
Focusing at the problem
ƒ 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
ƒ The brain is always attempting to reach the best
possible result with the lowest possible activation level
(lowest consumption of blood sugar)
ƒ 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
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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:
ƒ Neural stress= The brain works at high activation level
ƒ Rest stress= The lowest stress level in resting
condition
ƒ 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:
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Increased blood pressure
(Over) activated nervous system
Blood sugar burned quickly
Long term effects: increased risk of
certain illnesses and psychological
problems
ƒ Concentration problems
ƒ Decreased memory
In the real life –
Auditory problems
=>decreased auditory
discrimination
ƒ Oversensitive hearing
ƒ Sinking hearing curve (high freq. missing)
ƒ The pit on the hearing curve (some
frequencies missing) causes abnormal
phonetic structure
ƒ Unbalanced hearing, left ear dominance
ƒ Problems in hearing correctly=>spelling
mistakes
ƒ Poor memory
ƒ Difficulties learning to read or a slow reader
ƒ Concentration problems
ƒ Speech problems
ƒ With those having ADD, ADHD, mutism,
autism, aphasia, auditory problems are
common
ƒ Left ear dominance can also cause Visio
spatial problems
Balance problems
ƒ Poor motor control
ƒ Poor control of eye muscles can cause
problems with eye movement and slow
reading=>short term memory problems
ƒ Often involved in concentration and
learning difficulties
Visual problems
ƒ Tires easily (Unnecessary use of
muscles => burns blood sugar)
ƒ Slow reading
ƒ Decreases memory
ƒ Concentration problems
Taste & Smell
ƒ Concentration problems
ƒ Risking limited nutrition
Tactile sense
Over sensitive tactile sense can cause
ƒ Concentration problems
ƒ Social problems
Reflex problems
(uninhibited primitive reflexes)
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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:
ƒ Left hemisphere = logical processing, language
& behavior control
ƒ Right hemisphere = Visio-spatial & emotional
ƒ If not integrated well enough it causes learning,
concentration, emotional and motor problems
What can be done?
ƒ Sensomotor training In kindergarten and
schools
ƒ Specific individual physiological assessment
(hearing tests and auditor balance, visual
system, balance mechanism, reflexes …)
ƒ Analysis of the early development
ƒ Individual intensive training program, done
daily at home with help of parents
ƒ Control assessments in about 3 month
intervals, 4-5 assessments within one year
Our segments
ƒ Learning and/or concentration difficulties
(Dyslexia, ADD, Non verbal Learning
Difficulties NLD…)
ƒ Concentration diff. and hyperactivity (ADHD)
ƒ Autism
ƒ Aphasia with children (Dysfasia)
ƒ Mutism
ƒ Handicaps
ƒ Neuroses
ƒ Asperger
Learning and
concentration difficulties
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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 …
ƒ Therapy often very effective
Concentration difficulties,
hyperactivity
ƒ Very difficult to concentrate=>can have many
kind of problems with school or/and social
environment
ƒ Medical approach helps sometimes, but does
not solve the problems behind the syndrome
ƒ Therapy helps always, however some people
might have neural lesions or other neurological
problems => needs more therapy and the
success rate is uncertain
Autism
ƒ Often unbalanced sensory system and/or week
integration of the brain
ƒ Often oversensitive auditory system
ƒ Often hypo at deep tactile system=> do not feel
pain
ƒ Many autistics receive help from the
therapy=>the problem has been at least partly
developmental. It is worth investing resources to
these segments
ƒ Even “difficult” cases can be helped
Aphasia with children
(Dysfasia)
ƒ Problems in producing and/or
understanding language
ƒ Often poor auditory discrimination
ƒ 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
ƒ A limited study in a school where every
student had a diagnose of aphasia
ƒ Age 7-9 year old
ƒ 7 boys and one girl, where 6 “clear”
aphasia cases
ƒ The study was made by dr. Pirjo
Korpilahti (presently prof. in University of
Oulu )
Assessments
ƒ The hearing levels were tested with every
child
ƒ The balance tests
ƒ 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:
ƒ Many had so called “normal” hearing curve
ƒ Many of the studied individuals had left ear
dominance (left ear dominance is a risk for
weakened auditory discrimination)
ƒ Children who listened therapy tapes attained
better auditory discrimination (no more left ear
dom.)
ƒ The result of the study suggest that left ear
dominance is one of the risk factors with
aphasia with children
ƒ 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
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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
ƒ 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:
ƒ impairment of fine motor skills
ƒ handedness not established
ƒ restless behaviour
ƒ difficulties to follow instructions and to comprehend speech
ƒ fluent but deformed speech
ƒ 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”
ƒ Only mother could understand him partly
ƒ The doctors at the University of Oulu said
to the mother : “the most difficult case
ever”….”will probably have difficulties at
school”
ƒ Had very oversensitive auditory system
ƒ Nina A-L made assessment to Aaro and she
designed the therapy program
ƒ Aaro began to listen the therapy music and
do his balance and motor exercises
ƒ 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
ƒ Presently at first class
ƒ Teacher says that Aaro is one of the best
pupils on the class
ƒ Active and talkative
ƒ Normal 7 year old boy
Mutism or selective mutism
ƒ Can be reflex based (MORO)+ auditory
discrimination problems
ƒ Can be strong psychological background
ƒ Therapy always worth trying
Handicaps
ƒ Neurological based
ƒ 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
ƒ Needs much more training than
developmental based cases
Neuroses
ƒ Cases we have seen had unbalance in the
sensory system
ƒ Children have often good development in
sensomotor therapy
ƒ 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
ƒ Research showed, that many have
remaining uninhibited early reflexes
ƒ Sensomotor therapy can help
HS 21.11.2006, ”Psychiatric care with children
increased rapidly”
“Psychiatric care with children
increased rapidly”
ƒ High neural stress is a risk for
psychological problems
ƒ A correlation of increased
sensomotor problems and increased
needs of psychiatric care can be
found
Asperger
ƒ Often unbalance in the sensory system
ƒ Often oversensitive auditory & tactile
sense
ƒ Therapy can help, however, often very
challenging to the therapist, family and
environment
ƒ High risk in braking off the therapy
Mixed syndromes
ƒNeuroses
ADHD
Mutism
ADD, Dyslexia, NLD
AUTISM
Aphasia
Handicaps
Special segments
ƒ Musicians
ƒ Sportsmen
How to recognize the
problem?
ƒ Does not hear well or hears incorrectly, often asking,
“What”
ƒ Problems in speech and pronouncing
ƒ Slow reader, spelling mistakes
ƒ Pressing pen, poor handwriting, difficulties in writing
ƒ Clumsy child, not good in sports, does not like sports
ƒ Difficulties in sitting still, abnormal seating position,
needs to move all the time
ƒ Difficult to move fingers quickly (playing instrument)
ƒ Very high stress, forgets everything in exams,
even if seemed to know all at home, poor
memory
ƒ Impulsive, easily angered, mood swings
ƒ Phobia type reactions
ƒ New situations can be very difficult
ƒ In new situations “freeze”
ƒ Very tired after school day
ƒ Boys have more language problems but
problems with girls (women) are often “hidden”
ƒ 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
ƒ Difficulties with sitting
and/or poor hand
writing / pressing pen
grip
Sensomotor center in
Helsinki
ƒ Individual Therapy
ƒ Education of therapists (5 weeks lessons
+ practical training)
ƒ Education of teachers to use sensomotor
training methods in schools and
kindergarten (2 days course)
Sensomotor group training
(a 2-day teachers’ course)
ƒ Children will train every day in school or kindergarten,
10-15 minute / day
ƒ Based on balance, visual, reflex, sensory integration and
logical thinking exercises
Children will achieve:
ƒ Better concentration
ƒ Better ability to learn
ƒ Better motor control and self-esteem
ƒ Better logical thinking
ƒ Normal opportunities in the future
Education of therapists
ƒ The theory and practice training will
take 24 days of full lecturing and
working days
ƒ In practice it will be cut to 4-5 one
weeks educating weeks
ƒ Needs own therapy and practice at
home
Who are behind of these
methods?
Håkan Carlsson,
Sweden
Founder of
Sensomotorisk
Centrum i Mjölby
ƒ Kjeld Johansson,
Danmark
ƒ Developed Auditory
Discrimination
Training
method we use
ƒ Sally Coddard and Peter Blythe,
INPP , UK.
ƒ 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?
ƒ The theory?
ƒ The therapy?
ƒ Education?
ƒ 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