Introducing Kimberly’s Corner

Who is Kimberly Koala?

When Judy and I founded the practice we choose a koala for our mascot and named her Kimberly. Her image was captured by the artist who painted our children’s immersion mural on the walls of our original suite. During our founding years we also published a physical newsletter, one of whose standing items was Kimberly’s Corner. The latter provided insight into the inner workings of Creative. Imagine Kimberly up in her tree looking down and listening and then reporting.

Koala Facts: Koalas can only live in one place in the world, Australia. The koala only eats Eucalyptus leaves and it eats so many leaves, it smells like the leaves. The koala hops from tree to tree and climbs the trees to get the leaves. The koala will eat 2.5 pounds of food a day.

Kimberly’s Corner

I’m glad Richie is letting me publish again since I have a lot to share. We all love Richie but often he uses big words and long sentences and it’s hard to understand him. It’s not his fault and probably best that you don’t tell him what I just said. I don’t want to hurt his feelings.

Speaking of big words, I’m sure you’ve seen Creative’s tag line. How could you not? It’s everywhere including the top of this newsletter. Six words, 21 syllables, 67 characters including 2 em-dashes and a trade mark symbol. Well, despite its being kind of stuffy, the Creative team follows it, and you’ll see that from some of my columns, including this one.
Today I’m going to tell you about the One O’clock. Every day the Creative Team meets from one to two o’clock to discuss the day’s afternoon clients and the next day’s morning clients. They also discuss new clients, issues with any clients, new therapy techniques, new programs, ideas for new programs, and ways they can improve. That last thing Judy calls in-servicing and I know that sounds boring but it’s really interesting.

Anyway the first thing they do at the One O’ clock is room assignment. Not only do they make sure each client has the best possible room but they also talk about transitions and sometimes even getting two clients to informally interact to help their social development. After room assignment and client discussion the team sometimes talks about other cool stuff. The other day Danielle taught everyone about AAC—Augmentative and Alternative Communication. It was really interesting in spite of its scary name.

Not only does the team talk together during the One O’clock, but I see them doing that all during the day. And it’s really interesting to listen to them.

Anyway, I found out recently that Richie knows about the talking together and even encourages it. But of course he has to use big words to describe it, saying Creative has institutionalized collaboration. A true Richie phrase: two words, 11 syllables, and he wonders why people don’t understand him.

Well, it’s time to go. For today, there are two things that I want to ask of you. First, I don’t mind if you tell your therapist that you read my column. In fact, I often feel like the therapists don’t even see me or know I exist, so telling them would be good. Second, don’t tell Richie what I say about him. If he starts using regular size words and normal expressions then it won’t be as much fun.

– Kimberly

Foundations (and phases) – a journey of discovery – Part 1: Cautious Optimism

 

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

Play Therapy

Is your family frequently disrupted by your child’s meltdowns? Does the school report that your child’s behaviors disrupt the classroom? Is your child angry, withdrawn, sad, clingy, or anxious?

Descriptions of Play Therapy sometimes begin with the famous Plato quote: you can discover more about a person in an hour of play than in a year of conversation. As a fan of Plato, I enjoy his quotes as much as the next guy, but regarding Play Therapy, I don’t think the quote goes far enough. It’s not just about our discovery of the child, it’s also about the child’s self discovery.

I stumbled onto the significance of play early on in my parenting. It was a moment of deep insight to me—a young parent—when I realized that the toy tools to me were real tools to my son. I had thought of play as a way children pass time as they grow, toys as diversions. Now I had my first insight. It would take many years for me to understand just how much a child’s play was involved with their neuro-physiological development—and I still have more to learn.

My learning took a nice boost early this year when I met Sharon Lucas, LCSW. As we discussed clinical approaches, I was pleased and impressed with not only how much and how well Play Therapy meshed with our pediatric services, but also by how our philosophies and perspectives aligned. We seized the opportunity to add a powerful dimension to our service, dove-tailing with and extending our developmental neuro-physiological approach to incorporate unique cognitive and imaginative elements.

As always, whether and which therapies are appropriate and most effective is best answered by your therapist who will be working with the Creative Team behind the scenes.

If you are interested in Play Therapy, here is some detail provided by Sharon..

Play is a child’s natural language

Play therapy can help a child feel better from the inside

Play therapy can help improve behaviors on the outside

We provide Play Therapy that is child-centered and directive as needed to help children express their thoughts and feelings in a nurturing, validating, and safe space. Your child can process life challenges while exploring and practicing skills that help with self-regulation, self-mastery, problem-solving, and social skills. We coach parents and encourage and support their participation in their child’s therapy.

During Play Therapy your child has the opportunity to integrate and practice skills learned in allied modalities including occupational and speech therapies. Creative’s daily collaboration with customized and comprehensive treatment promotes optimal outcomes.

Toys are carefully selected so that children have the greatest chance of expressing themselves—

all while having fun!

Norman Doidge — putting to rest the static brain

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

Suzy’s Story


We are infinitely more than our limitations or our afflictions

– Jeffrey R Holland

We interviewed several occupational therapists recently and three asked: Can you tell me the story of Creative. Why did you start it?

One of the reasons was the Kiles.

I first met and become friends with the Kiles over 30 years ago when I lived in Edgewood, Pennsylvania, a near suburb of Pittsburgh. The Kiles had two daughters, Sally and Suzy, who were about the same age as my youngest daughter, Dawn, and they all played together.

Suzy was a child with Down Syndrome. One day Suzy’s mother Ellen told me what had happened when Suzy was first diagnosed.

The doctor was a well known expert in his field practicing at the prestigious University of Pittsburgh Medical Center.

That doctor told the Kiles that Suzy “wasn’t going to make it.”

Ellen looked right at him and said: “Suzy is my daughter and she will make it. I will make sure of that.”

Not only did she make it under Ellen’s care, but Suzy flourished.

I was fortunate enough to get to know Suzy. I used to take my children on excursions to museums and other places of interest. One weekend Dawn asked if we could take Sally and Suzy. I said it should be okay but I’d have to check with Ellen.

I went to the Kiles’ house and asked Ellen:

“I’d like to take the girls to the Carnegie Museum. I know that Suzy has a shunt. Is it okay that I take her? Is there anything I need to look out for?”

I’ll never forget Ellen looking at me, staring silently for a long time. I thought I might have said something inappropriate, crossed a boundary that I wasn’t aware of. Finally, she said:

“I’m sorry. I was never asked that question and never thought about it. No one has ever asked to take Suzy anywhere.

“It will be fine. If something happens all you or me or anyone can do is call 911. And it’s very unlikely.”

Time to time through the years Sally and Suzy and Dawn and me had fun excursions. Suzy was thriving, loving, and curious, a joy to be with. Eventually I moved away and lost touch with the Kiles, but they will always be in my heart, inspiring me. I often think of Ellen’s response to the doctor and the excursions with Dawn and Sally and Suzy, the sweet girl no one thought to take anywhere.

The Kiles are my heroes and one of the reasons I co-founded Creative. Here we affirm the unlimited potential in each of us.

By the way, we hired one of those therapists, a wonderful OT named Liz Souza (no relationship to and spelled differently than John Philip). She’ll start at the end of the month.

(The names of the family were changed for their privacy. The story is true.)

My next article on this theme will address the dangers of pejorative terminology.

Richard Feingold, Co-founder

Modified Music – a High Level Perspective Part 1

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)

[Disclaimer and disclosure: I’m not a therapist nor have any kind of medical degree. Furthermore my story is anecdotal. And personal. One key personal element is that I have suffered anxiety and depression on and off all my life.]

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.  

Regarding the latter, when Judy (my wife and our Chief Therapist) first introduced the idea that modified music could have a profound positive clinical effect I was…skeptical. Yet, the more I researched and dug into it, the more I understood and appreciated how and why it worked.
Several months ago at Judy’s urging that I begin a modified music program. I have been improving ever since. Modified music has helped and continues to help with my stress, anxiety, and depression. It has been and continues to be the most effective therapy that I personally have had. In addition, I’ve seen its successes in the children and the occasional adult that we treat.
Understanding how and why modified music is an effective treatment has been an interesting journey for me. Somewhere in the midst of that journey it struck me  that music is a profound and essential element of human communication.
Music has been part of human civilization for eons. It has been referred to as the universal language and is found in every society known to anthropology. – Arlene R. Taylor PhD, “Universality of Music
Watching a movie with the music muted would underscore its importance in communicating context as well as emotion.

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.

As a scientist he discovered casual relationships between our sound processing and brain development. And that the process, amazingly, begins early in pregnancy.
In Part 2 we continue this discussion expanding on the the discovery and understanding of modified music.
There are 4 leading well established scientifically based modified music programs, each of which we are certified in: The Tomatis Method, Therapeutic Listening (TL), integrated Listening systems (iLs), and Advanced Brain Technologies (ABT) The Listening Program (TLP).
We work with families interested in modified music therapy to find the best fit. The latter has many considerations such as availability, logistics, clinical relevance, and budget.
  
Regarding the latter, these programs are rarely covered by insurance. Thus we’re always looking to improve affordability. That’s why we are particularly excited about the latest offerings from ABT including rent to own, streaming, individual and family plans. All have greatly improved the affordability of their offerings.
  
Whether you’re a current or previous client or new to our practice we’re happy to provide a free consultation with Judy to see if any of the programs are a good fit, and if so how to most affordably provide them. Talk to your therapist or call 703-910-5006 or email info@creativehealthllc.com.
  
Richard Feingold, Co-founder