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Published on November 16, 2020
Raise your hand if you were taught in school that the cerebellum’s main responsibility is to coordinate movement 🙋🏻♀️.
If you’ve taken any advanced courses in sensory processing disorder, you know that movement coordination is probably not the entire story.
This article lays out the history of what we know about the cerebellum and how recent research has shown cerebellar problems to be highly associated with disorders such as autism and schizophrenia.
Looking back, it doesn’t make a lot of sense for such a big part of the brain to have a small role in cognition. We know now that every part of the brain works together with every other part. We just don’t know enough yet to know how or why those pieces fit together to make a cohesive personality.
Scientists have begun to map the cerebellum using functional MRI technology and have been able to locate areas that influence or control many functional skills such as:
Despite these advances in neuroscience, though, we still don’t know exactly what the overall role of the cerebellum is.
I think about articles like this a lot when I’m trying to explain sensory processing disorder to families.
We, as health care professionals, are really good at reducing every observable behavior to a specific brain region or function.
But the reality is we still don’t have a good idea about what’s causing a lot of deficits and behaviors that we see in therapy. I mean, we still don’t know what the cerebellum actually does.
Over the years I have spent an exorbitant amount of money on training and equipment for various listening programs. I even hired a “mentor” to guide me through choosing the right music for the right child using a program she was paid to lecture about.
What I found was that many kids hated wearing the headphones, hated the music, or both. And I’ve never had a patient show any real progress that I could relate to a listening protocol.
I have many colleagues, who I greatly respect, who have noticed changes in their patients that they could relate directly to the listening programs they use. I’m definitely open to the possibility those programs work for some kiddos.
No tool is going to work for everyone, and I admit I may be too skeptical of the approach for it to actually be successful for me. I just don’t buy into passive stimulation as a treatment tool.
Yes, I know listening is an active process. But hearing and listening are two different things, and it’s often difficult to determine which process is happening under those headphones.
Still, I’m open-minded. I’d love to find that magic tool that changes a child’s life. I am completely sold on using music as a tool in therapy, just not as a protocol.
I ran across this article that appeared to be a study about hypersensitivity in children with autism. While I was disappointed with the discussion of treatments, I did learn a lot.
The article describes two pathways for auditory processing: the classical pathway and the non-classical pathway. The classical pathway starts at the 8th cranial nerve (the vestibulocochlear nerve) and connects to the auditory centers of the cortex.
The non-classical pathway also starts with the 8th cranial nerve, but it ends up in the limbic system. In young children, the non-classical pathway seems to be more well-developed.
This makes sense because toddlers have very little cortical control over their behavior and emotions – that comes with age.
Toddlers tend to react strongly to loud noises, and this tendency fades as they get more cortical control.
It’s likely that since children with developmental disabilities tend to demonstrate widespread neurological immaturity the non-classical pathway activation could persist for a much longer period of time. This could explain why a 10 year old with autism may still have tantrums when he hears loud noises.
The authors of this article cite evidence regarding the effectiveness of systematic desensitization for children with auditory hypersensitivity. The problem with that approach is that the child has to be cooperative with the systematic desensitization, which is a big ask.
They suggest listening therapies as a first line of treatment, as those approaches are passive and allow the child to become more accustomed to listening to sounds without major emotional breakdowns.
I guess this could work as an introductory strategy for children who show hypersensitivity to most sounds. But it’s still a passive approach, and neural plasticity depends on active participation.
The article didn’t convince me to jump back into the world of listening protocols, but it does give a good deal of insight into why auditory hypersensitivity might exist. It’s worth a read. You can read it here.
If there’s one thing many of our patients can’t do, it’s learn from social experiences. But why is that? There are lots of theories including mirror neuron dysfunction, lack of attention and lack of theory of mind.
This article explains how “direct learning” and “socially influenced learning” may work, and a disruption in these neuro circuits may offer a better explanation of why many of the children we treat have such difficulty learning from others.
Direct learning is your ability to learn from your own actions and expectations. For example, let’s consider what happens when you meet a new patient for the first time.
Socially influenced learning is similar, but involves adjusting your behavior based on the behavior of others. Let’s continue with the above scenario, only this time you are co-evaluating the new patient with a speech therapist.
Interestingly, direct learning, and to some extent social learning, are governed by the prefrontal cortex circuitry which isn’t fully developed until your mid-twenties. And we know that most of our kiddos have immature functioning in that area compared to their typical peers.
A disruption in these learning circuits may explain why some of our patients have such difficulty learning from their friends.
“When affect is regulated, we are at our most adaptive, our most self-possessed, our most engaged, our best. We are alert and all our psychological resources are available. Relevant memories are accessible to guide our actions based on prior experience. Our attention goes where it needs to go, and, when the situation calls for it, we can concentrate it where we wish.”
–Daniel Hill, Affect Regulation Theory*
Who do you really admire? Why? How are they similar to you?
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