“Imagine if you could exercise weak areas of the brain like you can exercise your muscles. These patients have weak neurological pathways that lead to areas of the brain not being able to communicate with each other. This loss of coordinated brain function leads to loss of the higher human function such as executive planning, language and social skills (nonverbal and verbal) as well as behavioral and academic problems. We use a neurological rehabilitation program called Sensory Motor Hemispheric Integration Therapy to exercise the weak pathways and neural circuits to bring about improved physiologic capacity and learning ability.”
–Dr. Nelson Mañé
Dr. Nelson Mañé, D.C. uses a combination of functional neurology including Hemispheric Integration Therapy as well as functional medicine and D.A.N. protocols to treat children with ADHD, sensory integration disorder and others on the Autism spectrum. All the treatments are individualized to your child’s unique situation. The treatment regimen used will be determined after an in depth history and functional neurological exam to see what best fits your child’s specific needs. Dr. Nelson Mañé, D.C. is one of the few doctors in the country using this unique approach. Read more about functional neurology, H.I.T. and the D.A.N. approach below.
Brain Based Approach
ADHD & Autism Spectrum Disorders
Our approach is a functional neurology approach based on the work of my former classmate and colleague Dr. Robert Melillo, a fellow chiropractic neurologist and PhD candidate in neuropsychology and rehabilitation and Dr. Gerry Leisman, MD, PhD. They are the authors of the textbook Neurobehavioral Disorders of Childhood, an evolutionary brain approach and Disconnected Kids: The groundbreaking Brain Balance Program for Children with Autism, ADHD, Dyslexia and Other Neurological Disorders.
We are a brain based multifaceted approach. We will determine where the dysfunction is (all aspects will be addressed with emphasis on the primary functional lesion). Which side of the brain and at which levels. Negative factors such as allergies, nutrition and environmental toxins are addressed. Then a specific program individualized to the child’s needs is developed to create positive changes based on the science of neuroplasticity and epigenetics to correct the dysfunction. This is all done without the use of global brain stimulants like Adderall, Ritalin, Vyvanse, Concerta, Daytrana, Focalin, Metadate CD. The progress is measured and periodic assessments are made. A deficiency in any functional area of sensory integration- sight, smell, taste, touch, balance, coordination or any combination can cause processing problems within the brain that may produce symptoms of ADHD or Autism.
Hemispheric Integration Therapy
Most people are aware that if you damage the brain, such as with a stroke, it affects the body. We have all seen people who have suffered strokes and have unique postures and gaits. But the system works both ways. There is feedback between the brain and the body and between the body and the brain. It is the receptors in the body that feed up to the brain. The receptors are the starting point of your nervous system. This may be something as familiar to you as light receptors in your eyes or sound receptors in your ears.
However, most input to your brain comes from less known proprioceptive receptors in your muscles and joints especially anti-gravity and postural muscles. The brain uses receptors to understand your environment for interpretation. If these receptors and the pathways leading up to the brain are not working because they were damaged or it did not develop properly, the activity level of the brain will be decreased and different areas of the brain may not communicate with each other properly.
The functional neurology approach is to evaluate the receptors and pathways to determine where the areas of dysfunction and miscommunication are occurring. We will then strengthen weak areas by exercising those pathways in the same way that one exercises their muscles. This may include visual stimulation, auditory stimulation, olfactory stimulation, vestibular stimulation, rhythm and timing exercises and cognitive exercises among others. In the end, this all has to be fused together in order to allow for multimodal processing so that the child can function at a high level.
This approach addresses both processing disorders as well as sensory integration disorders. This targeted stimulation allows the neurons to become stronger by increasing their DNA activation which in turn allows each cell to produce all the cellular contents it needs to be healthy. This increases the connections between neurons. In Hemispheric Integration Therapy we find that we must correct problems from the receptors to the brain. In addition the right and left sides of the brain must be balanced in order to allow for proper communication to take place between the different areas involved in higher brain function.
In general, more neuron connections means better brain function. Although, there are some common areas of dysfunction, this treatment cannot be standardized as child's developmental delay and sensory integration patterns are different and therefore their treatment plans must not only be different in the beginning but adapt and change as the child progresses.
The Defeat Autism Now! Philosophy:
We believe autism encompasses spectrum of disorders with multiple provoking stressors and multiple possible susceptibilities. The Defeat Autism Now! Philosophy does not endorse a set protocol for treating autism because our approach is based on paying careful attention to the unique symptoms, history, examinations and data of each child. We offer a process of choosing various options for biomedical intervention. Autism and related problems reflect dysfunction of the neural, metabolic, immune and/or digestive systems in individuals genetically predisposed to such problems as sub-optimal nutrition, food, intolerances, microbial overgrowth, metabolic abnormalities, immune deregulation and reduced ability to eliminate toxins. People with autism spectrum disorders have difficulty processing sensory, perceptual, cognitive, biochemical and immunologic messages and have faulty mechanisms for regulating, organizing, expressing, processing and detoxifying various inputs.
We believe that a combination of environmental factors may interact with genetic predispositions that are due to variations in the human genotype. Timing of the appropriate treatment is important because certain insults appear to occur at vulnerable times in human development when the brain’s neuronal network connectivity is being established.
Appropriate treatment involves identifying and alleviating the problems causing symptoms in a particular individual, rather than attempting to suppress symptoms through the use of psychoactive drugs. Our focus is on biomedical balance in the individual emphasizing two questions: Does he or she have a special unmet need that would advance healing if it were met? Does he or she have a special need to avoid or get rid of toxins, allergens or metabolic by-products?
The answers to these questions come by a careful sequential process in which the patient is recognized as the expert who, by his or her history, physical examinations, lab results and responses to therapy, helps practitioners choose the best options for each diagnostic and therapeutic step. With our patients and their parents, we conduct collaborative conversation with an abiding respect for the intelligence and intuition of parents and their children. We involve families as full participants in the search for answers and recognize that the child is often listening, even when he or she appears inattentive.
We reject one-size-fits-all strategies while including the broad range of diagnostic and treatment modalities that are appropriate to each patient. We look for ways to support nature’s strong impulse toward healing.
We also value relational, occupational, physical, speech, educational, and other external therapies, many of which become far more efficacious once underlying biomedical conditions are addressed. While our focus in on biomedical interventions, we look for opportunities to collaborate with our education, behavioral, physical, and speech therapies and colleagues.
We draw information and inspiration from the fact that autistic children are treatable by systematic means that address the need to restore deregulated biochemical and immunological processes to the virtuous pathways from which they descend. We believe that autism is also preventable by paying greater attention to environmental issues and parental health. We endorse Dr. Bernard Rimland’s position of trying to disregard our egos and remembering that most of the important elements in our understanding of the treatment options for autistic individuals have come from listening to parents.
Wikipedia Definition of Epigenetics and Neuroplasticity:
In biology, the term Epigenetics refers to changes in gene expression caused by mechanisms other than changes in the underlying DNA sequence. These changes may remain through cell divisions for the remainder of the cell’s life and may also last for multiple generations. However there is no change in the underlying DNA sequence of the organism, instead non-genetic factors cause the organism’s genes to behave differently. In plain English, ADHD and Autism are not genetic but epigenetic and therefore can be treated. If these conditions were genetic then there is no hope. But we believe they are not genetic but epigenetic and that there is hope.
Neuroplasticityrefers to the changes that occur in the organization of the brain as a result of experience. The concept of neuroplasticity pushes the boundaries of the brain areas that are still re-wiring in response to changes in environment. Neuroscientists are presently engaged in a relationship of critical period studies demonstrating the immutability of both structural and functional aspects.
In plain English, the brain is not hard wired and it’s structure and function can be changed.
What is ADHD?
The medical condition that affects how well a person is able to focus, sit for long periods of time and be attentive is an attention deficit hyperactivity disorder also known as ADHD. People suffering from this condition have problems with the parts of the brain that control attention and activity. Most commonly they have trouble with focusing on tasks and specific subjects, they may act impulsively which may lead to getting into trouble and they may appear to be hyper or “wired”. Although it is common for any person to zone out or daydream during certain activities, school or work, people suffering from this condition have such a difficult time staying focused and controlling their behavior that it affects their emotions and how well they perform such activities. The symptoms of ADHD can become less severe with age or even diminish, yet the issues with organization and attention most often remain. More than half the kids with ADHD will continue to show signs of this condition as young adults.
What causes ADHD?
Our model proposes that ADHD is actually an under functioning of certain areas of the brain as well as an under communication between different areas of the brain. If the areas of the brain that control hyperactivity, impulsiveness and attention are underdeveloped or not synchronized well with the rest of the brain, then the symptoms of ADHD will manifest. Thus, it is not that the child does not want to control his behavior but due to the under functioning or desynchronization of the brain the child is not able to regulate his impulsiveness, focus, fidgeting and hyperactivity.
ADHD Signs and Symptoms
The signs and symptoms of ADHD may show up in many different forms. The three core areas which most of the symptoms fall under are inattention, hyperactivity and impulsivity. Although most children exhibit some degree of these three categories normally. It is when the impulsiveness and/or hyperactivity go beyond the social norms that these signs and symptoms become clinical. Your child may have difficulty paying attention, he may be fidgety, and easily distracted. He may not be able to sit still or have problems with squirming in his seat and sitting still. He may be disorganized and have difficulty with doing school work, homework or chores around the house. However, it is when these activities become disruptive to the social norms that the diagnosis of ADHD is considered. Is your child so disruptive or fidgety in class that it interferes with the teacher's ability to teach the other students? Does he blurt out answers in class? Can he not wait for his turn in line? Is your child so hyperactive that he cannot sit through church service or a movie?
Facts
While medical estimates vary, it is commonly reported that ADHD affects between 5 and 10% of school age children and 3 to 4 times as many boys as girls.
It is also reported that between 50% and 60% of these children will continue to experience ADHD symptoms throughout adulthood.
78% of pediatric prescriptions are for attention issues.
Currently more prescriptions are written for ADHD than for any other childhood condition. It is conservatively estimated that over 20 million prescriptions for ADHD related drugs are written annually.
In 1995, the use of Ritalin increased by 250%.
What is Autism?
Autism is a complex neurobiological disorder that appears during the first three years of life. It impairs the ability for one to communicate and interact with others. It is defined by certain behaviors and is classified as a “spectrum disorder” affecting individuals differently and varies in degrees. It is related with routines and repetitive behaviors. Behaviors range from mild to severe. Autism was first identified in 1943 by Dr. Leo Kanner of Johns Hopkins Hospital. At the same time, a German scientist, Dr. Hans Asperger, described a milder form of the disorder that is now known as Asperger Syndrome. These two disorders are listed in the DSM IV (Diagnostic and Statistical Manual of Mental Disorders) as two of the five developmental disorders that fall under the autism spectrum disorders. The others are Rett Syndrome, PDD NOS (Pervasive Developmental Disorder), and Childhood Disintegrative Disorder. All of these disorders are characterized by varying degrees of impairment in communication skills and social abilities, and also by repetitive behaviors. With Autism being a dysfunction within several areas of the brain and body it doesn’t mean damage or disease, so just a few areas and systems may not be functioning as they could be.
What Causes Autism?
More and more research is pointing toward autism being an epigenetic disorder. This means that it is not purely a genetic disorder which can not be treated. But in fact, certain switches on the genes can be influenced by environmental factors. These are called at epigenetic triggers. These switches on the genes are influenced and can be flipped on and off by environmental factors. These multi-factorial triggers may be anything from a toxin such as mercury or lead, to prenatal and postnatal stress, delays in motor development such as crawling and walking among others. The significance is that if the switches can be flipped on they can be flipped off. This would make autism treatable.
Autism Signs and Symptoms
Although autism symptoms are varied depending on how far along the spectrum the child is. Usually, there are three core areas that typically are involved, these are social, communication and repetitive movements or limited interest. The communication aspect is usually ascertained by the age of three when there is delayed or absent speech. The “aut” in the autism refers to self. As in being by themselves, and not socially interacting with the world and others. Many times there are sensory integration issues. An increase or decrease sensitivity to various sensory input such as sight (light bothers them), sound (scared to walk into home depot), touch (doesn't like the way clothes feel on there skin, etc.) The child may stim using repetitive movements such as rocking and flapping motions of the body and hands. The child may be fascinated by certain subjects such as dinosaurs or video games. He may have a hyper focus with certain toys or pieces of toys.
Facts about Autism
1 in 150 children is diagnosed with autism
1 in 94 boys is on the autism spectrum
67 children are diagnosed per day
A new case is diagnosed almost every 20 minutes
More children will be diagnosed with autism this year than with AIDS, diabetes & cancer combined
Autism is the fastest-growing serious developmental disability in the U.S.
Autism costs the nation over $35 billion per year, a figure expected to significantly increase in the next decade
Autism receives less than 5% of the research funding of many less prevalent childhood diseases
Boys are four times more likely than girls to have autism
