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

Neuro scientists have pinpointed the brain structure regulating our sense of personal space, possibly opening the way to a better understanding of autism and other disorders.

The structure, the amygdala - a pair of almond-shaped regions located in the brain - was previously known to process strong negative emotions such as anger and fear and is considered the seat of emotion in the brain.  However, it had never been linked rigorously to real-life human social interaction.

The scientists, led by Ralph Adolphs, psychology and neuroscience professor and post-doctoral scholar Daniel P. Kennedy, at the California Institute of Technology

(Caltech), were able to make this link with the help of a unique patient, a 42-year-old woman known as SM, who has extensive damage to the amygdala on both sides of her brain.

"SM is unique, because she is one of only a handful of individuals in the world with such a clear bilateral lesion of the amygdala, which gives us an opportunity to study the role of the amygdala in humans," says Kennedy, who led the study.

SM has difficulty recognising fear in the faces of others, and in judging the trustworthiness of someone, two consequences of amygdala lesions that Adolphs and colleagues published in prior studies.

During his years of studying her, Adolphs also noticed that the very outgoing SM is almost too friendly, to the point of "violating" what others might perceive as their own personal space.

"She is extremely friendly, and she wants to approach people more than normal. It's something that immediately becomes apparent as you interact with her," says Kennedy.

Previous studies of humans never had revealed an association between the amygdala and personal space.

From their knowledge of the literature, however, the researchers knew that monkeys with amygdala lesions preferred to stay closer to other monkeys and humans than did healthy monkeys.

Intrigued by SM's unusual social behaviour, Adolphs, Kennedy, and their colleagues devised a simple experiment to quantify and compare her sense of personal space with that of healthy volunteers.

The experiment used what is known as the stop-distance technique. Among the other subjects, the average preferred distance was .64 metres-roughly two feet.

SM's preferred distance was just .34 meters, or about one foot. Unlike other subjects, who reported feelings of discomfort when the experimenter went closer than their preferred distance, there was no point at which SM became uncomfortable; even nose-to-nose, she was at ease.

Furthermore, her preferred distance didn't change based on who the experimenter was and how well she knew them.

"Respecting someone's space is a critical aspect of human social interaction, and something we do automatically and effortlessly," Kennedy says.

The discovery appeared in the Sunday issue of Nature Neuroscience.

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What these researchers do not allude to is that just because the amygdala may be wired in a specific way in people who have autism, this does not mean that the situation is unchangeable. We know that the brain possesses a high degree of plasticity and can and does restructure it's functional organisation in response to the environment in which it finds itself. Therefore if we provide the appropriate neuro-developmental environment, we give people who face difficulties on the autistic spectrum every opportunity for their brain to reorganise itself. This is exactly what a Snowdrop programme entails.

Neuroscientists have pinpointed the brain structure regulating our sense of personal space, possibly opening the way to a better understanding of autism and other disorders.

The structure, known as the amygdala - a pair of almond-shaped regions located in the brain - was previously known to process strong negative emotions such as anger and fear and is considered the seat of emotion in the brain.  However, it had never been linked rigorously to real-life human social interaction.

The scientists, led by Ralph Adolphs, psychology and neuroscience professor and post-doctoral scholar Daniel P. Kennedy, at the California Institute of Technology (Caltech), were able to make this link with the help of a unique patient, a 42-year-old woman known as SM, who has extensive damage to the amygdala on both sides of her brain.

"SM is unique, because she is one of only a handful of individuals in the world with such a clear bilateral lesion of the amygdala, which gives us an opportunity to study the role of the amygdala in humans," says Kennedy, who led the study.

SM has difficulty recognising fear in the faces of others, and in judging the trustworthiness of someone, two consequences of amygdala lesions that Adolphs and colleagues published in prior studies. During his years of studying her, Adolphs also noticed that the very outgoing SM is almost too friendly, to the point of "violating" what others might perceive as their own personal space.

"She is extremely friendly, and she wants to approach people more than normal. It's something that immediately becomes apparent as you interact with her," says Kennedy.  Previous studies of humans never had revealed an association between the amygdala and personal space.

From their knowledge of the literature, however, the researchers knew that monkeys with amygdala lesions preferred to stay closer to other monkeys and humans than did healthy monkeys.  Intrigued by SM's unusual social behaviour, Adolphs, Kennedy, and their colleagues devised a simple experiment to quantify and compare her sense of personal space with that of healthy volunteers.

The experiment used what is known as the stop-distance technique. Among the other subjects, the average preferred distance was .64 metres-roughly two feet.  SM's preferred distance was just .34 meters, or about one foot. Unlike other subjects, who reported feelings of discomfort when the experimenter went closer than their preferred distance, there was no point at which SM became uncomfortable; even nose-to-nose, she was at ease. Furthermore, her preferred distance didn't change based on who the experimenter was and how well she knew them.

"Respecting someone's space is a critical aspect of human social interaction, and something we do automatically and effortlessly," Kennedy says.  The discovery appeared in the Sunday issue of Nature Neuroscience.

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What these researchers do not allude to is that just because the amygdala may be wired in a specific way in people who have autism, this does not mean that the situation is unchangeable. We know that the brain possesses a high degree of plasticity and can and does restructure it's functional organisation in response to the environment in which it finds itself. Therefore if we provide the appropriate neuro-developmental environment, we give people who face difficulties on the autistic spectrum every opportunity for their brain to reorganise itself. This is exactly what a Snowdrop programme entails.

There are two major types of autism, of which you have probably heard. Snowdrop provides treatment programmes for both. They are autism and Asperger’s syndrome. First let’s look at classical autism, how would we recognise it? Well, autism was first recognised in the mid 1940’s by a psychiatrist called Leo Kanner. He described a group of children, whom he was treating, who presented with some very unusual symptoms such as; - atypical social development, irregular development of communication and language, and recurring / repetitive and obsessional behaviour with aversion to novelty and refusal to accept change. His first thoughts were that they were suffering some sort of childhood psychiatric disorder.

At around the same time that Kanner was grappling with the problems of these children, a German scientist, Hans Asperger was caring for a group of children whose behaviour also seemed irregular. Asperger suggested that these children were suffering from what he termed ‘autistic psychopathy.’ These children experienced remarkably similar symptoms to the children described by Kanner, with a single exception. – Their language development was normal! There is still an ongoing debate as to whether autism and Asperger’s syndrome are separable conditions, or whether Asperger’s syndrome is merely a mild form of autism.

What is the cause of autism?

In the 1960s and 1970s there arose a theory that autism was caused by abnormal family relationships. This led on to the 'refrigerator mother' theory, which claimed that autism in the child was caused by cold, emotionless mothers! (Bettleheim, 1967). However the weight of evidence quickly put this theory to bed as evidence was found to support the idea that the real cause was to be found in abnormalities in the brain. This evidence was quickly followed by findings, which clearly demonstrated that the EEGs of children with autism were, in many cases, atypical and the fact that a large proportion of autistic children also suffered from epilepsy.

From this time, autism has been looked upon as a disorder, which develops as a consequence of abnormal brain development. Recently, evidence has shown that in some cases, the abnormal brain development may be caused by specific genes.

However, we should not forget that genes can only express themselves if the appropriate environmental conditions exist for them to do so and consequently, we should not rule out additional, environmental causes for autism. We should not forget that autism can also be caused by brain-injury, that an insult to the brain can produce the same effects as can abnormal development of the brain, which may have been caused by genetic and other environmental factors. I have seen too many children who have suffered oxygen starvation at birth, who have gone on to display symptoms of autism or Asperger’s syndrome. So, it is my view that autism can also be caused by brain-injury.

Difficulty in socialisation is an area, which characterises the entire concept of autism. To many parents the lack of willingness on the part of their child to share in normal social interaction is of paramount concern. One parent to whom I spoke described her child as having social amnesia.

The social impairments, which typify autism are exact, that is, the child’s social conduct is not atypical universally. It is incorrect to declare, as some do, that children who are autistic, have a deficiency in their level of curiosity in other people. What they are deficient in is the proficiency for conveying or exploiting that interest. Uninjured babies are focused on faces and voices, whereas autistic children do not seem to be able to do so. They do not turn automatically to the sound of a voice, or fix their eyes on a parent’s face, and may actively avoid making eye contact. In many cases, this is due to sensory impairments, which can block the development of these social skills.

The importance of play

One of the first signs that a toddler or preschooler has autism is their atypical play. Even the brightest youngsters with autism display highly unusual patterns of play. Classically, many children with autism over-focus their attention on visual aspects of specific toys, or noises, which their toys make. Many researchers see this as a lack of imagination in autistic individuals and it is true to say that many children with autism do lack imagination and spontaneity within their behaviour, preferring to stick rigidly to routines with which they feel comfortable and safe. What I claim though, is that many times, these problems are created as a result of the distortions of sensory processing, which they suffer. There is now evidence that the abnormal behavioural patterns produced by many children with autism and Asperger's syndrome are a response to such distortions of sensory processing. Researchers writing in the Jounal of Autism and Developmental Disorders found that young children with autistic spectrum disorders not only experienced more tactile and other sensory sensitivities, especially difficulties with auditory filtering than children with other developmental disabilities, but that their sensory difficulties were significantly correlated with their stereotyped interests and behaviours. These hard scientific findings totally support Snowdrop's approach to treating the distortions of sensory processing experienced by children with autism. More information on such sensory processing difficulties are available in our book, 'Autism.'

Checklist of Behaviours associated with autism.

• Failure to make eye contact.
• Difficulty in sharing attention with anyone.
• Difficulty in communicating with others
• Avoids interaction with others
• Failure to engage in 'pretend' play
• Lacks understanding of the emotions and / or intentions of others.
• Avoids physical contact
• Seems disconnected from the environment.
• Children with autism also suffer sensory distortions, which may cause them to display certain behaviours.
• Appear not to notice anything visually.
• Appears visually distracted as though he is looking at something which you cannot see.
• Appears visually obsessed with particular features of the environment.
• appears unable to 'switch' visual attention from one feature of the environment to another.
• Appears uncomfortable with the visual environment.
• Appears not to hear anything.
• Appears auditorily distracted as though listening to something which you cannot hear.
• Appears auditorially obsessed with particular sounds within the environment.
• Appears unable to 'switch' auditory attention from one sound within the environment to another.
• Appears uncomfortable with the auditory environment.
• Appears not to feel much sensation.
• Appears distracted by tactile stimuli of which you are not aware.
• Appears obsessed with particular tactile sensations within the environment.
• Appears unable to 'switch' tactile attention from one sensation to another.
• Appears uncomfortable with the tactile environment.

Treatment for autism.

Many of the checklist of behaviours above could feasibly have their origins in distorted sensory processing in the brain. I believe that Snowdrop's neuro - cognitive approach with its emphasis upon re-tuning the neurological structures, which are causing sensory / perceptual distortions for the child is the best approach to treatment. Anyone wanting more information should email snowdrop_cdc@btinternet.com or visit our website at http://www.snowdropcerebralpalsyandautism.com.

You can also purchase my book, ‘Autism.’ By clicking here

What do we mean when we say autism is a 'spectrum disorder?'

When the term, 'spectrum disorder' is used it means that there are a range of symptoms, which can be attributed to autism. Any one individual may display any combination of these symptoms, in differing degrees of severity. Therefore an individual at one end of the autistic spectrum may seem very different to an individual at the other end of the spectrum.

Who first discovered autism?

Autism was first recognised in the mid 1940’s by a psychiatrist called Leo Kanner. He described a group of children, whom he was treating, who presented with some very unusual symptoms such as; - atypical social development, irregular development of communication and language, and recurring / repetitive and obsessional behaviour with aversion to novelty and refusal to accept change. His first thoughts were that they were suffering some sort of childhood psychiatric disorder.

At around the same time that Kanner was grappling with the problems of these children, a German scientist, Hans Asperger was caring for a group of children whose behaviour also seemed irregular. Asperger suggested that these children were suffering from what he termed ‘autistic psychopathy.’ These children experienced remarkably similar symptoms to the children described by Kanner, with a single exception. – Their language development was normal! There is still an ongoing debate as to whether autism and Asperger’s syndrome are separable conditions, or whether Asperger’s syndrome is merely a mild form of autism.

What is the cause of autism?

In the 1960s and 1970s there arose a theory that autism was caused by abnormal family relationships. This led on to the ‘refrigerator mother’theory, which claimed that autism in the child was caused by cold, emotionless mothers! (Bettleheim, 1967). However the weight of evidence quickly put this theory to bed as evidence was found to support the idea that the real cause was to be found in abnormalities in the brain. This evidence was quickly followed by findings, which clearly demonstrated that the EEG's of children with autism were, in many cases, atypical and the fact that a large proportion of children also suffered from epilepsy. Recent findings also point to various neurological abnormailities, the most common finding seeming to be that the brains of children with autism have an abnormal wiring pattern, - a pattern of connectivity between brain cells which is not present in non - autistic individuals.

So, autism is now looked upon as a disorder, which develops as a consequence of abnormal brain development. Recently, evidence has shown that in some cases, the abnormal brain development may be caused by specific genes.

However, we should not forget that genes can only express themselves if the appropriate environmental conditions exist for them to do so and so, we should not rule out additional, environmental causes for autism. We should not forget that autism can also be caused by brain-injury, that an insult to the brain can produce the same effects as can abnormal development of the brain which may have been caused by genetic and other environmental factors. I have seen too many children who have suffered oxygen starvation at birth, who have gone on to display symptoms of autism. So, it is my view that autism can also be caused by brain-injury.

There are also other possibilities, which can ultimately produce the type of brain dysfunction, which we recognise as autism. There is a great deal of research being carried out at the moment in the area of 'oxidative stress' and 'methylation' and it's effects upon the integrity of neural networks. There is also the debate surrounding mercury levels in vaccines, which is as of yet, unresolved.

The fact is that 'many roads lead to Rome.' - There are likely to be several factors both genetic and environmental, which can ultimately lead to the type of brain abnormality, which we call autism.

So, how do we recognise autism?

On a descriptive level, autism involves a dysfunction of the brain's systems, which control communication, socialisation, imagination and sensory perception. My theory is that it is the distortions of sensory perception, which are so characteristic of autism, which exacerbates many (but not all) of the other difficulties. Imagine a child suffering from autism who suffers distortions of sensory perception. For instance, the child who suffers distortions of visual perception, might find situations which require eye -contact to be exceptionally threatening, or on the other end of the scale might become obsessive about specific visual stimuli. The child who suffers distortions of tactile perception, might at one end of the spectrum find any situation which requires physical contact to be terrifying, whilst at the other end of the spectrum, they might be a 'sensation seeker' to the point of becoming self -injurious. The child who suffers distortions of auditory perception might at one end of the spectrum, be terrified of sounds of a certain pitch or intensity, whereas at the other end of the spectrum, they might actively seek out, or become obsessive about certain sounds.

Treatment

The question is, what can we do to help redress these distortions of sensory perception. Well, we believe we can learn from the newborn baby. When baby is born, he sleeps for most of the time, only spending short periods of time interacting with this new environment in which he finds himself; - a new environment which bombards his senses with new sights, noises and smells. So he retreats into the safe, calm environment of sleep, which provides the sensory safe haven which up until recently was the sanctuary of the womb. Very gradually, as baby adjusts his sensory system to his new environment, he spends more and more time in the waking world, interacting and learning to communicate, - but he adjusts very gradually!

There is possibly a neurological explanation for this. There are structures within the brain, which act to 'tune' sensory attention. These three structures, which allow us to tune our attention are structures, which enables us to ‘tune out’ background interference when we wish to selectively attend to something in particular. They also enables us to ‘tune in’ to another stimulus when we are attending to something completely different. They are the same mechanisms of the brain, which allows us to listen to what our friend is saying to us, even when we are standing in the midst of heavy traffic on a busy road. It is these mechanisms that allow us, even though we are in conversation in a crowded room, to hear our name being spoken by someone else across that room. It is these mechanisms, which allow a mother to sleep though various loud, night-time noises such as her husband snoring, or an aeroplane passing overhead and yet the instant her new baby stirs, she is woken. It is a remarkable feature of the human brain and it is the responsibility of three structures operating cooperatively; - these are theascending reticular activating formation, the thalamus and the limbic system.

Having made such a bold claim, allow me to furnish you with the evidence to support it. The three structures just mentioned receive sensory information from the sense organs and relay the information to specific areas of the cortex. The thalamus in particular is responsible for controlling the general excitability of the cortex (whether that excitability tunes the cortex up to be overexcited, tunes it down to be under excited, or tunes it inwardly to selectively attend to it’s own internal sensory world.) (Carlson, 2007). The performance of these neurological structures, or in the case of our children, their distorted performance seems to be at the root of the sensory problems faced not only by newborn babies, but the sensory difficulties our children face and yes, as the newborn shows, their performance CAN be influenced, - they can be re-tuned.

I believe the sensory system of some children with autism is experiencing similar difficulties to that of a newborn, - at one end of the autistic spectrum, the cortex is being over-excited by these structures and the person is overwhelmed and has difficulty accommodating the mass of sensory stimulation within the environment. At the other end of the autistic spectrum, the cortex is being under-excited and the person has trouble in perceiving sensory stimulation from the environment. The question is; - How do we facilitate the re-tuning of this neurological system in individuals who have autism.

The newborn retreats into sleep, a self imposed dampening of incoming sensory information. Whilst the child with autism does not do this, many children with autism attempt to withdraw from their environment because they find it so threatening.

We believe at Snowdrop that for the child at the end of the autistic spectrum who is suffering an amplification of sensory stimulation, we should create a setting where he can retreat from a world, which is overwhelming his immature sensory system. This 'adapted environment,' which should be as free as possible from all visual, auditory, tactile and olfactory stimulation will serve as a milieu where his sensory system can re-tune itself. Of course it may just be a single sense like vision, or hearing, or tactility, or any combination of senses, which are causing the difficulties and the environment may be adapted appropriately. The child suffering these difficulties will usually welcome this adapted environment, which is in effect a 'safe haven' for his immature sensory system. He should be given free access to, or placed within the adapted environment as needed and you will notice hopefully that he will relax and begin to enjoy being within its safe confines, where there are no sensory surprises.

This procedure should be continued for as long as necessary, - for several weeks or months. Indeed, some children might always need periods of time within the 'safe haven.' As the child begins to accept and be at ease in his safe haven, stimulation in whatever sensory modality is causing the difficulties, should begin to be introduced at a very low level, so low in fact that it is hardly noticeable. If the child tolerates this, then it can be used more frequently until it becomes an accepted part of the sensory environment. If the child reacts negatively in any way, then the stimulus is withdrawn and reintroduced at a later date. In this way, we can very gradually begin to build the level of tolerance, which the child has towards the stimulus.

For the child at the other end of the autistic spectrum, the child whose sensory attentional system is not exciting the cortex enough, with the consequence that he is not noticing enough of the stimulation in his sensory environment, the approach needs to be the exact opposite. These are the children who we see producing self-stimulatory behaviour. I believe that this behaviour is an attempt by the nervous system to provide itself with what it needs from the environment, - a sensory message of greater intensity! We see many children with autism 'flapping' their hands in front of their eyes, or becoming visually obsessed by certain toys, movements, colours etc. I propose that this is a reaction by the nervous system to attempt to increase the intensity, frequency and duration of the sensory stimulus due to a problem with perceiving visual stimuli from the environment.

Of course, children with autism display a far greater range of difficulties than a theory, focused upon a malfunctioning sensory – attentional system could explain. I am not attempting to claim that sensory problems on their own are an adequate explanation for every facet of autism, - that would be ridiculous! This is merely a possible explanation of a range of issues experienced by some children who have autism, which could be produced or exacerbated by the child suffering distortions of sensory perception. For instance, the following symptoms within the autistic spectrum could possibly be explained at the sensory level.

• Failure to make eye contact. 
• Difficulty in sharing attention with anyone.
• Avoiding interaction with others
• Avoiding physical contact
• Seeming disconnected from the environment.
• Appearing not to notice anything visually.
• Visual distraction, as though the child is looking at something which you cannot see.
• Visual obsession with particular features of the environment.
• Inability to 'switch' visual attention from one feature of the environment to another.
• General discomfort with the visual environment.
• Appearing not to hear anything.
• Auditory distraction, as though listening to something which you cannot hear.
• Auditory obsession with particular sounds within the environment.
• Inability to 'switch' auditory attention from one sound within the environment to another.
• Inability to 'tune out' extraneous sounds in the environment.
• General discomfort with the auditory environment.
• Appearing not to feel much sensation.
• Appearing to bee distracted by tactile stimuli of which you are not aware.
• Obsession with particular tactile sensations within the environment.
• Appears unable to 'switch' tactile attention from one sensation to another.
• General discomfort with the tactile environment.
• Difficulty in communicating with others.

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."

This is a variant on a question I am frequently asked.

Question.

I am going to have my 6 year old son tested for Autism and Sensory Processing Disorder. His teachers thought that would be a good idea. What i'm concerned about, is the fact that a lot of doctors won't acknowledge that SPD is different from Autism and treat it. They treat SPD as autism and thus the treatments don't work. Of course, this is all what I have discovered, and not experienced first hand. My question I guess, would be how do they know the difference in Autism and SPD since they have such similar signs? Also, if he has SPD and is treated for Autism, or visa versa will the treatments still work since they are different. Does anyone have any insight on this subject? Thanks in advance!

Answer. -

Hi. You are quite correct to distinguish the fact that it is possible to have SPD whilst not having autism. I see many children who have 'stand alone' SPD, also children who have dyspraxia and cerebral palsy who also have SPD. I also agree with you that it is very important to treat the SPD as an individual problem, - but I believe this to be the case whether it is found alone, in Autism or in CP or dyspraxia.

The brain operates on a series of sensory - motor loops, for instance if we have distorted visual perception, - because language, hand function, socialisation and motor systems are dependent upon good visual development for their own good development, - we can expect to see these systems suffer.

If we have distorted auditory perception then we will see the dependent 'output systems,' of language and social development being adversely affected. - These are primary systems which are affected in autism, so you can see why so many professionals automatically link the SPD with autism.

If we have distorted tactile development, then the dependent motor systems of mobility, hand function and socialisation will be affected, so we again see the connection with autism.

What I am clumsily trying to say, is that the pattern of brain injury which causes SPD, displays itself many times in output terms in what we like to call 'autism.'

Now for treatment. Personally, I don't go along with the treatment methods employed by the establishment at all. They are usually symptom oriented and I prefer to address treatment to the cause, - the injured brain which is producing SPD, or what I prefer to term 'distortions of sensory processing.' These distortions are produced primarily by the malfunctioning of two systems within the brain. The first is the 'Ascending Reticular Activating System,' which is partly responsible for directing our attention towards incoming stimuli from the environment. Second is the Thalamus, which has been shown to be a relay station for sensory information, directing it to the appropriate part of the cortex for further processing. The thalamus also 'excites' the appropriate region of cortex, to enable it to process and analyse that information.

So what goes wrong? When these two structures malfunction, it results in either the attentional systems not being directed to pay attention to incoming stimuli, - so we see a child who simply does not seem to perceive the outside world sufficiently in terms of vision, hearing, or touch. We can also see a situation where a child's attention is mis-directed so that he pays too much attention to a particular stimuli. As I said, the thalamus is also responsible for exciting the cortex and it can under-excite it, or over-excite it. This results in either undersensitivity in a sensory modality or oversensitivity.

The good news is that these two structures can be re-tuned by the provision of an appropriately adapted sensory environment. In this way the brain can be taught to modulate incoming sensory stimulation at a more natural level.

This is only a brief description of some of the many distortions of sensory processing which can occur, in order to give you an example. Hope this helps.

If you need more information, contact me at snowdrop_cdc@btinternet.com

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.