We have been taking David through his daily program as prescribed by the Institutes for a little over a month now. It is undoubtedly hard work, and it has also proved to be greatly rewarding. Every time there is even the tiniest victory it is a cause for joy. I have begun to keep a small notebook close to David's checklist to mark these observations and celebrate victories.
The most successful way to get sensory information to the brain is through frequency, intensity and duration, according to the Institutes. The more times information is presented, and the more intense it is, the higher the likelihood that the brain will receive this information. The duration of exposure to a certain input is is important as well.
For example, to stimulate the neural pathways related to David's vision, he is exposed to a pen light in a dark room ten times a day. The frequency is ten times. The intensity is the high contrast of a concentrated point of light in a completely dark environment. The duration is sixty seconds. This principle applies to all the exercises in David's program, including auditory and tactile.
Ten times a day, David is exposed to a deliberate environmental sound. Of course the random sounds of pots and pans, the blender, and anything else is always welcome. The goal is to create contrast by eliminating background noise as much as possible, which means no radio, TV, etc. With silence, the intensity of the sound can be felt. We started with one of those loud airhorns used at sports events but have moved on to less intense noises. Here is a photo of some of the things we use for auditory stimulation:
A whistle, can of Mardi Gras beads, rattle, clicker, cellophane, party horn.
We also use musical instruments for auditory stimulation, including guitar, piano and didgeridoo. The visceral sound of the didge adds another dimension to David's auditory program. We got this large instrument in Australia a few years ago. The boys are both fascinated by it, and when I play it for David, he moves his legs quite a bit! I think the deep, loud vibration affects the floor around him and creates a tactile sensation.
Speaking of, David receives a variety of tactile stimulation twelve times a day. From left to right, the above photo includes: bristle brush, make-up brush, velvet, therapeutic brush, gift bow, sand paper, coarse sponge, vinyl, fleece, soft sponge, fork, feather boa, wool, cellophane, tulle, astroturf, Mardi Gras beads of various textures, socks filled with rice (hot and cold).
These things are used on a daily basis. We combine them in a variety of ways, primarily using two contrasting textures one after the other. The beads are by far David's favorite! He loves handling them and being "rolled" all over with them.
For a little over a month now, we have been incorporating these aspects of the program into David's day successfully. One thing Jeremy and I are committed to now is organizing volunteers to help with patterning. Patterning is a method used to teach the brain how it feels to crawl. It requires three people to move the child in a crawling pattern, and more for larger individuals. Here is an example:
Video courtesy of Hulet Smith
The initial goal is to pattern David five times a day and work up to more. So far, he has responded positively, and really enjoys it. He anticipates being placed on the patterning table and is ready to go. After we stop, he wants to keep going! I have noticed an increase in David's alertness and energy in relation to patterning, even in the small amount of time we have been doing it.
Another item you may have seen on David's checklist is masking. Respiratory masking is a component of David's therapy that is currently in the works. It involves using a special mask that recycles the breath, expands the chest and enriches oxygenation in the brain. As this treatment becomes a regular part of David's routine, I will share our experience.
Adapting to the program is an ongoing process and it constantly changes as David does. I try to frequently reflect on how he is responding to each form of sensory input, taking note of the things he really enjoys or reacts to.
Oooh! Cellophane is exciting!!
Documenting new behaviors has become a source of motivation for us as parents. Every bit of progress adds up. When David first came home from the NICU at two months of age, the only response we could see were pupils dilating and constricting in response to light. His body was completely rigid and he required some respiratory support. He has come a long way since then! We are so proud of our "Wittle Bids!"