Tuesday, April 30, 2013

Zigging and Zagging and Bilateral Motor Planning

As my Gentle Readers remember, I have been doing all kinds of exercises to improve bilateral function these days. So, I decided to take it out to the real world and try a little dance classes at my local gym. So I walked in on a Zumba class and began shaking my booty.


Well the class zigged and I zagged. Think I have a bit more work on my bilateral exercises.


Monday, April 29, 2013

More on music therapy

I have been playing along in music therapy on some different instruments. I have not always been sure about the point but somehow I think it has been helping.

It is a very non directive therapy. The therapist and I play together and we see where we are going. One problem is that I am not very fluent in music and am definitely non good at improvising on the fly. (remember my problems with adaptative processing?). Bilateral skills are also challenging.

So, I stay away from the piano. I Am a beginner at it. And we never get anywhere as I can't organize my hands fast enough. So we stick xylophone, drums, and some very pretty textural instruments like rain sticks, etc.

Lately, we have taken up some of my bilateral exercises such as slap and tap and are doing them to music. This is going nicely. There is something about rhythmically moving to music and humming that helps the process.

Friday, April 26, 2013

Interesting post on language and vision

Thanks Suzanna for your question. Firstly you ask: "Do any of your patients experience linguistic confusion?"

The answer is definitely YES. In 1976, while studying Speech Pathology and Audiology for my Master's degree work, I published a paper on visual and auditory processing. As we well know there are visual connections in the brain that are linked from auditory parts. What this means is that our hearing and listening is affected as we re-educate the visual processing system. In my own case, at the age of 39, I could understand words from a song on the radio, while driving, for the first time. In addition, I have always had a kind of dyslexic approach to languages and great fear. This is changing now. In my case, it took a while before I had the confidence to verbalise, say words in German, for example. It appears that the binocular vision process activates new and deeper pathways that disorganises habitual language patterns. Fortunately, this is short-lived in my patients.


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Thursday, April 25, 2013


Went and had an evaluation over at Princeton Biofeedback Center for some neurofeedback. After getting myself really scrambled up and losing track of time and space, my Gentle Readers may wonder why I am trying this stuff again, albeit with a different provider. However, somehow, I do think this is the right thing to do and I would like to try to do this with a different provider.

I think these folks are the right ones for me. Instead of looking at my neurology reports, they looked at my symptoms. In particular, they were interested in physical and psychological problems. I am wondering if I have a very low level but constant agitated depression/anxiety/ADHD cluster. Rather than pointing out a single diagnosis at this point, I am wondering if somehow this whole clump of inattentiveness and irritability is somehow related. Maybe my problems are a big stress response sort of thing.

My first session went pretty well. It was much different from the other provider. The other folks used a bipolar protocol with electrodes at c5 and C3 on my head as well as an electrode on my ear. I watched a game of PacMan (chomper). This time, my therapist put a band around my head and inserted some electrodes around my head. I closed my eyes and was told that when I was in sync with my alpha waves, the light woud start flashing and a buzzer would start beeping. I listened to a CD on visualizing space within my body.

I felt remarkably calm after it was over. My binocular vision improved. Went home and felt very calm but a bit tired. Some mild tinnitus. I had this sense that one of my fears about returning to work in this very lousy economy had dissipated. I just got this very deep sense that it would all work out. Maybe everyone who is unemployed these days should get neurofeedback as part of their unemployment benefits!


Wednesday, April 24, 2013

Vision Therapy, Slap and Tap

Vision therapy Is going on with a new focus. In addition to the work we have been doing on the visual midline shift, my therapist and I figured out that I haven't done all the preparatory exercises that she thought my other vision therapists would have done. Perils of moving on to new therapists, I guess.

I don't have as good a grounding with bilateral exercises as she had thought. So I got a bunch of exercises to work on such as Slap and Tap where I slap different sides of my body or tap my left and right to the beat of a metronome. Or I look at arrows pointed in different directions and point accordingly. The. There is the circles and triangles on different sides of a line. I have a "circle" hand and a "triangle" hand and I move them across my midline accordingly.

We are also using the prisms more. I have a base in 30 for my left eye and a base in 8 for my right eye. Odd combination. But remember I have a visual midline shift. I am on a balance board and am gripping it with my toes mightily as the prisms are changed.

We are doing a lot of multisensory work. So it's a lot of calling out and walking around with prisms as well.

I am definitely getting there though. Much better sense of space.


Sunday, April 21, 2013

Nintendo Wii 'should be used to train surgeons' - Telegraph

Nintendo Wii 'should be used to train surgeons' - Telegraph: A group of postgraduate surgeons at the University of Rome were put on a month-long programme of gaming using the Nintendo’s Wii console.
Researchers then compared their performance with doctors who had not spent an hour a day playing games.
Those that had been playing with the Wii scored significantly higher as a group in simulated tasks designed to test the skills needed for laparascopy, or keyhole surgery.
The authors of the report, writing in the scientific journal PLOS One, said that using the Wii could become a “helpful, inexpensive and entertaining part of the training of young laparoscopists in addition to a standard surgical education based on simulators and the operating room.”

Copyright © 2010-2013 Traveller Journey Through The Cortex
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Opticians don't know how to measure PD for strabismics -

IMPORTANT: Opticians don't know how to measure PD for strabismics - Sovoto

I am going to cross post this message as it is extremely important for strabismics and for parents of strabismic children seeking prism lenses.

Be extra careful when ordering prism glasses as some opticians have no idea what to do with strabismic patients and may calculate their own pupillary distance (PD) measurement that will not be the same as the developmental optometrist's PD. The difference in the PD measurement can have disastrous effects on your prescription. Although Luxottica Retail says they'll change their training programs for their opticians after my incident, I don't know if they really will. Even if you go to non-Luxottica owned optical stores, make sure the optician doesn't override your doctor's prescription because of the "Standard Operating Procedure" for measuring PD.

I am not exaggerating when I say that what I experienced could have been fatal. Below is the description of what happened to me.

After two and a half LONG years in VT, I finally got a prescription for prism glasses in mid May. I went to Sears Optical to fill the prescription and after a long delay in making my lenses, I received a pair that almost caused me to crash my car because the pupillary distance was incorrectly calculated by the optician.

Effect: I had to drive with one eye closed because my left field of vision moved faster than my right field. The divider lanes on the left doubled at a 20 degree angle into my lane, causing me to get confused as to where my lane was. At night, the extra divider lane was not only at a 20 degree angle but it was sometimes elevated above ground. If you've ever had to drive with an eye closed, you know how hard it is.

I couldn't look down when descending a staircase because the end of the step would also double at a 20 degree angle, making it hard for me to see where the end of each step was. Other lines, whether they be on sidewalks or my kitchen floor, would double or be distorted.

This is especially important in Pennsylvania where the counter people do not have to be licensed opticians. For strabismics, you can get yourself really hurt. For normal folks, you can go round and round trying to get your glasses straightened out especially if you use the chains like Sears or Pearl Vision. In New Jersey, however, you MUST be a licensed optician to sell eye glasses


Saturday, April 20, 2013

Update on Vision Therapy: We are cracking the code

I think we are starting to nail it and I am on track to getting my Stereo Sue moment where I have true depth perception. As my Gentle Readers recall, I do have good binocular vision with 20 degrees of stereopsis. However, I do have a Visual Midline Shift.

So, we have been doing work with yoked prisms. First, vertical and, now horizontal.

Also, we have been doing a lot of multisensory work with walking heel and toe while reading down and across a column of letters.

Other drills include vision HTS on a big touch screen where I working my peripheral vision as I touch letters of the alphabet or chase after moving red, white and blue dots.

We are also putting a piece of paper at my sternum and I am tracking a ball in space. This forces me to use my left eye more which had got shut down.

Lot of work on balance board.

Net effect. I can see a much bigger area. When I drive, I am aware of what is going on on the other side of a muti lane highway. My panoramas and vistas are much broader. For example, I can take in many of the buildings of Philadelphia airport along with the runways and the planes sitting on them. When I drive north from Delaware, I can see the full complex of the Boeing defense plant. As I approach Philadelphia, I see the vast industrial works of South Philadelphia--its refinery storage, warehouses, and then the skyscrapers that make up the background.

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Friday, April 19, 2013

Rubin museum brainwave talk

Went to the Rubin as part of their brainwave series. This year, they are focussing on illusion. Next year at the Rubin Museum will be a series on Tibetan Medicine. I've been getting very interested at the intersection of Tibetan meditation, medicine, and neuroscience. More on that later.

As part of brainwave exhibit, Lior Lev Sercarz looks at your past and present through spices.

Donald Wilson is a neuroscientist who looks at memory, learning and smell.

Sercarz notes that you can't turn off smell . Wilson replies that this is part of autonomic system. Two things you can do to enhance smell: 1. Is to inhale. Sniff. The turbulence and flow of air influences how the molecules of smell reach your nose, 2. Humans are better at than any other animal with retro nasal smell associated with flavor and taste.

Wilson says that sense of smell is very fast because olfactory brain has a much shorter pathway. Smell in lizard is very similar to that of humans. We have added on speech pathways. 300 ms to figure out what it is. ms to decide whether to eat

Interesting talk. Got to sample spices. Maybe I will have Sercarz make a bespoke spice mix for me. Anybody got any good ideas? I wonder I'd he has anything for memory, cognitive processing speed, and smell

Thursday, April 18, 2013

Update on Hubby's Therapy

Hubby has been doing some Tomatis and Interactive Metronome therapy with the peeps over at A Total Approach. He has been moving much faster through the therapies than I had which does make me a bit jealous. Also, he hasn't been getting as wiped out by them as I did.

His therapy is a bit different. Hubby gets a massage and then He has to do some physical exercises to strengthen his core muscles. Poor hubby, he really doesn't have much in terms of core muscles. Unlike the rest of the male half of the human race, Hubby has a very thin muscle wall around his abdomen. So, no matter how hard he tries, Hubby will never have six pack abs.

He, then spends his time with the Interactive Metronome. So far, hubby doesn't have much to report except he is starting to get a little tired from IM.

Hubby has seen anything notable happening this week. Be we are expecting an improvement in coordination in the weeks to come.

Another Point of View

I like looking at things from another point of view. Over Thanksgiving, I sprained my ankle very badly. I was messing around in my garage and I went back into an alcove, which is 18 inches above the garage floor, and started digging into piles of stuff to take with me when I turned and done the floor and stepped down rather harshly on my foot.

I crashed down on the floor. And literally saw stars. I dragged myself to the living room and plopped down on the couch. I thought I would be able to get up in a few minutes, but I was wrong. After a few minutes, I put my foot down and pulled myself up, but even with the cane, I quickly realized that I really didn't want to walk. So off we went to the emergency room. I knew from previously working in a hospital that going to the emergency room early on Thanksgiving would be the best time to go. Much later, everybody has been eating and drinking and slipping and falling, getting in fights or car accidents, and then sitting around and thinking about whether they wanted to go to the emergency room or not maybe for a few more hours and then they all come rolling in the ER at once. You know how a restaurant near a ball field gets slammed with customers after a big game? So do emergency rooms get slammed with patients on the evening of a big holiday. Word to the wise, get there early, before the crush.

Went to the ER, and x-rays taken, and was told that I sprained ankle. I got some crutches and went on my way. I husband and I decided to continue to go on our vacation. We had planned to go away to Maryland's Chesapeake Bay for The holiday. There is a lovely resort in Rosehaven right on the bay. We drove for a few hours and then we checked into the hotel. The hotel was very nice about me not being able. They gave us handicap parking even though I'm technically not a handicapped person and we don't have handicap license plates. They drummed up a wheelchair and my husband pushed me into the room. Hubby was very nice to me that weekend and took care like the best the of nurses: he iced my foot, taped it up, elevated it, etc., all the good things that a nurse would do for a wounded foot. He was an excellent morale officer. We took a nice little ride on the dock with the wheelchair and I saw that the ducks preening and flapping and the boats bobbing up and down. It was really really beautiful...there is nothing like being on the breakfronts of the bay.

I paddled my wheelchair around the grounds by myself , as well. Being a nice resort like spot, this place gets its share of wedding parties. A lot of people like to come for their weddings and rent out rooms with large picture windows for their bridal suite. These parties usually involve copious amounts of alcohol and loud rowdy behavior. Bachelors came rolling in primed, each with their bottle of beer already uncorked. Someone apparently saw me and made some not very flattering remark relating to the fact that I was in a wheelchair. I couldn't really hear it but I heard the response along the lines you could end up like yourself, too.

My first response was to say, "hey, I'm NOT HANDICAPPED! I JUST HAD A NASTY FALL. I'LL BE ON MY FEET IN A FEW WEEKS. I'M NOT NOT ONE OF THOSE PEOPLE". I seriously considered rolling up to one of the yahoos and explaining my situation.

This response made me think a lot about myself. Why was my first reaction to disown kinship with the handicapped? What's wrong with not being completely whole as the average person defines it? What is it about group identification and how we define it? We make categories and stick people into them. Us and Not Us.

In fact, someone reading my blog could make a pointed remark about my invisible disabilities and how I should show more empathy towards the handicapped as I among myself.

I think my secret hope has been that by doing all my therapies that I will be "cured" and no longer part of the handicapped. At this point, I have gotten out of the autistic world (if I was ever truly part of it). There's a lot of questions about the validity of the assessment that led to that diagnosis. Maybe the differential in verbal vs performance IQ has more to do with vision and occular motor skill problems than a real diagnosis of a nonverbal learning disorder. Correct the vision and the performance IQ goes up adn the diagnosis of nonverbal learning disorder goes away. On another level despite the diagnosis, I never really felt a kinship with THOSE PEOPLE. I really never felt a connection with that category of humanity. Along with many of my therapists, I never felt like the diagnosis fit.

Another diagnosis is ADHD. I am not sure about it. There is a lot of overlap and misdiagnoses between eye problems such as convergence insufficiency and ADHD. Think about it. If you have an eye problem where it is hard for your eyes to fixate on a target such as a light flickering on and off (part of the ADHD test suite), you aren't going to score well. Ditto for ocular motor problems like hitting the switch when you should. Same for hearing. There's a lot of overlap and confusion between auditory processing disorder and ADHD.

But when I think about my rejection of autism and how I just don't want tobe with a bunch of people who have a reputation for not getting along with the rest of humanity, I'm just not too proud of myself. It's one thing not to like a diagnosis for not being a good fit and quite another for not acknowledging the humanity of another bunch of people.

I don't have the same problem with ADHD. It seems to fit better. ADHD seems a bit mad cap with the potential to unwittingly annoy people. I don't know whether the diagnosis is going to be correct so we shall see. But maybe when I think of my experiences on a wheelchair or with diagnoses of autism, I'll approach things with more humility.

Monday, April 15, 2013

Searching for Genius in the Brain

Genius is a big concept to get one’s head around. I was surprised to find that no studies of this topic have ever been reported in the scientific literature. There exist numerous studies of intelligence, creativity, personality—some of the key ingredients—but none regarding the “big one.” Perhaps that is why such a diverse array of panelists were brought together to discuss genius at the World Science Festival’s Beautiful Minds: The Enigma of Genius—a physicist expert in string theory, a director, a mathematician, a psychologist, a neuroscientist, a neuropsychologist, and a composer. I know that one panelist is not a genius (myself), and suspect that at least two are (Julie TaymorPhilip Glass). If we were to design a study of genius, how would we go about it?
Measures of intelligence have been around since the turn of the last century, with the introduction of Alfred Binet’s test, in 1905, to help identify students who needed extra help in school. These tests have grown to be highly refined over the 20th century, with current measures being some of the most reliable and valid measures of human behavior in existence. If genius were merely the measurement of high intelligence, we could easily identify such individuals by their membership in societies such as Mensa (98th percentile), Glia (99.9th percentile), or Mega (99.9999999th percentile). Something like this happened with a researcher named Lewis Terman, who used IQ tests to select the brightest students (their average IQ was 151), and followed their life progress over time. These students did extraordinarily well, achieving great success in science and industry (2000 scientific publications and 70 “American Men of Science”). However, one man tested by Terman had an IQ that was too low to qualify for the study: Nobel Prize winner for physics William Shockley, co-inventor of the transistor and certifiable genius. Oh.
So, unusually high creative capacity is another distinguishing characteristic important to genius. But it is nearly impossible to get access to folks like Julie Taymor or Phillip Glass (on the one hand) and, having pulled them into an MRI scanner, tell them to “create!” Rather, our field tries to break this big thing (creativity) down into parts that are reliably measured in the laboratory. One such measure, relied upon too heavily over the last 50 years, is of so-called “divergent thinking,” which asks people to think of as many different/creative ways they can to use a common object such as a brick. Research subjects give answers ranging from “to throw through a window” (less creative) to “cufflinks for the jolly green giant” (more creative). They also are asked to draw as many figures using four lines (straight line, curvy line, dot, all count as 1 line) as possible in a certain amount of time. These measures of verbal and non-verbal divergent thinking are commonly scored in terms of “fluency” (number of items produced), “flexibility” (number of different categories produced), and “originality” (the unusual or low frequency of the response). There are similar methods to measure insight (Remote Associates Test), flow, convergent thinking, persistence, openness to experience, and other pieces of the big puzzle of creativity. We link all of these measures to what we see in terms of brain structure and function to make inferences about creativity writ large.
But what does this look like in the brain? During the panel discussion, I brought up the notion of “transient hypofrontality” on several occasions. This is not just some neuroscience jargon, but represents my best attempt at a model for how one aspect of creativity (divergent thinking) works in the brain. I must give credit to Arne Dietrich, a big thinker in the creativity field, who coined the term and with whom I have had several discussions about the subject. What we found in our research was surprising: in individuals with higher divergent thinking ability, lower measures of brain integrity were also found (whether measured by biochemistry, white matter fidelity, or cortical thickness), particularly within the frontal lobes (at its most basic, the part of the brain that inhibits us from doing things we should not do, and organizes our behavior). We believe that this “disinhibitory” capacity of lower organization, in our normal young cohort, allows them to spin out more (think fluency) and unusual (think originality) ideas during divergent thinking tests. To use a poor metaphor, they have their foot off the brakes and more on the accelerator when performing these tests of divergent thinking by virtue of their frontal lobe organization. Now, they will need their frontal lobes later to push their unusual ideas forward to an unforgiving world, so the “transient” is important in “hypofrontality.”

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Friday, April 12, 2013

Auditory Processing Disorder and TBI

A100319_MAMC_TBI 1
A100319_MAMC_TBI 1 (Photo credit: Joint Base Lewis McChord)
I have been doing some thinking about my hearing problems and I am wondering if I
am missing a key portion of my hearing due to some deficiency that belongs in the 
Traumatic Brain Injury (TBI) world rather than the Developmental Deficit world.

Ah yes. Labels.  A common refrain in the disability community is that we are more
just labels.  And that is so true.  In defense of labels, grouping all the symptoms 
together in a category gives a practitioner some guidance as to the therapies that
will probably be the most helpful.  On the other hand, patients aren't so neat.

So, I am going to ask my audiologist to look at my hearing problems in another context
other than the developmental one.  Since I have one documented deficit in vision,
visual midline shift, that belongs in the traumatic brain injury or medical disease 
(multiple sclerosis, e.g.) category, maybe there is something in those categories that
pertains to auditory processing disorder

This isn't to reorient the focus of my problems in the developmental arena to a new focus.
I talked to my optometrist and he is still thinking that the gist of my problems are
developmental with just this one outlier in another field.  However, in order for me to 
get true depth perception, we have to get my visual midline realigned. 

Also, in the course of therapy for visual midline shift, we have noticed that I haven't
done all the physical therapy for bilateral functions.  So, we are planning to do 
more work there.  I am wondering if this work is going to have any impact on my 
auditory processing. 

Here is a nice presentation on auditory processing and TBI
Copyright © 2010-2013 Traveller Journey Through The Cortex

Thursday, April 11, 2013

Discussion of Nordoff Robbins Music Therapy

English: music therapy
English: music therapy (Photo credit: Wikipedia)
"Nothing activates the brain so extensively as music," says Oliver Sacks, M.D., professor of neurology at Columbia University and author of Musicophilia." 

 Interesting discussion of Nordoff Robbins Music Therapy.  I got interested in music therapy for a couple of reasons:

1.  Overall brain functioning.  Like Oliver Sacks says, music activates many parts of the brain.  I think part of my problem is overall interconnectivity between various parts of the brain.

2.  Rhythm.  Just keep reinforcing previous Interactive Metronome therapy to help with problems  that I have had with rhythm and timing.

3.  Motor Apraxia.  I am  starting to wonder about overall apraxia and, in particular, apraxia involving speech.  My music therapist would like me to sing but I have been too embarrassed.

4.  Memory.  Memory issues are coming to the fore front so I think music could help with that.

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