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  1. 1. Early Signs of Subluxations in Infants <ul><li>High pitched crying </li></ul><ul><li>Lack of interest in things around them </li></ul><ul><li>Unusual posturing </li></ul><ul><li>Stiffness </li></ul><ul><li>Eyes crossing more than 50% </li></ul><ul><li>Feeding and swallowing problems </li></ul><ul><li>Head tilt to one side, Laying in same position </li></ul>
  2. 2. Effects of Early Subluxations <ul><li>Vertebral subluxations, or spinal traumas, can cause lasting effects on the spine such as: </li></ul><ul><li>Delicate nerve tissue can be damaged and can interfere with the brain’s ability to process and send messages to the organs, muscles, and tissues. </li></ul><ul><li>Disc & blood vessels can swell and inflame. </li></ul><ul><li>Body may create bone spurs or other abnormal growth </li></ul><ul><li>The immune, digestive, and respiratory systems may not function optimally. </li></ul>
  3. 3. Signs of Subluxations… <ul><li>Pain </li></ul><ul><li>Limited Range of Motion </li></ul><ul><li>Point tenderness </li></ul><ul><li>Neurological Changes </li></ul><ul><li>Abnormal Postural Changes such as: </li></ul><ul><ul><li>Foot flare </li></ul></ul><ul><ul><li>Toe walker </li></ul></ul><ul><ul><li>Torticollis, head tilt </li></ul></ul><ul><ul><li>Uneven shoulder height </li></ul></ul>
  4. 4. Chiropractors are the only health professionals specifically trained to detect and correct subluxations! <ul><li>Chiropractors get to the cause of a health problem. The primary focus is the detection, reduction, and correction of spinal misalignments (subluxations) with resultant nervous system dysfunction. </li></ul><ul><li>Chiropractors correct the cause of dysfunction by adjusting the vertebrae that surround the nerves and allowing proper communication between the brain and body. </li></ul>
  5. 5. Chiropractors Restore Function by Gently Adjusting the Spine. <ul><li>Chiropractic’s drugless and prevention approach to good health makes it perfectly appropriate for infants, children, and teenagers. </li></ul><ul><li>Chiropractic is licensed in all 50 states for the care of children of all ages. </li></ul><ul><li>The intent of an adjustment is to remove interference from the nervous system, thereby allowing a restoration of normal function so </li></ul><ul><li>that the body can return to a level of optimal health. </li></ul>Remember… The Nervous System Controls All Cells and Organs In Your Body!
  6. 6. How can you measure the level of function of the nervous system? <ul><li>Muscle tone & strength, joint motion, skin sensation, reflexes , & overall energy levels are affected if the nervous system is not functioning properly. </li></ul><ul><li>Additional studies and tests such as nerve testing or x-ray may reveal areas of possible irritation or malfunction . </li></ul>
  7. 7. Primitive Reflexes
  8. 8. Importance of Primitive Reflexes <ul><li>In the newborn, the nervous system is not fully developed. </li></ul><ul><li>As each primitive reflex disappears in the infant, the nervous system is continuing to mature as it becomes more organized and integrated. </li></ul><ul><li>Evidence of existing primitive reflexes beyond infancy indicates high level lesion, degenerative changes, or disorganization of neurological information at the brain stem. </li></ul>
  9. 9. Importance of Primitive Reflexes <ul><li>Research studies show that reflex reactions can provide a visible sign of the level of functioning within the Central Nervous System. </li></ul><ul><li>Reflexes can be used to assess damage, disease, and dysfunction. </li></ul><ul><li>Clusters of abnormal primitive reflexes may indicate neuro-developmental delay. </li></ul>
  10. 10. Neuro-Developmental Delay <ul><li>Able to measure immaturity in Central Nervous System. </li></ul><ul><li>Cluster of abnormal primitive and postural reflexes over age 3 ½ </li></ul><ul><li>Indicators of Neuro-Developmental Delay: </li></ul><ul><ul><li>Traumatic Birth </li></ul></ul><ul><ul><li>Cranial Distortions </li></ul></ul><ul><ul><li>Breastfeeding/Bottle Feeding Difficulties </li></ul></ul><ul><ul><li>Late walkers and late talkers beyond 18 mon </li></ul></ul><ul><ul><li>Poor hand-eye coordination </li></ul></ul>
  11. 11. <ul><li>Reflexes remain present due to a “wiring” problem in the Central Nervous System. Reflex stimulation and inhibition need to start from the spinal cord and brain stem and work towards the cortex. </li></ul>Primitive Reflexes
  12. 12. Importance of Primitive Reflexes <ul><li>In the newborn, the nervous system is not fully developed. </li></ul><ul><li>As each primitive reflex disappears in the infant, the nervous system is continuing to mature as it becomes more organized and integrated. </li></ul><ul><li>Evidence of existing primitive reflexes beyond infancy indicates high level lesion, degenerative changes, or disorganization of neurological information at the brain stem. </li></ul>
  13. 13. Primitive Reflexes <ul><li>Reflex Age Inhibited </li></ul><ul><li>Moro 2 - 4 months </li></ul><ul><li>Palmar 2 - 3 months </li></ul><ul><li>Rooting 2 – 3 months </li></ul><ul><li>ATNR 4 – 6 months </li></ul><ul><li>Spinal Galant 3 – 9 months </li></ul><ul><li>Symmetrical 9 – 11 months </li></ul><ul><li>Tonic Neck </li></ul>
  14. 14. Asymmetric Tonic Neck Reflex <ul><li>Turn baby’s head to one side and arm and leg will extend with opposite side going into flexion. </li></ul><ul><li>Important in-utero for establishing balance mechanism and increases neural activity. </li></ul><ul><li>ATNR important during the birth process to stimulate contractions and moving baby down birth canal. </li></ul>
  15. 15. Asymmetrical Tonic Neck Reflex <ul><li>Birth process reinforces ATNR as progressing down birth canal </li></ul><ul><li>Children with C-section or forceps delivery do not get ATNR reinforced </li></ul><ul><li>Higher risk for developmental delay due to immaturity of ATNR </li></ul><ul><li>ATNR persists the child may have trouble with laterality </li></ul>
  16. 16. Primitive Reflexes and Chiropractic <ul><li>A study was done in 2000 by Cherqui in which Craniosacral osteopathic intervention was carried out in children with a cluster of abnormal primitive reflexes (3 sessions in 6 weeks). </li></ul>
  17. 17. Primitive Reflexes and Chiropractic <ul><li>By re-establishing motion to the spine and decreasing irritation and excitability which resulted from the osteopathic lesions, reactivation of reflex maturation was found. </li></ul><ul><li>Reassessment of the presence of primitive reflexes at the conclusion of treatment revealed inhibition of primitive reflexes but regression of postural reflexes. This indicated that treatment started a sequence of normal development from cephalad to caudal progression. </li></ul>
  18. 18. Sensory Processing Disorder
  19. 19. Jean Ayres Sensory Integration and the Child <ul><li>“ The behaviors and academic learning of your child are the visible expression of the invisible activity within his nervous system. Learning and behavior are the visible aspects of sensory integration.” </li></ul>
  20. 20. What is Sensory Processing Disorder? <ul><li>According to the KID Foundation, sensory processing disorder is a complex disorder of the brain that affects children and the way they perceive incoming sensory information. Children and adults receive sensory input from all of our senses and it is the role of the brain to process and organize the information and to make an appropriate response. </li></ul>
  21. 21. Sensory Processing Disorder <ul><li>AKA’s: </li></ul><ul><li>Autism Spectrum Disorder </li></ul><ul><li>Pervasive Developmental Disorder </li></ul><ul><li>Cerebellar Processing Dysfunction </li></ul><ul><li>Sensory Integration Disorder </li></ul><ul><li>Sensory Modulation Disorder </li></ul><ul><li>Sensory Discrimination Disorder </li></ul>
  22. 22. Neurosensory Dysfunction and Diagnoses that Co-exist <ul><li>Autism Spectrum Disorder </li></ul><ul><li>ADD/ADHD </li></ul><ul><li>Down Syndrome </li></ul><ul><li>Cerebral Palsy </li></ul><ul><li>Bipolar Disorder </li></ul><ul><li>OCD </li></ul><ul><li>Learning Disabilities </li></ul><ul><li>Traumatic Birth and Brain Injury </li></ul><ul><li>Reactive Attachment Disorder </li></ul>
  23. 23. What do we see in children with sensory processing disorder? <ul><li>Hyperactivity and distractibility </li></ul><ul><li>Behavior problems </li></ul><ul><li>Speech development delayed </li></ul><ul><li>Poor muscle tone and coordination </li></ul><ul><li>Difficulty learning at school </li></ul><ul><li>Lack of organization </li></ul>
  24. 24. <ul><li>Abnormal sensory processing occurs because of improper communication between the Central Nervous System and the Peripheral Nervous System. </li></ul><ul><li>Neurological interference or subluxations can alter the development of the child. </li></ul>
  25. 25. <ul><li>Proper functioning of the Central Nervous System is a critical component in how we process and react to certain experiences and how we plan and organize an appropriate response. </li></ul><ul><ul><ul><li>For example, the child can have an overactive or under active response to certain stimuli like touch, sight, or sound. </li></ul></ul></ul>
  26. 26. <ul><li>Abnormal sensory processing occurs because of improper communication between the Central Nervous System and the Peripheral Nervous System. </li></ul><ul><li>Neurological interference or subluxations can alter the learning and development of the child. </li></ul><ul><li>Children with SPD have a “disruption” or “gap” in processing information between the brain and the body. </li></ul>
  27. 27. <ul><li>When a child has a disorganized response to a sensory input then it results in an imbalance within the CNS. The output response by the PNS will then in turn be disorganized. </li></ul><ul><li>The child may be hyperactive, disorganized, uncooperative or distracted. </li></ul>
  28. 28. <ul><li>The nervous system must connect like puzzle pieces. In a child with sensory processing disorder, the pieces do not fit together correctly or the child is slower than normal putting the puzzle together. </li></ul>
  29. 29. The Senses
  30. 30. Jean Ayres 1994 <ul><li>We learn through our senses. What we see, what we hear, what we touch, and what we experience through the perception of movement of our joints and muscles are our foundations for learning. Sensory integration theory is a way of looking at how the brain and the body work together to process sensory information. </li></ul>
  31. 31. The Five Senses <ul><li>We are taught that there are 5 senses by which we experience our environment: </li></ul><ul><ul><ul><li>Touch </li></ul></ul></ul><ul><ul><ul><li>Taste </li></ul></ul></ul><ul><ul><ul><li>Smell </li></ul></ul></ul><ul><ul><ul><li>Hear </li></ul></ul></ul><ul><ul><ul><li>See </li></ul></ul></ul>
  32. 32. <ul><li>Actually there are two additional senses that must work together for proper learning and social development to occur. </li></ul><ul><ul><ul><li>Vestibular </li></ul></ul></ul><ul><ul><ul><li>Proprioception </li></ul></ul></ul>
  33. 33. <ul><li>Three Senses in which Chiropractic can play a huge role: </li></ul><ul><li>Oculomotor </li></ul><ul><li>Vestibular </li></ul><ul><li>Proprioceptive </li></ul>
  34. 34. The Vestibular System <ul><li>It is the most important system as it acts as the chief regulator of all incoming information. If the vestibular system is not functioning properly it will affect all the other sensory systems. </li></ul><ul><li>It has the ability to increase or decrease the intensity of all information that is coming into the brain for processing. </li></ul>
  35. 35. <ul><li>Vestibular sensations are processed in the cerebellum and the vestibular nuclei. The sensation is sent down the spinal cord and into the brain stem for proper integration. </li></ul>
  36. 36. <ul><li>If a child has a vestibular sensory processing disorder it will affect all of the other sensory systems. Children may have a history of ear infections or tubes. They may also exhibit some of the following: </li></ul><ul><ul><ul><li>Head banging (Self correction) </li></ul></ul></ul><ul><ul><ul><li>Dizziness or nausea </li></ul></ul></ul><ul><ul><ul><li>Excessive spinning </li></ul></ul></ul><ul><ul><ul><li>Hearing difficulties </li></ul></ul></ul><ul><ul><ul><li>Balance problems or appear clumsy </li></ul></ul></ul><ul><ul><ul><li>Movement avoidance </li></ul></ul></ul><ul><ul><ul><li>Self regulation dysfunction </li></ul></ul></ul>
  37. 37. <ul><li>Children with dysfunction in their vestibular system must be checked for vertebral subluxations of the cervical spine, especially the upper cervical spine. As this area can cause mechanical irritation to the spinal cord. </li></ul>
  38. 38. Vestibular System and Spinal Manipulation <ul><li>Hikosaka & Maeda. Exp Brain Res 18:512, 1973 . </li></ul><ul><li>Cervical proprioception can influence vestibular function. Vestibular excitation of the Abducens Nerve was inhibited by contra lateral and facilitated by ipsilateral electrical stimulation of the cervical dorsal roots and facet joints at C2 and C3. </li></ul>
  39. 39. Proprioception… <ul><li>The proprioceptive system tells us where our body is in space. Proprioceptive information is received by joint and muscle movement especially in joints around the spinal cord, brainstem, cerebral cortex, and cerebellum. </li></ul><ul><li>Chiropractic spinal adjustments are important in firing joint proprioceptors. </li></ul>
  40. 40. Proprioception… <ul><li>Children with dysfunction in proprioception may demonstrate some of the following: </li></ul><ul><li>Needs to be held or swaddled </li></ul><ul><li>Avoids hair washed or changing clothes </li></ul><ul><li>Needs heavy blankets or heavy backpack to feel grounded </li></ul><ul><li>Clumsy and bumps into objects </li></ul><ul><li>Avoids team sports </li></ul>
  41. 41. Proprioception… <ul><li>The joints around the spine are the main source of movement stimulation to the brain. If there is a subluxation in the spine, proprioceptive information that the brain receives will be altered. </li></ul><ul><li>Each time a chiropractic adjustment is performed, proprioceptive information from around the spinal column is sent to the brain. Thus restoring proper proprioceptive communication between the brain and the body. </li></ul>
  42. 42. Proprioception & Spinal Manipulation <ul><li>McCouch et al demonstrated in cats that the tonic neck reflexes were mediated through the joint receptors rather than the cervical musculature. In addition to its influence on postural neck reflexes, upper cervical spine proprioception is thought to be responsible for the generation of the cervical-ocular reflex. </li></ul>
  43. 43. Proprioception & Spinal Manipulation <ul><li>Lephart PhD, ATC et al. Am J Sports Med 1997. </li></ul><ul><li>Proprioceptive neuromuscular control influences 3 levels of motor activation in the CNS: </li></ul><ul><li>1. Spinal reflexes: Muscular stabilization of joints </li></ul><ul><li>2. Brainstem motor control: Vestibular center, visual input to maintain balance & posture, and integrates info from joint mechanoreceptors </li></ul><ul><li>3. Highest level of CNS function: Provides awareness of body position and voluntary movements </li></ul>
  44. 44. Proprioception & Spinal Manipulation <ul><li>Patterson, PhD. Somatic Dysfunction in Osteopathic Medicine. The Role of Subluxation in Chiropractic. FCER 1997; 26-31. </li></ul><ul><li>Various areas of the musculoskeletal system are extensively innervated with mechanoreceptors, especially around the spinal column which seem to work as one proprioceptive organ. </li></ul>
  45. 45. Tactile (Touch) <ul><li>Touch is our first system to develop and function in the womb. Tactile input is important to determine our behavior. Inadequacies in tactile sensations can lead to difficulty in our daily routines such as dressing and eating, and later on with school activities like learning to write and cut. </li></ul>
  46. 46. Children with difficulties processing tactile sensory input may appear: <ul><li>Anxious </li></ul><ul><li>Aggressive </li></ul><ul><li>Avoids/Craves touch </li></ul><ul><li>Avoids messy play </li></ul><ul><li>Irritated by tags on clothes </li></ul><ul><li>Puts objects in mouth </li></ul><ul><li>Difficulty manipulating </li></ul><ul><ul><li>Small objects </li></ul></ul>
  47. 47. Auditory (Hearing) <ul><li>The auditory system is closely related to the vestibular system. A child that has difficulty with processing auditory input may appear: </li></ul><ul><li>Agitated with loud noises </li></ul><ul><li>Covers ears frequently </li></ul><ul><li>Talks in loud voice </li></ul><ul><li>Repeats loud sounds or noises </li></ul><ul><li>Hum or sing to drown out </li></ul><ul><ul><li>Background noises </li></ul></ul>
  48. 48. Olfactory (Smell) <ul><li>Children who have problems processing different smells may suffer from allergies. The child may try to smell everything that he touches. Typically the child will not like new clothes, new toys, or new furniture due to the new smell. </li></ul>
  49. 49. Taste <ul><li>Children who have sensory processing difficulties related to taste may be classified as “picky eaters”. The child might also eat non-edible items such as dirt, chalk, crayons, paper, etc. The child may not like getting their teeth brushed or cleaned because there is something in their mouth. </li></ul>
  50. 50. Vision <ul><li>The child may have normal vision, but may still have difficulty processing what he sees. The visual and vestibular systems must work closely together for proper learning to occur. Subluxations in the upper cervical spine and thoracic spine may cause abnormalities in proper processing of visual input. </li></ul>The spinal cord plays a role in the visual coordination of posture and the control of eye movements.
  51. 51. What do we see with sensory processing disorder of the visual system? <ul><li>Difficulty going up and down stairs </li></ul><ul><li>Poor hand and eye coordination </li></ul><ul><li>Pain or discomfort when required to do visual work (copying off the board) </li></ul><ul><li>Inability to read without losing one’s place </li></ul><ul><li>Rubbing eyes after reading or writing </li></ul><ul><li>Complaints of frequent headaches or stomach aches after working </li></ul><ul><li>Difficulty copying off the board </li></ul><ul><li>Inability to read out loud when asked </li></ul>
  52. 52. Vision <ul><li>The cervical spine and upper thoracic spine have direct neurological input going to the eyes and to the brain to process sensory information. </li></ul><ul><li>If there is a subluxation in this area of the spine, the message going to the eye or brain may be “altered”, making the processing of the visual information difficult. </li></ul>
  53. 53. What do we see in children with Sensory Processing Disorder? <ul><li>Decreased ability to organize information coming in from the senses. </li></ul><ul><li>Decreased ability to integrate information </li></ul><ul><li>Decreased ability to respond to sensory information correctly </li></ul><ul><li>Decreased ability to plan and execute actions </li></ul>
  54. 54. Sensory Processing <ul><li>Sensory processing is the ability of our brain to organize and respond to different sensations or stimuli that our body receives in order for proper adaptation and learning to occur. </li></ul><ul><li>The area of our brain that is very important in sensory processing is the BRAIN STEM. </li></ul>
  55. 55. Sensory Processing… <ul><li>Children who have Sensory Processing Disorder or any of the subcategories have problems with the regulation of sensory information. They can have an abnormal response to stimuli. The response can be either be hypo, hyper, or a combination of the two. </li></ul>