Treatment Protocol Stages
Neuro-Sensory-Motor-Emotional and cognitive integration
Step 1: Vagus nerve stimulation -Listening program , Breathing and Advance Cranio-Sacral Therapy (Neuro-Organisational-Technique)
We initially start with an auditory listening program and NOT for client’s before starting our reflex & brain integrations program. The therapy calms the nervous system by stimulating the vagus nerve. Some benefits seen include calmer mood, better sleep, improvements in social settings, improved receptive language, improve expressive language, less anxiety, fear and agitation.
During the early stages of development ( 6 weeks in utero to 6 weeks post-natal) neuro-networks for parasympathetic nervous system ( vagus nerve) are being developed which is crucial for organised nervous system. Prenatal trauma, epigenetic factors, chemical toxicity, trauma can interrupt this process. A disorganized nervous system can result in “fight or flight” responses to sensory stimulation, impaired cognitive processing, impaired self-regulation, impaired social skills/language skills/motor skills and possible difficulty with motor planning later in life.
Children that would benefit from starting at this step are those that have anxiety, separation anxiety, agitation, irritation, poor sleep behaviour, excessive crying, low muscle tone, poor appetite, inability to follow instructions, poor emotional regulation, tantrums, fear and behaviours that may prevent them from working on reflex exercises.
The Goal of this phase is to set the conditions to assist individuals to feel safe and improve parasympathetic function of the nervous system.
Step 2: Primitive Reflex Integration
Primitive reflexes are the first foundation of the nervous system. They originate in the brain stem and integration of the reflexes creates the foundation for future controlled movements.
Primitive reflexes are innate, automatic motor patterns, movements and reactions emerging during foetal life until after birth crucial for an infant’s survival. These reflexes are being integrated and replaced gradually in term infants into higher-level righting, support, and protective postural reactions.
Several reflexes are important in the assessment of newborns and young infants. These central nervous system motor responses are eventually inhibited by 4 to 6 months of age as the brain matures and replaces them with voluntary motor activities but may return with the presence of neurological disorders.
Here is an example of a Primitive reflex and what happens when it is not integrated:
Moro Reflex: The Moro reflex acts as a baby’s primitive fight/flight reaction and is typically replaced by the adult startle reflex by four months old. If a child experiences an unintegrated Moro reflex beyond 4 months, he may become over sensitive and over reactive to sensory stimulus resulting in poor impulse control, sensory overload, anxiety and emotions and social immaturity. Some additional signs of a retained Moro reflex are motion sickness, poor balance, poor coordination, easily distracted, unable to adapt well to change, and mood swings.
- Car sickness or poor balance and coordination
- Poor stamina
- Doesn’t maintain eye contact
- Sensitive to light
- Sensitive to sound
- Adverse reaction to drugs
- Dislike of change
- Anxiety or nervousness
- Mood swings
- Poor math sense
This dynamic transition is part of the neuro-motor-emotional-cognitive organization and development, occurring in response to increasing environmental influences and demands. The involved reflex integration allows a change in the quality of movements, from clumsy to more natural, spontaneous, and efficient sensory processing, internal postural control, and acquired, goal-directed, precise, and well-coordinated voluntary motor skills and movements against gravity, which in effect, affect learning and behaviour of a child in his later stages of life.
Unintegrated primitive reflexes make the body feel unsafe and trigger our ‘fight or flight’ response which creates chronic stress to our body contributing to disorganisation of the nervous system and contributing to:
- Anxiety and stress
- Poor concentration
- Attention difficulties
- Handwriting issues
- Compulsive traits
- Adrenal fatigue
- Speech problems
- Problems with fine motor skills
The Therapy: Utilizes a specific, clinically proven individualized, sequence of movements to integrate neural pathways thus creating functional connections that improve processing of the neurons in the brain significantly reducing symptoms shown in Sensory processing and developmental disorders.
The Goal of this phase is to move your child through integration of the core primitive reflexes to create a routine and body awareness against the gravity with reflex integration, plus neurodevelopmental movements for proprioceptive strength. before moving onto more advanced sensory Integrations such as sound and vision.
Step 3-Metabolic Profiling / Urinary Organic Acid Assessment
Human genes are assumed to number more than 50,000, out of which 4,937 Mendelian inheritances are presently known. There are more than 500 inherited diseases in which primary defects are located in enzyme proteins or non-enzyme proteins. About 180 diseases are known for disorders of intermediary metabolism, which occur as a result of a single enzyme defect.
Interruption of mental and physical development often occurs in surviving cases of certain disorders. Several of these disorders can now be treated, if early diagnosis is successfully made, and a special dietary regimen is administered to prevent metabolic disorders. Urinary Organic Acid is one of the approaches that provides us with a window into your child’s metabolic activity, such as Protein, Fat, Carbohydrate metabolism, brain neurotransmitters, Gastrointestinal health and Energy production.
Treatment approaches for metabolic disorders include sufficient caloric and protein intake to support normal growth and development. Dietary restriction , supplementation of coenzymes and cofactors may also be needed.
A healthy diet promotes a healthy gut, which communicates with the brain through what is known as the gut-brain axis. Microbes in the gut produce neurotransmitters like serotonin and dopamine, which regulate our mood and emotions, and the gut microbiome has been implicated in mental health outcomes.
The Goal of this phase is to remove unproductive biochemical stimulants hindering normal brain development and provide adequate nutritional support, which is crucial for the formation of the brain networks, laying the foundation for the development of cognitive, motor, and socio-emotional skills throughout childhood and adulthood.
Step 4- Social Brain-Emotional regulation
Focuses on children’s brain development and the impact of the social environment on children’s emotional state and behaviour. Social brain describes how each of us perceives and responds to the world around us and adapts emotional patterns and behaviors.. Understanding your individual social brain provides safety and awareness of our and others’ uniqueness of characters and behaviors. In the long term, we can develop the capacity for emotional regulation.
There are three modes of social brain;
- Physical and action capacity
- The mind or intellectual capacity
- Relational and emotional capacity
Each mode has a dominant sensory profile. A person inherits at birth one of these default mode networks predominately. This is how we are wired to perceive the world. We then have three executive networks through which we respond, either through action, through thinking or through feeling or relating in what we respond to predominately as our lens to the world.
If we are aware of the innate wiring from early childhood strategies and interventions can be introduced to help the child optimise the inherited and innate gifts each child has.
Once we identify your child’s default social brain, we then work with the parents to identify their child’s needs even if they can not communicate their needs to parents or carers.
Children’s connections with other people are critical for being able to tolerate and regulate their own emotional responses, and this sense of connection – the sense of feeling held, of feeling supported, of feeling understood by another – occurs somewhat through words, but an awful lot through nonverbal communication. That includes everything from touch to eye contact, to prosody, to simply the kind of presence that we establish with another person.
The Goal of this phase is to create a sense of emotional safety and acceptance for the child. This is crucial for further emotional maturity, self reflection, self control,
Social adaptation through engaging within a familiar social environment, sensory integration and accessing their learning capacities.
Step 5- Sensory Processing Patterns
Sensory processing involves many sequential parts, including perception, integration, modulation and responses. One of the integral parts of sensory processing that is often overlooked is modulation. Modulation determines how efficiently we self-regulate, in every aspect of our lives. Sensory Modulation is how the brain processes, organizes and regulates sensory input (e.g. filtering out loud noises from a lawn mower). Sensory modulation is automatic in a healthy sensory processing system. An individual with sensory modulation disorder will emotionally react to the loud noise, perceiving it as a distraction from their focus, leading to frustration.
We do not consciously think about the majority of sensations around us unless in emergency situations, such as touching something extremely hot, or in less urgent circumstances for instance spinning around in circles, where our brain directs us to stop once we start to feel sick. Most of the sensory stimuli in our world is irrelevant. A simple wisp of air hitting our skin, or the touch of a cold desk, ignites sensations that we would otherwise ignore automatically, so that our attention can remain focused on the meaningful activities around us. However, an individual who focuses on every small piece of information or stimuli he or she receives is constantly distracted.
When excitation and inhibition (sympathetic and parasympathetic) are balanced, we can make smooth transitions from one state to another. Thus, we can switch gears from inattention to attention, from sulks to smiles, from drowsiness to alertness, and from relaxation to readiness for action.
Modulation determines how efficiently we self-regulate, in every aspect of our lives.
Signs and symptoms of a sensory modulation disorder may include the following:
- Extreme emotional reaction to unwanted sensory stimulation (hot, cold, touch, texture)
- Withdrawal from bright lights
- Gags on foods
- Refuses to eat certain textures
- Oversensitive to sound
- Pulling away from unexpected touch
- Dislikes brushing hair
- Struggling to brush teeth
- Avoiding messy things on hands such as mud or lotion
If your child experiences any of these signs and symptoms, increasing your sensory integration through movement and sensory activities could help.
Self-regulation is our ability to respond appropriately to sensory information or emotional triggers. Individuals with poor self regulation have passive strategies towards sensory events. For example, being in a place with many sensory inputs can make individuals with poor self regulation feeling uncomfortable, and may react with frustration. Individuals with good self regulation utilize active strategies towards sensory events such as adjusting one’s position to get a manageable amount of sensory input.
There are four sensory processing patterns. They are:
(1) sensation seeking (create sensory experience to satisfy the deprivation of pleasure from sensations),
(2) sensory avoiding (withdrawal from sensory stimuli),
(3) sensory sensitivity (high detection skill for sensory stimuli and then react to the stimuli),
(4) low registration (failure to notice sensory stimuli).
It is scientifically proven that sensory processing re-patterning can change and rewire how the brain is organized. This rewiring strengthens existing connections in the brain while also helping to create new ones.
The human brain integrates the information derived from various sensory modalities into a coherent representation of the surrounding events, a function known as multisensory integration. By facilitating the processing of sensory inputs and increasing their salience, multisensory integration can improve motor responses to sensory events hence enhancing neuroplasticity and child’s social interaction and learning.
Various manual therapeutic protocols are also used to enhance somatosensory awareness, including techniques such as sensory re-education or tactile kinesthetic guiding. Anatomically specific sensory and positional awareness can occur with passive or active-assisted movement, as well as with manual techniques such as stroking and tapping.
Brainwaves change frequencies based on neural activity within the brain, be it by hearing, touch, smell, vision and/or taste. These senses respond to activity from the environment and transmit that information to the brain via electrical signals. Hearing and vision are considered the favorable senses for affecting brainwaves safely.
Visual approaches – Another sensory modality relevant for motor control and skill acquisition is vision. Action Observation Therapy (AOT) is utilised with the aim of activating the motor system through vision by generating an internal representation of the observed action that can be targeted for motor learning. Observation with intent to imitate the observed action is fundamental for priming the motor system for execution.
Auditory rhythmic stimulation facilitates gait training. The motor system is physiologically sensitive to arousal by the auditory system; furthermore, the neural activity from the auditory rhythm stimulates neural motor activity.
Both vision and auditory training has multiple stages which needs to be implemented before a child is ready for higher cognitive learning.
One popular method of treating and overcoming sensory problems is the use of a sensory room in our centre. These “safe” spaces are designed to provide a place for individuals with sensory issues to decompress and confront a variety of sensory issues in a way that will ultimately help them learn to cope with seemingly normal experiences.
The Goal of this phase is to improve sensory integration and processing as it reflects in a child’s ability to regulate posture, relate, communicate, and exhibit flexible and adaptive social behavior.
STEP 6- Sleep regulation
Bedtime is challenging for both the child and family. Things that seem like minor irritations to most people can keep sleep out of reach. Chiming clocks, washers and dryers, and people talking in the other room, can disrupt a child’s struggle to block out background noise. Children with tactilely sensitivity complain about the tags on their pyjamas, the texture of bedding, or the temperature of the room. Even when all those other conditions are met, children face the hurdle of calming restless body, and the slightest addition of stress can make sleep seem near impossible.
When children finally sleep, possible sweating, snoring, teeth grinding, body jerks, sleep talking, sleep walking, night terrors, nightmares, multiple arousals and difficulty falling asleep again, takes a heavy toll on their brain development, learning and stamina the following day.
Sleep is divided into four stages of Non Rapid Eye Movement (NREM) (purple) sleep and REM (Blue) sleep. These are sometimes referred to as “sleep phases” or “sleep cycles“. Dreaming occurs in both stages, mostly during REM sleep. Each cycle of NREM and REM is repeated every 90 minutes, 4 to 5 times a night. 5-6 cycles is an ideal amount of sleep required for everyone after 15 years old.
Sleep needs vary over the life cycle
0 – 2 months = 10.5 – 18 hrs
2 – 12 months = 14 – 15 hrs
12 – 18 months = 13 15 hrs
18 mo – 3 yrs = 12 -14 hrs
3 – 5 yrs = 11 -13 hrs
5 -12 yrs = 10 -11 hrs
On Avgerage = 9.25 hrs
On Avergage = 7 – 9 hrs
Can you recall the last time you felt sleep-deprived? Your body probably felt tired and achy; your attention was all over the place; you forgot some important information; or you felt irritable towards people around you. What you might not have noticed is that poor sleep reduces your child’s regulation of emotions as well. Getting even one night of poor sleep can throw our hormones out of whack. We may develop high levels of cortisol (stress hormone), oxidative stress, insulin (blood sugar regulation hormone), ghrelin (hormone that makes us hungry) and shorten our telomeres. This is why sleep deprivation is thought to be one of the major contributors to emotional regulation, motivation and learning in children.
Sleep plays a crucial role in the development of young minds. In addition to having a direct effect on happiness. research shows that sleep impacts alertness , attention, cognitive performance, mood, resiliency, vocabulary acquisition. Learning and memory.
Sleep also has important effects on growth, especially in early infancy. In toddlers, napping appears to be necessary for memory consolidation, executive attention and motor skill development.
Sleep rejuvenates and recharges the brain and the body, detoxifies body, regulates inflammation, repairs damaged tissues, initiates growth and aids in the process of sorting and storing everything we learned, felt and experienced during the day. Without quality sleep, the person can be depressed, has little motivation to initiate anything and cannot adapt to changes in internal and external environment.
The Goal: The goal at this phase to assist the child in sleep regulation.
STEP 7- Brain Hemispheric Balance
This program builds upon Foundations. During Integrations we continue with primitive reflex integration exercises while adding in sensory stimulation: tactile, visual, auditory, smell, vestibular, and proprioceptive for the weaker hemisphere. We’ll work together to assess your child for brain hemispheric weakness and use a brain balance approach to increase hemispheric connections. The sensory-motor connection helps to integrate reflexes and create balance between brain hemispheres. This portion is 100% personalized for your child.
When a child demonstrating difficulties in learning & reading , we need to strengthen the root level brain processes that control learning & reading. The brain relies on proper function of lower brain centres ( Step 1-5) in order to process information optimally. A child who demonstrates difficulty in learning (reading, writing, dyslexia, auditory processing, etc) has underlying disorganization in their nervous system. For example, when reading, the left side of the brain processes what the right eye sees; while the right side processes the left. The two sides must coordinate the information quickly and effortlessly. Movements that cross the midline, integrate the brain hemispheres and challenge the balance system all help to improve the visual system and higher-level cognitive functioning.
Children learn using their dominant sense. Once that is identified, personalised learning programs using their preferred sense is developed to improve learning. In some instances the reading age have shown to improve between 2-4 years in one term.
The Goal: The goal at this phase is to enhance comprehension, memory recall , self regulation and the speed in which brain process information using light, sound and movement
STEP 8- Advance brain training – QEEG and Neurotherapy
In some instances we have discovered that more advanced intervention are necessary to achieve our desired goal in children’s emotional regulation and learning.
Learning disabilities are neurologically-based disorders, meaning they stem from a root problem with brain function. Neurofeedback targets areas in the brain naturally by retraining the brain to function at an optimal level. An initial brain map (QEEG) of the patient shows where the brain is having trouble functioning, and from there, protocol is developed to specifically retrain the brain to function at its best. Neurofeedback has been proven to successfully treat the following learning disabilities, eliminating unwanted symptoms, allowing better academic performance.
Some of the areas that can be identified and assisted with neurotherapy are:
Auditory Processing Disorder: The brain has trouble processing and interpreting sounds. A person is unable to recognize and understand certain differences between words and sounds despite having the ability to hear them. Other issues associated include having trouble processing and interpreting the order in which sounds are heard, where the sounds might be coming from, and having trouble tuning out other unrelated sounds.
Dyscalculia: The brain has trouble processing numbers and math symbology, making math very difficult to learn and understand. A person may struggle to memorize and organize numbers, and may have difficulty counting and telling time.
Dysgraphia: Fine motor skills are affected which directly impacts a person’s ability to write. This is often marked by issues with writing compositions such as allowing enough space to write, illegible handwriting, spacing words when writing, poor spelling, and the inability to think and write simultaneously.
Dyslexia: The order of letters in a word or words in a sentence are reversed, impacting reading comprehension, writing, recalling information from a text, spelling, and can even affect speech.
Dyspraxia: The brain has difficulty with muscular control, causing problems with coordination and movement and with language and speech. This disorder is not technically considered a learning disability, however it can have a great impact on learning for a student.
Executive Function Disorder: The brain is unable to manage tasks efficiently, effecting planning, organization, attention, memory, and time management. This disorder makes learning, completing assignments, and taking exams very challenging.
Language Processing Disorder: This type of Auditory Processing Disorder creates difficulties for students in ways such as attaching meaning to sounds of certain words, making comprehension of sentences and stories difficult. LPD can have negative impacts on the student’s ability to express ideas verbally as well as taking in new verbal information.
Non-Verbal Learning Disabilities: The brain has difficulty with motor, visual-spatial, and social skills, making it difficult to interpret nonverbal cues like body language or facial expression. Someone with this disorder may also have poor physical coordination.
Visual Perceptual/Visual Motor Deficit: The brain has trouble comprehending visual information, making writing, drawing, and/or copying very difficult. Some signs include poor hand/eye coordination and missing subtle differences between shapes and letters.
Each individual brain develops a complex interactive system designed to gather and apply all our previous experience to keeping us safe, comfortable, able to adapt, able to relate to internal and external environment, learn from experiences and love through developing heart intelligence so we be successful in the universe in which we live in.
Habitual patterns are encoded within the electrical impulses of brain , called brain wave . Some brains fire slow when they could be resting, others fire when they need to be processing and some brains fire fast or slow in areas that do not function as well with those patterns.
How can we change brain habits? By changing the habitual patterns in our brain we can literally change our perception of our interaction with the world we live in. Our mind is our experience and it does not control the brain, rather, by changing the brain we can change our mind effortlessly.