Three reasons why your child is not “regressing”

Three reasons why your child is not “regressing”

So many times, families will make statements during the course of intervention alluding to their child appearing to be going “backward” instead of forward. We do believe this to be quite disconcerting and would like to reiterate that such comments are not taken lightly. When families invest heart, soul, mind, time and finances in intervention, they want to see the results they are hoping for and they are completely within their rights to expect a positive outcome. Families come to us because they want their child to improve on overall function, from development to academics to social-emotional behavior. It is a big ask, and we can make quite a difference with the newer brain-based technologies we have available to us today. Due to neuroplasticity research, we believe in high intensity, high frequency intervention interspersed with weekly services particular to the child’s profile. And for the past 19 years, we have stood the test of time and created change in many clients over a range of diagnostic categories across the age spectrum. This does not mean that we have perfect answers to every situation, but we have learnt, studied and experienced multiple different scenarios that we had to find answers for. And yes, we do experience the question of “regression” multiple times in families. Let me explain:

The first reason why what looks like regression is not truly a regression, is because of neurophysiology. It is simply not possible for the brain pathways to go “back” except if the child experienced blunt force brain injury, has a medical diagnosis that includes degeneration of nervous system pathways or aging. Once the brain processes at a certain speed, this speed is available to the child. The good days you are observing the child you wish to have, is the “real” child waiting to happen on a consistent basis. If parents shift their focus from the exact place they want to see, they will usually find that there are other changes taking place at the same time as they are seeing the “regression” in specific skills. This is a temporary situation that subsides as soon as the nervous system has run its course in the shifts that need to take place.

A second reason lies in the nature of typical development. Children who develop neurotypically naturally go through growth spurts during which our little “angel” turns into not being an “angel” for a period of time. During growth spurts specific pathways are being pruned for integration, causing a momentary “re-shuffling” of the “known” to meet the unknown. This is disconcerting to the developing child, who is also struggling for autonomy and independence. It makes them feel unsettled for a while until both the “old” and “new” merges into new found strength and ability. When children go through a brain-based program, these “re-shuffling” stages occur at older ages where no one thinks the “growth spurt” is cute any longer and due to now having gained more intelligence more is expected of their behavior. But the child essentially has to go through these growth spurts in order to gain ground, so yes, it may temporarily look like the child’s behavior is getting worse, though in effect, due to the child’s age and intelligence, it feels worse than for the neurotypical child going through change at younger ages. Children do not understand why they are feeling out of control. To please others expectations is just as elusive to them as it is feels baffling to the parents. Due to the increased complexity of age and stage, these disruptions can take longer than if it happened at the neurotypical ages, though not in all situations.

Sometimes families note that their child has “lost” skill, instead of gaining skill. The third reason can also be traced back to neurotypical development. Remember when your neurotypically developing child was saying some words and when  they started to walk the first time, they stopped talking for a while? Then after they mastered the act of walking, the talking came back? This happens because the brain is pruning in separate directions, a necessary step before integration when we can multi-task and do separate tasks simultaneously. 

High frequency, high intensity intervention may have a temporary cost and we clearly explain this to families from the outset and invite them to share this journey of discovery with us. We frequently consult, send videos home and ensure that families understand their child’s process every step of the way. It is a time and financial commitment, but the time it saves the child in the longer run to feel in control, feel capable and less anxious, makes it all worthwhile. It can be rough, but living every day with average to high intelligence and not being able to perform commensurate to expectations for multiple years is even more rough. We thank each and every family for helping us learn what we needed to know in order to stand strong today. Their belief in us have been instrumental in creating change where change was necessary.
If you think we can help your situation, please contact to do an initial phone call at no charge to you.

Four Reasons Why your Child may not be able to pay Attention in the Classroom

Four Reasons Why your Child may not be able to pay Attention in the Classroom

So many parents are called or hear at parent-teacher conferences that their child / teenager simply cannot focus on their work or they are “distracted”. Most of those times, parents are referred to medical practitioners to discuss the need of medication. While medication can really be good in many circumstances, it may not always be the right answer. What does a student need in the classroom to pay attention adequately? Posner’s research highlights a number of developmental steps that needs to be in place in order to make the most from our learning environment.

Firstly, we need to be sure that the student is able to register all the information taking place. Are all the senses prepared to receive the information coming in to the brain at the same time? Is your child able to look and listen to their teacher, while simultaneously ignoring any background information that may be coming in? We also need to consider if they are able to withstand information from their own head and body (internal sources) that may be competing with the information coming in from external sources.

Secondly, as we register the information our bodies, we also need to respond in split second timing to the incoming stimuli through an orienting response from our bodies. Now we have to be sure all our primitive reflexes (formed in utero) are fully integrated and not competing for attention within the student. We also need to consider if your child / teenager has sufficient postural control and body mechanics to stay seated at the desk to maintain the arousal and attention to incoming stimuli.

Next, the incoming information would require high speed timing and pacing to travel through the different pathways simultaneously to reach into the pre-frontal cortex in order to be analyzed for meaning adequately. This is where neuropsychologists discuss “processing speed” in their testing of IQ scores. The pre-frontal cortex relies on the fact that all the relevant information is coming in at the same time and speed, otherwise it feels to the student like a badly “dubbed” movie with the teachers’ non-verbal gesture (visual information), not matching up with the verbal speech (auditory information). This can be very confusing the student and frequently cause them to lose attention or allow themselves to become distracted because it is simply too much effort to sustain attention.

Finally, the pre-frontal cortex relies on aspects such as long-term memory, and working memory to keep sustaining the attention. The student uses working memory to retrieve information from long term storage associated with the new learning taking place and uses this information in the working moment to make sense of what the teacher is teaching at any given time. Good teachers always scaffold new learning based on what was taught before, relying on the student’s brain to assimilate ongoing newer information based on what they already know.

If your child / teenager’s working memory is unable to process the new information due to inadequate prior processes of registration, orientation, speed and timing, he / she may become overwhelmed and lose the ability to sustain attention.

All of these processes occur in the subconscious brain and is formed through the developmental process of growing up from being a baby, a toddler, through childhood and further refined through adolescence. Is medication sometimes an answer to consider? Yes, of course medicine could be supportive. Is it the only answer? Therein lies the conundrum. Teachers need to have their entire class focused to remain attentive to the curriculum and medication does seem to be a “quick fix”, but it also can lead to multiple side effects, including the repercussions with regards to feelings of wellbeing and self-esteem when needing to be dependent upon medication to function in a classroom. If you are a teacher, consider referring to an occupational therapist that understands the developmental pathways to attention as described above. With the right kind of therapy in the appropriate steps of development, a student can get the development they may need. If you are a parent, consider an assessment by an occupational therapist that can tease out the developmental pieces and target the origin of attention difficulties. The brain is very complex and not any one individual is exactly the same.

Contact for an initial “no charge” phone consultation to see if your child is a fit for our dedicated battery of assessments geared towards attention and executive functions.

Three Lessons Affirmed by a Powerful Mentor

Three Lessons Affirmed by a Powerful Mentor

I conducted a Tomatis Level 4 training a couple of weeks ago and was reflecting on my path with one of my mentors, when I had the thought to tell her story. I do not think I  can do her justice, but this is more my personal reflection of her influence in my life. Most families and professionals who know me, know that I am a strong advocate of the Tomatis Sound Therapy program and have been doing this work since 2003 and training all 4 levels of workshops since 2009. No one program is ever a cure, but I affectionately call this program, my “regulatory” program. At the basis of sensory processing, learning disorders, mental health disorders, there is the need for basic regulation between the sympathetic and parasympathetic system that creates a “just right” balance for us to be available for learning and socialization. The Tomatis program has evolved greatly over the years, from an analogue to a digital era and with increased precision in each newer device.

 Back to my story…… About 6 years ago, I was hosting a Tomatis Level 2 training at my office in Pennsylvania, when I had a call from Canada. The basic request was: “Can Doc also come when we come for our training?”. I thought: “Who was Doc?” They stated that she trained and worked with Dr. Tomatis in the sixties and seventies and is now 100 years old. She owned a private school in Ontario, Canada and have been doing Tomatis through all these years and now her staff was becoming trained in the newer models of care. I must ashamedly admit that I thought that at that age of maturity she likely would sleep through half of it, but sure, she could come. Well, Agatha Sidlauskas may have been 100 years old when I met her, but she was as sharp as a whip. Instead of intimidating me with her many years of experience, she acclaimed, validated and appreciated me as a trainer and I was in awe of her! She was still reading books on brain health and newer advanced care and though things have changed, she still had it! I fell in love with her and visited her in Canada, where we simply sat and listened to her story.

 Agatha grew up in Lithuania in a time period of very little education in their rural home. She was sent to live on her own, boarding with another family at a very young age and taught herself Italian and English through a Bible she had at the time. She went on to study in Italy, got involved in all kinds of adventures before leaving Italy by the skin of her teeth during the war. She found herself in Canada and became a professor at a local university and also promoted Dr. Tomatis and his work from those very early stages. She even showed Charl and I a picture of her in a book doing a full plank position mid air resting her entire body on her elbows at the age of 84! She was a remarkable woman, who brought healing to many over the years in her private school.

 Agatha and her life-long friend, Marilyn, invited Charl and I to spend some time in the Bahamas at Marilyn’s “home-away-from-home”. Every evening after dinner, Agatha and I would stay long hours at the table discussing the brain, the “work” of Tomatis and what the research was currently saying. Her eyes sparkled and she was clearly enjoying herself in these discussions, as was I. Agatha gave me space to ponder three major tenets in my life in my journey thus far, as we shared these pieces in our lives even though she was 50 years my senior. This gap did not matter. These tenets are:

  • Every child is born innocent of the influence of this world. While there are genes that could provide us temperament in the early years, it is our experience in this world that builds our personality and would give space to expression of those inherited genes or not.
  • Children’s behavior is an expression of communication that we as professionals would have to figure out the “why” to. To assume the reason as for example, manipulation, is far too simple as it frequently asks for more complexity of understanding than the child’s developmental level is capable of.
  • As professionals we cannot look at any child’s development from only one lens. We need to cross over in the domains of other professionals if we want to think of understanding the entirety of one child. The child has to put all of us together into their system in order to make sense of this world (Sensory, emotional, behavioral, language, social, etc.).

 Agatha’s innate respect for others, her fierce instinct to protect those she viewed as “weaker” and her sense of trust in the ability of children to heal, so resonated with me in my own thinking. I realized through Agatha, that these were my mantras from the beginning of opening my practice and little did I know in 2001, where this would lead me in my journey. I wish for every professional to have an Agatha in their journey. She was able to bridge years of knowledge into the newer knowledge of today and gave me great perspective in respecting what came before me and my time.

 I was able to persuade Agatha and Marilyn to come to Paris to an international Tomatis convention in 2015, where I presented her a plaque for her years of good service to the Tomatis Method and the happiness on her face was what I remembered when she passed at the age of 103. She came home to Paris, where it all began for her and under her influence, I was able to affirm my home, my beliefs and my journey.

 Thank you, Agatha!

When The Teacher Says Your Child Might Have Attention Problems

When The Teacher Says Your Child Might Have Attention Problems

By Maude Le Roux, OTR/L, SIPT, RCTC, DIR® Expert Trainer at A Total Approach

Has your child’s teacher sent home a note to let you know your child may have an attention problem?

First of all, you’re not alone. The A.D.D. Resource Center estimates over 6.4 million children in the United States ages four through 17 have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), which is characterized by an ongoing pattern of inattention, hyperactivity, impulsivity -or all three behaviors combined- that can interfere with a person’s executive functioning or development. Teachers are often the first to spot an attention deficit or hyperactivity disorder in their students.

However, the reasons these behaviors may be related to ADHD are the same reasons these behaviors may be related to a general developmental delay, also called a sensory processing delay.

4 Major Areas of ADHD Behavior

  • Inability to sit still, fidgeting, continuously moving around while trying to listen
    • This may occur because the child is not able to look and listen at the same time. Why do people pace when talking on the phone? Visual information is removed and in order to enhance the auditory information, they access vestibular (movement) information by pacing or moving around. Our movement system and auditory system are connected to the same cranial nerve, so they affect one another.
    • Another reason for fidgeting may be that the child’s postural control system is not in balance and they are not able to stay put in a stationary position at a desk.
    • A child may not have the ability to sit still because some reflexes from early development haven’t yet been integrated.
    • Being distracted by things that are happening in the environment
      • Human beings normally process information from all of our sensory systems at any given moment with the same split-second timing. However, not all kids are transporting every avenue of sensory information at the same rate and speed. Being in a classroom environment can be quite overwhelming for them, despite their cognitive intelligence being able to understand the material.
      • The visual pathway and the auditory pathway in the brain both need to process information at the same time and speed for adequate working memory, which is how kids learn. If this doesn’t happen, the information reaches the prefrontal cortex at different times, like a badly-dubbed movie. The child becomes overwhelmed with new information and starts omitting one sense in favor of another.
      • Both of these above scenarios cause great fatigue in the attention system and makes a child more vulnerable to being distracted.
    • Impulsivity
      • Such as a child who raises their hand whenever they want, simply because they have something to say right then.
    • Capability of having great ideas, yet not able to put them to paper in a thoughtful, organized structure.
      • Executive functions have not developed adequately to support organization, working memory and attention.

The Nature of Attention

  • We’re not born to pay attention. We must develop our attention.
  • Attention isn’t only a chemical process. It’s also a developmental process.
  • Attention is a high-order structure in the brain that a child attains based on their early development.
  • The developmental delay is about the sensory systems not developing at an adequate rate and speed.
  • Attention disorder often goes hand-in-hand with behavior-like impulsivity, when a person simply cannot delay their gratification, but this is also part of a timing disorder.

What can you do about it? Call us to learn more about our unique new program that delivers another unique opportunity for understanding your child.

A Total Approach Attention Deficit and Executive Functioning Program

As occupational therapists we consider the impact of central nervous system development early in life as it relates to occupational function. Our new attention deficit and executive functioning program can help clinically decrease symptoms of attention difficulties, impulsivity, hyperactivity, and inattention while improving executive functioning skills of your child or anyone struggling through these behaviors.

By decreasing symptoms, wellbeing and productivity can be revitalized – which will help to improve academic outcomes, social skills and self-esteem, whether you’re age 5 or age 99.

Unique Comprehensive Program

  • Assessment includes developmental hierarchy, attention measurement, executive functions, including working memory and social function
  • Assessment is tailored to each individual profile
  • Program is designed for individual needs and could include Occupational Therapy (OT), Speech Language Pathology (SLP), DIR®/Floortime™, Sandplay Therapy, and Executive Functioning Coaching
  • Appropriate for people ages 5 to 99
  • Executive Functioning Coaching
    • Certified Executive Functioning Coaching (EFC) available
    • Different options of assessment available to determine best program delivery
    • Offers practical ideas and strategies for home, school, college, and the workplace

There are center-based and virtual options available, so do not delay. Give us a call today at 1-484-840-1529 to discuss your situation.

Technology Addiction

Technology Addiction

By Maude Le Roux, OTR/L, SIPT, RCTC, DIR® Expert Trainer at A Total Approach

Ever since our response to the COVID-19 pandemic began, we’ve been spending much more time using our smartphones, tablets and computers. We rely on our devices as well as social media and digital content as primary ways to stay informed, entertained and connected.

While the use of tech devices immediately replaced in-person meetings and classroom learning, it is likely to continue this way for some time. That’s why we are all at increased risk for technology addiction during the COVID-19 pandemic—especially adolescents, who have already accounted for one-third of internet users before the coronavirus outbreak.

John K. Kriger, MSM, LCADC, CPS, sees a correlation between dependent device use and substance use disorder as defined by the American Psychiatric Association’s fifth edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), especially with regard to the cycle of obtaining, using and recovering from device use.

John educates therapists and parents about tech dependence and the ways to manage it. He’s been studying tech dependence for 12 years, and he has found evidence that both children and parents may develop a tech addiction due to their dependence on devices.

Especially in a physical-distancing household during the COVID-19 pandemic, children and adults could be developing a technology addiction if they:

  • Are increasing their use of devices, which creates a desire for more use.
  • Have a constant need to check email or text messages.
  • Get anxious and irritable without their devices.
  • Lose their sense of time and underestimate how long they’re on their devices.
  • Spend excessive amounts of money on their devices.
  • Are limiting their social and personal interactions because of their devices.
  • Stop taking care of themselves because of their devices.
  • Fail to fulfill major obligations like work and homework because of device use.
  • Are critically distracted by their devices in physically hazardous situations like driving, walking.

Technology Addiction: A Mental Illness?

Considered a mental illness by scientists, addiction is defined as a chronic and complex brain disorder characterized by compulsive substance seeking, continued use despite harmful consequences and long-lasting changes in the brain. The National Institute on Drug Abuse (NIDA) “Preventing Drug Use Among Children and Adolescents: A Research-Based Guide” identifies indicators of future substance abuse, including:

  • Social isolation.
  • Poor social skills.
  • Early antisocial behavior.
  • Inability to bond with positive peer groups.
  • Low commitment to school and community.
  • Positive attitude toward substance abuse.
  • Lacking a positive peer group.
  • Having an older sibling who is involved.

All these signs are evident in a person’s behavior when they’re dependent on devices.

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Impact of Tech Addiction on Child Development

The negative impact of technology dependence, abuse or addiction and digital media on child development can be far-reaching. A 2011 study from the American Academy of Pediatrics finds that, after watching just nine minutes of the popular Nickelodeon cartoon “SpongeBob SquarePants,” 4-year-old children tested poorly on executive function activities that challenged abstract thinking, short-term memory, impulse control and the ability to delay gratification.

Researchers believe the overstimulated experience of watching hyper-fast-paced, fantastical cartoons like “SpongeBob” can also distract younger children and decrease their attention spans, which can lead to autistic-like behavior, such as:

  • Losing the ability to have healthy interpersonal relationships.
  • Preoccupation with a narrow topic of interest.
  • Repetitive body movements like rocking or flapping hands.
  • Upset over changes in their routine or environment.
  • Obsessive attachment to devices or unusual objects like light switches or rubber bands.
  • Clumsiness, atypical posture or odd ways of moving.
  • Hyper- or hypo-reactivity to sensory input.

Science Is Studying Screen Time

In 2018, the National Institutes of Health embarked on a 10-year study of children’s brains to see if and how time on phones, tablets and other screens impacts young brain development. It’s called the Adolescent Brain Cognitive Development Project at the National Institute on Drug Abuse and is directed by Dr. Gaya Dowling.

Two years into the study, the data from MRI brain scans of 9- and 10-year-old kids is showing “significant differences” in the brains of those who use smartphones, tablets and video games more than seven hours a day, such as premature thinning of the cortex, typically related to malnutrition.

The researchers are also finding that kids who spend more than two hours a day on screens of any kind are making lower scores on thinking and language tests.

The results of this groundbreaking study will be complete after 2028—and will likely incorporate the influence of tech dependency in the time of COVID-19.

To learn with depth, focused attention is required to increase the brain’s capacity to process information. A Better Communications Research Programme (BCRP) study suggests a recent increase of 70 percent in children’s speech delays in the U.K. is due to tech devices, indicating that too much time on devices is affecting children’s speech and language skills.

In 2019, Rutgers-New Brunswick conducted the first classroom study that finds cell phone distraction in the classroom can lead to lower grades. When students are allowed to use their devices for non-academic purposes during classroom lectures, they perform worse in end-of-term exams.

Other studies show students can’t resist multitasking when a device is near, and it’s impairing their memory. Continual distraction impairs the ability to focus and learn, which leads to “partial focused attention.”

The underdeveloped adolescent brain lacks restraint and self-control. Parents need to help their children learn moderation when it comes to the use of tech devices.

Screen Time Guidelines

In 2016, the American Academy of Pediatrics (AAP) announced the most recent recommendations for digital media immersion to help families maintain “a healthy media diet.” The guidelines include creating a personalized Family Media Use Plan and these key recommendations:

Children 18 to 24 months: No digital media use except video chatting. When their children are old enough, parents should introduce digital media with high-quality programming and watch it with their children.

Children ages 2 to 5 years: Limit screen time to one hour per day of high-quality programs, and watch it with the children.

Children ages 6 and older: Place consistent limits on screen time and types of media and “make sure media does not take the place of adequate sleep, physical activity and other behaviors essential to health.”

Designate media-free times together, such as during dinner or while driving, and media-free locations in the home, such as bedrooms.

Have ongoing communication about online citizenship and safety, including treating others with respect online and offline.

Strategies to Offset Tech Addiction

  • Parents’ behavior should model what they want from their children’s behavior.
  • Parents should retain total access to all mobile phones, tablets and computers in the home and monitor device use of anyone less than 18 years of age.
  • For special-needs children, limit handheld games to “rewards” of no more than 15 to 20 minutes.
  • Log scheduled time on apps, checking and responding to email and texting.
  • When reducing tech use, offer opportunities for increased interpersonal interaction and engage in reading, board games and other non-electronic activities.
  • Consider introducing your children to meditation, prayer or other periods of introspection.

Three Ideas for Practical Application

When your kids are likely going to be in front of the computer multiple hours during the day for school—and they’ll still want to use screen time for fun—here are a few ideas for parents to incorporate during COVID-19:

  1. Have your child take sensory breaks.
  2. Keep ice water next to your child.
  3. Rather than always being seated directly in front of the computer, have your child view the screen from different positions such as standing or on laying on the floor.

It is a well known observation that children struggling with a developmental delay and / or corresponding diagnosis, tend to find technology to be a strong outlet for their superior cognitive skills, making them more prone to tech addiction, leading to a decrease in much needed social and problem-solving exposure. 

Call us now at 484-840-1529 for a free initial phone consultation.