Hydrocephalus Mobile App hopes to be new mHealth Test

The DiaCeph Test was created in 1997 to evaluate CNS shunt performance in patients with the disorder, hydrocephalus. It is a mathematical formula and algorithm born out of my experiences as a patient and patient advocate, and from 18 years of experience in diagnostic nuclear medicine, including, with hydrocephalus and software.

DiaCeph’s algorithm uses a weighted probability of a patient user’s clinical complaints, or complaint markers, to the most likely of (17) types of malfunctions that can occur with a CNS shunt. The results are displayed and ranked in order of probability. In addition, the markers are plotted on time vs complaint level graphs, where they are compared to the patient’s baseline markers and earlier shunt outcomes. The impetus for creating the DiaCeph Test came from my poor post surgical outcomes and frustrating diagnostic experiences as a patient user for hydrocephalus following a 1992 auto accident. I’ve used my DiaCeph methodology (paper forms) to track the shunt outcomes, make shunt valve pressure predictions, and diagnose shunt malfunctions for my last (8) shunt revisions. Still in 2016, there is no reliable diagnostic means to determine how well a CNS shunt is working. The DiaCeph Test could readily be made into a mobile app, providing the necessary funding, administrative, and FDA regulatory requirements can be satisfied.

The DiaCeph paper methodology could easily be produced as a mobile data app.

DiaCeph Test born out of FDA Petition/Unmet Need in Hydrocephalus

Hydrocephalus is the leading neurosurgical disorder in children, often resulting as developmental changes in utero, shortly after delivery, or by brain cysts early in life. It occurs in seniors in the form called NPH, or normal pressure hydrocephalus, and in the past NPH was often confused with dementia and/or Parkinson’s Disease. It can also occur following trauma and tumors in the brain. It is most often treated by surgical insertion of a “CNS shunt,” which the patient will live with the remainder of their life, and which are very problematic technology often requiring surgical replacement.

My DiaCeph data app slide above is from my original (1997) design of the DiaCeph Test. This came out of my research in authoring an important 1996 FDA petition on anti-siphon shunts. I was familiar with hydrocephalus and CNS shunts from my many years of diagnostic work in nuclear medicine, where I worked with software and regularly wrote procedures, and occasionally basic software code.

Stephen Dolle invented his DiaCeph Test following his 1996 FDA petition that was then used to direct this 1998 shunt surgery

I had been a patient user of CNS Delta valve shunts for hydrocephalus since 1992, and had experienced unexplained poor outcomes from three surgeries over a period of four years. In 1996, I learned of a new critical study published in the Journal of Neurosurgery by a well known Japanese neurosurgery group, that cited specific safety & performance issues with Medtronic PS Medical Delta Shunts & Anti-siphon devices that seemed remarkably similar to complaints I was experiencing. Sadly, neither my treating physicians, shunt manufacturers, or the Food & Drug Administration were able to help me.

In November of 1996, I petitioned the U.S. Food & Drug Administration (FDA) Center for Devices and Radiological Health with this important FDA petition on CNS anti-siphon shunts, concerning problematic CNS shunt technology which I had been implanted for 4 years, and was experiencing unexplained poor outcomes. It was in 1996 that a critical study was published in the Journal of Neurosurgery regarding the risks of using anti-siphon devices. The petition took me almost a year to prepare, and required that I obtain supporting FDA records on microfiche, obtain and learn the federal government’s applicable CFRs to CNS shunts, pay a librarian consultant for many of the (52) cited studies, and carry on correspondence with Ralph Nader’s group Public Citizen.

What I learned, was that between 1976-1996, many thousands of patients had been implanted with Medtronic Delta valves & Heyer-Schulte anti-siphon shunts and that about one-third of these were experiencing the kinds of poor outcomes as cited in the Higashi et. al. J. of Neurosurgery study. Higashi and his team described these shunt performance issues as “functional obstructions” of the CNS shunt system, most of which occured in the upright posture. However, some were reported with sleeping and other external pressure over the body of the shunt valve. What made the problem particularly challenging, was that there was no available (in-vivo) diagnostic test to identify and quantify the issue in patients. Available CT/MRI and shunt patency testing was usually “negative” for shunt malfunction, which is termed a “false negative.” Higashi and his team then cited the need for a new type of diagnostic test to identify these shunt outcomes issues in affected patients. Once I authored my petition, my next challenge was in creating a new type of test to evaluate these shunt performance issues.

I sought out a method to chart & analyze non-invasive clinical markers in hydrocephalus in different postures, and during different times of the day. This was 1997, and the same year researchers at the U. of Pittsburgh and Henry Ford Institute, were quietly doing this to monitor sports concussion. It took me more than a year, during which I also consulted aerospace scientists on possible math formulas. Once it passed the first proof of design phase, I expanded my test to evaluate any type of problem with any type of CNS shunt. And then I aptly named it the DiaCeph Test. Dia– meaning to diagnose. And Ceph– meaning of the brain. The design and proof of concept were completed in Sept. of 1997. And then I began using it to evaluate my Delta shunt for corrective revision.

Initially, I was going to “give my method away” to one of the shunt manufacturers. But it was a friend from little league baseball who convinced me to try and PATENT it. Which I did via the law firm Knobbe Martens Olson & Bear. The photo above was taken just days after my Feb. 1998 shunt revision where I used the DiaCeph Test to help determine which type of shunt would fit my CSF outflow needs.

 

My experience in nuclear medicine and working with hydrocephalus and diagnostic software proved invaluable in the creation of the DiaCeph Test. Over my 18 years of nuclear medicine (beginning in 1975), I had authored hundreds of diagnostic procedures, set up hospital imaging procedures, started and run an imaging company, and provided diagnostics for a wide range of medical conditions. Two of those tests for hydrocephalus were cisternograms and shuntograms.

In 1997, my DiaCeph Test was so new, it didn’t have a category name. But today, these type of applications are widely termed, “mHealth.” As such, my DiaCeph Test design was one of the earliest mHealth tests, and remains state of the art still in 2016. But, designing it was no simple task. I had to contend with frequent cognitive or memory difficulties, shunt malfunctions, terrible headaches, and lack of funding.

In 1998, I filed my full patent on the DiaCeph Test and formed the start-up, DiaCeph, Inc. DiaCeph was to be a dedicated PDA app, like the Palm Pilot that had just become available. The Internet at that time was just mature enough then to allow patient data and results to be sync’d with a PC either at the patient’s home, or at the physician’s office. I proposed how a server could allow uploading & sharing of patient results.

DiaCeph can analyze non-invasive user data and render a diagnosis of the type of shunt malfunction. I created a series of clinical markers (as can is seen in the slide above), and by establishing a patient’s baseline normal values, incident results could be compared and produce a diagnosis based on the change from normal. Where there was no comparitive data, the program still aggregated resulting data and compared it with the most likely data known by the program for the different types of shunt malfunction. I was advised that patients not be given access to the results by FDA and others involved in the project. Today we know its best to give patients this information. Below, is earlier web site information on the DiaCeph Test. Below that, an Orange County Business Journal‘s 1999 story about the DiaCeph Test entitled, “The Accidental Inventor.”

DiaCeph Test at DolleCommunications.com 

Stephen Dolle, Dr. Eldon Foltz, and Stephen Natawpski of Knobbe Martens are interviewed by the Orange County Business Journal regarding the invention of the DiaCeph Test, and Stephen’s FDA efforts in Washington, D.C.

Stephen Dolle interviewed in the Orange County Business Journal for his FDA efforts and DiaCeph Test invention Page 2

DiaCeph underwent initial evaluation and development at the University of California Irvine (UCI). My lead physician was the long time neurosurgeon and professor, Dr. Eldon Foltz, who was excited about the DiaCeph Test and offered to mentor me. He shared he had been trying to develop a similar test since 1980. Dr. Foltz helped me form a board of medical advisers at UCI, and introduced me as an mHealth pioneer.

After the FDA granted my shunt petition in Sept. 1998, I was invited to attend the FDA’s STAMP Technology Conference in Bethesda, MD, which was to address shunt safety issues as cited in my petition. However, the conference never did! Nor were these CNS anti-siphon shunt challenges discussed, nor DiaCeph mHealth concept. And neither was I was not invited to appear on the conference panel, despite being the person who helped create the conference. As a result, my DiaCeph Test and similar solutions never received the exposure they deserved. It no doubt hurt prospects for the DiaCeph Test at a time it was badly needed, and amid my limited resources as a patient developer.

As time went on, I looked for new novel ways to utilize the DiaCeph methodology. Below, are SlideShare.net slides of new (July 2016) DiaCeph Test NPH Instructions, a NPH 6-Marker Form, and a new Chronological Outcomes Form or “flow chart” for creating a patient record of many years with various shunts, opening pressure settings, and hydrocephalus outcomes (complaints/status) in a patient. There are instructions on how to complete the historical flow chart in the back of the NPH instructions.

These materials are FREE to use. But if you have questions or would like my assistance with monitoring or related hydrocephalus and shunt issues, please contact me directly. My consulting rates are $125 per hour.

Diaceph 5 day 7 marker NPH hydrocephalus shunt monitoring form

DiaCeph Test MONITORING INSTRUCTIONS

DiaCeph Test MONITORING FORM

DiaCeph Test FLOW CHART

DiaCeph, Inc. as a Brain Software Company

By 1999, I was exploring other brain apps & software and making plans for this as part of DiaCeph, Inc., to be an innovator in this space. This was prior to the advent of Google apps, social networking, and mobile tech leaders like Samsung and Apple. At that time, the only two mHealth apps under consideration were by Aetna’s health division for CHF and asthma. I was also in communication with Hewlett Packard, Microsoft, the Coleman Institute, and other institutions involved in assistive cognitive technologies. I presented DiaCeph to a number of university centers and medical device companies. But I could not get any committments to partner or fund it. Apparently, no one saw my vision.

By 2003, I had begun to move on to other neuroscience interests. My brain also remained significantly swollen due to unresolved and mis-understood hydrocephalus, and kept me on disability, working only part time. I could not get a neurosurgeon to undertake additional surgery without diagnostic documentation. It was a Catch 22! I believe if the DiaCeph Test were available then, it would have answered these diagnostic questions.

In the end, the DiaCeph Test was never made into a PDA app due to lack of funding, FDA regulatory barriers (costs), and lack of support from medical device companies in the field of neurosurgery. However, DiaCeph could still be produced today as a mobile data app. I wrote up a “creative brief” in 2014. The challenge now lies mainly in the FDA regulatory costs of mHealth apps, where estimates have said to be in excess of $1M. It is doubtful this cost could ever be recouped in sales of the app. So I prepared wider prospects for other neurological apps in my expanded Creative Brief.

Hydrocephalus today still faces considerable mis-diagnoses due to unavailability of imaging and mHealth solutions. Radiologists regularly mis-interpret CT and MRI brain scans, which leads to undiagnosed shunt malfunction and incorrect settings of programmable shunts. This in turn has resulted in significant quality of life issues and costs for patients living with hydrocephalus.

Below, is a screen shot of a CT/MRI mHealth Display method I’ve been using since about 2002. This helps to organize CT and MRI scans into useful formats for review by your physicians, especially when there are many scans over a period of years. At present, the link is to a blog I authored on LinkedIn. I hope to sometime elaborate further on this in a new company blog. I also consult on preparing these at my same $125 per hour rate.

Method of Organizing CT & MRI Images for Chronological Review

Innovative Dolle mHealth method allows CTs & MRIs to be chronologically oarranged and compared.

You should obtain CDs of all your CT/MRI brain scans. The method allows for review of 1000s of CT & MRI images by placing the most critical images in a chronoligcal sequence for comparison. These displays can also reduce interpretation medical errors.

To create these, I first create folders on my PC for each CT or MRI series. Then I export the images as JPEGs into the respective folders using the media software included in the radiology CD disc. Next, I review, select, and label the relevant images and copy them to special forlders where I arrange them in chronological order for better viewing. This format makes interpretation much more scientific, and it minimizes any human (visual) error during interpretation.

This method is particularly important in hydrocephalus care – where it is common to have dozens of studies and 1000s of CT and MRI images for review. This mHealth display method would benefit radiologists, neurologists, and neurosurgeons involved in hydrocephalus care and other care involving CT and MRI studies.

This method allows for more detailed evaluation of shunt settings, shunt performance, and shunt malfunction. I put these mHealth methods to good use in my hydrocephalus consults and shunt monitoring services.

Once you have assembled the critical MRI/CT Images Folders, they can be easily sync’d and copied to folders on your mobile phone and tablet device. Then when you see your physician, you’ve got all your CT and MRI images neatly organized for review.

Below, is a diagram of my current shunt valve, the Codman Certas valve, which was implanted in Nov. 2012. However, in May 2013, it was recalled due to stability issues during MRI exams.

Illustration of the Codman certas valve, an externally adjustable programmable CNS shunt valve with 7 pressure settings, and is used in the treatment of hydrocephalus.

The DiaCeph App today could be made as a mobile data app and text app (for use in developing countries). It would enable 24/7 monitoring of hydrocephalus and could be coupled with a variety of neurological, EEG wave, and other apps now available.

Additional Resources on Hydrocephalus Monitoring

Hydrocephalus NPH Monitoring by Stephen Dolle/Dolle Communications

NPH/ Hydrocephalus Monitoring

Mobile Apps, mHealth, and other Solutions for Hydrocephalus

 

I’ve been providing NPH/Hydrocephalus Monitoring Services & Patient Consults with DiaCeph paper forms/instructions since 2009. I also host FREE monitoring forms and information on hydrocephalus. My experience with hydrocephalus now spans 18 years of diagnostic work in nuclear medicine, and 21 years in FDA regulator affairs, CNS shunt reviews, mHealth design, cognition and assistive technology, drumming & music therapy, and global patient consults for affected individuals/families around the world.

I also host two consult reports on the top blog above (Hydrocephalus NPH Monitoring by Stephen Dolle). The first report was completed by a legally blind man. I provide each patient a custom set of forms and instructions. If an mHealth app were available, it would direct patients or users in the collection of this data, and then offer physicians the data in a finished format for earlier diagnoses, intervention, and surgery.

HydroPowered.org – Super Heroes

The Terminator is the ultimate super-hero for adults and children affected by hydrocephalus.

Early on, after I was implanted with a VP shunt for hydrocephalus, I began to seek creative comfort in stories about Super Heroes. As an inventor, I also began to equate living with a CNS shunt implant to the Terminator character in the movie of the same name. Eventually in 2013, I created a fun web site and Facebook page for hydrocephalus – where I began to write about “super-heroes” for hydrocephalus. Here I am today pictured below in a current photo following a speaking engagement. My rates are very reasonable, and I have a list of topics I speak on. Contact me for more information of this.

I have undergone 12 brain operations, or shunt revisions as they are termed, since my initial diagnosis in 1992. I became a shunt device, hydrocephalus “expert,” and early inventor of an mHealth mobile app, the DiaCeph Test. It was my 1996 petition to the Food & Drug Administration as a CNS shunt patient that led to my designing the DiaCeph Test. My efforts then helped bring about the 1999 International STAMP Conference in Washington D.C. At that time, many in industry felt the conference and FDA upholding my petition were heavy handed actions designed to hinder innovation in industry. But in the years since, it has been shown to be just the opposite, that without mHealth tools and patient engagement, there will be less innovation, more challenges for physicians, higher costs & disability rates for patients, and a lower quality of life for those affected. It is time for industry, FDA, and Congress to stand in our shoes! In 2015, I also published my current health challenges with hydrocephalus and a related neuromuscular disorder on my blog in this case study.

Many of the CNS shunts in use today are programmable shunts, where pressure and flow rate can be externally adjusted for each patient. But, many of these devices have been susceptible to inadvertent reprogramming from household appliances and technology magnetic fields. At present, FDA does not allow patients to own the reader or programming tool to help manage these unforeseen events. I would love to develop a mobile app or accessory tool to allow patients to check the setting of their shunts.

Other Brain Apps

I use other brain apps on the Android Play Store to help with the management of hydrocephalus, including, a Decibel Meter, EMF Detector by Smart Tools, and a Weather & Barometric Pressure app by Elecont Software. The more recent availability of EEG readers has further elevated the prospects of brain apps in neurological care, and in meditation and mindfulness – SEE my other blogs for information on these.

I advise and write about brain apps, often helpful in hydrocephalus and other neurological disorders. In this blog, I share tips on design & using apps:

Design & Best Use of mHealth Apps

And in this very popular mHealth blog, I discuss how to use a weather app for management of migraine headache:

Weather Apps and Web Sites for Management of Migraine

The slide image below is the barometric pressure reading from my Elecont weather app.

The Elecont HD app provides an hour by hour barometric pressure reading that can be used to help manage migraine headache.

DiaCeph Development Costs and Other Barriers

Estimates to develop a hydrocephalus mHealth app are as high as $1M. Requirements by FDA are driving these high costs. In developing countries, FDA guidance does not come into play. And for those regions, a “text app” version of the mobile data software could be created to do monitoring on a standard mobile phone, and text the results to a regional hospital or clinic. My DiaCeph Creative Brief is currently 16 pages. I understand this is too large for most reviews. So I am preparing a “short” and “long” version.

I understand there are organizations who could help develop or fund my mHealth app project. My wish would be to work with a mHealth software group and provide the guidance and expertise to develop the DiaCeph app, and then advise on other applications.

Currently, development of mHealth apps for disease management have become a political ball game between patient advocates, the Food & Drug Administration or FDA (backed by big corporations), and Congress. Earlier this year, a bill was introduced in Congress by Senators Deb Fischer (R-Neb.) and Angus King (I-Maine), identified as the PROTECT Act (Preventing Regulatory Overreach To Enhance Care Technology). The bill has garnered the support of IBM, athenahealth, the Software & Information Industry Association, and Newborn Coalition and McKesson.

Shortly after introducing the act, the legislators penned an editorial in USA Today calling FDA’s regulatory process burdensome and a hindrance to innovation. One organization, with connections to big pharma lobyists, calling itself the mHealth Regulatory Coalition (MRC), has come out and opposed it. But I suspect they don’t live with a medical condition like hydrocephalus, that would benefit from these mHealth app innovations.

PROTECT Act Bill S2007

Protect Act Story on Protect Act

Groups Opposed/Conflicts of Interest to mHealth

Protect Act under Fire

Pediatric Hydrocephalus Foundation supports PROTECT Act

Many individuals with hydrocephalus have had 100 and 200 surgeries, and live a very poor quality of life. Quality of live, and unnecessary brain surgeries, would no doubt be improved with the availability of mHealth app diagnostics.

If you are interested in development of the DiaCeph Test, obtaining a hydrocephalus consult, mHealth consulting, or my speaking at an event, please contact via the information below.

Stephen Dolle
Dolle Communications
Email: contact [at] dollecommunications.com
http://www.dollecommunications.com/
http://www.hydropowered.org

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Drumming Therapy experience in a Child with Cerebral Palsy and Autism

Hand percussion instruments helpful in music and drumming therapy, and handy when traveling

As many of you might expect, I almost always have percussion instruments with me, even while on vacation. When I traveled to Northern Michigan in 2012, I brought the above claves, shaker eggs, a cylinder shaker, woodpecker, gongo bell, flute, and thunder tube. I travel with these should I be asked to entertain or do a drumming therapy session. This request came from a friend of the family for an 11-yr old girl with cerebral palsy and autism from a chromosomal defect. The child was quite challenged and could not walk or talk, and suffered from restlessness and difficulty sleeping.

Stephen Dolle, Neuroscientist & Drum Circle Facilitator

The Patient Workup

In preparing for my sessions, I perform a brief patient workup that consist of speaking to the parent in the presence of the child – to get the relevant patient history and to let each see me speaking in the presence of the other – which establishes permission. I am experienced in doing clinical workups from my prior nuclear medicine work and current hydrocephalus consults and drumming work. All together, I have 17 years of clinical workup experience as a nuclear medicine technologist (10 years with my company Certified Nuclear Imaging), 15-20 years hydrocephalus and medical device consulting, more than 10 years in drumming, and 10+ years earlier experience coaching youth soccer and baseball where some of my kids had speacial needs

Next, I introduced myself and spoke directly to Eliza, the eleven year old child in this session. I wanted to assess her present state of mind and willingness to work with me- which was positive. I assess the eyes, body movements, and listen to any verbal responses to any nervousness or physical complaints that might interfere with the session. It is important to know any issues that might limit the session – so I can ideally adjust ahead of this. I shared with her mother that I would keep the instrument play simple and not too loud, and start simple and increase stimulation and complexity as long as she was agreeable and engaging. As the therapist, I must continually observe her engagement and adjust my interactions accordingly.

Sensory Processing Disorder

Cognitive Accessibility.org currently under construction

Most all children with autism also suffer from sensory processing disorder (SPD), as do many with hydrocephalus, ADHD, PTSD, Parkinson’s, post TBI and the like. IN SPD, the individual will become easily over sensatized to sound, light, motion, or scents. Sound is the most common, but lights and colors are often an issue too. The list of accommodations for individuals with SPD as a medical challenge vary, but now fall under “cognitive accessibility,” which medically and legally defines the neurologic functional needs of the individual. I have become increasingly involved in cognitive accessibility over the last 5 years.

As I sat down next to Eliza, I observed her to be drooling, a bit anxious but also curious about what I was about to do. She was cooperative. My approach is to be calm and assuring. In these sessions where sensory processing disorder is present, sound, color, my voice, and movements become a critical part of the music therapy session. I maintain my attentiveness to her responses.

Color, Movement, and Music

These shakers come in all sizes and flavors and are very handy in music and drumming therapy.

I began by playing a simple 1-2 beat on my wooden claves, and it immediately drew her attention. I followed this up with one shaker egg, and then two, and she responded with giggles and excitement the more I played. With the colored egg shakers, it was hard to differentiate how much of her response was due to the egg color and motion versus sound from the eggs. Then I played the cylinder shaker, which can be loud if not careful, and I got more positive response from her. Next, I played the woodpecker and shaker together, and she went bananas! Yes everyone likes the wood pecker. By this time, she had been awaiting and anticipating my every movement and instrument sound. It was as much fun for me as it was for her. She became a terrific student and fan!

Then I played the Remo thunder tube. And she became so excited, she reached out and grabed it. Her mother said she couldn’t hold things in her hands. But she pinned the thunder tube between her right hand and lap, and resisted a bit as I reached to take it and play again. However, at no time did she play any of the instruments. I tried to get her to hold a shaker egg, but without success. Eventually she held the thunder tube almost entirely in her hand. My session lasted almost 40 minutes, and I was very pleased at her attentiveness, willingness to engage me, and willingness to challenge her own limitations.

Music and the Brain

This music and the brain illustration depicts the areas of the brain involved in listening and playing music

I believe the favorable response and attentiveness during this treatment was due to the child’s attentiveness to engage me and the sounds and colors of the instruments. By the end of the session, she had remarkable focus and level of excitement, and briefly drank from a bottle. And then stood up by holding onto the porch railing, and stretched in excitement. I explained to her mother that these type of therapies might be helpful in her walking or talking someday. The family has a piano where she and the other kids will gather around and play together. I’m told she likes the bass notes on the piano. So I suspected she’d love the sound of a bass drum (I did not have on this trip). I would be curious as to what an EEG would show of her brain waves since she craved active sounds. She’d also been to a Blue Man show where the performers made her part of the show.

Music & Drumming Therapy as Healing Arts

EMDR therapy is one related sound and movement therapy that comes to mind and is used in PTSD and sensory processing disorders to desensative the individual. I reflected on new EMDR methods in 2002 when I undertook my sound sensory study with the Boss metronome (discussed further below). As EMDR is also a “healing art,” I’ve shared my blog below on CAM and alternative medicine. It is from  2012. But it’s been updated. It is the first third or so of this blog, where I discuss my past mind-body methods, that I think is relevant to music and drumming therapy today. In these regards, I believe the benefits come from more than sound and interaction, they come from the authencity and “intent” of the therapists. And this is widely true thoughout the various alternative medicine modalities. There must be a BUY IN by the patient! The trust and optimism causes a release of neurochemicals in the brain and change in cell structure throughtout the body.

Healing thru Complimentary and Alternative Medicine

Illustration of the Meridian fields used in Acupuncture and Alternative Medicine

Drumming for the Brain & its Effect on Brain Wave States

In EMDR Therapy, the therapists determines what to say and how to integrate sound and visual cues. It has been discovered via Parkinson’s Disease work that happy and relaxing activities please the brain and aid in the release of endorphins, particularly dopamine. Dopamine levels often run low in PD. I am uncertain as to the effect seen in cerebral palsy and autism. But I observed in my session with this child that she had a strong affinity for rapid stimulation thru musical toys, also confirmed by her mother.

The four levels of brain wave states are shown in this illustration

I am unsure whether Eliza’s low functioning state kept her brain waves in a lowered state, i.e. alpha. But she craved rapid stimulation. I felt it critical that I engage her in a step-by-step method of rhythmic movements and sound so as not to overstimulate her, and maintain her focus and level of engagement. Most of what I played were slower rhythms. The most up tempo I played was a moderate samba on the bell and clave. And this was only one session. I didn’t have opportunity to stimulate her on multiple levels. And at the end of this single session, I could see she was tired.

I suspect a djembe drum or bass drum might also captivate her. I’ve observed a young girl with marked autism at the HB pier who will sit right in front of the large fast playing djembes. I’ve been concerned it may not be healthy for a child at her level, though she appears drawn to the stimulation. Children have lower brain waves until their teens. So any artificial attempt to speed them up could have adverse consequences. This is also why caffeine and sugar act differently in children.

The next day Eliza’s mother contacted me to share that she slept thru the night and seemed remarkably calmer after the drumming session. This experience is one of the reasons WHY I became involved in drumming. It has also helped me personally in managing many of my own challenges with hydrocephalus. Further below, I discuss some of the contraindications and research with sensory processing disorder, including, a blog with audio examples from YouTube of problematic machinery noise.

Group Drumming Events, Drum Circles, Drumming Therapy

Young children captivated by their play in a drum circle

I have been involved in drumming therapy since before I became involved in drumming in 2004. It was my 2002 sound sensory processing study with the Boss metronome which were my orginal efforts in sound patterning. After becoming involved in drumming in 2004, my interests were split between play and research. I authored this first web page on drumming entitled, What is a Drum Circle, which discusses some of the science plus my own views on drumming, or drum circles.

In 2005, I put on my very first drumming for the brain workshop at the High Hopes Head Injury center in Tustin, CA. From there, I began to put on a wide array of drumming for health events, though these were mostly for disorders of the brain and central nervous system. This drumming for wellness page below features some of these efforts.

Drumming for Wellness

Drumming therapy is finding success today in 1:1 and group sessions with ADHD, ADD, autism, hydrocephalus, Parkinson’s Disease, post TBI, aging, and more. What is critical in all of this is that the individual and group ENGAGE!

The information on my above drumming web pages discusss how you can obtain a drumming event, workshop, or therapy session with me.

Dolle Communications – Cognitive Neuroscience

The brain and sensory system during cognition.

I created the above Cognitive Neuroscience web page to encompass my neurosciences efforts from hydrocephalus to mHealth, sensory processing disorder, drumming, drumming therapy, cognitive accessibility, and related outreach. Like so many sites and pages, it is a work in progress to keep it up to date.

Generally speaking, decibel apps only help you with loudness or decibel level of surrounding sound before it might become problematic for you, your child, or parent. Unfortunately, the triggering aspect of sound, is more in its pattern and pitch than loudness, and is why I undertook this next study in 2002 on sound and sensory processing – to understand the types and effects of sound exposure on persons with hydrocephalus who also have SPD. I feel the types of SPD challenges I evaluated in hydrocephalus is similar to that of autism and other neurological and learning disorders.

Boss recorder and metronome were used in 2002 to evaluate sensory processing in individuals with hydrocephalus.

Sound Sensory Dysfunction in Brain Injury and Neurological Disorders

Cognitive Accessibility in SPDs.Hulk Destroys Tree Shredder

As for balance, coordination, fitness, and sensory processing challenges, it doesn’t get much better than shooting baskets – which I began doing therapeutically in 2008. I eventually met up with another shooter, Al Massip, and our on court discussions turned to philosophy and brain science. One day, I posed the question, Where does the Shot come From? And this became a focal point of our shooting for several years, until 2015 when  I published this in-depth blog that now attracts 500+ monthly visitors from all over the world. This suggests a lot of people are trying to answer this question. The answer may be in part mystical too. On a therapeutic level, my basketball and drumming with basketball methods are very helpful for a number of neurological disdorders and brain health.

Sports Science vs Brain Science of Basketball: Where does the Shot come From?

Basketball allows participants to feel and move rhythmically with a touch sensitive ball

My next blog discusses how mobile apps are helpful in managing sensory processing disorder in everyday life, no easy feat. This is a detailed blog with supporting links.

Mobile apps Helpful in Managing Sensory Processing Disorder

mHealth Apps in Neurology

The final supporting presentation below was from my power point as part of a talk I delivered at Wayne State University on drumming and rhythm methods in STEM3 education. I discuss a range of implications from language and learning, to speaking tempo and entrainment of teacher/student, to health and sound sensory processing and classroom noise considerations.

From my 20+ years in living with hydrocephalus, research and writing about the brain, a lifetime of playing music, 17 years in nuclear medicine, and coach on 20 little league soccer and baseball teams, I truly understand how drumming helps others.

Contact me if you are interested in drumming therapy sessions, consults, or having me speak at an event. The best method of contact is via email.

Thank you.

Stephen Dolle
Neuroscientist, mHealth Inventor & Drum Circle Facilitator
Email: contact[at]dollecommunications[dot]com
DolleCommunications.com