Tag Archives: Therapeutic listening

How Therapeutic Listening Enhances Motor Skills

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My readers know that I am a huge fan of Quickshifts in treatment.  I have had some amazing successes with Quickshifts for regulation and modulation.  Their focus on combining binaural beat technology with instrumentation, rhythm, melody and tone makes these albums effective, and it eliminates the challenges of modulated music for very young or fragile kids.  But many parents (and a few therapists!) think that if a child doesn’t have severe sensory processing issues, then therapeutic listening isn’t going to be helpful.

That indicates that they don’t understand the principles and the rationale for the use of therapeutic listening.

Since every movement pattern has rhythm and sequence, it is completely logical that enhancing brain function with an emphasis on a calm-alert state with music will affect movement quality.  (This includes speech.  Speech is a highly skilled series of very small movements in a precise sequence! )

I am currently treating a toddler who experienced encephalopathy in infancy.  A virus affected the functioning of his brain.  The residual low muscle tone and praxis issues are directly improved by using Gravitational Grape in sessions.  He is safer and shows more postural activation while listening.  Endurance while standing and walking is significantly improved.

Another client with low tone has Prader-Willi syndrome.  Her movements are so much more sequenced with the Bilateral Control album.  Her ability to shift her weight while moving is significantly better during and immediately after listening.

All of us are more skilled when we are in the calm-alert (alpha brainwave) state that Qucikshifts entrain.  For people without motor or sensory issues, alpha states can help us think clearly and organize our thought and movement for higher level performance.  For children with movement control issues, it can improve their safety and stability.  They move with greater ease.  Therapy sessions are more productive, and play or school functioning is less work.

Due to COVID-19, I have been forced to do telehealth and use therapeutic listening with more children, rather than rely on equipment or complex sensory processing activities.  The silver lining is that parents are more involved in my sessions and can see what benefits this treatment is having on their children.   When social distancing retreats, I hope that therapeutic listening will be seen for the powerful treatment it most definitely can be!

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Should the PARENTS of Kids With Sensory Issues Use Quickshifts?

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My clients and my blog readers know that I started using a therapeutic sound treatment called Quckshifts earlier this year Quickshifts: A Simple, Successful, and Easy to Use Treatment For Regulation, Attention, and Postural Activation.  I haven’t lost my enthusiasm for this treatment.  It has made easy sessions more effective, and difficult sessions workable.  Kids that are struggling get a boost, and kids that needed a lot of preparatory sensory activity to regulate and engage rapidly find their footing.

Could this be useful for parents too?

There is no age limit on the use of Quickshifts, and the creators at Vital Links write and speak about treating adults using this program in their training materials.  But thus far I haven’t heard them talk about the use of Quickshifts with the parents of their clients.  I wonder why.

If you have a child with sensory issues, even one who attends mainstreamed programs and is doing fairly well in social activities, your days have a certain level of stress in them.  Sensory diets work, but they also take work to use and monitor.  Children aren’t crockpots, so you are actively administering or at least setting up the activities the comprise a sensory diet.  Kids reach bumps in the road, and kids with sensory issues can have bigger meltdowns over smaller bumps.  Parents have to help them manage things that other kids shrug off.  And parents always are thinking ahead, wondering what effect a new summer camp or new school with have on their child.  Even when things are going well, parents can feel some stress about all of these things.

It is well known that if you are a therapist treating children with sensory processing issues, at least one parent could say to you “Wow; I used to have the same problems, and everyone told me I was just being difficult/stubborn/picky, etc.”  Treatment options picked up in the early 90s, so we do hear this less and less.  But not in every community  or school system.  And if a parent’s parents refused to “believe” in sensory treatment, then these kids got nothing.  Or perhaps they were sent to a psychologist.  When I describe their child’s experiences using sensory processing terms, some parents recognize that their responses are very similar.  They have been told, or they have assumed, that they are reacting psychologically to events or stimuli.  They now are thinking differently about themselves as well as their children.

Finally, in this era of #MeToo, there is growing awareness that many of the parents of the children we work with bring their own trauma with them into parenting  Are You a Trauma Survivor AND the Parent of a Special Needs Child?.  I just did a presentation in FL (Feb2020) on using sensory processing treatment to help adults with traumatic dissociation.  The dysregulation that accompanies trauma doesn’t disappear after delivering a child.  At times, having a child can bring past traumas up to the surface and create problems that seems to have been handled or forgotten.  These parents need our support and assistance.

Which brings us to the question:  Should the parents of kids with sensory processing issues, especially the parents that have problems with self-regulation, use Quickshifts as well?

My strong opinion is that since there isn’t a downside, they should give the Regulation albums a try, and see how they navigate a typical day after listening.  The changes in adults are more subtle because their lives are more complex.  Parents need to know what changes to look for: usually the ability to remain calm with transitions, to focus on a task or to think a process through more easily.

Parents with more anxious tendencies might use Gentle Focus successfully, and parents that need to up-regulate would love Synching Up or Rockin’ Surf.  The decision to use Quickshifts and how to select albums really is easier when you consult an OT.  Wasting money and time buying and using the wrong album is unnecessary!  I love working with adults that have regulation issues or sensory sensitivities.  The relief in their faces tells me that they are getting the help they need to be their best.

 

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Hypermobility and Proprioception: Why Loose Joints Create Sensory Processing Problems for Children

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When most parents think of sensory processing issues, they think of the children who hate clothing tags and gag on textured foods.   Joint hypermobility, regardless of the reason (prematurity, Ehlers-Danlos syndrome, head injury, etc) can result in kids who stumble when they move and wobble when they rest.  They are seen by orthopedists and physical therapists, and told to build up those weak muscles.  Well, hypermobile kids have sensory processing issues too!   And they deserve more effective treatment for these issues than they typically receive.

Lack of joint integrity, especially decreased joint stability, results in a decrease in proprioception and kinesthesia.  These two under-appreciated (and poorly explained) senses tell a child about her body’s positions and movements without the use of vision. The literature out there is sparse.

If you are hoping that a lot of research on this topic exists, and you think your pediatrician understands why your child can’t grasp a pencil but can squeeze the @@#$% out of Play-Doh, good luck.  

Who will believe AND understand you?  Your OT!

Most of the scientific research into proprioception and hypermobility has been done by PTs, and is focused on proprioception in the leg. They are interested in how it affects mobility.

The problems with poor proprioception and kinesthesia go far beyond walking.  Essentially no research has been done on hand function or the practical application of research to living skills of any kind when it comes to hypermobility syndromes and proprioception. But OTs can teach you and your child’s classroom staff about the connections between sensory processing and motor performance.  They can help your child improve skills based on their knowledge of neurology and function.

Here is a simple explanation of how proprioception and kinesthesia affect function.  Consider the process for touch-typing.  Your awareness of your hand’s position while at rest on the home row is proprioception.  You know where your movement starting and end points are via proprioception without looking.  Your awareness of the degree of movement in a joint while you are actively typing is kinesthesia.  Kinesthesia tells you that you just typed a “w” instead of an “e” without having to look at the screen or at your fingers.Your brain “knows”, through learned feedback loops, that your finger movement was too far to the left to type the letter “w”, but far enough to have been a “e”.  Teachers and others call this “muscle memory”, but that is a misnomer.  Muscles have no memory; brains do.  And brains that aren’t getting the right information send out the wrong instructions to muscles.  Oops!

You are able to grade the amount of force on each key because your skin, joint and muscle sensors transmit information about the resistance you meet while pressing down each key.   Your brain compares it previous typing success and the results on the screen, and makes adjustments in fractions of a second. This is sensory processing at work.

Why do children with hypermobility have proprioceptive and kinesthetic processing problems?  Because information from your body is transmitted is through receptors embedded in the tissue within and surrounding the joints.   These receptors respond to muscle and tendon stretch, muscle contraction, and pressure within the joint.   Joint hypermobility creates less stimulation (and thus less accurate information) to these sensory receptors.  Like the game at the carnival, the ball isn’t hit hard enough to ring the bell at the top of the post.  The sensory information coming into the brain is either insufficient or delayed (or both), and therefore the brain’s output of directions to achieve postural stability or dynamic movement is correspondingly poor.

This shows up as a collapsed posture, difficulty quickly changing positions to catch a ball or leap over an obstacle, a heavy-footed gait, and a whole lot of other difficulties.  One of the most common issues are the awkward or extreme positions these kids get into, and sometimes strongly prefer.  They look like they should be in pain, but they aren’t.  Read more about what to do when your child insists on sitting in a position that could harm them in Is Your Hypermobile Child Frequently In An Awkward Position? No, She Really DOESN’T Feel Any Pain From Sitting That Way.

What should parents be looking for when they wonder if proprioception is affecting their child’s functional performance?

Can children with hypermobility improve their sensory processing and thereby improve the quality of their movements in daily life?  Absolutely.

Because sensory processing is a complex skill, addressing each component of functional performance will give the hypermobile child more skills.  Building muscular strength within a safe range of joint movement is only one aspect of treatment.  If your child is experiencing difficulty in music lessons or when playing sports, please read Should Your Hypermobile Child Play Sports? and  Hypermobility and Music Lessons: How to Reduce the Pain of Playing for some useful ways to think about what you say to your child.  Positioning a child to give them more sensory feedback while in action is essential.  Increasing overall sensory processing by using other sensory input modalities is often ignored but very helpful.

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I’ll bet that you didn’t think of toileting as a proprioceptive issue.  When thinking about toileting the hypermobile child, the biggest problem is often an interoceptive issue; the kind of proprioception that involves internal organs.  This can make it difficult for hypermobile kids to feel when they need to “go” in time to get to the bathroom, but it can also create retention.  The urge isn’t very powerful for them. Read For Kids Who Don’t Know They Need to “Go”? Tell Them to Stand Up and Teach Kids With EDS Or Low Tone: Don’t Hold It In!.  And of course, you might want an e- book that will help you with toilet training.  I wrote it for youThe Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

I believe that vestibular input is one of the most powerful but rarely used modalities that can improve the sensory-motor performance of hypermobile children.  They don’t have to demonstrate vestibular processing deficits to benefit from a vestibular program.  The lack of effective sensory processing due to poor proprioceptive registration and discrimination creates problems with balance, and targeted vestibular input is designed to fine-tune the brain’s balance center.  I could link you to scholarly articles on this concept, but you would fall asleep before finishing them.  Trust me, vestibular input can make a difference.  This program can be done without stressing fragile joints, which is often a limitation for the programs that focus too much on muscular strengthening and stabilization activities.

 

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My favorite sensory processing strategy for hypermobile kids?  The use of rhythmic music during movement.

Therapeutic music programs that use the powerful effects of sound on the brain are effective treatments for hypermobile children.  Using sound to improve vestibular processing increases the quality and the speed of response to a loss of balance.  Muscle tone increases in children while they are listening through stimulation of  midbrain centers, and this combo of improved tone and improved vestibular processing helps children improve their safety while moving and even while sitting still. For all of you with kids who fall off chairs while doing nothing, you know what I mean!  I have been trained in the use of Therapeutic Listening through Vital Sounds, and I really like to ease of using Quickshifts.  These short pieces of music that entrains both sides of the brain for activation and attention can really make a change in hypermobile kids.  There are other programs that work well too.  I prefer Vital Links’ Quickshifts for greater options and ease of use in a daily schedule Quickshifts: A Simple, Successful, and Easy to Use Treatment For Processing, Attention and Postural Activation.  You download their free app and buy the music for your phone!  The most significant benefit to adding a listening program to a home program for any child or adult is that there is no stress on connective tissue, even for kids that are in a lot of pain and have very limited mobility.  For kids that have POTS as well as hypermobility, this can be a real advantage.  The middle ear is connected intimately to the vagus nerve, which impacts the autonomic nervous system.  Treatment of the vestibular system can directly improve the ability of the autonomic nervous system, without the risks associated with many activities.

Another technique to enhance sensory processing is the Wilbarger Protocol.  Although not created for children with hypermobility, I believe that it can be altered to address poor proprioceptive discrimination in specific conditions such as EDS.  Read Can You Use The Wilbarger Protocol With Kids That Have Ehlers-Danlos Syndrome? for a look at how I adapt the protocol with safety in mind.

Kineseotape can be helpful to provide some of the missing proprioceptive information.  When your child has a connective tissue disorder, or is under the age of 3, skin issues complicate taping.  Read Can You K-Tape Kids With Ehlers-Danlos and Other Connective Tissue Disorders? for some suggestions to make this treatment more effective and less risky.

It is difficult to explain to insurers and sometimes even neurologists ( don’t get me started on how hard it is for orthopedists to follow this),  but if you understand the complex processes that support sensory processing, you will be changing the background music in your clinic or your home in order to capitalize on this effect!  I recommend the Vital Links Therapeutic Listening programs for their ease of use and child-friendly music.

Children with hypermobility can benefit from occupational therapy sessions that provide more than a pencil grip and a seat cushion.  All it takes is an appreciation for the sensory effects of hypermobility on function.

Looking for a manual that empowers you and your hypermobile child?

I wrote 2 e-books just for you; one for the smaller kids, and one for the school-age child!

The JointSmart Child:  Living and Thriving With Hypermobility Volume One: The Early Years is my e-book for the parents and therapists of young children, packed with strategies that make life easier and build a toddler’s and preschooler’s skills!

It is available as a read-only download on Amazon and as a printable and clickable download at Your Therapy Source    YTS has it bundled with my book on toilet training for a complete set at a discounted price.

Read how my new e-book can help you today:  Parents of Young Hypermobile Children (and Their Therapists) Finally Get Their Empowerment Manual!

Need a book for older kids?  Here you go!

The JointSmart Child:  Living and Thriving with Hypermobility Volume Two:  The School Years is my newest book, filled with even more information for kids ages 6-12.  There are strategies to help them write and play sports with less risk of injury, plus methods to communicate with teachers and doctors to get the services your child needs.  Learn how to pick the best chairs, bikes, even the right clothes to make your child safer and more independent.  Read more about it here:  Parents and Therapists of Hypermobile School-Age Kids Finally Have a Practical Guidebook!  It is available on Amazon as a read-only download and as a printable e-book on Your Therapy Source!

Does your hypermobile child also have toileting issues?  

My e-book, The Practical Guide To Toilet Training Your Child With Low Muscle Tone, could help you make progress today!  

The Practical Guide is available on my website, tranquil babies and on Amazon as well as at your therapy source, a great place for therapists and parents to find exercise programs and activities for children.  Read more about it, and hear what parents have to say about this unique e-book:The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

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