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Keep Up with Dr. Sam

Keywords

children, patching, trauma, stress, mechanical symptom management, eye coordination

Summary

The conversation delves into the psychological and emotional effects of patching on children, highlighting how it can be perceived as punishment and the limitations of traditional mechanical approaches to symptom management.

Takeaways

Children have no context on why they’re being patched.

Sound bites

“Patching becomes like a punishment.”

Chapters

00:00 Understanding the Impact of Patching on Children

Sam Berne (00:03.732)

Sam Berne (00:29.454)

Sam Berne (00:45.454)

What I read about your history is that in your daughter, you first noticed the eye turning at about 10 months. Is that right? And when did you actually either go to your pediatrician or ophthalmologist to have it checked out? Yeah. So I think it was like her one year appointment that the doctor, I had mentioned it and then he had said to go to an ophthalmologist. went there.

It was so interesting. She had said that she didn’t notice any eye turn, which is fine because it doesn’t happen that often. So she didn’t notice it in the appointment. she said that she’s like, I don’t know. She just said there’s nothing to do with it. But then she said that my daughter was farsighted and then she just wanted to put glasses on. For me at 10 months old, I was just like, or a year, guess at that point, it just felt like,

a one year old, like she can’t tell me if it’s too much if she can’t see it. You know, if we put glasses on her, just felt like it just didn’t feel right for me. Sure. Sure. Didn’t land. We’ve been doing a lot of just waiting. I’ve been. Yeah, it’s interesting when it’s summertime and we’re outside, it hardly ever happens.

and now is, yeah, it’s getting to fall. It’s getting darker earlier. We notice it more in the darkness. It is a lot worse. If the room isn’t well lit and it’s quite dark, it’ll be a lot worse. But if we’re outside, we’ll go camping for like a week in the summer and it will not happen while we’re camping. So did you get the glasses prescription filled or did you just say, no, we’re not doing the glasses?

Sam Berne (03:08.75)

seem to do more vision therapy and stuff like that, but.

Yeah. So she, didn’t jump on them. Good. That was a good choice. And what city are you in? I’m in Edmonton, Alberta. Okay. All right. I used to teach a lot of workshops in Vancouver. Okay. A lot of to the osteopaths and occupational therapists. this was pre COVID. I haven’t really been back since, but I do have a good, good connection.

Okay. So what you’re looking for is what, what would be your ideal goals and objectives today? well, it’s actually that you speak on occupational therapy. worked as an occupational and physical therapy assistant. So I kind of have a background a bit and it, guess I just felt like there was something we could do exercise wise.

alternatively to just jumping on glasses. And I know there’s a lot of people who doing patches in the surgery. So I just felt like there was some sort of alternative, whether it be exercises or food or supplementing or something like that. Yeah. Okay. So I’ll just speak for a minute about kind of the philosophy that I, uh, I learned a long time ago, over 40 years ago, which is number one,

Sam Berne (05:10.542)

There certain developmental experiences that children go through in developing their sensory motor systems. And one of the first experiences is going through the learning curve of something called the primitive survival reflexes. Have you heard of the primitive survival reflexes?

I have heard a little bit of, don’t know much. never did anything in occupational therapy. So the primitive survival reflexes are very early in utero movement patterns that the fetus makes. And the purpose of these primitive reflexes, one of the functions is it helps the newborn when they come out of the birth canal.

or their birthed to adjust to the new kind of environment being out of the womb, the safety of that. And there’s several primitive reflexes that are controlled by the brain stem, the reptilian brain, which is our survival brain. And these primitive reflexes are important for infants and toddlers to go through in their movement explorations.

because they are the foundational movement patterns that once they’re integrated, then the infant can then move more to the higher centers of the brain, the upstairs brain, so to speak, like the cerebellum. And then eventually as they get into school, the prefrontal cortex, they call that executive function. So I just have to move. just have to.

Sam Berne (07:35.342)

Sam Berne (07:48.334)

Sam Berne (07:58.03)

Sam Berne (08:06.572)

which has to do with integrating the inner ear, which is our proprioceptive orientation and our vision, our peripheral vision. Okay. So what does all this have to do with the eye turn when the eye is turning? The brain is shutting off the eye. That’s kind of the mechanism.

And the other, the other choice would be double vision. Like it’d be interesting to ask her in a stress-free moment. Do you ever see two things? have asked her that. Um, I don’t know if she can comprehend that she has said no. Okay. Well, that’s okay. know, uh, like mommy, I, it’s more than one item. I’m seeing more things, but anyway,

Doesn’t matter. Yeah. So when you see the left eye turning in, that means that she’s suppressing that eye. The brain is kind of, goes offline, so to speak, and there can be an alternating or can be on one side. yeah. Sorry. I noticed with her for the most part, like when it happens, it’s the left eye every once in a while, the right one will turn.

And that’s why another reason why I’m like, I feel like patches wouldn’t be a good idea because it’s just not making it work together. Well, so with patching, first of all, children have no context on why they’re being patched. It becomes like a punishment. And the patch for long periods of time doesn’t work. It actually creates more trauma and stress to do that. It’s a very

Sam Berne (10:33.516)

that there’s a lack of integration, a lack of connection and coordination, not only in the eyes, but in the entire person’s brain and body. So we see it in the eyes, but it’s a symptom or a signal that there’s a lack of overall global integration. It also was a signal that somewhere along the line

the primitive reflexes did not get fully integrated into the brain. So where you start in the reeducation process is reintroducing the primitive reflexes as a movement exploration, a movement exercise.

We couple that with doing one primitive reflex and then working with helping the child learn how to use both sides of the body and the eyes in an integrated fashion. Like we actually introduce opportunities to do that and over time because children especially have a level of neuroplasticity.

You can retrain reprogram create new pathways in the brain that will influence the eyes to be more integrated. So prescribed playful type activities that you would introduce to encourage and nurture the opportunity of using the eyes, the brain and the body in a more unified integrated way.

Sam Berne (12:54.19)

Yeah. Is we call her floppy and hoppy. Like it’s very, doesn’t seem well coordinated. Okay. Yeah. So I know that sounds good. I, I work with a lot of occupational therapists, physical therapists. and here’s what my takeaway is. I take away that the exercises and activities I’m going to introduce to you will help.

Get the eyes back online to work with the body. So in other words, we’re leading with the vision to move the body through space, spatial processing, spatial IQ, depth perception, because our eyes are really our GPS system. And we make decisions based on how we see and move our body through the world.

Based on that, especially as a, as a child. Okay. This is kind of like a school for vision. And we’ve talked about the distinction between eyeballs and eyesight and vision. If we nurture the vision, the eyes will straighten organically and you’re there. Now there are a couple of caveats. Number one.

The eyes are a signaling system to you. If somebody is stressed or tired or getting sick, you will see the eye turning. It’s just a signal. And that is a timeout. It means there’s depletion. You might need to support the nervous system more. In other words, there needs to be some harvesting.

Sam Berne (15:22.656)

I always try to wonder what the correlation is. Sometimes when she is sick. There’s a nutritional level, which we’ll get to. There’s an energetic level. You know, there’s a physical level. So many different factors. We as human beings are impacted by the world and others, and we get overwhelmed. And so then we have to shut down. have to.

You know, withdraw. And when the eye turns in, there’s a shutdown. It’s a suppression. It’s like, I’m overwhelmed. I can’t, I can’t do it all. Okay. So, what I’m going to speak about, I’m also going to send you some handouts. And since you’ve worked in some degree in occupational therapy, the, there’s some key elements here. The first element is.

You want to be able to do something every day as a, as a stimulation for learning and developing. And the more time you put into it, the faster the results. Now you can break up the periods of when you introduce these experiences, you don’t have to do them all at once. And you’re probably going to be met with some resistance. That’s

the deal and so it’s an art to either introducing it in another way or bypass it for now. think I’m pretty, I feel like that’s something I’ve dealt with a lot working with. worked a lot with seniors, a little bit with children, but I think I’m good at that because I know there’s always some, yeah, you know, there’s resistance. So whenever I created, whenever I do a session with a child,

Sam Berne (17:52.098)

there’s that dynamic as well. So that’s just all part of the mix. And the thing is, is that the exercises or activities, the goal is not to do them perfect. The goal is to just introduce them in a re-patterning way. there are many different ways

to offer it, but there is not like an exact, I’ve got to do like the gym and the trainers, like, hold, you got to do it exactly. Or you don’t get the benefits. This isn’t like that. This is we’re introducing experiences in the development so that the brain can go, I haven’t really done that before. Let me explore it as a discovery.

So we start off with the first primitive reflex called the Moro reflex and this is startle reflex and the integration of the Moro reflex is called the starfish. And what you’re going to learn about this reflex is that it is the global movement.

that eventually is going to cue and signal the eyes because the way it’s done is the person is basically lying on their back. Their head is on a pillow and their arms are spread out and their legs are spread out and they come into the midline or middle with their arms and their legs where they’re right.

Sam Berne (20:16.582)

is being able to have both eyes go into a divergence. The left eye wants to come into convergence by itself. And this is saying, can I converge with both sides of my body into my middle? And can I diverge with my limbs? And the third part of it is moving my head while I’m doing it. Because in the moral reflex,

Basically the infant is going like this. They’re sitting or that’s the moro starfish. Okay. So that that trips the, or stimulates the vestibular system. When the eye turns in the vestibular system is under working. And so, in this moral reflex integration, the starfish is moving out, moving in right over left. Then

it out, left over right. We do five on each side. Now might be that you demo it for her. You say, Hey, let’s do it together. Another way to do it would be her back is to your front and you’re, moving her arms and her head forward and backward, like you’re cupping her. that would, that’s another way it’s the startle reflex. It’s tied in with something called the fear paralysis reflex. And it is fundamentally

when it’s not integrated can be one of the causes of strabismus and visual tracking. I have a question with that. I know that swaddles like is that a do would you do you recommend swaddling children or do you think that affects the more reflex? Well, have you done swaddling? I did. Yeah, I did do swaddling with her.

Sam Berne (22:43.022)

Sam Berne (23:02.446)

Yes. So when I was pregnant with her, I struggled with insomnia. Okay. And I sometimes wonder like, is that something that really because it was a very it was lasted almost the entire pregnancy. I ended up getting completely healed of it, which was absolutely amazing. But that was a long time in her in the pregnancy. And you know, there was a lot of

Obviously, there’s a lot of stress when I’m laying in bed and can’t sleep. Like I would get very anxious. And so I wonder if that caused a lot of strain on her in utero. Well, you know, some of the researchers I’ve worked with have said that, you know, when there’s a direct disruption in sleep and utero that sometimes can affect sensory motor pattern and

It it it help what it does is it confuses visual spatial learning. so kind of depends on the neurotransmitters that you know, we’ve got dopamine acetylcholine serotonin GABA and so sometimes you know, it can affect the sensory motor development. I would say the other thing

is how much activity and movement you did during pregnancy. And also what was the actual birth process? How long you in labor? Was it a normal birth? Was there any distress? Did you have to do, know, pitocin or anything like that? You know, what happened at that juncture?

Sam Berne (25:26.102)

midwife, is really great. So what that says, what that says to me is that probably just doing some of these exercises. Like I have another family that I’ve been working with literally within two weeks, they came for their second appointment and the mom is already saying, wow, her handwriting is better. She’s better emotionally. She’s calmer. So, I mean, it’s a pretty,

You know, and I don’t want to make guarantees or say this is going to happen, but I’ve seen over and over again. is something in the maybe it was postnatally around the primitive reflexes. So like another thing would be first of all, we’re all we’re vaccinations administered. How many did you get it once?

Was that? didn’t have any. The only thing we did have was she did get vitamin K. Okay. That’s fine. Other than that, there was nothing else. What was her, how long was, did she stay in her crawling stage? so she crawled at 10 months and crawled for about four or five months. So she was about 14, 15 months. good. So, you know, there’s a lot of, there’s a lot of really positive things here. There is a lot of obstacles.

and could be one of the reasons why it’s not a constant full time I turn it just, we just may need to nurture. So we’ll do the moral reflex. And then the second thing would be to work with her balance. And there’s a couple of ways to work with balance. You can do a static balance where you guys play a yoga game and could she, can she balance on one foot?

Sam Berne (27:52.206)

Working with the static balance and then the active balance would be say either walking on a two by four forwards and backwards or a piece of tape or curb like having her work with her balance on some kind of a balance beam or something like that to really get the visual vestibular integrated into her movement and her body.

So working either with static balance or dynamic balance would be the next phase. Now you could also do some vestibular stimulating things. If you have like either a physio ball and put her belly ball and just roll her from, you know, side to side. We’ll do this sometimes with the kids as the beginning of the session to calm their nervous system.

But sometimes stimulating the vestibular is a way to just immediately straighten the eyes because it reconnects that vestibular visual kind of interplay. That’s necessary. Sometimes when it turns in the vestibular system may not be connecting. She may not be getting information there. So the mic on her back on her side, in other words, some kind of spinning or

There’s actually an occupational therapy. There’s something called the astronaut training and then that you sitting in a chair and you’re very slowly while she’s in the chair. You’re rotating the chair around in a circle like a clockwise or counterclockwise with eyes open and eyes closed. So just thinking about primitive reflex balance and vestibular and then

Sam Berne (30:16.77)

and move. Now, when you say an obstacle course could be in your living room or your, your den, you put a couple of chairs or chairs and pillows or, you know, and the prescribed movement would be either bear walk and across patterning.

Walking, hopping, galloping. And the most critical point to this is wherever she’s motoring forwards. You have her do the optical course moving backwards. Okay, so when kids have a crossed eye going in, they have no concept of back body. Everything is thrusting forward. And when you start

saying, okay, I’ve got to look behind me and you have an obstacle course. And I’ve also got to have a bilateral component to it. You’re going to find over a few weeks that she’s going to open up a 360 part of her vision instead of right now when the left eye turns in there’s very little access beyond like 30 degrees ahead.

So using the body and the movement going backwards and developing backspace to help her open her eyes into a more divergent experience just by just by working with movement. It helps tell the eyes. I can actually spread my my vision out so that I’m aiming in a divergent way. So any kind of

Sam Berne (32:33.932)

movements that tells the brain to work in an infinity sign. That’s like, both sides integrated simultaneously. That’s going to tell the eyes to say, my eyes need without doing eye exercises and I push ups or whatever, you know, we’re not there yet. So that’s way too, too advanced. Okay. Now you could do it with a bike, an obstacle.

But we want the biking slow. We don’t want to one speed. You could do with a soccer ball. You could do with a basketball. Okay. So now this brings us to more specific eye movements. Eye movement exercises. So the first one that’s very non demanding and threatening is you both get a flashlight. Do this in bed.

You’re both looking up at the ceiling. You move your flashlight. So let’s say your daughter sitting laying down to your left. I’d be working a lot with flashlight tag having her move that flight way out. So her left eye has got to look to the left the peripheral up down. So again, my light is on the ceiling. I’m on my back, but I’m opening up.

Can I, can you touch my light? You know what I’m saying out to the left, up to the left, to the left. Now you can go to a pharmacy. You can play the pirate game where you patch an eye. Maybe you both get a patch and you just do the flashlight tag with one eye, but here’s the thing. You’re not just going to work with patching the right eye. You’re going to equal opportunity.

Sam Berne (35:02.242)

we’ll do that kind of short patching and then I’ll put them on a machine and they immediately get 3D vision just by Wow. Because we’re just waking up. We’re just yes. And that makes that makes sense to me to do it in that sort of way. That’s the call to them being patched both of them working. Yes. And so that’s one tracking exercise. Another tracking exercise would be

Something called a Marsden ball. I’m going to be sending you some directions but visualize this you get a rubber ball and you get a metal hanger hook or you get some kind of hook that you can screw into the rubber ball. Okay, so now you got a hook in the ball. You tie a string to the hook and you hang it on the ceiling could be in your garage. It could be even outside by a tree. In other words, you want to swinging rubber ball.

The size of like a baseball. She stands in front of the ball and you have and I have the ball lower than her face. Maybe like by her solar plexus and I just say, can you hit it with your right hand five times straight out? Can you hit it with your left hand? Can you do an alternating? Can you play Simon Says so she’s hitting the ball and you go, okay, Ivy right hand touch your head once go back to the ball.

Left hand touch your right knee. She’s going to learn different parts of her body. Right hand touch your left hip. So while she’s hitting the ball, you’re giving her some visual thinking something. you can also swing the ball side to side with the eye patch and have her put the flashlight on the swinging ball.

Sam Berne (37:28.748)

Because in Christmas, what’s happened is the brain is disconnected from directing the eye muscles where they should be directed. It’s just I haven’t learned to aim yet. I do not aim my left eye. So I just move it in. That’s my default. So once you start working with tracking and light ball ball flashlight, eye patch, that’s a good one.

Mm-hmm. She is. I was she’s really good at if we tell her to make sure she’s using both her eyes. She can fix it. Okay. Is that something that is okay to continue doing as long as it’s done with no shame and know like there’s something wrong with her? Yeah. Yeah. Okay. So you need to keep those energies out of it. It’s done with love and just say, hey.

in a game, can you move your eyes around? Yeah, it’s a discovery. It’s an inquiry, but there’s nothing on it around shame or something wrong or like your your punishment or like, know, goodness, your eye is turning in again. Can you yeah, you got to keep all that out. This is a very sensitive time.

Because there’s a difference here in her versus say somebody else who’s her age, that’s not dealing with the I turn. Yeah. Right. And it is sensitive. Yes, for sure. And I think that’s another reason why we are really wanting to get on it is exactly you want to notice I’ve noticed just other kids to. Yeah.

Sam Berne (39:54.446)

It’s a perfect world. Amen. You couldn’t ask for a better environment than what you’re doing. Like I said, this is a school for vision. Yes, exactly. And I am already prepared of how to do it. How we’re going to work it into our day and make it a fun exercise and fun break from schooling. Now, I’d like you to do the primitive reflex, the moro.

for at least two weeks. Two weeks. So that’s an, a, that’s an everyday thing that you’re doing the morose. And then you’re going to substitute that. You’re going to stop that one and you’re going to do the second reflex called the tonic labyrinth reflex. Okay. So I’ll describe it, but I’ll send you a handout. Okay. She lies on her belly. Her legs are straight.

She takes her thumbs and puts them on her nose.

Like this. You do that. right. Well, let’s let’s let’s not do this now. Let’s go. Okay. What’s happening? She’s going to lift her upper body off the ground. So her elbows her upper torso and she turns her head to the right. She pushes the right thumb out. She’s looking at the right thumb and she brings back in. She turns her head to the left.

Sam Berne (41:59.31)

to lift her head neck and upper torso off the body off the ground. If she do that, she can do it on the ground. It’s better if she lifts up that reflex is going to really help midline. I hand coordination. It’s like the baby you give her a rattle. She’s out here with it. And then she brings it into her mouth. You know, there’s there’s that that kind of in and out and again.

What we want to what we want to include is can I go out with my eye as well as come in right now? I go in that’s my default, but I want you to be able to that I out to your ear and then back in so that I’ve got both range but in the range of it. So you substitute the morrow for the tonic labyrinth reflex and you can continue with these other exercises.

and I’m going to give you one cognitive exercise. That’s really fun. And so you get it from this website. I don’t know about in Canada, but you’ll, you can at least look at it. Maybe Amazon. I don’t know. It’s called learning resources.com.

And you’re going to look for a set of puzzles called parketry. P R Q U E T R Y. It’s a set puzzle with triangles, squares and rectangles, squares and diamonds. It’s going to be a set of cards that are going to come with that, which are designs.

Sam Berne (44:20.622)

Every day while she’s doing her motor work at the end or at the beginning, have her do some block designs. Okay. That’s a copying from vertical to horizontal. If that’s too hard, she can make it right on top, but the park is going to help her spatial reasoning using the blocks. So it’s using more of the frontal brain prefrontal cortex, and it’ll be a nice,

kind of balancing with all the motor stuff she’s doing. So that would be one add-on. And again, you can just mix and match the exercises. And I would say my recommendation would be in four to six to eight weeks, we should have a second session during that session. There’ll be a recap of

What’s work? What hasn’t how she doing? And then we can move on to some of the more advanced primitive reflexes gross motor fine motor perceptual stuff. And then she would be ready for that at next level at next layer. But you you will see some behavioral things some tendencies of

Preferences because you’re adding some new stimulation to the brain. Eye body that’s going to interfere with the default of the left eye turning in, which actually is very positive. Okay. It takes a lot of energy to suppress the eye. Yeah. turn away, basically turning away from life.

Sam Berne (46:30.104)

can be helpful in reducing strabismus. I know for a stand, because many years ago I went to, went as an eye doctor, I went back to massage school, I had a craniosacral therapist and I do craniosacral on these kids. And sometimes it really releases the strabismus. So what worth to pursue. I have heard some other moms talk about that that had worked.

Well, it works. Yeah. So that gives you another idea. All right. Last. What is the color of Ivy’s eyes? They’re a blue, more of a darker grayish blue. What I saw. Okay. So there’s a couple of things here from an iridology standpoint. The eye recaps the body.

And with that color of eyes, there’s a couple of things you want to pay attention to. call them nurture point. Good lymph movement. Possible tendency towards inflammation. Okay. So watching the gluten, dairy, sugar formula. Not good. And liver health.

Liver rules. What was that? Liver health. The liver. Liver rules the eyes in Chinese medicine. OK. Now in that one, we’re not going to do a liver cleanse right now, but lemon water, bitter vegetables, bitters, liver likes bitters, lymph. So walking, jumping.

Sam Berne (48:56.062)

Sam Berne (49:12.302)

doing like a lemon, celery, beet, cabbage smoothie will probably be awesome. Sounds delicious. So use a hot tea as a base. Sinus can be an issue. Achey joints can be an issue sometimes with the blue eye people. Lymph is very important. We can go into more detail on the iridology the next time.

Probably taking an omega three would be good. Children’s omega complex. So you said a B complex, a B complex, that’s good for stress. with some good minerals and maybe you get a vitamin mineral supplement. Be complex.

and magnesium in the evening. actually directly affects the muscles.

Is it it be good for her to have? I have like a magnesium spray. It’s an oil. Is that okay to do or is it better orally? Well, you could you do that to me. best magnesium is a magnesium glycanate. I don’t know what this is. If it’s not, that’s okay. It depends on, you know, her her ability to tolerate the taste and texture texture. So that would be the

Sam Berne (51:24.334)

Sam Berne (51:35.186)

Yeah, a lot less. Yeah. Well, you know, I can point you in some directions to do that.

Sam Berne (52:19.502)

Sam Berne (52:32.898)

I’ll send you the send outs and the recording and you can go to it. Okay. Thank you. I had one question about have you heard at all about Castor oil on the eyes? Well, in this particular case, I’m not sure it’s the direct like number one thing you need to do. Castor oil is good for

Moisturizing. Again, because of the sensitivity, I don’t think I’d be applying things right now. It’s more of a functional learning. I need to know how to use these guys than applying something like that. mean, for yourself, if you want to experiment with it, you can do castor oil.

I think what you want to do is create an environment of um nurturing and loving the eyes through exercises. Yeah. I think that’s the that’s the strategy for for Ivy. Don’t go start putting lots of stuff on the eyes. We don’t want to create more stress and trauma and like what the heck is this? Yeah. Just because you read it somewhere. Yeah yeah. What I’m giving you

is directly will give you a direct result of what you’re looking for. Perfect. That’s what, that’s what we’re after later on. Do more of that esoteric stuff and that’s right. not now. Okay. All right. Yeah, I think that is everything.

Sam Berne (54:30.862)