Tuesday, October 21, 2014

What is the Anat Baniel Method and How does it work with Neurodevelopmental Therapy?

I used Neurodevelopomental therapy with Jett and have gotten great results. (See my Therapy page for details.) So, when I had Jett's baby brother, Oliver, who suffered a brain injury shortly after birth, I naturally went to ND. Well... because of Oliver's PSTD (Post Traumatic Stress Disorder) and because of his spasticity (muscle ridgeness), I couldn't really manipulate him as needed for some aspects of his ND program.  (It made him tighter and angrier.) Instead, I had to look to the ABM and MNRI to get him calm enough and loose enough to continue with ND.

I haven't yet tried ABM or MNRI for Jett, but am interested in exploring the benefits of ABM for our children with Down syndrome. That brings me to Rashmi Sundareswara, a lovely mom with a child with Down syndrome who uses both ABM and ND when working with her adorable and smart, Teyjas. She has graciously taken the time to write this beautiful piece for us....

You can see a World in a Grain of Sand
And a Heaven in a Wild Flower
Hold Infinity in the palm of your hand
And Eternity in an hour

    -William Blake

Have you ever experienced wonder in the midst of a mundane or an unpleasant experience?  If so, then it’s probably because you stopped to pay very close attention, even if just for a few seconds, to the beauty of it all – the process of unfolding, of discovery.

That “attention” is the one of the nine essentials of the “Anat Baniel Method” (ABM) [Baniel, 2012].  When combined with the other 8 essentials, it can be very powerful in transforming our movement, our thinking and our lives, wherever we are at.  The power of the ABM philosophy (as well as mindfulness in parenting in general [Zinn, 1997]) has been vital for our family.  It gives us a way to see our kids for who they are and not through our veils of fear and anxiety.  Science is now validating that ancient practices of mindfulness meditation can bring about beneficial effects on attention and emotion regulation, both of which are important for cognition[Kilpatrick, 2011, Kang 2013, Wells, 2013, Zeidan, 2010].  In addition, studies show that it can delay the progression of Alzheimer's, probably due to its influence on the brain's attentional and emotional networks.

The brain longs to find patterns, make sense and “create order from the chaos” [Baniel, 2012] it sees around it.   Our brains are endowed with billions of neurons and trillions of connections for the purpose of interpreting stimuli from our sense organs.  What we make sense of depends on what we bring our attention to.  During an infant’s first couple of months, there is a lot of differentiation in the brain – straight lines vs curves, mother’s voice versus father’s voice, mother’s smell versus dad’s, straightening out a knee versus bending, etc.  In all this, a baby is actively moving and sensing with attention (Essential No. 1) and often doing so slowly (Essential No. 2) to get new input for feeding its hungry brain’s need to differentiate.  The brain is craving “variation” (Essential No. 3) and hence the little scientist is motivated to gather input by experimenting with different ways of bending that knee or moving the pelvis.   As the baby grows, the differentiation becomes more subtle (Essential No. 4) for example, grabbing the rattle ever so gently versus attempting to grab it with force.  Imagining (Essential No. 8) herself being picked up when her mother comes near, a baby can replicate the sensation by activating the strong muscles in her pelvis.  This skill, with enough practice, turns into another skill of rolling over – something a baby practices over and over because she is so enthusiastic about it (Essential No. 5).  Throughout the child’s life, learning is taking place as long as the child is motivated and aware (Essential No. 9), which keeps the child’s  “learning switch” on (Essential No. 7).   Freeing ourselves from rigidity and having flexible goals (Essential No. 6) for our children gives them the freedom to experiment with their movement and their thinking and can help them become curious, independent, motivated, gritty and happy individuals. 

These nine essentials, brilliantly described by Anat, are what the “typical” brain does naturally.  When a child has special needs, one or more of these essentials is not functioning well.  What the Anat Baniel Method (ABM) and concepts in the book, Kids Beyond Limits (KBL) [Baniel, 2012] aim to do is bring back the missing essential(s) into the movement or thought pattern that is compromised so that learning can be improved. 

The ABM method imparts a deep respect for the “process” of development and discovery by the child rather than milestones in and of themselves.  By focusing on the process, we as parents are present to the wonder of our child’s current abilities rather than what “should” be.  When a learning process unfolds naturally, it creates a rich web of connections in the brain that are intentionally redundant.  Redundancy makes sure that the brain learns many ways of doing the same thing.  Imagine a spider web that is richly woven.  This rich web makes sure that there are many ways to get to the same spot.  Redundancy is everywhere in nature – from the blood vessels in our brain to the rich network of veins on a leaf.   When something gets broken, redundant networks make sure that the job can still get done.  They provide resistance to damage and allow space for creativity.

Neurodevelopmental programs provide activities that are geared to help the child’s developmental process as well and/or to address sensory needs (in addition to a whole host of other programs like reading, math, etc).  Many ND programs have a list of activities to be done with a certain frequency, intensity and duration.  In several activities (especially those for younger children), the goal is to provide input to the child’s brain by the parent since the child’s muscle tone or sensation/perception system is not allowing them to generate the input for themselves.  We do NACD with our son, which also wants the “process” to unfold by itself – by helping to develop areas such as muscle tone, oral awareness or auditory processing just to name a few.  They have techniques that go beyond the original Doman-Delacato method that they are based on and are also continuously evolving in their quest to help children achieve their fullest potential.

There are many who feel that neurodevelopmental (ND) programs are at odds with various aspects of the nine essentials of the ABM method.  So can the two be reconciled?  I believe so and I hope this blog entry can help you find ways to add an ABM flavor to whatever ND program you might follow.  I would also highly recommend reading Anat’s book, Kids Beyond Limits for a thorough explanation of the nine essentials and taking classes with an ABM practitioner.  This short blog opinion is in no way doing justice to the rich information that is contained in the book.  In addition to going into detail about each Essential, the book contains lots of scientific studies validating the nine Essentials.  I am extremely grateful for Anat and her work, as well as her practitioners, Marcy Lindheimer and Brendan Elms, who have all helped my child (and myself) and thousands of other children.  My heart was palpitating with excitement when I first read her book – every sentence is exactly in line with my background and interest in mindfulness.  I was so excited that there was someone out there who validated the importance of mindfulness for raising a child with special needs.

For me, doing the suggested activities in our ND program while keeping the ABM principles in mind required a shift in my thinking.  I had to be creative and attentive, rather than do them on automatic pilot .  Even though I may only get in 30%-40% of a day’s frequency (hard enough for a working mom who also wants her son to primarily play after he returns from his wonderfully stimulating preschool), what is important to me is to have done it mindfully and with my son’s attention.  Sometimes, the stress and the anxiety of not getting through a program can deter us from doing it with mindfulness.  The beauty and rich possibility of the present moment with our child will dissipate very quickly if we let concerns of the future, our anxiety or our schedules take over.  And most unfortunately, this is what our children too will learn – our anxiety and stress.  I am guilty of this every day, but I am getting better (it’s a process, right?!).  However, I want to parent for the long-term – I want to have fun with my child during these crucial, formative years but do so in a productive manner. 

For the remainder of this discussion, I will use examples of four activities that are quite common to most ND programs for kids with Down syndrome: deep pressure on the limbs, the sit-stand sequence, oral stimulation and auditory processing.   For each one, I’ll describe how I do it while keeping the nine Essentials in mind.


This activity in an ND program is suggested to increase the sensation in the low-muscle tone child.  It comes with a certain daily frequency, intensity and duration to normalize the tone.   I wondered when my son would get bored with it and not care for it anymore.  I mean, honestly, if I was deep-pressured or tickled 6 times a day for weeks on end, would I still be tickled?  Wouldn’t I become desensitized to it?  But I have normal muscle tone and my son does not, so I do not know if he will have the same reaction.   However, I do know how I can make sure that my child is paying attention to it.  So, I use the Essentials: “awareness” and “movement with attention” not just for my son, but for myself as I interact with him.  When I apply deep pressure, I think of it as way of discovering him, as if the first time.  “Hmmm…. This is what his toes feel like – his little toe is just as cute as when he was born! …. Interesting, I had not noticed before how his thigh skin is so much softer than the skin on his calf.”    My brain was developing subtleties and hence becoming more differentiated too because I was not on “automatic pilot”!  He too, seemed to be enjoying the activity more because I showed him so much more attention.  That is one of the best gifts we can give our children – our full attention.  But wait!  He soon got tired of me doing that, so then I had to think of other ways of holding his and my own attention.  I started drawing alphabets on his legs and he was so excited to guess what they were!   Some other suggestions from the book are to pause when you are about to start a movement with him and to support and exaggerate the movement.   For the sit-stand portion of the activity (this is where the one or more parents help the child pull-up to stand from a sitting position) I also tried to exaggerate the movement of pulling him up to stand.  I asked him to feel how strong his legs were – and he used to laugh.  I changed up the way I said “strong” to a deep, deep tone.  I varied what he would be sitting on when he was pulled up to stand.  Sometimes, the platform he was sitting on was only an inch high; sometimes, it was 5 inches high.    I would sometimes give him only one arm to hold onto, sometimes two.

I would vary the spacing between his left and right leg, putting one or both feed on the platform, sometimes even let him get close to falling … you get the idea.  Variation.  It’s important – the brain thrives on it.  My brain thrives on it!  I needed to think of ways to change it up to prevent myself from going on auto-pilot.  That is something I want to avoid for myself and my son because that is end of useful information for the brain.  We want the information to be as novel as possible because that means new synaptic connections in the brain.  The end result is hopefully multiple ways of completing a task from a host of starting points. When you see your child successfully learn to use a shape-sorter, for instance, you will probably have noticed that at first the child was experimenting with all sorts of incorrect orientations of the shape through the sorter until the right one clicked.  Having learned this way time and time again probably meant that he could fit the piece correctly no matter what orientation it started in his hand.  That is the idea here with “variation” and can apply to almost any skill your child learns.  I’ll end this section by saying that it had come to a point where my son would beg me to do “sit-stand” with him!


As far as the activity of patterning goes, I’ve wondered why it works for some kids and some do not.  I think the key is “attention.”  Here are my thoughts:  ABM says that stimulation, for example, given by the parents, by moving the child’s limbs for them – patterning – is not the same as information to the brain.   What does this mean?  This means that as long as the child’s brain is not paying attention to the particular sensation, then it’s not information to the brain – it is just stimulation.  Attention to anything – even for us adults – is what transforms outside stimulation into usable information by the brain.  How many times have you walked in your neighborhood and discovered some aspect of a house (or an entire house!) that’s always been there and you have looked at a thousand times before?  We need to have our children feel, be aware, interested and excited about the activity – then the attention to the movement happens – and the connections form.    Without it, one can pattern, pattern, pattern and not get the desired results – what one might get instead is a lot of frustration for both parent and child.  You want to, as much as possible, as Anat says, to “invite” the movement, rather than “impose” it.

Oral Stimulation

Hard one.   Most people reading this might be familiar with the ‘nuk’ brush.  The bumpy brush that we are supposed to rub and massage the insides of the mouth with.  Again, same idea here: if you want the child to feel it as much as possible, we have to make them 1) look forward to doing it  and 2) feel the sensations that we intend for them by having them pay attention to it.  To this end, I sometimes have him feel the bumps on his finger and then I ask him, “hmm… I wonder what this would feel like inside your mouth?”  Once when I said that, he grabbed the brush excitedly from me and put it in his mouth!  Sometimes, I draw letters on his tongue and ask him to guess what they are or I ask him what alphabet he would like me to draw.   I do the same for around his cheeks.  If your child is not familiar with the alphabet yet, you can try drawing a “ball” or a “triangle” or anything simple that your child is familiar with.    I have also asked him if the nuk brush feels differently on his fingers than it does on his tongue, and how so.  The possibilities are endless.  I will admit that it can be exhausting constantly think up new ways of having him feel the brush in his mouth, so I sometimes just use it on his body for a change.

Auditory Processing

There are many suggested ways of doing auditory processing.  I will take one example to expound upon: digit span.  This activity requires the caregiver/teacher to say out loud to the child a certain amount of digits, a second apart, and the child repeats it back in the correct sequence.   The number of digits usually grows linearly with age up to a point.   My son counts in four different languages (English, French, Spanish and my native language of Kannada – a language of one of the states in the Southern India).   We do digit span in different languages.   He was first used to doing it in English only, so when we introduced the different languages, it threw him off a little.   The result was that he paid more attention and got back on track.  He still prefers to do the activity in English, but the other languages provide enough variation to keep it interesting and difficult.

And in the end...

Doing our ND program is not easy.   It requires enormous discipline to come back and do the same set of activities day in and out.   The only way one can come back and do it over and over again is if there is the strong belief that it will work.  This belief, for my husband and myself, wavers all the time, even though we have seen good results for our son and have a huge amount of respect for NACD.  Let me explain why.  The first issue is that of time – both my husband and I work full-time.  The second is our own parenting legacies:  My husband and I were raised in two different continents.  We were both just left to play, however we wished to by our parents, when we were under their care.  Neither of our parents are technical-minded, however now my husband has a Masters in Mathematics (almost a doctorate) and I have a doctorate in Computer Science (my focus incidentally is Artificial Intelligence).  Granted we achieved this because of the opportunities that environment provided for us and hard work – but it was not in the way of our parents helping us when were young other than allowing us to be whatever we wanted to be.  I understand that our children need more help than typical kids, but just how much help is a question I constantly struggle with… I want him to learn to read by himself because he wants to do so; because he sees how excited I am to read with him, not necessarily through flashcards.  You see my dilemma.  I do want to work hard with my son, but what I really want to teach him, along with increasing his muscle tone, sensory issues, is “grit” because that studies show that is more powerful than IQ [Tough, 2012] in navigating our world.  (Quick digression here, I just want to mention even though reading does change the brain in desirable ways, specifically sharpening visual attention skills, strengthening split-second micro movements of eye muscles, it also makes one less adept at other visual feats that people with dyslexia are good at – spotting visual anomalies and a propensity for visual causal reasoning [Schneps, 2014], skills that serve scientists well).

Teyjas independently finishing a 24-piece jigsaw puzzle.
Doing our ND program with the nine Essentials in mind makes it a bit more exciting and hopefully more effective.  However it also requires a huge amount of discipline – discipline to be completely aware of my intention as I work or play with my son (Is it kind or anxious or greedy?), discipline to not “impose” desired movement on him but to gently “invite” it from him, and discipline to not let feelings of discouragement come through in my interactions with him.  It is a daily practice achieved through frequently becoming aware of the state of our body, breath and mind.  This skill of focused contemplation gets better with time – not just with frequency, intensity, duration, (ha ha – sorry, couldn’t help it!), but with a generous amount of self-compassion. Parenting any child is hard enough, but parenting a child who has some extra needs is phenomenally hard.   It is easy to judge ourselves all day long.  If we are compassionate to ourselves first, then it becomes easier to transfer it to the other people in our lives – including and especially our children who are doing marvelously despite the issues they face.

The old adage, “It’s the journey, not the destination” (or the process, not the milestone!) really fits my journey on this path of parenting my son.  My son, Teyjas, just turned four.   He continues to surprise me everyday – not just with his cognition and speech, but his “grit”, his motivation and his humor.  I want my son to glean from my husband’s and my own experiences – successes and failures – in parenting him.  I want him to know that just like there are innumerable questions/methods on how to help our kids – there is always an answer lurking around – and its an exciting, gritty, grateful, journey to sort through it all – and best of all – to see each new moment as ripe with potential.

Thank you Andi for extending to me the opportunity to voice my thoughts on your well-deserved, extremely inspiring blog for parents of children with Down syndrome.

Teyjas loves coconuts!
May all our children break through stereotypes of the past.

May we all gracefully walk the fine line of high expectations and acceptance.

May we all be present to the enormous love, compassion and possibility in every moment.

Rashmi Sundareswara and her (incredible) husband Sam Peterson are parents to Teyjas, recently turned 4 year old (with Down syndrome), and 6-month old Maya.  We all live in sunny Santa Monica, CA.

*Anat's take on “intensity”: The “intensity” issue. Amos Tversky and Daniel Kahaneman’s research demonstrated that under uncertainty conditions people will not diverge more than 30% off their baseline/start point. ND is based on the DD (Doman-Delacato) approach that believed in lots of hours daily of exercising the desired function.
That can easily lead to greater grooving in of existing limitations, or portions there of.
Current research shows the incredible instantaneous and HUGE changes that can occur within a few minutes if the brain gets the info it needs and that continued “practice” right away actually can inhibit the changes. So if ND can go beyond the 30% change from the baseline, I would redefine intensity to mean – CHANGE! And when change occurred it is time to stop for a while – preferable at least a day and come back to it gently and minimally later. And if there is no change after a few minutes then – STOP – because its not working. Do something else.


Baniel, Anat, (2012), Kids Beyond Limits, New York, NY. Penguin Group.

Decharms RC, Merzenich M., (1996). Neural Representations, Experience and Change.  The Mind-Brain Continuum, MIT Press.

Tough, P.  (2012) How Children Succeed. Grit, Curiosity and the Hidden Power of Character, New York, NY, Houghton Mifflin Hartcourt, 2012

Zinn, Jon-Kabat, (1997) Everyday Blessings: The Inner work of Mindful Parenting, New York, NY, Hyperion.

Schneps, Matthew  (2014) The Advantages of Dyslexia. Scientific American. August 19, 2014.  http://www.scientificamerican.com/article/the-advantages-of-dyslexia/

Kilpatrick LA, Suyenobu BY, Smith SR, Bueller JA, Goodman T, Creswell JD, Tillisch K, Mayer EA, Naliboff BD (2011) Impact of Mindfulness-Based Stress Reduction training on intrinsic brain connectivity, NeuroImage. 56(1):290-8. doi: 10.1016/j.neuroimage.2011.02.034. Epub 2011 Feb 18.

Kang DH, Jo HJ, Jung WH, Kim SH, Jung YH, Choi CH, Lee US, An SC, Jang JH, Kwon JS. (2013) The effect of meditation on brain structure: cortical thickness mapping and diffusion tensor imaging. Soc Cogn Affect Neurosci. 2013 Jan;8(1):27-33. doi: 10.1093/scan/nss056. Epub 2012 May 7.

Rebecca Erwin Wells, Gloria Y. Yeh, Catherine E. Kerr, Jennifer Wolkin, Roger B. Davis, Ying Tan, Rosa Spaeth, Robert B. Wall, Jacquelyn Walsh, Ted J. Kaptchuk, Daniel Press, Russell S. Phillips, Jian Kong. (2013). Meditation's impact on default mode network and hippocampus in mild cognitive impairment: A pilot study.  Neuroscience Letters, 2013; 556: 15 DOI:10.1016/j.neulet.2013.10.001

Zeidan F,  Susan K. Johnson, Bruce J. Diamond,, Zhanna David, Paula Goolkasian, (2010) Mindfulness Meditation Improves Cognition: Evidence of Brief Mental Training.  Consciousness and Cognition, Volume 19, Issue 2, June 2010, Pages 597–605

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