Neural Organizational Technique (NOT)

As the name implies, this very specialized technique concerns itself with proper development and integration of the central nervous system.

As developed by Dr. Carl A. Ferrari of New York in his work with seriously neurologically impaired children, the treatment protocol is divided into three separate sections: primitive reflexes, structural scoliosis and information processing and integration.

The first phase of the protocol deals with the very primitive reflexes that are usually integrated during infancy. As the infant progresses from lying to sitting to crawling to standing and then to walking, these external changes are preceded and accompanied by important neurological maturation as the central nervous system establishes its interconnections.

When development is hindered by birth trauma, genetic factors or chemical insult, the process proceeds but the critical steps of integration are neglected. The nervous system finds alternative ways to compensate for the deficit. Basically, the wires get hooked up differently. The "differences" allow the child to function but have consequences for the "higher" processes of mentation -- sensory information processing and integration. What we recognize as "learning disabilities" or "dyslexia" or "attention deficit disorder" are actually in many cases the end effects of a lack of neurosensory integration.

Fortunately, the integration process can be completed by correction of the involved reflexes, particularly in children. The neurological connections can still be made by treating the involved areas and then encouraging the use of the proper pathways by exercises and activities that use both sides of the body --swimming is an excellent example; balancing activities are another.

The second phase of the protocol deals with the structural distortions that develop once a child is weight-bearing and is compensating structurally for the lack of integration. In youngsters, this step often only has to be performed once or twice. In adults, the correction may have to made repeatedly to finally "untwist" the long-standing distortion. In fact, the correction in adults may trigger a temporary "healing crisis" as the body learns what "normal" feels like.

The last phase of the protocol involves processing sensory information. By treating the various association areas of the brain in combination with each other, the brain learns to correlate auditory information with visual stimulus, for example. At this phase, too, using the newly opened pathways is very important. Depending upon the individual cases some of the helpful adjuncts would include: vision training, tutoring in reading or mathematics, translating verbal instructions into physical activity, etc.

The results of these treatments can border on the miraculous. The more severe the neurologic impairment, the more spectacular the results can be. Dr. Ferrari had a clinic in New York where he treated Down's Syndrome children (and others) from all over the world.

There are simple functional tests which we conduct at our office by appointment that can determine whether this treatment is what is needed for you or your child. Corrections are made more easily in younger children. However, I have successfully worked with individuals in their 40s and 50s. Of course it is much harder, takes longer and may require "tune-ups" more often than a young child.

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How Neural Organizational Technique (NOT) Changed My Life

Paul -- A 58 Year-Old Male, After 8 Months of Weekly Treatment

Memory - Placement
I used to look for my glasses three or four times per day. Now I look for them once a week, and generally I find them quickly.

Memory - Keeping a Thought "On Hold"
If I was working on a task, and thought of another task that needed my attention, I used to quickly write a note to myself. Otherwise, I just wouldn't remember. Now I do not need to write down what I am thinking, as I am able to keep such a thought "on hold" until I finish the task I am working on. I just remember the next task.

Patience vs Impulsivity

In the past when I would access my voice mail, the pleasant voice would say "Press 1 for messages," and I would press "1" as soon as I was instructed to do so. In other words, I'd hear "Press 1" and that is exactly what I would do. Unfortunately, you have to wait until the word "message" is said before pressing "1" or nothing happens. This "impulsivity" was part of my life, even though I knew full well that quickly pressing "1" was futile. I would often be saying to myself "you know you have to wait until the word 'message,' so why can't you remember to wait?"

I now effortlessly wait for the word "message" before pressing "1." It's such a relief.

Another example.

When I would get out of the car, the seat belt would sometimes drop down into the door frame. When that happened, I'd close the door and then notice the door was ajar because the seat belt was jammed between the door and the frame of the car. This is about impulsivity and memory. That is, jumping out of the car quickly without looking to see where the seat belt lands (this is the impulsivity) even though I knew that such behavior often meant the door would close ajar (this is about memory).

I now effortlessly notice where the seat belt lands, and move it if necessary. I don't have to "remember" to do this. I just look now as easily as I used to fail to look.

Spatial Problems

When moving furniture or lamps, I'd often bang them into the ceiling (i.e. taking them up or down stairs) or hit the doorframe. Keeping track of all three dimensions at once was a challenge. Even when I thought I was looking everywhere I needed to look, it would sometimes happen. I now have a much better sense of where the item I'm moving is located as I move it. I rarely hit ceilings or door frames as much.

Less Irritability
Things that in the past would cause me to get quickly angry just don't bother me as much. With my children, I'm much more calm when they do something wrong. I just talk to them about it or tell them what the punishment will be without getting all fired up. Also, my wife tells me I'm easier to live with now.

Visual Issues
When something needed fixing in a tight place where seeing what you're doing might be difficult, I'd often just work on the problem by touch. For example, putting a screw through a bracket and then putting on a washer and nut. I'd do it without looking. Doing it this was less frustrating than trying to do the task while contorting myself to look. I don't understand why, but now I find it easy to get down and look at what I'm doing. It's not frustrating, and of course it makes the task easier.

Seeing in Three Dimensions
I remember after one NOT session I was about to get into my car, when I noticed a tree close by. First, this was the beginning of noticing things that I'd not noticed in the past. Most of the time I would only notice exactly what I needed to notice to be successful with the task at hand. Noticing the tree was not a necessary step in terms of getting into my car, so in the past it would have been ignored.

Second, I noticed the tree separate from the foliage and buildings behind it. This is to say I saw it in three dimensions separate from the rest of the landscape. Until then I didn't realize that most of my life I'd been seeing things as if they were part of a painting or photograph -- seeing things flat in two dimensions. That day was the beginning of seeing more of what was around me (effortlessly and without intention to do so) and to see those things more in relief or in three dimensionally. [sic]

I also discovered that when I would look at an object, for example a photograph standing up on a dresser, I would also see the objects around it as part of a group. This was new. Normally if I was looking at something, that would be all that would register with me. Items very close by would be ignored. Now I see not only what I'm looking to see, but also things around it effortlessly. I am less oblivious than before the NOT process.

Hearing the Words to Songs
As I've talked with other ADHD adults, I find that some can hear the words to songs, and other(s) really struggle to do so. When I was in High School I was amazed that all my friends knew the words to the popular songs. Yet I just couldn't hear and remember them. After several months of NOT work, I was listening to an oldie's station. While singing along it struck me, I was picking up on the words and singing along with some of these songs for the first time in my life.

During Dinner

For years I wondered why I couldn't just sit with my family and stay in touch with them the entire time we ate. I would find myself thinking of other things or not noticing what the children were doing unless someone was talking. Then I could focus and be present. Otherwise, I could almost have been alone. I often tried to stay present during meals, only to discover that it hadn't happened. After NOT it was easier to see what my children were doing and to stay present with the family. I still think about things at dinner. But when I decide to be attentive or simply observe what's going on at the table, I am usually successful.


Case Profiles

Case Profile ( Pediactrics, NOT)
"School was pretty frustrating for S. He is very artistic - a gifted artist and musician - but reading and study skills were very challenging. In fact, the school system had categorized him as a "marginal" student. S's learning difficulties were structural - at four, he had been hit on the left forehead with a baseball bat. After that incident, he was more emotional than others his age, had difficulty sitting still and trouble learning to read and write. Private tutoring in reading in first grade helped him compensate, but reading was a struggle. And dealing with the school authorities was an endless battle.

"When S. was approximately 12 years old, treatment was begun with Neural Organizational Technique. At first, the treatments were exhausting. It would be very difficult for him to perform the necessary tests, and he would need to sleep after every session. However, the results soon spoke for themselves. He went from a D average in junior high school, to placement in honors classes in high school. He graduated from high school at 16 by passing the State proficiency exam. Now, at 19, he's earned his certification as an Emergency Medical Technician, and is in training to become a fireman." --Aunt of SIS

"I would not have been able to achieve what I've accomplished so far without my NOT treatments. Life would have continued to be overwhelmingly difficult. --SIS<