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Case Study - Gerard

This is the story of a parents quest to help their son.  The parents hope to create a discussion about what they believe to be a true success story that has come about with the help of the Institutes for the Advancement of Human Potential.  The parents would be happy to share their experiences with others, however people who need more detailed information should contact the Institutes directly.  The parents can be reached via the BRIGHT Foundation at maplg@ourpostbox.com   The Institutes for the Achievement of Human Potential can be reached at: http://www.iahp.org/

Discuss this case study:

I am Ilse Montocchio, the mother of 4 children. Our third child, Gerard, is brain-injured. We have been doing an Intensive Treatment Program from the Institutes for the Achievement of Human Potential (IAHP) for 1 year and 10 months.


     Gerard at 4 yrs

Gerard was born on 10 October 1995 in Vienna, Austria. He weighed 5 kg and looked completely healthy. He did not drink well, and became more and more lethargic. When he was two days old, he was taken to the emergency unit of the Pediatric Clinic of the General Hospital. At this time, he had only 20% Oxygen in his blood. He was diagnosed with a Transposition of the Major Arteries, a serious heart defect where the Pulmonary Artery and Aorta are switched. He was put in an artificial coma and artificially respirated. He was immediately operated upon (Rashkind-Manoever) , and had a rough time for quite a while, including a period on a heart-lung machine, kidney failure and dialysis, heart failure briefly, and then at the age of 17 days, on the 27 of October, he had an arterial Switch Operation, a 5-hour operation where the Pulmonary Artery and Aorta are severed and sewn on in the correct position. He then developed Hydrocephalus (water on the brain), so on the 23rd of November he had a Ventricle Peritoneum Shunt-implantation with a Low-Pressure-Valve, to ensure that the brain fluid can be drained off properly. He had one seizure, and was put on Phenobarbital. A Computer Tomography showed that he had extensive hypoxic brain damage, with a triangular-shaped lesion in the occipital region. Visually Evoked Potential and Auditory Evoked Potential Tests indicated that both his vision and hearing were neurologically impaired. After 2,5 months, he was released from hospital, still being tube-fed through the nose, and hardly able to move his limbs. His general progress since then, was very slow but steady. He never had any serious setbacks, and is very healthy. 

Therapy until April 2000, aged 4,5: 

Logopaedic therapy: Daily for the last 3 weeks of hospital stay, then one hour weekly for next 1,5 years.

Physiotherapy: Bobarth-therapy daily for the last month of hospital stay, then Vojta-therapy one hour weekly until age 4,5. I did 2 sessions of Vojta-therapy (15 minutes each session) with Gerard on a daily basis.

Cranio-sacral therapy: One hour weekly from age 4 months until age 4,5 years 

Occupational therapy: 1,5 hours weekly until aged 4.

Hyperbaric oxygen therapy: 20 sessions in January 2000, aged 4 years and 2 months.

Development until April 2000:

Mobility: When he was one year old, he learned to turn from his back onto his side. By 21 months, he had learnt to roll over from both back and tummy, and could log-roll as a means of transport. Just before his 4th birthday, he learnt to move forward by pulling himself along on his belly. In April 2000 he could crawl a maximum of 10 meters per day, in half-a-meter stretches at a time.

Vision: Over the years, his severe nystagmus had improved a lot, but he still had alternating divergent strabismus. He was functionally blind, as he could only see outlines against a strong light, and could occasionally follow moving objects. He had a weak, inconsistent light reflex.

Hearing: He was almost deaf, could only hear over 90 Decibels (as loud as standing right next to a big passenger airplane taking off!)

Tactility: He could not feel any pain, hot or cold, but enjoyed it when we tickled him in his neck.

Manual dexterity: By age one he could grasp objects with both hands, using the thumb and all four fingers. He had not progressed to a pincer grip.

Muscle tone: A mixture of hypotonic and hypertonic. He tended to arch his neck back-wards. His truncal tone was hypotonic, and he had difficulty holding his torso upright. Over the years, his legs had become very rigid (spastic). Both hips were dislocated, his legs scissored, both feet turned outwards and downwards. The hamstring tendons in his legs were shortened, his legs were permanently bent and could not be straightened. His hands and arms were becoming increasingly rigid.

General Health: Excellent, but he had not put on any weight in the last 1,5 years. He had problems with reflux (vomiting) 5 times a month on average.

After consulting with our homeopath, we slowly weaned him off Phenobarbital. When he was one year old, he was detoxified, and he has not had any seizures since.


In February 2000, a friend gave me the book "What to do about your brain-injured child" by Glenn Doman, and both my husband and I decided immediately that we had to try this therapy program. In April 2000, we attended the 5-day course "What to do about your brain-injured child" in Philadelphia. There we learnt how to evaluate and design a home program for Gerard. In May we started an intensive therapy program, working with Gerard 8 hours per day, 7 days a week. After 3 months, we sent in a Home Program  Consultation, after which a staff member called us for an hour-long consultation, suggesting changes to his program based on the progress that he had made. In October 2000, we went to Philadelphia with Gerard for his first 2-day aspirant appointment. He was evaluated by the staff, and they designed and taught us a new program based on the progress that he had made. 

We now go to Philadelphia every 6 months for a 5-day visit, which includes evaluation, 2 days of lectures, and a new program that is taught to us.

My e-mail address: poppie@aon.at

                        Gerard at 4 months

The most important principle is that the brain grows by use ­ brain growth and development can be slowed down or stopped by brain injury, BUT it can also be speeded up (plasticity of the brain). Everything that we learn, is learnt through the five sensory pathways into the brain ­ seeing, hearing, feeling, taste and smell. Brain injury creates a "barrier" between the environment and the brain, and a normal stimulus or input (enough for a well child to develop in all facets) will not get through to an injured brain.

Therefore the frequency (how often during the day you do each activity), intensity (how bright the light in visual stimulus, how loud the sound in auditory stimulus, how far does the child move in mobility, etc) and duration (the length of time you do each activity) has to be high enough, otherwise the message will not arrive in the brain. With 60 years of experience in treating brain injured children, the Institutes know exactly at what intensity, frequency and duration each part of the program has to be done, for the children to progress. The brain injured child's capabilities are evaluated in the three most important input pathways (seeing, hearing and feeling) and the output pathways (mobility, language and manual competence). (See the Institutes developmental Profile at http://www.iahp.org/developmental_profile/index.html )

A program is then designed and taught to the parents which helps the child develop from one stage to another in each pathway through activities which reinforce the level that the child is at, and stimulate the next level.

Excellent nutrition, eliminating harmful chemicals (purifying water and air), respiratory programs to increase the oxygen supply, and intellectual programs (reading, maths and intelligence bits) are vital ingredients of the Institutesı programs.

The Institutes believe that the parents are the answer ­parents know their kids the best and love them unconditionally and are willing and capable of working with their kids for many hours daily until their child reaches its true potential.

Gerard's program has included:

I will only describe Gerardıs program in general terms, because each program has to be taught to the parents by the IAHP staff. The program changes as the child develops.


a) Stimulating the light reflex with a flash light

b) To create outline perception: Environment around him with checkerboard wall; showing him black and white outline bits

c) To learn to see detail: Colorful shapes on checkerboard; detail bits with color


a) Banging two wooden blocks together

b) Other loud noises, like banging pots and pans, sirens, whistles, etc.

c) Environmental sounds, for example bells, clapping hands, telephone ringing, musical instruments

d) Transient Electronic Auditory Stimulation ­ based on the work of Guy Bérard, TEAS are CDıs with music on it, interspersed with powerful, short-duration, random, high-frequency pulses.


a) Contrasting stimulation of hot and cold; stimulating with sharp fingernails

b) Contrasting stimulation of rough and smooth


a) Cross-Patterning: Three adults move the childıs limbs and head through the movements of crawling or creeping. The child lies on his tummy on a table. This is not physical exercise for the child, it is a sensory experience, telling the childıs brain "This is how it feels to creep"

b) The Floor as a Way of Life: Spending every available moment on the floor on his tummy.

c) Belly-crawling on a smooth surface wearing an anti-roll device. Log-rolling is a dead-end in mobility development, it doesnıt lead to the next stage of mobility, creeping ­ the anti-roll device prevents the child from rolling over. He learns that if he wants to move, he must crawl.

d) Crawling on carpet.

e) Medullary Reflex Program ­ rolling down an incline.

f) Body Weight Suspension Program ­ hanging upside down. Gravity helps to stretch his shortened tendons, improve scoliosis and hip luxation.

g) Assisted creeping with an anti-sit device on ­ Two adults move his arms and legs in cross-pattern creeping; the anti-sit device supports his legs.

h) Creeping on all fours in the Gravity-Assisted Environment: The child is given the opportunity to FEEL what it feels like to move using his own brain and balance areas of his brain. He wears a harness, to which are fastened bungee cords that come down from a track attached to the ceiling. He is put in the quad position with four cords attached to his shoulders and hips.

           Gerard wearing his anti-roll device

Respiratory Programs:

a) Reflex mask

b) Positive Respiratory Machine

c) Oxygen Enrichment Program

NB: The respiratory programs can and should only be done when they are prescribed by IAHP, as there are some contra-indications.


No sugar in any form; no milk products; very little salt, liquid balance; a healthy balance between proteins, carbohydrates and fats in every meal; vitamin and mineral supplements. For the last 6 months all the foods that he is allergic to has been taken out of his diet.

Update Reports

Progress since starting the IAHP program in May 2000

Mobility: After 8 months on the program, he reached his belly-crawling goal of 300 metres per day on the smooth surface. He then started crawling on the carpet (which is a lot more strenuous, as there is more friction), and reached his carpet crawling goal of 300 meters per day on 2 December 2001, 19 months after starting the program. He can now push himself up into a quad position on all fours, and hold it for 4 minutes. He is well on his way to learning to creep on all fours. His strength, balance and stamina has increased vastly. He can crawl 25 meters in one go. I am 100% convinced that he will learn to walk with time, based on the many children that I have seen at IAHP who have made the same mobility progress as Gerard.

Vision: After 2 months on the program, Gerard could track objects accurately and fast. After another 2 months, he started seeing detail, which means that he could see facial expressions and mimic them. He can now see tiny objects on the floor (as small as a piece of fluff), crawl to them and pick them up. His nystagmus has completely disappeared. His strabismus has improved ­ he is alternating much faster between his eyes. He crawls to stairs, sees that they are going down, and will stop before the stairs.

Hearing: This is the area of least progress. He reacts much more often to sounds (turns his head towards the sound), but does not do this all the time.

Tactility: After 3 months on the program, he reacted properly to pain, hot and cold, pulling away from the stimulation. He can now feel and react to gentle touch all over his body.

Speech: The volume of his babbling has increased 10 times. He hardly ever cried, now he lets us know when he is unhappy or has hurt himself! He is making many more sounds much more frequently, but his speech development is dependent on his hearing. He will have to hear better before he will be able to improve his speech.

Manual competence: He has not yet developed a pincer grip (grabbing objects between thumb and index finger), but he can grab objects much faster, hold them for a long time, deliberately let go of objects, bang two sticks together.

Weight: In the first year of program, he put on 1,5 kg, and then stayed at this weight, despite a high calorie diet of 1 500 calories per day. We had every conceivable conventional test done (stool, allergy, thyroid, growth hormone tests), but every test came back negative. In October 2001, the nutritionist at IAHP did a kinesiology muscle test, and found several foods and environmental substances that he was allergic too. From the moment that we cut out the foods that he was allergic too, he started eating really well, had no more reflux, and put on 1 kg in one month!

General: Within one month of starting the program, his feet were almost straight and had a lot more tone. The rigidity in his hands and arms have improved a lot, his left hand (the hand he uses the most) is beautifully loose. The rigidity in his hips and legs have improved tremendously. His legs are now nearly straight, his legs can be opened to an angle of 90° (before program 30°). He has finally realized that he has legs and that they can be used! He can now swallow liquids without choking. Feeding him is a pleasure, previously half the food fell out of his mouth. He is now using his tongue to move the food to the back of his throat. He knows the members of his family ­ he gets very upset and starts crying when one of us leaves the room and leaves him alone. His legs used to look like sticks, he had no noticeable muscles ­ now he was super-duper thigh, tummy, back and arm muscles. When we pick him up, he grabs us round the neck to give us a hug.

He can be held upright just by holding him under his bottom ­ previously he would have flopped backwards immediately. According to IAHPıs evaluation in October 2001, he has progressed 9 times faster in the 1,5 years that he has been on the program, compared to the entire 4,5 years before he started the program.

Why has he progressed so much faster with the intensive IAHP program?:

First of all, the other therapies were not intensive enough in terms of time to make a real difference for a profoundly brain-injured child like Gerard.

Secondly, each therapy program that we pursued addressed only one specific area of his development. For example, Bobarth-therapy is a neurologically-based physiotherapy, but because he did not spend enough time on the floor on his tummy, his mobility development was much too slow.

Without solving the problem of increasing spasticity, his mobility development would have slowed down even more, and he would probably have regressed.

The Institutes' program addresses every area of development in a structured way. Everything is interdependent ­ if the child canıt see well enough, he is not motivated to move. If he canıt feel where his leg is, he can't move.

If his breathing is inadequate, he has no stamina to move. If his nutrition is bad, his brain and body is not getting the nutrients it needs to function properly. If he is too thin, he has no stamina to move enough to be able to get to the next stage in mobility development, etc. On the other hand, every bit of progress in any area has a positive influence on the other areas.

I have been amazed at his progress in the last year and 10 months, and look forward to his further development ­ he has not nearly reached his true potential.


The Institutes for the Achievement of Human Potential: http://www.iahp.org/


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