subject: Neuro - Cognitive Therapy for Cerebral Palsy, Autism and other neuro-developmental disabilities [print this page] My approach is based upon certain irrefutable facts concerning brain function, which I apply to the treatment of children's developmental difficulties. The most important of these is brain plasticity.
What is Brain Plasticity?
It is the ability of the brain to respond to changes in the environment to enable the person to function as efficiently as possible within that environment. It is led by environmental demand. It is the repeated sensory demands produced by the environment which produce function in the child, - because the brain responds to those sensory demands by building the neural architecture to support the function necessary for the child to function.How do we know this? Because we know that the developmental function of children who have been exposed to poorly stimulating, impoverished environments, is poor, - as is their brain development. We also know that children who are raised in highly stimulating, enriched environments have superior developmental function and superior brain development.
Now think about it for a moment, - what is the effect of a brain injury in terms of a child's ability to interact with the sensory environment all around him? That's right, it impeded his ability to interact with that environment! It does this in several ways. - It might have injured the neural systems responsible for detecting, passing on or interpreting the sensory information coming from outside. The injury might result in the child percieving the environment in distorted ways, which is quite common in children who have autism. It might have injured the motor areas of the brain so that even if the child has normal perceptual abilities to begin with, they will not develop and mature appropriately because he cannot physically interact. So, because of these impaired sensory messages coming into the brain, - brain plasticity is driven in directions which are unhelpful to the child and his / her development. So we see the neural architecture being built to support hypersensitive hearing, stiff muscle tone, tactile undersensitivity, etc.
What can we do about this? What I try to do is to manipulate the sensory environment to which the child is exposed in order to encourage the natural plasticity in the regions of the brain, which are responsible for processing the sensory stimuli, (the sensory - attentional filter of the brain, - the ascending reticular activating system and the thalamus), to re-tune the structures and to process information more normally. Evidence that it is the thalamus and reticular system which carry out these functions is widely available. (Carlson, 2007).
We encourage these systems to re-tune by providing an adapted sensory environment which is tailored to the individual perceptual problems the child is facing. In this way, (because as we know brain plasticity involves, the brain growing new synapses and pruning disused ones), we can influence not only brain function, but the development of it's structure. The aim being that the synapses which have been built to support the problems which the child is displaying are pruned and that synapses supporting more normal functioning are built.
Evidence that these structures can be re-tuned can be seen in all human beings, but a good examples is in a mother who is lying asleep and is blissfully ignorant of the traffic passing by outside, - the neural systems in question being used to 'tuning out' this noise. However, the instant her newborn baby makes a sound, she is awake! - Her tuning system has re-tuned to classify this sound as one (within her changed environment), which requires immediate attention and consequently, she wakes!
Sensory impairments such as these, which our children commonly display in varying degrees of severity, can have wide ranging effects upon the areas of development which produce our 'output' functions, for instance, language, mobility and social development are all heavily dependent upon sensory processing abilities, as is the development of hand function. It is often the case that as sensory abilities begin to improve due to our efforts to directbrain plasticity in morepositive directions, so do these abilities!
Another aspect of our approach is aimed at any learning difficulties the child might have and is informed by research from Vygotskian psychology. Recent research has provided ample evidence concerning how children learn. (unfortunately, often children do not learn in the manner by which schools teach) (Rogoff 1990. Rogoff, B., Mosier, C., Mistry, J., & Goncu, A. 1993. Wood, 1998).
Our approach to learning dfficulties utilises Vygotky's concept of the 'zone of proximal development.' We look at the child's current developmental level in terms of his / her cognitive development and we reinforce these abilities. We then look at the next stage of development for the child (his proximal development) and in recognition that learning is a social activity, we provide support to enable him to attain that ability (this support encompasses Bruner's concept of 'scaffolding' and Rogoff's concept of 'apprenticeship.') This may also entail breaking the developmental task down into smaller, simpler sub-components thus enabling the child to succeed. As the child improves his functioning at the desired cognitive / developmental task, the scaffolding (support) is gradually removed until he is performing the desired task automaically. This is not just the way in which children learn, - this is the way we all learn. (Mercer, 1995. Hughes & Westgate, 1997).
Brereton. A. (2010). Brain Injured Children. Tapping the Potential Within. Snowdrop Publications. Exeter
Carlson, N. R., (2007). Physiology of Behaviour. (9th Ed). Pearson. London.
Hughes, M. and Westgate, D. (1997). Teachers and other adults as talk partners for pupils in nursery and reception classes. Education. 3-13. (1997) March. In Woodhead, M.; Faulkner, D., and Littleton , K. (1998). Cultural worlds of early childhood. London & Milton Keynes. Routledge & Open University Press.
Kolb, B & Wishaw, I. Q. Brain plasticity and behaviour. Annual Review of Psychology. Vol. 49: 43-64
Mercer, N. (1995). The Guided Construction of Knowledge: Talk amongst teachers and learners. Clevedon. Multilingual Matters.
Moll, L. C., & Whitmore, K. F. (1993). Contexts for learning: sociocultural dynamics in childrens development. Oxford . Oxford University Press. In.Faulkner, D., Littleton , K. and Woodhead, M. (2003). Learning relationships in the classroom. London . Routledge.
Rogoff, B. (1990). Apprenticeship in Thinking: Cognitive Development in Social Context. Oxford Oxford University Press.
Rogoff, B., Mosier, C., Mistry, J., & Goncu, A. (1993). Toddlers guided participation with their caregivers in cultural activity. In Woodhead, M.; Faulkner, D., and Littleton , K. (1998). Cultural worlds of early childhood. London & Milton Keynes. Routledge & Open University Press.
Tizard, B., & Hughes, M. (1984). Young children Learning: Talking and Thinking at Home and School. London . Fontana . In Woodhead, M.; Faulkner, D., and Littleton , K. (1998). Cultural worlds of early childhood. London & Milton Keynes. Routledge & Open University Press.
Vygotsky, L. S. Mind in Society. Development of Higher Psychological Processes. Harvard University Press.
Vygotsky, L. S. (1986) Ed )Thought and Language. MIT Press.
Wood, D. (1986). Aspects of teaching and learning. In Woodhead, M.; Faulkner, D., and Littleton , K. (1998). Cultural worlds of early childhood. London & Milton Keynes. Routledge & Open University Press.
Wood, D. (1998). How Children Think and Learn. (2nd ed). Oxford . Blackwell.
Neuro - Cognitive Therapy for Cerebral Palsy, Autism and other neuro-developmental disabilities
