The Diagnostic and Statistical Manual of Mental Disorders 5th Edition, known as the DSM-5 or DSM-V, was changed in 2013 to include several disorders under the umbrella of Autism Spectrum Disorder (ASD). According to the National Institute of Mental Health “Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behavior. Although autism can be diagnosed at any age, it is said to be a ‘developmental disorder’ because symptoms generally appear in the first two years of life.”
The Journal of Pediatric, Maternal & Family Health published a report on December 3, 2018, titled, “Autism & Chiropractic: A Selective Review of Literature.” The objective of the report was, “To evaluate current research on chiropractic in the management of children with a diagnosis of autism.”
The authors of this report described the criteria needed for the diagnosis of autism. “The presence of two of the following four behaviors is a strong indication of a positive diagnosis of autism: 1) extreme attachment to routines and patterns and resistance to changes in routines, 2) repetitive speech or movements, 3) intense and restrictive interests, and/or 4) difficulty integrating sensory information or strong seeking or avoiding behavior or sensory stimuli.”
In reviewing existing literature on chiropractic and autism, the authors found 11 studies on the subject. The studies involved a variety of chiropractic techniques and all resulted in a variety of positive results.
These 11 studies involved a total of 205 children who had been diagnosed with autism and in one study, related problems such as developmental delay syndromes. Eight of the studies were case studies which followed the cases of individual children who had been diagnosed with autism and where helped by chiropractic. Most of the studies utilized a standardized test called the Autism Treatment Evaluation Checklist (ATEC), to document the improvement of the children while under chiropractic.
The common thread of the studies that were reviewed was that all the subjects were under chiropractic care for the correction of vertebral subluxations. In most of these studies, the focus of that correction was at the upper cervical area involving the top bone in the spine known as the atlas. Several of the studies specifically mentioned that they were not treating autism but were evaluating how the correction of subluxations affected the patients who were suffering with autism.
The Association of Chiropractic Colleges defines the practice of chiropractic as it relates to subluxation by saying, “Chiropractic is Concerned with the preservation and restoration of health, and focuses particular attention on the subluxation. A subluxation is a complex of functional and/or structural and/or pathological articular changes that compromise neural integrity and may influence organ system function and general health.”
In the reports conclusion the authors wrote, “Based on the papers that point to the upper cervical area of the spine for evaluation and correction, attention to this area may be a good source for initial conservative treatment for those who present with developmental dysfunctional disorders along the autism spectrum.”
The November 2018 issue of the Journal of Clinical Chiropractic Pediatrics published a case study documenting the improvement in a 3-year-old who was diagnosed with autism spectrum disorder (ASD). This study defines this condition by saying, “Autism spectrum disorder (ASD) is a complex developmental disorder that can cause problems with cognition (thinking), emotion (feeling), language (talking) and sociability (the ability to relate to others).”
According to a report by the U.S. Centers for Disease Control and Prevention, (CDC), the rate of diagnosis of this issue has significantly increased. It is now estimated that approximately 1 in 59 children are reported as having some form of ASD in 2018. According to the Community Report on Autism released by the CDC in 2016 ” …the economic burden of treatment for individuals nationwide diagnosed with ASD from birth to age 17 was estimated to be between $11.5 – $60.9 billion per year in the United States.”
ASD is treated medically in a variety of ways including behavior and communication therapies, occupational therapy, family and educational therapies, and medications. The medications are usually given to address the symptoms and to assist in socialization or learning. However, there is much controversy concerning using medications on developing brains, as well as the long-term impact of this type of medication usage.
In this case, a 3-year-old girl was brought to the chiropractor by her mother. The girl had been diagnosed with ASD. She could not communicate verbally and did not use any form of non-verbal cues such as pointing for basic needs or sign language. Her only form of communication was through crying and an occasional guttural sound. The young girl did not like being touched. At times being touched would not bother her, but other times it would send her into a temper tantrum. The girl seemed to walk on her toes half the time and seemed off-balanced, often bumping into things when walking or running.
The history revealed that the mother had a difficult birth with her daughter. Due to difficulties, both vacuum and forceps were used during the vaginal delivery. A large amount of head swelling was noticed on the infant after birth and she was cyanotic requiring oxygen to be immediately administered after birth. The girl had received all scheduled vaccinations. From previous testing, it was determined that the girl’s original ATEC total composite score was 105. A score of 104 or higher indicated that the girl was considered severely autistic.
Considering the girl’s condition, the chiropractic examination was modified to accommodate her situation. The examination included inspection, a postural analysis, leg-length analysis, and both motion and static palpation. Based on the findings, chiropractic adjustments were started.
After the girl’s fourth adjustment, it was reported that she held eye contact with her mom for five seconds. This was the first time that her daughter had made purposeful eye contact with her mother. By the seventh chiropractic visit, the girl’s mother stated that there had been a “big change” in the amount of eye contact that her daughter would do and her demeanor had gotten much calmer when they are at home.
During the 11th visit, the girl held the chiropractor’s hand calmly after her adjustment. Her subsequent ATEC score had dropped to 63, which was a significant improvement. As the girl’s care continued over time, she was able to make additional improvement surpassing several milestones. Eventually, the girl’s ATEC score had reduced to 32. A score below 50 indicates that the child will most likely be able to lead a semi-independent life without needing to be placed in a formal care facility. A score below 30 would indicate that the child possesses somewhat normal behavior patterns and communication skills and has a high chance of leading a normal and independent life.
In the conclusion, the authors of this study wrote, “This case report helps to strengthen the relationship between correcting subluxations and the improvements in the myriad of symptoms of children diagnosed with ASD.
A case study was published in the Journal of Clinical Chiropractic Pediatrics November 2018 issue that documented the improvement and eventual resolution of bedwetting in a little girl as a result of chiropractic care. The technical name for bedwetting at night is nocturnal enuresis.
According to this study, “Nocturnal enuresis can be defined by the involuntary loss of urine during sleep, without organic disease at a developmental age of 5 years or older.” Nocturnal enuresis is more common in younger children but can be present as a child grows older. The prevalence shows that this condition occurs in 15% to 20% of children of five years of age. It then decreases in prevalence to 5% of children of 10 years of age, and only 1% to 2% of children at age 15 years or older.
Common medical treatment involves medications or behavioral interventions. However, in many cases the problems re-occur when the medications are discontinued. Bedwetting can lead to a social and emotional stigma, a reduction in the quality of life, and can lead to self-esteem issues.
In this case, a mother brought her 10-year-old daughter to the chiropractor. The mother was seeking a second opinion to see if chiropractic could help her daughter with bedwetting that had been unsuccessfully treated both medically, and with behavioral modification. Prior to seeking a chiropractic evaluation, the young girl had never experienced a dry night. She had no history of traumas, accidents or other injuries. Due to her problem, the girl has been sleeping with pull-up diapers since age five.
A chiropractic examination was performed with the primary goal of looking to see if subluxations were present. According to the study authors, “In chiropractic, a vertebral subluxation is a biomechanical change in the spinal column that causes neurological dysfunction. The urinary bladder is supplied by both autonomic and somatic nerves emerging from the lumbopelvic region of the spine.” If there was a subluxation affecting the nerves that control the bladder, then correction of that subluxation could cause normal bladder function and the correction of the nocturnal enuresis.”
After obtaining informed consent from the girl’s mother, specific chiropractic care was started to address the subluxations that were determined to be present. The young girl was initially seen twice per week for four weeks, after which visits were reduced to once per week. The girl was asked to keep a diary of her progress so that she could monitor changes.
After the first week of chiropractic care, the girl reported two consecutive dry days. After her third chiropractic visit, the girl reported in her diary that she was no longer waking in the morning with fully wet pull-up diapers. After five chiropractic visits, she reported having four consecutive dry nights. The young girl was very pleased with her results as she was very happy and proud to show her bedwetting progress she had recorded in her diary. Between the girl’s 8th and 12th visit she did experience some minor setbacks due to family activity and stress. However, between her 12th and 14th visit, it was reported that she was totally dry, which represented the longest period of her life that she had experienced dry nights.
Long-term follow-ups of this girl’s case showed that she continued to remain free of nocturnal enuresis. This created a positive change in the girl’s mood and self-esteem. It was reported that she was able to participate in more frequent sleepovers with friends without the stress and fear of wetting the bed.
The Journal of Clinical Chiropractic Pediatrics (JCCP) published a review of studies in their November 2018 edition that shows that breastfeeding early in life reduces the possibility of childhood obesity. This paper reviewed previous studies on breastfeeding as it related to early obesity in children.
This study was conducted at AECC University College, Bournemouth, in the United Kingdom. The statistics of obesity in this study were from the European union, but similar, and in many cases worse statistics are true in the United States. The issues are therefore comparable on both continents and should be addressed equally on both sides of the ocean.
The study begins by noting that obesity in the European Union (EU) is increasing. Notably, England and Poland have demonstrated the steepest increases in obesity. It is estimated that each year 400,000 children across Europe are becoming overweight or obese. Evidence shows that overweight children generally become overweight adults. This then puts them at higher risks of all the health issues that arise from obesity as well as a higher risk of death from the issues related to obesity. It is estimated that in the EU around 2.8 million deaths per year result from obesity associated diseases.
The study authors point out that proper diet and exercise can correct obesity, but they concede that the implementation of this lifestyle is many times easier said than done. They also note that there is a correlation between the tendency to become an overweight child and breastfeeding early in live. They state, “Several high-quality studies indicate that breastfed children have a lower risk of childhood obesity.” Unfortunately, the researchers point out that England has one of the lowest rates of breast feeding in Europe.
The study recommendations for breastfeeding say, “It is extensively acknowledged that infants should be nourished with nothing other than breastmilk for the first six months of life and that breastfeeding should continue with the addition of complementary foods for up to and beyond two years of age.” The researchers sought to find out if lower rates of both exclusive breastfeeding and combination of breastfeeding and formula feeding could affect the increase rate of obesity in children.
Using a calculation known as the body mass index (BMI) as a common way to determine obesity, the researchers looked at a large number of studies to determine how many fit the criteria and could add insight into breastfeeding rates and the effect on obesity. In their review, they determined that 25 studies with 226,508 subjects met their criteria. Data from these studies was then analyzed to draw conclusions.
The results of the analysis of all these studies showed that babies who were breastfed for seven months or longer were 22% less likely to be obese compared to who had never been breastfed. When the researchers compared those children who had at sometime been breastfed to those that had never been breastfed, the results still showed a 15% reduction in obesity for those babies who had some breastfeeding as compared to those who had never been breastfed at all.
In their discussion the authors state that, “The answer to the research question is that breastfeeding appears to reduce the risk for childhood obesity, at least to some extent.” They continued in the study conclusion by saying, “Research suggests that early breastfeeding is protective against childhood obesity.”