Tuesday 23 May 2017

4th Assessment for a Little Girl with Cerebral Palsy through Bilateral Haemorrage.

Today we welcomed back a 4 year old little girl and her family today for her 4th assessment. She had suffered a bilateral haemorrhage, leading to cerebral palsy.  She had suffered the bleeds shortly after birth and the doctors had told mum and dad that 'if she survived' and they did not expect her to, she did not have a bright future and would most likely have severe disabilities.  However, she is doing very well indeed. 

At four years of age she is now top of the developmental ladder in visual development being able to read via both sight recognition and through phonological building of a word from it's constituent graphemes / phonemes.  Auditory development which was plagued by sensitivity around 2.6 Khz is now also at the top of the developmental profile.  The sensitivity issue is important because although human hearing goes right up to 20,000 Hz, the 43 speech sounds of the English sound system are compressed within a frequency range of 450Hz - 4,500Hz.  A sensitivity at 2, 500HZ, which is right in the middle of speech sound frequencies is likely to cause problems in processing speech sounds and therefore in producing those speech sounds in the form of language.  The sensitivity has been dealt with by the activities of the Snowdrop programme and she now understands language in advance of her age and produces perfect, grammatically correct language.

Yes she has some problems with visual acuity but when there is also a retinal bleed that is almost inevitable. Gross motor development has progressed from 18 months to the 36 month level, which considering she has been on programme for 16 months, is phenomenal progress, although we have to work on quality of movement. A very intelligent little girl here, who will go a long way!

Monday 22 May 2017

Today's Assessment, 22nd May 17. West Syndrome and CVI

Today we welcomed back a 3 year old little boy and his family for his 4th assessment. He has West Syndrome and CVI and has been on the Snowdrop programme for 15 months.

 West Syndrome consists of group of symptoms characterized by epileptic/infantile spasms, abnormal brain wave patterns called hypsarrhythmia and intellectual disability. The spasms that occur may range from violent jackknife or "salaam" movements where the whole body bends in half, or they may be no more than a mild twitching of the shoulder or eye changes. These spasms usually begin in the early months after birth and can be difficult to control, requiring steriod treatment.

Cortical visual impairment, (CVI) is a form of visual impairment caused by the brain not being able to process information from the eyes passing along the visual pathways in the brain.  In my observation there are varying forms of CVI, caused for instance by the thalamus not exciting the cortex sufficiently to process visual stimuli, to actual injury to the occipital cortices.  Another possibility is that vision becomes 'de-automated!'  Vision is something which just happens to us, we cannot help but see, - it is an automated programme, however I see children who have to be reminded to 'use their eyes!' - It comes in many forms.

With today's little boy we saw clear improvements in the use of vision, which is now 'switched on' for much of the time. He is also understanding more language, responding to simple instructions and his former auditory sensitivity is now gone. His tactile processing problems are resolved and he is now 'high kneeling' and his upper body control is good enough for us to begin working towards developing a standing balance. He also demonstrated that he now has 2 words of speech. He is though, very busy and we have to work further on slowing him down a little. His biggest change in my eyes is in sociability, he now really tries hard to interact. Well done to his parents who work so hard with him. It was great to see you again.

Sunday 21 May 2017

Autism Symptoms Improved by Vitamin D Supplementation.

This is encouraging and could feed directly into the treatment of children with autism who are part of the Snowdrop programme

"This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD. At this stage, this study is a single RCT with a small number of patients, and a great deal of additional wide-scale studies are needed to critically validate the efficacy of vitamin D in ASD."

With thanks to Wiley online library and the Journal of Child Psychology and Psychiatry.