Consider this as the second installment of When Harry Met Serena. In the piece prior to that I indicated that I had ordered their phenomenal new book from Amazon.com. Harry’s protege, Dr. Green, appropriately pointed out that we should order the book directly from the publisher Profectum. The list price of the book is $65 and Amazon doesn’t give you any discount for the order anyway. I’ve already ordered two more copies, this time from Profectum directly, one to give to my Resident and the other a copy for our VT staff as reference. My copy is quickly becoming dog-eared already! One of the most valuable things Serena Wieder brings to the floor regarding the original Wachs & Furth Piagetian material, is the influence of emotional development. So let’s focus on that a bit more.
Dr. Wachs acknowledges studying the work of the innovative optometrist Dr. Gerry Getman, who was among the first to formally conceive of vision as a form of intelligence. To this he added Piagetian concepts to pioneer in the cognitive aspects of vision. But neither Piaget nor Wachs specifically identified emotions as a key component, and emotional intelligence must be factored into the cognitive equation.
It was DIR/Floortime, the system evolved by Serena Wieder and Stanley Greenspan that prompted Harry to scrutinize the child’s affect. A radio broadcast by Greenspan in 2005 with Serena Wieder as a guest, sheds some light on this. You can listen to the broadcast, with key points relevant to our conversation made by Dr. Wieder:
“We broke this down and this was with the help of Harry Wachs, who really henceforth formulated a lot of this early on, more than 20 years ago, to six basic capacities. All of these are going on at the same time, developmentally … These are not things that we teach children or just give them to practice, per se, but they have to kind of evolve developmentally in a simultaneous fashion … We do know that some babies don’t develop this body awareness. They are not sure of what their hands can do. Often, with children with special needs, we see the child reaching for the parent’s hand to do something, and not their own. They don’t have their own awareness that their hands can come to midline, that they can hold and turn something. Somewhere along the line, they know that their parent’s hands can do it better and they have not gotten the kind of practice and the use of their own hands as an extension of their bodies that can do things …
You have to know what one side of your body is doing to counter-balance what the other side is doing, and then you have to know what your hands and feet are doing. So when you break it down, it’s a pretty complex activity that we are asking children to do. It’s very noticeable. Most kids will catch up with practice. Children, again, who have special needs have more difficulty of doing these kinds of things and need to do more of this kind of work every single day.”
A Center co-developed by Dr. Greenspan’s son has a concise overview on its website of how visuo-cognitive therapy, as conceived by Dr. Wachs, related to a child’s emotions: “There are many different levels and types of visual processing challenges, and many result in negative emotions. Frustration, anger, confusion, anxiety, and avoidance are some of the common emotions triggered when we have difficulty understanding our environment. Many of the behavioral and learning challenges children experience are, in part, connected to visual processing, but they are also, in part, a result of the emotions triggered by the difficulties and stress perceived by the child.
To help children fully succeed it is important to address both components, the visual processing and the emotional processing.
Visuo-Cognitive Therapy, pioneered by Harry Wachs, O.D., is an important part of a program to address these challenges. This technique differs and goes beyond standard vision therapy by adding a hierarchy based on thinking abilities to improve a broader range of functioning, not just the movement of the eyes. In this way, the student develops by thinking, and is able to maximize his or her potential by applying sensorimotor skills to cognition and executive function. Working on with the emotional system to help understand and tolerate the stress in the child’s life and reduce the conflict that can arise within the family relationships is another important component.”
With this background we’ll begin to take a look at some of the specific therapeutic activities suggested by Serena and Harry.