Principles of Treatment.

My work is based upon two principles.

(1). The brain is plastic. - What do I mean by plastic?  The brain is capable of altering its own structure and functioning to meet the demands of a particular environment. What evidence can be produced to sustain this view? -  There is ample evidence in the scientific literature that if a child develops in an impoverished, under-stimulating environment, the size of the brain is smaller and the richness of its connectivity is comparatively poor. This is reflected in relatively poor physical, social and intellectual development. A child, who is fortunate enough to develop in an enriched, stimulating environment, will possess a bigger brain, with richer connectivity. This is reflected in relatively superior physical, social and intellectual development

This view has recently been verfied by incontravertible evedence from the Max Plank Institute for Biological Cybernetics at Tubingen, who 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 scientists were able to trace how large populations of brain cells in the human forebrain are able to reorganise and change their connections to other brain cells as a consequence of environmental stimulation.  (Current Biology, March 10th, 2009).

Now consider what a developmental disability, such as that which produces cerebral palsy orautism in effect does to a child. It creates a de-facto impoverished environment because the child’sdevelopmental processes must attempt to proceed through the constraining effects of the developmental disability. In effect, the brain injury creates a barrier between the child and his environment, either by not permitting appropriate development of the sensory systems, or by distorting them, so that he cannot gain access to the stimulation he needs.

However, the now proven phenomenon of brain plasticity also means that recovery of functionmust be possible. To have the best opportunity of recovery of function, the child who has a developmental disability needs to be placed in a highly enriched, appropriately stimulating environment, which is adapted to cater for his developmental level.  In this way, as the Tubingen scientists have proven, we can provide the best possible environment for the brain to reorganise its functioning and change the connectivity of its neural networks.

So, the first principle of neuro-cognitive therapy is to design the appropriate ‘developmental environment’ for the child. (This could be a room in the house, - the child’s bedroom, or a spare room for example, which can be adapted to meet the child’s need for increased or decreased sensory stimulation. 

Learning can lead development. As early as the early 1900s, this was being proven by a psychologist named Lev Vygotsky. Vygotskian learning theories proposed that children’s learning is a social activity, which is achieved through interaction with more skilled members of society. Recent studies, which have looked into the ways in which children learn, confirm Vygotsky’s ideas. So what do we know about how children learn and develop?
  • We know that prior to attending school, children learn in the informal, natural setting of the home and wider community. 
  • We know that children are taught, without being aware they are being taught and parents along with other family members and members of the wider community teach children, without being aware they are teaching.
  • We know that this natural teaching is a social activity and that consequently what is being taught and learned is ‘social,’ – it is within the interaction between adult and child.
  • We know that little by little, with supervision and guidance, what is being taught is ‘internalised’ by the child to become part of that child’s new developmental capability.
  • We know that the more the child practices this new ability, whether it is physical, intellectual or social, the more effective his performance at it will be and the quicker he will be able to carry it out ‘automatically,’ without having to think about it.
This is the way in which children learn and it would be wrong to think that children who have developmental disabilities are different to this in the way they learn: - THEY ARE NOT! All we have to do is to make these teaching techniques more explicit and ensure that we pitch the developmental learning tasks at the appropriate developmental level and level of intensity. If we are successful in doing this,  developmental gains can be possible in even the most severely affected child.