A New Frontier for Caring for the Child With ADHD and Sensory Integration Dysfunction
By Claudia Anrig, DC
For doctors of chiropractic who serve the challenged child segment, it is not uncommon to hear, "Doctor, can chiropractic help my child with ADHD?" In my personal practice, I have seen many children helped with these disorders, and I have spoken to colleagues worldwide who shared their personal success stories. However, in all honesty, these success stories do not necessarily mean we can produce repeatable "breakthrough" results.
Over the years, I have never seen any specific technique, system of chiropractic analysis, protocol of care or adjunctive therapy (e.g., exercise, nutrition) to treat such challenging disorders. Now, however, the wait finally may be over. Monika Buerger, DC, and Robert J. Melillo, DC, DABCN, each have established timely, instructional programs for those seeking to serve these challenged pediatric population groups.
Dr. Buerger has been in private family practice for 15 years, specializing in sensory integration disorders in children. In her experience, she has found that many children who are diagnosed with ADD/ADHD, dyslexia, and various other autism spectrum disorders and learning disorders have an underlying problem with sensory integration dysfunction (SID). She notes that many of these children are being prescribed unnecessary medications and/or are not receiving proper treatment.
Sensory integration is the ability to take in, process, organize and assimilate sensory information so that we feel comfortable and secure; we then can respond appropriately to given situations and demands. All forms of learning occur through this process. Children with sensory SID experience a "disconnect" between the brain and the body (PNS and CNS) and have difficulty processing sensory information. Two rarely known senses are vestibular and proprioceptive sensations, both of which commonly function improperly among children with the above disorders.
Several years ago, Dr. Buerger became interested in this area and began extensive research, attending various seminars and workshops. Most sensory integration work has been performed in the occupational therapy arena; however, knowing the great impact chiropractic plays on the occulomotor, vestibular and proprioceptive systems, not to mention the entire nervous system, she knew the chiropractic profession needed to be a vital component in the treatment of these children. The more she researched and began to work in this field, it seemed to her that the neurological basis for SID was written for the chiropractic profession. Armed with a DC degree and a bachelor's degree in exercise physiology from California State University, Fresno, she began developing a program in her office for children with ADD and ADHD. As the children's success became known in her community, this area of her practice grew and began to include a variety of children with learning disorders. She also began to develop programs for local elementary schools.
Dr. Buerger is on the postgraduate faculty of several chiropractic college and is an instructor with the ICPA. She is also a contributing author to Pediatric Chiropractic. She shares a mission to teach doctors vital information regarding the treatment of children. As part of this mission, she developed a sensory integration program for the doctor of chiropractic, integrating the neurological principles of SID and those of chiropractic. The program in now offered through the ICPA and teaches how to perform a specific and detailed history, including what she calls a sensory and academic profile (SAP), a detailed neurological and sensory analysis and evaluation, specific short-lever adjustment protocols, home, school, and recreational recommendations, nutritional and biochemical considerations, and specific sensory exercise programs that are "graduated" in difficulty as children progress.
The program also discusses ways to implement a sensory integration program into your practice at any level, depending on how much space you have in your office, how much time you want to spend with patients, and how much you want to invest financially. The program is designed to give the doctor of chiropractic a firm understanding of the fundamental principles of neurosensory disorders and how they relate to children with ADD, ADHD, dyslexia, autism spectrum disorders, and various other learning and behavioral disorders. Its neurological basis gives the doctor of chiropractic a solid understanding as to why these children need chiropractic and its value as part of a drug-free treatment approach.
At the University of Bridgeport College of Chiropractic, Dr. Robert J. Melillo has been working with children in the area of neurobehavioral disorders like ADHD, dyslexia, learning disabilities, and autism for more than 10 years. He started to research the problem in 1995; at that time, the statistics showed a 250 percent increase in the use of Ritalin between 1990 and 1995. With these disturbing facts in mind, Dr. Melillo chose to devote much of his professional career toward trying to understand not only what causes ADHD and other neurobehavioral disorders, but also what can be done to correct these problems on a long-term basis, without the use of medication.
In 2004, Dr. Melillo published a textbook titled Neurobehavioral Disorders of Childhood - An Evolutionary Perspective, which describes what he believes to be the primary neurophysiologic mechanism that produces many of the most common neurobehavioral disorders. Applying this neurophysiologic mechanism to chiropractic, he focuses on three main areas: sensory/motor systems, biomechanical/nutritional, and neuropsychological, with the main concept revolving around hemispheric balance. His belief is that most of the symptoms seen in children with ADHD can best be explained by decreased activity in one hemisphere in the brain, often caused by an imbalance in the way that postural, vestibular and occulomotor information is being sent to the brain. As a result, one hemisphere is underactive, preventing the proper synchronization of the two hemispheres, which is necessary to properly share and process information.
From a chiropractic standpoint, an imbalance in postural muscle tone producing an observable subluxation complex may result in more gross postural disturbances, such as head tilts, which also could have central neurological consequences affecting and involving cognitive and behavioral functions.
Dr. Melillo recognizes that each child is different and should therefore be treated specifically; however, he has made his courses and treatment approaches more protocol-driven throughout the years for teaching purposes. He has developed specific protocols that involve not only precise adjustments, but also particular nutritional-, sensory-, motor- and cognitive-based protocols as well. The key, as he sees it, is to get the doctors to start seeing results, and protocols are the best means to that end.
A graduate education in neurology is not necessary for chiropractors wishing to take either of these new programs. The courses provide the chiropractor with all of the information necessary to treat children with ADHD and to help them feel comfortable interacting with other professionals such as teachers, occupational therapists, psychologists, and optometrists who also treat these children. To learn more about these programs, contact Monika Buerger, DC, at www.icpa4kids.com or Robert Melillo, DC, DABCN, atwww.carrickinstitute.org.