Dr. Michael Gruttadauria's Presentation

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Drive Brain Development:

Closing the GAP between your child’s developmental age and their chronological age.

Presented by: Michael A. Gruttadauria, DC, DACAN Board Certified Chiropractic Neurologist & Diplomate of The American Chiropractic Academy of Neurology

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We have a serious problem…

As of now, 1 out of every 60-100 children will develop Autism… What about next year?

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Even Worse… underlying dysfunction in biochemical and neurological systems is never identified in most children because their doctors are not looking for them!

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My Motivation

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More Motivation

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Typical Development 

Brain function develops in a baby secondary to sensory perception and movement. A baby starts to orient to sounds and his/her mother‟s voice and begins to look at objects. This is the beginning of sound and visual sensory perception.

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At the same time, the baby starts to kick their feet and move their hands. This is the beginning of motor development.

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Then the baby tries to hold their head up against gravity…this is the beginning of vestibular development. These things translate into „developmental milestones‟ (sitting up, babbling, crawling, walking, etc.) that give us cues into the nervous system‟s growth. Appropriate development of these milestones is absolutely essential to the eventual „higher functions‟ like language and communication.

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Higher Development

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AUTISM : A Brain Disorder or A Disorder That Affects The Brain? - Martha R. Herbert, MD, PhD Clinical Neuropsychiatry - 2005

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The encephalopathic features of autism may rest on chronic tissue abnormalities and maladaptive processing patterns, and may be treatable and even reversible.

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Abnormalities in autism may come from sustained neuromodulator and/or processing and connectivity abnormalities that may be amenable to reduction by properly targeted interventions.

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What Causes Autism? Neurobiological data suggests that autism is caused by late disruption of the Central Nervous System (CNS) just prior to birth, perinatally, or postnatally. (Bachevalier, 1994; Kemper and Baumann, 1993). When viewed from a neurodevelopmental perspective, this is very encouraging because it means that most all of the neurons have already been established and therefore very little neural tissue would be damaged or affected. This certainly corroborates the findings by Tsai (1989) and Kemper and Bauman (1993) that there is no gross neuranatomic involvement in autism. It may also offer much greater hope for reversing the behavioral disturbances that occur with the syndrome of autism.

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Autism: A Brain Disorder or A Disorder That Affects The Brain? - Martha R. Herbert, MD, PhD Clinical Neuropsychiatry – 2005 cont.

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Treatment targets for metabolic changes in autism may point to pathway-related interventions such as enzyme cofactors (e.g. vitamins and minerals) that are GRAS (generally recognized as safe).

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Improvement at any of these levels may alter system properties to improve brain functioning, behavior, health and quality of life for autistic individuals.

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Autism is Not a Disease, But a Series of Dysfunctions. It is NOT a psychiatric illness. 50% Neurological & 50% Biochemical The few doctors that do treat kids with autism look only at their biochemistry, not their neurology.

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Three ‘types’ of Autism 1. Baby is slow to develop from birth.

2. Baby is slow to develop, and has regression. 3. Baby is developing typically, then has a regression and loss of acquired skills.

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Neurology Brief

Average number of neurons in the brain = 100 billion Each with 1,000 – 10,000 synapses!

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The Brain Has a ‘Central Integrative State’

The sum of all excitatory and inhibitory firing. Any alteration of this CIS leads to brain dysfunction

Input and Output are balanced

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Brainstem

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We Experience the World Through Our Senses Vision

Balance

Hearing

Smell

Touch

Taste

They all converge to give us our REALITY

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What is Actually Wrong? “Likely that several functional neural loops are implicated and that all impinge on neurocognitive/social cognitive functions that are crucially impaired in autism.” –

(Gillberg 1999, Gillberg & Coleman 2000)

A „disconnect‟ between brain regions causing changes in all cortical function.

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NEUROLOGICAL DYSFUNCTION SENSORY PROCESSING DISORDER (Multisensory Dysintegration)

FUNCTIONAL DISCONNECTION SYNDROME (Cortical Hemisphericity) Sensory Processing Disorder means that the brain is having a hard time taking in all of the senses and combining them to form individual experiences or percepts. These kids usually have a mixed sensory profile with some senses being over stimulated and some that are understimulated. (ie. A child that ‘stims’, but also covers their ears to block out noise) Cortical Hemisphericity means that the two halves of the brain are not communicating as much as they should with each other, and usually one side is actually weaker than the other. ** These problems are changes in function not structure, so they are not seen on an MRI or CT Scan. They can be found by a trained clinician.

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Sensory Issues 

Picky eater - sensitive to taste or texture, maybe unable to feel the food around mouth - slowly introduce different textures around the individual's mouth, eg flannel, toothbrush, foods, introduce small portions, change texture of the food, purée it. Encourage activities that involve the mouth, such as whistles, bubble wands, straw painting.

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Chews on everything, including clothing and objects - may find this relaxing, enjoys the tactile input of the item - latex-free tubes, straws, hard gums (chill in fridge).

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Refuses to wear certain clothes - dislike the texture or pressure on their skin, turn items inside out so there is no seam - remove any tags or labels; allow them to wear clothes that they are comfortable in.

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Difficulties getting to sleep - may have difficulty shutting down senses, in particular visual and auditory - use blackout curtains, allow child to listen to music to cut out external sounds, weighted blankets.

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Finds concentrating in the classroom difficult - may have too many sensory distractions: too noisy (talking, bells, chairs scraping the floor), lots of visual stimuli (people, pictures on the wall), may also find holding a pencil uncomfortable (hard/cold) - position them away from the doors and windows, use furniture in the room to create an area free from distraction or if possible an individual workstation, try different textures to make the pencil more comfortable.

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Sensory Dysfunction  

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Ermer, J., & Dunn, W. (1998). The Sensory Profile: A discriminant analysis of children with and without disabilities. American Journal of Occupational Therapy, 52, 283-290. In this study, we compared the children with autism, children with ADHD and children without disabilities to see whether we could sort them into separate groups based on their Sensory Profile scores. We found that we could identify children into their appropriate groups with 89% accuracy based on specific scores on the Sensory Profile. Children with autism were more likely to have oral sensory processing challenges, while children with ADHD were more likely to have distractibility. Myles, B. S., Hagiwara, T., Dunn, W., Rinner, L., Reese, M., Huggins, A., & Stansberry, S. (2004). Sensory Issues in Asperger syndrome and autism. Education and Training in Developmental Disabilities, December. In this study we compared 68 children with AS and 68 children with autism to determine whether there were differences in sensory processing patterns between the two groups. For the subtests of Emotionally Reactive and Inattention/Distractibility, individuals with AS received a lower score than their counterparts with autism. The authors discuss the possibility that sensory processing may be an area to identify differences in the 2 groups.

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Sensory Dysfunction Researchers found significant differences between children with autism and peers on the Sensory Profile scores. Watling, R., Dietz, J., & White, O. (2001). Comparison of Sensory Profile scores of young children with and without autism spectrum disorders. American Journal of Occupational Therapy, 55(4), 416-423.

Children with autism had differences in sensory processing when compared to peers. Their differences occurred across all areas tested on the Sensory Profile. Kientz, M. A., & Dunn, W. (1997). Comparison of the performance of children with and without autism on the Sensory Profile. American Journal of Occupational Therapy, 51, 530537.

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Neurological Soft Signs

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Patients with schizophrenia and related psychoses have an excess of minor

neurological abnormalities (neurological soft signs) of unclear neuropathological origin. These include poor motor coordination, sensory perceptual difficulties and difficulties in sequencing complex motor tasks. Neurological soft signs seem not to reflect primary tract or nuclear pathology. It still has to be established whether neurological soft signs result from specific or diffuse brain structural abnormalities.

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We conclude that neurological soft signs are associated with regional grey matter volume changes and

that they may represent a clinical sign of the perturbed cortical–subcortical connectivity that putatively underlies these disorders.

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What is Dysfunction? Electrochemical changes within the system that changes communication between brainbody and brain-brain.

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Once Dysfunction is Identified… Then What?

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NEUROPLASTICITY AND REHABILITATION JRRD Volume 42 Number 4, July/August 2005 By Mark Hallett, MD

CONCLUSION For the future, a variety of innovative methods may well emerge that take advantage of brain’s plastic processes.

…other techniques may utilize brain stimulation methods to improve rehabilitation.

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Where Do You Start? BRAIN BALANCE Use specific sensory training on the side OPPOSITE the cortical soft signs. Light, Sound, Brushing, Deep Pressure, Vestibular Training, Balance Exercise, Mobilization, Smell & Motor Planning.

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MULTISENSORY TRAINING Developmental Plasticity Studies of neural connections indicate that afferent cells after damage can produce new connections based upon a process called synaptic reorganization. This discovery forms the bases for brain plasticity. Brauth,et al 1991; Gazzaniga,et al, 1979)

Multisensory Training requires the brain and supporting nervous system to be externally stimulated in order for growth and development to occur. This brain plasticity concept requires four important factors to be present at all times: 1. Environmental Stimuli 2. Frequent Stimulation 3. Proper Duration of Stimulation 4. Consistency

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Hebb’s Law: “Neurons that fire together, wire together.” - Donald Hebb (1949) Neuroplasticity: A phenomenon in which neurons react to changed conditions by making new connections or using existing connections in different ways.

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A new study from Temple University researchers found that children with autistic spectrum disorders who underwent sensory integration therapy exhibited fewer autistic mannerisms compared to children who received standard treatments.

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Such mannerisms, including repetitive hand movements or actions, making noises, jumping or having highly restricted interests, often interfere with paying attention and learning.

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Ongoing Cognitive Drive Focused on the use of high-tech positive reinforcement learning ‘games’ to engage a child and help them learn and grow.

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Interactive Metronome Training The goal of Interactive metronome training is to bring about lasting improvements in an individual’s fundamental information processing, planning and sequencing and attention capacities. With sufficient practice over sessions the trainee’s brain develops enhanced information processing capacity.

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Studying Autism Is Not Enough! It is time to treat it aggressively.

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Success…one child at a time

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For More Information: Contact Us Long Island Spectrum Center, Inc. 100 Manetto Hill Road Suite 106 Plainview, NY 11803 516-470-9525 www.lispectrum.com