In order for a special needs child to be able to develop further it is essential for him or her to be able to return to the baby stages. This is true on both the bodily level, as well as on a cognitive level, although the mechanisms are somewhat different.

ABR treatment is based upon restoring the baby stages to the body’s development. The tissues that are being regenerated with ABR are very primitive and basic bodily structures, but at the same time absolutely fundamental to the child’s further functional development. Without a restoration of this primary tissue system of fascia and connective tissues, the child will be caught and captured in his limited muscular skeletal development. Stages that a child missed in his or her early years, can be re-gained through the work that the parents do with ABR.

In order for the body to regenerate, sleep is essential. Requiring more sleep, is one of the signs of a child who is starting with the ABR program. During the sleep, the child rebuilds inner structures and strengthens his internal system. So, if the child sleeps more, or falls to sleep during the exercising times, then be assured that the efforts are paying off and that the child is utilizing the ABR input to the most optimal degree.

Not only is it important that the children in the ABR program get enough sleep, but also that they are allowed what we call “down time”. This is time where the parents and therapists are not running around after them, trying to get them to crawl or to creep or to perform some tasks that one thinks are important for them to learn to do; but where the child simply has time to himself to internalize his own inward bodily sensations.

For the healthy child and the special needs child alike, this type of “quiet time” is equally important. During such minutes and hours, a child explores the possibilities of his own system. He explores a great magnitude of the so-called “mini movements”. He rocks back and forth, he pushes with his feet against the crib, he grasps his own hands or feet, he tilts the pelvis slightly to the right or to the left, and so on. All of these mini-movements and explorations of the own body are absolutely essential for both integrating the movement capacity of the body, as well as for the actual mechanical strengthening of the joint connections! Moreover, these mini-movements, which parents tend to overlook, are important transition to what is called long chain movements, which involve many joint connections and are executed over long kinematic chains.

So, our fundamental advice to parents is: Allow your children lots of this down time, for internalizing and exploring the potentials and capacities that one is creating through the ABR work.

Unfortunately in today’s electronic world, one needs to add, that such internalizing cannot be done when the child is sitting in front of the computer or watching television. For this internalizing activity, the child needs to free up his sensory system for inward investigation, and not be caught up in the consuming impressions of a television screen.
Formal “training” of a special needs child usually is based upon the philosophy that the child is simply not smart enough to do the things that the parents or the therapist wish for him to do or to achieve. If he is not smart enough, then we have to show him, and train him to be able to do the things better. This philosophy can go to great lengths – even to the extent of forcing a child with a weakened muscular skeletal system to crawl long distances each day. Here again the underlying thought is: The child is not smart enough – and then, by taking the philosophy that one must teach the child everything to the extreme, justifies filling up every moment of the day for forcing the child beyond its own natural limits.

Unfortunately this philosophy overlooks some essential elements about the developmental system of both a healthy and a special needs child.

All children instinctively seek an inner equilibrium in their performance of movements! They take the path which is easiest for themselves and which comes most naturally. Why is this? – Simply because the muscular skeletal system is one of the bodies most expensive systems. It not only demands extensive involvement of the nervous system, but it “costs” the body a huge amount of expensive energy to run. Studies have shown that a child with spasticity uses four or five times as much of this expensive energy to perform even simple movements as the healthy person does.

On the other hand the structure of a special needs child is only similar to a healthy child on a superficial level. When one begins to analyze the muscular skeletal system of a special needs child one can notice that many of the movements or activities that one often tries to “train” a special needs child to do, such as to crawl, to creep, or to walk with some type of assistance, have no similarity with the crawling or creeping of a healthy child. And this “fake crawling” that a special needs child can be forced into doing excessively, is always stereotyped in nature, never varies in momentum or in speed or in distribution of weight to the joints and muscles, always uses the same muscle groups, and by over-using a small group of muscles, eventually leads to further disintegration and spasticity of these parts.

It is therefore that ABR focuses its attention on addressing the fascia as being a more primitive and basic connective tissue structure. These tissues are not “expensive” for the body. They do not require the expensive ATP supply of energy, but run on a back burner both with respect to energy and also with respect to the attention needed from the nervous system. Strengthening these tissues means that the child receives the background support from inner structures, to allow the muscles to work more efficiently and effortlessly.

At the same time the child’s cognitive system is freed up from extensive muscular effort and can be utilized for the development of cognitive activities.

If we take the healthy child as our starting point, we can see that the healthy child is always busy – from early until late. He explores in the early years the extents to which his body can move, and then goes on to use the body to explore the world around him. If left to his own devises, he develops a beautiful and organic way of using his muscular skeletal system. He explores new movements daily, integrates the newly gained elements into the already attained system, strengthening the system as he goes, in order to be able to maintain the new challenges that he is putting on the system.

The special needs child – and especially the children in the ABR program – require this quiet time, down time and baby time, not only for extensive regeneration, but for exploring, internalizing and realizing the newly born potentials of his or her motor skeletal system.

Diane Vincentz

ABR is a technique that addresses weaknesses within the connective tissue skeleton and brings architectural and structural  improvements to children with muscular skeletal and movement disorders. The following explanation is given in order to create a basis for understanding how these structural improvements translate to improved function.
The child cannot sit independently. What stages does she have to go through to attain independent sitting? How will we be able to mark and to notice the improvements when they start to appear?

The speed of transitions from one step to another will depend upon the severity of the child. A mildly affected child will progress through these stages in such a way that the parent may not even notice it. The parents will notice the appearance of more dynamic functions like rolling and crawling and creeping, as well as the emergence of transitions from one position to another. In the case of a more severe child, these stages will show up more gradually.

In the description given below, sitting is used as an example, but this example could equally be applied to most other movements and functional complexes as well.

What ABR demonstrates repeatedly is that, when the direct road to the achievement of independent sitting is closed for the child, one can take the U-Turn approach and still come to independent sitting.

On the other hand, if the child does not show any spine movement, if the thorax is excessively weak, and the entire body responds as one block in respect to changes in positioning – the child will not learn to sit independently, regardless of how much external training and brain stimulation the child receives.

The U-turn approach describes the functional steps that will show up along the way that lead the child to the attainment of the function of independent sitting.

Normally the problem is analyzed as follows:
If we were to put the child into a sitting position on a stool and go away the child would fall. One could say: “Well her brain is damaged and the brain is sending poor signals to the body. Therefore she cannot sit.”  One then goes on to try to train her to sit anyways –  and this is the basis of most training programs.

But this will not help the child to come further. We need to look deeper to find the elements of independent sitting that the child is missing, and then make a strategy as to how to attain them. We can see that she seems to initiate the fall  often through some kind of full body stiffening or protective reactions.  Many children appear to “throw themselves backwards”. But, if she initiates a fall she is not able to stop or to brake the fall. Movement in the healthy person is not only constituted of the ability to initiate a movement, but a controlled movement is also made up of the ability to stop or brake the movements in any and every position and at any and (almost) every acceleration.

Initially, if the child starts to fall, she will do this with the accelerated fall. She does not have a simple fall that follows the gravitational pull, but will fall with an increasing velocity. This is due to the fact that when we put her into a sitting position we do this against inherent bodily resistance. This resistance is a result of a combination of factors such as backline spasticity and fascial shortening  – which are brought into an elongated tension when she is put in sitting position. As soon as the external support is taken away, the tightness along her back re-contracts and returns to the neutral position, making the velocity of her fall accelerate. We can observe the “snap back” reactions.

At the same time the child has not been able to “index” the variety of positions which a healthy person has in respect to the sitting position.  This huge variety is an  “unknown unknown” for the child.  The bottom of the child cannot grip the surface she is sitting upon and then the entire body goes into a protective reaction.  When the full body stiffening occurs, the child shoots.

When she does this, she is simply unable to brake the fall.

1. If we want her to improve we need help her to go through several phases.
   The first thing that needs to happen is that she can begin to fall with a simple, floppy and loose fall. This will appear when spasticity and fascial tightness in the trunk begins to release and is – never the less – a result of connective tissue strengthening and remodeling. This is a deep and important improvement, but not necessarily yet a functional improvement.  The parent may not even notice when the child goes through this stage.
2. The next step is that she will be able to begin to slow down the fall. She may not yet have achieved the strength needed to brake the fall entirely, but if we – for example – initiate a change of position, the child will begin to show us that she is trying to slow down the fall.
3. Thereafter the child will move on to having control of the fall in some positions, but not yet in all of them. The child still cannot really sit alone, but if we change the sitting position, the child will not helplessly go into the falling mode, but will be able to stop the fall at some of the positions between being upright and being completely horizontal.
4. After arriving at this stage, the next really big step is when the child begins to perform the counter balancing movements. A counter balancing movement is a movement that balances out another bodily movement in order to avoid distortion of the body or the loss of balance. We make the stages of counter balancing development visible by initiating a movement through the utilization of one segment – for example the head or the upper trunk or pelvis for this. If the child can start to return part of the body towards the initial position whilst another bodily segment stays or still moves in the counter direction, then the counter balancing movements are starting to appear. In effect all of our changes of positioning and especially walking involve a highly developed complex of counter balancing movements. With respect to a child who has not yet attained free and independent sitting, the achievement of some counter balancing movements show us that the child is getting close to being able to sit without support.  Often at this stage the child can begin to sit alone or with support on his or her arms when placed in the sitting position.

On the way to achieving the counter balancing movements, the child will of course have improved significantly in respect to trunk strength and stability, pelvis positioning, the strength and mobility of the vertebral column as well as to increasing bodily segmentation. The child will begin to show mobility in the upper body that is independent of the movements of the extremities, i.e. arms and legs. The head will have to become independently mobile with respect to the trunk, and the thorax needs to be independently mobile in respect to the abdomen, etc.

In this way one can understand how the ability to perform segmented movements of bodily parts in respect to each other is essential for the attainment of independent sitting.  As long as the different segments – be it head, neck, chest, abdomen, arms or legs – are all fused together as one movement unit, then the possibility for both “braking” a movement and also for the counter balancing movements are not available to the child.

In order to summarize one can say that the child will go through the stages of:

1. A simple and loose fall
2. Slowing down of the initiated fall
3. Stopping an initiated fall
4. Counter balancing movements
5. Maintaining the sitting position for shorter or more extended periods –  on the way to the attainment of a free and independent sitting.

This describes the “U-Turn” approach that is possible to achieve through ABR work in conditions where the progress has otherwise shown to be impossible.

Diane Vincentz
Director
ABR Denmark Aps

The concept of “Bio-tensegrity” plays a big role in ABR technical development and ABR based understanding.

Together with  Dr. rer. nat., Dipl. phys. Danièle-Claude Martin, Dr. Steve Levine and others Leonid Blyum initiated the Biotensegrity Interest Group – a think tank which researches into biotenesegral ideas, concepts and effects.

ABR Assessment development and ABR Technique development are closely connected with the understanding coming from this work.

When writing her book called Living Biotensegrity – www.kiener-press.com/books, Daniele Martin asked us to write a chapter about the effects of Biotensegral ideas in the practical work with children with cerebral palsy.

You may read the chapter written by Diane Vincentz here: Living Biotensegrity – ABR but also feel inspired to read the entire book that can be ordered online at this link as well: https://www.amazon.com/Living-Biotensegrity

Diane Vincentz

We are supplying this link so that all can see a great illustration of how the proper body – limb coordination works.

This is the example salamandra shows us on the left. The body starts with the undulatory motion, and the limbs follow the undulation of the body. The example in the middle has a blocked undulatory motion, but she still can come forwards. On the right however we see an example of the inverted coordination. When the limbs react first and try to impose this movement to the central connections (spine) – then the complete chaos occurrs. This shows us the fundamental issue with any training based upon a method that starts with the periphery – limbs, through imposing movements on to the child from without through devices, splints, commands, standing frames, etc. Then one imposes the movements from without through the limbs. In this case, a child with a weak core needs to stiffen with his central connections and becomes at the most more like the middle salamadra.

Watch the clip several times, to get a feeling for how the undulatory motions initiate our movement. The human being of course has the undulations in all three planes: sidewards, forwards/backwards and rotations – and all work together at once.

ABR techniques are designed to help the child to develop and to initiate the undulatory motions at ages and stages where it is normally no longer possible. In fact the establishment of these movement stages belong to the earliest development moments from 0 to six months. After the age of about six months, the child can no longer initiate and establish these movements on his own.

The sequences of activation not only relates to the trunk and the limbs, but also corresonds to muscle types belonging to the trunk and limbs respectively. The muscle types that react first belong to the trunk (type one) and those that have a higher reaction threshold (type two) are mostly the superficial muscle layers typical of the limb reaction.
Training through normal exercises can only initiate an inverted sequence of reaction within this highly organized muscle reaction sequence.

The waking up of and activation of the type one muscle fibers belongs intrinsicly to ABR work which is desinged to install the “baby stages” of deep intrinsic undulatory movement in children and adults who have long left the baby stages – and also in those that at this young age are too weak to initiate the proper coordination between the deep intrinisic muscles of the trunk and those of the limbs on their own.

Diane Vincentz

Snow is falling and wind blowing hard here in Denmark. Before I met ABR, winter was a time of continuous sore throats, bronchitis’s, ear infections and pneumonias. ABR work changed this situation dramatically for my son Gawain, but also keeps our whole family much more healthy because we can react quickly to the oncoming colds and flues.

Many of our ABR families do not realize that some of the basic exercises can be applied for acute winter illnesses like bronchitis, sore throats, ear infections and pneumonia. In fact, one could even say that for a CP child, these ABR applications are really the best “first aid actions” should any of the above sicknesses occur. For an otherwise healthy child or adult, one can often cure sore throats and bronchitis within several minutes with these ABR techniques.

The passive ABR applications – (excluding of course the PAVES and active exercises done upright involving active participation from the child) cannot be compared to gym exercises or training. When a child is ill, it is the normal reaction of the parents to “give the child a break” from ABR exercises. But this instinctive reaction – which would be correct in respect to any other kind of training – does not actually serve the basic needs of the child and overlooks the fact that in the case of illness, the special needs child is even more vulnerable when faced with common colds, than the otherwise healthy individual is. They often require, and can profit immensely from extra “biomechanical care” in order to overcome even a simple bronchitis or cold and to prohibit it developing into a serious bronchitis or pneumonia.

ABR exercises do not cause any energy expenditure for the child, but on the opposite, through the path of mechano -transduction, serve as an additional source of energy that the child could not otherwise gain access to.

Biomechanical compresses and plasters

Traditionally colds, flues and earaches have been successfully treated with household remedies. The usage and knowledge of these remedies has been widely forgotten, but their effectiveness remains for those who know how to apply them.

Substances like onions, boiled potatoes, quark, cabbage, lemon and black mustard seeds have been used traditionally with good success for hundreds of years. Antibiotics – even though they have dubious long term effects, forced household remedies almost into oblivion.

These compresses are easy enough to apply, but involve some knowledge of how to do it and are often a bit time consuming.

On the other hand, for the parent equipped with ABR towels, foam constructions and soft balls, one can go to work immediately without involving any messy kitchen substances, and help the child to recover quickly. For the special needs child, the ABR methods serve even better help than the age-old house hold compresses and remedies.

Sore throats: It is not often easy to detect a sore throat in a non-verbal child. Even a healthy and speaking child will not always tell the parents that the throat is hurting. Sometimes one can hear that the voice sounds hoarse, but not always. Early detection of a sore throat is important because a sore throat can often develop into a bronchitis or pneumonia, and it is much easier to get rid of if one can stop it early and at the throat level.

The basic 3-Q U-Shaped exercise is a great application for sore throats. In fact, one should always have the U-Shaped construction prepared and ready to use in the winter months. If the child cries with a sore throat, or if one looks into the back of the throat with a small flash light or torch and sees that the throat is bright red at the back, then one should do some frequent bursts of the U-Shaped exercise to stop the cold at this level before it becomes a lower respiratory problem.

If one gets a sore throat oneself then it is possible to take the U-Shape construction and apply the exercise for ten or twenty minutes until the soreness disappears. Long movements mixed with rhythmical oscillating movements serve best.

Bronchitis – it is important to detect and to treat a bronchitis infection in a cp child as fast as possible due to the danger of the bronchitis developing into pneumonia. Many families chose to take immediate flight to the hospital when a bronchitis appears, let the child receive high doses of antibiotics, which, when given repeatedly, serve to further weaken the child’s immune system. Not all families have access to a good homeopathic doctor, naturopath or an anthroposophical doctor who can advise and support the parents in the treatment of these illnesses without antibiotics usage.

ABR Bronchitis first aid help consists of:

Frequent Chest applications of both 3 – Q and Ball Rolling.

3-Q – using a large melon construction. One can work on the upper and lower thorax for several short periods during the day. Utilize the long movements as well as periods of rhythmical oscillating movements.

Super Soft Ball Rolling – should be done on the anterior and posterior thorax

In addition, especially if the child cannot cough or is not coughing successfully, one should add clapping techniques. Clapping has been done for centuries, and one can add to the effectiveness of simple clapping on the chest, but putting some foam and towel layers between the clapping hand and your child’s chest. The wrist is relaxed and the hand is allowed to fall with its entire weight on the chest. Clapping should also be done frequently, all around the thorax, front, sides and back. It also helps to release mucus that is lodged in the bronchial system.

Parents who have learned PAVES exercises can also combine the above with short intervals of placing the child on a gymnastic ball or peanut ball together with a soft memory foam pillow. The oscillating applications can be done with the child in various positions resting on his thorax over the pillow and ball.

Between the parent’s hands and the child, one can place a few layers of foam batting and back up foam.

Oscillations:

1. Pre-compression – a deep volume touch
2. Pause
3. Small , short, oscillating bounces starting downwards
4. Fifty to one hundred oscillations in each position

If the child should get pneumonia in spite of one’s efforts, then the above applications are also suitable.

Ear Infections:

3-Q – Use a medium sized melon that sufficiently covers the ear area.

Super Soft Ball Rolling – use a foam ball filled pocket and a small ball like the kiga overball to roll the area especially downwards and forwards towards the face.

Diane Vincentz

“Meso – Anatomical” is the term given by Leonid Blyum to precisely describe what all ABR families do when working with the large variety of ABR manual techniques shown at each course.

“Meso “ is a term that many of our ABR parents should already be familiar with.  Meso comes from the Ancient Greek language and means: “in between – related to the middle – intermediate”.  In many lectures with ABR parents we spoke about the Embryological Mesoderm or Mesen-chyme as being the origin of connective tissues in the early embryological stages.  In this respect the “meso”-derm refers to the tissues that are developed between the two polarities of the ento (inner) and exo (outer)- derm’s.  The entoderm later develops into the tissues that become our metabolic system – whilst the exoderm develops further into what becomes our skin and nervous system.  These two systems are so far away from each other in their basic and fundamental dynamic, that they require a “middle way” – a “meso” in order to bind and connect them to one organism.  Dr. Jaap van der Wal – a world leading Embryologists says:  “The meso is not a derm! – It is a “meso”! – meaning that the meso is not a “skin” or a tissue – but it is that system which is able to live between the two extremes and at the same time creates a basis for all the various life functions – and for the inwardness of perception (proprioception, interoception)  and being as well.

By adding the prefix of “meso” to the word “anatomical” another meaning for “ in between – in the middle – intermediate”  is brought to light.  This term describes the specific qualities of ABR Techniques.  In this context “meso” designates  a quality of anatomy and movement that is not “micro” and not “macro” – meaning not on the cellular level (microscopic) and on the other hand not on the level of macro- anatomical either as would be in the case of an entire organ or a specific muscle, or muscle chains.

With ABR techniques we create movements within the child or adult that are within a very small range – the range of about one centimetre.  This range is much higher than the microscopic level, and on the other hand – if one thinks about long chain movements like taking a step or throwing a ball – these ABR movements at first seem minimal.

But these movements only “seem” minimal as long as one has not yet understood the magnitude of the importance of these movements.

What is so special about the “meso” range that we utilize, explore and promote with the manual techniques being taught in ABR and being used in the variety of PAVES exercises shown?  The answer to this is manifold, but we can start by identifying two or three main elements:

1. When we implement these movements by utilizing our various ABR tools such as balls and mats then we are able to help the child or otherwise affected adult to begin to implement movements that he or she cannot initiate himself. These movements are for example the movements belonging to the deep myo-fascia of the trunk and spine.  Buried within the structures of our vertebral column the nerve endings are located that are the primary communication links about any changes in our body –whether changes in posture or any positional changes requiring counter balancing reactions, stability, etc.
2. By using meso – anatomical techniques, one is able to “induce” movements that are a part of the primary dynamic repertoire which one normally learns in the first half a year of life. At this time an infant develops this primary dynamic repertoire.  This is a repertoire of movement that can no longer be learned consciously at a later time of life.  After about six months of age the door for learning these movements closes.  At this time the length and the weight of the arms and the legs changes sufficiently in proportion to the size and weight of the trunk.  This change in proportion makes it even more difficult for a person to “learn” to execute these movements later in life.  One cannot “teach” the primary dynamic repertoire!
3. Through “induction” of these movements to the child or adult, one can “re-train” the system to be able to carry out and to integrate these movements into the movement repertoire. Through having access to these movements, then the child is able to “balance”, to “stabilize” to control the movements.  The door to movement development is opened for the child.
4. Here a robot example of what happens if the primary dynamics of the deep spine structures are not working can be seen here:

https://www.facebook.com/permalink.php?story_fbid=1001882553253264

At the same time this short video clips gives illustration to the spinal mobility condition of many ABR clients pre -program.  Whenever the child needs to adjust with the spine, the spine does not move.  The result for our children is that they “cannot sit”, “cannot stand” and cannot maintain weight-bearing positions.

ABR Meso-Anatomical Techniques are an unbeatable tool for getting to these deep Primary Dynamics and improving the mobility and repertoire of usage.

Diane Vincentz

ABR Denmark

Director