1. Presentation Designed by: Eric Epstein, Ms. T., D.C. Sharon A. Vallone, D.C., D.I.C.C.P. Jean Elizabeth, Director, Kentuckiana Children’s Center Palmer Lyceum August 8, 2003 A Chiropractic Foundation and Multidirectional Approach in Treating Children on the Autism Spectrum Eric C. Epstein, Ms.T., D.C. Vice Chair Kentuckiana Children’s Center

2. A Chiropractic Foundation and Multidirectional Approach in Treating Children on the Autism Spectrum Eric C. Epstein, Ms.T., D.C. Vice Chair Kentuckiana Children’s Center

3. Founded in 1957 by: Dr. Lorraine M. Golden “Our basic philosophy will continue to be that no child will be denied the healthcare needed just because the family cannot afford the services.” Dr. Lorraine M. Golden, D.C. Founder, 1942 Palmer College Graduate Dr. Lorraine M. Golden (1918 -1998)

4. T he Mission of Kentuckiana Children’s Center is to improve the lives of children by providing a foundation for healing through integrative chiropractic care.

5. Our Vision is BIG! Healing All Children… Hope for the Whole Child

6. DID YOU KNOW? Over 1.5 million Americans are affected by autism. U.S. rate of growth over the last decade: Population: 13% Non-autism-related disabilities: 16% Autism: 173% Today 50 families in America will find out that their child has autism. (2001 F.E.A.T) "Children are one-third of our population and all of our future." Select Panel for the Promotion of Child Health, 1981

7. What in the world are Autism Spectrum Disorders? Angleman Syndrome Apraxia Asperger’s Syndrome Attention Deficit Hyperactivity Disorder Fragile X Syndrome Hyperlexia Landau-Kleffner Syndrome Pervasive Developmental Disorder (PDD) Prader-Willi Syndrome Rett Syndrome William’s Syndrome

8. Incidence and Demographics Prior to 1985, epidemiologic studies within the US suggested an incidence of autism of 4 per 10,000 children. (Prevalence of Autism in Metro Atlanta in 1996, M. Yeargin-Allsopp, et al, Nat’l Center on Birth Defects and Developmental Disabilities, CDC, Atlanta, GA 1996) From Sept. 12, 2001 to Dec. 13, 2001, 600-700 new cases of autism diagnosed in California alone, representing 7-8 new cases per day. (Autism 2001: The Silent Epidemic, F. Edward Yazbak, M.D., F.A.A.P., Dec. 13, 2001) In California, autism has surpassed mental retardation, CP, Epilepsy, and all other conditions similar to mental retardation as the #1 disability entering California’s Developmental Services System. 1 in 250 to 1 in 1000 children in the United States (Nat’l Inst of Mental Health, January 2003) Boys are 3-4 times more likely to become autistic than girls. If a family has one child with autism, there is a 5-10 percent chance that the family will have another child with autism vs. the 0.1-0.2 percent chance of a family that does not have a child with autism.

9. Excerpted from Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery, by Karyn Seroussi, published by Simon & Schuster in February 2000.

10. The diagnosis is NOT the child

11. –DAN: Defeat Autism Now! www.defeatautismnow.com –CAN: Cure Autism Now www.canfoundation.org –ARI: Autism Research Institute www.autism.com/ari –GF/CF Kids: www.gfcfdiet.com –NVIC: The National Vaccine Information Center www.909shot.com RESOURCES

12. Theoretic Etiologies Some immunologic assault occurs to an otherwise normally developing child between 1 to 2 ½ years of age Genetic Predisposition Environmental Influences

13. Theoretic Etiologies Once activated, the genetic predisposition triggers an autoimmune response. Gut inadequacy Allergy Yeast and Pathologic bacterial overgrowth Inability of the Metalothionine system to eliminate metals (mercury, lead, aluminum, etc.). Frequent antibiotic use Autoimmunity

14. Theoretic Etiologies MMR (Andrew Wakefield) Vaccines containing Thimerosol (removed from childhood vaccines as of 2001) Vaccinating a sick child Vaccinating a child who is also on an antibiotic Use of multiple vaccines in one shot Vaccine Reaction

15. S eek the wisdom of the ages, but look at the world through the eyes of a child. -Ron Wild

16. Autism Treatment methodologies are intended to: Engage the Central Nervous System Heal the gut first Provide for nutrient absorption Remove allergens

17. Autism Treatment methodologies are intended to: Reduce autoimmunity Improve social interactions Improve focusing Allow for the highest expression of life possible

18. Chiropractic Care Engages the Central Nervous System Enhances all other treatment options for ASD Encourages better social interactions Is the foundation of all treatment rendered by Kentuckiana Children’s Center

19. Pharmaceutical Intervention Chemically controls behavior Utilize SSRI’s and other potentially harmful drugs Serve to suppress behavior, not encourage normal function Sometimes necessary when behavior is dangerous and limits exposure to other treatment modalities

20. Nutrition Assists in controlling Leaky Gut Syndrome Removal of potential allergens The GF/CF diet Salicylates Artificial additives and colorings (excitotoxins)

21. Nutritional Supplementation Necessary since Leaky Gut reduces absorption of nutrients Needed for removal of mercury and other toxic metals Helps to improve behavior Helps to rebuild a brain ravaged by autoimmune reactions Supplements are prescribed in an organized fashion, never all at once, and always with attention to potential side effects

22. Occupational, Physical, & BehavioralTherapies Help to develop delayed functional skills Develop the greatest level of daily functioning Repetitive Therapies increase the ability to focus Strengthen physical experience of movement and speech Develop coordination & flexibility

23. Behavioral/Physical Intervention Social Services Sensory Integration Movement Therapy Dance Therapy Art/Play Therapy

24. CranioSacral Therapy Compliments chiropractic care Assists normal pressure dynamics of the cranium –Clenching and bruxing is predominant in ASD Allows for relaxation Normalizes the autonomic nervous system’s function Helps improve behavior Necessarily accompanies all treatments as a synergist

25. Our Patients 75% fall somewhere on the Autism Spectrum The balance of kids we see have allergies, asthma, CP, Down’s Syndrome, Tourette’s Syndrome, microcephaly, traumatic brain injury, & other neurological challenges Wellness care Children subluxate too!

26. Challenges we face… Many of our children have no spoken “language” as we recognize it or do not speak English This requires the development of alternative skills for communication –Reading body language –Interpreting sounds Does that noise mean pain? Stim? Conversation? Need? –Using dolls or stuffed animals so they can indicate with their hands what hurts, etc. –Toys, games and child appropriate equipment

27. Challenges we face… The Chiropractor may adjust or the Therapist may treat the children sitting on the floor or climbing over tables or chairs It is important to meet the child WHERE THEY ARE!

28. "The potential possibilities of any child are the most intriguing and stimulating in all creation." Ray L. Wilbur

29. Extensive Intake Evaluation Information is gathered regarding all aspects of a child’s history, from prenatal environment, through the childbirth and throughout life. Records of any clinical nature are reviewed. Collaboration with outside practitioners. Orientation with social services.

30. Initial Examination Age appropriate pediatric physical Laboratory studies such as: Trace Mineral Analysis, Comprehensive Digestive Stool Analysis, DMSA Mercury Challenge, IgG/IgE Antibody Test, others. X-ray studies when necessary Nutritional Evaluation –7-Day Diet Diary

31. Report of Findings A written report delivered to caregivers Methods Measurable Goals and Outcomes Timelines Follow up

32. Treatment Plans Designed to meet measurable goals and outcomes. Founded on chiropractic care. Include physical support therapies: –CranioSacral Therapy –Massage Therapy –Neurodynamic Therapies –Orthotic Therapy Emergencies

33. Treatment Plans Orthotic Therapy –FOOTLEVELERS continues to provide orthotics for children at KCC Nutritional Therapy and Supplementation –Nutritional counseling: GF/CF Diet, SCD, Feingold Diet –BODY BALANCE donated by Life Force International –Additional supplementation as recommended

35. Treatment Plans Typical frequency of treatment over the first 6-8 weeks consists of: –Chiropractic: 2x week –CranioSacral*: 2x week –Sensory Integration Therapy –Social/Behavioral Therapy –Movement/Dance/Art/Play Therapy*: 2x week *Choice of modality and duration of visit for supportive care dictated by specific need and condition and often based on child’s tolerance Re-evaluation at 6-8 weeks

36. Treatment Plans Continued Care Plan depends on –Response of the child and outcomes of previous 6-8 weeks plan –May include continuation of original treatment plan with an addition or change in supportive therapeutic modality(ies) May recommend an “INTENSIVE” May reduce the treatment plan –Frequency or modalities May refer out for concurrent care

37. N o children are considered... MAINTENANCE patients at KCC Each child has an optimum potential An ongoing assessment is based on careful observation and constant input from children, parents, staff, other health care providers It is our responsibility to scrutinize each child’s progress and “RAISE THE BAR” This responsibility to the child has led us to “THE INTENSIVE”

38. Intensive Care Plan An Intensive Care Plan may be created based on –Referral –Child’s initial evaluation merits intensive –Child’s response to care Has the child’s progress reached a plateau? An Intensive Care Plan consists of a daily protocol of chiropractic and supportive therapies administered in ½ day sessions over the course of 2 weeks with a graduated continuum of up to 4 weeks

39. Therapeutic Support Services include: CranioSacral Therapy Pediatric Massage Therapy Social/Behavioral Therapy Sensory Integration Therapy Movement Therapy Dance Therapy Nutritional Therapy Art/Play Therapy Parenting and Family Relations Education

40. Follow Through & Collaboration Staff Clinical Case Correlation conferences Re-evaluations to date Concurrent care with outside professionals Frequent reporting to parents to inform them about their child’s current status, treatment plan, measurable goals and outcomes

41. Hayley– age 9 Reason child came to KCC – “Alternative treatment for her Autism and Cerebral Palsy, one that involves no psychotic drugs, which the pediatrician is always quick to prescribe.” Michelle(mother) What does Kentuckiana Children’s Center mean to you and your family? KCC Questionnaire “HOPE” –Michelle (mother)

42. EDUCATION Many families come to Kentuckiana Children’s Center… AFTER…“having tried everything else” Our goal is to move Kentuckiana Children’s Center from it’s place as “the last resort” to one of the top choices of facilities providing services for the care of children with special needs

43. EDUCATION Many parents who bring their children to Kentuckiana Children’s Center have NEVER experienced chiropractic themselves New families bring their children because - they have been referred by other enthusiastic parents whose children have noticeably benefited from our care -other health professionals who may not understand what we do, but have seen the results with their patients who have been treated at the Center

44. EDUCATE… parents and children about –Anatomy –Neuroanatomy –Philosophy of Chiropractic and Kentuckiana’s Integrative Approach Optimum potential The Wellness model

45. EDUCATION Promotes… –Compliance from parent and child –Improves outcomes –Creates Referrals

46. HOPE happens because of… EDUCATION, RESEARCH & OUTREACH Kentuckiana Children’s Center’s goal is to provide a forum for education and research for the community and for the profession

47. OUTREACH It is critical for Kentuckiana Children’s Center’s staff and doctors to be involved in organizations and events that are important to our parents: –Health fairs and school scoliosis screenings – Eric (vol staff/board) –Upledger ShareCare – Pam (staff), Dona (board), Eric (vol staff/board) –FEAT – Jean Elizabeth (staff ) –Prader Willi Friends – Jean Elizabeth (staff) –BirthCare Network – Pam (staff) –YMCA – Jean Elizabeth (staff) –Play Therapy Association - Desiree (staff )

48. COMMUNITY OUTREACH Kentuckiana Children’s Center provides a community meeting room for organizations such –FEAT (Families for Effective Autism Treatment) –Play Therapy Association –Prader Willi Alliance for Research –BirthCare Network

49. OUTREACH KCC Conducts Upledger CranioSacral ShareCare Workshops for parents, caregivers and professionals

50. EDUCATION Kentuckiana Children’s Center educates community groups about the importance of beginning chiropractic healthcare early in the child’s life by showing the video Hands of Love Witnessing the Miracle of Birth Dr. Carol J. Phillips www.newdawnpublish.com This video is shown to: –BirthCare Network –Upledger CranioSacral ShareCare –Prader Willi Alliance for Research

51. EDUCATION Collaboration with Chiropractic Colleges through Preceptorships Guest lectures and seminars for colleges and state associations The annual Golden Conference In-House trainings

52. IMAGINE IF… –We were able to treat these children earlier? Younger? IMAGINE… –The benefits of beginning treatment before birth…

53. OUTREACH Kentuckiana Children’s Center provides services in the community –Lake Dreamland Project

54. OUTREACH –Scoliosis screening Schools Health Fairs Community Events

55. RESEARCH

65. We can imagine… the difference chiropractic can make in the lives of this group of young men who are burdened with so much anger in their young bodies before they become men who will enter the world and partner in parenting the next generation of children. Can You?

66. We create HOPE! hope: n. a desire for the future to be as good as you want it to be. –Cambridge International Dictionary

67. How do we do it? National and Local VOLUNTEERS –Our Board –Parent Volunteers –Doctor and Staff Volunteers –ICA Council on Chiropractic Pediatrics –ICA –ACA

68. How do we do it? Those who donate their services to Kentuckiana’s Annual Golden Conference: Dr. Dan Murphy Dr. Eric Plasker Dr. Sharon Vallone Dr. Eric Epstein Noreen Wallace, OTR/L Brenda Aufderhar, RN, CST Dr. Carol Phillips Dr.Dan Murphy (L), Dr. Eric Plasker (R) Brenda Aufderhar, RN, CST Dr. Carol Phillips Dr. Eric Epstein Dr. Sharon Vallone

69. How do we do it? Your valuable support! The Golf Mini Marathon The Golden Conference Grants and Gifts

70. How do we do it? Quarterly Newsletter Other documents available on website: – Newsletters – Annual Golf Mini Marathon – Annual Golden Conference www.kentuckiana.org

71. KCC’s Giving Levels Golden Light of Hope Leadership$5000 Guardian of Hope Leadership$2500 Heart of Hope Leadership$1000 Light of Hope $ 500 Hope $ 100 Other gift “The best investment you can ever make is in the children.” JE

72. Kentuckiana Children’s Center 1810 Brownsboro Rd. Louisville, KY 40206 502.366.3090

73. We can't form our children on our own concepts; we must take them and love them as God gives them to us." Goethe Presentation Designed By: EE/JE/SV 2003 To obtain additional copies of this presentation please call 502-366-3090.