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Reading, writing, arithmetic…are extremely complex processes that can develop only upon a strong foundation….
– A Jean Ayres, Ph. D.
I’m about to engage in a journey of discovery that will show you how we can best understand and help those children (and adults) who face the growing array of developmental and other neuro-physiological challenges.
If you join me you may be fascinated by the wisdom and insight of some of the greatest minds of the last several decades; you may nod in agreement or open your eyes wide to new concepts; and you may be gratified (or relieved) to know that every issue we raise will have a corresponding treatment.
Somewhere towards the end of my essays you will understand and appreciate the power and effectiveness of finding and treating root causes.
Treat the Child Not the Diagnosis
– Patricia Lemer
In the poignant book Sway: The Irresistible Pull of Irrational Behavior
the authors (and brothers) Ori Brafman and Rom Brafman present a cautionary description of a medical tragedy stemming from Diagnosis Bias. The latter is the prejudicial and incorrect treatment of a client based on an unwavering and unjustified assumption of what is wrong and thus the (treatable) cause of the disorder.
While the hindsight seems obvious, the doctors in question were well meaning and were certain that they were helping. Their blind spot was the mental quirk that equates diagnoses that are categorizations of symptoms to treatable causes of those symptoms.
The way to avoid such errors is to explicitly and thoroughly determine root causes–what we call foundational issues. In pediatric special needs the diagnoses are typically descriptions of symptoms and rarely explanation of causes.
When I activate clients I try to convey this understanding, and because the root causes are usually (very) treatable, I encourage my clients to be cautiously optimistic.
Since co-founding Creative, I’ve been studying the findings of some of the greatest scientists and practitioners of the last several decades and I’ve come to appreciate the power and beauty of finding and treating the root causes–the foundational issues.
Indeed, as you learn about the foundational elements, a fascinating world reveals itself. I want to introduce that world to you.
Any child, no matter the diagnosis, should be seen as an integrated whole in terms of the many facets we as humans hold dear
– Maude Le Roux
I offer you a journey of discovery of human development that begins prior to the fourth month of conception and persists throughout life. I will show you a vista of concepts including primitive reflex integration, sensory processing, brain rhythm and timing, the role of emotion in human develop, praxis (how we learn), the power of music, the visual-vestibular-auditory triad, the role and importance of self-regulation, and perhaps more..
We live in a time of unprecedented challenges, perhaps the most important are the epidemic of childhood issues–autism, attention deficits, autoimmune disorders such as asthma, learning differences, attachment disorders, premature births, seizures, and on and on.
We live also in a time of unprecedented insight and capability. The people I’ve previously mentioned have provided us the insight and tools to prevail over those challenges. They include Doidge, Greenspan, Ayres, Kawar, Frick, Feldenkrais, Tomatis, Le Roux, May-Benson, Masgutova, and others. They have provided the foundational elements, the insights, and the modalities and methodologies.
We have the tools. Once we determine the underlying issues and causes, we can apply the tools appropriately and most effectively.
Thus begins our journey, a series of essays identifying foundational issues and the treatments to address them.
— Richard Feingold, Co-founder
Neuroplasticity is the property of the brain that enables it to change its own structure and functioning in response to activity and mental experience1
Today, May 5, 2017, is the 10th anniversary of the publication of The Brain That Changes Itself by Norman Doidge, a seminal and transformational introduction of brain neuroplasticity to a broad international audience. It has sold over one million copies and has been published in at least 19 different languages.
Prior to the work of Doidge and others in the last 20 to 30 years, most people believed in a static brain and the limitations of that model: once you reached adulthood, brain growth was complete, the wiring was permanent—fixed and unchanging, repair was limited, and there was no renewal. Irreplaceable neurons died one by one or in bunches. If you had a stroke or accident or other disease, then the damaged areas were lost forever. Regarding the permanent “wiring,” that notion was so firmly entrenched, its prejudice so prevalent, that even the idea that a blind person could develop greater sensitivity in the non visual senses was considered urban legend (despite massive anecdotal evidence to the contrary).
We see with our brains, not with our eyes
Norman Doidge was one of a select few that questioned the static brain orthodoxy. He not only challenged the notion but demonstrated that it was false and wrote two best sellers. His seminal The Brain That Changes Itself was transformational as it introduced neuroplasticity to millions of readers. His second book, The Brain’s Way of Healing puts the knowledge and insight of the first book to work with real world examples and further insights.
Those of you who have heard me wax philosophical may have heard me say “the human brain is the greatest organ in the universe.” To me the brain is great both in its capacity to understand and change the world and its versatility, resilience, and ability to change itself and to heal. What inspires me about the work of Doidge and others involved in neuroplasticity is their belief in the brain’s vast capacity and our capability to use that plasticity to transform ourselves.
Too many of our interventions are based on looking at symptoms and not nearly enough on what we might call pathogenesis – underlying causes
Norman Doidge has taken us to the leading edge of understanding that most remarkable organ. While his work begins with the brain, it spans all human neuro-physiology development—the whole person. It is a key supporting element of the treatments we provide here at Creative. For those with special needs who need help, Doidge has not only made the case for neuroplasticity and hope, but demonstrates the practical treatments that make use of it.
The brain is a far more open system than we ever imagined, and nature has gone very far to help us perceive and take in the world around us. It has given us a brain that survives in a changing world by changing itself.
— Richard Feingold, Co-founder
1All quotes are from Norman Doidge
To learn, you have to be able to listen
– Alfred Tomatis
The last seven and a half decades have seen an explosion in understanding how we develop as human beings and how we relate to each other and the world. It has seen us use leading edge developmental neuro-physiology1 to effectively treat children (and adults) with special needs—often with dramatic results.
Through a series of articles I will introduce you to the people behind this revolution.
Our time frame begins with the 1943 publication2 of Dr Leo Kanner’s seminal work on pediatric autism. Though a series of essays we will explore the wonders of being alive and human and having the greatest organ in the universe (thus far known): the human brain. You will meet some of these incredibly perceptive pioneers who have changed the way we understand human development.
These are a few of them:
- Dr Leo Kanner
- Dr Alfred Tomatis
- Dr Jean Aryes
- Mary Kawar, MS OTR
- Patricia Wilbarger, MEd, OTR
- Dr Stanley Greenspan
- Dr Norman Doidge
- Teresa May-Benson, ScD, OTR/L
- Sheila Frick, OTR/L
Each of these remarkable individuals provided novel insight into how we develop and function as human beings—and most if not all provided tools to transform their philosophical understanding into effective therapies.
Before we begin the biographies I want to introduce two ultimately interrelated topics. (1) The wonders and reach of the human brain. (2) Gödel’s Proof.
The human brain is special. Its capacity to understand and control the world through machines and technology is unbounded. Human beings have created effective models of the microscopic world, the entire universe, and the beginning of time. Our intelligence has allowed us to control the forces of nature through fire, chemical reactions, and nuclear energy, and we now stand on the verge of controlling matter/anti-matter reactions. Physical and virtual libraries are filled with books on our ability to organize society, manufacturer things, build cities, grow food, and travel through space. As we’ll see through the works of the pioneers, the brain has the singular if not unique ability to learn, grow, adapt, reorganize, and change itself—through our entire lifetime.
Gödel showed us something even more.
Published in 1931 when he was 25, Godel’s Proof3 is one of the most remarkable discoveries in all of mathematics. Ironically, it is not well known even among many mathematicians.
While Godel’s mathematics is formidable, his results are straightforward and intuitive: Roughly speaking, most of the truths that can be known by human beings cannot be known, discovered, or proven by any of today’s computers (even quantum computers) or by any artificial intelligence (AI) based on current computer architectures and programming.4 Not only can human beings know more truths than computers, they can know infinitely more. This result affirms, supports, and validates my belief in the incredible potential and capability of the human brain—the greatest organ in the universe.
Now let’s go meet the people.
Empathy comes from being empathized with
– Stanley Greenspan
— Richard Feingold, Co-founder
1 The meaning of developmental neuro-physiology will reveal itself in the course of these articles. I will not attempt to define it.
2 Kanner, L. (1943) ‘Autistic disturbances of Affective Contact’, Nervous Child 2: 217-250.
3Kurt Gödel, 1931, “On Formally Undecidable Propositions of Principia Mathematica and Related Systems, I,” Monatshefte für Mathematik und Physik, v. 38 n. 1, pp. 173-198.
4While it’s hard to imagine the type of computer to which Gödel’s Proof doesn’t apply, I must allow for its possibility.
Your brain has a natural ability to physically change itself by creating new pathways and connections in response to your experiences. This neuroplasticity can be positively stimulated by engaging in the right activities, often enough, over a sufficient period of time, resulting in positive life changes. Modified music through neuroplasticity creates measurable changes in the brain. (Adapted from the Advanced Brain Technologies website)
Over the last several decades scientists, doctors, and therapists have developed new transformational treatments for children with special needs. Judicious and inspired use of recently discovered habilitative methodologies have improved many lives. In this essay I discuss one modality in particular: modified music.
Our journey of discovery begins with the genius of Alfred Tomatis and the serendipitous confluence of his medical and musical capabilities. Dr Tomatis, a French otolaryngologist from a family of musicians, several decades ago discovered and refined the relationship between listening to (ultimately modified) music and treating disorders such as reading problems, dyslexia, depression, severe schizophrenia, and autism.
Is transdisciplinarianism a real word? First, let’s see what it means.
The 20th Century brought us many great things. And many challenges. The Newtonian physical theories of both the very large and very small were supplanted by General Relativity and Quantum Mechanics. Nuclear technology revolutionized everything from medicine to power generation to war and peace. Aviation and the automobile transformed travel. Computers have transformed most everything from navigation to entertainment.
Science, technology, and information processing drove material progress and had profound social implications and enormous cultural influence. One of the most unfortunate takeaways of this progress was reductionism—the idea that problems could be solved by reducing them to their most basic constituents.
That perspective was often adopted in healthcare. Specialization dominated. Practitioners isolated symptoms, minimized the domain of interest, and treated. Specialists even specialized within specialties. This was further challenged by a medical model that shifted from health and healing to symptomatic diagnosis and characterization and long term pharmacological intervention.
There was the all too true cliché of seeing clients as personifications of their symptoms. Patients referred to by their issues: “Send in the broken arm.” “When am I scheduled to see the bowel obstruction.” I cringe when I hear someone referred to as a “special needs child.” To me, it is a child with special needs or better, a child with differences.
It’s not political correctness, rhetoric, or semantics. It’s fundamental. We must see the child as a unique holistic human being with differences from typical development that inhibit his or her ability to engage the world, to know themselves and feel good about themselves. We must treat the whole child.
And to treat a child holistically, we a need a single integrated plan of care. The services provided must be driven and defined by the unique needs of the child.
So, how do we do that when there are increasing modalities to learn? more and more knowledge necessary to successfully treat the children we see?
It’s by continuing to learn and work as a team. It’s by meeting every day as a team and remaining focused on the unique needs of the child.
That’s transdisciplinarianism: The perspective, belief, and practice that informed treatment must optimally focus on and respond to the holistic needs of the individual and multiple disciplines are combined, integrated, and harmonized for maximum benefit.
Our practice believes so strongly in this approach that we meet as a team one hour every day. Every day. Each child we see requires, deserves, and receives the benefit of our collective expertise. Each child.
Okay, transdisciplinarianism is not a real word yet. I have faith that will become one. In fact, I just added it to my spelling checker dictionary.
What do you think?