Neuroplasticity - Understanding the Brain

The brain is the most complex organ of the body. It is responsible for our actions, emotions, thoughts, language, movement, and internal systems of the body. A brain that is not working to its full potential can show up as learning disabilities, developmental delays, mental illness or brain trauma. In order to help the brain get back on track, we must first understand what makes it work.

What is neuroplasticity?

"Neurons that fire together, wire together"

Neuroplasticity is the ability of the brain to change itself. The brain was once thought to be hard wired - meaning you were stuck with the brain you had once you grew into an adult. New research has shown that many aspects of the brain remain changeable (or "plastic") even into adulthood. Neuroplastic change can occur at the individual neuron level or to the whole brain as it remaps itself after injury. This is important to those suffering from a diagnosis (PTSD, brain injury, attention issues, autism, FASD, dyslexia, etc) because with the proper treatment of a knowledgeable rehabilitation therapist, many of the symptoms can improve.

Look at the video to understand neuroplasticity better.

Dr. Norman Doidge, a psychiatrist in Toronto wrote two fascinating books called The Brain that Changes itself and The Brain's Way of healing. He appeared on The Nature of Things. Look at these documentaries.

The Brain that Changes Itself documentary

The Brain's Way of Healing documentary

Doidge, N. (2015). The brain’s way of healing: Remarkable discoveries and recoveries from the frontiers of neuroplasticity. New York, NY: Penguin Group.

Rehabilitation Principles

When dealing with a disability or injury it is important to follow a logical approach to treatment in the following order:

  1. Rehabilitate
  2. Find an alternative way
  3. Compensate
  4. Substitute

Based on the diagnosis the occupational therapist (OT) will determine where to start. In most cases, the OT should first help to rehabilitate the person to restore previous function or improve to a new level of function. Once the person reaches a "plateau", the OT determines if the person is back to normal function, if not then the OT needs to find an alternative way of getting the person to do the task. If this is not possible, then the OT would give the client compensatory strategies to cope. If the client is not able to compensate, the OT puts resources in place to substitute for lost function. If the diagnosis will cause the person to deteriorate, then rehabilitation is not possible and steps 2-4 are implemented.

When dealing with children or adults with learning disabilities or brain injury, although steps 2-4 help with day to day living, it is important to rehabilitate the brain by focusing on interventions that improve neuroplasticity.

A systematic approach

When a baby is born, he has limited control over his body and uses his reflexes to survive and to prepare him for movement.  As he engages with the environment he will take information in through his 8 senses (feels his stomach grumbling (interoception); feel his wet diaper (tactile); be soothed by the rocking motion (vestibular) or mom’s voice (auditory).

Once he integrates this, then he is able to start to crawl (gross motor), then he starts using his hands to put together puzzles (fine motor), then he puts it all together and is ready for higher learning. When any of these skills are delayed, higher level tasks will not be efficient.

Infant reflexes can reappear in adults who have brain injury or trauma. They find themselves in survival mode and may heavily medicate themselves to try to cope.

The good news is that both children and adults can get back on track with a systematic rehabilitation plan. This is called a "bottom-up approach". It is important to strengthen the foundation for other higher levels of function to be successful. We will evaluate each area, then offer a treatment plan to help strengthen the skill.