Recognizing the Link Between the Central Nervous System

Recognizing the Link Between the Central Nervous System Maturity and Sensory Integration Lillian Chen-Byerley, MS, OTR/L, RCTC 171 Lagoon Drive Northfield, IL 60093 847. 441. 9484 Autism One Conference fourchen@sbcglobal. net 23 May 2009 www. senseablekids. com

Abstract By integrating the salient values of multiple neurodevelopmental theories consistently into each of the child’s autism therapies along with the school setting and the home, one has the opportunity to more directly impact the central nervous system, harnessing the developing brain’s neuroplasticity and potentially producing a more positive overall therapeutic outcome.

Objectives: the importance of developmental integration of primitive reflexes in terms of overall outcomes how the central nervous system is impacted by sensory integration theory the critical role of auditory listening programs the importance of consistency across therapeutic, home, and school environments to maximize therapeutic gains

Nervous System Central Nervous System (CNS) Peripheral NS Autonomic NS Sympathetic NS Somatic Brain NS Parasympathetic NS Forebrain Spinal Cord Midbrain Hindbrain Metencephalon Telencephalon Diencephalon Mesencephalon Cerebral Cortex Basal Ganglia Hippocampus Amygdala Thalamus Hypothalamus Tectum Tegmenturn Pons Cerebellum Medulla

Central Nervous System (CNS) Brain Forebrain Spinal Cord Midbrain Hindbrain Metencephalon Telencephalon Diencephalon Mesencephalon Cerebral Cortex Basal Ganglia Hippocampus Amygdala Thalamus Hypothalamus Tectum Tegmenturn Pons Cerebellum Medulla

Function of the Reflexes: Present in all of us as part of our central nervous system (CNS) at birth and are involuntary movements Primitive reflexes have a limited life span w/the purpose to help a newborn survive the first 9 months to a year of life. Integration of these reflexes lead way to postural reflexes or higher neural ability for voluntary control

Purpose of Primitive Reflexes: It is believed that reflexes are “hard wired” before birth and elicited in the newborn As the brain matures, they are inhibited or disappear http: //www. asktheneurologist. com/primitivereflexes. html

Reflexes as a Diagnostic Tool The central nervous system (CNS) maturity can be measured by the presence or absence of reflexes During key stages neural development will determine when a reflex emerges and when it integrates (or becomes inhibited)

Primitive Reflexes Moro Tonic Labyrinthine Asymmetrical Tonic Neck Reflex (ATNR) Spinal Galant Symmetrical Tonic Neck (STNR)

Moro Reflex The Moro Reflex is when the entire body responds to sudden changes in vestibular, movement, auditory, visual or tactile stimuli Develops at nine weeks in utero Integrates between two and four months of age

Tonic Labyrinthine Reflex The Tonic Labyrinthine reflex is elicited when there is a change of head position forward or backward thru mid-plane Provides the basis for upper trunk control leading to normalized muscle tone throughout the body regardless of head position Balance, posture, and coordination results from the mastery of head control

Asymmetrical Tonic Neck Reflex The ATNR is activated by spontaneous and passive head turning from side to side Develops during the third month in utero Integrates between three to nine months

Spinal Galant Reflex The Spinal Galant Reflex is activated by touch on the side of the spine Develops at twenty weeks in utero Integrates between three to nine months

Symmetrical Tonic Neck Reflex (STNR) The STNR is activated by the flexion and extension of the head causing a reciprocal movement of arms and legs as seen when the head is flexed the arms will bend and the legs straighten Develops between six to eight months Integrates between nine to eleven months

Postural Reflexes The Righting Reflexes (quadruped) Equilibrium Reactions (bipedal)

Neuroplasticity and Rehab 1. Body parts can compete for representation in the brain and use of a body part can enhance its representation.

Neuroplasticity and Rehab 2. The premotor cortex can substitute for the motor cortex to control motion.

Neuroplasticity and Rehab 3. The contralesional hemisphere can take over motor control if all else fails.

Neuroplasticity and Rehab Intervention Neuroplastic mechanisms can be facilitated and this is a good basis for intervention Example: Stroke patient

Sensory Integration Sensory Integrative Developed by A. Jean Ayres, Ph. D with the premise that there are five neurosensory systems: ◦ ◦ ◦ Auditory Visual Vestibular Proprioceptive Tactile

Definition “Sensory integration is the neurological process that organizes sensations from one’s body and from the environment, and makes it possible to use the body to make adaptive responses within the environment. To do this, the brain must register, select, interpret, compare, and associate sensory information in a flexible, constantly-changing pattern” A. Jean Ayres, 1989

Effects of Sensory Processing Sensory processing is the result of the ability to regulate arousal, organize behavior and modulate sensation as a result of its affect on the environment… Knowing how one’s body in space, and the ability to deal with the environment allow us to move Bilateral integration form and space perception, praxis and body scheme are all a result of the development of posture So praxis is the result of good sensory processing when the sensory and motor systems work together

What is Sound Therapy? Sound therapy is sometimes referred to as auditory training, auditory re-education, or auditory intervention Depending on the tested needs of the person, the primary principle of any sound based therapy is that it utilizes sound vibration to make an impact on the body by using specialized equipment which play individualized programs which are modified music, and/or specific tones/beats

Neurodevelopmental Frameworks Neuroplasticity The brain’s natural plasticity provides the opportunity to improve how the brain functions. Applying the neuroplasticity theory allows us to utilize sound therapy to stimulate the sensory channels with the appropriate input with sufficient frequency, intensity and duration.

Neurodevelopmental Frameworks Sensory Processing The ear is more than your hearing sense; it is responsible for your vestibular function— balance, coordination, muscle tone, eye-hand coordination, proprioception, and affects vision The ear is the major sensory stimulator for the body. It stimulates our sense of: taste, touch, sight, smell, and hearing, which affects emotions, digestion, and social skills.

Neurodevelopmental Frameworks Sensory Processing (continued) Efficient sensory processing of the auditory system allows one to maintain auditory attention, filter extraneous sound, allow sound discrimination, temporal processing, and auditory memory Poor sensory processing compromises listening, learning, behavior and communication. These distortions result in difficulties processing information and relating in the environment

Now What? Integration of these principles tell us that we are the primary motivators of change. Our brain will allow us to evoke change Utilization of technology will help us identify and narrow our focus in treatment so that we can enhance success at the cellular level change

Consistency in Intervention Consistent integration of neurodevelopmental theories are critical in therapy, home and school

Superbrain Yoga Can Yoga Help Boost Your Brain? Super. Brain Yoga by Master Choa Kok Sui, Inc. Institute for Inner Studies Publishing Foundation, and Benny Gantioqui (Paperback - Dec 15, 2005)

Brain Gym Brain Gym: Simple Activities for Whole Brain Learning (Orange) by Paul E. Dennison Ph. D. and Gail E. Dennison (Paperback - Jun 1, 1992)

Rappin on the Reflexes a Practical Guide to Infant Reflexes by Eve Kodiak. M. M. (Spiralbound - 2006) (unavailable)

References Neuroscience: An Outline Approach, Anthony Castro | icg. harvard. edu/~psy 1 -s/ lectures/06 sensation Neuroanatomy/Brain Imaging Information is from: Eric H. Chudler, Ph. D. E-mail: chudler@u. washington. edu URL: http: //faculty. washington. edu/chudler/neurok. html Brain Matters, www. brainmattersinc. com Mirror Neurons: “Cells That Read Minds”, Sandra Blakeslee, January 10, 2006 Children With Disturbances in Sensory Processing: A Pilot Study Examining the Role of the Parasympathetic Nervous System July/August 2003, Volume 57/Number 4 Roseann C. Schaaf, Lucy Jane Miller, Duncan Seawell, Shannon O’Keefe Evolution and the autonomic nervous system: A neurobiological model of socio-emotional and communication disorders Stephen W. Porges, Ph. D. Olga V. Bazhenova, Ph. D. Polyvagal Theory by Stephen Porges, Ph. D, UIC (Google Porges) Neuroplasticity Information is from: Mark Hallett, MD http: //www. vard. org/jour/05/42/4/hallet. html

Vision Information is from: Deborah Zelinsky, OD, Mind Eye Connection http: //mindeyeconnection. com/ Dyslexia link between auditory and seeing http: //www. eurekalert. org/pub_releases/2003 -11/wfubdmi 110303. php References for Sound Therapy: The Conscious Ear. My Life of Transformation Through Listening. Alfred A. Tomatis. Station Hill Press. Listening For Wellness. An Introduction to the Tomatis Method. Pierre Sollier. Mozart Center Press. When Listening Comes Alive. A Guide to Effective Learning and Communication. Paul Madaule. Moulin Publishing. Listening with the Whole Body. Sheila Frick. Vital Links. Suggested Web Sites (more links within Tomatis sites under some providers) www. tomatis-group. com or www. iarctc. com www. thelisteningcenter. net www. theswaincenter. com www. thelisteningclinic. com www. tomatis. com

References Suggested Reading for DSM Exercises: The Cerebral Code: Thinking a Thought in the Mosaic of the Mind by William H. Calvin, The MIT Press, Cambridge , MA , 1998 The Number Sense: How the Mind Creates Mathematics by Stanislas Dehaene, Oxford University Press, 1999 Mind Sculpture: Unlocking Your Brain's Untapped Potential by Ian Robertson, Fromm International, New York 2000 Opening the Mind's Eye: How Images and Languages Teach Us How to See by Ian Robertson, St. Martin 's Press, New York 2002 The Mind and the Brain: Neuroplasticity and the Power of Mental Force by Jeffrey M. Schwartz, M. D. , and Sharon Begley, Harper. Collins Publishers Inc. , New York 2002 Left Brain Right Brain: Perspectives from Cognitive Neuroscience by Sally P. Springer and Georg Deutsch, W. H. Freeman and Company, New York 1998 © Copyright 2004 Donalee Markus, Ph. D. & Associates