In his paper "Ontogeny of Reading Problems" presented to Claremont Reading Conference in 1963, Dr Carl Delacato, ED. D reasoned that the process by which one attains the ability to learn to read - the ability to learn to express oneself starts at birth. If the child is not afforded the opportunity to develop total neurological organization, the child cannot become totally " human ", and as a result cannot communicate at the level, at which the child might have been able to, had neurological organization been completed.

Based on the rationale of neurological reorganization, prevention of communication dysfunction and, as well, the development of meaningful communication is very possible. It must be based, however, on the premise that there are significant development stages of neurological organization which cannot be bypassed, and as the child reaches each stage chronologically, it must be given every opportunity to master the functional neurological activities at that level before moving on to the next. With such a logical approach to child development, we could become able to deal with the problems that face us today, by seeing that every child is given the opportunity to develop wholly and completely in terms of functional neurological organization.

Prior to the presentation of this paper at the Claremont reading Conference, Carl Delacato had spent over 10 years developing the theories on which his paper was based; studying cultures around the world, and working with, and studying children and adolescents with varying degrees of communication and development delay problems. This research led to his premise that all the affected individuals studied, had either an incomplete neurological development, or had received, or been subjected to an event, which interrupted the natural sequence of development, leading to complete neurological development. His two books published in the period up to 1963 outline his rationale and treatment regime, which leads to neurological completion and thus to the individual to achieving meaningful communication.

It is the contention of Delacato International, that individuals exhibiting development delay, neurological dysfunction, behavioral problems, learning delay, communication problems, etc. essentially came to be as a result of incomplete or disrupted neurological organization.

A lack of neurological organization can be the result of a number of factors. It can be the result of a genetic bias; this is known to represent a small percentage of the problems. It should be pointed out that genetic research in this area is still ongoing, and experts agree that there is still not enough knowledge to be absolutely certain that this is a contributor. A second area of etiology is trauma (by this we mean physical, biological or environmental). The third etiological area is the area of the lack of environmental opportunity.

Diagnostically we can begin to assess the etiology of such problems prior to birth. A family history helps to give an insight into the existence of that small group, that which is potentially genetic in etiology. Birth data, early childhood data, illness, and encephalitises give us an insight into the second group of a traumatic etiology. The third, and that group, which lacked environmental opportunity, can be seen if we view the child in sequential stages from a developmental and functional neurological bias

Data collected from our clinics in Europe suggest that one third of children not attaining successful neurological development, were born with a problem which hindered complete neurological development, another third were subjected to birth trauma. The last third appear to be the result of environmental disturbance or environmental deprivation.

At the start of this treatise it was argued that neurological reorganization is the pathway to help neurological dysfunctional individuals overcome their problems .We now know that the root cause of neurological dysfunction that creates conditions that we label Dyslexia, Dyspraxia, ADD, ADHD, PDD, Asperger Syndrome, Autism etc, has its origins in a mild organic diffuse brain injury acquired by the individual in early stages of development, or as a result of incomplete neurological organization during development.

The acquired brain injury disturbs the functions of the central nervous system (CNS) and thus disturbs the sensory perceptual systems (i.e., hearing, seeing, smelling, touch and taste).

The use of EEG tracings, CAT scans, MRI scans, or other high definition images, can now detect even the smallest discontinuity or anomaly in the brain.

As an example, a recent study published August 2002 by Sommer, et al based at the Universities of Hamburg and Goettingen, who conducted research into individuals who stuttered, using the latest high definition scanners, found structural anomalies in the left hemispherical cortex region of the brain.

Analysis of data available to Delacato organizations worldwide, concerning individuals presenting with some form of brain scan and EEG’s, showed the following. There was a preponderance of mild dilation of the ventricular system visible in scans leading to a natural conclusion that these children surveyed as a group, lacked gross pathological defects of the structure of the brain, but still showed evidence of mild changes to the structure, and hence function of the brain. EEG studies tended to show dysrythmia. Typically these disorganized EEG’s showed a preponderance of slow wave activity with a significant percentage showing "spiking" as well. Most of the EEG’s were abnormal and non-specific.

All individuals displayed soft neurological signs, lack of coordination, development delay, strabismus, laterality dysfunction’s, toe walking, attention aberrations, and significant learning delay.

Studies of individuals were and are carried out to ascertain the incidences of various types of sensory perception problems; within the groups the findings are as follows;

Tactility problems 90-100%.
Auditory problems 80-90%.
Visual problems 60-70%.
Taste and smell 25-30%.

Children with tactility problems presented a hypotactile picture in a 2:1 ratio over hypertactile. A great majority of hypertactile individuals present a sensitivity and or hyper-reactivity to food colourings, preservatives, drugs and certain food types.

A 3:1 ratio of hyperauditory over hypoauditory patients was observed.
A 3:2 ratio of hypervisual over hypovisual was reported.
Only a small percentage presented problems of smell and taste.
Children with at least 2 hyper areas (excluding taste and smell), e.g. vision, auditory or tactility, have a prognosis for progress is quite good, children with no areas of hyper senses but with all areas as hypo made least progress.

The basic treatment technique for all patients visiting the Delacato Clinics is firstly, an evaluation, secondly an individualized home programme specifically designed to normalize the sensory channels of that child. This programme is taught to the child’s parents to carry out at home. Later programmes are aimed at improving each patients general development based on progress and observations made during follow-up consultations.

The second stage of rehabilitation is to address the sensory problems identified and administer the programme therapy.

At this point it is important to understand what is termed neurological organization. Previously brain growth was considered a static and irrevocable fact, completed and unchangeable at birth and if injured could not be altered.

The theory of neurological organization views the growth and organization of the brain very differently. Recent studies confirm the ability to influence brain injury, growth and recovery.

Each child must follow an essential sequence of experiences and development laid down by revolutionary heritage. This development and organizational sequence begins prior to birth, progresses vertically through the spinal cord, then through the brain stem and medulla, the middle brain up through the two hemispheres of the cortex. In humans uniquely, there is one final stage in this developmental progression. This is a lateral development wherein one hemisphere of the cortex becomes the language or dominant hemisphere of the brain.

As a result of this uniquely human final lateral stage, man becomes the only creature who is correctly one sided, that is right handed, right eyed, right eared and right footed or conversely, left side usage of all sensory gathering organs, and thus only man has been able to develop written or spoken language.

Treatment is based on recapitulation. If a development stage is missed or not completed, the child is given the opportunity to go back through the experience. We have seen many children who have completely missed the creeping stage (on hands and knees) of progression. It is known that the brain can become better organized if significant development milestones are retraced, and re-experienced. Children are taken back to a function typical of a younger age, we then have to practise the related motor functions that reinforce their sensory and neurological development. When lower level stages have been mastered, lateralisation can then take place making them all one sided.

Based on this theory, the child’s development is evaluated based on significant areas of development. These areas are subdivided into the sequential order and time schedule in which they appear in non compromised children.

There are three major intakes or sensory areas.

1) Vision; beginning at birth with a light reflex and progressing through 7 stages to understanding writing.

2) Hearing; beginning at birth with a startle reflex and progressing through 7 stages to understanding speech.

3) Tactility; beginning at birth with tactile withdrawing reflexes and progressing through 7 stages to the ability to recognize two-dimensional objects through manual tactility.

The profile also contains 3 expressive areas, each of which also progresses through 7 development stages.

1) Mobility; 7 stages, through movement without mobility, to normal walking.

2) Manual function; 7 stages from grasp reflex to ability to write.

3) Language; 7 stages from birth cry to human speech.

Treatment consists of providing the child with the opportunity to go back and re-experience the stage(s) in which it exhibits a weakness. Remember steps to speech and language reading and writing are through crawling on the stomach to creeping on hands and knees, to walking upright to language and recognition.

Final development only takes place when intermediate stages have been successfully accomplished.

At this point we can start to address the sensory perceptual problems of the individual.

Recall we mentioned the senses, which govern our lives and enable us to understand and interpret the world around us and survive in that world.

There are two major sensory dysfunction’s, hypersensitivity and hyposensitivity plus a third, less prevalent one we call white noise. Hyper individuals receive to much information from the environment which overloads them, and may result in their "switching off" as a form of defense mechanism. Hypo individuals do not receive enough stimuli and are starved of outside information. White noise, like static on a radio also blocks out the normal stimuli.

To read the sensory problems of the individual, one need only observe the individual; the actions will point the observer to the problem. These actions can be viewed as the individuals attempt to treat it himself.

A fish out of water placed near to water will flap itself vigorously on the land. We may view its convulsions as a sad reminder of the frailties of life – the death throws of a "lost cause", or are they an attempt to move itself back into the water its natural environment? . If the fish is close enough to the water it will often succeed and thus save its life.

Recall the conclusions of studies of sensory impaired children. 90-100% have tactility problems.

Hypertactile children shy away from touch, they do not welcome contact and are sensitive to certain types of fabrics, are happier wearing loose fitting garments rather than tight fitting ones and take off any garments they are not comfortable with. These are the children you cannot take out of the bath, and the ones you cannot get into the shower.

Hypotactile children are the self-mutilators, biting hands, fingers, hitting heads, sometimes against walls, doors, anything to try to induce a sensation.

Recall an earlier comment about children showing reactions to certain food types and foods containing preservatives flavour enhancers, food colourings, these are the children with severe hypertactility problems. The surface hypersensitivity is skin deep as our skin layer contains millions of nerve cells transmitting information back to the central nervous system. From a perceptual point of view, the skin on the outside of our bodies is essentially the same skin lining of our total digestive system. Hypersensitivity on the outside becomes hypersensitivity on the inside increasing the chances of the chemicals in the food we eat, and the liquids we drink, reacting adversely on children with hypersensitive stomach linings.

Now to Auditory problems, we know that three times as many children are hyperauditory than hypo. These are the children who put hands to ears, put fingers in ears, run away from busy environments, scream in noisy rooms. These are the children, who can and do fail the standard listening tests because they have the ability to switch off their hearing when it becomes an overload for them.

In the inner ear we have the mechanism which maintains our balance, as hyper auditory children do not use their auditory system efficiently this balancing system is not being used effectively. Hyperauditory children often have no fear of heights can perform amazing balancing acts and can spin themselves without becoming dizzy.

Turning now to visual problems, again hypersensitivity is prevalent. This manifests itself by the children who do not make direct eye contact; often looking at you sideways. They blink in bright sunlight, and often perform visual stereotypes involving hands, paper, or strings.

These children are trying to reduce the amounts of visual stimuli entering the system, turning them off when they cannot cope.

Finally we come to taste and smell, usually these act in tandem, as these two sensory gathering systems are intimately connected. Only a small percentage of autistic children are affected. Hypertaste / smell children tend to be picky eaters, eating mainly bland foods, sometimes no solids at all, while hypotaste / smell children eat and drink everything, especially strong taste and strong smell items – often to their own detriment.

As a rule, mildly affected individuals show two or more hypersensitivities and no hyposensivities, and are the easiest to rehabilitate. Individuals with hyper and hypo take longer and need much more therapy.

On the positive side children having had hypervisual and hyperauditory sensory problems essentially see everything better than the average child, hear everything, miss nothing and have an incredible memory . This child has the ability to learn better than the average child yet is often misdiagnosed as mentally retarded.

These children do not have learning difficulties, they have essentially no problems with input only output. What underlines the sensory perceptual problems are development delays due to their adversely affected sensory systems. Once these sensory problems have been rectified, and the ability to learn and develop has been given back to our children,(ideally with hemispherical dominance being attained), the ability to master written and spoken language can be achieved .

Robin Burn
The Autism Centre. Jan 2005

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