HANDLE Therapy is a cornerstone of the Mindstretch Preschool programme
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HANDLE Therapy at Work

HANDLE therapy is key to the Mindstretch Preschool programme. You might even call it the jewel in our crown! I have seen its power, having practiced HANDLE for 18 years. Learn here how we used it to help one little boy.

Shared by Mindstretch School’s Principal Jennifer.

How it Began

Simeon joined our reception class in January 2021. He presented as younger than his three and a half years. He couldn’t walk and preferred to lie on his back and study the clouds above. Though he showed intermittent interest in the surrounding environment, he did not have the motor planning or muscle tone to let him explore. He was reluctant and unable to carry his own body weight.

During his first weeks, we encouraged him to stand holding onto a supporting structure, but he struggled and soon gave up.

  • Read more on Simi’s journey in his mother’s wonderful Tribute

A Tailored Programme

I quickly determined that Simi needed a tailor-made HANDLE Therapy programme with emphasis on movement. We delivered this daily during the school day, through a dedicated early morning session as well as targeted activities throughout the day. Simi’s low muscle tone meant he could only tolerate short periods of work. As he got stronger, we increased the session times.

  • Learn more about HANDLE (Holistic Approach to Neuro-Development and Learning Efficiency) Therapy at handle.org.

One Year Later, HANDLE Therapy at Work

Simi made significant, quantifiable progress every month. He became more alert and interactive. Gradually his focus improved. He showed a desire to learn. With our encouragement he started initiating movement, and began to crawl toward things that interested him. Then, on one amazing day three months after enrolling at Mindstretch School, Simeon walked!

By the end of his year at Mindstretch, Simi was walking and even climbing with confidence. He clearly enjoyed the social interaction and vibrancy of the small classroom. He journeyed from somewhat passive to participating in all the activities presented to him and his class.

Therapeutic Programme Overview

We worked daily on many interventions, the core of which were:

  • Vestibular system activities
  • Proprioception exercises and motor planning
  • Promotion of interhemispheric integration
  • Facial nerve stimulation

We took a multidisciplinary approach and engaged other professionals. They included Simi’s physiotherapist, Ashley May, with whom we brainstormed, and who gave us many good ideas.

Simi’s progress surpassed expectations as he went from essentially immobile to walking a good distance within a year.

Handle Therapy helps Simeon at Mindstretch Peschool

Vestibular System Activities

The VESTIBULAR SYSTEM centred in the inner ear, is critical for balance, coordination, motion and spatial awareness. It’s a bit like an internal GPS.

We immediately started with gentle vestibular input on a daily basis. Simi particularly enjoyed the following activities.

  • Gentle swinging on our baby swing, though first we had to teach him to hold on.
  • Slow vestibular rolls on our giant therapy ball, moving on the forward and back axis. Over time we extended the sweep of the roll. The next step was to teach him to put his hands out and brace himself as he tipped forward towards the ground.

Proprioception Exercises and Motor Planning

PROPRIOCEPTION gives information about the body’s position in space. It’s also how we identify how our body parts are moving and how much strength our muscles need to apply to keep us in motion. Proprioceptors are mechanosensory neurons located within muscles, tendons and joints.

It quickly become evident that we needed to address proprioceptive awareness and also motor planning skills. Simi responded particularly well to these activities.

  • We implemented the HANDLE Therapy ‘joint tapping‘ technique on a daily basis, whereby we would tap on all the joints, so that the proprioceptors registered the input and sent signals to the brain.
  • We gave Simi a daily massage by rolling our 1.5 kg medicine ball over him slowly as he lay on his tummy. He loved this one!

As Simi progressed, he sometimes climbed onto objects, but he lacked the motor planning skills to get down. We gave him achievable tasks that required motor planning. Gradually we increased the complexity and lessened the support. In time, Simi was able to retrace his steps and come down from objects he might have climbed on to.

Promotion of Interhemispheric Integration

INTERHEMISPHERIC INTEGRATION activities help the brain integrate processes that are lateralized to the left and right brain hemispheres.

Simi displayed poor interhemispheric integration, in part shown by his unwillingness to crawl or make other bilateral movements. And so we began with these activities.

  • First, we encouraged him to crawl by placing interesting things just out of his reach. As his crawling improved so we encouraged him to crawl under a table and eventually through our play tunnel. Our therapy dog was a great motivator. Simi loved him and made great efforts to reach him.
  • We encouraged Simi to reach across his midline with the opposite hand to grasp something of interest.
  • We undertook several exercises that involved using alternating hands and then both hands together. As Simi’s bilateral movement improved so we were able to introduce ‘high fives’ using alternate hands, thereby engaging both brain hemispheres.

Next we introduced walking. At first this was heavily assisted, but gradually we lessened support until Simi took his first tentative steps alone!

After consulting with Simi’s physiotherapist, we encouraged him to climb up a small, slanted jungle gym ladder. This requires good coordination and bilateral movement. In an exercise for muscle tone and motor planning, we also had him climb up the slide from the wrong direction, grasping the sides with his hand and pushing with his feet. By the end of the year Simi was climbing independently.

Facial Nerve Stimulation

Simi’s a handsome little boy but in the early days he lacked facial expression. He also tended to drool and put things in his mouth. This quickly improved with our intervention focused on facial nerve stimulation.

  • We implemented the HANDLE Therapy ‘face tapping’ technique, which stimulates the facial and trigeminal nerves. We did this on a daily basis and whenever we noticed that Simi was seeking input, for example by putting things into his mouth and chewing to excess.

Simi’s face began to light up and he now displays a good range of facial expressions. He continues to seek input by chewing and benefits from a chew necklace.

Interested in HANDLE? We apply it every day at school. Contact Us for information on our programme.

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