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Posted by Sylvia on Thursday, January 15, 2004 (14:50:46)
Miami.com 15/01/2004
By Elinor J. Brecher
Adopting a therapy that originated in the Netherlands, Jackson Memorial Hospital unveils a new multisensory room to treat children with brain injuries.
On Dec. 5, Angel Pennywell was driving her two young sons to Earlington Heights Elementary School in Miami when a heavy work truck slammed into her 1988 Chevy Blazer and flipped it sideways.
Tavarious Williams, 9, was in the front seat. Terious Williams, 7, was in the back. As their mother bolted from the wreck screaming for help, she thought her sons would die.
On Sunday, Tavarious - conscious but barely responsive - became Jackson Memorial Rehabilitation Center's first in-patient to test an exotically equipped room that rehabilitation professionals hope will hasten the recoveries of brain-injured children and eliminate the need for some of their medication.
The Snoezelen (pronounced snooze-a-lun, a contraction of the Dutch words for ''snoozing'' and ''sniffing'') room is part physical-therapy studio and part kiddie carnival, with a soft white floor and ceiling, mood lighting and New Age music.
The Snoezelen philosophy, developed in the Netherlands in the 1970s, says that surroundings can have a profound effect on behavior: calming the agitated and stimulating the passive.
THOUSANDS OF ROOMS
There are thousands of such rooms all over the world, including 1,000 in England and 140 in Israel. Ten of more than 300 in the United States are in Florida, according to Carrie Aspan, an account representative with Flaghouse, a New Jersey-based firm licensed to sell Snoezelen equipment in the Americas.
Reports in professional medical journals and a large body of anecdotal information indicate that many adults suffering dementia, children with autism and people of all ages with developmental disorders respond well to the room and its techniques. In some cases, stress levels drop dramatically; in others, nonresponsive patients begin to communicate.
It also is used for patients with chronic pain.
But little research has been done with the kinds of children - those with brain injuries - who will use the room at Jackson.
According to Dr. Glen R. Finney, a behavioral neurology fellow at the University of Florida, research shows that in dementia patients, "there seems to be a benefit to their behavior while [multisensory stimulation] treatment is ongoing. . . . Whether it would have long-lasting effects . . . we don't know. But any stimulus will improve chances of recovery. This encourages the brain to try to heal itself.''
A Department of Children & Families facility called Community of Landmark in Carol City operates the only Snoezelen room in South Florida for developmentally disabled adults.
The center's administrator, Michael Mayfield, said it started around 1995 ''and we've assembled it piece by piece. The equipment is very expensive.'' He estimated the cost at nearly $100,000.
PIONEERING PROGRAM
Jackson is using the technology differently, modeling it after a pioneering program in Israel that uses Snoezelen techniques with very young, neurologically damaged children.
A yearlong research study led by Hotz for the medical school's departments of surgery and pediatrics, using up to 20 children should, among other things, show whether patients who use the room can eliminate certain medications, said Gillian Hotz, University of Miami School of Medicine neuro-trauma researcher.
''There's no hard-core data that this works instead of giving a kid Ritalin,'' Hotz said. ``It's perfect because [South Florida] is No. 1 in the country for kids with brain injuries.''
Ten doctors, nurses and therapists recently trained with two therapists from Beit Issie Shapiro, an Israeli social services center that uses Snoezelen techniques with autistic children and others with sensory disturbances.
The Jackson room is due to open next month, Hotz said. By then, it will look like ''the inside of a marshmallow,'' with a light-hued padded floor and a ceiling tented in iridescent gauze.
Even in its unfinished state, the room's impact on Tavarious was obvious. Strapped into a wheelchair, he was stiff and vacant, his head lolling helplessly to one side. His breathing sounded like a person with a bad cold snoring, and his hands were clenched tightly into half-fists.
(His brother Terious, who also suffered head trauma, was less-severely injured and should be discharged in a few days, according to Hotz.)
Tavarious entered the darkened room in a chair pushed by his mother. They parted a curtain of fiber-optic cables. Lights in the cables changed color in a rainbow sequence.
BUBBLING WATER
First stop: a five-foot plexiglass column filled with bubbling water atop a gently vibrating padded platform.
Base lights change the water's color every few seconds. The kind of instrumental music that might accompany a soothing spa massage played in the background.
In one corner, a pit filled with soft, clear-plastic balls looked like a hot-tub bubble bath lit from beneath. A contoured ''leaf'' chair swung suspended from the ceiling.
A mirrored ''disco ball'' cast bits of reflected light against the walls.
Therapist Michele Shapiro and colleague Mona Julius positioned Tavarious atop the platform so that he could see the water column and, beyond that, his own reflection in a mirror. Julius lightly massaged his hands, Shapiro his feet.
Within minutes, Tavarious stopped rasping. His breathing grew calm and quiet. Slowly, Julius was able to draw down his right arm, which he holds rigid in an L-shape.
The fingers on his left hand, clamped around a toy motorcycle, also began to relax. ''His whole heart-rate probably came way down,'' Hotz said.
Moved to the leaf chair, Tavarious appeared to track the lights in a bunch of fiber-optic cables that Julius slowly stroked across his legs.
''I saw he was more relaxed,'' the boy's mother said. "His eyes were more alert. He was trying to move and reach out.''
Todd Torchin, a 4-year-old who nearly drowned two years ago, also tried out the room. The tow-headed Coral Springs boy had been a Jackson patient but now gets outpatient therapy.
Todd seemed fascinated by the water column, grinning in open-mouthed delight at the fast-rising bubbles.
The bubble pit also appeared to please him. As Julius lightly rubbed his arm with a plastic ball, Todd laughed.
''He was communicating with you,'' physical therapist Isabel Rodriguez told Shapiro.
Shapiro described a child she worked with as ''a block of wood'' before Snoezelen.
After working with the child in the room for several days, ''he looked at me and smiled,'' Shapiro recalled. "This is quality of life!''
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