Reaching Sensory Processing Disorders: Working to Benefit ADD/ADHD to Autism through Structure and Function Charles W Chapple, DC, FICPA 360 E Irving Park RD, Roselle, IL (630) 894-8778 www.drchapple.com Selected 2006-2008 “Guide To America’s Top Chiropractors” 2008 “ Five Star Excellence Award in Chiropractic” What are Sensory Processing Disorders? Any condition which demonstrates the inability to process information through the Senses. Interestingly the DMSR only acknowledges the sensory component in ASD as a secondary finding( Diagnosed by language, social and behavioral variations). Inter-related Conditions? ADD/ADHD AUTISM PDD SPD CHALLENGED “Normal” Children Prevalence ADD/ADHD: 5 Million Children in USA alone Autism: Every 21 minutes another Child is Diagnosed. Challenged Child: 12 to 30% of Children. How is Information Gathered for Our Sensory System? Through Senses Through Reflexes Reflexes and Sensory Processing Can’t be Separated Body Senses Include Far Senses - Allow us to respond to stimuli outside our body: Hear See Taste Touch Smell Near Senses - Or Hidden Senses – Automatically respond within our body to stimuli: Body Position/Awareness Movement/Balance Reflexes and the Sensory System: Primitive Reflexes Postural Reflexes What are the Primitive Reflexes? Primitive reflexes are automatic survival responses to stimuli (Sensory Input) which develop during uterine life and should be fully present at birth. Anatomy of Primitive Reflexes: Within the brainstem – Oldest part of the brain (Reptilian or PreCortical) => Midbrain => Cortical Automatic vs Volitional Stimulus elicited (e.g. A Chocolate Cookie) Survival / Instinctual Primitive Reflexes Charted A Closer Look at Primitive Reflexes Fear Paralysis Reflex Palmar Reflex Fetal Tuck Reflex Moro Reflex Clasping Reflex • Facilitates the 1st “Breath of Life” • Only PR connected to ALL senses • Matures to “Adult startle response” – Shoulders shrug w/ head turn • If underdeveloped maybe factor in SIDS Grasping Reflex • Related to early feeding (hand/mouth) Stimulation bilaterally inhibits Moro Reflex • Matures to “Pincer Grip” • Plantar Reflex • Trouble w/Gait, Run, Toe Walk Rooting/Suck Reflex • Cardinal Points Reflex Hand-mouth neurologic link A Closer Look at Primitive Reflexes Continued Asymmetrical Tonic Neck Reflex Spinal Galant Reflex Kicking & Vestibular reflex • Assist birth process • Enables the fetus to “feel” sound • Reduced by Auditory Integrative Training • In Utero provides continuous motion stimulating balance/ neural connections • Assists & reinforces birth process • First eye-hand coordination • Integrates vestibular w/ other senses; enhances myelination • If underdeveloped maybe factor in SIDS Spinal reflex A Closer Look at Primitive Reflexes Continued Symmetric Tonic Neck Reflex Tonic Labyrinthine Reflex Rolling reflex • First assistance of body to defy gravity • Influences body muscle tone in horizontal halves (crawl) • Crawl assist hand-eye coordination essential for reading & writing Vestibular reflex – Forward & Backward • Backward emerges w/ Postural Reflexes • Early method of response to gravity - Giving sense of direction based where in space • Shared circuit of eyes & brain • Influences muscle tone throughout the body What If Primitive Reflexes don’t Integrate? Primitive reflexes that remain and do not integrate, are “Retained” and therefore postural reflexes do not develop fully resulting in a “Reflexive No Man’s Land” or “ A Reflexive Seesaw” (e.g. Car stuck in the Snow). Thus the body remains under the influence of involuntary responses instead of voluntary. Retained Primitive Reflexes cause: Difficult voluntary movements and Balance Irregular Visual Perception Irregular Auditory Processing Irregular Sensory Perception Observing SPD’s An Individual defined as having SPD concerns exhibits variations of sensory activity in : Frequency Intensity Duration Observed as either as a Hypersensitivity or a Hyposensitivity The Sensitivity of the Seven Senses in SPD Hypersensitive - Hyposensitive - requires requires less stimulation Avoids sounds Overwhelmed by intense visual Object to textures and gag Avoid textures and being touched Avoids odors Rigid and uncoordinated Apprehensive running, climbing and swinging more stimulation Appears to ignore sound Appears uninterested by visual Tastes inedible objects Chews and presses into objects Unaware of unpleasant odors Limp and clumsy Craves rocking, twirling and fidgets How SPD Presents More Specific Symptoms of Retained Reflexes: Fear Paralysis Reflex • • Oppositional Defiance “The Screaming Child” Moro Reflex Palmar Reflex • Poor Manual Dexterity (Thumb) • Speech Difficulties • Manual Tasks Inhibit Talking • Difficult writing (w/Mouth Motion) • Aggressive or Withdrawn • Overactive (Ready-Fire-Aim) • Overemotional (Weeping Anger) • Learning Difficulty (Pupils problem w/ black print on white paper • Visual attention drawn to outside edges (Peripheral Vision) • Hypersensitive to ALL senses • Adrenal Fatigue=> Weak Immune • Overall effects emotional profile Plantar Reflex • Trouble w/Gait, Run, Toe Walk More Specific Symptoms of Retained Reflexes: Asymmetrical Tonic Neck Reflex: • Easily Distracted • Poor Pencil Grip, Excessive Grip • Missing Visual Reading Fields When reading • Difficult Distance Perception • Poor Ball Skills • Difficult cross crawling on stomach (Barrier crossing midline) • Difficult tasks involving both sides of Body ; Favors same side motion & since choice of side not automatic becomes unnecessary source of confusion • Learning Difficulty Tonic Labyrinthine Reflex: • • Poor Judgment of Balance, Space, Distance, Depth, Motion & Time • Motion Sickness & Dislike P.E. • “Floppy” or “Rigid” Child • Fatigue when Neck Flexed Learning/Visual Difficulty (Mirror Write) More Specific Symptoms of Retained Reflexes: Rooting/Suck Reflex • Symmetrical Tonic Neck Reflex Difficult Chew, Speech and Dribble • Relation to manual dexterity • • • Spinal Gallant Reflex: • Delayed Sitting • Abnormal Gait/Posture • Poor Bladder & Bowel/ Bed Wetting • “Ant’s in Pants” Child • Poor Concentration & Learning Difficulty • Poor Posture, (Ape like) Walk “W” leg position w/ floor sitting Poor Hand-eye coordination- eating Swim better underwater w/ less gravity The Next Developmental Step As higher brain centers mature or the PR’s Integrate more voluntary Postural Reflexes and Cortical development occurs Postural Reflexes: • The Righting Reflexes (Quadruped) • Equilibrium Reactions (Bipedal) Developmental Movement Patterns The Building Blocks of movement and understanding CONTRALATERAL Integrates all previous patterns; Gains ability to intend HOMOLATERAL Differentiates right and left side of the body; Gains mobility HOMOLOGOUS Differentiates upper and lower halves of the body; Gains the ability to act SPINAL MOVEMENT Differentiates front and back of the body; Gains the abilityto attend NAVEL RADIATION Differentiation and connection MOUTHING First limb to reach, grasp, hold and let go BREATHING Simplest ground of physical presence The Significance of Primitive to Postural Reflexes: Primitive Reflexes Form foundations for later body functions Postural Reflexes Provide the framework within which body systems operate The Integrity of one effects the Integrity of the Other (The Model Home) Learning Hierarchy Academic Functioning Development of logic and reasoning for schooling-reading, writing and math Conception Making sense of the world Language Development of speech Perception Development of sight, hearing and touch Motor Patterns Development of correct motor pattern, crawling and climb Postural Reflexes Development of ability to be in an upright posture and balance against gravity Primitive Reflexes Emergence and integration of survival reflexes along with hearing and touch competence Difficulty with Senses and Reflexes Difficulty with Skills Motor/ Muscle Tone Cognition Communication Socialization Independence Difficulty with Behaviors Impulsiveness Self Control Distractibility Frustration Social Emotional SPD Expression Cause: Difficulty with Senses and Reflexes Effect Difficulty with Skills and Behavior Low Self Esteem Intervention Traditional Treats causes as genetic, prepostnatal trauma and unknown Treatment is geared from outside the body to inside the body ( e.g. Behavioral Modification) Reactive (The Model Home) Alternative Treats the structure in order to improve the function as cause is a Sensory & Reflex imbalance System Overwhelmed Treatment is geared from inside the body to outside the body (e.g. Chiropractic and Craniosacral Therapy (CST) Proactive (The Model Home) Controlling the Senses and the Reflexes The Central Nervous System (CNS), comprised of the brain, brain stem, the cranial nerves, the spinal cord and the nerve attachments controls the senses and the reflexes. CNS Involvement Hear………………………………CN 8 (Vestibular Cochlear) See………………………..CN 2(Optic)..CN 3(Occulomotor), CN 4(Trochlear)..CN 6 (Abducens) Taste………………………………..CN 9(Glossopharyngeal) Touch……..............................Afferent and Spinal Pathways Smell…………………………………………..CN 1 (Olfactory) Body Position...................CN 8, Brain stem and Spinal cord Movement………………………..Brain stem and Spinal cord Cranial Nerves Involvement CNS Structure and Function The Cranium and Spinal Cord are the boney structures protecting the CNS. Improper Structure (Alignment and Position) Improve Structure Improper Function Improper Sensory and Reflex Processing (Motion and Nerve Communication) Improve Function Improve Sensory and Reflex Processing The “PROFOUND” Link The CNS and its intimately related boney protective network form the profound link of communication and functional interaction between an individual’s internal and external environments. Craniosacral Therapy (CST) Focuses on relieving pressure on the brain and spinal cord through manual pressure techniques used at the cranium and sacrum. The Craniosacral System Consists of membranes and cerebral spinal fluid, which protect the CNS. Restrictions in this system are detected, and corrections are identified through manual monitoring of the craniosacral rhythm (CSR). The Bones to the Senses and Reflexes The Bones in Motion Variations in CSR. Variations in the CSR (6-12 bpm) could indicated any number of motor, sensory, reflex or neurological impairments, as well as causes of pain. The Chiropractic Approach to the CNS Chiropractors identify the necessity for the reduction of Subluxations, and utilize gentle spinal pressure techniques called Adjustments in order to remove Subluxations. What are Subluxations? CNS irritation characterized by: – – – – – Irregular boney mechanics or spinal misalignment Nerves imbalances Muscle irritations Tissue inflammation Degenerative wear The poor structure or mechanics involved in creating Subluxations results in poor motor, sensory, reflex and neurological function, as well as causes of pain. Spinal Involvement A Step in the Right Direction 75% of imperfections from poor foot mechanics are transmitted up through the spine via Presso-receptors. Digital Foot Scan…. Orthotics The Best of Both Worlds CST and Chiropractic adjustments work to restore more appropriate motor, sensory, reflex and neurological input and therefore improve function. Improve Structure Improve Function Working inside to out and not outside to in. Synchronizing Structure and Function Primitive Reflexes CST Chiropractic Postural Reflexes CST Chiropractic Core Activation CST Chiropractic Presso-Receptors Orthotics Homework: Primitive Reflexes Starburst Snow Angel Stomach Fly Stomach Twist Homework: Postural Reflexes * Gross motor function proceeds Fine motor function * Exercise is in essence Gross motor function and correlates to higher academic achievement * Chiropractic has been shown to increase exercise performance 2 to 4x’s when compared to exercise alone. The Better Alignment, Motion, Balance and Strengthen….The Better the Posture, Health and Life. Measuring CNS Function Health care practitioners are challenged to quantify variations of the CNS communication with SPD conditions. Frequently conventional tests such as blood markers, MRI’s and EEG’s appear unremarkable. The CNS Simplified Noninvasive Testing of the CNS Infrared Thermography Measures temperature variations along the spine as indications of imbalances in the Autonomic nervous system which result from subluxations within the CNS. Surface Electromyography Illustrates the effectiveness of motor nerves by measuring the amount of current at the muscle, with imbalances being indication of subluxations within the CNS. Infrared Thermography Surface Electromyography More Scans Clarification: There is no HealthCare that is guaranteed or without risk. However, Chiropractic and CST are among the most safe effective in benefiting the CNS. A Mom’s Story Dear Parents, After a frustrating year of indifferent doctors who ignored my concerns about my son, finding Dr Chapple was like a gift. Over weeks of therapy he has improved considerably. He no longer cocks his head. Spins or presses his forehead onto me. In Fact, we took him for a haircut, and for the first time he sat still for the whole thing….No unfinished haircut, frantic barber or parents. It’s sad, but I had never really noticed that he didn’t run very much before. When he did…he ran on his toes with a very awkward gait. Now he races around on his little feet for the sheer joy of running that all children have. More Resources: www.icpa4kids.com www.upledger.com www.autismspeaks.com www.movementbasedlearning.com Some Help from Michelangelo… “the danger that exist is not aiming to high and reaching it, but aiming to low and achieving it.” We can never aim to high for our children The Structure and Function of Sensory Processing Disorders: Working to Benefit from ADD/ADHD to Autism Charles W Chapple, DC, FICPA 360 E Irving Park RD, Roselle, IL (630) 894-8778 www.drchapple.com Selected 2006-2008 “Guide To America’s Top Chiropractors” 2008 “ Five Star Excellence Award in Chiropractic” Abstract Reaching Sensory Processing Disorders: Working to Benefit ADD/ADHD to Autism through Structure and Function So frequently Sensory Processing Disorders: ADHD to Autism, are addressed through a variety of behavioral and biochemical approaches that the significance of the biomechanical aspects of these conditions can be underestimated. Experts state that if a cluster of irregular nervous system reflexes remain unaddressed they will prevent ”sustained long term improvement". This presentation introduces the importance of the nervous system with its biomechanical relationships to the spine and cranium, and the noninvasive approaches of Chiropractic and Craniosacral therapy for the benefit of individuals struggling with sensory processing concerns and retained primitive reflexes.