Spring 2018 Newsletter

What you will find in our Spring Newsletter:

– Anxiety: A little is OK. Too much can be debilitating and even neurotoxic!
– Watchful Waiting Or Acting: If something is going on with your child, don’t just sit there and hope it gets better! 
– Commonly asked questions surrounding the School Neuropsychological Evaluation process.
– How We Learn: What can go Wrong? What can be done to maximize learning efficiency?
– What’s all this talk amongst OTs and Developmental Optometrists about “Primitive Reflex Therapy?”
– Summer Just Around The Corner Grow your brain while you are having fun!

Anxiety – A little is OK. Too much can be debilitating and even neurotoxic!

Worry, fear, frustration, anger, avoidance, somatic illnesses, resentment, embarrassment, and pretty much all emotions (with the exception of love) are driven by the activation of a portion of the brain called the amygdala, which is within the limbic system. This system serves primitive needs and is responsible for four basic drives: fighting, flighting, feeding, and reproduction to sustain one’s personal gene pool (propagating one’s own genes).
       A small degree of anxiety is actually normal. Each morning we get up because we worry we need to earn a paycheck, take care of our families, protect and care for our property, and set plans up for the future. At times, we can become frustrated, angry, resentful, jealous, etc., which serves many purposes to motivate us to make changes.
      However, when we make “dinosaur problems” out of “mouse problems” in our minds, this manifests itself as clinical anxiety.When the arousal of the limbic system is such that it leaves us unable to eat and/or limits our access to a normal productive happy life, that is considered clinical anxiety.Many times, untreated anxiety can lead to obsessive-compulsive tendencies and even depression.
       When anxiety is based on “unrealistic fears,” this is true clinical anxiety.However, when one is placed in a situation where their ability to navigate that environment is lacking (e.g., such as students with specific learning style differences that make them stand out from their peers),this is not clinical anxiety, but a poor fit between the child’s repertoire of abilities and the demands being placed on them from moment-to-moment.When this happens, all the therapy, psychotropic medications, and parenting strategies in the world will be of little value.
       When limbic system dysregulation (chronic anxiety) is present, a cascade of chemical events ensues. These events lead to changes in neurotransmitter and hormone levels that can blur clear reasoning by shutting down the frontal cortex, so as to allow lower-level, primitive brain regions to be in command. This canthe production of brain-derived neurotrophic factor, which is necessary for healthy hippocampal functioning. The hippocampus is the core brain region involved in working memory and new learning.

  I would also like to invite any of you that are interested in learning more about anxiety to consider attending a local presentation of the new documentary, Angst, sponsored by Fusion Academy at the Boca Raton Museum of Art on April 25th at 6pm. I will be a guest participant on the panel selected to discuss concerns and insights taken from this presentation.
      For more information on the neuroscience behind anxiety, please see the following link:  https://adrenalfatiguesolution.com/hpa-axis/?utm_expid=78249309-22.8ZE_1nPdQ8CLi3GYYm5qkg.0&utm_referrer=https%3A%2F%2Fwww.google.com%2F

Watchful Waiting or Acting – If something is going on with your child, don’t just sit there and hope it gets better! 

Commonly asked questions surrounding the School Neuropsychological Evaluation process

      As I mature and move gracefully into my golden years,I have become much more proactive than reactive in assessing possible threats related to the safety of my loved ones and my own personal future.At times, I find myself in our original home office in Weston, Florida, and I cannot help but overhear the phone conversations that ensue between our intake specialist, Sandy Cirulnick, and parents seeking information about the testing process.I hear Sandy’s attempts to answer questions that can frequently be clustered into five themes.Utilizing her 15 years of experience as an intake specialist and her own personal situations, she does her best to answer questions in great detail. In order to create a tool to answer these common questions more specifically and personally, I developed a series of videos that address the following topics: How Long Will It Take to Get My Child Evaluated?
Insurance, Reimbursement, and Costs
What Exactly is Assessed in an Evaluation?
What Happens After the Evaluation?
What Tests Will be Used?

Click on the video or any of the above links to be taken to our video library.

How We Learn – What can go Wrong? What can be done to maximize learning efficiency?

How We Learn New Things – A Conceptual Model 

 Click here for in-depth information on the “how we learn new things” model. 

1. Something gets our attention 

a. We orient toward a stimulus

b. Stimulus quality drives affinity to stay focused

c. What could go wrong?

i.     Must have relevance to the learner

ii.     Must not be too easy so it creates interest

iii.    Must not be too difficult to understand

iv.    Must not be competing with other stimuli that may be of greater interest

v.     Must have the cognitive processing sophistication to manage the              incoming information effectively

2. Central Executor is awakened 

a. One’s awareness becomes engaged with the stimulus (new information). Frontal brain regions enlisted to increase attention and “we become aware” (working memory is activated)

b. We start to accumulate/package new information into bundles for analysis

c. Consciousness is aroused, and old memories related to the new situation are summoned from long term memory

d. What could go wrong?

 i.     Short term memory/working memory limitations (i.e., cannot hold enough of the necessary information in awareness)

ii.     One may need more time than average peers to process information

iii.     Weaknesses in sensory systems may impede listening skills, writing skills, auditory processing skills, language skills, etc. to manage incoming information

iv.     Weaknesses in attentional vigilance, a low threshold for becoming distracted, or difficulties with attentional shift may impede this stage

v.     Weaknesses in “inhibitory control.” Top down processing may result in not recognizing what the stimulus is not, which results in careless, impulsive decisions

3. Old Memories are surveyed and compared to the new situation (Long Term Memories) 

a. The more old knowledge related to the new situation at hand, the easier the understanding and learning

b. Cognitive systems (processing abilities) necessary to manage the load and sensory information must efficiently continue to manage incoming information and begin to integrate new stuff with old stuff

c. Information being presented for learning has some intrinsic value to the learner (they care) or maintaining attention will be easily compromised as ones shifts to something with more intrinsic reinforcement value

d. What could go wrong?

i.     No adequate prerequisite knowledge

ii.     Old information is not easily accessible

iii.     Limited space in working memory

iv.     Difficulty establishing relationships or seeing consistencies/links between new information and old information 

4. Subtypes of Long Term Memory

a. Declarative

i.    Episodic – refers to memories and experiences from real life; events often referred to as autobiographic memories

ii.     Semantic -refers to how much you know about new learning situations (fact-based)

b. Procedural – These are memories you are not aware of that have become so ingrained that you do not even have to think about them (e.g., the ability to chew, drive a car, ride a bike, throw a ball, use tools, remember math procedures, spell words, write without thinking of how to form the letters, read fluently without thinking about the words, etc.)

5. Association and Insight (the “ah ha” phase)

a. What is actually going on here and how can I load this information into what I already know about this topic?

b. Can one see novel ways to use this information to problem solve and add to their personal reservoir of knowledge?

c. What could go wrong?

i.     Difficulty with cognitive processing requirements to see relationships between seemingly unrelated variables

ii.     Difficulty holding enough information in immediate awareness (consciousness) to be available for inductive and deductive reasoning

iii.     Lack of prerequisite knowledge (general knowledge) 

6. Short Term Storage

a. New information being positioned for long term consolidation

b. This is where newly learned information is stored for moments or days, not forever.

c. What could go wrong?

i.     We don’t have enough prerequisite knowledge to make sense of what we are trying to learn

ii.     We don’t have the cognitive processes (typically nonverbal reasoning abilities) to see abstract, implied relationships between variables

iii.     We lack the mental imagery abilities to see and understand concepts and how they relate to other concepts and old knowledge

7. Long Term Memory Consolidation

a. Information stored in temporary storage is sorted and moved to discrete locations in the cortex for later use. What is irrelevant or deemed unimportant is discarded. There is change in neuronal patterns (rewiring of neuronal pathways) to reflect new learning. This process is termed long term potentiation. Neuronal cells are reorganized to understand and integrate new information into existing circuitry (new memories are laid down)

b. This process occurs primarily at specific stages and phases in the healthy sleep cycle

c. Sleep spindles – longitudinal neurons that project long distances compare what is being learned to other distance concepts; searching for overlap

d. Once understood and deemed worthy of remembering (subconscious process) these memories should be available for future use

e. What could go wrong?

i.     Limited ability to conceptualize, compare, and contrast new information to existing knowledge

ii.     Limited short term/working memory abilities; not much available to move to LTM

iii.     Difficulty quickly retrieving information from LTM

iv.     Poor sleep hygiene – not enough time sleeping, not cycling through sleep phases appropriately, etc.

v.     Too much anxiety present – cortisol levels are too high, and this inhibits learning 

8. A new basis of knowledge is now available for future learning

a. The cycle repeats itself with a stronger foundation to load new memories

Memory, Learning, and Early Exposure

If one can grasp the key components of the “How We Learn New Things” model described above, they will recognize that the key concepts to learning are as follows:

1. Having adequate levels of attentional skills to stay engaged with what is being presented to be learned:

a. Recommendations for improving attention
i.     Teaching children to “attend” for longer and longer blocks of time to neutral stimuli or slightly non-desirable stimuli (boring stuff) can be incorporated into parenting styles

ii.     Games that require sustained attention can be incorporated into play time

iii.     Clinical applications through “computer exercises” are available to assist with increasing/improving attentional vigilance and attentional shift 

2. Having strong working memory abilities (so as to have information adequately stored in short term storage for later consolidation):

a. Recommendations for improving working memory
i.     Cogmed Working Memory Training (www.cogmed.com)

ii.     Games that encourage short term memory and working memory demands: Battle Ship, Card Games, Simon Says.

iii.     Milton Dehn’s book, Working Memory and Academic Learning (https://www.amazon.com/Working-Memory-Academic-Learning-Intervention/dp/047014419X)iv.     David Newman’s book, Working Memory Activities: A workbook to develop memory skills (https://www.amazon.com/Working-Memory-Activities-David-Newman/dp/1492912689)

3. Long Term Memory Sophistication:

a. Recommendations for improving declarative and procedural memory
i.     Talk to your children a lot

ii.    Take your children to lots of places (e.g., zoos, parks, nature trips, vacations, historical sites, etc.)

iii.    Play games encouraging science, math, geography, and history

iv.    Play games that encourage vocabulary skills development

v.     Introduce your children to harder words whenever possible – don’t wait for school to do it

4. Having adequate cognitive processing abilities in order to learn:

a. For some children, the processing abilities to manage the sensory input, recognize relationships between seemingly unrelated variables, store memories, retrieve memories, process sound, generate written language, listen, etc. are compromised due to break downs in other cognitive systems

b. If things are not going well, DON’T WATCH AND WAIT! If you have the time and resources, seek out a sophisticated school neuropsychological evaluation

c. The more comprehensive the evaluation, the more clarity that can be shed on what is impeding new learning. All evaluations are not the same!

5. Developing good Executive Function Skills:

a. Do not provide immediate gratification (see this video for a replication of Stanford University’s “Marshmallow Experiment”: https://www.youtube.com/watch?v=Yo4WF3cSd9Q)  

b. Seek out Executive Function Coaching

c. Seek out a free Executive Function screening through the use of rating scale forms at Child Provider Specialists (contact Sandy at 954-577-3396)

6. Having good sleep hygiene: 

 a. Sleep hygiene is now being seen as the third wave in healthy living. Exercise and diet have been much more in the spotlight over the last 20 years. Sleep hygiene is the newest frontier. Proper or improper sleep patterns contribute enormously to memory consolidation, seeing abstract relationships, problem solving, and brain chemistry (restorative process). It is not a coincidence that the phrase “I’ll sleep on it” has emerged in our cultural vernacularb.    Check out Matthew Walker’s latest book, Why We Sleep (https://www.amazon.com/Why-We-Sleep-Unlocking-Dreams/dp/1501144316

General Knowledge and Long Term Memory

I recall a trip to Europe when I chatted with a cab driver about global politics, a waiter about global warming, a hotel concierge about the state of the middle east, etc. It boggled me how much the general population knows about politics, science and government affairs in other parts of the world. However, back here in the US, I see many high school students who cannot even tell me what Martin Luther King, Jr. was known for, what the capital of Italy is, where the first Olympic games were, etc.

      An area where parents and teachers can clearly impact children’s learning in the US is the reservoir of information available in their long term memory. Long term memory serves as a platform for new learning and is critical to both attending to and understanding newly presented information.

       An important component of being a thinking member of society and a successful student is the reservoir of culturally relevant general knowledge one possesses. Although no big fuss is typically made about this aspect of intelligence, which almost all IQ measures do in fact assess (general knowledge), this reservoir of knowledge is critical to learning and rising to higher levels of thinking (being knowledgeable and wise). It is not so much that you know more “stuff,” it is that you can see more relationships, patterns, and variations in themes when presented with challenges. While a great deal of resources are channeled into education to teach children to read and spell words, the same is not true for developing their reservoir of general knowledge.  

Please click here to continue reading.

What’s all this talk amongst OTs and Developmental Optometrists about “Primitive Reflex Therapy?”

Primitive reflexes are the first building blocks/foundations for one’s eventual ability to navigate space and conquer gravity, as well as to launch smooth/precise motor responses to visual, auditory, olfactory, and tactile stimulation.

      When primitive reflexes do not extinguish as an individual moves more toward what is termed “postural reflexes,” this can interfere with many aspects of life such as the following: body schema (knowing where one’s body ends and the world starts), pairing motor movements with sensory stimuli, self-regulating attention and emotions, developing higher-level coordination (fine and gross motor skills), developing appropriate nonverbal mannerisms to be consistent with the situation (using hand and body gestures to supplement language), running or walking with smoothness and traditional posturing, all aspects of handwriting, processing speed, bilateral integration, oculomotor tracking and convergence, and other higher cortical functions.

      When primitive reflexes become integrated, a strong foundation for more sophisticated, normal postural reflex development will be possible. As primitive reflexes slowly extinguish, what’s left will merge with postural reflexes as a child transitions in development. Postural reflexes are automatic movements that control the body position/awareness (schema), of an infant, toddler and preschooler, as they become upright, move, and learn to negotiate with gravity. These reflexes maintain posture, balance, fluidity for movement, and bilateral integration. What are the primitive reflexes that should get out of the way of developing postural reflexes?

Moro Reflex

The Moro Reflex is often called the Startle Reflex. That is because it usually occurs when the baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out his or her arms and legs, cries, and then pulls the arms and legs back in. A baby’s own cry can startle him or her and trigger this reflex. This reflex lasts until the baby is about 2 months old. 

Rooting Reflex

The Rooting Reflex begins when the corner of the baby’s mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and “root” in the direction of the stroking. This helps the baby find the breast or bottle to begin feeding. This reflex lasts about 4 months.

 Please click here to continue reading.

Summer Just Around the Corner – Grow your brain while you are having fun!

This year, we will be celebrating our 10th anniversary hosting the Brainforest Adventure Summer Camp. Our program integrates state-of-the-art technology remediation techniques with small group instruction, provided by highly trained speech-language and educational therapists. Strategies are employed to enhance the development of the sensorimotor system, social skills, and areas of weakness in learning. These techniques are integrated with traditional camp activities (science, arts and crafts, recreational activities, field trips, etc.). 
Please see the attached brochure for more information on this exciting summer option or call Karen directly at 954-577-3396.

TED Talk Nomination

      Please help us out! We are nominating Dr. Rizzo (a.k.a. Coach Mike) to share his presentations with a greater audience. Coach Mike travels around the country giving presentations to universities, schools, and conventions. He has spent his life helping others and is asking for a chance to help more children on a broader scale. Here is the link to fill out a nomination form. It shouldn’t take more than a minute, but you are free to accept or refuse! Thank you in advance.  

Click here:  https://www.ted.com/participate/nominate

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