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Brain-Based Interventions Toddlers to Adults


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  • 1. Lynne Kenney, can be found at Brain-BasedInterventions forChildren &Adolescents
  • 2. Attributions and #Gratitude  David Nowell, PhD  Lanie Zigler, PhD  Martin Fletcher, PsyD  Raun Melmed, MD  Ron Fischler, MD  Susan Fralick-Ball, PsyD  Laurie Dietzel, PhD
  • 3. What We Will Cover Today  Neuroscience in therapy  Motor-IntelligenceTherapy  The Family Coach in-home intervention methodology  Five step pyramid for brain-based skills interventions  The 18 sensory-motor and social-emotional domains forintervention  Skill-set analysis, development and intervention  Research-based skill development exercises, nutrition andtools for your practice
  • 4. What We Will Learn Today  Domains of Executive Function and their relationship toADHD, SPD,Anxiety and more  How and why to teach new skill sets for better behavior  How to build neuronal pathways with MIT~Move2Think  How to quarterback a case  Behavioral tracking for better self-regulation  Data-based treatment planning  How and why to incorporate movement into your work  How we can play math for better math skills as well as EF  Why food matters and what foods to eat
  • 5. Becoming ABrain-BasedClinician
  • 6. Neuroscience in PsychologyBiologicalTheoryNeuropsychologyOccupationalTherapyCognitivePsychologyPsychotherapyKinesiology
  • 7. Books on Brain Development Brain Facts – Society for Neuroscience  The BrainThat Changes Itself ~ Norman Doidge, MD  TheWomanWho Changed Her Brain ~ Barbara Arrowsmith-Young  Brain School ~ Howard Eaton  TheWhole Brain Child ~ Dan Siegel, MD  HowTo Reach andTeach Children with Challenging Behavior~ Otten &Tuttle  Smart But Scattered ~ Dawson & Guare
  • 8. Neuroscience + Cognitive/Dev Psych + OT + PEMotor DrivesCognitionThinkThinkFeelMoveDoLearnMotor IntelligenceTherapy
  • 9. Where Does The Brain Come Into Play? The brain is ever-changing The brain is use it or lose it The brain is experience neutral Neuronal connections grow based on experience Why experience needs to be multi-modal
  • 10. What is a Brain-Based Intervention? An intervention that engages cognitive or motorparts of the brain One that increases neuronal communication One that builds skill sets One that increases collaborative parenting strategies
  • 11. What does executive dysfunction“look like”  Child completes work but “forgets” to hand it in  Child has difficulty transitioning from one situation ortask to another  Child doesn’t seem to catch “careless” errors  Child needs more external support and reminders thanpeers  Child can’t seem to keep track of directions, possessions,and assignments  Child is very inconsistent in her performanceo  Original source Dr. Laurie Dietzel
  • 12. What is Executive Functioning (EF)? An umbrella term covering related yet distinctskills Refers to cognitive control/self-regulatoryprocesses Can be understood as Cognitive and Limbic
  • 13. McCloskey 23 Self-Regulation ExecutiveFunctionsPerceiveInitiateModulateGaugeFocus/SelectSustainStop/InterruptFlexible/ShiftInhibitHoldManipulateOrganizeForeseeGenerateAssociateBalanceStoreRetrievePaceTimeExecuteMonitorCorrect
  • 14. EF Domains  Attention, focus, distractibility  Cognitive control, shift and flexibility  Memory, input, manipulation, output  Emotional regulation and modulation  Problem solving, decision making  Impulse control and management  Organization, planning, and time management  Motor management planning, pacing, initiation,maintaining, stopping Kenney 2012
  • 15. I. Executive Functions includethe ability to:  Survey and preview  Plan, organize, sequence, initiate and execute tasks  Hold, manipulate and retrieve memory  Shift focus, sustain attention, tolerate and adapt tochanges in expectations  Stop, think, decide, respond
  • 16. II. Executive Functions include theability to: Conduct visual-spatial mental operations Track information and activities in working memory Perceive, read, interpret and respond to socialsituations Regulate and manage emotions Evaluate, plan and manage time Use language to facilitate communication withinrelationships Reason, evaluate choices and make decisions
  • 17. Types of AttentionFocused attention:This is the ability to respond discretely to specificvisual, auditory or tactile stimuli.Sustained attention:This refers to the ability to maintain a consistentbehavioral response during continuous and repetitive activity.Selective attention:This level of attention refers to the capacity tomaintain a behavioral or cognitive set in the face of distracting orcompeting stimuli.Therefore it incorporates the notion of "freedomfrom distractibility"Alternating attention: It refers to the capacity for mental flexibilitythat allows individuals to shift their focus of attention and move betweentasks having different cognitive requirements.Divided attention:This is the highest level of attention and it refers tothe ability to respond simultaneously to multiple tasks or multiple taskdemands. Source: Dr. Fralick-Ball SFBPsychMedEd 2010-2013
  • 18. What skills do we wish to teach? Set, achieve, review andrevise goals Preview, plan, organize,sequence, execute,review, revise Pace, rhythm and timing Observe time-frames &passage of time Hold, manipulate andutilize via memory Initiate, Execute,Complete Inhibit, Resist, Delay Shift, flexibility,tolerance, acceptance Identify, manage andmetabolize emotions
  • 19. Twitter ~ The Research PlaygroundBRAIN DEVELOPMENT  @davidnowell  @drbethkids  @all4mychild  @braininsights  @viviensabel  @drmarty01  @DrEscotet  @TheTeenDoc  @NutritionistJan  @jtbakler
  • 20. Good Books on EF
  • 21. Enhancing Executive Function with skillset developmentWhere we are heading: Improving Neuronal Connections Knowing the difference between askill deficit and willful non-compliance Strategies to build brain connections
  • 22. Your Brain is Like A Placemat Insulted? Don’t be. A placemat is agood thing. Connect the dots.
  • 23. How do Neurons Connect?The electrical signals (nerve impulses) carried by neuronsare passed on to other neurons at junctions called synapses.The signal may be directly transferred at electrical synapsesor, if there is no physical link between adjacent neurons, thesignal is carried across the gap by chemicals calledneurotransmitters. By using neurotransmitters, the nervoussystem can alter the way a message is passed on. Each neuroncommunicates with many others and this contributes to theamazing complexity of the brain.
  • 24. What is The Synapse?  When a nerve impulse reaches the synapse at the end ofa neuron, it cannot pass directly to the next one. Instead,it triggers the neuron to release a chemicalneurotransmitter.The neurotransmitter drifts across thegap between the two neurons. On reaching the otherside, it fits into a tailor-made receptor on the surface ofthe target neuron, like a key in a lock.This dockingprocess converts the chemical signal back into anelectrical nerve impulse.
  • 25. Neurotransmitters  Your brain uses over 50 different neurotransmitterchemicals.Although electrical signaling between neuronsis quicker and more energy efficient, chemical signalingis far more versatile.The signals carried by someneurotransmitters excite the target cell while othersdampen down their activity, depending on the type ofneurotransmitter released at the synapse and thereceptors they reach.This is what sharpens the contrastbetween light and dark in the eye, for
  • 26. Connections  Neurons can connect with up to ahundred thousand other cells. Thisnumber of connections is atruly enormous number: 10thousand trillion.  One neuron can have as many as100,000 dendrites.  In a human, there are more than125 trillion synapses just in thecerebral cortex alone
  • 27. How Do We Build Brain Connections? Exposure Experience Doing, thinking,mirroring Practice ~ and a lot
  • 28. Pruning In a human fetus, almost a trillion neuronsare produced. During the last month, they areproduced at the unbelievable rate of250,000 per second.  Eighty-to-hundred billionof these neurons will be utilized by experienceand become permanent, while the other 900billion will be pruned – that is, carefullydismantled with the material recycled by thebrain’s unique immune system.
  • 29. Brain-BasedInterventionsEnhancingEF & Behavior
  • 30. Domains ofInterventionLanguageImpulsivityBody SpaceSocialInteractionsSelf-RegulationCognition MotorMoodModulationSelf-Help
  • 31. Domains ofIntervention IIFine MotorPlayMathClassroomSkillsReadingGrossMotorSafety InfoWritingFamilySkills
  • 32. Executive Function and Education  EF and intelligence  Twice Gifted  Disorganized students  Homework interventions  TaskAnalysis  Skill-set development  Multi-sensory interventions (MIT)
  • 33. EF and Intelligence  Intelligence and executive functioning are different setsof skills (Barkley, 1997a)  Modest correlations are seen between scores on IQ testsand measures of “higher-order” EF such as cognitiveflexibility in problem-solving  UNITYAND DIVERSITY OF EXECUTIVEFUNCTIONS Miyake et al. (2000) CognitivePsychology41,49–100 (2000)
  • 34. Gifted/Talented Children  Many children who are highly gifted show uneven skilldevelopment; executive skills may lag behind thedevelopment of abstract thinking abilities.  There is no reason to think that a child with acceleratedacademic skills will also have advanced EF.  Neuro-atypicality ~What goes together.
  • 35. Twice Gifted ~ 2 E  Gifted individuals are those who demonstrate outstanding levels of aptitude(defined as an exceptional ability to reason and learn) or competence(documented performance or achievement in top 10% or rarer) in one or moredomains.  Domains include any structured area of activity with its own symbolsystem (e.g., mathematics, music, language) and/or set of sensorimotor skills(e.g., painting, dance, sports). NAGT  2 E’s “…are identified as gifted and talented in one or more areas ofexceptionality (specific academics, general intellectual ability, creativity,leadership, visual, or performing arts); {and have a} disability defined byFederal/State eligibility criteria: specific learning disability, significantidentifiable emotional disability, physical disabilities, sensory disabilities, autism,or ADHD.” (Colorado Dept. of Education 2009)  Misdiagnosis and dual diagnosis of gifted children and adults ~Webb et al.
  • 36. Disorganized Students
  • 37. Organizing The Disorganized Person  Determine “Help Me” domainlistening attending, focus, note taking, impulse control,transferring data, input, output, audition, vision,organization, previewing, planning, execution, time-management Identify needed skill-set Make a plan Execute, monitor, review plan
  • 38. Scaffold, chunk, get specific
  • 39. Calendars and Planners  Calendars, planners and schedules  Routines and daily activities  Task Lists  Project Management  SYSTEMS: Digital, paper, post-it notes, planners, mobilestools,,
  • 40. Helping children “do as expected”takes previewing and planning  1. Tell the children what is about to happen. “We are goingoutside to play.We will quietly get in line, stand helicopter distance from oneanother and keep our voices quiet.”  2. Tell them what they can do with their hands and theirbodies. “While you are on the playground, keep your hands to yourself asyou run, jump and play.”  3. Tell them how they will know the activity is over.“When you hear our‘secret signal,’ you will line up at the red door and we willslowly walk back inside.”
  • 41. Planning/Time Management Use timers (auditory, visual) Use alarms Estimate amount of time needed for a taskand then write down actual time SarahWard ~The
  • 42. What every person needs to know ~How to… Plan Initiate Execute Review Revise
  • 43. Manage The Work Space  What does your space look like? How functional is it?  How organized is your study space?  Does your student have all the items he needs?  Does your student have the ability to use multi-sensory transfer skills?  Describe the study space setting, could you work there?  Is there an adult near-by?  Do you have a time set aside?  Are you working in 15 min increments or those suitable to yourchild?  Do you have prompts or cues?  Is your workspace portable or stationary?
  • 44. Go Multi-Sensory Encourage transfer skills Use video, audio and tactile strategies Use marker boards Use quad bulletin board Draw and doodle Plain, graph, wide ruled, narrow ruled Create mentors and teachers not only students
  • 45. There are no BUT’s here Help the student feel valued Let the student have some control in thediscussion and plan Ask questions without making assumptions The relationship is the agent of change
  • 46. Prioritization The modified Sullivan technique forprioritizing, planning and execution A B C 48 hrs
  • 47. The FamilyCoach Method
  • 48. Foundational Concepts An organized home leads to an organizedbrain If you have an expectation make sure thechild has the skills to meet the taskdemands Parenting up-close in the space betweenenhances relationships Collaboration is key Time-In notTime-Out
  • 49. Skill Deficits and Willful Non-Compliance
  • 50. You Cannot Punish A Child Into A NewSkill
  • 51. What Is The Family Coach Method? A three tiered methodology for in-home and in-office interventions thatmoves families away from coercion,threats and time-out and into brain-based skills and strategies.
  • 52. How America Turned Parenting UpsideDownWe began to believe that we couldpunish or consequence a personinto a new behavior.This maywork in the moment but it doesnot build skill sets.TODAY –We explore1.  How to build skill sets byunderstanding braindevelopment.2.  The mechanics of buildingskill sets inADHD andbeyond.
  • 53. To Build Skills You Need A FoundationSKILLSETSThe Foundation: A Culture of Respect
  • 54. Every Family Has A Culture  What is our landscape?  What is our game?  How do we play?  Where and how do we live?  What is our mission?  How do we model our values?  Are our expectations known?
  • 55. Every Family Has A Mission  Why do we exist?  What do we stand for?  When other people see our family, what do they see?  What messages do we send inside our family?  What do we teach others when they are here?  The who, what, when, where and how of our family  We are a family who…  In our family we…  We agree that…
  • 56. Implementing TFCM  Initial evaluation, needs assessment, points of of entry/referral  When will we know we have met your goals?  The First Session ~ Build a Pond  The Second Session ~ Mission, values, expectations  TheThird Session ~ Mentors and Behavior Captains  The Fourth Session ~ Skill set development  Pain point analysis  Existing strengths  Agreements around sabotage behaviors  Ongoing work
  • 57. Identifying A Skill Deficit  What is the behavioral expectation?  Does the child possess the skill set to meet the taskdemand?  Right now under these circumstances?  If yes, expect it.  If no, teach it.
  • 58. Skill Deficits vs Willful Non-compliance The 80/20 rule A skill deficit is when the task demands exceedthe skill level Are the expectation clearly understood? Chunk Be detailed Model role play, practice
  • 59. Breaking Down Skill SetsListening  I chose not to speak  I established eye contact  I listened to someone speaking  I nodded my head to show I was listening  I repeated back what I heard, when asked  I asked a question when I did not understand  I remembered instructions  I followed the instructions
  • 60. Breaking Down Skill SetsFor The Parent  I defined an expected behavior  I named the expected behavior  I chose my behavior, thinking it through  I practiced ready, steady, act  I practiced “I have a choice”  I thought about the next step  I spoke the sequence of my actions  I wrote the sequence of my actions
  • 61. The High-Risk Factor ~ Impulsivity Waiting one’s turn Refraining from touching others Keeping one’s hands to self Not grabbing without permission Keeping one’s body still Thinking before you act Practicing think, decide, act Managing oral-motor movements Verbalization, waiting one’s turn Speaking in turn
  • 62. EF and Behavioral Change  Visualizing and verbalizing  Role Play  Social Stories  The Beginning, Middle & End  Going Full Circle  See, say, play, touch, build  Mentoring others  Motor movement
  • 63. Polyspot Stories
  • 64. Cognitive & LimbicInterventions
  • 65. Brain Training  Some programs include Luminosity,  Captain’s Log,COGMED, MC2, Brain Gym and Brain Builder. If the childor adult has not had a neuropsychological or executivefunction evaluation that may be a first step.  Exercise is brain training.Activities that involve motorcontrol and thinking at the same time build brainconnections. Some activities to consider include: XBoxDance Dance Revolution, karate, double dutch jump rope,yoga, hacky sac, swimming and tennis. Getting up, out andmoving in any way possible is good for everyone.  Preventing brain loss: Cognitive-motor exercises, workingmemory, nutrition, exercise
  • 66. The Caveman and The ThinkerYour Child’sTwo-Part BrainThe Defensive BrainCollaborationWorksCalm the caveman to engagethe thinker
  • 67. It’s a Two-Way Street  The Caveman is about perceiving. He attaches emotional tenorto experiences to sort out danger.  TheThinker mediates the meaning of the perception. He addsthe planning, organization and decision making to theperception.  The Caveman says run, hide, fight.  TheThinker says, slow down you will be okay.
  • 68. The Caveman and The Thinker  The neocortex (TheThinker) is located in the front of the headbetween your temples. It receives and stores information fordecision making and remembering. It is involved in higherfunctions such as sensory perception, generation of motorcommands, spatial reasoning, conscious thought, and in humans,language.  The limbic system (The Caveman) is a complex set of structuresthat lies on both sides and underneath the thalamus, just underthe cerebrum. It includes the hypothalamus, the hippocampus,the amygdala and several other nearby areas.The limbic systemcontrols all the automatic systems of the body and the emotions.
  • 69. Self-Regulation Recognizing escalation Asking for help (I feel revvedup, angry, annoyed) Stopping escalation Making a choice to use acalming skill De-escalating Initiating calm Maintaining calm Using calming skills(breathing, music, motormovement, yoga, meditation Using energy release skills(jump ropes, trampoline,jumping jacks)
  • 70. Anger Mountain
  • 71. We Calm Down To Think  Teach relaxation breathing and self-talk  Allow for a break (including a physical place to calmdown) when child encounters a change  Employ yoga, meditation and mindful thinking  Provide warnings (signals) prior to transitions – they canbe visual, touch, or verbal  @stressfreekids Lori Lite
  • 72. Why We Calm The Caveman Then EngageThe Thinker High levels of arousal diminish attentionand focus. High level of arousal limit EF activation. High levels of arousal lead to forgetting.
  • 73. Meet Mr. Amygdala  The amygdala is the part of the brain responsible for identifyingthreats to our well-being, and for sending out an alarm whenthreats are identified that results in us taking steps to protectourselves.  Perception, emotional tenor, fight, flight freeze.  The amygdala is so efficient at warning us about threats, that it getsus reacting before the cortex is able to check on the reasonablenessof our reaction.  Our brains are wired to influence us to act before we can properlyconsider the consequences of our actions.  It’s not only the Fear Factor
  • 74. Physiology of Anger  As you become angry your bodys muscles tense up. Inside your brain,neurotransmitter chemicals known as catecholamines are released causingyou to experience a burst of energy lasting up to several minutes.  This burst of energy is behind the common angry desire to protect or aggress.  At the same time your heart rate accelerates, your blood pressure rises, and yourrate of breathing increases.  Your face may flush as increased blood flow enters your extremities inpreparation for physical action.  Your attention narrows and becomes locked onto the target of your anger. Soonyou can pay attention to nothing else.  In quick succession, additional brain neurotransmitters and hormones (amongthem adrenaline and noradrenaline) are released which trigger a lasting state ofarousal.  Youre now ready to fight.
  • 75. Why we need to prime the caveman toremain calm  The adrenaline-caused arousalthat occurs during anger lasts avery long time (many hours,sometimes days), and lowers ouranger threshold, making it easierfor us to get angry again lateron.  Though we do calm down, ittakes a very long time for us toreturn to our resting state.  During this slow cool-downperiod we are more likely to getvery angry in response to minorirritations that normally wouldnot bother us.
  • 76. Anger and Forgetting  The same lingering arousal that keeps usprimed for more anger also can interfere withour ability to clearly remember details of ourangry outburst.Arousal is vital for efficientremembering.As any student knows, it isdifficult to learn new material while sleepy.  Moderate arousal levels help the brain tolearn and enhance memory, concentration,and performance.  There is an optimum level of arousal thatbenefits memory, however, and whenarousal exceeds that optimum level, itmakes it more difficult for new memoriesto be formed.  High levels of arousal (such as are presentwhen we are angry) significantly decreaseyour ability to concentrate.  This is why it is difficult to rememberdetails of really explosive arguments. Source:Harry Mills, Ph.D
  • 77.   Motor to Cognition  Music  Writing andTelling Stories  Repetitive Movement  Diaphragmatic Breathing  Art, Drawing Mandalas  Meditation  YogaMethods For Calming The Caveman
  • 78. Methods For Calming The Caveman  SEL  Physical Movement  Repetitive Movement  Rhythmic BreathingTake Five  Music/Stories Listening  Art Drawing Mandalas  Listen to a Raisin – Meditate  VisionTherapy
  • 79. “I’m a puppet you cantell me anything.”Dr. Beth Onufrak
  • 80. Motor Development Tools ~ ShelleyMannell YogaWedge The Strong Institute Rhythmic listening inthe ambient air Indo-board – Surfboard trainer
  • 81. EF ~ Social Skills I 1. Perspective-taking -The ability to see asituation from another person’s perspective 2. Impulse Control -The ability to control initialimpulses (thoughts, desires) without acting onthem 3. Delaying gratification -The ability to delaygratification of needs and desires
  • 82. EF ~ Social Skills II  4. Conflict Resolution –The ability to solve aninterpersonal problem satisfactorily to both parties,without resorting to aggression (verbal or physical)  5. Reading social cues –The ability to decode facialexpressions, actions and words  6. Mood modulation – Managing the ups and downsof feelings in the moment, employing calming skills,using one’s thoughts to manage one’s feelings
  • 83. Twitter ~ The Research PlaygroundINTERVENTION  @Inclusive_Class  @marianne_russo  @‫‏‬special-ism  @movingsmartnow  @micheleborba  @talkingteenage  @Kiboomu  @kidlutions
  • 84. Data BasedTreatment Planning
  • 85. Parents Ask: Where Do We Start?  When your child is first diagnosed sometimes it’shard to know where to begin.  Do you have a brief neuropsych eval to assess IQ andexecutive function?  Do you see an OT for sensory issues?  Do you improve food and nutrition?  Do you look into amino acids to impact neurotransmitters?  Do you do brain training?  What behavioral interventions do you consider?  Is it time for a medication trial?
  • 86. Intervention Pyramid  Medication  Neurotransmitters Food/Nutrition Developmental,Behavioral, LearningInterventions
  • 87. • What is the observed behavior• When and where does the behavior occur• Frequency of the behavior (how many times)• Duration of the behavior (how long)• What happens right before the behavior• What happens following the behavior• What did they get or avoid• Setting of current behavior• Who is around when the behavior occurs• What is the environment in situations where the behavior is occurring• What is the environment in situations where the behavior is notoccurring• Other variables that appear to be affecting the behaviorBehavioralTracking
  • 88. Predictability and Preferences  Daily activity schedule  Predictability of routines  Variety of activities or materials  Social relationships  Preferences of the student  Medical and physical issues (nutrition, illness,medications, sleep patterns)  Challenging family situations•  Tracy Gershwin Mueller
  • 89. 5 Things About The Teen BrainYou were afraid to ask, but need to know  Teen brain growth (neuronal connections) is in spurts and startsTheTeenYears Explained:A Guide to HealthyAdolescentDevelopment (Johns Hopkins University, 2009) by Clea McNeelyand Jayne Blanchard  Go away!Wait, where are you going? (Separation andIndependence)  Why do moody?The limbic interference relates to neuronalgrowth, hormonal changes and brain re-organization  Why so cliquey? Teens are herd animals…  What?Your brakes aren’t working? (Impulsivity and risk takingand the teenage brain)
  • 90. Teens and Tweenies Teenage as a second language ~ Barbara R.Greenberg, & Jennifer A. Powell-Lunder Get out of my life! But first will you takeme and Cheryl to the mall ~AnthonyWolf Why do they act that way? ~ DavidWalsh
  • 91. Freedomland
  • 92. Eat Sleep and Exercise:What they don’t teach you ingraduate school
  • 93. Amino Acids Are The Building Blocks ofLife  WhatYou Eat Matters  Amino acids that come from the protein you eat are the buildingblocks of your brain’s network.Amino acids can excite or calmyour brain as well as nourish your brain throughout it’s lifetime.  Your body breaks down dietary protein into the amino acids ituses to assemble the 50,000 different proteins it needs tofunction – including neurotransmitters and chromosomes,hormones and enzymes.
  • 94. 5 Food Rules1. 1 oz water per pound per day2. If it does not rot or sprout do without3. Consider 1-2 oz protein/fats every four hours for children4. Consider 8-10 servings of color per day (1/2 cup per serving)5. Consider pharm grade or whole food multi-vitamins, Omega 3’s,probiotics and antioxidantsPlease consult with your physician regarding your specificneeds.
  • 95. Seven Simple Tips For HealthierFamilies Meal plan weekly Buy real whole food and make it available cleanedand at eye level in your fridge Demonstrate portion management Get your kids involved in cooking Get your kids involved in shopping Shop local and organic Drink water not soda
  • 96. You are what you assimilate  Get back to real whole food  Consider amino acids  Consider vitamins, fats, minerals and probiotics
  • 97. Nutrition Resources
  • 98. Twitter ~ The Research PlaygroundNUTRITION  @NutritionBlogs  @MelissaMcCreey  @childobesity (nourish interactive)  @ RMNutrition  @nutritionistjan  @eatingarainbow
  • 99. SleepS = Similar bed-time schedule and routine nightlyL = Light-off, dark, cool sleep environmentE = Everything off, phone,TV, musicE = Exercise, regularly at least 45 mins dailyP = Preparation and planningWake-up tipsMost children need about 45 minutes for their early morning routine. Rushing increasesstress hormones, so we like a routine that is calm, slow and well-organized.1. Create a “soft entry” into the morning, give your kids a gentle verbal reminder or alittle touch on the shoulder that says,“We’re getting up in ten minutes.”2. Have all your own tasks completed before you get the kids up, they need amom or dad to gently guide them through the early morning routine.3. Create a calm environment with soft music.4. Have a hearty breakfast ready and raring to go!5. Make lunches, put out tomorrow’s outfit and leave packed back-packs at the door thenight before.
  • 100. Motor IntelligenceTherapy ~ OtherApplications
  • 101. Field Trip!
  • 102.  Play Math is a cortico-cerebellarmath program that alternates fineand gross motor movement to teachchildren ages 6-12 fact families,factors and fractions (Kenney 2012)
  • 103.  Mirror or Skip Count (Balls) Slide and Glide (Blocks) Over and Up (Blocks) How do numbers fit together? What makes a family? Advanced techniquesThe Method
  • 104. Three things children taught me abouthow they learn math.1.We build to learn:  Exploring factfamilies in “arrays” (we call them squares andrectangles) we have 7 year olds learningorder of operations, distributive property andfact families all through play.
  • 105. Three things children taught me abouthow they learn math.2.We need to touch the blocks for better encoding:With base ten blocks, when children start to see with theirown eyes or feel with their own hands/feet/rhythm or saywith their own voices, that 6 fits into 12 and you can make 12several different ways 3+9=12 9+3 =12; 6+6=12 11+1 =12, the children love it.They make patterns and do groupingnaturally.This enhances memory encoding.
  • 106. Three things children taught me abouthow they learn math.3.We build brain connections with:a. Rhythmb. Fine and Gross Motor Movementc. Mentoring
  • 107. Audition and Rhythm  For younger kids who have trouble getting started withthe morning or evening routine at home, use a song theylike to guide them through  Before starting a seated task, engage in some gross motoractivity (quick walk, throw a koosh ball, etc.)  Alex Doman ~ HealingAtThe Speed of Sound  @Kiboomu
  • 108. Subcortical Brain Research  Sensory Integration, Sensory Processing, and Sensory ModulationDisorders: Putative Functional Neuroanatomic UnderpinningsLeonard F. Koziol & Deborah Ely Budding & Dana ChidekelCerebellum. 2011 Dec;10(4):770-92.
  • 109. Sensory Processing DisordersSensory Modulation Sensory Discrimination Sensory-Based MotorDisorderSensory Over-Responsivity Visual Postural DisordersSensory Under-Responsivity Auditory DyspraxiaSensory Seeking/Craving TactileVestibularProprioceptiveGustatoryOlfactorySource: Lucy Jane Miller
  • 110. Sensory Books
  • 111. Domains of OversensitivityOlfactory – “ewe it smells”Gustation – “It’s gritty mama”Tactile – “Ouch!That hurts”Visual – “There is still light”Sound – “I need to get out of thiscar!”Motor - “Inside I am just shaking”A learning story ~ 9 year old JasonThere is still light!
  • 112. Challenging Behavior
  • 113. Anxiety
  • 114. Mindfulness
  • 115. FLIPSWITCH FOR TEENSDepression: According to the National Institute of Mental Health (NIMH), morethan 1.5 million children under the age of 15 are severely depressed. Bipolar disorder in children often begins with major depression, marked by notwanting to play, chronic irritability and sadness.  Preschoolers may talk of wanting to“make myself dead.”Early Onset:  Fifty-nine percent of adults with bipolar disorder surveyed by theNational Depressive and Manic-DepressiveAssociation in 1993 reported thatsymptoms of their illness appeared during or before adolescence. The time betweenonset of symptoms and proper treatment is often 8-10 years, longer for pediatric-onset cases.
  • 116. Bi-Polar and Depression Resources
  • 117. The Importance of Play
  • 118. We Teach EF Through Play  Self-awareness (the video technique)  Other-awareness  Decision making (what’s the thing to do when)  Inhibition  Cognitive flexibility  Attention  Focus  Shift  Creativity/Imagination
  • 119. Gill Connell ~ Play  PLAY: How it Shapes the Brain, Opens the Imagination,and Invigorates the Soul by Stuart Brown, M.D.  THE POWER OF PLAY: LearningWhat Comes Naturallyby David Elkind, Ph.D.  PLAYFUL PARENTING by Lawrence J. Cohen, Ph.D.  A CHILDSWORK –The Importance of Fantasy Play byVivien Gussen Paley  THEART OF ROUGHHOUSING byAnthonyT.DeBenedet, M.D. and Lawrence J. Cohen, Ph.D.
  • 120. The Power of Hopscotch  HOPPING = MIDLINE DEVELOPMENT For children, hoppingsignals sophisticated advances in both physical coordination,balance,AND cognitive development.You see, as your child refines herphysical coordination, she is also building essential neural pathways in the brain.Its those exact same pathways which will one day become theconduits for left/right brain thinking tasks such as creativity,reasoning, and self-regulation.  DONT STEP ONTHE LINE = BODY CONTROL  STOP & START = BODY RHYTHM  LEAPING = MUSCLE STRENGTH  SPACES = SPATIAL
  • 121. Prescribe Love and Caring