In helping a child or teenager with a neuro-developmental disorder such as ADHD it is essential to address the underlying cause of the disorder. As Functional Neurologists we know that a properly functioning brain requires communication between both hemispheres. This communication via nerve impulse within the brain should occur very fast. In children with neuro-developmental disorders this communication is slow or out of sync. This miscommunication between the two sides of the brain is called Functional Disconnection Syndrome and is the root cause of many childhood neurodevelopmental disorders.
When the brain is out of sync and there is poor communication between the two hemisphere there will be learning, behavioral and social problems.
The term "functional" means that the problem is not structural and the brain is not diseased or damaged -- it is simply not developing as it should. This developmental lag may cause one brain hemisphere to be out of sync with itself or with the hemisphere on the other side.
It is unfortunate, but typically, when a child is evaluated due to a learning, behavioral or social disorder, they undergo minimal neurological examination and are usually given a label as having a disorder such as ADHD, a learning disability or autism. The majority of these concerns such as ADHD, learning disabilities, reading disorders, OCD, Autism, Tourette's Syndrome, Asperger's Syndrome and sensory processing disorders are caused by Functional Disconnection Syndrome.
These conditions can be caused by either a left brain deficit or a right brain deficit. For example children or teenagers struggling with ADHD and poor focus typically have a Functional Disconnection Syndrome affecting their right brain. The majority of the Autism Spectrum disorders such as ADHD, Asperger's Syndrome, PDD-NOS and even OCD are right brain deficit problems. ADHD is a less severely involved right brain disorder as compared to autism. In ADHD, many times just one region such as the right dorsolateral pre frontal cortex is involved, where in autism, many regions of the right brain may be involved.
Problems such as dyslexia, reading disorders, learning disabilities and poor handwriting are typically caused by left brain deficits.
In order to fully understand these neurodevelopmental disorders, Its essential to look at them in terms of "hemispheres," or sides, of the brain.
When we understand what each side normally does for a child when they are in balance (integrated), we can understand what goes wrong when there is an imbalance (functional disconnection).
The Right Hemisphere:
- The "brake" pedal
- Withdrawal responses: stop movement, stop thought
- Controls gross motor: posture, big movements
- Likes Low Frequency Stimulation
- The "Where" part of the brain
- Non-linear, "creative"
- Non-verbal communication: face, eyes, body
- Stimulated by novel, new stimuli
- Reading and math comprehension
- The "sad" brain
The Left Hemisphere:
- The "gas" pedal
- Approach responses: initiates movement, initiates thought
- Controls fine motor: small movements
- Likes High Frequency Stimulation
- The "What" part of the brain
- Memorization of facts
- Verbal fluency
- Likes routines, sameness
- The "happy" brain.
Here are a few signs a Brain is Out of Balance
- Loves TV, Videos, computer
- Like sameness, routines, rituals
- Often great memory
- Normal and often above average intelligence
- Poor social skills/poor verbal skills
- Tantrums, poor emotional control
- Very self-directed, not very passive
- Tendency to fidget or stay moving
- Tend to fixate (perseverate)
- Often have "sensory" issues
- Reading and learning issues
- Language delays
One may ask why are there language delays in Autism if it affects the non- dominant non- verbal right hemisphere?
The Right hemisphere is responsible for non-verbal communication whereas the left hemisphere is responsible for verbal communication.
Non-verbal communication is the foundation of verbal communication. One must first have non-verbal communication such as understanding one's feelings,facial expressions and body language before verbal communication develops. Essentially the non-verbal precedes the verbal.
If a child has a right brain delay, they never develop these and the functional disconnection inhibits communication of the right non- verbal with the left verbal.
Without these basic pillars of communication, appropriate verbal communication is delayed.
One method to encourage appropriate speaking in these children is to work on building the foundation - non-verbal communication which is the right brain.
Why are there so many "sensory" problems with these children?
Sensory issues most often are not a problem with the particular "sense."
Often the problem is with the frontal lobes and inappropriate withdrawal responses to the sensations.
We look at each specific brain region that could be affected. In addition, we also examine the child or teenager's specific functional capabilities and the neurochemical components as well. This is different from just using parental questionnaires and generalized batteries of tests, and quick observation to make a diagnosis or assign a label. That approach does not look at various areas from a functional neurological model.
The traditional treatment option of medications do not take into consideration the issue of HEMISPHERIC IMBALANCE and which side of the brain needs more stimulation? Right or left? They also do not look at the specific areas of that side such as the parietal lobe, the temporal lobe, the frontal lobe or the cerebellum.
We are also very concerned about knowing the individual child's brain metabolic capacity or endurance.
How much therapy can they handle? What is too much? What is their neurologic stamina?
We don't want to over stimulate or exceed the child's metabolic capacity with our therapies. This approach is very individualized . We determine all of this in our examination.
Proper sensory and motor development is essential for proper growth and development of your child's brain. Your child's interaction and experience with the world provides the sensory and motor stimulation required to build and develop their brain.
To understand how our therapies work it is essential to understand how the brain develops through The Brain Development Pyramid:
The brain develops from the bottom up -- from the brain stem up to the cognitive cortical centers of the brain. When a baby is born, their brain stem is the primary area of their brain that is developed and functioning. The higher level cortex has not yet developed. The brain stem controls all internal organ functions and causes movements that are primitive and purely on reflex such as hand grasping, sucking and rooting.
With proper neurologic development these primitive reflexes governed by brain stem activity should be remediated or inhibited and hidden. Sensory stimulation such as hearing, vision, touch, taste, smell and inner ear or vestibular begin to develop the sensory areas of the brain. The sensory stimulation provides feedback to the lobes of the back of the brain to drive and build them.
The next developmental milestone is motor and frontal brain development where movement of the legs and arms, pushing up on the belly, eye tracking to follow objects, voluntarily grasping objects, rolling over, pulling up, crawling and walking occur.
The motor system drives the sensory stimulation leading to the next stage of development: sensory motor is when body awareness, reaching for particular objects, postural security, and motor planning develop.
Next is perceptual motor where language skills, spatial awareness, eye hand coordination and ocular motor control develop.
The last stage of development is cognition when attention/focus, behavior, social skills and academic learning occur.
These stages are the basis for developmental milestones that we use to determine how our children are growing. Delays at any level can cause altered development of the following stages leading to issues in attention, behavior, academic learning and social skills.
With the traditional care of tutoring, counseling and medication, ADHD, Autism and learning disabilities are evaluated and treated at the top of the pyramid in an attempt to address the cognition, social skills and attention and focus directly.
The problem is that ,without developing a strong base, it is virtually impossible to correct these problems from the top.
If there is a problem in the bottom or middle stages (such as an infantile reflex that is still persistent, a sensory development issue, an issue with proper cross crawl mechanism, improper oculomotor control, poor eye tracking or other aspect of the early development), then the later components such as attention/focus, language skills, behavior, social skills or academic learning will suffer and not function properly.
This hierarchy of development supports a bottom-up strategy including sensory motor therapies to go back and work areas that may not have been fully developed.