Snowdrop

The more we repeat something, the better we get at it; this much is uncontroversial. But that doesn’t mean it isn’t worth examining. The connection between repeating an action or a skill and then improving because of that repetition is a concept that is so natural and intuitive, so well accepted as common knowledge, that we often fail to appreciate the fascinating mechanics behind the process of skill acquisition. It follows the old adage, 'practice makes perfect!'

On the most basic level, learning a new skill or improving a skill involves changes in the brain. There are a few different ways that our brains adapt to picking up new skills and changing environmental conditions. The first involves a rewiring of the networks of neurons in the brain. Each skill or action that a child performs involves the activation of neural pathways. In Norman Doidge’s book on neuroplasticity, The Brain That Changes Itself, Dr. Alvaro Pascual-Leone has a beautiful little analogy for the way that these pathways relate to skilled performance (Page 209):

"The plastic brain is like a snowy hill in winter. Aspects of that hill–the slope, the rocks, the consistency of the snow–are, like our genes, a given. When we slide down on a sled, we can steer it and will end up at the bottom of the hill by following a path determined both by how we steer and the characteristics of the hill. Where exactly we will end up is hard to predict because there are so many factors in play." “But,” Pascual-Leone says, “what will definitely happen the second time you take the slope down is that you will more likely than not find yourself somewhere or another that is related to the path you took the first time. It won’t be exactly that path, but it will be closer to that one than any other. And if you spend your entire afternoon sledding down, walking up, sledding down, at the end you will have some paths that have been used a lot, some that have been used very little.”

Every action we perform, every new skill we pick up, involves beating down and refining a kind of neural trail. We are making real changes in the brain. And our brains are remarkably efficient to change in response to training. In one study, video game players who played the dark, fast-moving action-based game Call of Duty for 9 weeks were not only better at the game, but were able to see significantly more shades of gray, post-training, than a group who played a simulation strategy game that did not exercise those skills.

Over a longer time span, it is also possible to see significant structural changes in the brain. For example, the brain area associated with motor control of the right index finger in blind subjects who are braille readers has been found to be significantly larger than that of sighted individuals. Similarly, a famous study of london cabbies, famous for their ability to navigate the twisting streets of the city, found that they had greater brain volume in the hippocampus, a structure heavily involved in both memory and spatial navigation, than bus drivers who followed a predefined route every day.

With respect to the brains of children who have developmental disabilities, the brain injuries or abnormalities they suffer might slow that response to training down a little, but the response is still possible.

Evidence for neuroplasticity abounds, - from the structural differences which have been found between experienced athletes and novices, through to the Chinese study of expert divers which found increased gray matter volume in brain areas associated with skilled motor control. Along the same lines, an Australian study of skilled racket-sport players found that brain areas associated with the racket arm were larger than in a matched group of non-athletes. The evidence is irrefutable!

The overarching theme here is that the brain is malleable–it changes with training. It is an interesting concept to keep in mind, especially with respect to brain injured children and it is the overarching principle of the Snowdrop programme.

It’s easy and natural to think about training in terms of muscles, the body and physical skills. But every new skill that a child learns is accompanied also by neural changes that may be harder to see, but are equally important.

If you would like more information about the Snowdrop programme, just visit our main website on http://www.snowdrop.cc - email us at snowdrop_cdc@btinternet.com or call on 01884 38447

A baby's brain has the capacity to grow at a phenomenal rate. At birth it is only one quarter of its adult size, but by three ears of age it will be 80% the size of an adult brain. At birth it is one of the only organs which has not yet fully developed and it is sensory stimulation derived from environmental experience which drives this growth and consequently which drives the development of the child.

Billions of neurons are created throughout the primary stages of foetal development and through birth. Indeed at birth, the only brain structure which is developed to anything like its mature form is the lower brainstem. This part of the brain controls the primitive reflexes and vital functions such as respiration, cardiovascular function, etc. Immediately after birth, baby's higher brain regions begin to make billions of connections between neurons. These connections, called synapses, are used to transmit information based upon sensory experience. Stimulation through the senses of touch, hearing, vision, smell and taste, in addition to vestibular and proprioceptive experience, directly influence these neurons and help in establishing these connections.

The more frequently the neuron connections are used, the stronger and more efficient the new connections become, this is a phenomenon known as 'long term potentiation.' If some of the neural pathways are not used, they become weak and are pruned, (this is known as 'long term depression.'). This is why the repetition of the activities within a Snowdrop programme of developmental stimulation are so important.

We know that babies who are born into an impoverished environment do not develop the rich connection between neurons which develop in other babies. Children who are neglected, exposed to stress, trauma, abuse, have negative experiences which can have a detrimental effect upon brain growth and development. It has been shown, that those infants or children who are not exposed to adequate sensory stimuli because of these factors can develop brains which are smaller then those who have had those "good" sensory experiences.

So, you might ask, how does this apply to children who have suffered brain injury? Well, what effect does brain injury have on a child? It acts as a barrier between the child and his environment. It does so because it prevents the child from interacting with his sensory environment. Because he is unable to gain the necessary sensory experience from his environment, due to the 'roadblock' of the injury, or because the injury is acting to distort incoming sensory information in some way, the brain is unable to make the same number, or quality of connection as it would otherwise have done and as a consequence baby's developmental processes are either stopped, slowed, or distorted.

Is there anything which an be done to rectify this situation? Well yes, at Snowdrop we believe there is. We take children who have suffered brain injuries and as a consequence are experiencing developmental difficulties and we provide them with an 'adapted sensory environment.' Where the injury is acting as a barrier between the child and his sensory environment, the adapted environment acts to amplify the sensory stimulation to which the child is exposed, breaking through the barrier and giving the child's brain the opportunity to form connections. Where the injury is acting to distort incoming sensory information, making the child hypersensitive, or unable to selectively tune in, or to mask sensory information, our adapted environment seeks to re-tune the neurological structures which are responsible for this. Again, in this way we encourage the brain to make the appropriate number and quality of connections and to consequently improve the developmental prospects of the child.

This is the basis of a Snowdrop developmental stimulation programme. Anyone interested in learning more about Snowdrop's work should email snowdrop_cdc@btinternet.com

Breathing is something we all take for granted because it is an automatic function, to which we do not have to pay attention. Only when something interferes with the smooth function of our respiration, such as exercising, or an adverse reaction to an allergen, or if we develop a respiratory disorder do we become all too aware of it!

Many children who have cerebral palsy, have difficulties with their breathing. Not many people are aware that the rate and depth of our breathing is subject to the forces of development and that consequently the rate and depth of a babies breathing is simply not comparable to that of an adult. For instance, the breathing rate of a newborn baby is around 40 breaths per minute, but by the time the child reaches his first birthday, this has dropped to around 35. By his second birthday the average rate has dropped to 30 and by the time he is 5 years old, it has dropped to around 25. We then see a slower decline and by the time he is 12 years old it has dropped to around 20, until finally it reaches its adult rate of around 15.

What implications does this have for a child with cerebral palsy? Well, the brain injury which adversely affects the development of the child in other areas, can also affect the development of the rate of respiration and this can have negative effects. If a child is growing physically, but his rate of respiration remains stuck at the level of a baby at around 40 shallow breaths per minute, it will create obvious consequences for the ability of that child in terms of his eating, drinking and the development of spoken language. (To test this out, try running up and down stairs until you are out of breath and then try to eat a biscuit or cake or try reciting your favourite poem. – Its difficult isn’t it)? This is the situation many of our children are faced with constantly. – Imagine the nightmare of trying to coordinate chewing, swallowing and breathing at such a rate!

Another factor which can be a worry as the child’s growing musculature demands more oxygen from a system which simply cannot provide it, is the creation of a poor physiological environment for the brain. The brain uses up 25% of all the oxygen we take in and as it develops, it not only demands more oxygen from a respiratory system which cannot deliver it, - with the consequences of brain development being slowed, but the increasing demands being made from a growing physical body provide stiff competition for the limited oxygen which is available. This can not only have the effects of limiting physical and neurological development, but can cause a child to have seizures.

So what can be done about this situation? The obvious answer seems to be the direct delivery of Oxygen, such as is seen in hyperbaric oxygen chambers, but this in turn throws up additional problems. There are sensors in the base of the brain, which are sensitive to the levels of oxygen and carbon dioxide in the bloodstream. They help regulate the rate of delivery of oxygen to the brain by widening and narrowing the arteries as is necessary. When they detect higher than normal levels of oxygen in the bloodstream, they act to constrict the arteries so that the brain is not flooded with oxygen. So in directly delivering extra oxygen, we may actually be depriving the brain of it! In the more extreme cases this has led to people experiencing a form of stroke known as an ischaemic attack!

So what do we do? At Snowdrop I find that when a child embarks on a programme of neurological rehabilitation and when we begin to make progress in developmental terms, very often the respiration makes improvements too.

Anxiety isn't a problem that you would automatically think to associate with cerebral palsy, but some children really do suffer quite badly with it. This can be due to many reasons. One reason is the discomfort produced by stiff musculature. A high muscle tone can be uncomfortable for a child and having to cope with this constantly is bound to have an anxiety raising effect.

Another possible cause can be the overproduction of norepinephrine in the brain, leaving the child on a hyper-anxiety inducing adrenaline 'high.'

Yet another cause can be sensory over-sensitivity. - A child who is unable to mask extraneous incoming sensory stimulation, but who sees, feels and / or hears too much, or whose sensory system over-amplifies incoming stimulation is likely to experience anxiety.

Another factor can be lack of sleep. Many children who have cerebral palsy have a poor sleeping pattern. We all know how we feel if we lose a night's sleep, tired, overstressed and anxious.  So for many children, anxiety can simply be part of their every day existence.

There are techniques, which Snowdrop employs within some of its programmes, which are designed to help relieve this situation, but in the most severe cases intervention can be necessary with anti – anxiety medications.

The basal ganglia is a set of sructures, consisting of the caudate nucleus, putamen, nucleus accumbens, globus pallidus, substantia nigra, subthalamic nucleus and ventral stratium. These structures which are interconnected between the cortex, the thalamus and the brainstem, form the neural circuitry which is involved in an individual developing addiction. The key is the production of dopamine, which stimulates desire, or craving for a specific experience provided by a substance or activity.

The basal ganglia plays a role in motor function, cognitive processes, emotional processes and our ability to learn. It also provides inhibition to the thalamus, a part of the brain which mediates our sensory experiences. So, without this inhibitory role, one can imagine a thalamus in effect operating without its 'braking system' which might produce many of the sensory distortions we see in children who have brain injuries. It also acts as a 'braking system' for movement, which enables us for instance, to sit still. In order to sit still a 'brake' has to be placed on all other movements. Consequently injury at this level hampers the 'braking system' and we see children who cannot sit still and are in constant movement (athetosis, or athetoid cerebral palsy, or Parkinson's disease or Huntingdon's Chorea) and children whose sensory perception is distorted. Injury to this part of the brain also exhibits itself in many children, by retention of the primitive postural reflexes, as it is the role of the basal ganglia to suppress these in order to enable the child to move.

Children with basal ganglia/internal capsule injury are also more likely to have altered muscle tone, which can be floppy or stiff depending upon the precise location of the injury, flaccid paralysis, and persistently impaired balance and ambulation performance.

Can children with basal ganglia injury be helped? Yes, we know that "activity dependent synaptic plasticity occurs at the level of the basal ganglia, which also supports the acquisition and maintenance of certain types of learning." (Wickens, 2008, Beretta, et al, 2007).

At Snowdrop I see children with injury to this area of the brain and develop appropriate stimulatory treatment programmes. If you are interested in more information about Snowdrop's treatment programmes, should email snowdrop_cdc@btinternet.com, or call 01884 38447

Further Reading.

Berretta, N., Nisticò, R., Bernardi, G., Mercuri, N. B. Synaptic plasticity in the basal ganglia: A similar code for physiological and pathological conditions. Progress in Neurobiology. Volume 84, Issue 4, April 2008, Pages 343-362

Wickens, J. R. Synaptic plasticity in the basal ganglia. Behavioural Brain Research

Volume 199, Issue 1, 12 April 2009, Pages 119-128. Special issue on the role of the basal ganglia in learning and memory.

This is why Snowdrop uses both 'top down' (whole word recognition techniques) and 'bottom up,'(phonological awareness programmes), in it's treatment of language and literacy development difficulties in children and adults who have problems with language development.

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Although babies typically start talking around 12 months of age, their brains actually begin processing certain aspects of language much earlier, so that by the time they start talking, babies actually already know hundreds of words.

While studying language acquisition in infants can be a challenging endeavor, researchers have begun to make significant progress that changes previous views of what infants learn, according to a new report by University of Pennsylvania psychologist Daniel Swingley. The report, published in a recent issue of Current Directions in Psychological Science, a journal of the Association for Psychological Science, describes an increasing emphasis among researchers in studying vocabulary development in infants.

Infants have a unique ability to discriminate speech-sound (phonetic) differences, but over time they lose this skill for differentiating sounds in languages other than their native tongue. For example, 6 month old babies who were learning English were able to distinguish between similar-sounding Hindi consonants not found in English, but they lost this ability by 12 months of age. Since the 1980s it has been known that infants start focusing on their language's consonants and vowels, sometimes to the exclusion of non-native sounds. More recently, researchers have increasingly focused on how infants handle whole words.

Recent research has shown that during infancy, babies learn not only individual speech sounds but also the auditory forms of words; that is, babies are not only aware of the pieces that make up a word, but they are aware of the entire word. These auditory forms of words allow children to increase their vocabulary and help them to eventually develop grammar. Although they may not know what the words mean, children as early as 8 months start learning the phonological (sound) forms of words and are able to recognize them-and just being familiar with the words helps increase the children's vocabulary. Studies have shown that 18 month old children who are familiar with a word's form are better at learning what it means and are also able to differentiate it from similar sounding words.

Knowing word forms may also contribute to children's inferences about how their language works. For example, 7.5 month olds do not recognize words as being the same if they are spoken with different intonations or by a man and a woman. However, by 10.5 months of age, babies recognize the same words despite changes in the speaker or the intonation used. Another interesting finding was that although children learning a language can distinguish between long and short vowels, they interpret this difference according to the rules of their language. For instance, Dutch 18-month-olds considered tam and taam to be different words, while English 18-month-olds did not-showing children's early learning of how each language uses vowel length.

How can researchers find out what young children know about words and the forms of words with children have only just begun to talk? One method takes advantage of the fact that even young toddlers like to look at images or objects that we name. In these experiments, the children's eye movements are tracked while they are looking at two objects (for example, an apple and a dog). The researcher will say the name of one of the objects and see if the child's eyes move to that object. In this way, researchers can change the sound of the words slightly (for example, instead of "dog" say "tog") and see if the baby will look at the dog the same amount, as if indifferent to the change, or less, as is the case with adults who know that "dog" cannot be said as "tog." The results of those studies showed that the children were less likely to look at the correct object when it was mispronounced, indicating that by one year of age, children are able to recognize mispronunciations of words.

This new research in language acquisition indicates that infants learn the forms of many words and they begin to gather information about how these forms are used. The author notes that "these word forms then become the foundation of the early vocabulary, support children's learning of the language's phonological system, and contribute to the discovery of grammar."

In addition, there is a relationship between young children's performance in word recognition and their later language achievement. The author concludes that "testing very young children's ability to interpret spoken language, whether by identifying novel words as novel or by comprehending sentences, may prove a more sensitive predictor of children's language outcomes than simpler tests of speech-sound categorization."

The approach to the treatment of cerebral palsy and other neuro-developmental disabilities which is used by Snowdrop is known as 'neuro-cognitive therapy.'   The question is, why do I believe it offers the best chance for children to make developmental progress and what evidence can be provided to support it's use?

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).

Anyone who wants more information should email on snowdrop_cdc@btinternet.com or visit the website at http://www.snowdropcerebralpalsyandautism.com

References and Further Reading.

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

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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 children’s 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. 

For twenty years now, many people working in the field of neuroscience, including myself have been saying that the brain is capable of re-wiring itself. Twenty years ago, the medical professionals I said it to laughed at me and gave me the sort of looks, which are usually reserved for those who are 'not quite right in the head.'  Ten years ago, they smiled and looked in disbelief.   Today, we have actual evidence. Snowdrop has been utilising this principle within it's programmes for children with cerebral palsy, autism and other developmental disabilities, since it was established. Read on.

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Scientists in Tübingen have proven for the first time that widely-distributed networks of nerves in the brain can fundamentally reorganize as required

Scientists at the Max Planck Institute for Biological Cybernetics in Tübingen have succeeded in demonstrating for the first time that the activities of large parts of the brain can be altered in the long term. The breakthrough was achieved through the experimental stimulation of nerve cells in the hippocampus.

Using a combination of functional magnetic resonance tomography, microstimulation and electrophysiology, the scientists were able to trace how large populations of nerve cells in the forebrain reorganise. This area of the brain is active when we remember something or orient ourselves spatially. The insights gained here represent the first experimental proof that large parts of the brain change when learning processes take place.

Scientists refer to the characteristic whereby synapses, nerve cells or entire areas of the brain change depending on their use as neuronal plasticity. It is a fundamental mechanism for learning and memory processes. The explanation of this phenomenon in neuronal networks with shared synapses reaches as far back as the postulate of Hebbian learning proposed by psychologist Donald Olding Hebb in 1949: when a nerve cell  'A' permanently and repeatedly stimulates another nerve cell 'B', the synapse is altered in such a way that the signal transmission becomes more efficient. The membrane potential in the recipient neuron increases as a result. This learning process, whose duration can range from a few minutes to an entire lifetime, was intensively researched in the hippocampus.

A large number of studies have since shown that the hippocampus plays an important role in memory capacity and spatial orientation in animals and humans. Like the cortex, the hippocampus consists of millions of nerve cells that are linked via synapses. The nerve cells communicate with each other through so-called "action potentials": electrical impulses that are sent from the transmitter cells to the recipient cells. If these action potentials become more frequent, faster or better coordinated, the signal transmission between the cells may be strengthened, resulting in a process called long-term potentiatation (LTP), whereby the transmission of the signal is strengthened permanently. The mechanism behind this process is seen as the basis of learning.

Although the effects of long-term potentiation within the hippocampus have long been known, up to now it was unclear how synaptic changes in this structure can influence the activities of entire neuronal networks outside the hippocampus, for example cortical networks. The scientists working with Nikos Logothetis, Director at the Max Planck Institute for Biological Cybernetics, have researched this phenomenon systematically for the first time. What is special about their study is the way in which it combines different methods: while the MRI scanner provides images of the blood flow in the brain and, therefore, an indirect measure of the activity of large neuronal networks, electrodes in the brain measure the action potentials directly, and therefore the strength of the nerve conduction. It emerged from the experiments that the reinforcement of the stimulation transmission generated in this way was maintained following experimental stimulation. 

"We succeeded in demonstrating long-term reorganization in nerve networks based on altered activity in the synapses," explains Dr. Santiago Canals. 

The changes were reflected in better communication between the brain hemispheres and the strengthening of networks in the limbic system and cortex. While the cortex is responsible for, among other things, sensory perception and movement, the limbic system processes emotions and is partly responsible for the emergence of instinctive behavior.

What is ataxia?

Ataxia is caused by injury to a part of the brain called the 'cerebellum,' a structure low down in the back of the brain. The functions of the cerebellum are to help control balance and coordination via it's connection with the vestibular system and the eighth cranial nerve. It also has a function in regulation of muscle tone, smooth movement, proprioception and depth perception.  Injury to the cerebellum produces many symptoms such as poor balance, coordination, low muscle tone, (hypotonia),  jerky, uncontrolled movements, poor depth perception, wide based gait (walking or standing with the feet an unusual distance apart), poor proprioception, reading difficulties and a tremor which appears when the individual tries to move a limb.  These symptoms are seen in many conditions such as the cerebellar ataxia, cerebral palsy, multiple sclerosis and Friedreich's ataxia to name just a few.

The question is, can these problems be treated?   The answer is 'yes, they can.' At Snowdrop we believe the answer to improvement of these difficulties lies in those important connections between the cerebellum and the vestibular system and consequently the pons, medulla and the eighth cranial nerve.

Let's take a look at where this neurological system begins, with the first order vestibular afferents (afferent nerves are nerves travelling into the brain from a sensory 'end system' in this case the ear). These nerves are bundled with others to become the Eighth cranial nerve. This nerve then enters the brainstem at the level between the pons and medulla, where the fourth ventricle is at its widest. A few of these vestibular nerves split off here and travel directly into the cerebellum through a part of that structure called the 'inferior cerebellar peduncle.The eighth cranial nerve is actually three separate nerves in one bundle.

One part is concerned with transmitting sensory information about hearing and the other two with sending sensory information about balance and proprioception from the middle ear to the cerebellum and brainstem. This is why, very often when we see a child who is suffering from injury to this system, we also see that the child is suffering a distortion of sensory processing with regards to their hearing. This distortion might result in the child experiencing oversensitive hearing, undersensitive hearing, or experiencing some other distortion to the perception of hearing.At Snowdrop we have developed techniques to help ameliorate these symptoms and to help restart children's developmental processes.

Were you aware that Snowdrop have published a book titled 'Cerebral palsy: A Guide to Understanding

...and Helping your Child.'in which they describe their approach to promoting recovery of function...in children with cerebral palsy and other developmental disabilities? 

The book begines by examining how parents react to the disclosure of diagnosis by medical professionals and looks at how the family adjust to their child's disability. It also describes the sometimes problematic relationships which can and do develop between health professionals and

parents.

The book then moves on to explore the problems faced by children with CP and looks at their development in the context of the developmental progress made by uninjured children. In particular they

describe the difficulties of sensory perception faced by children with CP and explain how these difficulties impact upon other areas of development such as mobility, language and communication, socialisation

and hand function.

They then elucidate how sensory perception can be distorted due to the injury of the neurological structures, which relay sensory information to various parts of the cortex and clarifies the

effect this can have on the child.

The book then moves on to discuss Snowdrop's treatment philosophy of'neuro-cognitive stimulation,' which consists of two branches. The first is aimed at the creation of the correct neurological environment designed to accommodate any sensory distortions the child may be experiencing and is aimed at 're-tuning' the neurological structures,which are producing such distortions.

The second branch of treatment is rooted in Vygotskian psychology and draws upon the concepts of the'zone of proximal development' and 'scaffolding.' Snowdrop assert that learning leads development and that if information or developmental tasks given to the child are pitched at the appropriate level of intensity and simplicity and are pitched at the appropriate level of development, it is possible for any child to learn, no matter how severe their difficulties.

Cerebral Palsy: A guide to understanding and helping your child.

Written by Snowdrop

Published by Snowdrop Publications

ISBN 978-1-4457-5747-6

Available from Lulu