What is Brain Plasticity?

Brain plasticity, also known as neuroplasticity, is a term that refers to the brain's ability to change and adapt as a result of experience.  In the case of brain injured children on the Snowdrop programme, that experience comes through the repetition of the developmental activities within the child's programme. 

Up until the 1960s, researchers believed that changes in the brain could only take place during infancy and childhood. By early adulthood, it was believed that the brain's physical structure was permanent. Modern research has demonstrated that the brain continues to create new neural pathways and alter existing ones in order to adapt to new experiences, learn new information and create new memories.

Psychologist William James suggested that the brain was perhaps not as unchanging as previously believed way back in 1890. In his book The Principles of Psychology, he wrote, "Organic matter, especially nervous tissue, seems endowed with a very extraordinary degree of plasticity." However, this idea went largely ignored for many years.  It is still not accepted and largely ignored by the medical community in the UK who adopt an attitude of "once a brain is injured, there is nothing which can be done," - consigning children to the 'scrapheap' of life whilst refusing to accept the evidence of plasticity and what that could mean for the child and his / her family in terms of recovery of function.  This is where the Snowdrop programme comes in, - stimulating plasticity and consequently directing the child down the correct developmental pathway. 

In the 1920s, researcher Karl Lashley provided evidence of changes in the neural pathways of rhesus monkeys. By the 1960s, researchers began to explore cases in which older adults who had suffered massive strokes were able to regain functioning, demonstrating that the brain was much more malleable than previously believed. Modern researchers have also found evidence that the brain is able to rewire itself following damage.

How Does Brain Plasticity Work?

The human brain is composed of approximately 100 billion neurons. Early researchers believed that neurogenesis, or the creation of new neurons, stopped shortly after birth. Today, it is understood that the brain possesses the remarkable capacity to reorganize pathways, create new connections and, in some cases, even create new neurons in structures such as the hippocampus.

The first few years of a child's life are a time of rapid brain growth. At birth, every neuron in the cerebral cortex has an estimated 2,500 synapses; by age of three, this number has grown to 10,000 synapses per neuron.

The average adult, however, has about half that number of synapses. Why? Because as we gain new experiences, some connections are strengthened while others are eliminated. This process is known as synaptic pruning. Neurons that are used frequently develop stronger connections and those that are rarely or never used eventually die. - 'Used frequently,' that is a key term - This is why the repetitive nature of the programme is important, so that synaptic connections associated with the developmental functions we are trying to stimulate are strengthened.  By developing new connections and pruning away weak ones in this way, the brain is able to adapt to the changing environment, - in the case of our children, the developmental environment provided by the programme.

Anyone wanting to learn more about the Snowdrop programme should email andrew@snowdrop.cc

Walking After 11 Months on the Snowdrop Programme

This young man from the United States has hemiplegic cerebral palsy.  He has been on the Snowdrop 'distance programme' (a programme where the child is assessed remotely via questionnaire and video footage), for just 11 months.  When he first started the programme he wasn't even crawling, but he has made incredible progress and here he is demonstrating his new found skill of walking.

Max's Story.

This post was written a couple of days ago by a mum from Australia who has a little boy on our distance programme.  Max has been on the Snowdrop programme for around 12 months and in that time he has made incredible progress.  Although your kind words are much appreciated Faith, you are the real star here, having worked incessantly to rescue your little boy from the depths of brain injury.

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Wake up Sleepyhead

 

I started writing this blog, about 2 weeks after Max's stroke. A good friend suggested it might be cathartic to write about our experiences. It's also been a good way to disseminate information everyone wanted to know. In the first few weeks of writing, I wrote furiously to get all the facts down on paper before I forgot them. My early posts are pretty crappy and straight to the point. Over time, I've written a few 'flashback' posts, and talked about certain events in more detail. Which is exactly what this post is going to be....

Max spent about 2 days officially, in a medically induced coma. It was the only way, they could stop the seizures which was causing his brain to dangerously swell. It probably sounds strange, but I was grateful for those 2 comatose days. It gave me a chance to process everything which was going on. Every medical professional I spoke to in those 2 days, uttered the same phrase "we'll know more about his prognosis, once he's out of the coma". I was in no hurry for him to wake up, I was petrified of the reality we were going to face. 

In those 2 days, I sat with him, with every intention of reading him stories and singing his favourite songs. I never did either of those things because I couldn't find the strength. Instead, I cleaned his eyes when they got mucky, I cleaned his mouth and kept his lips moist. Occasionally, I changed his nappy, although there wasn't much point because he had a catheter and his bowels were essentially 'paralyzed'. 

The thing I did most of all, during those days, was think. I had no idea who my son would be when he woke up. By that stage, we knew he had permanent brain damage but didn't know how it would affect him. Would he be permanently paralyzed? Would he be dependent on me for the rest of his life? Would he be mentally handicapped? Would he ever do those 'normal' things that other parents take for granted? I feel a little ashamed, but the one thought which had the most air time, was 'I never signed up for this sh*t'.

Coming out of a coma is nothing like you see in the movies. On TV, the (beautifully made up) comatose patients eyelids flutter before they slowly open, they look at the person sitting lovingly by their bedside and stutter "wh-wh-at happened?". 

In reality, the process is very long and extremely tedious. For 2 days, I'd basically seen, no signs of life from my baby. No twitching, no eyelid flutters, no response to anything. 100% of his breathing was done by a life support machine. Slowly, we started to see little twitches, his eyes started moving behind closed eyelids and every now and then, he breathed for himself. His eyes didn't flutter open like they do in the movies. They opened millimeter by millimeter, over the course of 24 hours. Once they were open, his gaze was vacant. 

There's one particular photo, I look at fairly often which tells the story of how far we've come since last June. It was taken by my mother on the day Max started coming out of the coma. I don't think I took any photos on that day, because it hurt like hell. When I think back to that day, I still feel the stabbing pain in my heart. 




It took days, maybe even weeks for the Thiopental (aka Coma drug), to wash out of his body. The doctors explained in laymans terms, Thiopental literally soaks into every fat and muscle cell of the body. It was going to take his little body awhile to rid itself of the drug (Incidentally, I later discovered, Thiopental is the first of the 3 lethal injections given in executions- I'm glad I didn't know that at the time). 

Even after the Thiopental and pain killers were out of his system, Max was still a space cadet. He would've been happy lying in his cot all day and staring at the wall. Not once did I let him do that. When Max was awake, Max's brain was being stimulated somehow. We played music, read stories and took him for walks around the hospital. I was the crazy mummy, who took her baby to the Starlight room and joined in the art groups. Despite all of this, he was still pretty vague. I could bang saucepans only meters away from him and he wouldn't respond. Yet, we knew, his hearing was perfect. 




After months of (slightly obsessive) researching, I started Max on the Snowdrop Program. He literally 'woke up' after only one day of the program. On Monday, I could carry him into the shops easy peasy. On Tuesday, he was a humanoid Octopus who tried to grab everything off the shelves. 

Looking at him now, it's almost impossible to believe he's the same child. Check out these recent pictures, he is alert, hyperactive and incredibly mischievous. 




















From a physical perspective, we still have a long way to go, but that's a whole other post. I have days, when the cheeky little sod is driving me batty and I have to remind myself of how far he's come. There aren't enough ways to say thank you to Andrew and the Snowdrop Program. It's my greatest wish, for us to travel to the UK, because there's one thing I really need to say to him in person. "Thank you for bringing my son back". 

This isn't a sponsored post but for anyone wanting to know more about the program, here's the link- 

Snowdrop for Brain Injured Children

Music can help you to sleep.

This needs more research, but it is interesting and could help our children in the future. Snowdrop already incorporates music into our programmes of treatment for children with cerebral palsy, autism, ADHD & more, -  for instance both gregorian chant and baroque music are proven to positively influence brainwave patterns towards sleep.http://www.medicalnewstoday.com/articles/253101.php

Brain Plasticity in Action, (on a trampoline)!

This young man is just 19 months old.   When he was 6 weeks of age he suffered a massive stroke which destroyed the left side of his brain.  His doctors told his mum that as a consequence he would never be able to use his right side limbs, which meant he would never crawl, never walk, and because language functions are situated in the left hemisphere, he would never understand or produce spoken language.  His mum refused to accept this and after many months of despair, she found Snowdrop via an internet search.  We instituted a programme of neuro-developmental stimulation, which he has been following for just 1 year.  The results have been astonishing and he did crawl, he does walk, (and run) and he most certainly does talk!  Here we see him coordinating both legs in order to enjoy the trampoline.  This young man is proof positive that not only can we stimulate brain plasticity, we can successfully direct it down a developmental pathway and thus restore the functions of children who have suffered brain injury.

 is trampolining using both legs in coordinated style! Go Max!

The Principles of the Snowdrop Programme

(1) Brain injury is in the brain and if we are to help our children overcome their problems we must direct our efforts towards influencing brain plasticity.

(2). The brain responds to 3 major influences, -genetic instruction, - its internal operating environment, - the demands placed on it by the environment. These three factors drive the development of the child forward. We cannot influence genetic instruction, but we can influence the other two factors.

(3). How do we influence the demands of the environment and therefore also influence brain plasticity? - We do so through repetition of stimulus. A brain injury acts as a 'roadblock' preventing stimuli from the environment from being processed properly in the brain and therefore the child fails to develop. The Snowdrop programme assesses where that developmental roadblock lies in each area of development and provides an appropriate developmental activity which is repeated over weeks and months and which acts as an increased environmental stimulus, helping to overcome the roadblock and allowing the correct stimulation to reach the brain.

(4). The brain prefers to take in information in short, sharp bursts, which is why most activities within the programme are carried out for between 1 and 3 minutes,

(5). The brain needs plenty of 'downtime' in order to process and organise information, for this reason the programme is not as 'intensive' as might be imagined.

(6). Children learn and develop in social situations with the help of family and friends. All new abilities begin as abilities which are just beyond the reach of the child and he / she can only perform those abilities with help from family / friends. The programme activities are therefore carried out with the child by family and friends.

(7). Those friends and family who are helping the child learn and develop in social situations are providing assistance which Bruner termed as 'scaffolding' to enable the child to complete developmental tasks which are just outside of his ability to complete them alone. As the child becomes increasingly competent at the ability through repetition of stimulus, the scaffolding is gradually withdrawn until the ability is 'internalised' and the child has attained that developmental ability. This is what Vygotsky termed 'passage through the zone of proximal development.' In this way we marry academically sound Vygotskian psychology with current evidence on stimulating neuroplasticity.

The link between music and language development.

This is the reason why exposure to music is a primary factor within the Snowdrop programme for brain injured children.  With thanks to 'Medical News Today.'

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Contrary to the prevailing theories that music and language are cognitively separate or that music is a byproduct of language, theorists at Rice University's Shepherd School of Music and the University of Maryland, College Park (UMCP) advocate that music underlies the ability to acquire language. 

"Spoken language is a special type of music," said Anthony Brandt, co-author of a theory paper published online this month in the journal Frontiers in Cognitive Auditory Neuroscience. "Language is typically viewed as fundamental to human intelligence, and music is often treated as being dependent on or derived from language. But from a developmental perspective, we argue that music comes first and language arises from music." 

Brandt, associate professor of composition and theory at the Shepherd School, co-authored the paper with Shepherd School graduate student Molly Gebrian and L. Robert Slevc, UMCP assistant professor of psychology and director of the Language and Music Cognition Lab. 

"Infants listen first to sounds of language and only later to its meaning," Brandt said. He noted that newborns' extensive abilities in different aspects of speech perception depend on the discrimination of the sounds of language - "the most musical aspects of speech." 

The paper cites various studies that show what the newborn brain is capable of, such as the ability to distinguish the phonemes, or basic distinctive units of speech sound, and such attributes as pitch, rhythm and timbre. 

The authors define music as "creative play with sound." They said the term "music" implies an attention to the acoustic features of sound irrespective of any referential function. As adults, people focus primarily on the meaning of speech. But babies begin by hearing language as "an intentional and often repetitive vocal performance," Brandt said. "They listen to it not only for its emotional content but also for its rhythmic and phonemic patterns and consistencies. The meaning of words comes later." 

Brandt and his co-authors challenge the prevailing view that music cognition matures more slowly than language cognition and is more difficult. "We show that music and language develop along similar time lines," he said. 

Infants initially don't distinguish well between their native language and all the languages of the world, Brandt said. Throughout the first year of life, they gradually hone in on their native language. Similarly, infants initially don't distinguish well between their native musical traditions and those of other cultures; they start to hone in on their own musical culture at the same time that they hone in on their native language, he said. 

The paper explores many connections between listening to speech and music. For example, recognizing the sound of different consonants requires rapid processing in the temporal lobe of the brain. Similarly, recognizing the timbre of different instruments requires temporal processing at the same speed - a feature of musical hearing that has often been overlooked, Brandt said. 

"You can't distinguish between a piano and a trumpet if you can't process what you're hearing at the same speed that you listen for the difference between 'ba' and 'da,'" he said. "In this and many other ways, listening to music and speech overlap." The authors argue that from a musical perspective, speech is a concert of phonemes and syllables. 

"While music and language may be cognitively and neurally distinct in adults, we suggest that language is simply a subset of music from a child's view," Brandt said. "We conclude that music merits a central place in our understanding of human development." 

Brandt said more research on this topic might lead to a better understanding of why music therapy is helpful for people with reading and speech disorders. People with dyslexia often have problems with the performance of musical rhythm. "A lot of people with language deficits also have musical deficits," Brandt said. 

More research could also shed light on rehabilitation for people who have suffered a stroke. "Music helps them reacquire language, because that may be how they acquired language in the first place," Brandt said.