Play therapy
Play therapy is a unique approach to psychotherapy specifically designed for children and based on the fact that a child’s most natural form of self-expression is through play. Play therapists focus on “hearing” the messages found in a child’s play and on facilitating progress of certain skills and expression of feelings. Play therapy allows for a natural sense of pace since it is child-directed and encourages a trusting and workable relationship with the therapist. For children with learning differences, play therapy can help with skill deficits such as problem solving, critical thinking, understanding social cues, as well as identifying and appropriately expressing feelings. Play therapy toys are usually similar to those found in the classroom or at home such as puppets, play food, dolls and games.

As a parent, how do you make sure your child’s therapist is qualified? According to the Association for Play Therapy, registered play therapists and registered play therapist-supervisors are licensed or certified practitioners who have earned a master’s degree or higher mental health degree, have 150 or more hours of specialized play therapy training, have substantial clinical and play therapy experience and supervision, and at least 36 hours of continuing education during subsequent three year renewal cycles. For more information visit the Georgia Association of Play Therapy Web site, www.gapt.org and the Association for Play Therapy Web site, www.a4pt.org.

Acupuncture
Simply put, acupuncture is the ancient Chinese practice of inserting needles into the skin to relieve pain and treat diseases. The theory is that energy flows through channels between the surface of the body and internal organs, and that pain and disease are the result of these channels becomingblocked. Western medicine’s theory is that the placement of acupuncture needles at specific pain points releases endorphins and opioids (the body’s natural painkillers), and perhaps immune system cells, neurotransmitters and neurohormones in the brain. By placing needles at one end of the channel or the other, healthy energy can be restored. The idea of your child cooperating while someone places needles into their skin may make you laugh, but acupuncture has been shown to be helpful in treating a variety of conditions in children. The needles used in acupuncture are small, and very fine and solid, unlike the hollow needles used for vaccinations. While children can feel the needle pierce the skin, they cannot feel any pain. Acupuncture is often used to treat chronic pain, but has also been known to help with the overall health of children with learning differences. A good starting point for research and finding a licensed acupuncture physician, is the American Academy of Medical Acupuncture Web site, www.medicalacupuncture.org. Other articles of interest can be found at www.healthlink.mew.edu/article/991233942.html and www.umm.edu/pediatrics/acupuncture.htm.

Hippotherapy
Hippotherapy uses the multidimensional movements of a horse to address developmental issues. Specially trained physical and occupational therapists, and speech-language pathologists, use horses as “mobile therapeutic treatment tools.” A horse’s rhythmic, repetitive movements while walking allow a child to receive sensory input through the proprioceptive, tactile, auditory, visual and vestibular systems. In addition, maintaining balance while adjusting to and accommodating for the horse’s movements increases sensorimotor integration. Therapists have children ride in different positions (backwards, sideways, standing in the stirrups), and they encourage the child to stretch and play games. Hipppotherapy usually takes place inside a covered ring thereby allowing the child to participate no matter what the weather.

Each child should be evaluated before starting hippotherapy. Parents should look for a program where the therapists are licensed or registered to practice physical therapy, occupational therapy or speech-language pathology; have received training in the principles of hippotherapy, equine movement and equine psychology; are the equivalent of a North American Riding for the Handicapped Association (NARHA) registered instructor (or have an NARHA registered instructor assisting with the horse at all treatment sessions); and maintain current professional and general liability insurance. Please visit the American Hippotherapy Association Web site for more information, www.americanhippotherapyassociation.org

Yoga
For children with learning differences, yoga can be a source of self-esteem and increased concentration. Because yoga improves self-awareness, self-realization and self-acceptance, children more fully experience who they are and this confidence may bring positive changes in the classroom. Yoga also provides time for self-reflection, helping students to become less influenced by their weaknesses and more aware of their strengths. Since frustration comes along with nearly every learning disability, with some students succumbing to aggravation which hinders even further their ability to learn, the breathing techniques taught in yoga can help people to relax, rejuvenate and try again. Yoga often helps children increase concentration skills, which are crucial for learning. Yoga practice requires students to focus on their breathing as they move through the poses, which strengthens the ability to stay on task. Through the exercise of focusing on a certain spot for an extended period of time, yoga can offer increased efficiency of the optic nerve, more relaxed facial muscles and increased functionality of certain areas of the brain. These benefits all work together to improve a child’s ability to focus visually. Yoga also increases the circulation of oxygen and blood to the brain and stimulates the central nervous system. Look for a yoga studio that has experience working with kids, especially those with learning issues. Some children may need more attention or one-on-one help during their yoga sessions. Also, if your child has physical concerns, please check with his doctor before beginning a yoga program. You can learn more by visiting www.ezinearticles.com/?Yoga-and-Learning-Disabilities&id=363339 and www.healthandyoga.com/HTML/news/therapy/rtherapy73.asp.

Adapted swimming
For many children who struggle with motor planning and processing, traditional swimming lessons can cause frustration, fear of the water and a sense of failure. Adapted swimming teachers know how to modify lessons and progression plans so that the child effectively learns to swim. For example, a child who has poor motor planning skills may work on just one aspect of a swimming stroke at a time. Until that skill is mastered, the teacher will not add a new task. Also, since learning new physical skills is challenging for some children, fatigue can influence how learning actually gets accomplished.

Ann Leverette, an adapted swimming instructor in the Atlanta area with more than 25 years experience, says, “For the child to fully experience the effect of the water on her body, skills may need to be taught with more emphasis on play than drill and practice.” An effective adapted swimming teacher can teach swimming skills in a way that incorporates games and fun. With appropriate support, almost all children can learn to swim and gain a lifetime leisure skill. For more information about adaptive swimming visit, www.at4learning.org.

Hyperbaric oxygen therapy
Hyperbaric oxygen (HBO) treatment is a specialized therapyin which the air pressure in the environment is increased. When a person’s body is placed in a more pressurized environment (a hyperbaric “chamber”), it absorbs more oxygen molecules per volume of compressed air. By increasing the air pressure, oxygen is then driven into the body’s fluids, allowing a super-saturation of tissues and organs with oxygen. The increased pressure infuses the body with oxygen, even reaching injuries with damaged circulation. Traditionally, HBO treatment has been used for stroke recovery, diabetic foot wounds, decompression sickness, brain injuries, thermal burns, wound healing, crush injuries and bone grafts, just to name a few. Many elite athletes use HBO to improve their workouts. Current medical theory holds that because HBO increases the blood flow to the brain, it may offer benefits to those with neurological conditions.

A recent study entitled, “Hyperbaric treatment for children with autism: a multicenter, randomized, double-blind, controlled trial,” was conducted by lead physician and researcher, Dr. Daniel Rossignol. From six centers in the United States, Dr. Rossignol and colleagues studied 62 children with autism, ages 2-7 years, to assess the efficacy of hyperbaric treatment. The study, published in BMC Pediatrics, found that 30 percent of the treatment group was rated by doctors as “very much improved” or “much improved.” The best place to start researching HBO treatment (and reputable treatment centers) is your child’s pediatrician. Visit the International Hyperbaric Association at www.ihausa.org, as well as www.news.bbc.co.uk/2/hi/health/7940149.stm and www.foxbusiness.com/story/autism-study-finds-significant-benefit-hyperbaric-treatment/ for more information.

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Six for the Summer: Try Something New!

Kids can be tough on their young nervous systems. With intense athletic activities and poor posture habits throwing developing spines off balance, chiropractic visits are quickly becoming a part of some children’s regular check-up routine.

Whole body health
The philosophy of chiropractic medicine is to live a healthy balanced life while realizing full potential. A chiropractor knows a healthy nervous system is the key to whole body health. Many factors can keep a body’s nervous system from working efficiently. Adults feel the effects of stress: pain, indigestion, a compromised immune system, inability to focus and process information, restlessness and insomnia. Children are not immune from experiencing those same effects. Pressures in school or on the athletic field add mental stress. Artificial and chemical additives found in many of the foods that kids eat add stress to the nervous system. According to the American Chiropractic Association and the American Academy of Pediatrics, heavy backpacks are a leading cause of back pain among students.

The brain and the nervous system
Nerves carry feedback to the brain to keep it informed of what the body is doing and how it is feeling. They let the brain know how respiration, digestion and circulation are functioning. They alert the brain to a loss of balance or coordination, if the body’s temperature is not regulated, or if the immune system is not working to capacity. Damage to the spine may shift the vertebrae out of alignment leading to pinched nerves, sprained tendons, muscle spasms, postural distortions and even difficulty with breathing. When the spine and nervous system are off kilter, it affects the entire body. Think of the human body as a car, and the spine and nervous system a the frame of that car. If the frame is out of alignment or in disrepair, then the car gets poor gas mileage, the steering is compromised and the tires will wear out sooner. Likewise, when the “frame” of the human body is out of alignment, the rest of the body suffers.

Keeping bodies healthy: the chiropractic exam
A chiropractor’s goal is to ensure the nervous system is working properly so that every system in the body is functioning as it was designed. A pediatric chiropractor may begin by asking questions about the child’s medical history. Were there problems with the birthing process? Has the child had any bad falls? Depending on a child’s activities and accidents, damage to the spine can add up over time and cause misalignment. The physical portion of the exam may involve an evaluation of posture. Is the child’s head centered? Are the shoulders and hips level? Are the knees and feet pointing straight ahead? The back and neck range of motion are checked for restrictions. To check for imbalances, muscle spasm or swelling, the doctor might gently palpate the spinal bones and muscles. The actual adjustment is a tiny and delicate push, often done with the pinkie finger, on the vertebrae that may be misaligned. Some chiropractors are more conservative than others, so x-rays will not always be taken as a matter of course.

An effective chiropractor will teach the child and parents about the developing spine and nervous system.

Kids, chiropractors and the classroom
For the brain to work optimally, the spine should be in the best alignment possible. The spine protects the nervous system, which is why there is vertebra covering spinal cord. For many kids, there are many factors that throw the spine off balance. Sports, academic pressure, poor diet, lack of exercise and poor posture can all lead to a spine and nervous system that is overloaded. It’s as if the body is an overloaded circuit – too many appliances plugged in at once – and the power blows. For kids to have maximum performance in the classroom, the spine and nervous system need to be in balance with the rest of the body. This balance tends to make students more functional in the classroom.

A team approach
Medical practitioners can be so specialized that many times there is not a whole body approach to health care. Developing spines and nervous systems are especially susceptible to damage and stress which can make a chiropractor a great addition to a child’s healthcare team. Pediatric chiropractors are trained to take all aspects of the child’s health into consideration when making their evaluation. By focusing on the spine and nervous system, the end result is balance for the whole body.

Dr. Caroline von Fluegge, owner of Balance Atlanta Family Chiropractic in Buckhead, has specialized in pediatric, pregnancy and family chiropractic for more than 10 years. Through television and articles for wellness magazines and Web sites, Dr. von Fluegge educates and empowers families to live a healthy lifestyle. In 2009, she will be the chiropractic consultant to NBC’s Atlanta’s Biggest Loser fitness program. You may contact her directly at caroline@balanceatlanta.com.

Though it is not the objective of Kids Enabled to endorse any intervention, we provide Innovative Interventions to inform our readers of all possible approaches when searching for ways to help their children. For more information on children with learning differences and chiropractics, you can visit the Web site for the International Chiropractic Pediatric Association.

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Kids and Chiropractors

Summer is a wonderful time to add new and fun activities to your child’s repertoire. As the hustle and bustle of the school year winds down, your child may benefit from adding a little tune to his world.

Cameron walking, Noah singing a tune, Pablo waving hello, Ryan listening and following directions, Jack asking questions, Michael performing a minuet on the piano… These are all magical occasions I’ve experienced working as a music therapist. Experiences like these make it easy to see the successes of music therapy. Explaining how it works is more complex. The American Music Therapy Association (AMTA) defines music therapy as “an established healthcare profession that uses music to address physical, emotional, cognitive, and social needs of individuals of all ages.” In other words, music therapy is the use of music by a trained professional to achieve therapeutic goals.

What music can offer
Music is a universal way of communicating and is shared and understood by people from many different backgrounds. Since music is a non-verbal communication, language skills are not needed to participate. The structured rhythms and tempos in music are organizational, just like the rhythms and tempos of our pulse and respiration. Music is also motivating and, as all therapists and parents know, sometimes motivating a child is half the battle! Since music is temporal (existing in present time), participation requires children to practice awareness, attention and flexibility all at the same time. Music is also neurologically unique since it is encoded in both hemispheres of the brain. Typical activities in a session are: singing, chanting, playing instruments, dancing, moving, composing, analyzing lyrics and improvising.

Choosing a music therapist
Competent therapists will have completed an approved academic music therapy curriculum, conducted 1200 hours of clinical training and passed the national examination offered by the Certification Board for Music Therapists (CBMT). Look for MT-BC (music therapist – board certified) after a therapist’s name to ensure that he has the above credentials. Most music therapists have extensive education and training in applications of music to assist in developmental improvement and/or rehabilitation. While a physical therapist uses a variety of therapeutic exercises and activities to address one area of development (motor), music therapists use one medium (music) to address all areas of development.

Therapy or lessons?
Music therapy is used to promote and improve non-musical skills, for example, answering “wh” questions. The music is a part of the process of therapy, not the product. Music therapy services will also have goals and objectives which track progress. In contrast, music lessons teach music performance on an instrument. A possible end goal of music lessons is playing a Mozart sonata on the piano, while a possible goal of music therapy is improved fine motor skills. Adapted music lessons combine music skills and therapy. Adaptive lessons teach music literacy (e.g. playing guitar), while also addressing non-musical goals (e.g. finger isolation). Sometimes the non-musical goal is addressed specifically; sometimes it is embedded in the music lesson itself. In a music therapy session, it is a happy accident if a child learns long and short notes. In an adaptive lesson, the student learns that these are called quarter and half notes.

Personal Stories of Growth
The following information has been shared with permission from the families.

Cameron
Cameron is a cheerful 13-year-old, whose spirit touches everyone he meets. He was diagnosed with a metabolic disorder that resulted in a severe seizure disorder, visual impairments and global delays. He is unable to independently dress, walk, eat or talk. He has been doing speech, physical and occupational therapy for most of his life. Three years ago, his physical therapist (PT) brought me in for a consultation. She felt music could help Cameron’s pre-walking skills and wanted some guidance for this task. I brought an Autoharp™ into the room and played a simple greeting song. Cameron immediately sat up, looked at the Autoharp™ and was instantly engaged. His mother was amazed at his immediate, powerful response to the music. Because music reaches him so deeply, he has been participating in weekly music therapy sessions for about three years. During this time, music has helped him focus and shape his vocalizations, activate his communication device on cue, increase his attention and awareness, and walk with assistance. To really understand how music therapy played a role, here are two illustrations.

Cameron is now able to activate his communication device on cue. When we began working on this skill, I adapted a song called “Sing Hi” specifically for this task. The word “hi” is at the end of each musical phrase. At each session, “hi” was recorded onto the device. At first, he was given physical assistance to use his device in time to the music. As Cameron became familiar with the song structure and more practiced with the motor task, he was able to use his communication device to sing “hi” during the song! Coordinating this movement is very difficult for him because of his neurological impairments. The structure of the musical phrases helps Cameron anticipate and organize his responses.

Cameron is now able to walk with assistance. His physical therapist and I work together with him twice a month to facilitate this goal. We are using a technique called “rhythmic auditory stimulation” or RAS. RAS uses the physiological effects of auditory rhythm on the motor system to improve the control of movement, in this case gait training. With the help of a metronome, I play music at the appropriate tempo while the PT physically assists. After some warm-up steps, Cameron entrains (matches his walking pattern) to the tempo and is able to walk with a more steady cadence, velocity and stride length.

Jack
Jack is a handsome, 8-year-old boy who has been diagnosed with Autism. Like many individuals on the Autism spectrum, Jack is musically gifted and blessed with perfect pitch. He began adaptive piano lessons in May 2007. At that time, his mom was convinced he had a possible talent in music and was hoping music therapy could help him discover that talent. She reported that Jack had always been responsive to music and was even picking out tunes on their keyboard at home. He quickly learned the fundamentals of music theory and the piano, all the while demonstrating good attention and focus skills. Jack is now able to play elementary-level piano pieces, transpose songs, and is even beginning to improvise with his own melodies. He showcased his talents at the winter recital in December. Besides learning how to play the piano, Jack is also learning some non-musical skills during these lessons. Through his piano playing, Jack has learned to use multiple fingers – a very difficult task for many children. When we play duets, Jack is now able to play in time with me. Using parallel attention is a difficult social skill for most people with Autism. Learning to play from printed music is also assisting him with his visual-motor coordination and reading skills. He has also learned some social communication skills. Each week, Jack and I start our session with a “getting to know you” song. When we began this song, he was having difficulty even listening, but now he is able to sing the lyrics, answer open-ended questions and is even beginning to ask me questions!

Pathways Academy
Music therapy can also be offered in a school setting. At Pathways Academy in Marietta that specializes in the education of children with reading, writing and spelling difficulties, a weekly music session is offered. Lesson plans are geared toward specific educational support. Some lessons assist with general skills, such as sequencing or decoding. One of the favorite activities of the students is musical ensembles, where groups of students play different parts of the same song from symbolic notation. Some lessons assist with specific skills, such as learning the months of the year. To learn these, we borrowed the tune “Battle Hymn of Republic” and superimposed the months of the year as the lyrics. Musical mnemonics is the way all of us learned our ABCs.

Music can be very therapeutic no matter how it is used, but knowing the difference between music therapy, adaptive lessons and music lessons can help parents determine the best option for their child. It could provide the beginning of improvements in a child’s skills and the start of a lifetime of enjoyment of music.
 

Elizabeth Hampshire Coyle, NMT, MT-BC is the Owner / Director of Music Therapy Services of Greater Atlanta. She can be reached at beth@mtsga.com.

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Music Therapy: Seeing – and Hearing – is Believing

Choosing the right therapy would be easier for parents if there was a “one size fits all” solution to helping their child overcome a learning difference. Since every child is unique, the task of determining the most effective therapy can be daunting. The good news is that current brain research provides new ways of looking at and treating learning differences. While there are more choices for parents to research, the likelihood that one will help a student succeed is high.

Brain Balance Achievement Centers
The Brain Balance program recognizes that many children who are diagnosed with learning differences have an “under-connectivity” of brain activity within and between the two halves (hemispheres) of the brain. Identified as “functional disconnection syndrome,” this condition can be responsible for many of the learning and behavioral struggles associated with learning and cognitive disorders. Participants in the program engage in “hemispheric-specific” activities which stimulate sensory, motor, behavioral and biochemical components of the brain. These activities can include any combination of

• balance and posture training
• light, auditory, olfactory, tactile or vestibular stimulation
• aerobic, breathing and strength exercises
• and fatty acid, vitamin or mineral supplementation.

The goal of these activities is to restore a balance in communication between the hemispheres of the brain. All Brain Balance activities and exercises are developed and implemented to address each child’s specific areas of difficulty and increase brain function. Jennifer Plunk’s 7-year-old son, who was diagnosed with high functioning Autism, showed marked improvement after three months in the Brain Balance program. Jennifer says, “…Matthew is more interested in others, more responsive and able to have much more natural conversations. His endurance has also increased. He still gets tired, but he’s much more likely to take a break and then join back in with us…His handwriting and other fine motor skills have also improved significantly.”

Brain Gym®
Started in the 1970s, Brain Gym® is a program designed to help children and adults with learning differences. This program focuses on learning through movement and is known as “educational kinesiology.” Brain Gym® includes more than 25 targeted exercises and activities that “integrate mind and body” to increase skills in concentration, reading and writing, physical coordination, and listening and memory. Brain Gym® is not just for academic students and is used in corporate, performing arts and athletic training programs. Though Brain Gym® movements are best learned when taught by a licensed instructor who correctly models the movements, there is a short book entitled Brain Gym® by Paul E. and Gail Dennison, the program’s founders. This book gives brief information and illustrations of each of the Brain Gym® exercises.

Chiropractic Neurology
Chiropractic neurology is a brain-based chiropractic practice that combines current neurological understanding and chiropractic care. Its goal is to achieve a balance of left-brain and right-brain function thereby achieving optimal brain health. Using the latest techniques in assessment and rehabilitation, chiropractic neurologists discern how the body’s different systems (visual, olfactory, auditory, vestibular) are stimulating the central nervous system and its relation to the brain. A specific treatment plan may include chiropractic adjustments, percussive treatment, brain exercises, cold laser and diet and nutritional supplementation. Neurofeedback, a method for training brainwaves, might also be used. Training brainwaves may change the structure and function of the brain and enhance its performance. Dr. Soutar, who practices at the New Mind Neurofeedback Center says, “We make a brain map, like a weather map, of each person’s brainwave patterns and determine the best way to train them. Brainwave training is like working out at the gym, but instead of a better body you get a better brain.”

Craniosacral Therapy
The craniosacral system of the body consists of the fluid and membranes that surround and protect the spinal cord. It encompasses the bones of the skull, face and mouth (the cranium) all the way down to the sacrum and coccyx, or tailbone. During craniosacral therapy, practitioners “apply a subtle movement of the spinal and cranial bones to bring the central nervous system into harmony.” This treatment can eliminate distortions and tensions in the craniosacral system by assisting the flow of cerebrospinal fluid. Reiko Donato says her daughter, Alex, was more “with it” and connected to her environment after craniosacral treatments.

LearningRx™
By focusing exclusively on training the cognitive processes which impact the ease of information processing, LearningRx ™ learning centers identify and strengthen the skills behind how students learn. These cognitive skills, such as attention, memory, processing speed, auditory and visual processing, and reasoning are measured using specialized tests developed from 30 years of research and clinical trials. LearningRx™ traces its beginning to the work of Dr. Ken Gibson, a specialist in visual processing whose practice was one of the nation’s first to concentrate on children exclusively. His work with children inspired him to commit to helping them become better learners. Through the preschools, learning centers and private schools that he founded, Dr. Gibson gathered clinical data and experience. He observed that children attended to task and focused better, experienced better recall and processed information faster when they were given short but intense periods of cognitive training. The results of Dr. Gibson’s work have been tested and refined, and today LearningRx™ uses two primary training programs to work with students, ThinkRx and ReadRx. These one-on-one non-academic training procedures can strengthen the brain’s core mental abilities. One parent whose daughter went through the LearningRx™ program for six months says, “Tena has improved in her memory, her comprehension, her organizational skills…In addition, she is much more confident.”

Neuropsychology Therapy
Neuropsychology is a specialty of clinical psychology dealing with the relationship between behavior and brain function. A neuropsychologist has a Ph.D. or Psy.D. in psychology and works closely with other professionals such as neurologists, neurosurgeons and psychiatrists. Various assessment techniques are used to evaluate the brain-behavior relationship in each client. This assessment can include a review of medical, academic and/or psychological records, standardized psychological testing and computerized functional brain assessment techniques. Once strengths and weaknesses are defined, the results are used to prepare an individualized treatment plan which may include medical, chemical, psychological and/or physical or occupational techniques. The goal of neuropsychology is to increase positive brain function. For struggling students that can mean a rise in reading, writing and math skills, better organizational skills and an increase in focus and attention.

Partners in Achievement (PIA) and PACE (Processing and Cognitive Enhancement)
The purpose of the intense PACE program is to produce significant changes quickly so that the student sees the changes and stays motivated to learn. The program is now distributed world-wide by licensed therapists and educators and is available for both adults and children. The PACE approach is process-specific using planned, repetitive exercises that place demands on mental functions. Once the student masters the exercise, the same cognitive skill is targeted again with a more demanding exercise. Darren Scheyer, M.S., is a member of Partners in Achievement, a group of highly experienced doctoral and master’s level-trained psychologists who administer the PACE program. He says, “All activities, school, sports, art, dance, music and even video games, require different mixes of processing skills. … A weakness in even one processing skill can cause even the brightest of students to become frustrated with school to the point of losing motivation.” Partners in Achievement believes processing skills are the underlying cognitive “tools” that are critical to effective learning and academic success. Developing these skills requires one-on-one attention. Besides providing cognitive training to increase processing skills, Partners in Achievement provides diagnostic evaluations to help parents determine the best course of intervention for their student.

While researching available brain boosting therapies, parents should be aware of costs, program duration and expected outcomes. They should also remember that what works for one child may not be the best match for another. The unique needs of each student should be at the forefront of the decision making process. Knowing their child’s strengths and weaknesses with learning and cognitive skills is invaluable in helping to develop an effective therapy plan. Current brain research augments the parents’ knowledge base as they look at appropriate solutions for treating their child’s specific learning differences.

Article photos courtesy of Brain Balance Achievement Center and Learning Rx™.

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Connecting the Dots: Finding the Best Brain Therapy