CES has been used successfully since 1984 at Dove Ministries for Children to treat autistic populations and disorders like attention deficits, autism spectrum disorders, developmental coordination disorders, hypotonia, and sensory processing disorders. CES can address both disorders of state (arousal levels) and disorders of skill through targeted placement of electrodes. The bipolar device helps modulate disordered states of arousal, while the monopolar device improves acquisition of specific skills like social skills, language, motor coordination, and more. Differences in performance are often seen within 90 seconds of CES application.

1. CES with Autistic
Populations
Renee Okoye, MSHS, SIPT, OTR
Board Certified, Pediatrics
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2. Dove Rehabilitation Services
Sensory Integration specialists for primarily
pediatric patients, Including:
• Attention deficit disorders
• Autistic Spectrum Disorders
• Developmental Coordination Disorders
• Hypotonia
• Sensory Processing Disorders
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3. Diverse Autistic Population
• Traditional Autistics
• Asperger’s Syndrome
• Pervasive Developmental Delay
• Regressive Autism
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4. Diverse Symptoms Among Autistics
Disorders of State Disorders of Skill
• Under aroused • Auditory, visual,
somatosensory
• Over aroused processing deficits
• Self stimulable • Dyspraxia (Motor
• Gross incoordination)
disorganization • Poor social
reciprocity
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5. CES applications among
Autistic populations
At our facility, CES has been used since
1984 within the context of occupational
therapy treatment.
This is to say that the patient wears the CES
device while engaging in functional
activities that incorporate performance
components that need to be improved
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6. Each Treatment Involves
• A pre-test of performance for the day
(given that Autistics typically have variable
levels of performance on a daily basis)
• Identification of targeted skills and/or
behaviors to be improved
• Application of the CES device
• Documentation of differences seen
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7. Expected Outcomes with CES
• Used on a regular basis
– At home, twice daily during structured
activities
– At clinic visits, twice weekly during therapeutic
activities
• Differences between in pre-test and
treatment performance can usually be
noted within the first 90 seconds of the
application.
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8. Differences are Noted When
• Home program has been consistent
And
• Placement of leads is congruent with task
demands
Examples
•Language tasks with leads placed trans-
cranially on Wernicke’s and Broca’s areas
•Motor tasks with leads placed trans-
cranially on parietal and motor areas
•WITH RED LEAD PLACED FOR
DOMINANCE
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9. CES Applications
With Autistic populations we have
successfully used CES to impact
3.Disorders of state using the bipolar device
5.Disorders of skill using the monopolar
device
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10. Device
Disordered State of Arousal
Bipolar
Physically and mentally
over-aroused
Monopolar Device
Physically calm, but mentally
active - ready for learning
Physically and mentally under
aroused, poorly focused
sleep
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11. The Bipolar Device
Early research with assay of CSF showed
that the bipolar device produced twice as
much:
• Serotonin
• Dopamine
• Beta-endorphins
Neurochemicals for calming/organizing CNS
state
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12. When used with Autistic
Populations, Clinical Experience
Has Shown
Modulate the disordered state of arousal
Address acquisition of discrete skills
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13. Paul Shows Unwanted Behavior
Due to Over-Arousal
9 year old Paul has difficulty He then darts into the gym
transitioning into the clinic and seeks to hide
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14. Six weeks later
With use of the Bipolar Device
Paul is better able to organize his behavior
• Transition into and out of activities without
unwanted behavior
• Enter and sustain a more appropriate level
of arousal (Alpha State)
• Focus attention on
acquisition of skills
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15. Disorders of Skill Commonly Seen in
Autistic Populations
• Visual processing
deficits (i.e. gaze
aversion)
• Auditory processing
deficits (i.e. hyper-
sensitivities)
• Motor incoordination
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16. Use of The Monopolar Device
with Autistic Populations
Impacts skill acquisition in terms of:
• Social reciprocity and other social skills
• Decreased gaze aversion with emergence
of more appropriate visual perceptual
skills
• Improved language skills including
listening, reading, and vocal inflection
• Improved fine motor skills
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17. Use of the Monopolar Device for
Skill Acquisition
13 year old Patrick shows poor gross motor
skills involving reflex integration, balance,
and bilateral motor integration.
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18. His fine motor skills are impacted
• Oral motor coordination,
impacting articulation
• Ocular motor coordination,
impacting visual pursuits for
reading and negotiating the
environment
• Prehension patterns are
compromised as shown by his
4 fingered pencil grasp
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19. The monopolar device is applied
• Patrick uses a Monopolar Device daily at
home with his speech therapist and SIET
teacher.
• He uses it with each clinic visit at Dove.
• The site of application differs with the
various therapies and types of activities he
is engaged in
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20. When the Monopolar Device is
used during this visit
He spontaneously
looks with intent to
formulate a plan
His balance is
improved
A bi-parietal application at
Area 39 is used to enhance
integration of visual, motor,
and auditory influences He lands without
(inner language to sequence stumbling
motor output)
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21. Difference is also seen in
Fine motor skills as shown by:
• Relaxed tone through his fingers
• Individual finger function
• Emergence of a three jaw
chuck pencil grasp
• Bilateral motor integration
• Use of the left as a
stabilizing assist
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22. Differences Were Noted
• The differences shown were noted within
the first few minutes of the application
• We take this as an indication that the
potential for higher levels of performance
await additional input to the LEF’s (local
electrical fields) within the neural
pathways.
• CES appears to provide the boosted input
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23. Do the Changes Last?
• Typically, initial changes fade quickly
• With daily use as prescribed, myelination
of pathways appears to occur
• Sophisticated behaviors across all
domains (social, emotional, motor skills,
communication skills) begin to emerge
and impact overall functional performance
within the first month of daily treatment
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24. For Further Information
Feel free to contact Renee Okoye directly at
info@doverehab.com
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