Learning Disabilities and the Neuro Developmental Functional Approach Therapy
Dr. Gilad Schafman Msc.D.
• In this article I am using the term child to refer to children of all ages from infants to aging folks.
The Neuro Developmental Functional Approach (NDFA) is a dynamic approach to understanding and helping many of the issues regarding learning disabilities from ADD to CP and PDD in all ages from infancy to the elderly. It was developed by two developmental psychologists: Rami Kats and Judi Rabinovitz. The NDFA is based on the individual work of many people in the field of learning disabilities like Dr. Karl Delacato, Jane Eires, Tomatis, Erlain, and more, integrating their understanding into a whole body view. Understanding the senses, their function and their integration with one another.
The awareness to learning disabilities is a rapidly growing subject in the last decade or two. Many ways of working with LD have developed and some still are. As practitioners it is important to look not only at the symptoms (like inability to read) but also at the reasons behind them, not allowing the body to do what it can in optimal conditions. It is important as well to check if the labels we use (dyslexia, disgraphy, ADD, ADHD, PDD and more) are describing the problem or are they just labels describing a group of symptoms that create a certain attitude and behavior towards the child. If we look back several decades, we will see that the number of the students found with learning disabilities was much lower than it is today. That comes as a result of a few factors: a. the awareness to the whole subject of LD is much greater then it was. So many people who are evaluated as a LD today would not have been observed in the past for lack of knowledge and a different point of view. b. The stimulation children experience today is different in type and intensity than the stimulation that was available about three decades ago. Many children vegge in front of the TV or the computer for many hours every day. For instance TV is a high intensity visual and auditory stimuli. After watching TV children go to the classroom and the teacher has to “compete” with the level of stimuli that they are used to in order to keep them attentive and interested. c. Children grow today with less stimuli in the proprioceptive (deep sensation of the body), vestibular (part of the balance function), and coordinative system than they used to. Many of the outdoor games that were common in the past are not as common today like jump rope, marbles and more. These games have an Important influence on the motor, sensory and social development of children.
Another part of this equation is the educational system and its need for labels (it is so in Israel although there is a good chance that at least some of it is true for other places as well). Teachers can tell who has some difficulty in learning or who is disturbing the other students, or who cannot sit without moving. In order to know how to label him, he is sent to be evaluated. In the evaluation we will find the obvious, the child is hyperactive, has ADAD and so on, something which we already know. In many of the evaluations the reasons to the problem are not addressed or found. The focus is on the symptom. For instance; if a child cannot read it is important to see what is preventing him from reading, is the problem is in his motor skill of the eyes then we need to strengthen his ability in this function. Corrective reading lessons without exercising the eyes will be by far less efficient than it would if it is done after practice. The NDFA examines the sensory and developmental aspects, which in most cases are the cause to the symptoms we see.
Hyperactivity symptoms can come from several reasons. One of them can be from the proprioceptive aspect. Proprioception (the deep sensation of the body, muscles and joints) is the information sensation that the muscles, the ligaments and the joints send the brain. This information contains the movement and the power the muscles exerted. When a child is hypersensitive in this function, he receives much more information than a child we can call normal. Each sensation is felt much stronger than it is. This causes great discomfort in the body and will cause the child to move a lot, which will look as though he is hyperactive. Such a child will sit in the classroom on the tough chair, the chair will feel very hard and uncomfortable and it will be very hard for him to listen to the teacher. A child with such over sensitivity will suffer from pain from light touch and the child doing the touching who is not over sensitive will not understand the strong reaction from the other party. An over sensitive person sensing so much in his body will complain to the doctor that he has this or that pain and when this reoccurs the doctor will tell that person that he is a hypochondriac, and he will still not understand why the people around him do not get his condition and cannot be sympathetic to him. Lack of proprioception can also be the reason for hyperactivity. When a child lacks sensations from the body the brain is seeking to feel. This can cause a lot of movement but the reason now is a search for sensation. Such a child can also touch and hug with great force and at the same time not understand what he is doing or that he is causing discomfort or pain to people around him. Sometimes children who “like to fight” are children who lack proprioceptive sensation. The deep sensation they are looking for is experienced when they fight. I encountered such an example several years ago in a kindergarten, one of the children loved provoking his friends to hit him and lay over him and when they did he was so happy laying there and being beaten.
Hyperactivity can be the result of another dysfunction in the vestibular system. The vestibular system is a part of what we usually call balance, which is not a system but a function. This system tells us of change in movement, direction and where gravity is.
The arches/semicircular canals of the vestibular system
Lack of sensation in the vestibular system can be the cause of hyperactivity in some people. The child who needs stimulation of this system would love roller coasters, theme parks and the faster and more daring rides. The stronger the stimulation the better he feels and the happier he gets.
The Search for stimulation where it is missing and the avoidance of it when there is over sensitivity are both disrupting the child’s attention. The meaning of this is that the learning process or function cannot work efficiently because some (a little or a lot) of the attention is going to the system (or systems) that is not in balance and does not let the child listen to the teacher, focus on reading or do other activities.
It is important to remember that hypo- and hyper-sensitivities can come at different levels from minor to extremely high. The higher the imbalance the more radical behavioral and functional patterns we will find. These patterns become through the years a part of a one's personality. In many of the cases there is a tendency to focus on the psychological aspect and miss the developmental aspect from which it is driven.
By applying the appropriate exercise and massages to the child we can change the way which he experiences the world. That will reflect in behavioral patterns and on the child’s ability to learn and perform different tasks without creating stress in the body in the process. A good example of this change is a woman who went though a series of sessions of NDFA. After several weeks of sessions she got a call from the bank to verify the she was the person signing her checks. This shows us how profound was the change not only in the functional side of her life but her personality as well for writing was not what she had worked on. Many examples show us that a change in the sensory aspects of the body enables a profound change that looks like the person has “stopped” being hyperactive where in reality he might have only appeared as one. Such a change can only occur when the actual reasons have been removed a there is no longer a discomfort in the body.
The NDFA is good for adults as well as for children. LD and functional difficulties do not disappear at age 18. We can see difficulties in learning to drive, lack of concentration in college or other postgraduate schooling, dysfunction on the job and more.
It is important to remember the elderly folks as well for in many instances lack of use of the body brings to a deterioration of the ability to function as before. The body is meant for usage, work, and activity. When we don’t use it we can see a decrease in physical strength, ability to do things that were easy in the past and in the cognitive abilities. Encouraging the elder to resume physical activities as well as cognitive ones with proper exercises is part of what we can do to improve the quality of life in this age group.
The NDFA is integrated in schools on one side and practiced by private practitioners on the other. In schools teachers integrate their understandings of the approach under the guidance of “The Center for Advancement of Functional Capacities” led by the senior developmental psychologist Rami Katz and his team. Practitioners are working with individuals or groups in community centers or private clinics. The NDFA understandings are the ground on which school program are adapted to, to make the learning more experiential as it should be. That contributes to the sensory development of the children and makes them more interested on one hand and leaves them with a taste of fun so they want to learn more and enjoy it.
To conclude: the NDFA evaluates and works on imbalance of the sensory and functional systems of the body. We work with all ages from babies to the elderly. This work is significantly beneficial to everyone. It is possible to integrate this work with other modalities like: Bach flower remedies, one brain, TAT, nutrition, EFT, homeopathy and more. In some cases other professionals are working in conjunction like: Psychologist, occupational therapy, corrective learning, orthoptist and more.
Gilad has recently moved to Miami Beach to join the integrative staff of Miami Beach Pediatrics. Gilad has been a therapist for over two decades. In his practice he incorporates many modalities to bring the client into balance in the most effective way he can. In The clinic he is evaluating using the knowledge of the Neuro Developmental Functional Approach (NDFA) to assess the different imbalance that can cause ADD, ADHD, behavioral issues, and more. The NDFA is a dynamic approach aiming to resolve any physical (sensory and functional) condition that needs calibrating and sets a course of action towards that goal. The NDFA is also used to enhance learning skills and was tested and showed it ability to improve on children's school results in schools that incorporated the NDFA into the regular teaching curriculum. Gilad is one of the founders of the Israeli Massage and Bodywork Association and was its president for seven year. He is one of the creators of the curriculum of the NDFA therapists course and one of the leading teachers responsible for the practical application of the NDFA. Gilad is also practicing Structural Integration (SI) also known as Rolfing. He is a SI practitioner since 1991 trained by the leading teachers in the field. SI is intended to improve one's posture by organizing fascia (connective tissue) in a more efficient way in the field of gravity. These 10 sessions series has been proven to be effective for a wide variety of conditions including improvements in scoliosis. SI is an educational processes as well as it educates the receiver on how they can move with more ease grace and efficiency in daily life.