Autism, One of the Many Labels Addressed by Integrative Manual Therapy
A community consciousness and brain health essay.
Working with the underlying cause, is the way massage therapists, physical therapists and psychologists trained in Integrative Manual Therapy (IMT) address autistic children or people with autistic like behavior.
At The Nerve Whisperer and CenterIMT we have extensive experience treating autistic children ranging in age from small children to teenagers. We have seen remarkable results, more importantly, we have seen children who had a label of autism, recover and thrive in their lives.. The child often rejoins other children in the regular school system and interacts normally with their friends and family.
We see children who have a label of autism for a variety of reasons. Some children have dysfunctions of the tentorium or cranial diaphragm which crosses the head at about the level of the ears. This contributes to sensitivity to auditory stimulus (sensitivity to sound) due to the tensions on the ear complex. It can also contribute to visual dysfunctions because the cranial nerves that innervate the muscles of the eyes and facial muscles travel through the tentorium and can be compressed by a torque in the tentorium. We work with hands on techniques to normalize the balance within the connective tissues, blood vessels and neural tissue within the head.
Other children have a diagnosis of autism but what is contributing to the behavior is pain in the head or elsewhere in the body. These children see great results through IMT treatment to address and resolve that pain, where ever it may be. We work with people with headaches, back pain, joint, muscles pain and much more.
Visual dysfunctions can also lead to frustration, sensitivity to visual stimulus, and aggressive behavior, typical of some autistic children. Kimberly Burnham, clinical director for CenterIMT Boulder is also the director of our VisionIMT program addressing a variety of visual dysfunctions in children and adults. The mother of a two year old born with a corneal ulcer, recently reported that through treatment at CenterIMT Boulder her son has significantly less tactile defensiveness.
Toxicity and immune system dysfunctions can also lead to a diagnosis of autism. We work with a wide range of immune system techniques from decompression of areas of detoxification, such as the liver or thymus to recommending dietary changes and elimination of preservatives, additives and artificial sweeteners. We work with a number of children who are also labeled “failure to thrive”. These children greatly benefit from our skill with immune system dysfunctions. The digestive system improves, the immune system improves and they start to grow, develop and function normally.
Many parents, wonder whether their autistic child will tolerate hands on treatment. We are comfortable working in a clinical setting with autistic children and often they come to love the gentle hands on treatment.
The first two hours with one six year old boy was more like a wrestling match than treatment, but the therapist persisted. The next time, he came in for treatment the therapist geared up for another wrestling match, only to find that the boy jumped up on the massage table and laid down ready for treatment when asked to do so at the beginning of the session. Our experience tells us that if you decrease a child’s pain, they are very compliant.
We also have a range of easy to follow “homework exercises” for the parents to participate in their child’s recover. We are happy to talk with the parent of any child in need of treatment. We would like to help you meet your goals for your child, where ever they are on their path to a healthy active life.
Autism Presentation Nov 19, 2005 Verona, Italy Kimberly Burnham, IMTC, PhD Candidate
Science fiction writer, Arthur C. Clark once said, “Any sufficiently advanced technology is indistinguishable from magic.”
At CenterIMT the magic is the children who feel better and function better, the parents who enlarge the dreams they have for their children’s futures and the therapists who see positive growth and development in their clients.
The techniques used at CenterIMT to treat children with autism and other developmental dysfunctions are not magic, they are a form of advanced technology based on clinical evidence.
At CenterIMT we use Integrative Manual Therapy — a hands on treatment using touch, pressure and knowledge of anatomy and physiology — to help children grow healthier and reach their goals.
The mother of one boy reports: “We are also going to change to an entirely different school this year. Carl has asked for it because he says he is so different now than he was several years ago and he wants to go where kids don’t know him. He feels that people aren’t allowing for these changes. He is so right.”
Integrative Manual Therapy (IMT) techniques can be placed in three categories.
The First:
Therapists work with biomechnical techniques, using pressure, positioning, mobilization and movement to shift tissues for better movement of joints, muscles, blood flow and improved drainage.
The biomechanical and postural problems of children with autism differ from other children. Some of these joint related dysfunctions contribute to pain and behavioral dysfunctions.
In 1992 Kohen-Rax and Volkmar noted that “The postural patterns of children with autism differed from those observed in normal children, in mentally retarded children, and in adults with vestibular disorders.
In comparison to normal children the autistic subjects were less likely to exhibit age-related changes in postural performance and postures were more variable and less stable with more lateral sway.
Autistic subjects also exhibited … more “stressful” postures, putting excessive weight on one foot, one toe, or one heel.”. (Kohen-Raz et al. 1992)
Improvements in structure, posture and the ability to walk, run and play are the traditional realm of manual therapies. At CenterIMT we assess how structural problems negatively influence movement, contribute to pain and add to behavioral problems.
An analysis of gait indicates that, rather than gait parameters or balance control, the main components affected in autistic children during locomotion are the goal of the action, the orientation towards this goal and the definition of the trajectory due probably to an impairment of movement planning. (Vernazza-Martin, et al., 2005).
Some of these structural problems of the pelvis and sacrum contribute to tensions on the spinal cord and brain tissue contributing to cranial dysfunctions and a lack of blood flow to the brain. Integrative Manual Therapist work to decrease muscle tensions, releasing joint dysfunctions and improving blood flow to the brain.
In the medical literature autism has been associated with microcephaly, temporal lobe dysfunction, particularly the medial aspect of the temporal lobe and the superior temporal sulcus. This is the part of the brain closely associated with the ears, hearing and sensitivity to sound.
Autistic like behavior has also been linked to other brain structures, such as the amygdala and hippocampus. When the container — the cranium — is dysfunctional, this contributes to abnormalities in brain function.
“The superior temporal sulcus areas are involved in highest level of cortical integration of both sensory and limbic information. Moreover, it is now recognized as a key cortical area of the “social brain” and is implicated in social perceptual skills that are characteristically impaired in autism. Therefore, the convergent anatomical and functional temporal abnormalities observed in autism may be important in the understanding of brain behavior relationships in this severe developmental disorder. (Boddaert and Chabane, et al. 2004).
Two independent studies described a lack of blood flow in the bilateral temporal lobes of the brain in autistic children. The study noted that the more severe the autistic syndrome, the more cerebral blood flow is low in this region, suggesting that left superior temporal hypoperfusion is related to autistic behavior severity.” (Gendry Meresse, I., M. Zilbovicius, et al. (2005). The temporal regions of the brain are implicated in social perception, language, and “theory-of-mind,” abilities that are impaired in autism.
Integrative Manual Therapy techniques can improve head and neck motion, which facilitates improved blood flow, increases drainage and decreases neural tissue tension. We particularly find that problems of the tentorium, the connective tissue membrane traversing the cranium between the temporal bones and ears contributes to autistic like behavior, particularly sensitivity to sound and tactile defensiveness of the head.
A 2005 study found a significant correlation was found between parental ratings reflecting autistic symptomatology and the measure of grey matter density in the junction area involving the amygdala, hippocampus and entorhinal cortex.
The data reveal a pattern of impaired and relatively preserved mnemonic function that is consistent with a hippocampal abnormality of developmental origin.
The structural imaging data highlight abnormalities in several brain regions previously implicated in ASD, including the medial temporal lobes. (Salmond, 2005)
When a seven year old boy with attention deficient disorder and learning disabilities came in for his second Integrative Manual Therapy treatment. I asked him what he had notice or what had changed after his first treatment. His father rolled his eyes as if to say, why are you asking a 7 year old what changed. The boy said, my head doesn’t hurt so much. The father said, you never told me your head hurt.
Sometimes poor joint and soft tissue function is causing the child pain, which is contributing to the behavior. By using IMT to decrease pain, the child has more choices and options in how they interact with the world.
Another mother pleased that her son was developing a better sense of himself re-counted this experience: “He has also started to defend himself, physically. Last Sunday we were at a birthday party. There was a moon-bouncer toy that the kids were jumping in, but only 3 kids at a time were supposed to be in it. Greg and 2 other kids were jumping in it when this 5 year old boy decided he wanted to jump as well and he tried to drag Greg out by pulling his shirt by the shoulder. Greg WHACKED him! The 5 year old tried to pull him out again and Greg gave him another WHACK! Although I don’t encourage hitting, I am taking this as another positive sign!”
Another mother recounts:
“I have also noticed a big change in his gait. His heels have really dropped down and he heel strikes now instead of walking on his toes. Both arms are swinging with walking. They never did before.”
“I am weaning him off the use of his gameboy, TV, computers. They were a great help when he couldn’t tolerate his environment but now they are a detriment. He is developing better social skills and other interests are developing.”
Noting that as her son grew healthier his behavior also improved, one mother said, “His overall health is excellent. He has gained another 6 pounds since June bringing his weight to 77 pounds. He is growing like a weed!!!! He is no longer that sickly, malnourished-looking kid that you first met. As a matter of fact he is quite husky.”
The second way to describe Integrative Manual Therapy techniques is as a system of reflex points.
Integrative Manual Therapist consider mechanical problems as well as using a system of reflex points to improve health in children with autism.
There are many treatment modalities that use reflex points. Acupuncture for example stimulates meridian points to create a shift in the tissue.
A short list of conditions recognized by the World Health Organization to benefit from acupuncture includes neurological and musculoskeletal conditions, emotional and psychological disturbances, circulatory disorders, gastrointestinal disorders, respiratory conditions and more.
In a 2003 article entitled the Benefits of Osteopathic Treatment for the Pediatric Patient, American Osteopath, Paul Capobianco, notes that Chapman reflexes can be effectively used for a variety of pediatric conditions including autism.
The reflex points used at CenterIMT with children with autism were developed by Sharon W. Giammatteo. Stimulation of these points are clinically found to influence a child’s ability to learn and develop.
Steven was diagnosed with Smith McGinnis — a genetically based disorder contributing to aggressive, behavior and mental retardation. His mother was told she should institutionalize him, that he would always be a danger to himself and others and would never fit into society. Today Steven, is in a very bright 11 year old in a Montesorri school. He has been playing piano for 3 years and can play Bach backwards, if he wants. He is a very sweet boy who looks at the world in a unique way. He has so far exceeded predictors of outcome, that most people would not believe that he has Smith McGinnis. He has been coming for IMT treatment for about seven years.
A third way of describing IMT is in the use of techniques to address certain rhythms in the body.
Integrative Manual Therapists treat structural dysfunctions and uses reflex points and certain rhythms in the body. These motilities or rhythms are reflective of the function of the nervous system tissue and other tissues in the body.
By way of an example, if someone has a heart attack and you do CPR…..CPR could be described as using a specific pressure on a specific location to normalize the rhythm of the heart. At no time is the heart actually touched. There are clothes, skin, muscles, bones and other soft tissue between the heart and the hands, and yet with CPR many people use pressure to successfully normalize the hearts rhythm.
At CenterIMT we use specific pressure in specific locations to normalize the rhythm of the nervous system tissue, the digestive system, and other structures in children and adults.
Some people ask if we can really feel these rhythms, but is it any harder to believe that someone can take a sip of wine and tell you the year, the country and who bottled the wine.
At CenterIMT we are taking sensory information, touch rather than taste and smell and converting it into something else. Rather than a year and a country we use our experience to interpret the sensory information to mean a certain part of the brain is or is not functioning properly or that the bones around the ears are not moving well.
We can easily check whether a wine taster is correct or not by looking at the bottle. At CenterIMT our clients know whether we are correct or not because they feel better, function better and look healthier.
Six years ago I started treating a non verbal 5 year old boy with severe autism. Treating is perhaps the wrong word, because the first two hours was mostly a wrestling match, but the treatment made a difference. I think it decreased his pain, because the second time I saw him, he laid down on the table, watched a video and I never had trouble treating him again.
Today he is in a Waldorf school, reading at a second grade level and saying things like, “Momma we have to talk about the toy train from Disney.”
Hands-on treatment focused on circadian rhythms, such as the craniosacral rhythm, can contribute to improvements in sleep patterns and improved circadian rhythms.
Autism has been linked with a number of circadian rhythm dysfunctions, including sleep disturbances.
“Autism is a severe neurodevelopmental disorder characterized by impairment in communication, social interaction, repetitive behaviors and difficulty adapting to novel experiences. The Hypothalamic-Pituitary-Adrenocortical (HPA) system responds consistently to perceived novel or unfamiliar situations and can serve as an important biomarker of the response to a variety of different stimuli. Previous research has suggested that children with autism may exhibit dysfunction of the HPA system, but it is not clear whether altered neuroendrocrine regulation or altered responsiveness underlies the differences between children with and without autism. In the results both groups showed expected circadian variation with higher cortisol concentration in morning than in the evening samples. The children with autism, but not typical children, showed a more variable circadian rhythm as well as statistically significant elevations in cortisol following exposure to a novel, nonsocial stimulus. Conclusions: The results suggest that children with autism process and respond idiosyncratically to novel and threatening events resulting in an exaggerated cortisol response.” (Corbett, B. A., S. Mendoza, et al. (2005).
There are a number of manual therapy techniques to address adrenal function by improving the movement of the rib cage surrounding the kidney and adrenals as well as facilitate improved movement of the spine which allows for better neural flow to the organs. Reflex Points for improved kidney and adrenal function and structure along with motilities reflective of stress levels, shock in the body and organ function.
One study noted a relationship between autism, sleep and epilepsy. and present the view that “sleep is abnormal in individuals with autistic spectrum disorders.
Epilepsy and sleep have reciprocal relationships, with sleep facilitating seizures and seizures adversely affecting sleep architecture.
The hypothesis put forth is that identifying and treating sleep disorders, which are potentially caused by or contributed to by autism, may impact favorably on seizure control and on daytime behavior.” (Malow, B. A. (2004).
Children with epilepsy and other seizure disorders have also been successfully treated at CenterIMT.
Pietro: In the week before I started treating him with Integrative Manual Therapy (IMT), he had 20 severe tonic clonic seizures and a multitude of smaller seizures lasting from a few seconds to 30 seconds.. His mother gave him 3 valium that week. It is the only thing that calms him down, but he lives in a coma-like state with the seizures and the valium.
A month ago he came to CenterIMT, a multidicipline clinic, where treatments include manual therapy, exercise rehabilitation programs and nutritional recommendations. In the three weeks after he started getting IMT, he had 20 tonic-clonic seizures and only a few of the shorter smaller seizures. He had two seizure free period one 6 days and the other 6 days. When he started to come for therapy, he was on 1000 mg of seizure medication. Now, his doctor has decreased the medications gradually to 250 mg.
He has had a few “bad days” in the last month but his mother reports that his speech is better, he is playing better with his 2 year old brother, he is more interested in playing with toys and running around outside, he listens and joins into conversations more.
“An abnormal circadian pattern of melatonin was found in a group of young adults with an extreme autism syndrome. …. In others, a parallel was evidenced between thyroid function and impairment in verbal communication. There appears to be a tendency for various types of neuroendocrinological abnormalities in autistics, and melatonin, as well as possibly TSH and perhaps prolactin, could serve as biochemical variables of the biological parameters of the disease.” (Nir, I., D. Meir, et al. (1995).
Again Integrative Manual Therapist look for dysfunctions in the musculoskeletal and fascial systems that are causing a compression or a tension on the neural and endocrine organs that they protect and house. This contributes to our success both with children with autism and children with seizures.
Patzold and Richdale, in a 1998 study noted that the “aim of the study was to investigate the specificity of sleep problems in children with autism and further explore the currently unclear association between sleep problems and daytime behaviour.
“Results showed that children in the PDD group exhibited qualitatively and quantitatively different sleep patterns to nonautistic control children.
They go on to discuss the findings in the “current literature concerning circadian rhythm dysfunction, social difficulties, and abnormal melatonin levels in children with autism.” (Patzold, L. M., A. L. Richdale, et al. (1998).
“When we first started with you, Carol was having a definite sleep pattern disturbance. She would wake up 3 to 4 nights per month anywhere between 3:00 and 5:00 am and could not fall back to sleep until 6:00 or 7:00 in the morning. This happened to her every month. I can now say that the last time she went through that was the month before she started therapy with you.”
Another area in which we have seen remarkable changes is in children with speech and swallowing issues. Improvements in drooling.
Working with speech involves a number of types of treatment. We use hands on techniques to normalize the muscles in the face and neck, allowing for normal blood flow to the soft tissue involved with speech production. Reflex points and motilities are palpated to assess the affects of the brainstem, cranial nerves as well as Broca’s speech area on the lack of speech. Then manual therapy techniques are used to focus on improving blood flow to the nervous system tissue and drainage and detoxification of the tissues.
One mother described her daughter’s progress: “Her language is coming along beautifully. She is talking more and more everyday. Every argument she gives me is music to my ears (Believe it or not!). She actually told me yesterday I love cupcakes, as we were putting them into the oven together. I always knew that she liked them because she would eat them, but to hear those words out of her mouth is a joy that I myself can not express.”
Another mother reports, “I have been wanting to update you on Carl. He is doing so well!!! After he was seen in February and working with the subcortical techniques he continues to transform. His hearing and ability to match pitch in sound has improved phenomenally. His music teacher is a bit shocked. He takes piano and voice lessons. When we started a year ago he could not match any pitch at all and they called him tone deaf. He used to speak in a monotone voice. He has been the topic of conversation at the music conservatory because they have never seen this. The other interesting thing that started happening in music is he not only matches the pitch he is improvising with harmony. It happened almost over night.”
One of the classes at the Connecticut School of Integrative Manual Therapy focuses on the treatment of subcortical tissues of the brain, including the limbic system. The treatment includes a look at the cranium — the container, the connective tissue within the cranium — the dura and the blood flow to the head and brain. There are specific technique using reflex points and motilities or rhythms aimed at improving the function of the brainstem, limbic system, the amygdala, the hippocampus and other brain tissue.
“Gary’s biggest gains were in speech. He uses vocalizations and gestures to request toys or food and spontaneously produces different types of consonant-vowel combinations when vocalizing. He has increased eye-contact and the ability to attend for 20 to 30 minutes in speech therapy sessions.”
At CenterIMT we also use a combination of nutritional supplementation, herbal medicine, and homeopathy. We consider what is in the diet that is contributing to problems, such as artificial sweeteners, preservative, gluten and casen. We make recommendations about what to add to the diet: fresh fruits and vegetables, “good fats” — olive oils, avocados, fish oils. We recommend green tea for its antioxidant properties.
One mother told us: “He has calmed down a lot! He is no longer that “superball” bouncing off the walls that I once described to you. The vitamins are working well.”
“He decided on his own he wanted to go off gluten. He is doing great! We have tried to take him off many times and it was always a bit of a battle and we were never very successful. This time he is reading the labels himself, self monitoring what he eats. We have noticed huge changes, mostly with behavior and attitude. He has noticed less pain in his body and no more tummy aches and migraines after eating. His thinking is much more clear and different. The only problem is that if he accidentally gets in to gluten now that he has been off for awhile, it knocks him flat. Severe stomachache and migraine within about 20 minutes. If he gets into gluten there is definitely more autistic like behavior. It is almost like he disappears for awhile. He is beginning to think gluten is “evil” as he says. He has become incredibly more cooperative. Everyone is thankful for this!”
The goal of the Autism Recovery Program at CenterIMT is to restore health, hope and optimal function to all children and adults diagnosed with Autism or autistic-like behavior.
Our CenterIMT mission is two-fold: 1) To educate the client diagnosed with Autism and their family about the body’s ability to heal, thus working to restore hope in their potential for recovery. 2) To provide the Autism population with the most recent and advanced diagnostic, structural and functional manual therapies available.
The Autism team strongly believes all children and adults diagnosed with Autism or who have autistic-like behavior have the potential for recovery, beyond the traditional predictors of outcome.
We believe there is no one single answer for Autism; however, with a combined approach of treating the entire body, we see that recovery is possible. Because it is vital for the children and adults diagnosed with Autism to play an active role in their recovery process, we feel it is empowering for the client to participate in the goal setting process, functional rehabilitation, and nutritional wellness programs.
Our team is committed to providing ongoing support to clients and their families throughout their recovery process. We are dedicated to further advancement of techniques through ongoing clinical research.
We want every parent to be able to say, as did one client, “It is very exciting for all of us. You have given me a positive feeling and of course positive results for our child. I thank you from the bottom of my heart.”
References
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Originally published at http://kimberlyburnham.blogspot.com on November 20, 2005.
