About the Provider
Name: Darla Bruno
Discipline/Credentials: Integrative Wellness
Modalities: Safe and Sound Protocol (SSP), Somatic Experiencing Practitioner (SEP), transforming touch practitioner, and health coach
Nina presents with global developmental delay, autism and apraxia. She lives at home with her mother and her mother’s partner, and travels to her father’s on a biweekly schedule for overnights on weekends. At her local public school, she works with a speech and occupational therapy (OT) team. Outside of school, she participates in private speech and language sessions, myofascial release, and a number of other modalities.
“Mom describes Nina as being ‘energetically not there,’ ” Darla reported.
The goal for this round of the SSP — Nina’s third round — was for Nina to become more present. Nina’s school and her mother are very involved in her treatment, providing loving, tuned-in support.
“This time around, I encouraged [her] mom to go very slow with Nina, to watch and listen for cues of activation, and to honor her need to stop if she noticed the cues, or [if] the child no longer wished to continue or was refusing,” Darla said. “So this time, it took almost two and a half months to complete the process.”
Although Nina has a diagnosis of apraxia, her mother reported that no one has been able to describe Nina’s challenges around language clearly. Nina is able to make noises and sounds, and can say every consonant and vowel, but has difficulties around motor planning.
“Instead of things ‘syncing and coming together,’ Nina has her ‘own alien language.’ ”
Implementation of the SSP
Nina’s mother delivered the SSP to her daughter at home, with Darla’s oversight. Nina listened to an average of 10 minutes every other morning with her mother nearby over the course of about two and a half months.
This schedule emerged after observing in the first week that listening everyday was far too activating for Nina, causing “symptoms of increased ‘activation’ like chirping, echolalia, stimming, sleep disturbance, an increase in sensitivity, more dysregulation at times,” which is when the frequency was changed to every other day and exclusively in the morning.
Her mother would sometimes hold and rock her, do foot compressions and usually provided opportunities for movement. Sometimes Nina wanted to play with a balloon or watch her visual timer.
“Occasionally, she refused [to listen to the SSP], and [her] mom respected this.”
Darla shared that some of Nina’s outcomes from the SSP include gains in speech, more connectivity, Nina being more alert and aware, picking up concepts more quickly, being more interactive, and being more present. Nina’s mother, aides and therapists at school reported progress every day.
“Nina has come a long way since [her] mom described her as having ‘her own alien language,’ ” Darla said. “One morning before school, Nina’s mother asked ‘Where are we going?’ to which [Nina] answered, ‘School,’ ” Her mother then said, “We’ll drive the…” to which Nina completed with “car.” “Very cool,” Darla added.
On another morning, her mother reported Nina “[was] saying words I have not heard before, like ‘wipe,’ ‘window,’ and was singing Baby Shark to herself.” At one point, Nina’s grandmother shared she has never seen Nina “that engaged.”
“The special teacher who works with Nina at school reported an increase in eye contact, comprehension in just the first couple weeks of listening and overall more [connection].” In addition, the teacher said that Nina is picking up concepts faster (such as new tasks at school, finding the hood of her coat to hang up, and putting on her backpack). Another special teacher noticed more presence and awareness around week four.
On another morning when Nina woke up, her mother reported that she was very upset and needed to eat breakfast before feeling much better. “In her crying, I could subtly make out her saying, ‘I don’t want to school,’ instead of saying, “Cry, sad.” She was saying “Why you sad Nina”… both first time ever.”
Darla shared that not pushing Nina past her cues of having enough of the SSP and advising her mother to take it very slow this time was a good approach. She also said that being tuned into cues, watching for them, and respecting boundaries when clients have had enough creates an important level of agency.
Discover the Safe and Sound Protocol
Developed by Dr. Stephen Porges, the SSP is a non-invasive acoustic vagus nerve stimulator that helps clients connect with themselves, others, and the world from a foundation of physiological safety.