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IMT Effects in Autism Recovery

Spectrum Demands Various Approaches

HAR_2017-09_IMT_for_Autism

by Ayelet Connell

Recovery from autism is becoming more and more of a reality—but with every child’s story of recovery, there is a long road leading to that point. Having worked with many families of children with autism spectrum disorder (ASD), one of the most common themes amongst these children’s stories is the multi-disciplinary approach that they follow. Many of these programs include Applied Behavioral Analysis (ABA) therapy in school and at home, sensory integration, IV nutrition and chelation, elimination diets (such as a gluten- and casein-free diet), homeopathy, hyperbaric oxygen and more.

Every child with autism is different—their history, their age of onset, their behavioral presentation and their level of health. This leads to a greater diversity in treatment programs. One child may present with high levels of mercury in their body, while another may undergo testing showing high levels of yeast. The test results lead to different treatment, all of which may be valuable. It has been found that a comprehensive program leads to the greatest recovery.

Integrative Manual Therapy

Integrative Manual Therapy (IMT) is a gentle form of bodywork that has been used to treat pain, disability and disease for more than 40 years. IMT falls into the category of structural rehabilitation, whereas some other types of therapies may be categorized as functional rehabilitation.

A helpful analogy to illustrate the difference between structural and functional therapies is to imagine a child sitting in front of a piano. Let’s assume for this example, that the child does not know how to play the piano. If we teach the child how to play the piano, then the music should sound great. But what if the piano is out of tune or even broken? No amount of piano lessons would lead to great music because the piano does not have the potential for good sounding music. However, if the approach was to fix the piano and then teach the child how to play, then the music has the potential of sounding wonderful. In this scenario, teaching the child how to play the piano is considered functional rehabilitation. Fixing the piano illustrates structural rehabilitation.

The simplest way to explain IMT is to use an orthopedic example such as a frozen shoulder. In this example, a functional approach would include strengthening and stabilization exercises as well as stretching. If the shoulder had a structural problem (commonly the case with frozen shoulder), such as a compressed joint or a bone bruise on the joint surface, using a functional approach would cause stress on the joint and ultimately be unsuccessful in reducing symptoms and increasing function of the shoulder. However, beginning treatment with a structural approach like IMT to correct the problem—perhaps by decompressing the joint—would create a potential for function. At this point, it would be more beneficial to introduce the functional exercise program. When utilized in this way, the results appear to be more long-lasting.

In the field of IMT and structural rehabilitation, performing a thorough assessment is important to discover underlying problems in the body that very likely are contributing to the person’s functional challenges.

No one would question that autism is more complex than a frozen shoulder. But why? Firstly, no two children with autism are alike. Secondly, autism involves multiple body systems. If we were to consider the concept of structural and functional therapies for treatment of autism, it is important to note here that they are both very important for recovery. Although there is such diversity among etiologies between children that have autism, they share similar behaviors which led to the diagnosis.

Let’s examine some of these behaviors to further illustrate the difference between structural and functional therapies.

Hypersensitivity to Sound

Many children with autism have a history of recurrent ear infections and allergies. One commonly found pattern in children with autism is severe compression of the inner ear. Within the inner ear, there are multiple important structures for hearing, including the cochlea, ear drum and vestibular nerve. When combined into the vestibular mechanism, these structures are not much larger than a peanut. They reside inside the ear, bordering up to the temporal bone. When there is severe compression, this peanut-sized vestibular mechanism within the inner ear pushes up against the temporal bone. This can contribute to significant hypersensitivity to sound, as well as headaches.

A functional approach to addressing the hypersensitivity to sound may be a form of music therapy or auditory integration therapy (AIT). This approach can be very successful when used at the appropriate time, but if there is severe compression of the inner ear, the benefits of AIT are limited. However, if IMT as a structural therapy is utilized first to help decompress the inner ear using a wide array of techniques, then the functional therapies have a greater potential to work.

Aggressive Behaviors

When considering aggressive behaviors, the solution may seem more complex for a number of reasons. Firstly, because the child is aggressive, it may be challenging to work with them. Secondly, aggressive behaviors stem from a very specific part of the brain—the limbic system, which is the part of our brain associated with survival mode and rage response. When the limbic system is in a state of dysfunction, there is a range of behaviors that may surface, including aggressive behaviors and obsessive compulsive behaviors. IMT is a wonderful tool to treat the limbic system and aggressive behaviors.

A common functional approach to treatment of these behaviors is ABA therapy or some type of behavioral modification. The challenge with these functional approaches is that the aggressive behaviors are reflexive—there is no voluntary thought process involved. Consider the example of a lion that has been shot, but not killed. It wants to destroy everyone and everything in its path. The lion is not thinking about consequences. Similarly, the child with autism that lashes out is not thinking about consequences. They are purely acting on a reflex from their limbic system. Whereas ABA therapy can be very effective in helping to develop normal behaviors through repetition and role modeling, aggressive behaviors are rarely reduced with this approach. But when used in combination with IMT, there can be reduction and even elimination of aggressive behaviors.

IMT as part of an Autism Treatment Program

IMT is practiced by many physical therapists, occupational therapists, massage therapists and chiropractors. When designing a comprehensive multi-disciplinary treatment program for a child with autism, IMT is an important component. It can complement and even accelerate the benefits of other treatment approaches by addressing structural problems in the body.

Dr. Ayelet Connell, PhD, PT, IMT, C is the owner of Integrative Wellness & Physical Therapy, a wellness center in Bloomfield, specializing in using holistic and advanced physical therapy, manual therapy, chiropractic, acupuncture and comprehensive nutritional wellness to find and treat the underlying causes of pain and dysfunction. Connect at 860-519-1916 or IntegrativeWellnessAndPT.com.

 

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