Sunday, September 27, 2015

Preschoolers with Down Syndrome Do Not Yet Show The Learning and Memory Impairments Seen In Adults With Down Syndrome.






"Essentially when matched mental age, preschoolers with Down syndrome performed equivalently with controls."

Read that to yourself again.

"Essentially when matched mental age, preschoolers with Down syndrome performed equivalently with controls."

Those are some of the most beautiful words that I have heard since my daughter has been born.  Before I begin and before you get the wrong idea I need to make this statement.  Emmalin is amazing, I love her and everything about her.  If someone offered me a pill to take away her 3rd chromosome I would not accept it.  I would never gamble with changing the core of who Emma is.

There has been study after study supporting TNI (targeted nutritional therapy) and our kids.  I have seen the data with my own eyes on lab test after lab test with Emmalin.  There are many of our kids that are on thyroid support because their numbers reflect that their thyroid is not working properly.  Unfortunately, most of our physicians do not look past 2 or 3 thyroid numbers.  We look at as much of Emma's overall body as possible.

I was at first hesitant to share this but I really want people to get a clear picture of what we are truly dealing with.  Just by adding 2 new supplements and adjusting some others you can clearly see an impact in her neurotransmitters alone.

Emma's lab spreadsheet


Now we are still working on a lot of different areas with Emma and her bodies needs will continue to change as she grows.  With Emma we are dealing with more that T21.  We are also dealing with hypothyroid, homozygous MTHFR gene mutation and a heart defect that did not get repaired for 3.5 months.

Over the next year we are traveling down some new roads.  As long at the research continues to support the decisions that we make and it is of no harm, we will press forward.






 2015 May;18(3):404-19. doi: 10.1111/desc.12225. Epub 2014 Oct 5.

Preschoolers with Down syndrome do not yet show the learning and memory impairments seen in adults with Down syndrome.

Abstract

Individuals with Down syndrome (DS) exhibit a behavioral phenotype of specific strengths and weaknesses, in addition to a generalized cognitive delay. In particular, adults with DS exhibit specific deficits in learning and memory processes that depend on the hippocampus, and there is some suggestion of impairments on executive function tasks that depend on the prefrontal cortex. While these functions have been investigated in adults with DS, it is largely unclear how these processes develop in young children with DS. Here we tested preschoolers with DS and typically developing children, age-matched on either receptive language or non-verbal scores as a proxy for mental age (MA), on a battery of eye-tracking and behavioral measures that have been shown to depend on the hippocampus or the prefrontal cortex. Preschoolers with DS performed equivalently to MA-matched controls, suggesting that the disability-specific memory deficits documented in adults with DS, in addition to a cognitive delay, are not yet evident in preschoolers with DS, and likely emerge progressively with age. Our results reinforce the idea that early childhood may be a critical time frame for targeted early intervention. A video abstract of this article can be viewed at https://www.youtube.com/watch?v=r6GUA6my22Q&list=UU3FIcom6UpITHZOIEa8Onnw.
© 2014 John Wiley & Sons Ltd.



There are many children exceeding the expectations set upon them early in life....all of our children can.
  




  

Thursday, September 17, 2015

Auditory Processing: what, when, how

Auditory processing is a large part of our lives.  It is extremely important. Bob Doman with the National Association of Child Development (NACD) describes it best as:

Over the years we have discovered that sequential processing, which is the brain's ability to process pieces of visual or auditory information in a sequence, normally develops in a predictable pattern as a child grows.  As sequential processing develops so does the complexity of thought. A child's ability to think determines their ability to understand, learn and act.  If anything interferes in the development of sequential processing, the child's ability to understand, learn and act will be affected in a number of ways.
The first seven to nine years of life provide the best window of opportunity to learn about the significance of sequential processing because sequential processing - particularly auditory sequential processing - has a lot to do with determining your child’s overall (or "global") level of maturity as well as their ability to pay attention and learn.  When a child comes to us with a label of learning delays, behavior problems, trouble concentrating, or just being immature for their age, the child will almost always be found to display lower than normal sequential processing abilities.  As we correct the delay in sequential processing by teaching the brain to process more pieces of information, we find many learning, behavior and attention deficit problems resolve without further intervention.

Sequential processing usually develops at the rate of one piece of information per year up until about seven to nine years of age. At that point, it tends to stop increasing without specific intervention.   In young children, we can determine their processing level by looking at how many directions they can follow in a sequence.  For example, a child who is between one and two should be able to follow a simple direction like, “touch your nose”, which amounts to processing one piece of information. With a child between ages two and three, you should be able to open a book and ask them, “Where is the horse and the dog?’ (two pieces of information).  When they are three years old, they should be able to repeat three things in a series, such as “yellow, green, and red” (three pieces of information). As the child grows, their sequential processing should continue to advance by one piece of information per year, so that by age seven they are able to process at least seven pieces of visual or auditory information in a sequence. 

Many of the typical challenges parents face in dealing with their little ones relate directly to the child's level of sequential processing.  Up until two years old, or the point at which the child can process two pieces of information, they are very easy to get along with.  Give them something to play with and they are happy; take it away and they will probably still be smiling because they will just redirect their attention from the object to you, processing one thing at a time.  When they hit two, things get interesting because the thought process becomes “I want” or “Don’t want,” and that is the end of the thought because they can't think beyond two pieces of information at one time.  Functionally this produces the “Terrible Twos” in which the child tantrums because they inevitably want something or don’t want something and cannot process a “but” or a “later.”  When the child reaches three years old, you can begin to reason with them because they can process a third piece of information - including that important word “later.”
But children at a processing level of  three are still rather challenging because they hit what we refer to as the “Lock and Block” stage.  At the “Lock and Block” stage, the child can process the concept of  “later” but cannot process well enough to think their way out of a situation they perceive as threatening in any way.  If they perceive something as fun or okay, they are all smiles.  But when faced with new situations, new people, or if you simply ask them to do something without using your friendly little kid voice, they may give you trouble.  And once they have locked and blocked, forget it!  But often, if you wait a few minutes and come back to them with the same request, they will be fine and comply without any difficulty. It all depends on their perception of threat. Around four years old, the brain is able to begin processing four pieces of information, and the child moves out of the Lock and Block stage and into a whole new set of behaviors that keep parents on their toes.  And so the process goes year by year.

Dealing with little ones can be challenging, but the real challenges come when your seven or eight-year-old processes like a four or five-year-old and you start hearing things like, “Johnny is distractible,” or “Johnny isn’t following directions,” or, perhaps, "We should test Johnny for ADD.”  The root of many developmental problems - from language delays to behavior and learning issues - lies in the fact that their sequential processing has not developed properly. The good news is that sequential processing can be increased fairly easily with the proper intervention.
 

You can learn more about auditory processing on youtube here:
You can learn more about NACD here:  


The purpose of this post is to encourage and give parents of younger children new ideas for accomplishing processing and to keep it interesting.  Remember "high frequency and low duration" as our neurodevelopmentalist Lyn Waldeck always says.  She also cleverly recommended putting small bracelets on one arm (correlating with how many processing sessions you need to do that day) and either remove them or switch them to the other arm as you complete each session.   You can fit them in throughout your day when going to the bathroom/changing diaper, stopped at a stop light, putting child in car seat, during bath time with bath toys, or before meals.  You can also a set timer for every 30 to an hour until you get your recommended sessions in.   I made this using old paracord (from my Army days), placed beads on it, and attached it to my purse. You can find both in the craft section of most stores. I move one down each time we do a quick processing session.  It also serves as a reminder when we are on the go. 



I made a cheat sheet with the following ideas, so when it is time to do auditory processing, I just glance at my sheet.  It takes some of the thinking out for me, and ensures I do not repeat one too soon.  These are geared for my 4 year old daughter (DS), but you can adjust accordingly for your child's age and interest.   You could also put each idea on a note card and use a different one each time or take them on the go. I say the number of items that correlates with her processing level, such as "cat, dog, duck" for processing a 3. NACD also has an app called Cognitive coach (link here) for younger children and a computer based program Simply Smarter (link) for older children. No, I am not a NACD rep, but we have used them since my daughter was 6 months old and love the program.

Processing Reference Sheet

1.  Follow commands:

            clap, high five, take a bow, stomp, turn around, jump, arms up, dance, peek a boo, open mouth, close eyes, hug, sit down, wave,  kick your legs, blow kiss, stand up, laugh, point, shake head, shrug shoulders, tap your head,        brush hair, wipe mouth, show teeth, play drum, lift arm,         make funny face, lift leg, puff cheeks, open box, close door

 2.  Repeat words:

            - Colors: red, yellow, blue, white, orange, pink, purple, green, brown, black
            - Numbers
            - Family/friend names:  Mom, Dad, Payton, Mark, Emma, Olivia, Vann, Claire, Michael, Izzy, Blakely
            - Pet names
            - Characters: 
                        * Minnie, mickey, daisy, goofy, pluto, pete, clarabell, donald
                        * Strawberry, Lemon, Plum, Blueberry, Orange, Cherry Jam, Pupcake, Custard
                        * Barney, Bop, BJ, Rip
                        * Cinderella, Rapunzel, Aurora, Tiana, Snow White, Poncahontas
                        * Rainbow dash, pinkie pie, applejack,
            - Animals: 
                        * Pets:     dog, cat, bird, lizard, fish
                        * Farm:    cow, pig, horse, sheep, goat, duck, chicken
                        * Zoo:      elephant, zebra, lion, tiger, bear, monkey, gorilla, giraffe, leopard, rhino
                        * Wild:     wolf, owl, coyote, squirrel, opossum, alligator, snake, turtle, raccoon
                        * Sea Animals: whale, dolphin, fish, manatee, shark, seahorse                       
            - Fruits & veg: apple, orange, banana, kiwi, grapes, blueberry, carrot, broccoli, avocado, lemon, kale
            - Random:  yes, no, maybe, east, west, north, south, up, down, around, on, off, over, under

 
3. Touch body parts:

            Head, shoulders, nose, ears, knees, toes, foot, belly button, teeth, tummy, leg, mouth, eyebrow, hair, head, arm,                hand, finger, cheek, elbow, back
 

4. Treasure Hunt:

Pick items from processing box.  Cover them before asking.  You can turn over cards with colors or shapes.  You can also put small items under separate cups or a lid.  See below for pictures of what is in my "processing box".

5.  Touch objects:

            Couch, piano, refrigerator, floor, window, door, toys, books, rug, foam alphabet letters on floor

 
6. Follow directions:

            Run like a deer, leap like a frog, hop like a bunny, crawl like a snake, roar like a lion, swing like a monkey, waddle like a duck, jump like a kangaroo, gallop like a horse, walk like an elephant

 
7.  Go get 3 items:

            Book, doll, Minnie, toy, blanket, spoon, fork, paper, pencil, crayon, drink, pajamas, towel

 
8.  Show me emotions:

            happy, sad, mad, sleepy, surprised

 9.  Pretend to be a:
            Airplane, train, elephant, duck, pig, gorilla, cat, monkey, wolf, owl, chicken, alligator, dog                             

 
10.  Play with a doll:  feed the baby, wipe her nose, change diaper, tickle her belly, put sock on, brush hair, give bath, make her turn around and hop

 
11.   Reading books:  tell her to touch certain items on the page

 
12.  Changing it up: Magnets on refrigerator. place word or picture cards in pocket charts/Velcro/magnet boards. Family/friend picture cards that you turn over as they tell you who it is.  You can take paint samples from a hardware store and tape to index cards and do the same.  Tricia puts a small piece of chocolate on each card that her daughter gets to eat when she tells her the right name.  Place small items under a cup.  You can send items down a treadmill or slide.  For older children, you could have them help fix a sandwich after telling them "bread, cheese, meat, bread". 


My processing box:
$1 wooden figures from Hobby Lobby

 
                 
  Small Strawberry Shortcake dolls

 
Craft sticks with Velcro and blocks that fit under small cups
Minnie and her friends, one of her favorites.
The colorful tops off of applesauce pouches.

Random assortment she finds interesting.

Paint samples taped to index cards so back is blank.

Some of the processing cards I carry in my purse.



Here are some example videos of processing:
(may not play on iphone)

video
 

 

  video
  video
 
Here is Blakely.  Her mom used family photos with
magnets on the back and a baking pan.  How creative!
video


 
Please post your ideas, so that we can all learn. 
Many blessings,
Robin