Enter the Therapy Zone

At the Spectrum Center, listening therapist Alison Welsh helps Jacob Yount, 5, read. The Washington area is a major center for innovative treatments for children with neurological and behavioral problems, but do they really work? (Lucian Perkins - The Washington Post)

When it was 3 p.m. Hailey yawned. Frustration was building again. She was tired.

"I don't want any hard questions," she said, frowning.

Payne has worked with Hailey for two years. "She's reading between a 3.5 and fourth grade level, and when she arrived here, she couldn't read at all," Payne said.

Tina and Hailey were headed back for Dynamic Development, where Hailey's day had started nearly seven hours ago. Tina was still chewing things over.

"Right now I feel very discombobulated," she said. "I don't know what's wrong with her, and I don't like that feeling. But other times, this is working. We really are moving up. We've never taken a step backward, though we have hit walls where we had to regroup."

Tina described being at one of Greenspan's conferences when someone explained what it felt like to be the parent of a child with special needs.

"He said, 'We're in a car, we don't know the make of the car, or what kind of gas it takes, we're on a road that is parallel to the main road, and one day we will come to a crossroads and hit the main road but we never know when we're going to get there.' " After which Tina leaned over to a parent and whispered: " . . . and you're blind and you don't have a driver's license!"

Inside the therapy room, Hailey stepped up to the Interactive Metronome (IM) machine. She had on headphones and a Velcro cuff with sensors on her left hand. The computer-based training program produces a rhythmic beat that sounds like a cowbell to which the child responds with various hand and foot exercises.

The therapy is said to improve attention, coordination and timing. HealthSouth Corp., the nation's largest health care services provider with more than 1,900 facilities, recently announced that it was piloting IM training at select locations for use in cognitive disorders and to enhance "peak performance" in academics, athletics and the performing arts.

Hailey works on the IM three times a week; she is now at an "advanced" level. Today, she was starting with two sets of 500 repetitions each to strengthen endurance and attention and improve her rhythm and timing. She looked a little bit like a tired Rockette practicing a dance routine.

"This is the best she's ever done," therapist Michelle Harris said enthusiastically. "Two weeks ago this was really hard for her."

Then she began tapping her feet 500 times to the cowbell sound while repeating sentences out loud, an activity that combines motor planning and word recall.

"I am a terrific person," Harris read from a book of 50 auditory-processing "self-affirmations," as Hailey repeated them.

"I am great and talented."

"I can enjoy positive comments from my parents and teachers when I do well."

"I am in control of what I do at home and during my therapies."

"Many famous and successful adults had similar challenges when they were younger."

"It's important to do my best but I don't need to be perfect."

"Say that one again," Harris said, teasing.

"I don't need to be perfect," Hailey screamed.

Last Stop: Progress, Peril

While Hailey worked on another task, Harris and Dynamic Development co-director Lisa Leyden conferred about Tina's concerns. They noted how much progress Hailey had made. "She has a very mild auditory processing disorder right now, and I can say it was severe at one point," Leyden said. "She has much better two-way communication, much better organization of her language, better attention, though we are still focusing on that, better reading and spelling, all those higher-level language and listening skills."

In fact, Hailey had real insight into her life. A few days before, she told me: "I'm a therapist's dream." Meaning, that she tried her best to cooperate and work hard. But the demands were getting heavier.

It was 4:30 p.m. and time for Hailey's last therapy of the day. "All right, Miss Hailey Bailey, you and I are going to do neurofeedback," Harris announced.

Neurofeedback is a form of biofeedback that gives users information about their brain waves so they can control them better, helping them to regulate the part of their brain used for attention and focus. Though controversial, supporters contend it is a useful tool to increase attention, focus and calming. Harris said there is some research that shows improvements in language, motor coordination and sleeping patterns.

Harris dabbed some cream on Hailey's skin and attached electrodes to her ear lobes and to a spot on her head. Hailey, who has done more than 50 sessions of neurofeedback, is so used to the process she barely noticed it. She was eager to play Chomper, a computer game that responded by "eating" little white dots on the video screen the more Hailey relaxed.

Finally, at 5:30 p.m., Hailey's therapy day ended. She changed into leotards for a dance class at La Petite Ballet. She would return to Dynamic Development the next day for three more hours of work.

Tina packed up to go. She said she had always been struck by something profound that someone once said to her.

"You are only as happy," she said, "as your least happy child."•

Cathy Trost is a former reporter for the Wall Street Journal.