Tracking Orthosis

Cerebellar Hypoplasia – Using the Anat Baniel Feldenkrais Method to Cure It

Liam was not hitting his developmental milestones at the recommended time period for each developmental stage.  He sat up around ten months old and was taught to crawl at twelve months after working with multiple Early Intervention therapists.

At ten months old a MRI revealed an underdeveloped cerebellum.  He was given a diagnosis of Cerebellar Hypoplasia. 

The following are some symptoms of Cerebellar Hypoplasia:

  • Developmental delays
  • Jerky movements and/or tremors
  • Ataxia – general uncoordinated movements
  • Hypotonia- low tone in muscles
  • Seizures
  • Involuntary eye movements
  • Mental retardation

Here are some symptoms we saw in Liam:

  • He didn’t hit his development milestones at the recommended time period
  • His legs were weak- he stood for only a few seconds and got tired quickly
  • Each time he performed a new movement, when reaching out to grab a toy or object for the first time, the reaching action would be shaky.  Once he has performed it a number of times, the movement would be smoother
  • He fell and still falls a lot
  • Saying new words would sound garbled although the tones are correct
  • He had no appetite – he drank a quarter of an ounce of milk and would be satisfied (as an infant he nursed for a total of 10 minutes on both breasts)

Liam did not have these symptoms:

  • No seizures
  • He had no eye problems- he can track people and things with his eyes
  • His cognitive development is delayed but there is no apparent mental retardation

Liam was enrolled in the Early Intervention program before he received his official diagnosis of Cerebellar Hypoplasia.  Liam was initially prescribed two days a week of physical and occupational therapy for thirty minutes a day.  Liam made little progress during this time.  About a year later, we saw a Development Pediatrician through EI and was finally given the appropriate amount of therapy.  He received five days of PT, OT, Speech and two days of Special Education.  He was also approved and fitted for the Sure Step bilateral SMO (Supra Malleolar Orthosis).

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I knew a little something about the cerebellum from Biology 101.  I knew it governs movements and had something to do with language but that was it.  I was on a mission to find a better solution to treat Cerebellar Hypoplasia.   But first I needed to understand the role of the cerebellum.

Cerebellum, Cerebellum…What is your function?

15 Cerebellum Facts:

  1. The cerebellum has two hemispheres, it is the lowest part of your brain right above the brain stem and it takes up 10% of the brain’s volume
  2. The cerebellum contains over 50% more neurons than the rest of the brain combined.  (A neuron according to the Miriam Webster dictionary is: a noun “a grayish or reddish granular cell with specialized processes that is the fundamental functional unit of nervous tissue”
  3. At birth the cerebellum is immature and develops through childhood and adolescence.  Full structural growth and maturity occurs around fifteen to twenty years of age.
  4. The cerebellum anticipates future movements and actions
  5. It controls body and limb movements
  6. It controls the smoothness of walking
  7. It makes corrections while moving
  8. It assist in learning new movement skills
  9. It organizes the learned and automatic movements
  10. It coordinates the information sent from the brain’s cerebral cortex and plans, times, organizes and makes the movement exact and smooth
  11. It senses the balance between your skeleton, muscles and tendons
  12. It checks on what is going on now- it’s a balance mechanism and senses where your body position is in space
  13. The cerebellum receives 200 million inputs from nerve fibers from all over the body.  One million nerve fibers are from the eyes
  14. The cerebellum plays a role in cognitive functions like language and attention
  15. It also plays a role in emotional functions like regulating mood and pleasure response

The cerebellum takes up 10% of the space in our head but contributes 100% of our daily movements.  So how does a therapist tackle a diagnosis of Cerebellar Hypoplasia?  From what I’ve observed the typical course of action is to take the child’s age and compare them to what a typical child is doing at this age and teach this to the child with the delays.  For instance:  Liam is two and a half years old, according to the Bayley Scale of Infant Development III, he should be walking and talking in two to three word sentences.  During therapy Liam is taught how to walk by being supported upright and walking around objects.  Liam is completely into the activity and would love to walk like all his peers so he is happily being guided along during these activities.  As for speech, Liam tends to get bored easily and wants to move on to another more exciting activity.  Liam had a team of dedicated and loving therapists who are ready to show him how it’s done and hope he will make some progress.

Over a year and a half of traditional therapy, we decided to stop it all.  There must be a better way to get the same outcome.  Liam was young, I want to use this to his advantage.  After learning more about the Anat Baniel Method from her Move Into Life Workshop that I attended, I decided this is the method that will allow Liam to be a complete person.  Her method puts order in the disorder.  It talks to the brain, it allows for the movements to come from within the child.

So how does the Anat Baniel Method differ in their approach?  First of all, a diagnosis is not important.  What’s determined first is whether or not the child’s brain is capable of learning.  When Anat sees a child, as she describes “I look for the first opening and seek the change, I am listening for the echo”, she is waking the brain up and getting it to reconnect with the body.  The method communicates with the nervous system, it wakes it up so it can find alternative ways of doing something.

Secondly, the method does not compare the child’s ability to any scale.  In order to truly teach someone something, you have to  start where they are at.  Making mistakes and adding variations gives the brain an opportunity to differentiate and really understand.  During a lesson, Anat or an ABM practitioner will touch and feel where movement is available in the body.  For example:  Liam had no forward movement in his pelvis.  Since he had no forward movement in his pelvis, Liam never transitioned to standing without using a prop to pull himself up.  After a few ABM lessons that focused the work on creating movement in his pelvis we saw Liam spontaneously standing up for the first time.

To quote Anat Baniel from her article “A new approach to helping children with Cerebral Palsy and other brain related disorders.” published in Cerebral Palsy Magazine, June 2003

” The gentleness with which the guiding movements are done and the insistence on having the child move in ways that feel easy and are not beyond the child’s true ability, creates a sense of safety for the child. This allows the child to feel him/herself and become aware of what he/she is doing and what is being done to them. As a result they become active, intelligent and happy learners just the way healthy children are. In fact, healthy children move –albeit spontaneously- in a great variety of ways that are easy and available to them. Portions from these movements get integrated by the brain into a useful action – for example crawling. Once a child accomplishes a milestone, it continues to generate a great variety of small and large movements from which the next milestone will be carved.”

About the Author

Michelle Tom

http://possible-ologist.blogspot.com


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