In this conversation, Megan Williams, a speech language pathologist, discusses the concept of neuroplasticity and its significance in therapy for children facing various challenges. She emphasizes the importance of tailored therapy techniques, real-life success stories, and the role of families in supporting neuroplasticity at home. The discussion also addresses common myths surrounding neuroplasticity and the understanding of progress in therapy, highlighting that change may not always be immediately visible but is nonetheless occurring beneath the surface.
Keywords
neuroplasticity, therapy, children, speech language pathology, feeding challenges, sensory processing, MNRI, DMI, TheraSuit, home exercises
Takeaways
- Neuroplasticity allows the brain to adapt and reorganize itself.
- Therapy should be tailored to each child’s unique needs.
- Families play a crucial role in supporting neuroplasticity at home.
- Little daily activities can significantly contribute to therapy progress.
- There is no age limit for neuroplasticity; it can occur at any stage of life.
- Neuroplasticity can also affect emotional regulation and mental health.
- Progress in therapy may not be immediately visible but is still happening.
- Therapies should not follow a one-size-fits-all approach; customization is key.
- Understanding the foundation of neuroplasticity helps in setting realistic expectations.
- Encouragement and support are vital for families navigating therapy challenges.
- Unlocking the Power of Neuroplasticity in Therapy
- Transformative Therapy Techniques for Children
- “Every family’s journey is different.”
- “Little things go a long way in therapy.”
- “There is no age cap for neuroplasticity.”
Resources Mentioned
Atomic Habits by James Clear
The Brain That Changes Itself: Stories of Personal Triumph from the Frontiers of Brain Science
Chapters
00:00 Understanding Neuroplasticity
01:51 Neuroplasticity in MNRI Therapy
05:10 Supporting Neuroplasticity at Home
09:41 Myths and Misconceptions of Neuroplasticity
17:48 Partnered Progress Intensive With Megan and Franchesca
25:44 Key Takeaways on Neuroplasticity
27:33 Medical Disclaimer
27:54 Insights for Parents
Show Transcript
Franchesca Cox (00:01)
Hi there, I’m Francesca Cox, an occupational therapist based in Houston, Texas. Over the years, I’ve had the incredible honor of working with children who have neuromuscular conditions, rare genetic disorders, and developmental delays. Using approaches like DMI therapy and TheraSuit, I’ve seen firsthand the resilience and strength of these amazing kids and their families. Each day brings new lessons, and my passion is to empower families with the tools and knowledge to support their child’s journey.
Megan Williams (00:26)
And I’m Megan Williams, a speech language pathologist also based in Houston, Texas. I specialize in feeding therapy and I’m an MNRI core specialist. I’ve worked with children facing feeding challenges and sensory processing issues using reflex integration techniques to support the brain body connection and help children thrive.
My mission is to guide families through the often complex world of feeding and communication, empowering them to support their child’s growth with confidence.
Franchesca Cox (00:58)
are here to share insights, practical strategies, and heartfelt stories that can help you navigate the unique challenges and joys of raising a child with special needs.
Megan Williams (01:07)
We know every family’s journey is different, but our goal is to create a supportive space where you feel seen, heard, and equipped with the knowledge to help your child reach their fullest potential.
Franchesca Cox (01:19)
whether you’re looking for therapy techniques, expert advice, or just a sense of community, you’re in the right place.
Megan Williams (01:25)
Let’s explore this journey together filled with hope, growth, and endless possibilities.
Megan Williams (01:31)
Welcome back to Little Brains Big Steps. Today we’re diving into a topic at the heart of our therapy approaches. It’s neuroplasticity.
Franchesca Cox (01:41)
This is the second part to our series on neuroplasticity. If you are wanting to hear the first part, please go back to episode two. We hope you enjoy.
Megan Williams (01:51)
so listening to you share your stories, thought of a few different scenarios. But yeah, one that comes to mind is a little girl who was able to attend an MNRI conference or an intensive. She was
receiving that intensive model of receiving MNRI and she coming into that week was motivated to eat by mouth definitely had the desire and enjoyed any kind of like tastes of food that she could get but what was
very apparent is that anytime food would be presented or offered coming towards her mouth, she would have a very strong fear, more mixed response to it. And you could tell she was wanting it, but her body and her brain were shutting her down saying, no, this is not safe.
Franchesca Cox (02:43)
Yeah.
Megan Williams (02:44)
And so she did the a week of the intensive therapy, and then she saw her.
Her mom, she and her mom were at an event a few weeks later and mom came up to me and you know, Megan, Megan! And I was nervous. I was like, my goodness, this is a lot of emotion. I hope everything’s okay. And so she said, she said, watch. And so she had her daughter in her wheelchair and her daughter was enjoying this most delicious chocolate chip cookie that I had a few myself. They were amazing.
Franchesca Cox (03:00)
Yeah.
Megan Williams (03:19)
and her daughter was just, mean chocolate was all over her face. She was using her Toby Dynavox to say, I want more, I love this cookie, this is delicious. And she was just really enjoying it and her mom was overwhelmed with just joy and happiness that her daughter was finally able to develop these new sensorimotor pathways that allowed her to
Enjoy a chocolate chip cookie and you know.
Franchesca Cox (03:48)
Thank
Megan Williams (03:49)
understand that food is delicious and it’s nourishment and it’s something that we can have together. Sharing a chocolate chip cookie and talking about how delicious it was and gave her all these communication opportunities and that is a true example of how that neuroplasticity stepped in and helped correct these neuro pathways that were created.
for protection and survival and they were able to be changed so that this little girl could you know enjoy food and I’m a foodie myself I love food and so it was great to see that I think we were all kind of teary-eyed just
Franchesca Cox (04:27)
Yes.
Megan Williams (04:33)
just over something that I think sometimes we take for granted that we’re able to do as non-disabled people. yep.
Franchesca Cox (04:41)
Yeah. It’s those little
things that you don’t, that we realize, right, are not little. They’re just so huge. It’s so amazing.
Megan Williams (04:51)
We definitely, I think, can attest that the neuroplasticity is what gives us a reason to believe that there will be progress, no matter how gradual. It’s why we never give up on a child’s potential and we are never ready to close that door.
Franchesca Cox (05:10)
Absolutely, absolutely.
Megan Williams (05:12)
So
what are some ways that you’ve seen that families can actually support neuroplasticity at home, whether it’s through the home exercise program or even just little things throughout the day?
Franchesca Cox (05:26)
I love that question because like I mentioned earlier, we get a lot that happens in the clinic, but the neuroplasticity and the magic continues and it should continue. And it’s only going to continue if it happens at home because they can’t live in the clinic, right? And they can’t take us home with them. And so it is one of the key things that you can do as a parent is ask your therapist and they may just not even have the time or the thought to give you something to do at home, but ask them.
What can I do at home to continue what you’re doing with my child in the clinic? And you may or may not be with them in this session. Every clinic is different. But ask for a specific thing, even one thing. How can I continue to help my child make this progress? Now, if they’re not making progress, don’t be afraid to advocate. okay, can we…
modify this goal, can we, you know, so definitely advocate for your child, but to continue neuroplasticity, I would say, ask for something if you don’t have something. If you have too much, ask your therapist, what’s most important here, because I can’t do it all. And so looking for just the just right challenge for yourself as a parent, like what am I able to do at home? And you can also like I was mentioning, you can streamline your activity. So
for the DMI, Thersuit, the things that I do with the patients, a lot of it’s gross motor mobility. So let’s say you’re busy, maybe both parents work, maybe we have older or younger kids to also take care of. Working those transitions in and out of bed. So like if I have a four or five year old that’s working on transitioning you know, up and down and we’re working on mobility, okay, turn them into the bed, let’s work on that.
while we’re getting ready in the morning, while we’re getting off the toilet, while we’re sitting down on the toilet, maybe we’re sitting down to breakfast. And so at the end of the day, if you’re tired, you know you’ve done some intentional work instead of, or even like with the baby, you guys say, instead of rescuing them and picking them up from the crib, let’s do a transition from side-lying to sitting and then picking them up. Because if you make a habit, and that’s one of the patients that I talked about earlier,
Megan Williams (07:22)
You
Franchesca Cox (07:32)
That’s exactly what her parents went home and did. And this child started sitting for like five minutes in no time. And it’s because they worked that into their routine. They’re both busy parents. Everybody’s busy, right? And so just streamlining your activities or home program into your day. And if you can’t think of ways to do that, ask your therapist, explain a little bit about your routine. And then I am sure that they’ll have some kind of idea instead of trying to find extra time to do, you know.
different things. Yeah, and I think that’s that’s the biggest thing just remembering that little things go a long way, you know, little steps, one thing over along there’s a book I think it’s man, I can’t remember the name, I will find it. But my friend told me about it.
But it talks about how a little thing, one thing, like you choose one thing to focus on over a long period of time, and then it forms a new habit. So we’re talking about neuroplasticity in children, but we’re also having to change things in our own lives as parents and caregivers of, you know, forming these new habits to help these children reach these goals. And so that’s one habit stacking like we talked about with James Clear. And then this other book, I think it’s called One Thing. I think that’s the name of the book, One Thing. Have you heard of that book, Megan?
Megan Williams (08:43)
No, but I’m like over here working on my list of books that I want to read while you’re talking about it.
Franchesca Cox (08:47)
Yes, yes.
So this book, it really is important because it talks about how you just do one thing over a long period of time, and then it changes your habits. And so I think that’s something to keep in mind as parents and caregivers of these children with special needs is don’t overwhelm yourself. Focus on one thing. And if you can add more to that, great. But yeah, that’s how I believe neuroplasticity can be best continued at home.
Megan Williams (09:14)
Yeah, I like that you talked about stacking these things with the actual activity. So one of the major motor principles of learning a new motor routine is pairing that sensory piece and then the activity that they’re actually gonna be doing. So if you’re going to want to learn how to, one of my,
personal thoughts about feeding and it varies therapist to therapist if you’re going to work on learning how to eat Then you want to do it with food, right? So There are properties of food that just can’t be mimicked with oral tools there are some cases where They’re necessary, but for the most part if you can work on
maybe the hands grasp reflex to work on holding a utensil or like a spoon and then helping the child bring it to their mouth. And then you’re working on tongue movement to open the mouth and scrape the spoon. So it’s, makes sense that, that this piece of neuroplasticity shows up in the home where the skills are actually being done. So I really liked that.
Franchesca Cox (10:29)
Yes.
Thank you. Yes, that’s such a good point about feeding. Yeah, that’s a whole new topic that we definitely need to dive deeper into.
Megan Williams (10:31)
that you mentioned that.
yeah, yeah. So I figured we could talk about some of the myths that are out there. Neuroplasticity is not a brand new thing that we’ve discovered. And so there are definitely some misconceptions. You know about neuroplasticity and parents may come across these if they’re talking to certain medical professionals. So if we can set that record.
Franchesca Cox (11:02)
just.
Megan Williams (11:04)
straight for them. So the first myth is that neuroplasticity only happens in young kids. So the idea is that, you know, once you reach a certain age, your neuroplasticity, your most plastic brain years is over and there’s nothing you can do. Have you heard this myth?
Franchesca Cox (11:24)
Yes, in different forms, I definitely have. And I think because DMI is created for children zero to five, parents carry this idea that I have to get them into DMI before they’re five. And while that’s important and definitely recommended, it’s definitely not necessary. So if you don’t find out about any kind of therapy that you think your child could benefit from until after the quote unquote, you know,
recommended age or whatever age you might be thinking or have heard, it’s still worth seeking out and trying. Because like Megan said, there is no cap. think every child, I believe every child is just wired differently, but there’s definitely no age where they’re just gonna never learn anything. I mean, if we take our stroke patients that are 60s and 70s and older, and maybe a little bit younger, we know that they’re given an intensive
the
protocol in the hospital. And they don’t call it an intensive, but it definitely is an intensive. They’re in the hospital for like three to six weeks and they get three hours of PT-OT speech and sometimes more than that. And we see massive changes within a few weeks. And that is because their brains are still plastic. And so how much more so would our children be? And so I definitely think this is a myth that we definitely need to squash and continue to
from the rooftops that there is no cap when it comes to neuroplasticity. In fact, when I did my TheraSuit training, one of the trainers, she went to physical therapy school in Brazil and she went so that she could help take care of her brother.
who had a disability and I think, I’m not for sure, it was some neuromuscular condition that presented a lot like CP, it may have been CP. He definitely did not walk. He had trouble sitting for long periods of time, that kind of thing. He was 16 when she got her PT license plus TheraSuit training. So she had been in school for a while. She started working with him at the age when he was 16 years old.
And she worked for six. I mean, you talk about neuroplasticity and devotion. She worked with him for six hours every day in and out of the cage with the suit, with the cage, with the universal exercise unit That was her modality of choice with her, with her brother. And so she worked with him for, think five to six years. So he was early twenties. He now works in her clinic. He helps her in the therapy clinic. He walks independently.
Megan Williams (13:38)
WAP.
Franchesca Cox (13:57)
He
has quality of life. He has independence. And so did it take work and sacrifice? Definitely. But I tell that story to my patients to let them know it is okay if your child’s 10 and you just found out about their suit. It is okay if your child’s 12, 14, whatever. We don’t know what their potential is because every child’s different and we haven’t tried it yet. So let’s just give it a try for sure.
Megan Williams (14:24)
crazy that even during puberty when we know you know all these crazy things are happening in the brain and the body with hormones and that she was still even able to to use this this modality that wow give him an amazing quality of life that’s incredible
Franchesca Cox (14:30)
Yes.
Yes.
I know it was
incredible. Yeah. And so it was no wonder that she was one of the teachers because it and so her story, she had to tell it to us in Portuguese because that was her first language. She knew some English, but Someone else translated for her. But she had pictures to back it up. She had I mean, she had her own story. It was just incredible. And she was brought on by the the TheraSuit training people to just emphasize how powerful
neuroplasticity is. So I’ve heard there’s a second myth that the concepts of neuroplasticity only apply to the sensory and motor cortexes of the brain. What is your experience with that?
Megan Williams (15:20)
Yeah, so we know about neuroplasticity and that’s probably where a lot of, so Dr. Michael Mirzenich, he, like I said, he was one of the pioneers of mapping the inner ear and the structures of the ear to come up with a way to actually create a cochlear implant, which
it in essence finds a way to turn sound waves into electrical impulses to stimulate the cochlea. And so, you know, it’s a mechanical ear, so to speak. But we also have seen that neuroplasticity can also occur in instances where there’s been a trauma. So an emotional trauma, physical trauma.
that has actually changed the autonomic nervous system function. So the part of the brain where we see that those parts of the brain housed are in the diencephalon, so in the midbrain region. Neuroplasticity can actually happen in that part of the brain. So that’s really how a lot of programs like EMDR and things like that work.
through neuroplasticity instead of this cognitive level of trying to heal from your trauma through talking about it. Instead, creating these new pathways through neuroplasticity to help people heal from trauma that can be really debilitating. It can happen to children, adults. know, nobody’s immune from,
what they can experience and the kind of long-term issues that happens with that.
Franchesca Cox (16:59)
So are you referencing mental health too? the mental health realm?
Megan Williams (17:03)
Sure, so yeah, because
we see when the diencephalon part of the brain is, know, trauma creates neurotypical pathways that are not healthy. And so the body becomes being constantly in fight or flight, always ready for the next trauma that’s gonna occur. The brain just gets stuck. And then mental health.
depression and anxiety and significant changes to a person’s mental health and personality can occur as an outcome of the trauma they sustain. you know, neuroplasticity creates a way for them to move on and move past that.
Franchesca Cox (17:46)
That’s life changing.
Megan Williams (17:48)
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Megan Williams (18:57)
So another myth is that neuroplasticity or programs that target neuroplasticity can be like a packaged one size fits all approach that you can use on every patient that you have no matter their diagnosis, their age, things like that. Like if you just subscribe to this one approach.
that it’s gonna work with everybody. Have you heard this one?
Franchesca Cox (19:22)
Yeah.
Yeah, I’ve, you know, maybe not directly, but I’ve definitely seen it promoted in different realms where, you know, this is going to help your child if they have this diagnosis and it doesn’t really work like that. I’ve seen, and I’m sure you’ve seen children with the same diagnosis at present, like night and day. And so as different as the children are, that’s as different as their treatment plans need to really be even within one approach. So like if you’re using MNRI or DMI or Thera suit or a combination,
It should never be the same because a child has such different needs. so I definitely think neuroplasticity doesn’t mean we’re going to use the same thing every day or even with the same thing, like I said, for every child. But we’re going to modify that and customize it.
like an OT or occupational therapy motto is giving finding the “just right” challenge for your patient. And that just means that we’re going to give them exactly what they need. But as a therapist, it’s our job to find out what that is. And so just like you wouldn’t when you go to a restaurant and you want your plate a certain way, because that’s how you need it, maybe, or that’s how you want it. That’s exactly how we need to address or approach every child.
And also as parents you want to make sure that your therapist is doing the same thing just Advocating making sure that they’re getting exactly what they need because time is precious and so and even though their brains are plastic for the lifetime we want to make sure that we’re using those early years as intentionally as possible and That’s done by just making sure that they are getting the “just right” challenge a lot of times patients will come our families will come in
and they just see such a difference in an intensive versus traditional therapy and that.
And that just means that there’s there’s some work to be done. And I always tell them, take this home program, ask them if they’re open to doing this, this and this. And then you have you have more people, you know, doing these customized approaches on your child. They don’t need anything special, no special equipment, but they just a different approach. And so it definitely is not a cookie cutter. It’s definitely should be customized if that helps debunk that myth.
Megan Williams (21:27)
Yeah.
Franchesca Cox (21:28)
Another myth that I’ve heard is if progress isn’t immediate, nothing changes in regards to neuroplasticity. What’s your take on this?
Megan Williams (21:38)
Yes, so as beautiful as neuroplasticity is and you know the things we’ve talked about today I definitely have heard some people say that if you don’t see those changes happen immediately then nothing’s happening and you’re wasting your time and your money and all these resources that we have have talked about that are you know really important to everybody.
but in situations where your child is needing a lot of assistance, it can be disheartening if you have been told that progress isn’t immediate, know, so we’re just gonna move on. That is not the case. So in reality, changes more times than not happen below the surface before they appear.
kind of on the surface functionally. So going back to my analogy of building these neural pathways needs to happen at the foundation. So the foundation may not be something you see visibly, but you know, we spend a whole lot of time and energy on making sure our foundation is level. There are no cracks, there are no sinkholes because we want
our finishes and the windows and the walls and the roof that’s the stuff you can see for sure but you need to have that foundation before you can really worry about what’s happening functionally so that to say like with some of the
reflexes that we work on to help with the autonomic fight or flight response. I have to help families really work through that, the idea that if we can’t calm the fight or flight system, we can’t expect a whole lot of verbal communication to happen. And so I really, really…
try to educate families that, you know, we can have a child try to imitate sounds, words, phrases, and things like that. And we may hear them produce those phrases sometimes. But if we’re going to try to turn around and have them say it again, that might not always happen because we need to go back and work on their autonomic system and help calm down.
their constant response to stimuli that’s coming at them a thousand times a second. And that’s an example of we may not see that immediate progress or you definitely won’t, you know, probably won’t see it in the clinic. But if you can carry over those exercises to the home, it just makes it easier for these developmental skills to fall into place.
Franchesca Cox (24:03)
Yes.
That makes so much sense. And what you said about not making the child re-verbalize something again, that makes me think of I’ve read somewhere when I was researching neuroplasticity is,
Part of neuroplasticity is the brain’s ability to quiet the noise that might be occurring, not literal noise, but background noise. Like for the clients that I see, a lot of times they have cortical visual impairment or they have some kind of low vision going on. And so we do the low lights and so that they can focus, they can really, we can reduce that noise coming into their visual cortex and we can focus maybe on auditory or tactile or
proprioception and so anyway I love that point about just focusing on quieting their brain before we’re trying to jump to the next thing because sometimes that’s not how the brain works.
Megan Williams (25:05)
And so many times traditional, more traditional approaches are looking at that top down where we’re just teaching the skill, do this, do this, do it again. And all of those repetitions are good because we know repetition is necessary, but if again, if you’re trying to do these repetitions, you’re trying to lay these shingles on a roof that’s not supported by a good foundation.
Franchesca Cox (25:14)
Yes.
Megan Williams (25:32)
Are they really going to matter? Are these expensive shingles that we have to put on our roofs, you know, do they have a function? So.
Franchesca Cox (25:39)
Yeah. Right.
Right. There. Yeah. I love that analogy.
Megan Williams (25:45)
So I think we’ve had a really good conversation about neuroplasticity. We’re about out of time, but I wanted to just kind of summarize some of the points about what we talked about today. So in regards to neuroplasticity, we want to make sure that the goals and the focus is specific to each patient’s life, their family support, what their quality of life goals are.
We want to get repetition of the right and adequate sensory and motor information. So we want to make sure that the information we’re sending into the brain for the neuroplasticity pathways to grow is correct. We also know that
Neuroplasticity can happen with parts of the brain that handle emotional regulation. We talked about the diencephalon, the midbrain. And we know that neuroplasticity should be a factor in every therapist’s kind of decision making, no matter what the diagnosis is and no matter
Franchesca Cox (26:52)
Yes, and we also talked about encouraging families and professionals to lean into the process that neuroplasticity takes, even when progress feels or looks slow.
Megan Williams (27:02)
Yeah, so if this episode has helped you understand neuroplasticity, please share it with someone who needs that same encouragement or maybe educational piece of it.
Franchesca Cox (27:13)
Yes, and we’d love to hear your questions or stories about your experiences with therapy, neuroplasticity, progress, anything that pertains to this topic. Your voice is an important part of this community. And please don’t forget to check out the show notes. All of our resources that we talked about will be there. And don’t forget, like Megan said, to please share this episode and subscribe.
Franchesca Cox (27:35)
We’re so glad you joined us for Little Brain’s Big Steps podcast. Please remember information provided on this podcast, whether from the hosts, sponsors, or guests is for informational purposes only, and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with your child’s physician and therapist before making any changes to their medical care.
Franchesca Cox (27:54)
We hope this episode provided valuable insights and support for your journey. If you know a parent who could benefit from this episode, share it with them today. Be sure to visit our podcast website for show notes and additional resources. Until next time, take care and keep making those big steps forward.
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