D. Neuroplasticity principles we could use with FASD individuals
21 February 2011
Diane Malbin, MSW, a recognized clinical social worker and speaker trainer in the FASD field, first spoke about the approach of "Trying differently rather than trying harder."
This idea refers to trying different perspectives and intervention options based on effects of the CNS damage and particular needs of the patient, rather than trying harder at implementing behavioural-based interventions that have consistently failed over time to produce improved outcomes for a patient. A strength-based intervention will allow the individual to develop positive outcomes by promoting success linked to the patient's strengths and interests (Malbin, 2002)
While there may be no “neurological cure” for FASD, many interventions have been used with certain degrees of success. Most models identified so far in the current literature are developmental approaches, based on developmental psychology (development occurs through the gradual accumulation of knowledge and information). At the same time, the strategies that seem to work better are comprehensive and individualized based on the needs of each individual, strengths focused rather than pathology or problem focused. The brain does have the capacity to reorganize its maps. (Doidge 2007, 48). Therefore through learning and stimulation, the change that occurs in the brain could result in reorganization of preexisting neuronal networks. The change in the neuronal structure of the brain could also produce cortical remodelling and growth.
In the next section we will look at different approaches and neuroplasticity principles that might be used with individuals diagnosed with FASD and FASD related conditions. While there is a spectrum of possible options that are based on neuroplasticity and its principles, here we will mention only some of them, hoping that with your help we will extend the list and the article database.
Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change and that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family). Psychotherapy can result in detectable changes in the brain. As demonstrated through brain scans, the brain plastically organizes itself in treatment. A study of the depressed patients treated with interpersonal psychotherapy showed that prefrontal brain activity normalized with treatment. (Doidge 2007, 233). Individual psychotherapy with children and individuals with an FASD is a productive process. While the Psychotherapy with individuals with FASD usually focuses effectively learn to cope with daily living experiences, to produce lasting effects and be used according to the neuroplasticity principles, psychotherapy should focus on restructuring neural networks, particularly in the subcortical-limbic system which is responsible for unconscious emotional motivations.
Techniques and methods used to improve the learning capacities
1. Arrowsmith Program
The Arrowsmith school was founded on neuroscientific research that demonstrates the possibility “to strengthen the weak cognitive capacities underlying their learning dysfunctions through a program of specific cognitive exercises”. (Arrowsmith School®) Arrowsmith School are privately owned day schools that are dedicated to helping students with learning disabilities. The Arrowsmith Program is based on the philosophy that it is possible to treat learning disabilities by identifying and strengthening cognitive capacities. The focus is on treating learning disabilities by identifying and strengthening cognitive capacities. The activities and exercises proposed are meant to stimulate neurons and improve children’s speaking writing and reading. The programs are individualized based on an initial assessment that identifies the specific learning difficulties of each student.
2. Fast ForWord
Fast ForWord is a family of computer based programs, disguised as a children’s game. The intent is to enhance cognitive skills of children. Fast ForWord was designed and developed for language-impaired and learning-disabled children. The seven brain exercises included exercise every basic brain function involved in language. According to the study reported in the Journal Science in 1996, the children who did Fast ForWard computer exercises made significant progress on speech, auditory processing and language tests. Further studies showed that Fast ForWord was having other unexpected benefits. Many students that were involved with fast ForWord begun to show improved attention and focus. This was because the fast ForWord led to general improvements in mental processing. Also Fast ForWord not only that has proven to help children with cognitive difficulties but also proved to be beneficial to a number of autistic children who begun to make some general progress (Schwartz, Begley, 2003, 234-36). Fast ForWork stimulates the control system for plasticity and generating improvements in thinking and overall mental processing. Fast ForWord software was developed and is commercially distributed by Scientific Learning Corporation.
Repetitive transcranial magnetic stimulation (RTMS)
Repetitive transcranial magnetic stimulation of the motor cortex (rTMS) can be used to modify motor cortical excitability in human subjects. rTMS works by stimulating parts of the prefrontal cortex. Numerous small-scale pilot studies have shown it could be a treatment tool for various neurological conditions such as migraine, stroke, Parkinsons Disease, dystonia, tinnitus) and conditions such as depression, mood disorders and auditory hallucinations. Transcranial magnetic stimulation was approved by the US Food and Drug Administration as a depression treatment in 2008. ("http://en.wikipedia.org/wiki/Transcranial_magnetic_stimulation") This experiemtnal procedure uses magnetic fields to stimulate nerve cells in the brain in the hope of improving chronic depression symptoms. (http://www.mayoclinic.com/health/transcranial-magnetic-stimulation/MY00185) Repetitive transcranial magnetic stimulation (rTMS) is currently used and viewed as a promising experimental tool for understanding and treating Autism Disorders.
According to Wikipedia, Neurobics are mental exercises, brain teasers and puzzles that are believed by some to enhance the brain's performance, although it's too early for any scientific evidence to support this idea. The term neurobics was coined by late neurobiologist Lawrence Katz and Manning Rubin to describe mental exercises designed to keep the brain alert. (http://en.wikipedia.org/wiki/Neurobics)
According to Katz, the exercise program calls for presenting the brain with nonrutine or unexpected experiences using various combinations of physical senses – vision, smell, touch, taste and hearing as well as the emotional sense. These actions produce more of such chemicals of the neurobiology system of body that encourage growth of new dendrites and neurons in the brain. (Katz, Rubin, 1999) Routine actions become so automatic to the individual that most of actions are done largely unconsciously. Such automated or unconscious actions require less activity in the brain, and exercise it less. With the help of neurobics exercises, it is claimed that one can stimulate the brain.
Some examples of neurobic exercise is to carry out a routine action such as showering with your eyes closed, dialing a phone number or brushing your teeth with your non-dominant hand. The goal is not to learn or remember anything specific but to provoke the brain into weaving more associative networks. Many of Katz’ neurobic exercises involve repeated pairing of different senses such as hearing (music) and smells or touch and hearing in order to increase the number of pathways in the brain. Neuroplasticity can occur anywhere. Simple changes in our daily routine could lead to neuronal changes.
Do you have other principles in mind? Please write a comment or send us a message.
When do we need to intervene? The earlier the better.
Although the appearance and the morphology of the brain change little after the birth, neuroplasticity allows it to undergo immense changes at the cellular level (Schwartz, Begley, 2003, 118).
The brain of the child is “plastic”. If a brain suffers damage in the early years and loses certain areas, it usually reorganizes itself. A young brain can usually compensate for injury to a particular region by shifting the function of the damage region to an unaffected region. By the age of 6 or seven the brain is becoming set in its ways and the lost of brain regions can leave severe and long lasting deficit.
Critical period – is a period when the newborn has to receive stimulation in order to develop normally. The brain is plastic and its structure is shaped by experience. For instance experiments showed that if we block a sense receptor during a critical period, the part of the brain that had been deprived of input from the sense receptor does not remain idle and will be assigned other functions. Language development has a critical period that begins in infancy and ends between eight years and puberty. After this critical period closes, a person’s ability to learn a second language without an accent is limited. Second languages learned after the critical period are not processed in the same part of the brain as is the native tongue. (Doidge 2007, 52).
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10. Arrowsmith School®, "Introduction." Arrowsmith School®. 27 June 2009 <http://www.arrowsmithschool.org/>.
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