PLATON S. The first visit to institute was at the age of 16 years in April, 2004 with complaints on difficulties of concentration, emotional instability, hypererethism. The boy showed low progress at school and had problems with the writing.
Anamnesis: Pregnancy of mother didn't have any pathology, childbirth was on 41 week; the latency period was about 2 hours. The boy was growing up restless, shouted a lot, slept badly. The early psychomotor development of the child was without deviations. Day time dream was absent from 2 years, difficulties with falling asleep. Complaints on writing problems, restlessness, disorders of attention appeared at the beginning of schooling. The boy was rearranging syllables and had problems with spelling. He takes regular courses of pharmacotherapy. During all period of school education the boy is constantly having lessons with tutors, logopedists in connection with dysgraphia and ADHD.
The objective diagnostic findings before first course of TCMP (tDC):
MRI: incipient features of the osteochondrosis are at the level of the СII-СVI, LIV-LV.
X-ray examination of cervical spine revealed instability of odontoid bone of atlas, asymmetry of lateral joints of atlas.
EEG: EEG is characterized by enough formed rhythms pattern for the age. There is a small increase of irritation index in frontal lobe in the condition of hypoxia. Interhemispheric asymmetry is characterized by moderate decrease of functional state in left hemisphere in comparison with right.
REG: Reduction on 30-35 % of blood filling (from an initial level) formed by pulse is observed during head dorsiflection in right and left vertebral artery.
The neurologist: There are syncopal states against the background of chronic vertebrobasilar insufficiency, the widespread osteochondrosis and a congenital pathology craniovertebral area. There is hypertensive syndrome owing to perinatal and traumatic damage of nervous system.
The logopedist: The boy reads fluently, sometimes does not read up the endings, he understands the sense of read text well . The boy writes by right and left hands (he uses the left hand recently). The boy makes mistakes with the letter spelling, writes off 1-2 words; sometimes he changes or does not finish the ending of the word. The boy doesn't memorize aurally sense of text fragment, remembers 2-3 words. Difficulties of education are connected mainly with attention problems.
The psychologist: the boy is communicative and adequate during research. The work speed is fast, working efficiency is high. The motivation is educational. The volition is developed. The manual dexterity is developed enough. Attention and memory are within the limits of age norm. Cogitative operations: the boy fulfilled the 73 % of generalization tasks correctly and 100 % of logic tasks. Emotions: The boy has a positive feeling/good mood. Difficulties in tasks fulfillment are mostly connected with the excessive haste, insufficient motivation.
First course of tDC (transcranial micropolarization) was carried out from 21.04 to 12.05.2004 and consisted of 4 sessions.
During individual lessons while procedures: the work speed was fast, there were no complaints on weariness. The boy made only three mistakes at the end in more difficult part of the text, mistakes were connected with unfamiliarity with the rules of the Russian language. The dictation for college intrants has been offered to the boy on the next lesson and boy made only one mistake. There was high enough level of written tasks performance despite of gradual complication of tasks.
It was revealed, that the basic subjective difficulties in school studing were connected with distractibility because of plenty of pupils in the class, distractibility during public answers, and distractibility on examinations because of excitement. Individual work with tutors was more efficient. In connection with all mentioned problems boy was recommended additional individual work with psychotherapist. In spring he was able to pass annual school exams with good marks - "4" (the highest (excellent) mark - is 5). One exam was passed with the resit. Anyway boy, himself marked the increase of working efficiency from 10-15 minutes to 1.5 o'clock without distractibility.
Second course of tDC was carried out 8 months later after the first course from 15.12 to 29.12.2004 and consisted of 3 sessions.
REG: In dynamics there was marked 30 % decrease of bloodflow in carotid system in comparison with the norm. Negative changes were also observed during head dorsiflection as more expressed reduction of bloodflow in right vertebral artery - on 50 %, and in left vertebral artery - on 35 % from an initial level.
On individual lessons during course of tDC the boy was writing difficult dictations without mistakes. At the same time the boy usually found only evident mistakes during checking of ready texts, he was missing other mistakes because of inattention. The boy was having lessons with tutors and was attending the preparatory courses to the University.
Data from the 2006 year. Platon became a student at the Medical University. He coped with the study load of the first years of education without special difficulties ("Here, as against school - nobody guides (rules) me and lessons are more interesting!" - this is motivation!).
The comment: Platon had electrophysiological inspections (EEG, REG) in our institute since 9-years old. Despite of constant additional lessons with tutors, his level of progress has gone down to marks "three - satisfactory" in last classes of school. His low writing literacy was kept, despite of courses of logopedic correction in connection with dysgraphia, also in different commercial educational centres. Therefore we were much surprised that the boy stably wrote difficult dictations (with " insufficient educational motivation ") without mistakes.
This is one more complexity in work with attention deficit and hyperactivity disorder. High distractibility to inductive stimuli can be based on tendency of nervous system to exhaustion: pay attention to the neurologist conclusion, the data of X-ray examination of cervical spine, REG (the data indicate the vascular inferiority). Against this background "the weak unit" suffers first of all, and propensity of nervous system to a fast exhaustion aggravates problems with attention which, in their turn affect the quality of learning. At the same time in the University in condition of increase of motivation level personal resources worked on mobilization of organism capability for new (study) loads.
ANDREY SH. The first visit was in February, 2003 at the age of 8 years old with complaints on problems with writing and reading.
Anamnesis: pregnancy proceeded with toxicosis of the 1st and 2nd part of pregnancy, mycoplasmosis. Birth was in time with help of caesarian section due to uterine inertia, weight of the child at a birth was 3450 grams, height - 53 cm, Apgar score was 7/8. The boy was observed by the neurologist with diagnosis of perinatal encephalopathy. The boy demonstrated early psychomotor development: the boy held a head from 4 months; could sit from 6 months, went from 10 months, the first words were at 8 months, phrase speech appeared after 2th years old. The boy easily adapted to kindergarden attendance. In 2002 the boy had a brain concussion.
The data of objective researches before first session of tDC:
Ultrasound investigation of a brain: residual-organic changes.
EEG: There are diffuse changes of the brain bio-electrical activity, more expressed in posterio-temporal and occipital areas mostly in the right hemisphere. There are no epileptiform EEG patterns. There is low-grade dysfunction of brain stem structures.
REG: Bilateral reduction of pulse blood filling on 40-45 % from an initial level is observed during head dorsiflection in right and left vertebral artery.
The neurologist: perinatal residual-organic lesion of the brain. There are hydrocephalic syndrome in a subcompensation stage, cerebral asthenic syndrome and dysarthria.
The psychologist: the boy goes in contact slowly; his behavior in situations of survey is adequate.
Handedness: the boy writes by right hand, uses both right and left hands if necessary.
The work speed is slow, working efficiency is low, efficiency is strongly reduced by the hindrances and acceleration of work speed.
Leading type of motivation is "playing" motivation.
The self-esteem (self-appraisal) is lowered. The volition is developed insufficiently.
Perception skills are within the norm range. The manual dexterity is developed on an average level.
Attention is involuntary, drained. There are difficulties in concentration and switching of the attention.
Memory is at the lower norm limit: visual involuntary memory is 7 elements, voluntary memory is 8 elements; aural memory is reduced.
Thinking: analysis - synthesis are developed (the boy collects the cutting picture, using fitting of the parts); generalization is at a stage of formation (the boy finds "fourth irrelevant objects in the test", but explains by secondary characteristics). Classification is developed insufficiently (the boy performs the task using one attribute instead of two needed). The boy finds the causal relationships within the norm limits. Abstraction (estimated by the contrasts test) is developed insufficiently. The logic (estimated by the pair analogies test) is developed insufficiently: the boy performs 45 % of tasks.
The conclusion: the thinking is eye-mindedness (visual), logical reasoning is at the stage of formation; emotional - personal features: The boy is disturbing, he is not self-assured and he depends on mother. Difficulties in learning are connected with drained attention, low working efficiency. A level of development is boundary with mental retardation.
The logopedist: the boy reads letter by letter. He misses an initial syllable while reading. The boy writes off letter by letter without mistakes. He does not know vowels and consonants. He does not separate sounds from a word. He writes words by self-dictation of letters during writing.
The conclusion: Dysgraphia. Dyslexia.
First course of tDC consisted of 7 sessions was carried out from 05.03.2003 to 16.04.2003.
On the lesson during 1
st session of tDC: the boy is strung-up, isn't relaxed. There is impulsiveness in behavior: he starts to do tasks, while hadn't listened to the end of the instruction. He does not know many basic concepts and therefore he cannot explain logic of actions. He seldom reacts to corrections by the tutor, comes to standstill; he takes mistakes into account only after numerous corrections. The active dictionary is limited.
On the lesson during 2
nd session of tDC: the boy goes in contact immediately. He quickly understands tasks, he instantly reacts to corrections.
The boy cannot operate concepts "the part - the whole", "the beginning - the end". The boy has difficulties with transference of words from the passive dictionary in the active dictionary. Relatives mark that the boy showed desire of participation in school holidays and competitions (he has ceased to be afraid to be in public).
During 3
rd session of tDC: the boy is calm. The work speed and working efficiency are sufficient. Impulsiveness has decreased, the attention concentration has increased. The boy better remembers new words; he better transfers the words from the passive dictionary into active using. During lesson he uses the information received on the previous lessons, but with additional stimulation.
During 4
th session of tDC: The working efficiency continues to grow. There is no necessity to repeat tasks to the boy, he stopped asking to repeat them. But boy frequently begins the true answer with words "I do not remember, I do not know". He quickly and effectively uses help, leading questions; he does not forget the previous corrections any more. The attention is unstable. He has written a control dictation in the class without mistakes and blots.
During 5
th session of tDC: boy is calm, organized. The concentration of attention is steadier. The boy remembers well the tasks and material he re-worked earlier and uses them. He has ceased to switch to search of distinctions during finding of the common attributes of the objects. If he makes mistakes he instantly reacts to the help, he uses it adequately. He still does not see distinctions between verses and prose: can distinguish them only in the book (verses are written by columns).
On the lesson during 6
th session of tDC (after the boy has had an acute respiratory disease): The working efficiency has decreased. He has written written works at school worse than he wrote before. The boy works more effectively individually with the teacher, than in a class.
The logopedist (after first course of tDC): The boy reads a little bit faster, but syllable-by-syllable as before. He does not miss syllables any more. He retells story better. At school his regular mark for reading now is "four" (good). The boy still writes with a lot of mistakes, but now he can find a mistake himself. There are difficulties with mathematics.
The conclusion: Dysgraphia.
The psychologist (after first course of tDC): the boy goes in contact immediately. He has coped with the task on generalizations (he is already guided by primary attributes during separation), he could perform the task earlier unachievable for him - the task on contrasts: he performed 9 of 12 tasks (74 %). The percent of performed tasks on "pair analogies" has grown from 45% up to 90 % (up to norm). The boy is more self-assured, but fatiguability remains increased.
At the beginning of new academic year (the second class) the boy reads 60 signs a minute. Quarter marks for Russian language and reading are stable 4 (good). There are difficulties with mathematics, especially with mathematical dictations, written control works in mathematics are better than mathematical dictations.
Several months later:
The logopedist (before second course tDC): The number of mistakes decreased. The boy still misses vowels; he rearranges unaccented vowels, makes mistakes in the endings. Reading is still syllable-by-syllable, without accents (emphasis); the boy does not stop on punctuation marks, does not make intonational emphasizing. The active lexicon is still small; therefore boy has complexities with retelling of stories. He makes mistakes in those words which he does not understand. Sometimes he does not find out a word because of a wrong accent (emphasis). Similarly with mathematics: he makes mistakes due to non- understanding of content, he needs the reinforcement by a graphic representation.
The psychologist (before second course tDC): the motivation has changed from playing to educational. The volition is more developed. Concentration of attention has essentially increased. The boy finds cause relationships more confidently. He is more self-assured, opened and benevolent. The work speed remains slow, working efficiency is low. If to speed up the work speed, works productiveness is reduced. A level of development is below age norm.
Second course of tDC consisted from 7 sessions was carried out in the period from 10.03 to 12.05.2004.
On the lesson during 1
st session of tDC: the working efficiency is kept low, impulsiveness remains. But boy can come to the true decision with the help of the psychologist. The boy makes mistakes during writing on hearing because he confuses optically and acoustically similar sounds. He recollects a spelling of letters during the long time; he even depicts them in air before to write on a paper.
During 2
nd session of tDC: the working efficiency has increased up to an average level, mistakes on dictations are similar as before.
On the lesson during 3
rd session of tDC: the working efficiency again has decreased. But boy improved himself in story generation as he could use complete sentences and he began to use compound sentences and smoothly connected the phrases and plots. However he has difficulties with spontaneously production of sentences (without a support of a plot): the boy forgets words, hardly selects the words, when he doubts he is starting to change variants.
On the lesson during 4
th session of tDC: the work speed has ceased to be reduced by the end of lesson, the boy distracts less, but the character of writing is without changes.
On the lesson during 5-7 sessions of tDC: the boy is more confident with answers, he has less doubts, the working efficiency and attention are stable; he thinks over answers, he does not hurry up any more. He reads the familiar text more fluently. He performs the tasks on searching hidden images correctly. The boy became more confident with writing. He less thinks about a graphic representation of letters, he less pronounces words while writing.
Relatives have noted during this period of time: the son has ceased to confuse connections between words, some works in mathematics he has written better, than in Russian. At the end of a tDC course as a whole the child became more active.
