Language center (neurological question)

[GoVanGogh]

<edited for privacy>

 

[Crimson Wife]

I'm taking a language development class now (have an 97.5% average 2/3 of the way through, woo-hoo!) There was actually a study published just a few weeks ago about how what's in our textbook is actually wrong: http://motherboard.vice.com/read/weve-been-wrong-about-where-the-brain-process-language-for-141-years

 

So in EVERYONE'S brain the language processing is spread out much more than previously believed. From the article:
 

 

There is no center but a network of interconnected areas, each with a slightly different specialization

 

 

Getting back to your original question, I would imagine that the neuropsych did a qEEG test. I've thought about having one done for my DD but hear conflicting views on its usefulness. Some clinicians swear by them. However, our family's pediatric neurologist (affiliated with Stanford) told me in February that like MRI scans, there isn't enough evidence yet to show that qEEG can reliably distinguish among various disorders.

 

ETA: MRI is useful for diagnosing structural abnormalities and we did have one to make sure there wasn't any neurological reason for my DD's hearing loss. But most kids with autism, etc. have MRI scans indistinguishable from neurotypical kids. My DD's MRI was totally unremarkable.

[geodob]

Hi GoVanGogh,

 

The crucial factor, is which hemisphere was effected by the stroke?

As the left hemisphere/ temporal lobe, is involved with processing and comprehension of language/speech.

While the right hemisphere/ temporal lobe, is more like a filing cabinet of words. Which organizes words within a hierarchy of folders.

So that we have these distinct roles for each hemisphere.

 

But crucially, their has been considerable research. That has shown that when the left temporal lobe has been damaged?

That the right temporal lobe, can then develop the ability to process and comprehend language/speech.

 

Though the converse, with damage to the right temporal lobe?

Hasn't shown that the left temporal lobe can also take on role of filing words?

 

So that I would make the assumption that your child's left temporal lobe has been affected, and that they are developing the ability to process and comprehend language/speech in the right temporal lobe?

 

But you wrote that 'Writing is a disaster'?

Where I wonder if it is the 'planning of writing' that is the problem?

[PeterPan]

I'm taking a language development class now (have an 97.5% average 2/3 of the way through, woo-hoo!) There was actually a study published just a few weeks ago about how what's in our textbook is actually wrong: http://motherboard.vice.com/read/weve-been-wrong-about-where-the-brain-process-language-for-141-years

 

So in EVERYONE'S brain the language processing is spread out much more than previously believed. From the article:

 

 

Getting back to your original question, I would imagine that the neuropsych did a qEEG test. I've thought about having one done for my DD but hear conflicting views on its usefulness. Some clinicians swear by them. However, our family's pediatric neurologist (affiliated with Stanford) told me in February that like MRI scans, there isn't enough evidence yet to show that qEEG can reliably distinguish among various disorders.

 

ETA: MRI is useful for diagnosing structural abnormalities and we did have one to make sure there wasn't any neurological reason for my DD's hearing loss. But most kids with autism, etc. have MRI scans indistinguishable from neurotypical kids. My DD's MRI was totally unremarkable.

Further, would a qEEG be altered by therapies like neurofeedback but still be on a person who needs a diagnosis? 

[PeterPan]

GvG, there's a therapy MTI (melodic therapy intervention) where they use music to reestablish the connection to speech in stroke victims.  You can look up youtube videos to see brief demonstrations, and the book is sold by ProEd Inc I think.  You tap right hand on left hand (to get the connection to the other side of the brain) and chant.  I know that's not exactly what you need, but the theory is striking enough that it seems to me it could apply to any language processing where you're trying to get the two sides of the brain to connection.

 

By writing is awful, do you mean physical (motor planning plus language), or is it crunchy even if he's doing dictation.  And does structure or having the thoughts already in his head seem to make a difference?  Can he do oral narrations, and how do they compare to his normal level of speech?

[Crimson Wife]

GvG, there's a therapy MTI (melodic therapy intervention) where they use music to reestablish the connection to speech in stroke victims.  You can look up youtube videos to see brief demonstrations, and the book is sold by ProEd Inc I think.  You tap right hand on left hand (to get the connection to the other side of the brain) and chant.  I know that's not exactly what you need, but the theory is striking enough that it seems to me it could apply to any language processing where you're trying to get the two sides of the brain to connection.

 

Is it this one? http://www.proedinc.com/customer/productView.aspx?ID=4102

 

I was looking at it and some other music therapy materials a few months ago.

[PeterPan]

Is it this one? http://www.proedinc.com/customer/productView.aspx?ID=4102

 

I was looking at it and some other music therapy materials a few months ago.

 

Yup, that's it.  Technically the diagnostic code the SLP first used with ds was aphasia.  I don't really sift all those things out in my brain.  I had been looking for was to teach music and singing to ds, because he has almost not tone/melody at all.  I need to sift into it more to answer OneStep's question about whether he's tone deaf.  I haven't really established that.  I don't *think* he is.  I think he can't make it happen.  

 

Here's the video I found helpful.  https://www.youtube.com/watch?v=ocIy6RijUWI

 

 

 

At the link Crimson provided I was looking at the manual.  I have not yet purchased it.  The intro is quite extensive, and while books are always helpful sometimes things just sorta click and you get it, kwim?  I may see if the SLP can order us things with our scholarship moneys.  Anyways, this connects to GvG's situation because when a stroke victim loses speech, it's praxis of speech.  So my boy's speech didn't develop, another praxis of speech.  

 

We've just done a little so far.  Remember I'm trying to get the reverse, to get melody for speech rather than connecting speech to melody.  However I can tell you he has *enjoyed* our sessions and that it seems powerful for him.  I think you know how that is, that when the kid is getting something he wants that's really right, he stays engaged.  I've tried singing at the piano with him, on the assumption that if we just could learn the words eventually it would all come.  It never worked, sigh, and he'd just run around and dance and get crazy on me, not really able to connect, no matter how I tried.  But with this, it slows him down and connects him.  It makes sure he's noticing the syllables.  I *think* the theory (either in the intro or my imagination) is that your tapping across the body like that because the music is on one side of the brain, the language on the other.  So we tap the opposite hand and chant.  That way we're getting some rhythm and EF going there and maybe working on connections with both sides.  

 

So anyways, that's all I know for sure.  I'm still playing with it.  I just liked the theory.  

 

Btw, the psych is going to give you recommendations, but I think an SLP who specializes in expressive language is who would help you work on language in the brain.  I don't know entirely what they can do, but there are things they can do.  Basically you want things connected so they work and can come out.  That would be a very special person though.  Or go through ProEd Inc, Linguisystems, and maybe Super Duper.  I'm not crazy about SD.  (my everlasting mortal offense list if you sell ineffective products for apraxia)

 

GvG, I know you don't need speech from music.  I'm just saying mine it as a way to tap into both sides of the brain and get connections.  

[Crimson Wife]

  Basically you want things connected so they work and can come out.  That would be a very special person though.  Or go through ProEd Inc, Linguisystems, and maybe Super Duper.  I'm not crazy about SD.  (my everlasting mortal offense list if you sell ineffective products for apraxia)

 

GvG, I know you don't need speech from music.  I'm just saying mine it as a way to tap into both sides of the brain and get connections.  

 

The bolded is why I'm interested in music therapy, interactive metronome, etc. My DD's receptive language is a LOT stronger than her expressive and there's something tripping her up in getting the language out.

 

Just this morning we were at the park with her ABA therapist and we stopped by the community garden. The ABA therapist asked her what was in the corner of the garden (sunflowers). DD knows the name but what she said was this: "Tall flower. Yellow. Like the sun. Sunshine?" The wheels in her mind were clearly turning but she couldn't quite pull out the right word from her mental dictionary.

 

I'm hoping if we can strengthen the brain connections, especially the one between the hemispheres, she'll be better able to access the information that's in her head and get it out of her mouth correctly.

[GoVanGogh]

Thank you so much for the information.

 

CW,

I have heard that, too, about language actually being across hemispheres and that it can shift with age. We are dealing with a midline brain issue and I think it is more that the connections aren't being made across the hemispheres. It is almost like the right side isn't realized. The arm hangs down at times where one would generally pull it up to use with the left.

 

Geo,

DS has high vocabulary usage and comprehension. One speech eval showed 20some year difference between oral expression and written expression. Neuropsych said his "filing cabinet" for oral usage is extremely high, but next to nothing for written expression. He has physical issues with writing, but typing (which he does well) doesn't solve the writing issue. Organization of thought is part of the problem, but she seemed to think it was more that the part of brain for written expression wasn't organized like it should be. (Like brain tried to reorganize around a damaged area, but wasn't able to.)

We were originally told CP was likely from lack of oxygen after birth, but neuropsych said his brain is scattered like he had perinatal stroke and tried to reorganize. I am not sure that it matters much at this point when the damage happened, but I am still trying to process this.

 

OhE,

Thank you for the info. I am actually very interested in music therapy, as DS loves music.

DS was originally diagnosed with apraxia but it has been suspected for past year that it could be aphasia. (We were told aphasia is from stroke, not apraxia, though know there are different types and causes.)

[maize]

I mostly lurk on these kinds of threads and try to understand what is being talked about, just want to say this is the only place on the web where I know this kind of discussion can happen among parents.

 

You guys are awesome. That class you are taking sounds very interesting Crimson, I would like to study more about the brain. 

[PeterPan]

The bolded is why I'm interested in music therapy, interactive metronome, etc. My DD's receptive language is a LOT stronger than her expressive and there's something tripping her up in getting the language out.

 

Just this morning we were at the park with her ABA therapist and we stopped by the community garden. The ABA therapist asked her what was in the corner of the garden (sunflowers). DD knows the name but what she said was this: "Tall flower. Yellow. Like the sun. Sunshine?" The wheels in her mind were clearly turning but she couldn't quite pull out the right word from her mental dictionary.

 

I'm hoping if we can strengthen the brain connections, especially the one between the hemispheres, she'll be better able to access the information that's in her head and get it out of her mouth correctly.

Have you read that book It's On the Tip of My Tongue... Good stuff, lots of details.  She goes into different error types, different coping techniques, etc.  I think you'll recognize some of it.  Also there's the idea of lexicon, or making the effort to organize things in the brain.  So you'll spend time doing ALL the flowers you can think of, ALL the sports, all the colors, etc.  Lots of lists.  Because you're trying to organize it in the brain and get the word put in the right spot.  Lexicon.  Picture dictionaries or picture encyclopedias, where things are organized around a theme on the page, can be great for this. I have a neat one aimed at kids.  I've mentioned the title in the past and don't have it handy right now to look it up.  Red cover with cells of pictures.

 

Is her dominance established?  Our SLP says kids get language bumps with OT, and I think the theory there is getting some of the dominance to settle down and pick.

[PeterPan]

GvG, this is totally unrelated maybe, but in his OT evals, did he have a retained STNR?  I'm just curious.  This book I read today painted this rosy picture of all the things that reverse when you get the STNR to integrate...  My ds still has his, so it was pretty striking to me.

[Crimson Wife]

Have you read that book It's On the Tip of My Tongue... Good stuff, lots of details.  She goes into different error types, different coping techniques, etc.  I think you'll recognize some of it.  Also there's the idea of lexicon, or making the effort to organize things in the brain.  So you'll spend time doing ALL the flowers you can think of, ALL the sports, all the colors, etc.  Lots of lists.  Because you're trying to organize it in the brain and get the word put in the right spot.  Lexicon.  Picture dictionaries or picture encyclopedias, where things are organized around a theme on the page, can be great for this. I have a neat one aimed at kids.  I've mentioned the title in the past and don't have it handy right now to look it up.  Red cover with cells of pictures.

 

Is her dominance established?  Our SLP says kids get language bumps with OT, and I think the theory there is getting some of the dominance to settle down and pick.

 

I hadn't heard of that book before but it looks interesting, as does her formal intervention program. The latter might be a good investment for me as a future SLP and/or ed therapist.

 

The OT's that we've seen don't do the dominance & retained reflex stuff. I'd be open to paying OOP for an eval with someone knowledgable on the topics but I haven't a clue how to go about locating a good OT for that. I don't want to just start cold-calling clinics at random, KWIM?

[J-rap]

The core of speech seems to be definitely centered in the left hemisphere for most people, but what scientists don't yet know is if that's where most language related information and processing is stored and takes place, or if that area would be more accurately described as the "computer" that connects and controls all language information and activity that actually resides in innumerable places in the brain.  Scientists lean toward the first, but recently information has been gathered that causes them to wonder if could be more like a central control area for language instead of the holding area for all language.

 

Different parts of the brain (still, mostly in the left hemisphere as far as we can tell) actually control every single tiny aspect of language, with many of them overlapping:  hearing words, hearing sounds, hearing grammar, speaking words, speaking sounds, speaking in grammatically correct sentences, reading, writing, etc. etc.  You say your son especially has trouble writing.  Can he speak in grammatically correct sentences?  Often, speaking and writing are at the same level when it comes to aphasia.  Speaking can have a whole host of other issues though, such as apraxia of speech, which is when the brain forgets how to move the mouth in order to make the necessary sounds (it's a motor planning problem).  It is apraxia of speech where music therapy is most helpful.  Music therapy is not so helpful for writing.  (Also, a stroke can cause both aphasia and apraxia of speech.)

 

There is HUGE potential for recovering speech.  Even a severely damaged brain can learn language again.  Different parts of the brain take over.  This is not something that just "happens over time."  You have to intentionally work at it.  A good speech therapist can make all the difference in the world.  It needs to be someone who really understands how the brain reconnects -- it requires very intentional focus and forced mental discipline on the part of the client.  Rote lessons and repetition without focused internal thinking will only get you so far. 

 

The only way to really know precisely which part of the brain is taking on a function is by doing an MRI as the function is taking place.  So for example, your son would speak out loud, or read out loud, or write, for example, as they were doing an MRI.  That shows the brain in action.

 

Anyway, just kind of rambling here.  :)  I know a lot more about strokes, aphasia, apraxia of speech, and learning language again than I ever wanted to.

[PeterPan]

My suggestion that you could take the ideas of MIT and apply them to other situations are just my own theories.  I don't think a lot of this stuff (the more extreme, complex, rare cases) has pat answers, so I think it's ok to go try something new, just to see what happens.  I'm a little tired here, but it was more a how could you adapt that kind of thinking out loud, not something I've seen done.

 

 

I hadn't heard of that book before but it looks interesting, as does her formal intervention program. The latter might be a good investment for me as a future SLP and/or ed therapist.

 

The OT's that we've seen don't do the dominance & retained reflex stuff. I'd be open to paying OOP for an eval with someone knowledgable on the topics but I haven't a clue how to go about locating a good OT for that. I don't want to just start cold-calling clinics at random, KWIM?

 

Oh that's funny, because for some reason I was thinking you were the one who mentioned the book here on the boards!  LOL  Well somebody did; it's not my find.

 

Yeah, that's kind of strange not to be looking at reflexes and dominance.  I'm seeing multiple places (OT conversations, books, etc.) that the pyramid of neurological development is reflexes at the bottom, the gross motor, then fine motor.  Our SLP has found that the kids who do OT with the lady she has (who actually just left, but that's beside the point) get jumps in language.  And what I'm reading is that when you get the dominance issues better, the brain can pick the side for language and settle that down.  I'm sure it's not so tidy.  Oh, and retained reflexes apparently hinder establishment of dominance.  

 

In other words, finding someone to help you with retained reflexes (or at least doing the checks yourself) might get you farther than you think.  RMT would be a therapy to look for.  This book I read today on Miriam Bender (Stopping ADHD) focused exclusively on STNR and had *8 months* of exercises.   :svengo:  So I'm trying to figure out if those exercises are just really ineffective or if there's really that much to do!!   :scared:  

 

I hope to take some time soon and really look at them and compare them to the RMT exercises.  Sometimes they're rubbing the same cat, just different ways.  But Bender definitely adds some stuff, and their place seems ADAMANT that you can make astonishing progress by getting the STNR fully integrated.  Now it might be like VT, where they're saying oh look at these extra bumps, and it was really that you worked on those extra things (in this case impulsivity).  But I don't know.  It's pretty fascinating.

 

If you want a fun project, just start googling through them and use youtube videos to learn the tests for the common ones.

[GoVanGogh]

GvG, this is totally unrelated maybe, but in his OT evals, did he have a retained STNR?  I'm just curious.  This book I read today painted this rosy picture of all the things that reverse when you get the STNR to integrate...  My ds still has his, so it was pretty striking to me.

 

Yes, we are also dealing with retained reflexes.

According to neurologists, they aren't fully retained, but are very easily triggered so are causing issues. Our OT and PT worked on the issue for two years, but we didn't see much improvement. We will soon be having another OT eval so will have this re-evaluated.

What book are you reading?

 

Dominance:

All specialists that have examined DS say that he uses his non-dominate hand. We just finished neuropsych eval and that is what they reported in the preliminary report. We won't have the full report back for a few weeks, but I am very anxious to hear more on this. 

I don't understand how they know or realize this? Though we have always thought it curious that he is left-handed. Also, he has always used his left hand and I do know they say most (true left handed) toddlers play around with both hands before settling on the left hand around age five or six. DS was very much left-handed from early on. (Nine months, maybe?)

 

[PeterPan]

What techniques are they using on the reflexes?  I've seen methods online with animal names.  There's RMT which has exercises that look like this  http://www.rmtsupport.org/images/new%20small%20poster1.jpg

 

The book is Stopping ADHD   and the book is almost entirely on the astonishing range of effects they attribute to a retained STNR (let alone the rest!) and their sequence of exercises that you do over 8 months to integrate it.

 

What I haven't figured out is the pattern.  Why does it supposedly integrate in 7 weeks for some people with RMT and take years or never happen for others?  Is the difference the degree of problems and neurological challenges?  Is it a difference in what exercises the therapist was doing?  I just don't know.

 

I need to spend more time and compare those exercises in Stopping to RMT's exercises.  To me Stopping goes farther.  It fascinated me, and at this point my plan is to cover my butt and do them as well as the RMT.  Actually, what fascinated me more than anything was their criteria for deciding the STNR had been adequately integrated.  They had a series of things, but basically it's that they wanted you to do the integration exercises a lot LONGER than you'd think, like more months and well beyond when you THOUGHT they were integrated.  They claim that that's what it takes to get to the point where it's so fully integrated that the affects on other things (dysgraphia, etc.) start to improve.  

 

I don't know, just saying that really caught my eye.

 

Hmm, so that's interesting.  So they think he's likely right-handed but *using* his left hand?  Well that would sure be good to get sorted out, mercy.  I know there was a point where I had to TELL my ds which hand to use, because he was coloring up to the midline and changing hands.  Not that he colors a lot, but that was a definite pattern, changing hands.  Or saying one hand was tired.  

 

Well it's a journey and you're on top of it, doing what you can.   :grouphug: 

[Tiramisu]

We were told by a neurologist that dd's left-sided dominance was unusual in that it was very strong, very clear, and established very early. We have an old report from age 7 that mentions "static left-sided encephalopathy" but other doctors haven't picked up anything to justify that. An auditory processing eval determined she is left-ear dominant and that can indicate that the language center was not established in the normal place and in the normal way. It's also common in ASD. In any case, there's something going on that's mildly not neurotypical, but that's true for the rest of us, too.

 

An MRI didn't show anything related to those issues.

 

Dd is halfway through her music therapy degree. Music was her only therapy outside of counselling. She is doing well academically. She has minor motor issues. She has good friends.

[PeterPan]

Just for your trivia, my dd also has that LEA (left ear advantage).  They calculate it as part of the APD screening.  Sometimes an SLP or np will run that test, but in our case an audiologist did it with a booth, the full shibang.

 

Anyways, LEA is the term if GvG wants to be able to google it.

[Crimson Wife]

All this talk about left vs. right ear dominance makes me think I need to call the CAPD specialist to see if she'll even test a kid with a known hearing impairment. DD won't be 7 until January but with the waiting list I probably need to book now if I want an appointment next winter.

[GoVanGogh]

What techniques are they using on the reflexes?  I've seen methods online with animal names.  There's RMT which has exercises that look like this  http://www.rmtsupport.org/images/new%20small%20poster1.jpg

 

The book is Stopping ADHD   and the book is almost entirely on the astonishing range of effects they attribute to a retained STNR (let alone the rest!) and their sequence of exercises that you do over 8 months to integrate it.

 

What I haven't figured out is the pattern.  Why does it supposedly integrate in 7 weeks for some people with RMT and take years or never happen for others?  Is the difference the degree of problems and neurological challenges?  Is it a difference in what exercises the therapist was doing?  I just don't know.

 

 

Hmm, so that's interesting.  So they think he's likely right-handed but *using* his left hand?  Well that would sure be good to get sorted out, mercy.  I know there was a point where I had to TELL my ds which hand to use, because he was coloring up to the midline and changing hands.  Not that he colors a lot, but that was a definite pattern, changing hands.  Or saying one hand was tired.  

 

Well it's a journey and you're on top of it, doing what you can.   :grouphug: 

 

I am not sure what program the OT and PT were using. We took a break from both right now, but will be resuming as soon as we get the neuropsych report back.

At home I was using "Rappin' on the Reflexes."

 

Thank you for the book title.

 

I don't understand reflexes, either. It is my understanding that my son's will always be easily triggered and that is part of the CP diagnosis, but they want to work on them so they aren't as easily triggered.

Furthermore, in our quest to find a new pediatrician after realizing our former pediatrician missed our son's condition, we have discovered that most pediatricians blow off primitive reflexes and don't understand why they are important.

I interviewed nearly a dozen pediatricians and was told over and over again, "Oh, we don't look at that really. If they aren't integrated at that appointment, we just assume they will be by the next appointment and we never go back and check on them." Which expalins why my son's medical records have that box checked... But leaves me rather angry that I spend all that time and money on well-child visits, not to mention all the years I asked about our son's developmental delays.Our pediatrician had also checked the boxes that she had observed both our son's gait and that he crossed midline, neither of which I believe she actually could have done.