Orion Diagnostic & Chiropractic Center - Dr. Khaled Khorshid
Chicago Ridge Medical Center
9830 Ridgeland Ave. Suite 5 - Chicago Ridge, IL 60415
Tel: (708) 288-2239

Autism and Chiropractic

By Dr. Khaled A. Khorshid

Khaled A. Khorshid (D.C., MS, M.B.B.Ch) was the former Clinic Director of Kentuckiana Children’s Center For Education, Health & Research, 1810 Brownsboro Rd., Louisville, KY 40206, (502) 366-3090/235-5239.
Dr. Khorshid’s education:
• The National College of Chiropractic: Chiropractic Family Practice, board eligible, Diplomate of American Chiropractic Internist (DABCI), ACA (300 Hours: From March, 1997 to July, 1999)
• Palmer College of Chiropractic, Davenport, IA (D.C. Degree with honors Magna Cum Laude, February 22, 1997)
• Cancer Center, University of Miami, Florida (Special Oncology Fellowship, 1981)
• Faculty of Medicine, Ain Shams University, Cairo, Egypt, (Masters Degree in General Surgery, May, 1985)
• Faculty of Medicine, Ain Shams University, Cairo, Egypt, M.B.B.Ch. Degree with Honors, December 1974 (Equal M.D. Degree in USA)
• Florida State University, a summer course; Sociology of Education, 1990

A sky-high increase in incidence of Autism was observed in both the USA (1/500) and UK (1/1000). A case study about an autistic child receiving chiropractic care in both Kentuckiana children’s Center and Oklahaven is reported here. We all know enough about Cerebral Palsy, but we may need to know more about this mysterious condition called Autism!

What is Autism?
Autism is a complex developmental disability that typically appears during the first three years of life. The result of a neurological disorder that affects the functioning of the brain, autism and its associated behaviors have been estimated to occur in as many as 1 in 500 individuals (Centers for Disease Control and Prevention 1997). Autism is four times more prevalent in boys than girls and knows no racial, ethnic, or social boundaries. Family income, lifestyle, and educational levels do not affect the chance of autism’s occurrence.

Autism impacts the normal development of the brain in the areas of social interaction and communication skills. Children and adults with autism typically have difficulties in verbal and nonverbal communication, social interactions, and leisure or play activities. The disorder makes it hard for them to communicate with others and relate to the outside world. In some cases, aggressive and/or self-injurious behavior may be present. Persons with autism may exhibit repeated body movements (hand flapping, rocking), unusual responses to people or attachments to objects and resistance to changes in sensitivities in the five senses sight, hearing, touch, smell, and taste.

Over one half million people in the U.S. today half autism or some form of pervasive developmental disorder. Its prevalence rate makes autism one of the most common developmental disabilities. Yet most of the public, including many professionals in the medical, educational, and vocational fields, are still unaware of how autism affects people and how they can effectively work with individuals with autism.

What Causes Autism?
Researchers from all over the world are devoting considerable time and energy into finding the answer to this critical question. Medical researchers are exploring different explanations for the various forms of autism. Although a single specific cause of autism is not known, current research links autism to biological or neurological differences in the brain. In many families, there appears to be a pattern of autism or related disabilities which suggests there is a genetic basis to the disorder, although at this time no gene has been directly linked to autism. The genetic basis is believed by researchers to be highly complex, probably involving several genes in combination.

Several outdated theories about the cause of autism have been proven to be false. Autism is not a mental illness. Children with autism are not unruly kids who choose not to behave. Autism I not caused by bad parenting. Furthermore, no known psychological factors in the development of the child have been shown to cause autism.

How is Autism Diagnosed?
There are no medical tests for diagnosing autism. An accurate diagnosis must be based ob observation of the individual’s communication, behavior, and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.

Since the characteristics of the disorder vary so much, ideally a child should be evaluated by a multidisciplinary team which may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or another professional knowledgeable about autism. Diagnosis is difficult for a practitioner with limited training or exposure to autism. Sometimes, autism has been misdiagnosed by well-meaning professionals. Difficulties in the recognition and acknowledgment of autism often lead to a lack of services to meet the complex needs of individuals with autism.

A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Parental (and other caregivers’) input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program. Sometimes professionals who are not knowledgeable about the needs and opportunities for early intervention in autism do not offer an autism diagnosis even if it is appropriate. This hesitation may be due to a misguided wish to spare the family. Unfortunately, this too can lead to failure to obtain appropriate services for the child.

What are People with Autism Like?
Children within the persuasive developmental disorder spectrum often appear relatively normal in their development until the age of 24-30 months, when parents may notice delays in language, play or social interaction. Any of the following delays, by themselves, would not result in a diagnosis of a pervasive developmental disorder. Autism is a combination of several developmental challenges (as in communication, social interaction, sensory impairment, behavior and possibly other disorders like epilepsy, mental retardation, or other genetic disorders).

What are the Most Effective Approaches?
Evidence shows that early intervention results in dramatically positive outcomes for young children with autism. While various pre-school models emphasize different program components, all share an emphasis on early, appropriate, and intensive educational interventions for young children. As chiropractors, we see the importance of chiropractic care to give the opportunity of the body to heal and bring back the optimum function of the central nervous system. Other common factors may be: some degree of inclusion, mostly behaviorally-based interventions, programs which build on the interests of the child, extensive use of visuals to accompany instruction, highly structured schedule of activities, parent and staff training, transition planning and follow-up. Because of the spectrum nature of autism and the many behavior combinations which can occur, no one approach is effective in alleviating symptoms of autism in all cases. Various types of therapies are available, including (but not limited to) applied behavior analysis, auditory integration training, dietary interventions, discrete trial teaching, medications, music therapy, occupational therapy, PECS, physical therapy, sensory integration, speech/language therapy, TEACCH, and vision therapy.
Studies show that individuals with autism respond well to a highly structured, specialized education program, tailored to their individual needs. A well designed intervention approach may include some elements of communication therapy.

In Kentuckiana Children’s Center (KCC) we investigate our autistic children conditions to give the best efficacy of our chiropractic adjustment. We look for any mineral intoxication, nutritional deficiency or allergy, and/or gastro intestinal abnormalities as candida infection.

Full spine adjustment (Diversified Thompson, Activator, and SOT) are the most common procedures we use in KCC. Currently, there is a research study in KCC to use upper cervical technique in autistic patients. The results of this clinical trial will be published soon.

Case Study
Lawrence presented to Kentuckiana Children’s Center (KCC), Louisville, KY, on 8/18/1999 diagnosed by ataxic cerebral palsy with Autism and developmental delay. Parents used traditional medicine only during the first years of his life. He enjoyed playing on the floor especially banging a bead maze. He was unable to crawl on the floor or stand without being held for support. He was at times difficult to engage socially. He would not always respond to his name or requests made of him. He ignored several tasks/objects, while becoming engrossed in others. Although he was about 5 years old his physical, social and communication age was 8 months, self-help and academic age was 12 months! He was not talking. He could use a walker with his brace on. He used pictures for communication. In 1999 he started ABA (Adaptive Behavior Analysis). Chiropractic care (mostly full spine adjustment)and special exercises started on 9/29/1999 with C1 (toggle), T7 (activator), L3 (div.) and Sacrum (drop). Similar adjustments twice weekly.

On 11/03/99 he was able to crawl from a room to another! On 4/05/00 he appeared more alert and in control. On 4/24/00 he showed more compliance. On 4/26/00 he showed better coordination and more control over his limbs. He started to walk with braces and support. 0n 7/12/00 he started cranio-sacral therapy in addition. He continued to improve in walking but with braces and frequent imbalance and falls. His jerky and shaky movements diminished and he became more expressive and aware of his surroundings. His motor skills improved immensely and he started taking a few steps on his own. This was a sign of miracles to his parents as his medical doctors told them that he would never walk unaided!

On 12/10/00 he received chiropractic care in Oklahaven Children’s Center in Oklahoma City, OK for two weeks. With more emphasis on upper cervical adjustments and frequent monitoring with aggressive exercise he could walk without braces. When he came back to KCC we observed his improvement in fine motor skills and alertness. He was walking, holding a bar transversely for balance. He had lots of sways and falls. Gradually, with continuation of chiropractic adjustments and exercise, (2-3 times/week) he became able to walk holding his arms transversely, for balance, instead of a bar. With time, he became able to walk with less falls and more confidence. On 1/31/01 he became able to walk without holding his arms and catching his balance instead of falling but with wobbling gate. We used to see him coming to the clinic with wobbly gait and leave without it after adjustment! Parents noticed his gait became wobbly when his adjustment was due! On 2/28/01 he became able to feed himself without help. On 3/5/01 his balance improved tremendously which improved his mood without frustration! On 4/25/01 he became walking without wobbling in and out of the clinic! Currently, he runs everywhere in the clinic with happiness and joy. He is still not talking but started few words.

            Chiropractic care is beneficial in children with special needs as this case with ataxic cerebral palsy combined with autism. This main problem in these children is neurological. Functional MRI for patients with autism showed significant difference from normal people in the activity of cerebellar, mesolimbic, and temporal lobe cortical regions of the brain when processing facial expression (2). These differences are most likely to be neurodevelopmental in origin. This may account for some of the abnormalities in social behavior associated with autism. Vertebral subluxation complex (VSC) has been found in this case. Addressed VSC in this case made significant positive changes after stationary neurodevelopmental arrest for almost 5 years. Being subluxation free, made the patient receptive to all other training (physical and behavioral). The remaining question is: which is the recommended chiropractic technique in these cases of autism? We need to research different techniques and implement the most suitable for these children with special need.

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