The Importance of MSE in Development and Learning
Sensory experience, the window to the brain/mind, is a precursor to all development including physical, cognitive, social, and communicative. On a daily and moment-by-moment basis, multi sensory experiences affect our motivation, attitudes, emotions, learning, physical activities, and our very being (Lotan & Shapiro, 2005). It is through our senses that we learn and develop an understanding of our environment (Ayres, 1979, 1982). The maturation of one’s nervous system continues during the first six years of life and is dependent upon the successful stimulation of the nervous system via sensory organs. The constant stream of data obtained through our senses helps the brain to interpret our surroundings, giving us vital tools to survive and thrive. Functional and cognitive development takes place as the nervous system matures. Failure to mature may be due to a disability or impoverished environment where stimulation of the senses is impaired or nonexistent. This lack of sensory input further affects one’s disability. Prolonged or frequent restriction of appropriate and meaningful stimulation can lead to negative psychological outcomes for individuals (Zuckerman, 1964). It is not only the amount of stimulation that is important, but also variation in the stimulation. Monotonous unchanging stimulation can be as negative as no stimulation. Many care settings exist in which people spend much of their time in non-stimulating environments or experience no variation in stimulation. Physical, sensory, and cognitive impairments further reduce the amount of meaningful stimulation that an individual receives. Impaired cognitive ability also restricts an individual’s ability to make sense of the stimulation that is received. Such deprivation of meaningful sensations can lead to negative outcomes such as anxiety, stress, depression, withdrawal and reduced motivation, agitation, and/or disturbed behaviors (Pinkney, 1997). Limiting sensory awareness and sensory stimulation not only affects a child’s learning ability, but also negatively impacts their quality of life (Hogg, Cavet, Lambe, & Smeddle, 2001; Lancioni, Cuvo, & O’Reilly, 2002; Stephenson, 2002).
Specific stimulation of the senses in an environment that excludes all extraneous stimulation makes perception and interpretation of sensations easier for people and alleviates the effects of deprivation. The stimulation can then be adapted according to the individual’s responses to it, thus making the experience increasingly appropriate and meaningful (Pinkney, 1997).
MSE seeks to assist in the repair and development of a functional nervous system by stimulating it in a consistent and organized way through a series of sensory activities and exercise. Adequate multi sensory stimulation and use of sensory motor ability produced in sufficient frequency, intensity, and duration excites and exercises the nervous system, improves its organization, and permits increased functional activities such as breathing, metabolizing food, walking, talking, reading, and so forth. By working toward a better organized, stronger, and more efficient nervous system, individuals become better able to demonstrate and access their true potential. The ultimate goal of MSE is to facilitate recovery or improvement of the nervous system so that individuals are able to process information of increasing variety and complexity (Hotz et al., 2006). Any program that puts an individual through an intensive period of sensory stimulation using repeated movement, sounds, and visual exercises slowly helps to create new neural pathways in the brain where there were none and to take over for damaged or underdeveloped pathways (DeBoer & Sutanto, 1997; Robbins, 2000). Multi sensory stimulation is essential for individuals with mental retardation, traumatic brain injury, and learning disabilities (Robbins, 2000), where sensory pathways are stressed and have not formed the appropriate connections.
When an organism is exposed to a new pattern of signal (sensory input) from the external environment, the strength of synaptic contacts and local biochemical and electro properties gradually change in a complex distributed constellation that represents learning (Goldberg, 2001). Sensory signals in different modalities can interact with one another, giving rise to many multi sensory phenomena. Multi sensory stimulation becomes a vehicle for learning and further shapes learning. When experiencing sensations, an organism is made more responsive to certain aspects of its environment, and through this arousing experience learning occurs (Ansell, 1991; Kater, 1989; Lotan & Shapiro, 2005). MSE awakens interest, and individuals in this enriched environment begin to explore and discover their surroundings. This exploration acts as a stepping-stone towards learning (Lotan & Shapiro, 2005) and has exponential benefits (Mount & Cavet, 1995; Stephenson, 2002).
New Developments in Neuroscience
New developments in neuroscience provide some answers as to why MSE has such positive outcomes for individuals with disabilities. These new developments include areas of neuroplasticity, neurochemistry, neuroelectrophysiology, epigenetics, brain synchronization and neural oscillations, stress, and brain arousal.
Neuroplasticity
The brain is a dynamic and extremely elastic organ. The human brain is capable of far greater feats of learning, remembering, and creating than had previously been imagined (Hutchinson, M. 1991). Recent studies in brain plasticity have shown that with proper sensory stimulation the brain can continue to grow producing more effective brain functioning, even late in life or after traumatic brain injury (Hotz et al., 2006; Passineau, Green, & Dietrich, 2001; Williams et al., 2001). Additionally, enriched environments have been shown to prevent long-term effects on adolescents raised in depressed, impoverished environments (Cui et al., 2007; Dennis, 2000). Research indicates that animals reared in enriched environments demonstrate significantly greater learning and memory skills than those reared in less stimulating or impoverished environments (Finger & Stein, 1982). Other research has shown that frequent and varying external sensory stimulation increases the number of brain cells and capillaries, increases cortical thickness, and produces neuron regeneration, which leads to enhanced learning and memory. MSE stimulates dendrite growth and branching (Tolle & Reimer, 2003; Nilsson, Perfilieva, Johansson, Orwar, & Eriksson, 1999), increased neurotransmission (Finger & Stein, 1982; Green, Greenough, & Schlumph, 1983), and improved synapse connectivity (Rampon et al., 2000; Williams et al., 2001). Recent work has demonstrated that MSE protects against cognitive decline in aging and significantly reduces spatial memory deficits (Frick, Stearns, Pan, & Berger-Sweeney, 2003; Lambert, Fernandez, & Frick, 2005; Wolf et al., 2006) observed in Alzheimer’s disease.
Neurochemistry
Acetylcholine, found in both the central and peripheral nervous systems, plays an important role in learning, memory, and the ability to process information. Mice raised in enriched environments have higher levels of acetylcholine and learned better than mice raised in standard or impoverished environments (Diamond, Lindner, Johnson, Bennett, & Rosenzweig, 1984). There is a link between Alzheimer’s and impairment in the brain cells that produce the neurotransmitter acetylcholine (Woodruff-Pak, Romano, & Papka, 1996). Because individuals with Alzheimer’s and dementia have low acetylcholine levels, they respond to conditioning more slowly and have problems with memory. Enriched environments stimulating the production of acetylcholine may explain why MSE has a positive effect on adults with dementia and Alzheimer’s. MSE has also been shown to improve the production of other neurotransmitters including norepinephrine, dopamine, serotonin, and histamine.
Neuroelectrophysiology
Every imaginable mental state is a result of a specific pattern or rhythm of electrical and chemical activity in the brain that can be altered and shaped by external stimuli such as sounds, lights, touch, and physical movement (Hutchinson, M., 1991). Neurobiofeedback shows that the central nervous system has some control over the autonomic nervous system and is a way to capitalize on the brain’s plasticity. Through neurobiofeedback, people with epilepsy are taught to heal themselves by regulating brain waves (Jensen, Kaiser, & Lachaux, 2007). It is also possible to regulate hyperactivity through neurobiofeedback. A person presented with a visual or auditory signal that gives feedback about alpha waves learns to activate more alpha waves. Since alpha waves are the dominant rhythm of a relaxed but wakeful mind, increasing alpha waves results in pleasurable feelings and relief of tension (Stein, Brailowski, & Will, 1995). Using neurobiofeedback a person can learn to alter involuntary systems such as blood pressure, heart rate, secretion of hormones as well as alter and control his or her thoughts, emotions, moods, and mental states (Hutchinson, M., 1991). The pleasurable “feel good” state is also responsible for increases in certain hormone secretion that also builds a stronger immune system.
Memory is related to theta and gamma rhythms, whereas attention seems closely associated with alpha and gamma rhythms (Ward, 2003). Oscillatory gamma-frequency activity has an important role in neuronal communication and synaptic plasticity (Jensen, Kaiser, & Lachaux, 2007). Animal research supports the hypothesis that transient oscillatory synchronization of neuronal assemblies at gamma frequencies (30-100 Hz) is closely associated with sensory processing (Jensen et al., 2007). Gamma-frequency activity also has an important role in attention and in both working and long-term memory (Jensen et al., 2007). This indicates that the coherence of fast EEG activity in gamma band increases in a process associated with learning (Fell et al., 2001; Zhigulin, Rabinovich, Huerta, & Abarbanel, 2003).
Epigenetics
“Epigenetics refers to heritable changes in gene expression caused by mechanisms other than changes in the underlying DNA” (http://en.wikipedia.org/wiki/Epigenetics, 2009). Cells flourish in a healthy environment. When the environment is less than optimal, cells falter (Lipton, 2005). Enriched environments can even override genetic mutation (Waterland & Jirtle, 2003). The genome is far more fluid and responsive to the environment than previously supposed. It has also shown that information can be transmitted to descendants in ways other than through the base sequence of DNA (Jablonka & Lamb, 1995; Willett, 2002; Van Praag, Christien, Sejnowski, & Gage, 1999).
Invisible forces of the electromagnetic spectrum profoundly impact every facet of biological regulation. These energies include microwaves, radio frequencies, the visible light spectrum, extremely low frequencies, acoustic frequencies, and the new scalar energy. Specific frequencies and patterns of electromagnetic radiation regulate DNA, RNA, and protein syntheses; alter protein shape and function; and control gene regulation, cell division, cell differentiation, morphogenesis (the process by which cells assemble into organs and tissues), hormone secretion, and nerve growth and function. (Liboff, 2004; Sivitz 2000).
Harmonic resonance mechanism can enable energy harmonics to positively influence the functions of our body’s chemistry (Lipton, 2005). Harmonic resonance enhances rather than stops atoms. These vibrations can be of electromagnetic or acoustic origin. For example, as a skilled vocalist maintains a note that is harmonically resonant with the atoms of a crystal goblet, the goblet’s atoms absorb the sound wave. Harmonic resonance is a synchronized electromagnetic wave whether sound or other. For example dropping two pebbles of the same size from the same height, and at exactly the same time, coordinates the wave action of the ripples, causing the ripples to converge on each other. The combined power of the interacting waves is doubled, a phenomenon referred to as constructive interference, or harmonic resonance. When the dropping of the pebbles is not coordinated, their energy waves are out of sync and at the convergence, these out-of-sync energy waves cancel each other out (Lipton, 2005).
Brain Synchronization and Neural Oscillations
Synchronous neural oscillations help us understand the nature of cognition processes, memory, attention, and consciousness. Conscious awareness may arise from synchronous neural oscillations occurring globally throughout the brain (Ward, 2003). Neural oscillations are brain rhythms and occur at different frequency ranges, in different brain areas. Some types of neural oscillations have been related to particular behaviors (Gray, 1994; Singer & Gray, 1995). Neural oscillations have been hypothesized to be involved in somatosensory perception (Ahissar & Zacksenhouse, 2001; Buzsaki, 2006), among other functions. Temporal synchrony between vision and audition during bimodal stimulation plays a central role in speech processing (Macaluso, 2006). At the physiological level, oscillators coordinate or synchronize various operations within and across neuronal networks in the brain, similar to the way the conductor creates temporal order among the large number of instruments in an orchestra. Brain rhythms and oscillations are an essential part of normal brain operations. If compromised, they can lead to rhythm-based cognitive maladies and brain disorders (Buzsaki, 2006). Schizophrenia, bipolar disorder, epilepsy, autism, Alzheimer’s, and Parkinson’s are all associated with abnormal neural synchronization (Buzsaki, 2006; O’Donnell et al., 2004). The data suggests close correlations between abnormalities in neuronal synchronization and cognitive dysfunctions, emphasizing the importance of temporal coordination and synchronization (Skosnik, Krishnan, Aydt, Kuhlenshmidt, & O’Donnell, 2006; Uhlhaas & Singer, 2006). Many disparate problems are really just one problem, deregulation of the brain or lack of brain rhythm synchronization (Robbins, 2000; Timmerman et al., 2005). Since the brain is command central, once it is strengthened and running at the appropriate speed, it can resist a myriad of problems (Robbins, 2005). Oscillatory responses in the beta and gamma bands are involved in a variety of cognitive functions, such as perceptual grouping, attention-dependent stimulus selection, routing of signals across distributed cortical networks, sensory-motor integration, working memory, and perceptual awareness.
Brain entrainment, also known as brainwave synchronization, is concerned with frequency following response, a naturally occurring phenomenon where the human brain has a tendency to change its dominate. By presenting abstract visual effects via an effect projector and music simultaneously, the user receives a pattern of rhythm that they perceive as synchronizing both effects together (entrainment). As the visual effect is moved (perceived speed can be adjusted) in all planes the user is motivated by change to move their head and look at the stimulation. The semicircular canals are stimulated, adding more input to the vestibular system and the brain. The user experiences pleasure.
Stress and the Brain
Stress has a profound impact on the nervous system and is the body’s way of motivating and protecting itself. Cortisol, a stress chemical, in low doses alerts us and organizes our behavior to protect ourselves. However, in higher does, it leaves us stressed out, inattentive, disorganized, and depressed, damaging the brain. Severe stress increases brain cell death and decreases the number of connections between brain cells. Sustained exposure to cortisol can cause serious damage to the hippocampus, affecting memory, mood regulation, and interpretation of space. Cortisol may cause damage to the left prefrontal cortex, which orchestrates emotion, arousal, and attention and keeps people from acting on impulse. The prefrontal cortex is key in teaching a child to feel remorse and establish a conscience. Increased levels of corticoids and stress have negative impact on the neuronal and glial cell population and cerebral cellular plasticity. Patients with depression often show volume reductions in specific brain regions. Environmental enrichment (EE) and physical activities have opposing effects on cerebral cellular plasticity by reducing negative stress. Environmental enrichment had the opposite effect and stimulated endothelial cell proliferation both in the hippocampus and in the prefrontal cortex. Running had a stimulatory effect in the hippocampus, but not in the prefrontal cortex.
Raised cortisol levels in depressed or elderly people could, by reducing endothelial cell formation/turnover, lead to rarefaction and aging of the vascular bed, resulting in possible impaired neuronal function. Thus, a physically and intellectually active life may protect against stress-induced vascular changes (Ekstrand, Hellsten, Tingstrom, Neurosci, & Lett, 2008). MSE as a form of enriched environment could consequently constitute a new tool in the combat of stress-related disorders.
Our ability to function in the environment and control stress is a dynamic, spontaneous, and ever-changing unconscious process. We can provide for our own healthy distractions to help alleviate chronic stress, such as a walk in the park, going to a movie, etc. However, children and adults with severe disabilities do not have the options to provide themselves with this distraction as their world is often controlled for them. Individuals with intellectual disabilities often do not have adequate cognitive function, or may have a serious illness, causing them to have an inability to cope. The ability to control anxiety, or stress, fluctuates with one’s state of arousal in the context of low to high stress, anxiety, or pain levels. Think of it as your mind’s ability to stay on vacation, not “out to lunch,” that comfort zone that allows us to function (Messbauer, 2006). Multi sensory environments positively influence our arousal levels. An arousal level can be defined as a state of consciousness, wakefulness, attentiveness, and low to high activity level of the individual (Pfaff, 2006).
Brain Arousal
Brain arousal is fundamental to all cognition and behavior (Pfaff, 2006). Nearly all health problems flow from over-arousal, under-arousal, or instability in the central nervous system. Neural pathways are the underlying mechanism for brain arousal. Disrupting brain arousal mechanisms can cause problems ranging from mild loss of vigilance or sleep, to the devastation of a vegetative state.
The brain and nervous system has a capacity to determine if the stimulus is (a) relevant (or important), (b) valued (assigning a positive, negative, or neutral value to the stimulus), and (c) properly modulated, referring to the ability of the nervous system to regulate its own activity. Stimulation at the right level increases the level of fascination. Brain arousal increases with intensity, complexity, unexpectedness, incongruity, affective meaning, and novelty (Messbauer, 2006; Pfaff, 2006). Arousal decreases with constancy, repetition, familiarity, and neutrality (Messbauer, 2006; Pfaff, 2006) (see Table 1). Alpha/theta waves decrease arousal and beta increases arousal. The optimal level of arousal is unique to each individual, based on their sensory preferences, and helps one modify and control stressors.
