SUCCESS STORIES

Intellectual & Developmental Delays

About the Client

Name:

Aaron

Age at Intake:

6

Diagnoses:

Aaron's Story

Aaron came to Jacob’s Ladder at six years old when his family was seeking support for his significant speech delays, low academic output, and severe behavioral challenges. Aaron’s diagnosis of severe dysgenesis of the corpus callosum was substantial, and for Aaron, only a small remnant of the anterior part of the corpus callosum was present. The corpus callosum is a bundle of nerve fibers connecting the brain’s two hemispheres. These nerve fibers ensure both sides of the brain can communicate and send signals to each other. When the brain’s two hemispheres cannot work together, functional output is severely inhibited, and for Aaron, this contributed to his global intellectual and developmental delays. 

 

Aaron’s former school reported his language skills at the same level as a two-year-old with significant articulation challenges; he engaged in significant visual sensory play that constantly pulled his attention, had difficulties with visual processing, and only showed mastery of basic pre-academic skills. Most notable were his behavioral challenges. Aaron’s behavior was described as immature; he was stubborn, impulsive, distractible, perseverative, non-compliant, and had significant tantrums. Due to these challenges, Aaron had few friends despite his deep longing for connection and relationships. 

 

Aaron’s needs were significant, specifically regarding his behavioral outbursts and severe language deficits, which significantly inhibited his learning in all areas of functioning. Aaron enrolled in Jacob’s Ladder programming, progressed through a 1:1 placement to small group participation, and successfully transitioned from Jacob’s Ladder to a local public high school. Aaron had the honor of being a student of Jacob’s Ladder’s namesake, Jacob Wuttke, who significantly impacted his life. Despite his previous challenges, at the time of his transition to high school, Aaron engaged in minimal to no maladaptive behaviors, was highly conversational, and made friends with anyone who crossed his path. Aaron’s life completely changed through his individualized therapeutic plan facilitated via the Interpersonal Whole-Brain Model of Care® (IWBMC™), delivered in a radically accepting environment. Aaron graduated high school, works at a local coffee shop, volunteers, and participates in a special needs weightlifting program where he has broken two world records.

Challenges Before Enrollment

Successes After Enrollment

Incoming Evaluation Results

During Aaron’s initial evaluation, he had severe challenges with non-compliance, visual deficits, and language delays. Aaron had tremendous difficulty teaming his eyes together and had divergent strabismus, correlating to visual difficulties with discrimination, replication, and sequencing. When assessing vestibular functioning, Aaron had a severely hypoactive response, relating to problems with language processing, focus and attention, tonicity, and stability. Further, Aaron was processing auditory and visual sequential information at the level of one’s, placing him in the Lower Extreme range when compared to same-aged peers. 

 

In addition to Aaron’s apparent neurodevelopmental gaps and behavioral challenges, he also experienced significant physiological disruption. Aaron had severe seasonal allergies multiple times per year, leading to systemic inflammation. These physiological factors greatly impacted his day-to-day functioning, correlating most specifically to increased behavioral outbursts. 

 

Aaron began full-time enrollment, working in a 1:1 setting in our Ladder program. While it was evident that Aaron had a kind and engaging spirit, his behavioral challenges were significant and greatly inhibited his progress. Aaron’s teachers noted consistent trends of stability and progress, followed by severe behavioral challenges and regressions. Aaron also engaged in a high degree of visual sensory play and had considerable sensitivities to activities of daily living, including haircuts and nail cutting. He was highly perseverative, frequently focusing on Thomas the Train, and while he could identify his colors and shapes, he could not consistently identify numbers 1-10.

Results at Program Completion

Aaron participated in a sensorimotor program emphasizing cross-lateral movement to build neuronal pathways across the brain’s two hemispheres. His programming included frequent running, cross marching, vestibular stimulation, deep sensory input, opportunities for language output, and visual stimulation. 

 

Although Aaron had substantial behavioral challenges to overcome, as the key physiological, self-regulation, and neurodevelopmental barriers were addressed, he became increasingly more compliant, engaged, and communicative. Within one year of intensive programming, his language went from speaking in one-to-two-word phrases to communicating with complete sentences. His auditory and visual sequential processing increased from the level of one to the level of four, reflecting three years of improvement within a twelve-month timespan. Additionally, Aaron’s defiant behavior diminished, and his academic skills improved. Aaron could read 172 sight words independently and complete simple addition and subtraction calculations independently. Within 18 months, Aaron no longer showed sensitivities to haircuts or nail cutting and was reading more complex content with minimal support. 

 

Each year, as Aaron was enrolled, he continued to progress. He successfully worked through his individualized 1:1 program approach to build a solid neurodevelopmental and academic foundation and to address his emotional-behavioral-relational barriers. As success was shown, he transitioned to a classroom setting, where he joined for short durations until he was ready to fully participate in a classroom setting for the entire school day. Aaron participated in a small group with approximately six clients and three teachers, including Jacob Wuttke. While Aaron and Jacob had known each other for several years, they developed a strong rapport and trust when Jacob started serving as his provider and challenged Aaron toward continued progress each day. Jacob worked with Aaron to prepare him for high school, where Aaron successfully transitioned to a public high school with minimal support needed. At this time, Aaron was fully conversational with his language, made tremendous academic gains, and participated in his whole school day with no emotional or behavioral outbursts.

 

Aaron graduated from his high school program and has remained a part of the Jacob’s Ladder family, continuing to attend part-time to build his independence and complete cognitive work. Aaron now works at a local coffee shop, volunteers, and is part of a special needs weightlifting community where he has broken two world records. He is thriving in all areas and loves being part of the community.

Top 10 Hypo-Coherence Connections Comparison

10/6/2011 & 5/22/2017

Brain Regions
Frequency
10/6/2011 Z-Score
5/22/2017 Z-Score
Change Toward Normative
Anterior Cingulate Gyrus - Right 33R to Cerebellum 8 - Left
High Beta 2
-6.81
-0.88
5.94
Anterior Cingulate Gyrus - Right 33R to Cerebellum 6 - Left
High Beta 2
-6.66
-0.58
6.08
Anterior Cingulate Gyrus - Right 33R to Cerebral Crus 2 – Left Brain Stem - Midbrain
High Beta 2
-6.60
-0.71
5.89
Anterior Cingulate Gyrus - Right 33R to Cerebellum 7b - Left
High Beta 2
-6.50
-0.99
5.51
Anterior Cingulate Gyrus - Right 24R to Cerebellum 8 - Left
High Beta 2
-6.19
-1.03
5.16
Anterior Cingulate Gyrus - Right 24R to Cerebral Crus 2 – Left Brain Stem - Midbrain
High Beta 2
-5.97
-0.74
5.22
Anterior Cingulate Gyrus - Right 33R to Cerebral Crus 1 – Left Brain Stem - Midbrain
High Beta 2
-5.92
-0.92
5.00
Occipital Cortex - Left 19L to Thalamus – Right Diencephalon
High Beta 2
-5.80
-0.58
5.22
Pre-Frontal Cortex - Right 9R to Cerebral Crus 2 – Left Brain Stem - Midbrain
High Beta 2
-5.60
0.16
5.45
Pre-Frontal Cortex - Right 8R to Cerebellum 8 - Left
High Beta 2
-5.46
-0.07
5.39

These qEEG images show the electrical activity occurring within the brain. Areas with insufficient activity are noted by cool colors (blue and teal), whereas areas with too much activity are indicated by warm colors (lime green, yellow, red, and orange). The blank spots or white colors indicate any areas with activity occurring within the normal range. 

 

In the Top 10 Hypo-Coherence Connections table, the brain regions with the most severely disconnected pathways are shown on the left, followed by the frequency band, z-scores from each qEEG, and the total change towards normative. Normative scores are considered to fall within -1.6 to +1.6. All data is collected from raw EEG data and is compared to a normative database based on the client’s age, gender, and handedness.

Aaron’s initial qEEG shows excessive delta, theta, beta, and high beta activity, paired with deficient alpha activity within the Absolute Power measure. This combination of excessive and deficient activity greatly impacted Aaron’s ability to take in and send information to the appropriate brain areas for processing. Further, within the Coherence measure, the blue lines reflect insufficient pathways within the frontal regions required for speech, emotional regulation, and executive functioning. 

 

In the 2017 qEEG, the patterns of excessive and deficient activity under Absolute Power are completely transformed, with minor excessive activity noted in only two frequencies and a complete clearing of deficient activity in alpha. This improvement is reflected in Aaron’s daily functioning and improvements, as noted by his improved communication, cognition, and emotional regulation. Further, under the Coherence measure, the deficient pathways previously shown by blue lines are no longer present, indicating significant improvement in the neuronal pathways that allow information to flow between brain regions. 

 

Additionally, in the Top 10 Hypo-Coherence table, the initial results reflect severe challenges with communication between the brain’s hemispheres, directly correlated to Aaron’s diagnosis. All ten brain regions with insufficient communication patterns are between the right and left hemispheres, with z-scores as severe as -6.81 standard deviations from the mean. The comparison results show tremendous improvements, with each of the ten coherence measures falling within the normative range.

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