April is National Autism Awareness Month!
April is Autism Awareness Month! Currently, there is a significant rise in the number of children in our country that are diagnosed with autism. The Centers for Disease Control recently published new statistics listed that 1 in 68 children (1 in 42 boys and 1 in 189 girls) in the US have autism. These numbers are incredibly high!
As many of us know, Autism is considered a spectrum of related disorders. Autism is a classification of behaviors. Some of these behaviors include the following:
1. Self-stimulatory behaviors or inability to self-modulate;
2. Neuro-aggressive or self-injurious behavior;
3. Inability to maintain eye contact with unfamiliar and/or familiar individuals;
4. Tactile defensiveness when child experiences negative reaction when being touched;
5. Distress behaviors associated with transition in routine schedule as well as ability to recover from distress behaviors;
6. Perseveration when child has difficulty letting go of idea or self-generated request;
7. Poor socialization where child has decreased ability to socialize with same-age peers;
8. Engagement in unsafe activities;
9. Lack of bonding and emotional connection to others; and more.
Children diagnosed with Autism Spectrum Disorder (ASD) may present with some or all of these behaviors. Generally, the child is labeled as more severe if they present with more of these behaviors.
There are many different interventions available to children with ASD. Most of these approaches are considered functionally-based. There are very few structurally-based therapeutic approaches for children with Autism. Integrative Manual Therapy (IMT) is considered a structurally-based therapy.
The following analogy will illustrate the difference between functional therapy and structural therapy. Imagine a child sitting at a piano. Consider the piano as the structure of the body and the child playing the piano as the body’s ability to function and move appropriately and optimally. Now imagine that the child has had many piano lessons and has the capacity to play the piano very successfully and produce beautiful music. In this scenario, the child would play beautiful music. This analogy would reflect a healthy body with healthy and optimal function. Now imagine a very different scenario: This same child with the same background and capacity for playing beautiful piano music, but with a piano that is out of tune, or even more problematic, a piano that is broken. Regardless of how many lessons the child has had, there is no potential for beautiful music. In the latter scenario, the broken piano is analogous to a body with dysfunction that is contributing to functional deficits such as learning disabilities or movement problems. In this scenario, a structural therapist (piano technician) can correct the dysfunction in the body using a structural therapy such as Integrative Manual Therapy. Once the body dysfunction is corrected, the child now has a greater potential for normal function.
This analogy can be utilized when considering many different types of disorders. Using a less complex diagnosis such as a frozen shoulder syndrome, if the structure of the shoulder complex is dysfunctional, no amount of shoulder strengthening and stabilization exercises will lead to a fully functional and symptom-free arm. Considering a child with learning disabilities, which can also be a component of Autism, what is the body structure or structures associated with learning? Many decades of neuro-scientific literature have shown us that learning comes from multiple sites in the brain, including the frontal lobe behind the forehead for general cognition, the eyes and occipital lobe for visual processing, the ears and temporal lobes for auditory processing, and more. Imagine a child that has poor circulation to the frontal lobe, poor drainage from the frontal lobe, as well as cranial dysfunction where there is pressure on the frontal bone—this scenario would create a structural problem in the body that would then cause a functional loss; in this case, a learning deficit as well as processing issues.
Children with Autism are more complex because typically, there are multiple functional deficits, including those listed previously in this article. In the field of Integrative Manual Therapy and Autism, it is widely known that each ‘autistic’ behavior is produced by a different pattern of structural dysfunction in the body. For example, let’s consider self-stimulatory behavior or inability to self-modulate. Imagine a child that repetitively rocks in place when there are faced with a challenge such as a change in their routine. Now consider the anatomy of the inner ear which is strongly correlated with sensory dysfunction such as this. A very prevalent structural pattern that is found in children with Autism is severe compression of the inner ear on one side or both sides. This commonly manifests as the child quickly covering their ears when exposed to a loud sound. When a child has severe inner ear compression, it can cause or contribute to self-stimulatory behavior.
Another example would be neuro-aggressive or self-injurious behavior where a child may hurt themselves or their family. This ‘behavior’ is caused by dysfunction of the limbic system. The limbic system is the core part of our brain. It is the part of the brain that we share with animals—the reptilian brain. When the limbic system is in a state of dysfunction, it can contribute to aggressive behaviors. It can also contribute to obsessive compulsive behaviors. These behaviors are instinctual—there is no amount of verbal reasoning that can be done with the child to decrease this aggression.
There are many structural patterns of dysfunction in the body that are associated with Autism Spectrum Disorder. These structural patterns are unique to Integrative Manual Therapy (IMT). In the perspective of IMT, to be able to successfully and sustainably eliminate these behaviors, you need to correct the dysfunction in the body. Similar to the analogy of the child and the piano, it may not be enough to just fix the piano. You may still need to teach the child how to play. This is where functional therapies fit into the larger program. Structural therapies such as IMT and functional therapies, such as Applied Behavior Analysis (ABA) therapy or Behavioral Modification as two examples, work hand in hand.
In the field of IMT, there are many different manual therapy techniques to correct structural dysfunction in the body. IMT was developed by Sharon Weiselfish-Giammatteo, PhD, PT, IMT,C over the last 30 years. Weiselfish-Giammatteo studied Physical Therapy in Israel in the 1970’s. She focused her graduate studies in the field of neurologic rehabilitation. Her Master’s degree was in Clinical Neurosciences. Her doctoral studies focused on Recovery from Traumatic Brain Injury and Coma. She has an extensive background investigating the effects of IMT in children with neurologic dysfunction, including Autism Spectrum Disorder.
IMT is a unique compilation of diagnostic and treatment techniques that assess and treat pain, dysfunction, disease and disability. It is a new approach to health care developed to address the needs of complex patients. IMT practitioners, many of which are Physical Therapists and Chiropractors, identify and address the underlying causes of dysfunction using a comprehensive and holistic approach. While IMT diagnostics and treatment modalities are predominately hands-on, IMT also integrates a wide range of diagnostic and treatment technologies as well as nutritional programs (i.e. natural supplements, diet, and herbs) to develop a customized solution for an individual person’s needs.
IMT treatment techniques are manual (hands-on), and generally involve gentle manipulative techniques to promote tissue repair, normalize structure and restore function. Unique to IMT is the integration of manual therapy techniques for all systems in the body (i.e. bone, nerve, fascia, muscle, organ, lymph and circulatory systems). As each tissue type in the body has unique requirements for healing, tissue specific techniques are used to yield optimal results. Often, multiple body systems are addressed to facilitate recovery, as a dysfunction in one system may influence or be influenced by a problem in another system. Upon assessment, to determine which structures were contributing to the child’s problems, treatment would ensue for the affected systems. As determined by the diagnostic findings, this may include treatment for muscles, fascia, joints, bones, nerves, circulatory vessels, lymphatic structures and/or organs. Ultimately, IMT is the integration of techniques to assess and address all systems in the body.