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What is ILT?

If you are reading this, the chances are that you have a child who is struggling at school. Maybe he or she is finding it difficult to master skills such as reading, writing, maths or spelling. Maybe he or she can do all these things but comes home with reports about unfinished work, or work left at home.

The teacher complains about her being disorganised, untidy or even aggressive towards other children. Or maybe she is described as being unfocused and a daydreamer who never seems to listen. And maybe you agree with the teacher because you see the same behaviour at home.

Labels such as ADHD, Dyslexia, Auditory Processing Problems, Sensory Processing Disorder are mentioned. What’s going on?


Testimonials

  • Can movement really help children with learning difficulties?

    Way, way back in 1996, a writer in an edition of Newsweekfocusing on Your Child’s Brainwrote “…. There is new evidence that certain kinds of intervention can reach even the older brain and like a microscopic screwdriver rewire broken circuits.”  This was exciting news to those of us researching ways of helping children.  

    The brain has neurons – that we call ‘wires’ – and these neurons need to communicate with each other so that we can function.  This means that there are umpteen billions of connections in the brain.  It is rather remarkable that most of us manage to form these neurons and their connections without faults but we need to remember that there are many things that can go wrong with this process, known as ‘neurodevelopment.’ 

    Thanks to research, we’ve had confirmation that things suspected through observation and experience are facts.  We now know that by carefully watching how a child moves and what a child needs to do to meet an expectation from school or his home, we can get an idea of where in the brain the problem lies.  Then, by giving the child’s brain a chance to repair itself, we can bring about positive changes.

    Let’s have a look at an example of how we apply neurodevelopmental insights to solve a child’s learning problem.

    An important reflex movement

    It’s significant that many children with learning difficulties have no Headrighting Reflex (HRR).  This reflex shows when the angle of the body in relation to the ground shifts – in other words, the body tilts to either side, backwards or forwards.  The reflex automatically adjusts the head to remain in a nearly vertical position.  In a less well coordinated child, the head does not remain or immediately return to the vertical position but stays in line with the body. In other words, the child’s head moves in line with his spine.

    If the head rights itself, there is very little shift in the background compared to when the head tilts in line with the spine.  (Try this yourself by swaying to each side, alternately keeping your head still in a vertical position and allowing it to align with the spine.)   Such a child will find himself in a constant state of visual strain because one of the reasons for this reflex is to stablise visual images on the retina of the eye.   There is little wonder that children who don’t have this reflex may have reading problems. 

    Giving a child the HRR

    This is where a knowledge of neurodevelopment can help.  We need to give children a HRR if they haven’t developed one themselves.  How do we do this?

    Different parts of our bodies are controlled by different nerves but it is wise to remember that nothing stands alone.  No function of the brain operates in isolation.  For example, when your vestibular system (in your inner ear) is stressed (perhaps by movement), you get seasick. You feel this in your tummy and it happens because of the intimate interconnectedness of different nerves. The vagus, one of the ten cranial nerves, is responsible for causing your stomach to revolt against the movement registered by an overwhelmed vestibular system.

    The HRR is influenced by another cranial nerve that controls the trapezoid muscle. This muscle controls the movements of the head and neck.  If a child hasn’t developed the HRR, it is likely that there is a poor connection between the trapezoid muscle and the cranial nerve that controls it.  Our job would be to connect this muscle and we use a seemingly simple movement activity to do so.

    The original movement came from Carl Delacato, who worked for many years with learning disabled children.  He found that having children lie on the floor and moving their arms, legs and head in a way that resembled the movement of a ghecko or lizard, caused significant and positive changes in the brain.

    The Flip Flop movement

    The benefits of the Flip Flops are many.  Information goes into both sides of the brain as the muscles move equally on both sides.  At the same time the brain gets sensory information from the weight of the body moving across the surface on which the child is lying.  This is very important because during later development the brain is constantly having to coordinate information received from the two brain hemispheres to allow for stereophonic hearing, posture and vision.  So with our Flip Flops, we are not only stimulating the cranial nerve to connect to the trapezoid muscle but also influencing vision, hearing and balance.  Through this, information is communicated to many other brain areas, especially to the cerebellum, the midbrain and the thalamus.  The thalamus is an area of the brain that acts as a gate-keeper – either allowing sensory information to pass through to higher brain (cortical) areas or not.  If it fails to allow certain information through, the important messages will not arrive at the proper destination.

    So in short, by giving a child a  (seemingly) simple activity, we are effecting profound changes in brain function.   We can’t control what comes out of the brain but we certainly can control what goes in.  This helps the brain receive the information it needs to correct faulty wiring. 

    Other reflex movements are significant too

    Giving the child a head-righting reflex is good but we need to test for later developing movements as well.  Once we’ve made connections in the lower brain regions, we have to persevere to encourage connections needed for more sophisticated functions. 

    When you bring about better neurological organization, you are addressing basic problems in the various areas of the brain.  This enables the child to function independently and with improved abilities in many different spheres of life.  Such children seem to ‘get it together’ and with this, their self-esteem and confidence soars.

     

  • Baby-led weaning or spoon feeding? The difference it makes to your child’s eating habits is actually very small

    This article appeared in a Science newsletter on April 2nd2019.  We thought it might be of interest as so many children these days present as ‘picky’ eaters who are difficult to feed.

    It was written by Sophia Komninou, The Conversation

    When it comes to avoiding picky eating and meal time tantrums, parents are usually ready to try any method that promises their child will become a better and less fussy eater. This is in part why methods of giving solid food to infants have received a lot of attention in the last few years. Some think that the way babies are introduced to solids can change their attitudes to food into childhood or even for life.

    The most common method used to give babies their first solids has long been to offer a puree or mash using a spoon. This helps parents make sure their babies receive adequate energy and nutrients for their development – something many are often anxious over.

    More recently, however, baby-led weaning has gained popularity – and divided parents. This method sees babies selecting finger foods – such as carrot sticks, broccoli trees or other pieces of whole, baby-fist size pieces of food – and feedingthemselves. While there have been unsubstantiated claims that this method can improve a baby’s dexterity and confidence, research has associated baby-led weaning with their ability to recognise when they are full and being less fussy with their food. This makes it an appealing choice for some parents.

    However, as with most things baby-related, the reality is that many parents don’t use just one method of feeding. It changes depending on the time, day or situation they are in. Which is why, for our recently published study, we wanted to compare how different styles of feeding affects a baby’s eating habits and attitudes to food.

    Is baby-led weaning better?

    We looked at four different categories of toddlers, whose parents introduced them to solids using either: solely baby-led weaning, mostly baby-led weaning with occasional spoon feeding, mostly spoon feeding with occasional finger foods, or just spoon feeding. We asked the parents questions about their feeding strategies and eating behaviours of their toddlers, like fussiness and food enjoyment. 

    Usually, in a statistical analysis, we look at whether there is a difference between groups. But what this doesn’t tell us is how big the difference actually is. To solve this problem, we looked at the size of the difference between the groups (what we call the effect size). It helps us understand whether the difference actually matters. 

    We found that the magnitude of difference in a toddler’s fussiness and food enjoyment is minimal across the four groups. This means that baby-led weaning, spoon-feeding or anything in between might not actually be the solution to future mealtime battlegrounds some parents hope it will be. That may seem to be in contrast with what the research shows so far, but it doesn’t negate those findings. Babies will be less picky about their food if they are fed using baby-led weaning as opposed to any of the other types of feeding, it’s just not by that much.

    Socio-economics at play

    When looking at the strategies parents use to feed their children, our study did show that those who follow baby-led weaning are less likely to use food as a reward or encouragement, and have less control on eating overall. This helps their toddlers learn to make eating decisions for themselves based on whether they are hungry or full. These parents are also more likely to breastfeed for longer, introduce solids after six months and eat more frequently with their toddlers.

    However, the key difference here is not that the children were fed using baby-led weaning but instead the type of families who usually follow it. Our findings show that these parents are usually of a higher socio-economic status and more educated, which makes them more likely to follow a distinctly different parenting style and be able to afford to spend more time and money doing so.

    Overall, our results suggest that the way a baby is introduced to solids will make very little difference to how fussy they will become, or how much they will enjoy food. It is important to remember that how children eat depend on a lot of factors, including their genetic background, their past experiences with food and their interaction with their parents.

    Research findings are important when communicating complementary feeding advice to new parents, but headlines and quoted study results can often be misleading. So remember that when reports of research say there is a difference between one method over another, it’s not the whole story. The size of this difference – something that is not often communicated – matters too. The most important thing that parents can do is to try their best and introduce solids in a way that is more appropriate for their family, rather than stressing about a specific method, as research suggests might make a only a very small difference.

     

     

  • Really effective help for families of picky eaters

     

     

     

    “WE’VE TRIED EVERYTHING – NOTHINGS HELPS, NOTHING MAKES THINGS BETTER”

    “I JUST DON’T KNOW HOW MANY MORE MEALTIMES LIKE THIS WE CAN TAKE…”

    These are real quotes from parents who felt like they had come to the end of the line in terms of finding solutions to their child’s picky eating. The internet can be a fantastic source of support for parents, but there are so many articles out there, often offering conflicting advice. It can be really hard to know what to trust, and sometimes, too much information can just feel plain overwhelming.

    Recently I came across Jo Cormack who specialises in childhood eating challenges.  She gave me permission to reproduce this article.  I would earnestly suggest that you visit her website and take advantage of the help she and her team offer.  Details are at the end of this post.

    You’ve had your child’s weight and growth checked and it’s all fine. You’ve ruled out physiological causes of their eating issues, like allergies or physical problems with chewing or swallowing. Everyone tells you that they will grow out of it; that it’s only a phase!  – Just put the food in front of them and wait for them to eat it, because “they won’t starve”. 

    But for some children who are extremely wary of unfamiliar foods – the ones who cling to their safe foods like a life raft in a stormy sea, and who really, truly need to know that the food they are offered is firmly within their comfort zone; these children need a bit more help. I call these children cautious eaters

    No amount of gentle (or forceful) persuasion, bribery, creative presentation or talk about the nutritional benefits of food will convince a genuinely cautious eater to eat something that they don’t feel comfortable with. In fact, research shows that trying to encourage children to eat can actually make their picky eating even worse.

    Serving cautious eaters foods that they don’t feel okay with in the hope that they will eventually get hungry enough to relent and eat something, can end in several terrifying days where children simply don’t eat. This is deeply distressing both for them and for you. Not to mention dangerous.

    It is so tough on parents when they don’t know what their next move should be. We can deal with pretty much anything if we feel that we know what we need to do, and we have the support required to do it. There is nothing worse than that feeling that you know your child needs your help, but you’ve simply run out of ideas.

    I understand this anxiety and desperation: The urge to feed and nourish our children is one of the strongest instincts a parent has, and to be honest, most of the parents who reach out to me are already at a very low point with their child’s eating… sometimes things have to get to rock bottom in order to ignite a change. 

    Help is at hand

    I want to share an incredibly valuable strategy that I use in my clinical work when I feel that a child’s picky eating is caused by a genuine fear of unfamiliar and disliked foods. It is all about laying the foundations for helping a child enjoy a varied diet, by teaching them to tolerate unfamiliarity. 

    Before I get into what this strategy looks like, I want to explain a little bit about how anxiety can be be at the heart of a child’s eating issues, because seeing your child’s eating through this lens can be a complete game-changer.

     CHILDREN CAN BECOME ANXIOUS ABOUT FOOD FOR MANY REASONS:

    • Perhaps they have sensory processing issues and their experience of eating certain food is so overwhelming to them that it is actually frightening
    • Perhaps they have a naturally cautious and anxious temperament; for them, an unfamiliar food (just like an unfamiliar situation or person) can be really challenging
    • Perhaps they have got into the habit of using their eating behaviours as a way of feeling in control. The idea of not being in control of their eating may be very scary as it takes a coping mechanism away from them
    • Perhaps they are not used to being offered foods that they don’t know and like. If parents consistently stop offering foods at the first signs of rejection, children quickly learn to fear the unfamiliar

    This is not an exhaustive list of the reasons why a child may be anxious about disliked and unfamiliar foods. But it has a common theme:cautious eaters feel safe when their food is familiar and unsafe when it is not. If they are expected to eat foods which are not on their safe list, this is extremely anxiety-provoking. 

    Laying the foundations for change: a 3 step approach to helping your cautious eater

    1) Empathy.Before you can truly be there for your cautious eater, you need to try to understand how it feels to be in their little shoes.

    It can be a bit of a shift of mindset to understand that your child’s response to food is not ‘bad behaviour’ – that it doesn’t necessarily fall into the categories of boundary testing or (developmentally normal) struggles for autonomy that run-of-the-mill picky eating can often be understood as.

    Your child isn’t trying to get attention, they are simply really, really scared of foods which are not on their safe list. Especially for children with an unusually high degree of sensory sensitivity, the experience of eating foods that are challenging in terms of taste, texture, appearance or smell, is just so intense.  

    Many young children can’t verbalise these fears. They may act out, and express their feelings through aggression or alternatively they may withdraw. The first thing you need to do in order to help them is acknowledge that their anxiety is very real indeed and is not a choice. Research is increasingly linking anxiety in children to eating struggles. However hard it may be to imagine being scared of the wrong brand of crackers – appreciating that your child’s reactions  may be anxiety-driven can be very powerful.

    2) Make sure that you have a good understanding of your role in relation to feeding your child. You may well already be familiar with Ellyn Satter’s Division of Responsibility (DoR) model. If not, you can learn about it on theEllyn Satter Institute website  where you will also find a very useful downloadable pdf about DoR. There are also lots of great articles written by feeding professionals about how DoR can help your family, like this article from Natalia Stasenko or this oneby Sarah Remmer, which includes a fab kitchen printable. If you are more of a book worm than a blog reader, this short, accessible bookby Katja Leccisi, provides a great overview of how to understand your feeding role.

    3) Teach your child to expect variation.This is the killer strategy that will make all the difference. You are seeing things from your child’s perspective, you have educated yourself about your role in relation to feeding your child. But you are stuck, because your child will only accept a limited list of foods. 

    You need to begin to teach your child to accept and expect the unfamiliar, in the context of their safe foods.

    Much of my work with picky eaters draws heavily on cognitive behavioural therapeutic theory. Cognitive behavioural therapy (CBT) teaches us that if we avoid something we are scared of, that fear becomes stronger. If we confront our fear and manage to do something that is outside of our comfort zone, the fact that nothing catastrophic happened – it didn’t give rise to a traumatic experience – tells our brain to produce a slightly smaller anxiety response next time that situation comes up.

    A key aspect of successful exposure therapy is about making sure that you set people up to succeed and not fail. This makes sense if you thing about it; if you try something scary and find that the outcome is very upsetting because the goal was just not realistically achievable, you reinforce your urge to avoid that situation and your fear increases.

    Setting your child up to succeed

    You need to introduce variety in a way that will be manageable for your child and which they will not experience as intimidating. You do this by drawing up a list of their safe foods and devising teeny weeny baby changes to the foods on the list. These changes are not meant to be hidden from your child; we’re not talking about sneaky changes that they may not notice as this erodes trust and will defeat the object.

    The kind of baby steps I’m thinking of, are ones that your child will both notice and cope with. For example, if your they like plain pasta, take a pasta shape that you know they usually accept and cut it in two (when it’s cooked… cutting dry pasta is no mean feat).

    Combination and deconstruction

    I use the twin concepts of ‘combination’ and ‘deconstruction’ as a jumping-off point for devising tiny changes to your child’s safe foods. Combination is all about pairing two safe foods in a way that is new for your child, and deconstruction is literally about taking food apart and re-presenting it in a slightly altered form.

    For this strategy to work, you need to understand that you have a lot of work to do before your child is even ready to try new or disliked foods, BUT that there is plenty of room for manoeuvre within the context of their safe foods. Some children will naturally be confident eaters, but cautious eaters need to learnfood-confidence. And they need to learn it from within their comfort zone.

    How this strategy works in practice 

    At meals, introduce a tiny change to one of your child’s safe foods. Don’t draw attention to it, just make it available to your child. Don’t praise them for eating it; this may increase pressure and fuel anxiety. Just remain focused on keeping your meals relaxed and upbeat. Perhaps initially try introducing change to their best meal of the day. For example, many picky eaters do best at breakfast – perhaps your child has toast. Cut it into fingers rather than squares. If they like raspberry jam, try sieving it before you put it on their toast so that the texture is very slightly different.

    Laying the foundations for change (by helping your picky eater get used to unfamiliarity via constant tiny changes to their safe foods) will set the scene for the longer term task of introducing variety into their diet. It can take weeks – months even – for children to begin to feel comfortable with unfamiliarity. Introduce it at their pace, tune in to them and their responses.

    You need to be patient, you need to be persistent and you need to be creative. Above all, you need to be in it for the long haul. But every time your child eats one of their safe foods in a new and different form,  you are inching incrementally closer to giving them a positive relationship with food that will last a lifetime.

    Jo does add a caveat to this advice.  She says that the approach is very effective but only once your family’s mealtime dynamics are right (meaning that meals are family occasions where the conversations includes all members) and when optimum feeding practices are in place.  If not, these ground rules need to be attended to first.

    For parents wanting to know more about how to parent in relation to picky eating, Jo hasVisit  a new membership site which you could link to: https://jocormack.lpages.co/your-feeding-team-sign-up-now/.  She has a formidable, experienced team ready to help you.

    Visit her website at www.jocormack.comto learn more.

  • Helping babies build their brains

     

    In last week’s post, I wrote that a baby’s brain is very undeveloped at birth, owing to the relatively small size of a newborn’s head. In fact, the newly born child has all the brain cells (neurons) he will ever need but they aren’t able to communicate with each other very efficiently. 

     One of the most important developmental stages in these early days is for the infant to do what is necessary for these neurons to connect to each other. Eventually, he’ll end up with neural networks that are needed for learning and living.  These networks provide us with the ability to learn language, interpret sound and vision, control emotions, think and remember.  The quality of the brain cells themselves and the way they connect to each other will determine whether that individual grows up with an average or a really smart brain.

     Some of this will depend on the child’s genes but a great deal will depend on the environment you provide and in which the child will develop.  It’s not true that clever parents will automatically have clever children. Academic success and intelligence are hugely reliant on a growing environment that is characterized by lots of love, little stress, mental stimulation and a good diet.

     Mental stimulation is not provided by mindless facts. Many children can learn to count, recite the alphabet, give correct answers to learned questions and so on, but these don’t indicate a good brain.  Essentially, as Dr David Perlmutter points out in his book (see reference below), the goal of parent’s interactions with their young children should not be whatthe children learn but howthey learn it.   Stay away from activities that dull their brains, deaden their senses and put them at risk for later learning difficulties.

     It’s better for a developing brain to learn what letters and numbers represent rather than being able to spell or count.  In order for this to happen, they need to learn their shapes and understand that letters and numbers are symbols that carry meaning according to their shapes.

     It’s also important that the connections being made by the neurons are firmly cemented in place.  For this to happen, children need repetition of incoming mental stimulation.  Most seek this out automatically by insisting that parents reinforce learning.  Most of us know how a child will demand the same story over and over again, or be happy to watch the same film again and again. This is a good example of how children learn and how they strengthen the connections in their neural networks.

     Here’s one example of a brain-building activity given by Dr Perlmutter that will help the child to learn the meaning of numbers:

     For a child beginning at around age 12 months:  Find a puzzle containing pieces shaped from numbers 1 to 10.   Fitting the numbers into their correct places allows the child to experience the ‘feel’ qualities of numbers, which helps to ingrain the picture of the number into their brains.   You can enhance her experience by showing her what a particular number represents. For example, when she puts the number 2 into the correct place on the puzzle board, hand her two small balls and say “Two.”  Every time she puts back another puzzle piece, add balls to her collection until the puzzle is completed. This paves the way for early recognition of the symbolic nature of numbers.  This is far more beneficial than simply teaching the child to memorise counting from one to ten.

     Acknowledgement is given to Dr David Perlmutter who wrote the informative book Raise a smarter child by kindergarten: Build a better brain and increase IQ up to 30 points.Available from Amazon books.

  • Is your child eating enough oil?

     

     

    The media has been focusing for quite some time on the benefits of fats and oils in our diets.  It seems that finally the world is realizing that saturated fats are not the killers we once thought they were and we are becoming aware that not all oils available in supermarkets are as healthy as marketers would have us believe.

    Standing out from this muddle of misinformation over the decades has been the fact that Omega-3 oil is a key nutrient for brain help.

    None of us would disagree that learning takes place largely in the brain. It follows that if the brain is deprived of the nutrients that it needs to be healthy, it won’t be able to fulfil its learning function. 

    We can all be labelled as ‘fat heads’ because our brains are predominantly made of fat.  Almost all of its structures and functions are crucially dependent on essential fatty acids. These cannot be made by our bodies but come directly from our food.  Pause then, for a moment, and consider the impact of the last thirty years or so during which we were sternly told that fat was bad for us and we should consume low-fat or fat-free products.  We now know without doubt that if a child’s brain is deficient in the important fatty acids (mainly Omega-3) it will still function but will process information far slower than otherwise.  Imagine an outdated computer that works but processes slowly, compared to an up-to-date version, which processes at the blink of an eye 

    Researchers in the UK have found that a child’s blood levels of Omega-3 (specifically a component known as DHA) can significantly predict how well he or she is able to concentrate and learn.  From sampling nearly 500 schoolchildren, they found that higher levels were associated with better reading and memory, as well as with fewer behaviour problems, as rated by parents and teachers 

    Many of the children identified as having below-average reading skills showed levels of Omega-3 that were way below the level considered optimal. Their parents also revealed that almost nine out of ten children in the sample ate fish less than twice a week, and nearly one in ten never ate fish at all.  This is significant because fish is the only really practical source of Omega-3 in our diets. If a child is sensitive to fish, flaxseed (or flax oil), pumpkin seeds and walnuts provide the most commonly available alternatives.

    In the light of this knowledge, it makes sense to encourage children to eat fish from an early age.  We have good sources of cold water fatty fish (which are the best sources of Omega-3).  Snoek, hake, trout, pilchards and herrings will all feed our hungry brains – but not battered and deep-fried – learn to grill, bake or lightly braai!

    The question naturally arises about Omega-3 supplements – particularly in children who are picky eaters.  I’ll be addressing this in next week’s post.

     

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