You may have heard that the path to success is paved with failures. We like to think of it differently. We believe the path to success is paved with ebbs and flows. At least, the Neuro-Developmental Therapy Path is.
The path to neuro-developmental success often follows a two-steps-forward-and-one-step-back pattern. Or it could look like a roller coaster, as in the image above. Just as the child is reaching a new summit, demonstrating new skills, feeling more comfortable in their skin, getting along with others better than ever, they appear to have a setback and experience the same or similar challenges as the ones they had before they started therapy.
Why do these setbacks occur? In a nutshell, the child’s brain is taking a break. The therapy the child has been receiving has been promoting rapid targeted neural growth to connect specific parts of the brain that previously have not been communicating clearly with each other, which had caused frustration, lack of skills, and behavioral dysregulation. But that rapid neural growth is unsustainable for long periods of time, and the child’s brain needs to “take a break” to fully myelinate the new connections, prune old ones, and integrate all of the new ways of processing that have been introduced to them. And it’s likely that everything feels uncomfortable, new-to-them, and dysregulated.
I liken it to a neural growth spurt period, much like the growth spurts children experience from birth to 3 years. When they experience them through typical development, they will often exhibit these behaviors: sleepiness, crankiness, increased hunger and thirst, clinginess, meltdowns at the slightest provocation, etc. These behaviors are also demonstrated when experiencing the “1-step-back” in neuro-developmental therapy, but it is much more aggravating and irritating to the adults when it’s a 10-year-old child vs a 2-year-old experiencing it.
We counsel parents about this pattern so they are not suprised or discouraged when they see an increase in undesirable behavior after a few weeks of therapy and so that they understand the value of continuing to provide intervention to keep moving forward. The most important thing to do when these behaviors surface is to continue to provide therapeutic intervention, either at home through a Home Program or through regular therapy sessions. We want to ensure that the brain is prompted to continue to grow and make connections, though we may reduce the speed or intensity of growth to allow it to “catch up”.
Fortunately, each successive “one-step-back” tends to be less disruptive and of shorter duration than the previous one. So progress can resume a more rapid pace and can be made more quickly each time, until the child achieves success in their goals.
One caveat to keep in mind is that when a child reaches puberty, they may experience similar challenges as the ones they originally struggled with. This can often be addressed with a check up in therapy, and a home program. Keep in mind that most children going through puberty are experiencing similar challenges.
~ Kim Hazelton, OTR/L and Your SAB Team