Integrated Learning Therapy (ILT)

For Parents and Teachers
How can you help a child to develop intelligence?
Written by Dr Shirley K***t

With thanks to Jane Healy

Are you tempted to use flash cards to teach your toddler to read? Are you considering buying computer programmes said to boost intelligence?

We are all hopeful that our children will succeed at school but to help them, we need to know how the brain develops and what kinds of learning will promote optimal development. Packaged programmes are not always the key to intelligence.

Making connections in the early years

Good brain function depends on a well-organised neural network, meaning that the brain cells have made zillions of connections and circuits are organized so that all areas of the brain function rapidly and smoothly. How does this happen?

In the first months of life, the child is in the so-called ‘sensorimotor’ period. His brain is learning to take in bits of information from the senses and practicing to respond with bodily movements. At this stage, the brain isn’t able to deal with much beyond physical experiences happening at a particular moment. He can’t combine information coming in from more than one sense. For example, he can hear a motor car and see the car but won’t be able to relate sight to sound. Only later will the sound of Mom’s car outside result in a mental picture of the car and the knowledge that it is bringing mother home.

As they grow more neural connections, toddlers begin to see the world in new ways. The development of language and symbolic play represent the beginning of abstract through. A child talking to Grandma on a toy telephone shows that she has a mental representation of both Grandma (out of sight) and the function of a telephone. It is generally believed that the roots of creativity also lie at this meeting of concrete and symbolic experience giving rise to ‘pretend’ play. Children who are good at pretending and ‘making up’ also seem to get along better socially.

Until sometime around age six or seven, children are ‘stimulus bound’. This means that her attention is easily drawn to any new stimulus and she appears to be easily distractible (useful when you are trying to distract her from a distressing event). Preschoolers are caught in the present, with only a vague concept of past, present and future. They have trouble with other people’s point of view; they can’t attend to any one task or idea for more than a few seconds.

Learning to grow beyond this needs firsthand experience and interest. Helping early intelligence to needs understanding the value of supplying a varying and interesting environment. Novelty and opportunity to experience new situations and settings provide the means of learning to pattern information.

The key to seeing patterns

Children will benefit through lots of self-organising play activities that will allow them to make physical and mental connections. This is more useful for healthy brain development than early tutoring. Because brain areas that function to connect sight, sound, touch and body awareness are still developing, it is difficult for young children to combine processes from more than one modality, such as in looking at a letter and copying it, or being encouraged to simultaneously dance and sing while listening to music.

It is possible to condition babies to associate two stimuli that are presented repeatedly together (e.g. the sight and sound of a letter of the alphabet) but this learning lacks real meaning for the child and she may end up using less efficient parts of the brain to do so. The higher levels of the brain ultimately responsible for these tasks have not yet developed enough. If she develops a ‘habit’ of using lower brain areas for higher-level tasks (such as word recognition or reading) and of receiving instruction (from you) rather than creating patterns of meaning, she may run into big problems later on.

So drilling your child in various learning tasks results in them being good ‘technicians’ in the early grades because they have learned to deal with isolated bits of information. However, when demands for comprehension increase, they become lost. In higher grades, they have difficulty organizing information into more abstract ideas. They simply cannot understand the content they are working with.

During the early years, some commonsense practices bring better results than expensive equipment. Here are a few ideas:

• Help your child figure out meanings and relationships in daily events; her endless ‘Why?’ questions show her need to make connections and her need for more explanation in order to do so.
• Introduce sequencing skills – arrange objects according to size, or remembering words or events in order.
• Talk about abstract sequences such as “If you go outside without your jacket you’ll get very cold because it’s winter”.
• Mental patterns are built on networks of sensory connections. Call the child’s attention to patterns in the sensory world: “What does that taste like?” “Do these look alike?”
• Call attention to visual patterns: “Look at the tree branches against the sky. It looks like the tree has arms. Let’s draw a picture of the tree”.
• Puzzles, blocks, dominoes, kaleidoscopes are all useful materials to help visual patterning.
• Finding something ‘wrong’ or missing in pictures links visual and intellectual skills.
• Encourage auditory patterning with rhymes, tunes, familiar stories, and attention to sounds around the house.
• Using tools (screws, nuts, bolts), measuring, cooking activities and gardening are all examples of activities that encourage perceptual and motor connections.
• Practice motor patterns over and over again: using utensils and tools; cutting; catching; throwing large, soft balls are all good.
• Self-help skills and household jobs are very important for the child to master. Give help when needed but encourage the child to do it himself even if the job isn’t done exactly the way you’d like it.
• Give the child time to organize her own play. Don’t hover or be too attentive. The is one study that showed that too-frequent offerings of food and drink to toddlers was related to later poor school achievement.
• If a child needs help mastering some motor pattern, scaffold the learning by gently guiding his body through the action sequence several times in order to lay down the neural pathway. Dividing the action into a series of smaller activity steps is also useful. Don’t expect young children to be able to copy complex actions that you show him. Allow him to learn with one sense at a time (in the case of a motor behavior, his body).
• Allow the child to make simple decisions. Also allow them to make minor mistakes. This is hard to do but necessary. Children need to have experience with cause and effect. For example, “If I throw my toy down hard on the floor, it will break”.
• Limit screen time. Choose a daycare centre where children don’t watch much – if any – TV or videos. Passively sitting and watching screens may lead to missing out of some of the most basic motor patterning and the attention skills and intellectual growth that goes with it.
• Allow time for reflection and thought. The brain needs downtime to process all the work going into its development.

Integrated Learning Therapy (ILT) strives to uncover the root causes of puzzling behaviours and learning difficulties in children. Visit the website www.ilt.co.za to learn more about this approach and find a practitioner near you to help.

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For Parents and Teachers
How children develop learning readiness
Written by Dr Shirley K***t

At Integrated Learning Therapy (ILT) we understand the importance of children developing learning readiness. If you understand what that means, then it becomes easier to understand your role as a parent to help them become ready for school learning. This is why it is important to know about child development. If a child enters school without being ready to learn, we have to know why. What is missing? What stage of development was missed or became disrupted to cause learning difficulties?

ILT practitioners are virtual detectives in their work with children. We look for clues to tell us what might underlie a child’s neurodevelopmental delays or other brain irregularities causing them problems.

Here are some of the stages that babies go through in a sequence . If a child doesn’t develop in this normal sequence then learning might be more difficult than it should be. It isn’t complete, but should help alert you to what stages are particularly important for later learning.

By 6 months
A child should be able to roll over from back to front and front to back. This movement helps break down the imaginary midline, which exists vertically down the middle of the body. Only when this midline is broken down will the child be able to show coordinated activities.
Babies will be learning through the skin (touch and taste), the muscles and the eyes as they reach, grasp and transfer things from hand to hand. They touch everything and everything possible goes into the mouth because they learn a lot from taste and smell.
Language skills are being laid down by listening, cooing and squealing.

By 12 months
A child should have had plenty of pulling herself along the floor prior to many months of crawling in a coordinated way on hands and knees. This lays the basis for the two sides of the body to become integrated. Crawling also gives the eyes good focusing practice at reading distance. A child of a year old should be able to use his eyes in a coordinated way, to investigate everything with his hands and have learned to release objects. Ears should be giving more accurate messages so that language will have progressed to naming special things and a few other words.

By 18 months
The child should be walking quite well and throwing, kicking and chasing balls. Eyes should work well together. There should be a love of blocks, sand and water and a lot of self-talk.

By 2 years
She should be walking smoothly, running well and jumping. Slides and swings are enjoyed. Visual skills should have improved to the point where things inspected by the eyes are not always touched. Language usage includes short sentences.

By 3 years
He can climb stairs with alternating feet. Eyes follow objects without any accompanying head movement. The eyes are used more than the hands when solving simple puzzles. Language usage has improved to the point where he asks and answers simple questions.

By 4 years
The midline wall should be completely gone. This means that the specialized areas of each brain hemisphere can develop and the hemispheres are able to communicate rapidly, leading to later efficient brain use. Balls can be thrown at targets and he can catch balls. Fine motor has developed to the stage where she can cut and colour between the lines. Self talk continues!

By 5 years
Most children will show hand, eye, ear and foot dominance – which hopefully will be on the same side. This might take until the 7th or 8th year in some children but it is always important to allow the child to decide by herself. Language should show basic, adequate grammar.

By 7 or 8 years
It is important at this age that the child is fully integrated, meaning that both sides and the body and brain work together efficiently. This allows the specialized areas of each hemisphere to be accessed for optimal learning and performance.
The symptoms of inadequate integration are poor concentration, inability to do more than one thing at a time, confusion over left and right and reversals.

This is a rather sketchy list, but these and other milestones are important indicators of healthy brain development.

Many children showing learning difficulties did not crawl correctly or for long enough. Some did not crawl at all. This will have affected coordination, focusing of eyes and the exploration of the space in the world surrounding them. Other children with learning problems regularly display difficulties in one or more of these developmental sequences. Some don’t put things in their mouth during babyhood. This lack of tactile experience means that they don’t learn enough about their own bodies. This means they can’t make sense out of the space around them due to being uncertain of their own bodies’ shape, size and ability to move. This flows over to two-dimension things like placing drawings or writing on a piece of paper. Children may try to do maths with crooked columns, or put numbers and words too far over on one side of the paper. They get mixed up as to which number is in what column when writing figures for number work.

Many children who are not learning ready still move their heads with their eyes when reading. They also cannot cross the midline, meaning that they lose their place in written work because their eyes ‘jump’. The presence of a midline beyond the age of 4 years is a noticeable characteristic of children experiencing school problems.

Lack of good balance and a stable posture are also telling signs of a developmental delay. A child who is unstable will have a risk of strained handwriting.

The good news

It is heartwarming to know that all of these areas can be attended to and corrected. Immature symptoms can be a guide for an informed professional as to what gaps need filling through a careful movement programme. It is especially worth noting that when the earlier sequences are taken care of, higher level functioning often spontaneously improves and might never need attention.

The key is to know whether there are signs of irregular development in your child and find help to intervene as soon as possible. Having an area of immaturity doesn’t mean that the child has some mental disorder. For this reason, ILT avoids labelling a child. Instead, we try to understand the root cause of an observed difficulty. Rather than diagnosing a ‘condition’, we give the brain a second chance by helping to develop areas that are needed to support a child’s learning and expected behaviour.

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For Parents and Teachers
Does your child need a Fiddle Toy?
Written by Dr Shirley K***t

Most of us like to fiddle and find it helps us focus. Some don’t and can keep quite still while attending to important matters. In general lots of children benefit from being allowed to engage in some subtle behaviours when rooted to their school desks and listening to the teacher. Those benefitting most from ‘fiddling’ tend to have problems with concentration. It’s become customary for helping professionals and even teachers to suggest fiddle toys to improve attention span.

But what kinds of fiddling would be most helpful, and following this, what kinds of fiddle toys would be really beneficial?

It’s easy to figure this out with a little knowledge of how the brain is structured and how it functions.

An area of the brain called the sensory cortex receives and processes information coming in through the senses, including hearing. So in order to attend and listen to spoken language, this area needs to be functioning well. A closer look at the sensory cortex (known as the homunculus) will show that the brain pays a great deal of attention to information coming in from the fingertips and hands. It also pays much attention to the lips and mouth. This is shown by the huge area of brain dedicated to processing information from these body parts.

In practical terms, this means that when we engage our hands or mouths, we are stimulating large areas of the sensory cortex – leading to better processing of, amongst other things, auditory information. We are even more efficient in processing information when we combine mouth and hand movements, such as you might see children doing when they continually put their fingers in their mouths.

This tells us that activities engaging the hands will help focus. So fiddle toys are useful.

But what kinds of fiddle toys?

A second fact to know about the brain is that for most efficient functioning, we need to use both sides of the brain. The specialised areas of the right and left brains are needed in order to hear and also understand what we are hearing. This means that a way of fiddling that will help to stimulate both hemispheres and improve rapid communication between the two brains will be most beneficial.

This would involve integrating the two sides of the body. As an example, rolling a pencil between the thumbs and fingers of both hands requires coordination of the hands and so good communication between the two brains. This is an excellent way of fiddling!
Less effective would be to twiddle a pencil in one hand, with the other lying idle. That would not allow for brain integration.

Other examples of excellent ways of fiddling that need the use of two hands working together:
• take a ball of plasticine or prestik or any other material and use both hands (thumb and forefinger) to mould it into a cube
• twist a paper clip or pipe cleaner into a design
• link the forefingers and make first the right finger pull the left finger and then switch. Repeat a few times, then link the remaining fingers in the same way, one at a time and have them each alternatively pull one another.

These activities need next to no financial investment yet can be hugely beneficial to improving focus through brain stimulation. They are also not causing visual or auditory distractions in class, nor causing envy and desire in young children.

From a neurodevelopmental perspective, fiddling is a valuable tool to use for improving brain function. Toys that fail to engage both sides of the body equally might be less effective. As with all therapeutic movements, it is seldom necessary to buy expensive equipment.

Integrated Learning Therapy (ILT) strives to uncover the root causes of puzzling behaviours and learning difficulties in children. Visit the website www.ilt.co.za to learn more about this approach and find a practitioner near you to help.

Remember to Like and Share this post to receive more.

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For Parents and Teachers
Is your child ‘sound safe’?
Written by Dr Shirley K***t

Sound and hearing are vital aspects of being human, learning and functioning optimally in the world. If our ability to hear is hampered, the effects are widespread. A weakened auditory system may result in auditory sequential processing problems. This affects short-term memory – the important ability to link pieces of auditory information. Auditory processing can also lead to difficulties focusing listening – another symptom of auditory dysfunction. These weaknesses negatively affect communication, language learning and attention skills. It seems reasonable, in the light of this, to ensure that your child is ‘sound safe’.

There are two primary forms of hearing and listening impairment . Noise-induced hearing loss (NIHL) occurs when protracted loud sounds damage the inner ear. The delicate cilia hair cells in the inner ear are destroyed and cannot be repaired.

In addition, stress can interfere with the way we absorb sound. This is called Stress-induced auditory dysfunction (SIAD). An expert in auditory impairment claims that “Poor listening can begin at any age and for any number of reasons. “It might result from a health problem, an accident, a major lifestyle disruption or from stress.”

Hearing loss, be it noise or stress induced, with the addition of auditory dysfunction, can result in muddled thinking and out-of-balance emotions. For this reason, we need to become more sound aware. Sound can be healing, comforting and an aid to learning. In the form of noise, it can also disturb us and negatively affect our functioning. We need to help our children take precautions to protect their ears.

The word noise comes from the Latin nausea meaning seasickness. Noise generally refers to any loud, unmusical or disagreeable sound. Your classification of noise will, of course, depend on your subjective opinion. What you call loud and noisy may reflect your audiological health and personal taste. What I call unmusical and disagreeable depends entirely on my taste in music; one person’s noise is another’s delight.

Nevertheless, noise damages ears. Acoustic trauma happens when an extremely loud sound strikes in an instant. One blast from an explosion can rip apart the ears’ inner tissues, leaving scars that cause permanent damage. Noise-induced hearing loss (NIHL) develops more insidiously over a period of time. Repeated or extended exposure to dangerous noise levels attacks the delicate sensory cells in the ear. Their function is to transport airborne vibrations from the inner ear to the brain. Without them, hearing is inefficient. In addition, loud sounds cause constriction of blood vessels in the cochlea, which is the hearing organ in the inner ear. A lack of a proper blood supply may result in damaging changes in the inner ear.

For these reasons, workplaces try to protect workers from hazardous noise levels, but what is being done to protect children?

In human adults, 80 dB is the maximum sound intensity that will not produce hearing loss. Above 85 dB, you run a risk of damage which worsens with length of exposure and higher dB levels.

Here is a table showing the decibel levels of common noises:

Watch ticking – 20 decibels
Whisper – 30 decibels
Average conversation – 40 decibels
Dishwasher, microwave – 60 decibels
City traffic – 70 decibels
Noisy restaurant – 70 decibels
Vacuum cleaner – 80 decibels
Busy city pavement – 80 decibels

Then we move into danger zones:

Lawn mower – 90 decibels
Screaming child – 90 decibels
Power drill or chain saw – 100 decibels
Blow dryer – 100 decibels
Car ho**er – 110 decibels
Noisy video arcade – 110 decibels
Rock concert – 100–130 decibels
Jet engine at 40 metres – 140 decibels
Jackhammer – 180 decibels

While we can cope with a certain amount of noise (if our auditory system is healthy), we should avoid prolonged exposure. The next table shows a 1984 standard of noise-level safety based on decibels and time-exposure levels. It was created for the workplace and the duration per day may be higher than what is truly healthy for your children’s ears.

90 decibels – not more than 8 hours
92 decibels – not more than 6 hours
100 decibels – not more than 2 hours
102 decibels – not more than 1.5 hours
115 decibels – not more than 0.25 or less hours

So how do you teach your children sound safety? You don’t want to be paranoid but neither do you want them to innocently damage their wonderful auditory systems. The result of damage is not always hearing loss; sometimes damage substitutes sounds for others and they are replaced with tinnitus, or ringing or buzzing sounds in the head. Hearing damage is not something to take lightly.

Here are some precautionary measures:

• Limit exposure to sounds over 85 decibels. If you have to be exposed for longer, wear ear protection. Ear plugs must be worn to really noisy events such as rock concerts or firework displays. Earplugs are made of foam, silicone or wax and are designed to reduce noise levels from between 20 to 30 dB. Cotton wool doesn’t effectively diminish excessive sound waves.
• When using headphones, do the following: Keep the volume down. If your child listens with headphones to music with a ten-digit volume wheel set at 4 or higher, hearing loss may result. Limit listening to one hour at a time and let the ears rest. Be very careful if using headphones when exercising.
• Give the ears a rest. Alternate quiet and noisy activities. Don’t go to a noisy party or club after a loud sports event.

Our ears don’t actually bleed after a blast of fireworks or a rock concert. That doesn’t mean that we have incurred self-inflicted damage. Our society is an increasingly noisy one. Sound pollution means that we have to teach our children to be aware of sound and to practice sound safety.

Integrated Learning Therapy (ILT) practitioners take a keen interest in auditory functioning. If you would like to read more about our approach, visit our website www.ilt.co.za. We also have a list of practitioners around this country and others.

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For Parents and Teachers
Understanding an anxious child
Written by Dr Shirley K***t

You may wonder why your child is prone to anxiety. Why she so often resorts to tears, fears and avoidance behaviours. While there are many possible reasons for this, it is sometimes useful to consider the actual development of the brain and how this may contribute to becoming an anxious person.

A principle of brain development that was described by the neurologist John MacLean, demonstrates that the brain develops from the bottom to the top and from inside out. The more primitive systems, being the brainstem, pons and medulla, develop first. This makes sense because they are our survival systems, controlling unconscious functions like heartbeat, breathing and so on. The systems regulating our emotions (the limbic, thalamus, hypothalamus and so on) develop next. Finally, the cortical systems that act as an executive control centre including decision making, problem solving, attending, controlling impulses and more, complete development at about the age of 25 years. These are the ‘smart’ brain systems.

Brain scans and imaging have shown how the primitive brain systems take over higher systems in situations of danger or threat. This is due to the natural need to enhance our survival and explains why when faced with a threatening situation, we cannot think clearly or act rationally. Oxygen supply to higher brain systems is reduced so that more oxygen can be directed to muscles and other body parts required to protect ourselves by fighting or running away. When in imminent danger, we don’t need to stop to problem solve – we need to react instinctively to survive. This summarises the stress responses of fight or flight and is a useful mechanism when really needed.

The downside is that if the stress response is activated too much or too intensely at a very early age (within the first twelve months from birth), the development of neural pathways to the brain’s frontal systems becomes compromised.

The reasons for this are threefold. First, the primitive systems are activated very strongly and stronger wiring in the survival brain systems results in weaker wiring in the higher level ‘smarter’ brain systems. This results in the development of the ‘anxious brain’. Secondly, chemicals are produced that are linked to the primitive brain structures. These chemicals (adrenalin, cortisol and others) are geared towards enhancing primitive survival and inhibit chemicals such as serotonin, which is geared towards smart brain development. Thirdly, ongoing electrical activity (firing between neurons) in the primitive systems strengthen the neural connections so a viscous cycle results – with primitive brain areas being gradually more and more in control with less ability to use the higher level smart brain systems.

This is why a well developing brain needs a safe, enriched environment to develop. Secure, enriched environments downregulate the overactivation of primitive systems that result in an anxious brain developing. If the child’s environment is compromised, it constantly activates threat or risk of not surviving, leading to the protective behaviours that are seen in stress responses. It is simply devastating for healthy neural development. Remember too that it isn’t only an emotionally unsafe environment that can predispose a child to becoming anxious. Physically illnesses also convey a sense of dis-ease and insecurity so even in the most loving and attentive families, a child prone to illnesses may be at risk for developing an anxious brain.

In order to help, what is needed is a bottom-up approach. It doesn’t help to ‘talk’ a child out of being anxious. Remember that the higher brain systems aren’t functioning efficiently. You are not going to want to discuss philosophical matters while a snarling dog is rushing towards you. The child has to be helped to feel safe both physically (including health) and emotionally.

Some of the basic needs that should be met in order to promote development and wellness are:
• The need for control (having our survival needs met, such as being fed when hungry, comforted when distressed) and understanding the situation. The latter refers to a child needing help to appraise a situation and to understand why she feels as she does)
• The need for attachment (closeness of the primary caregiver; trust)
• The need for distress avoidance and pleasure maximization. (We are all motivated towards pleasant experiences and avoid unpleasant or painful ones. This includes physical, psychological, emotional or social states, which we automatically evaluate as either ‘good’ or ‘bad’.) A child needs more ‘good’ experiences than ‘bad’ in order to develop optimally.
• The need for self-esteem enhancement and self-esteem protection. A child needs to evaluate her or his worth as a person as valuable and worthy. Positive feedback from others and unconditional love are important to developing a healthy self-esteem.

Fortunately, we know that the brain is plastic and can be changed. Neural connections can be established or weakened so by contributing to the child’s sense of security, her brain can reorganize the neural networks and begin to shift the firing of primitive systems to those of the higher level systems.

Stress is a major factor in children with learning difficulties, which is why Integrated Learning Therapy (ILT) practitioners address signs of stress in our clients. For more information about ILT, visit our website www.ilt.co.za. We also list practitioners around the country and elsewhere if you are looking for help.

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