Marielle, Developmental therapy and Ataxia

Marielle was born in Nancy, France.
She was the first child in the family. Both her parents are bankers in a very big bank.
Both her pregnancy and birth were exciting and normal. No sign for any special problem.
Only when she became one year old and did not complete her basic motoric stages – like lying on her stomach, rolling and crawling – her parents realized something is wrong.

The diagnosis results showed a severe case of Ataxia, with dysfunctional cerebellum. At the age of two, she started to receive Physiotherapy and Speech therapy sessions.

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When I first met Marielle, she was six years old.
She used to move crawling on her knees from place to place, her parents lifted her up to standing but she kept losing her balance and fell backwards. A situation that lead to many injuries and hospitalizations. Her inability to control her vocal cords, made her pronunciation not clear, with sharp changes between whispers to scream. Yet, despite all her physical difficulties, she spend her time inside the regular education system. A shy and quiet girl with normal cognitive abilities.
Outside of school, she still got sessions of physiotherapy, but that did not improve her situation much.

As a daughter for a very successful family, she had high expectations from herself. When these could not be reached due to her objective difficulties, she developed a very low self-esteem and very low competency. Her reactions to the world were based on tantrums, low motivations and avoidance of challenges.

Marielle missed the basic sensory and motor stages that most normal children learn in the first few months. In advance, she already developed in her six years, dis-organized motoric patterns and a distinct lack of coordination between mind and body. Her emotional and behavioral patterns were significant as well and were a result to her physical difficulties.

After the diagnosis, we set a therapy process plan.
The main targets were reconstruction of basic developmental stages whom she missed as a baby, and creating new connections in her brain that would help her bypass the injury and difficulty created by her disease. The assumption was that it would improve in addition to her motor skills, also her emotional, behavioral, and cognitive and linguistic skills.

First, we had to create a suitable developmental environment. This requires not just logistic rearrangements in the house, but also a full Involvement and commitment of the parents in their agreement to create the needed changes, both physically and emotionally.

Marielle’s parents had to learn and apply new ways of family communication that will give her support, encourage and challenge her to develop motivation and a sense of ability.

They had to break the habit of treating Marielle as a baby and doing everything for her. They needed to practice a new way that sees her as a six-year-old girl, who needs to develop her skills and her independency.

Assimilation of the therapy process in the daily life of the home and family is an important tool in my therapy. The thought behind it is that every moment in our daily life, is an opportunity to learn and develop. Caregivers and professionals who worked with Marielle (school assistant, teachers, music therapist and nanny) started to work in coordination with the parents and my support, developing the same goals and attitude. Extended family members also became a part of our “team”, in order to create an environment that would give the right nourishment to Marielle’s development.

With the therapy process Marielle learned to stand by herself and later to walk. She became independent in matters of eating dressing and in any motoric activity at home or in school. No more, she needed a special assistant in school. These days, he is playing with friends, go out to camps in nature, runs and loves the climbing wall. She learned to be aware of her body, to address the challenges confronting her and to develop a self-esteem and a sense of computability.

Her parents learned to let go a little and to trust her more. They embraced the concept that there is no “glass ceiling” above Marielle’s head. Nothing to stop her development, if she and they are willing to work hard. They learned how important it is to challenge Marielle and themselves and how powerful is a healthy family communication.

The emphasis throughout the developmental therapy process was on Holistic and systemic approach: Organization and coordination between the brain and body of Marielle, A combination of all the elements of her being (movement, senses, emotions, language, behavior and cognition), and coordination and cooperation among her major environmental components (Parents, extended family, school, therapists).

At the base of the therapy was the understanding, that the human brain is flexible. Even with a damage, it can create new neurological connections, by that we can learn and develop more and more. Another understanding was that improvement in her body organization would influence her self-esteem, her ability to act in the world and her emotional and cognitive manifestations in the world.

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The development process of Marielle did not end yet. The Damaged Cerebellum and Ataxia will always be present and force her to deal with the Consequences and difficulties deriving from that. Yet Marielle is standing today, ready to step on a new path. She acquired better skills and abilities to walk her own way, to confront her challenges and to fulfill her potential.

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