If you do not know how the brain makes and replaces habits, you will waste a lot of therapy time and get less than optimal results. When a baby with a damaged brain starts to move against gravity, the parts of the brain that are currently working control the movement. For example, in a baby with a right-sided hemiplegia, the left arm and hand start to bring the hand to the mouth, while the right side either cannot move or it moves badly. At this stage, some of the brain is permanently damaged and other parts are in a process of active recovery. The baby uses whatever is able to work and over time, she wires in an abnormal movement pattern.
Practiced Movements Wire into the Brain and Become Habits
It is easier for the brain to perform a wired–in habit than it is to learn a new way of moving. Anyone who has taken up a new sport, tried to play a musical instrument or learned to drive a car will remember how very difficult it was to learn new ways of moving your body. Remember the feeling of abject terror as you first tried to make a left-hand turn in a car across traffic. Now exactly the same movements require some concentration but they are easy and practiced. The key movements of driving a car have become well-ingrained habits, so ingrained that you often don’t pay any attention to your driving until you suddenly realize your habit has been driving you over the well known path to your home.
Brain and Body Habits are Energy Efficient
Whatever you do, you learn to do better and habits are much less effort. A child who has learned to walk with one of the characteristic movement patterns of cerebral palsy, developed this abnormal walking habit early in life. The habit was laid down in the brain when it was in the process of recovery. We assume that significant recovery after brain damage takes 3 to 4 years. By that age, the young child’s brain has recovered to whatever extent it can and other parts of the brain have matured and become functional. This means that new skills can be learned with a new brain.
Early Skills are Habits: Later Learned Skills Demonstrate Recovery
What this means is that in the early years, we have to all work together to keep the child’s movement patterns as normal as possible. This often involves spasticity management, braces and/or splints, compressive garments and even surgery in addition to working with skilled physical and occupational therapists. The goal is to minimize the development of maladaptive habits. If the child has already developed an abnormal movement pattern, the goal shifts to inhibiting or diminishing the use of the early learned abnormal habit while teaching new, more adaptive habits to replace the old.
This link is to a 2 minute You Tube video animation by Sentis that explains how the brain creates and changes habits. It is the best explanation of a difficult concept that I have ever seen.
Watch it a few times and even show it to older children and teenagers. Discuss it with any athletes or coaches you know. The concept of replacing a bad habit with a better habit is not new…it just has not been widely applied to children and adults with early learned movement patterns.
Coaches and Sports Therapists Know that Habits can be Replaced
Early Praise for The Boy Who Could Run But Not Walk: Understanding Neuroplasticity in the Child’s Brain
“An amazing book that proves habit hides recovery. It can be done; it doesn’t matter what the disability. A good therapist, parent or a sports coach can train a patient like an athlete – to achieve an optimal level of performance.”
Karen Orlando, BSc, PT, Owner ProCare Rehabilitation in Toronto. Member of the Canadian Olympic and Paralympic Medical Teams
Next week, I will start a series of blogs that will explore how you can uncover brain recovery hidden by maladaptive habits. As ever, I welcome your comments and questions.