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Daniel Enriquez de Guevara
Viola M. Frymann, D.O., F.A.A.O., F.C.A.
President of the Board and O.C.C. Medical Director
by Viola Frymann, D.O., F.A.A.O., F.C.A.
| Is it A.D.D., is it A.D.H.D, is it the Executive Syndrome, or is it dyslexia? But does the label solve the problem? Only by looking in the past may we begin to understand the present, and develop a strategy to enhance the future. Birth is one of the most traumatic events to which many of us may be subjected. In a study of 1250 newborn babies, 10% were found to have optimal physiologic function of their primary respiratory mechanism. That is the underlying structural and functional manifestation of life itself. The outward manifestations of this dysfunction apart from the observation of distortion in the facial features, the shape of the head, or the posture favored by the baby at rest are:
As growth continues does the baby roll over in both directions and when prone (face downward) does he begin to crawl, army style, in an integrated cross pattern keeping the body on the floor? Does this progress to creeping on hands and knees with such precise integration of opposing arm leg movements that only two clear sounds are audible? Frequently however a pitter-patter of four sounds may be heard because the arm and leg are not precisely synchronized in their movements. Pulling to a standing position, cruising along furniture and finally walking alone complete the next chapter in mobility development. These stages in the development of mobility are also contributing to visual and auditory function. When crawling prone, one eye and one ear are utilized, as the arm and leg are advanced on that side. Creeping on hands and knees stimulates binocular vision coordinating two eyes to provide a clear single image in all directions and binaural hearing whereby sounds are localized from all areas. Standing introduces the vertical dimension to vision and the tracking of eyes in all directions. Language has been developing simultaneously from the reflex cry of the newborn through meaningful sounds to expressive vocalization and eventually spoken organized language. Recollection of deficiencies in any of these stages indicates some developmental neurological inadequacies which may still be manifested today if tested. In other instances however, these difficulties may not be recalled and a happy, healthy infancy may be reported. But perhaps an accident occurred like a fall down stairs, off a tricycle, or off some piece of furniture and there was only momentary loss of consciousness if any, no fracture and no apparent neurological disturbance, but gradually over a period of time certain deterioration in behavior was noted, attention was more easily distracted and the child became less cooperative. But now the children in these respective groups are promoted to Kindergarten. It is reported that they do not sit still, they talk when they should listen, they do not complete a task, they have difficulty learning letters or numbers. The pediatrician cannot provide an explanation. Eventually first grade challenges them to read, to color within the lines, to participate in group activities in the classroom or on the playground. The teacher suspects a visual problem. The ophthalmologist finds healthy eyes and 20/20 visual acuity and urges more discipline at home. Psychological stress intensifies and the child is blamed and punished when homework is a problem and school sends bad reports. As the months and years go on the academic and the psychological conditions deteriorate, self esteem goes down and an aura of hopelessness gathers. Something must be done. A stimulant drug such as Ritalin is prescribed. Performance and cooperation may improve while the drug is used, but the underlying problem has not been addressed. Consider the second child described above. An osteopathic physician evaluates the neurological developmental status and considers there is no major inadequacy. But structural changes in the head, neck, spine or pelvis may be identified and attributed to that traumatic episode. Osteopathic manipulative treatment corrects those structural problems and the behavior and academic performance improve rapidly. Such injuries may occur later in a child's life. Grades deteriorate, behavioral problems may be attributed to approaching teenage years and stress in the family grows. Osteopathic manipulative treatment will reverse this downward trend and restore optimal performance. Now consider the child who did have a difficult birth and exhibited the difficulty sucking, or vomiting or inconsolable crying. His developmental performance was less than adequate but described as "normal." His eyes are healthy, his pediatric status is described as satisfactory yet he is a problem in school and a challenge at home. The osteopathic physician will make a thorough evaluation. Problems during pregnancy, difficulties during delivery, and the immediate state after birth will be considered carefully. Developmental milestones will not only be considered historically but their performance today will be observed. Classroom activities require integrated function of the eyes in tracking a horizontal line of print or a vertical column of figures and in accommodating the focus from the writing on the board to transcribing it on the desk. These skills will be tested and visual perceptual dysfunction will be recognized if present. A thorough physical and structural examination will be made and the consequences of a long labor or difficult delivery will be identified. Another area requiring close attention is that of nutrition for many foods included in the typical American diet also contribute to the learning and behavior problems. A consultation may be recommended with a neurological developmentalist and a developmental optometrist as well as a program of osteopathic treatment to address the structural inadequacies. As a result of this multi-disciplinary approach very gratifying changes may occur without the use of the standard stimulant medications, and this child will be on the way to achieving optimal well-being and performance. |
by Shawn Centers, DO, FACOP
| Autism in children is an important subject of current study. It is often in the news as scientists and medical researchers discuss their work hoping to find its source. Osteopathy can provide enormous help in understanding and dealing with this disorder in children. This article is provided to give an osteopathic perspective to parents about the causes of autism and treatment possibilities for their autistic children. Statistics indicate that the number of reported cases of autism is increasing in the United States. In the past 10 years, according to the California Department of Developmental Services (CDDS), there was a nearly 1000% increase in cases. Last year the department reported a 31% increase from 2001 to 2002. In the last 12 months the CDDS reported nearly 3,577 new cases of severe autism in California. Worldwide statistics show similar increases. The Problem: Mainstream medicine offers few, if any, solutions for autistic children or their families. Many medical practitioners still consider it a psychiatric disorder, a form of mental illness caused by cold, uncaring parents whom they term "refrigerator mothers." In the past they believed it was a type of infantile schizophrenia and treated these children with shock therapy, isolation, and extremely potent antipsychotic medications such as Respirodol and Prozac. These forms of treatments sedate the patient without treating the underlying problems. Major medical universities spend millions of dollars each year looking for genetic causes of autism but there is much data suggesting environmental causes. Certainly, autism may have a genetic component; however, the sharp rise in the number of cases suggests that genetic factors are not the sole or even major cause of this condition. In genetic diseases, the number of cases stays constant from year to year with only minor variations. With a 1000% increase in 10 years or a 32% increase in cases over one year, the evidence for genetics as a primary cause of autism is weak. What then may cause autism? Xenobiotics are foreign substances found in the natural environment. They include: Polychlorinated Biphenels (PCB's), pesticides, insecticides, sodium lauryl sulfate, and heavy metals. They are found everywhere from Antarctica to the pristine lakes of the Swiss Alps, where residents have the highest PCB levels in the world (as well as one of the highest autism rates). Xenobiotics are found in our water supply and in the human body. They enter the body through food, soaps, and, in some cases, vaccines. Nearly 80% of xenobiotics are untested for their carcinogenicity or their potential for damage to the human nervous system, yet they are prevalent in our society. For example, sodium lauryl is found in many children's shampoos, soaps, and toothpastes. Xenobiotics are known carcinogens and possible neurotoxins. Recent studies at the University of Georgia Medical College show that it is absorbed in the brain, heart and liver. However, more research is needed to determine the effects of other xenobiotics. Heavy metals such as cadmium, arsenic, aluminum, and mercury, common in the environment, can have severe effects on young nervous systems. Mercury and Aluminum One potential problem is the mercury and aluminum contained in childhood immunizations. In 2001 the law firm of Waters & Kraus acquired a confidential report authored by the Centers for Disease Control. The CDC scientists investigated autism as a potential neurological injury caused by mercury in childhood vaccines. The confidential study demonstrated that an exposure to more than 62.5 micro grams of mercury within the first three months of life significantly increases a child's risk of developing autism. Children with the exposure were more than twice as likely to develop autism as children not exposed. Today many children receive 187 mcg of mercury in the first 6 months of life. When Congress investigated mercury levels in vaccines in 1998, they found the cumulative mercury dose was nearly 18 times the level considered safe by the Environmental Protection Agency. The EPA's safe level was determined by studies of children of the Faeroes Islands whose mothers were eating mercury-tainted meat. The Faeroes children's' blood averaged four times the EPA's daily "safe" dose (0.1 micrograms per kilogram) and exhibited measurable neurological deficits seven years later. American children were receiving four times that dose by the age of six months. Aluminum, which is a known neurological toxin, is also found at high levels in vaccines, making it another component in possible vaccine toxicity. Since January 2005, California requires all vaccines to be thiomenosol free, whenever possible. Some vaccines, such as the flu vaccine are impossible to make without mercury. Birth Trauma:The Most Common Cause of Developmental Delays by Viola Frymann, D.O., F.A.A.O., F.C.  In at least 80% of children with developmental delays, including attention deficits and autism, there is a history of traumatic birth. In each diagnosis there are manifestations of various aspects of cerebral dysfunction, which in simple terms mean that the brain is not functioning as efficiently as it should.The brain is contained within the bony skull, which at the time of birth is designed to accept the temporary compression of the birth canal, and expand fully when the baby cries immediately after birth. The lower end of the central nervous system is located within the sacrum, the large bone forming the back of the pelvis. This, too, is designed to absorb the compressing forces of the contracting uterus, and then be restored by bodily movements after birth. The vertebral column protects the spinal cord connecting the head and the pelvis. Problems of labor and delivery may compromise these structural areas and thus disturb the nervous system within, thus interfering with its physiological development. Any of the following could be problematic: * False labor before real labor began * Premature rupture or leakage of membranes * Induction or acceleration of labor by use of medication * Presentation of baby in other position than face down * Very long (>18 hours) or very rapid (<3 hours) labor * Epidural anesthetic * Forceps or vacuum extraction * Cord around the baby's neck one or more times * Severe slowing of baby's heart * Period of uterine inertia, i.e. contractions stopped or slowed * Cesarean section delivery because of lack of progress The condition of the newborn baby or infant can also provide evidence of the health of its nervous system. Signs of potential difficulty: * Delay in sucking of more than 24-48 hrs. * Vomiting or spitting up after feeding * Arched back or throwing head back when held on mother's shoulder or lying on the side * Asymmetrical motion of arms or legs * Spells of inconsolable crying Lack of sequence or missing stages in motor development going from: rolling over, crawling flat on floor, creeping on hand and knees, cruising around furniture, and walking at approximately one year Any of these signs in the baby suggest that some areas of the central nervous system have been comprised. It is true that sucking may be established in a day or two or more, and that vomiting may stop in a month or two. The arching of the back and extension of the head may be less obvious when progression is made to standing and walking, but then toe-walking may be apparent. Children of school age who manifest problems may already have been subject to a variety of medicinal interventions. They may also have perceptual dysfunction's that interfere with visual and auditory skills. These children are in dire need of structural treatment to restore the musculoskeletal integrity of the whole body. A comprehensive osteopathic approach with precise, gentle, restorative manipulative therapy can help these children immeasurably. The general level of well-being, as well as neurological function, will significantly improve. Adjunct therapies, such as visualand auditory perceptual training, tutoring and a well-balanced diet of whole, natural foods, perhapswith carefully selected supplements, will then be far more effective. Structural dysfunction resulting from birth trauma can be corrected early so that neurological development progresses satisfactorily. Then academic, behavioral and developmental problems can be averted by establishing or restoring optimal anatomic-physiologic integrity. Therapeutic measures can teach a child how to use the body efficiently. When you have your next baby, have an osteopathic physician evaluate and treat you, the mother, during pregnancy in order to reduce any possible complications during labor and then provide a though evaluation of your baby during the newborn period. This is the essence of prevention. Common Problems of Newborns by Viola Frymann, D.O., F.A.A.O., F.C.A.  The area of the baby's head that leads the way out of the birth canal is the occipital area, the back of the head. It is the area that will take the brunt of obstruction if there is a delay in delivery.When there has been a long delivery, perhaps sixteen, twenty or twenty-four hours for a first baby, or even after twelve hours for a later baby - and sometimes we find mothers who havebeen in labor for several days, or perhaps even more important, there has been a period of false labor before the real thing began. False labor can be particularly damaging because the contraction is occurring and the baby's head has nowhere to go because the birth canal is not opening. So the baby is being compressed from above and below. It is the occipital area that takes that impact. That is where the hypoglossal nerve to the tongue and the vagus nerve to the digestive tract pass out through the skull. These are the areas that are the first to show the stress of the birth. One of the most important questions we can ask is, "Did your baby have any trouble vomiting, spitting up?" If the answer is "yes" then we know that there was some degree of a problem in this area at birth. Within the occiput also is that large opening through which the whole brain stem becomes the spinal cord. All of the nerve pathways that go to every structure in your body below the base of the skull must pass out through that hole in the occiput. Therefore, if the occiput is deformed by such pressures as we have described, the injury to the nervous system may vary all the way from the child who has mild spitting up to the child who is hyperactive, the child who is uncontrollable, who is aggressive, who eventually goes on to have learning problems, behavior problems and the whole gamut. So this is a most critical area, the area that we always look at when we look at newborn babies. Then we consider the skull as a whole. The skull is made up of some twenty-six bones. At this age some of those bones are in several parts. Therefore, the potential for compression in one or more areas is quite great if there was compression in the pelvis on the head during birth. An osteopathic physician’s hands are feeling hands, they are monitoring hands. They are not pushing things around. They are monitoring how that mechanism inside is working and how we can go with it to permit it to release areas of restriction. The temporal bone, that bone which I mentioned as carrying the ear, may also be compressed because it is very close to the occipital area. It is not unknown to find that the baby has its first ear infection at a few weeks of age. When that is so it suggests that the problem may have arisen from the trauma of birth. When that mechanism begins to move freely then the child recovers from the recurrent infections. When the head is compressed from the front backwards, a compressive force, which we will find particularly if the baby who was reversed in the birth canal. It was a posterior occiput rather than an anterior one. This sort of compression jams the skull at the center of its base.  At birth the occiput is not just one bone, as it is in the adult. In the infant the occiput is four bones because it is not yet fully developed. That large hole of the foremen magnum, through which the brain stem passes, is circled by developing parts of the occiput.The area of the base of the skull that becomes compressed is the area we are primarily concerned with in our small babies. The problems we find there may continue and cause difficulties later in life. The sooner you treat the baby the easier it is, but you never say "there is nothing that can be done." No matter how much or how little progress is made, progress is worthwhile. Life is always in motion. Life is always getting better or it is getting worse. We may not work as frequently; we may work for an intensive period to get over the major problem, then watch that the progress we have made is maintained, but let's go back again. What we do in the process of a treatment is just like unlocking the door so now those who are inside can move around. We have permitted progress to occur. Down's Syndrome (Congenital Hypopituitarism) by Viola Frymann, D.O., F.A.A.O., F.C.A. The child with Down's Syndrome is a very special person who reveals a purity and simplicity of life that is unique. He or she is a different human being, not a pathological one. Initially, he may have to make considerable adjustments to fit into this world as his physical body may have some specific needs. Some of these children are born with heart defects. Modern open-heart surgery in infancy has provided a full and long life for many. The particular anatomical form of their head, nose, sinuses predisposes to respiratory problems. However, if the nutritional program is specifically designed to meet their needs, and mucus producing foods are omitted this susceptibility can be minimized. The hypermobility of their joints and extraordinary flexibility of their body must not be confused with weakness for they soon become remarkably strong in body and will. The osteopathic manipulative treatment of these children enhances the overall level of well being by stimulating and bringing about harmonious interaction within the endocrine system. Restoring inherent physiologic mobility within the cranial and facial mechanism overcomes the tendency to nasal sinusitis and other respiratory conditions. An imbalance of the eye muscles may be noted as a rapid side to side motion (NYSTAGMUS) or an over convergent squint (STRABISMUS). Osteopathic contribution to the welfare of children with Down's Syndrome is not to make them as other children, but to enable them to achieve their optimal potential, to attain a high level of general good health and to grow into the unique and special people they are designed to be. Ear Infections by Viola Frymann, D.O., F.A.A.O., F.C.A.  During the years from birth to five years, the child is checked regularly by the pediatrician concerning his ears, throat, eyes, heart, lungs, digestive tract. In other words, is this child's body functioning efficiently?Many children get ear infections. The ears are examined and if the infections have occurred a number of times there may be a hearing test performed, and various tests that zero in on the ears. But the ear isn't something sitting out there in space. The ear is part of a total mechanism in this body. For example, the ear itself is held in what we call the temporal bone. (If you feel just behind your ear you will feel a somewhat pointed bone, which is the mastoid process.) From the inner part of the ear, that is known as the middle ear, the Eustachian tube extends into the throat. Therefore, what goes on in the throat has a bearing on what goes on in the middle ear, and vice versa. Not infrequently the problem may begin as a sore throat, a cold, and it progresses to an ear infection. Therefore, the state of the throat and the state of the ear are very intimately related. Let's come back to the temporal bone for a moment. The temporal bone articulates, or is connected to most of the other bones of the head, directly or with one bone in between. So, if this child has had a fall on the back of the head in which the articulation between this bone and the occipital bone at the back of the head has been jammed, the bones cannot move freely, one in relationship to the other. Perhaps at the time of the injury the child cried for a little while, had a bruise there or a swelling, and it passed. A few weeks later an ear infection develops. If you stop to think about it, you will find the ear infection has developed on the same side on which the head injury occurred. The blood supply to the ear by way of the arteries, the venous drainage from the ear by way of the veins, and the lymphatic drainage is impaired if that normal, rhythmic mobility of the temporal bone is interrupted. If there has been an injury it has interfered to some degree with the inherent mobility of that bone. Furthermore, if the child fell on the back of the head, that fall may have disturbed the alignment of the bones of the neck. The blood supply passes through the neck up into the temporal bone. So the ear problem is not confined to the ear. It may be related to certain things that have happened in levels below the ear. Now we begin to see that we cannot localize ear infection in an ear because it is tied in to other parts of the body. Of course, the circulation begins at the heart and ends at the heart, so anything between the heart and the temporal bone may be a factor in that circulation. The lymphatic drainage is associated with certain structures in the neck, going all the way down to below the collar bone. Anything in this area may have a bearing upon that ear infection. It is not uncommon to get the story that this child has had ear infections over and over again. Perhaps the first ear infection occurred when he was six weeks of age. He was treated with an antibiotic, he got over it; two months later there was another ear infection. He was treated with antibiotics, he got over it and six weeks later there was another ear infection, and so it has gone on, perhaps for several years, one after another. At some point the parents decide there must be some other way. Also, by this time the child may have reduced hearing in one or both ears. This is the time to go back structurally and inquire whether there is any evidence of injury at birth which may have started the process, and whether there had been any injuries since then to which the child is now responding with this susceptibility to infection. Early Evaluation Prevents Future Problems by Viola Frymann, D.O., F.A.A.O., F.C.A.  Dr. Viola Frymann, President of the Board and O.C.C. Medical Director of the Osteopathic Center for Children & Families, believes that every child should be evaluated and treated immediately after birth. That is preventive medicine at its best. The sooner the child can be treated the sooner optimal motion can be established in the body. The sooner the respiration and circulation can be optimized, as well as the movement of the central nervous system, the sooner the ill effects that may have occurred during the birth process will be reduced. This does not mean that problems may be totally eradicated if they are sufficiently severe, but they can be reduced.First of all, I would like to talk a little bit about Osteopathy in general. I would like to enlighten you about the differences between the way in which a medically trained physician thinks and the way an osteopathically trained physician thinks about a problem. When your child was born it was, first of all, evaluated by the pediatrician. He was looked at to make sure there was no congenital defect, either externally visible or invisible, such as perhaps in his lungs or the heart or the digestive tract, and also to make sure that all the systems were functioning efficiently as they should be. As osteopathic physicians we are looking at something more when your baby is born, because we recognize that the process of being born is probably the most traumatic experience that most people ever have. In the study of 1250 newborn babies it was demonstrated that 10% have a healthy freely movable cranial mechanism. In other words, all of the bones of the head are in correct relationship and moving as they should. This is a figure that has been consistent in several studies which have been done on newborn babies. The number of babies that have a gross, visible disturbance in the cranial mechanism - the sort of deformity that you can see across the room - that number may be somewhere about 8% or 10%. What about the other 80% of babies born -- that group in which the problem can be detected by an osteopathic physician trained to feel these minor difficulties within that mechanism. They may not be presenting major clinical problems at this age. The child may be spitting up. The child may have had a little difficulty learning to suck, a difficulty that passed in 24 to 48 hours perhaps. The spitting up may continue for days or weeks sometimes, and very often the story we hear is, "Well, it was assumed that the milk didn't agree with the baby," so perhaps the mother decided to stop breast feeding and try a formula. In many instances that didn't solve the problem, and after several tries, some cereal was put into the formula to make it a little thicker, and often that appeared to solve the problem. The fact that the baby was spitting up in that early period after birth, or that the baby did have difficulty learning to suck, is very important to us from a diagnostic viewpoint because it tells us that there was a degree of compression within the baby's head that irritated two of the important nerves that come out of the base of the skull -one being the 12th nerve, the hypoglossal nerve, which is responsible for the activity of the tongue and therefore is important in the sucking process, and the other the 10th cranial nerve that is very much concerned with the activity of the digestive tract at this age. Those two symptoms may be very important pointers to the problem at that time. During the years from birth to five years, the child is checked regularly by the pediatrician concerning his ears, throat, eyes, heart, lungs, digestive tract. In other words, is this child's body functioning efficiently? Many children get ear infections. The ears are examined and if the infections have occurred a number of times there may be a hearing test performed, and various tests that zero in on the ears. But the ear isn't something sitting out there in space. The ear is part of a total mechanism in this body. For example, the ear itself is held in what we call the temporal bone. (If you feel just behind your ear you will feel a somewhat pointed bone, which is the mastoid process.) From the inner part of the ear, what is known as the middle ear, there is the Eustachian tube which extends into the throat. Therefore, what goes on in the throat has a bearing on what goes on in the middle ear, and vice versa. Not infrequently the problem may begin as a sore throat, a cold, and it progresses to an ear infection. Therefore, the state of the throat and the state of the ear are very intimately related. Let's come back to the temporal bone for a moment. The temporal bone articulates, or is connected to most of the other bones of the head, directly or with one bone in between. So, if this child has had a fall on the back of the head in which the articulation between this bone and the occipital bone at the back of the head has been jammed, the bones cannot move freely, one in relationship to the other. Perhaps at the time of the injury the child cried for a little while, had a bruise there or a swelling, and it passed. A few weeks later an ear infection develops. If you stop to think about it, you will find the ear infection has developed on the same side on which the head injury occurred.  So the ear problem is not confined to the ear. It may be related to certain things that have happened in levels below the ear. Now we begin to see that we cannot localize ear infection in an ear because it is tied in to other parts of the body. Of course, the circulation begins at the heart and ends at the heart, so anything between the heart and the temporal bone may be a factor in that circulation. The lymphatic drainage is associated with certain structures in the neck, going all the way down to below the collar bone. Anything in this area may have a bearing upon that ear infection. It is not uncommon to get the story that this child has had ear infections over and over again. Perhaps the first ear infection occurred when he was six weeks of age. He was treated with an antibiotic, he got over it; two months later there was another ear infection. He was treated with antibiotics, he got over it and six weeks later there was another ear infection, and so it has gone on, perhaps for several years, one after another. At some point the parents decide there must be some other way. Also, by this time the child may have reduced hearing in one or both ears, so they are looking for some other answer. This is the time we go back structurally and inquire whether there had been any evidence of injury at birth which may have started the process, and had there been any injuries since then to which the child is now responding with this susceptibility to infection. This brings us to the first aspect of the osteopathic concept, the osteopathic approach towards the patient, and that is that we are looking at a whole patient. We are not just looking at the point which is producing symptoms and calling your attention to it. What is there in this whole child which is resulting in manifestation in a local area? The manifestation may be a neurological disturbance. This may be the hyperactive child who can't sit still through a meal, who can't sit still in school, who can't sit still period. The more the parents or the teachers say, "Sit still or you will go to the principal if you don't sit still!" All that does is make matters worse. I wonder if any of you have a condition which is known by the title, "restless legs?" Have you ever sat in a theater and thought you just couldn't keep your legs still? And if someone had said to you, "Don't you dare move!" that would have made you much more susceptible to moving. So it is with this child who has an inherent neurological dysfunction which makes it impossible for him to be still. The more we try to pressure him to be still, the more restless he becomes. There are many measures used to help these children. One may be to give them some medication, but the medication doesn't make them sit more quietly, it dulls their intellectual awareness. They may sit still and therefore learn more to some degree, but they are not functioning at their capacity because the drug is dulling their awareness. That is a stop-gap measure. It hasn't done anything about the hyperactivity itself. In fact, the longer the child takes the drugs the more difficult it is to break the habit because when the drug is stopped the child becomes more hyperactive than when the drug was introduced in the first place. What is the cause of the hyperactivity? Why does the child have to keep moving as if he is driven? Because he utilizes an external activity to make up for severe restriction in the inherent motion of these cranial bones and therefore all the structures that are related to them. They have to produce outside activity in order to make up for lack of internal activity. It is not one area of the central nervous system that is involved, but the brain is in contact with every part of the nervous system in the body, and therefore we are concerned with the whole patient and not just one little area. What we really are talking about is whole people, whether they be little people or big people, and recognizing that the structure of the body is intimately related to the way it functions. We might compare the body to a watch - not one of the electronic ones but the old fashioned variety that had a lot of wheels and gears in it. If your watch started losing or started gaining, or perhaps even stopped, and you took it to the watchmaker you didn't ask him, "Which wheel is it that is causing the trouble?" He probably would say to you, "Well, your whole watch needs overhauling so we can put it together so that every part works properly." The body is like that too. It isn't just one piece that needs to be oiled and put back. The whole body needs to be integrated. The structure of the body is causative, it is integrated. Childhood is a time of falls, injuries. We are not only concerned with falls that broke bones or locked the child out or put him in the hospital. We are concerned with any injury that happens to affect a critical part of this moving mechanism, and the only sign you may notice that it did that is that your child is less amenable to your directives. The tendency is to think he's naughty. As one osteopathic physician used to say , "Don't punish your children; treat them." You will find that when you treat them they change, and sometimes they change in an instant. Some of the children come into the treatment room acting as if everything is wrong, they don't want any toys, don't want to play, don't want anything done. All of a sudden, when that mechanism begins to move, "Can I have a toy, please?" It is absolutely phenomenal because it happens so fast. Once the key turns and the mechanism begins to move freely the child becomes himself once more. It isn't always as simple as that because it may not have been just the last injury. It may have been an accumulation of injuries that have occurred, one after another, over several years, so it doesn't always resolve immediately. But the principle is the same. It is that interrelationship of structure and function and the unity of the body functioning as a whole. It is not a series of isolated, independent parts. The body has within it the process which heals itself. If that is true why haven't all your children been healed long ago? I'm sure you have all had the experience of a cut on your hand. Perhaps it was a deep cut, perhaps it required some suturing and a dressing put on it. Then you were told to come back in five days for the doctor to take out the stitches. The doctor didn't heal the cut. Who did? You did. You healed your own cut. But sometimes, if something is not functioning properly in your body you will go back at the end of five days and the cut has not healed. The same may be true of a broken bone. The bone breaks, the surgeon approximates the two ends as closely together as he can and then he mobilizes it in a plaster cast. He usually gives the instruction to come back in six weeks. It will probably be healed. But sometimes it isn't healed in six weeks. Sometimes it isn't healed in sixteen months because something is not working in the body to permit that inherent healing process to take place. As osteopathic physicians we are very conscious of that inherent healing process. That healing process is not only concerned with knitting a bone together, healing a laceration or overcoming an infection. It is also concerned with moving the body structure. Probably many of you have had the experience of doing some unaccustomed hard work, such as working in the garden once in three months. By the time you went to bed every bone in your body felt as if it were out of place. But you went to bed and relaxed in sleep and by the morning most of that was gone. Who did that work? You did. That inherent force in your body which is working to bring it to its optimum function did it. But if the strain or the restriction in that free motion has gone beyond a certain point, then the body needs a little help in overcoming it. However, if we can work with what the body is striving to do we shall get there much faster. Therefore, much of what we do is not visible. By that I mean we are not forcefully manipulating the body in this way and that way. We are detecting how that body wants to move, how it is striving to overcome its restrictions and then just giving it a little help to do so. These are the three primary concepts upon which our practice is actually based. They are not just philosophical ideas in our heads which we agree to, they are actual working concepts - (1) the interrelationship of structure and function, (2) the recognition of the totality of the body, and (3) the inherent force within the body. Now, how do we do it? That is the $64,000 question, isn't it? The first process is getting acquainted. Still in the process of getting acquainted we are running our fingers over the various joints between the bones in the head to find out whether there is any over-riding of any of the bones, whether there is any hardness or irregularity, whether one is pushed up against the other, and also whether there is any asymmetry of the head, any imbalance in the structure of the bones of the head. Then we move down to the spinal area. We come down the neck and then we come down through the thoracic area, the rib cage, and the vertebral area and down into the lumbar area. After that we evaluate the lower extremities, the hip joints, knee joints and ankle joints. Then we evaluate the sacrum. The sacrum is that large bone that you can feel if you put your hand behind you (it's about the size of the palm of your hand in an adult). In the infant that is still five bones, not just one. The rhythmic motion of the sacrum is brought about with breathing. Every time you breath you move that sacrum between the pelvic bones. I place one hand on the sacrum and my other hand is on the pelvic bones, evaluating how the sacrum moves within the pelvis. This is the way in which we balance the pelvis and sacrum and we can balance the lumbar spine at the same time. This area is very important because as the baby is descending through the birth canal the head is opening the birth canal but the pelvis, the buttocks, gets the pressure as the uterus contracts down on the baby. If for some reason the baby doesn't descend smoothly and progressively through the birth canal as the baby's spine has to negotiate its way around the mother's spine, and if it gets held up in that position this may tend to produce a sidebending in that lumbar spine. This does not show itself outwardly at this age because this baby isn't standing. The spinal curve may not show itself until the baby begins to stand, but if we can pick it up by feeling it, by palpating it at this age and taking care of it (it only takes about 60 seconds) we can take out that twist which has become locked in there through the birth process. Next we evaluate the head area. Sometimes, in order to keep a little baby quiet and happy, it either nurses or sucks on the bottle while it is being treated. The area of the baby's head that leads the way out of the birth canal is the occipital area, the back of the head. It is the area that will take the brunt of obstruction if there is a delay in delivery. When there has been a long delivery, perhaps sixteen, twenty or twenty-four hours for a first baby, or even after twelve hours for a later baby - and sometimes we find mothers who have been in labor for several days, or perhaps even more important, there has been a period of false labor before the real thing began. False labor can be particularly damaging because the contraction is occurring and the baby's head has nowhere to go because the birth canal is not opening. So the baby is being compressed from above and below. It is the occipital area that takes that impact. That is where the hypoglossal nerve to the tongue and the vagus nerve to the digestive tract pass out through the skull. These are the areas that are the first to show the stress of the birth. One of the most important questions we can ask is, "Did your baby have any trouble vomiting, spitting up?" If the answer is "yes" then we know that there was some degree of a problem in this area at birth. Within the occiput also is that large opening through which the whole brain stem becomes the spinal cord. All of the nerve pathways that go to every structure in your body below the base of the skull must pass out through that hole in the occiput. Therefore, if the occiput is deformed by such pressures as we have described, the damage to the nervous system, the injury to the nervous system may vary all the way from the child who has mild spitting up to the child who is hyperactive, the child who is uncontrollable, who is aggressive, who eventually goes on to have learning problems, behavior problems and the whole gamut. So this is a most critical area, the area that we always look at when we look at newborn babies.  Then we consider the skull as a whole. The skull is made up of some twenty-six bones. At this age some of those bones are in several parts. Therefore, the potential for compression in one or more areas is quite great if there was compression in the pelvis on the head during birth.An osteopathic physician's hands are feeling hands, they are monitoring hands. They are not pushing things around. They are monitoring how that mechanism inside is working and how we can go with it to permit it to release areas of restriction. The temporal bone, that bone which I mentioned as carrying the ear, may also be compressed because it is very close to the occipital area. It is not unknown to find that the baby has its first ear infection at a few weeks of age. When that is so it suggests that the problem may have arisen from the trauma of birth. When that mechanism begins to move freely then the child recovers from the recurrent infections. When the head is compressed from the front backwards, a compressive force, which we will find particularly if the baby was reversed in the birth canal. It was a posterior occiput rather than an anterior one. This sort of compression jams the skull at the center of its base. At birth the occiput is not just one bone, as it is in the adult. In the infant the occiput is four bones because it is not yet fully developed. That large hole of the foremen magnum, through which the brain stem passes, is circled by developing parts of the occiput.ee. The area of the base of the skull that becomes compressed is the area we are primarily concerned with in our small babies. The problems we find there may continue and cause difficulties later in life. The sooner you treat the baby the easier it is, but you never say "there is nothing that can be done." No matter now much progress is made, progress is worthwhile. Life is always in motion. Life is always getting better or it is getting worse. We may not work as frequently; we may work for an intensive period to get over the major problem, then watch that the progress we have made is maintained, but let's go back again. What we do in the process of a treatment is just like unlocking the door so now those who are inside can move around. In other words, we are permitting the central nervous system to perform to a better standard and it will improve that standard progressively. The treatment is only the beginning of the process. It is now permitting that inherent therapeutic potency to do what it couldn't do before. Children tend to fall, bang their heads, so we treat them at regular intervals to make sure that none of these things (which are relatively minor) have been permitted to take them back one step instead of forward one step. Risk Factors Contributing to Overuse Injuries In Sports by Brett P. Thomas, D.O. Intrinsic (Anatomical) * Musculoskeletal malalignment * Musculoskeletal inability * Inflexibility of muscle * Muscle weakness Extrinsic (Training Errors & Equipment Problems) * Improper training technique or biomechanics * Changes in training technique * Changes in training environment or terrain * Inappropriate equipment or poorly fitted equipment * Increase in training frequency, intensity or duration (Note: Osteopathic manipulation is a valuable tool for the prevention and treatment of sports injuries.Ensuring that the body’s musculoskeletal system is in proper balance and alignment can prevent injuries. Once an injury has taken place, it is wise to be evaluated and treated osteopathically to quicken healing time, prevent chronic injuries and help the young athletes reach their fullest potential and enjoy all of their sports endeavors.) Treatment for Sports Injuries by Brett P. Thomas, D.O. Osteopathic manipulation is a valuable tool for the prevention and treatment of sports injuries. Ensuring that the body’s musculoskeletal system is in proper balance and alignment can prevent injuries. Once an injury has taken place, it is wise to be evaluated and treated osteopathically to quicken healing time, prevent chronic injuries and help young athletes reach their fullest potential and enjoy all of their sports endeavors. When the athlete, at any age, sustains an injury in a particular area, he/she should remember the RICE-O treatment for injuries! Rest Ice Compression Elevation Osteopathic evaluation and treatment Young Athletes and Sports Injuries by Brett P. Thomas, D.O. Osteopathic manipulation is a valuable tool for the prevention and treatment of sports injuries. Ensuring that the body’s musculoskeletal system is in proper balance and alignment can prevent injuries. Once an injury has taken place, it is wise to be evaluated and treated osteopathically to reduce healing time, prevent recurrent or chronic injuries and help the young athletes reach their fullest potential and enjoy all of their sports endeavors. An injury I sustained in high school changed my whole life. I sprained my right ankle severly in an attempt to get a rebound while playing basketball. This was the same ankle that I seemed to sprain one or two times a year. Four weeks later the swelling had disappeared but at times I still had a slight ache.After I was treated several times with osteopathic manipulation the tenderness was gone and I have never sprained that ankle again since! The success of the manipulative treatments I received, led to an interest in osteopathic manipulation and its role in treating athletes.  Chronic joint or muscle pain can develop and affect us in ways that are not always initially realized. When an athlete twists or sprains their ankle it not only affects the ankle but also the foot and leg, the hip, the pelvis, and even the back and head for the body is a dynamic integrated unit of function.A strain in the tissue called “fascia” which surrounds the muscles usually occurs with a sprained ankle. The fascia can be corrected by proper manipulation. If the fascia tissue is not treated then the area can have decreased blood circulation, ligamentous weakness, decrease range of motion and persistent tenderness. Even if there is not tenderness in the area of the injury, the ankle sprain could make an athlete susceptible to other injuries such as knee injuries. This is because the remaining twists in the fascia tissue can cause a decrease range of motion of the muscles which then can lead to muscle weakness and/or muscle spasms. Since muscles connect to bones, the muscle spasms or muscle weakness can cause bones of the human body to move out of proper alignment and balance which can lead to other injuries. An osteopathic physician has the medical training in musculoskeletal diagnosis and treatment which can relieve the strain of the fascia tissue, increase circulation to the area and correct malalignment of the musculoskeletal system. The prolonged use of muscles caused very small tears in my muscles which led to overuse injuries. Osteopathic manipulation was able to help decrease the inflammation in the area and helped balance the muscle and tissue strains in the area. In my case, the ankle injury led to a shoulder problem because I insisted on playing tennis. I had changed the motion of my tennis serve in order to avoid aggravating my slightly tender ankle. This change in tennis technique lead me to use muscles that were not used to vigorous exercise. A young athlete involved in collision sports (such as football, snowboarding, soccer) or a young athlete who is involved in a prolonged sports training is more vulnerable to overuse injuries. Overuse injuries deal repeated microtrauma to soft tissues or bones. The cumulative affects of these very small injuries can lead to stress fractures, Sever’s disease (common in soccer and running sports), Osgood-Schlatter disease or Little League elbow (elbow pain and decrease range of motion).Young athletes are more vulnerable because the epiphyseal plate (growth plate) is weaker than the surrounding tissues. The prolonged use of muscles caused very small tears in my muscles thus causing the overuse injuries. Osteopathic manipulation was able to help decrease the inflammation in the area and helped balance the muscle and tissue strains in the area. Minor injuries can have many prolong affects on the young athlete. There are several things that a person should do to prevent injuries: * Have an Osteopathic physician diagnose and treat all musculoskeletal abnormalities regularly. * Stretch muscles before and after exercising. * Improve sport technique. * Purchase appropriate athletic equipment. (Make sure it’s the right size!) * Plan a proper training regimen with attention to intensity and duration. * Exercise opposing muscles. When the athlete, at any age, sustains an injury in a particular area, he/she should remember the RICE-O treatment for injuries! Rest Ice Compression Elevation Osteopathic evaluation and treatment by Robert B. Sanet, O.D., F.C.O.V.D. and Carl G. Hillier, O.D., F.C.O.V.D. What is Eyesight? What is Vision? Eyesight, which involves the ability of the eye to distinguish small details, is only one component of eye vision. Guide to Classroom Vision Problems Vision is the result of the child's ability to interpret and understand the information that comes to him through his eyes. Many children can demonstrate 20/20 sight and still have a critical and interfering vision problem! It has also been shown that the informed parent and/or teacher make the very best "screening instruments" for identifying those vision problems that tend to cancel the teacher's efforts in the classroom. Vision and Learning Many children and adults continue to struggle with learning in the classroom and the workplace. It has been estimated that 75% of all classroom learning comes to the student via the visual pathways. If there is any interference with these pathways, the student will experience difficulty with learning. Learning is accomplished through complex and interrelated processes C one of the key aspects is vision. What Visual Skills Are Needed For School Achievement? Vision is a fundamental factor in the learning process. People at risk for learning-related vision problems should receive a comprehensive optometric evaluation. The role of the optometrist when evaluating people for learning-related vision problems is to conduct a thorough assessment of eye health and visual functions, and communicate the results and recommendations. The three interrelated areas of visual functions are:
Eye movements require the highest level of movement precision. Well-integrated eye movements allow for rapid and accurate shifting of the eyes along the lines of print in a book, quick and accurate shifts from desk to chalkboard, and sure visual tracking in sports. Inadequate eye movement control will cause an individual to lose their place when reading, have difficulty copying from the blackboard, and skip or omit small words when reading. Accommodation - Focusing Ability Rapid and automatic visual focusing is essential to efficient performance. Visual focus is also directly related to the ability to sustain visual attention. Focusing deficiencies will increase the time necessary for copying from the blackboard, induce visual fatigue and/or avoidance of close work, and result in reduced reading comprehension. In addition, visual focusing difficulties will make it more difficult for an individual to focus their attention and will contribute to attention deficit hyperactivity disorder. Binocular Integration - Eye Teaming Ability The human visual system is designed so that the eyes and their reciprocating muscles can work to such a high degree of teaming that the two eyes perform as one. This skill is intimately related to eye movement control and focusing ability. Deficiencies in eye teaming will cause an individual to use excess effort when focusing for reading and writing and will reduce their ability to sustain visual attention. Visual-Motor Integration (Eye-Hand Coordination) Skill in eye-hand coordination is essential to accurate and stress-free writing and to efficient performance in sports. Deficiencies in eye-hand coordination will make handwriting more difficult or fatiguing, and may also affect overall sports performance. Visual Form Perception Form evaluation skills allow for immediate and accurate discrimination of likeness and differences and the ability to reproduce and generalize forms. Deficiencies in visual form perception may result in difficulty recognizing or confusion of similar words. Visual Intake - Visual Memory Obtaining maximum visual information in the shortest possible time provides for optimal performance. The ability to retain this information over an adequate period of time is essential for reading comprehension and spelling. Dysfunctions in visual intake and visual memory may cause difficulty recognizing the same word on the next page and reduced reading comprehension. It will also result in prolonged time copying assignments and difficulties transferring information from one place to another. Back to top How Are Visual Problems Treated? Unresolved visual deficits can impair the ability to respond fully to educational instruction. Management may require optical correction, vision therapy, or a combination of both. Vision therapy, the art and science of developing and enhancing visual abilities and remediating vision dysfunctions, has a firm foundation in vision science, and both its application and efficacy have been established in the scientific literature. Optometric treatment for a vision dysfunction may include the use of lenses, prisms, visual training programs, and developmental vision guidance. In addition, specific recommendations may also be made concerning general health and nutrition. What Are The Clues To Look For When A Visual Problem Is Suspected? These symptoms may indicate that you or your child has a vision problem? Physical Clues
For further information concerning the prevention, early detection, and correction of learning-related vision problems, contact: Osteopathic Center for Children 4135 54th Place San Diego, CA 92105 (619) 583-7611 / Fax (619) 583-0286 San Diego Center for Vision Care 7898 Broadway Lemon Grove, CA 91945 (619) 464-7713/FAX (619) 464-7668 Parents Active for Vision Education (P.A.V.E.) National Headquarters 9620 Chesapeake Drive, Suite 105 San Diego, CA 92123 (619) 467-9620 / FAX (619) 467-9624 (800) PAVE-988 College of Optometrists in Vision Development (C.O.V.D.) P.O. Box 285 Chula Vista, CA 91912-0285 (619) 425-6191 / FAX (619) 425-0733 Optometric Extension Program Foundation (O.E.P.) 1921 E. Carnegie Avenue, Suite 3L Santa Ana, CA 92705 (714) 250-8070 / FAX (714) 250-8157 |
Newborns (as a vital link in prevention)
by Viola Frymann, D.O., F.A.A.O., F.C.A.
Very soon after my first course in Osteopathy in the Cranial Field where Dr. Sutherland was still lecturing once a day I was fired with enthusiasm to examine newborn babies. Over the next eight years I examined over fifteen hundred babies at a local hospital. All were examined within the first five days of birth for that was the standard duration of the hospital stay after delivery in the 1950’s. Many were seen within 24 hours of birth. Eventually the results of this study were published revealing the startling fact that approximately 10% of the newborn babies had perfect, freely mobile cranial mechanisms. Another 10% had had such severe trauma to the head that the diagnosis was obvious even to the untrained observer as the baby with the crooked head or plagiocephaly (the Greek word for a crooked head). But what about the remaining 80% who had some strain patterns in the cranial mechanism? They were relatively easy to correct in a few minutes.During the same era A.P. Warthman D.O., was examining elementary school children in the Detroit region for a particular school district. I was impressed that the strain patterns that he was describing in the children with academic problems were the same strain patterns that I was finding in the 80% of the neonates who did not have severe visible trauma yet were not in the perfect group. Would it be possible then to PREVENT the academic problems in elementary school, by correcting the strains present in the newborn? Eventually my hospital closed its maternity wing, and ultimately the hospital had to close its doors for the last time.
Now I turned my attention to the question of whether it was possible to identify something peculiar to the child with learning difficulties. The detailed analysis of the history and physical findings in two hundred children, one hundred of which were having learning problems in school revealed that the stresses of a long or difficult birth were almost invariably recorded in the histories of such children. When trauma occurred after about 3 years of age the child might have visual perceptual dysfunction which impaired the ability to follow a line of print smoothly and efficiently, or the ability to quickly adapt from distance vision on the board to near vision on the desk, or the skill to maintain a clear visual image in all directions without a “lazy” or wandering eye, but this child would not have the difficulty in learning.
At the time of birth all the nerve cells are present in the brain, but the nerve fibres progressively acquire a vital myelin sheath as the nerves develop their function. The child begins to move, to roll over, to crawl on the floor, to creep on hands and knees, to stand, to walk, to talk and do all the other activities known to small children. This progressive growth in function of the nervous system occurs within the precise formation of the skull. The skull is a mold in which nervous structure and function develops. Therefore optimal structural and functional integrity of the head permits optimal development and function of the central nervous system.
The conclusion then, is that if the osteopathic physician can evaluate, and if necessary correct the structure of the baby as soon after birth as possible many of the problems of childhood may be avoided.
This is PREVENTION at its best.
For this reason we encourage all mothers to give their new babies the opportunity for an osteopathic evaluation and treatment as soon after birth as possible.
Smart In Everything But School?
by Robert B. Sanet, O.D., F.C.O.V.D. and Carl G. Hillier, O.D., F.C.O.V.D.
20/20 Is Not Enough!
Studies show that 20% of school age children have a problem which interferes with learning.
Many people mislabeled as lazy, dyslexic, or attention deficit disorder (ADD) may actually be suffering from an undiagnosed Learning-Related Vision Problem. This may be true even though they have 20/20 sight!
Symptoms of Learning Related Vision Problems
* Loss of place when reading
* Skipping, re-reading, or substituting words
* Confusing similar words
* Difficulty retaining what is seen or read
* Failure to recognize same word in next sentence or page
* Reversal of letters in reading or writing
* Smart but working too hard to keep up
* Poor handwriting
* Short attention span
* Headaches
* Blurred or double vision
* Frequently rubbing eyes
* Achievement below potential
What Should Be Done?
A comprehensive Learning Related Vision Evaluation is the only way to determine if a child or adult has a visual problem which is interfering with learning.
Individualized Diagnostic Approach
The doctors at The San Diego Center for Vision Care - P.C. have specialized training to evaluate vision as it relates to academic achievement.
This comprehensive vision analysis includes an in-depth evaluation of visual tracking, focusing, eye coordination, and the underlying visual-perceptual and visual-integrative abilities necessary for efficient learning.
Individualized Therapeutic Care
Written reports are provided and personal conferences are scheduled so that all concerned will understand the evaluation results and the treatment recommendations.
Treatment may include visual stress-reducing lenses, a program of Optometric Vision Therapy, and the structuring of the classroom and home environment for maximum visual learning.
Optometric Vision Therapy is individually designed to meet the patient's specific visual needs. The length of the therapy program will vary depending upon the type and severity of the visual problem.
What is Optometric Vision Therapy?
Optometric Vision Therapy is a treatment program designed to eliminate visual problems, reduce visual stress and discomfort, and increase visual performance. Optometric Vision Therapy develops the visual abilities necessary for more efficient learning and performance in all areas of life. Scientific research and more than 60 years of clinical experience have proven Optometric Vision Therapy to be extremely effective!
Help At Any Age!
Many of our patients in Vision Therapy are adults with symptoms when reading or with visual problems which make learning more difficult. Symptoms may include slow reading speed, loss of place, visual fatigue, blur, headaches, reduced comprehension and difficulty concentrating.
Interdisciplinary Approach
Communication and inter-referral with other professionals ensure that the patient receive comprehensive care. Reports and specific recommendations help the classroom teacher meet the patient's specific visual needs.
Bright Futures Optometric Vision Therapy develops better vision for more efficient learning. When the Learning Related Vision Problem is remediated, the child's or adult's vision is more efficient at processing information and learning is easier.
Steps You Can Take at Home
by Viola Frymann, D.O., F.A.A.O., F.C.A.
A program of monthly meetings was instituted at the Osteopathic Center for Children & Families to provide informative lectures on various aspects of the work of the Center allowing for plenty of time for questions, discussion and valuable contributions from other parents whose personal experiences helped the newcomers. These were essentially extemporaneous talks, sometimes illustrated with slides, and occasionally with practical demonstrations of a child being examined or treated. These were not written lectures but from time to time a zealous parent would make an audiocassette for her friends. A few of these tapes were transcribed. I trust you will read them as if you were sitting in a group of parents eager to learn what happens to “my child” at the O.C.C. and how can this approach help him?
The subject I would like to discuss today is, “What can I do at home?” What we do in the Center is only a small part of the whole program. What we do in one-half hour a week needs to be supported by what you do on the twenty three and a half hours on that day and all the rest of the days between your visits here. In addition, there are acute episodes that come up and parents so often wonder, “Well, what can I do right now to cope with these acute episodes?” So I thought we might talk about a few of these things. Perhaps, as we go along questions will occur to you so don’t hesitate to interrupt if you have a question.
First of all, why do acute episodes occur? This is rather a fundamental concept of disease and health. We often seem to act as if these various bugs are floating around in the air and all of a sudden they decide to settle somewhere. If you happen to be the one they settle in, that’s just too bad. So you pull out some kind of shotgun to destroy that invader. We tend to say, “Well, he caught something,” and so you try to find something to combat the bugs. Isn’t that just about how it comes over to you most of the time?
Did it ever occur to you to ask yourself, “What is the purpose of this acute episode - the cold in the head, tonsillitis, digestive upset or whatever - what is the purpose of it? What is it there to accomplish? Is it just there to irritate the patient and distress the parents? Can we look at these acute episodes as a healing experience?” The body is trying to bring about a change, and, therefore, it has to produce a sort of eruption of some kind within the body’s physiology in order to bring that about. Have you ever thought of a child’s cold in the head as a healing episode?
A. No, I consider it somewhat of a nuisance. It just causes more trouble. (from the audience)
I agree it is inconvenient. Yes. That’s not the question. There are many things in life that are inconvenient but a lot of good may come out of them, nevertheless. Let’s consider for a moment why we tend to get colds. We get colds very frequently when our resistance is lowered,perhaps from wandering from good food or not getting enough rest or being under great stress. The cold takes us out of circulation for perhaps 24 or 48 hours, and forces us to rest, forces us to pour fluids into the body and so we begin to get better.
These acute episodes can if they are handled wisely, form stepping stones to better health. Let’s look at some of the symptoms that occur. Fever: It is universally taught via that box you have in your house, namely the TV, that if you have a fever you take something to lower the fever, Tylenol, aspirin, whatever. The first thing is to lower the fever. But the fever is one of the body’s efforts to combat the infection. The fever is the manifestation of the body’s immunity at work. The child who is sick without a fever gives us far more concern than the child who is sick with a fever. If the child doesn’t have a fever when there should be a fever, that indicates that the body is not putting up the resistance that is necessary in order to overcome this problem. I’m not talking about the fever that goes up to 104-106, I’m talking about the average fever of 101, 102, 103 which accompanies in most instances the flu, ear infection, the common infectious diseases of childhood. The fever is very important. So we do not address the fever, we address the cause of the fever, which is a different approach.
How about pain? What should we do about pain? The pain of an ear infection or a throat infection? It is generally assumed, often naturally so, that heat is more comforting than cold. The very thought of heat is much more soothing than is ice. Ice has the effect of stimulating the active circulation, whereas heat draws passive congestion. Just imagine for a moment that you soaked your finger in a cup of hot water - for 10 or 15 minutes. What would it be like when you took it out of the water? It would be swollen, red, probably throbbing, and it would be stiff. Is that what you would want to produce in your child’s ears or your child’s throat? He has enough congestion there already and that is why it hurts. If we can use ice or a cold compress, which means a cloth wrung out of ice cold water, in the immediate application you disperse the blood in the area, but almost immediately there is a reaction in the body that brings active circulation into the area, and that active circulation is part of the healing process.
If, in the event of an earache you use an application of cold instead of heat, it will have helped the process to turn around and begin to clear. If you use heat you tend to increase the congestion and in the end make the infection worse. Never use heat by itself. We may sometimes use heat alternated with ice to enhance the difference between the two.
I had one teacher who used to say, “Before you start treating the patient, get him to throw the heating pad out.” The only thing the heating pad is good for is keeping your feet warm in bed at night, but not to put on some local area of your body. That is also true for sprains, whether it be a back or an ankle. Put ice on it, put cold on it, and the swelling will be decreased, you will increase the motion, and it will begin to feel better.
Keep one of the ice packs which you can buy for the picnic basket in the freezer. Then you will always have a cold application if and when needed. It will be much more convenient and easier to use than ice. If there is an acute throat infection, wring a cloth out of ice water and wrap it around the neck. It is cold as it is put on, but as it draws the circulation into the area it becomes hot, very hot. You will often find that as the tonsils get better you will see a little rash on the skin, which is showing you the direction of the body’s reaction. In a very short time the rash on the skin disappears.
If, at the very first sign of a sore throat, you push the fluids, wrap a cold pack around the throat, you will find very often that in 24 hours it will be gone. Put cold fruit juices on the inside of the throat and cold packs on the outside.
What about sinus infection? The same basic principle applies. Just place the ice pack across the face. At first it may be difficult to bear the cold. It may be only a few minutes at a time, but you will begin to feel the congestion breaking up.
These suggestions don’t mean that you are going to be able to solve every problem at home. But if, instead of acting as if it weren’t there, you proceed actively at the beginning with the measures of pushing the fluids, applying the cold applications locally and encouraging rest, many of the minor problems come under control without any major complications. The longer you leave it untreated the harder it is to clear it.
Now let’s consider the relationship of injuries to acute episodes. Very often an acute episode will follow an injury of some kind, either immediately or a week or two afterwards. Some of the things we talked about in the past probably led you to begin to understand why this is so.
Never forget that the body is put together like a delicately designed piece of machinery, and every part of the body is designed to move, to move in relationship to every other part. You have a very delicately integrated, moving piece of machinery. And if something happens to that moving machinery and interferes with its free motion in some area, that in turn interferes with the circulation of arterial blood, the drainage of venous blood, the drainage of lymphatic fluid from the area and the actual motion of the area itself. That, in turn, produces stasis or stagnation in the area, it permits congestion to occur and then it becomes a fertile field for any organism that is in the area.
We find not infrequently that a child has a blow on the head and, before very long he is complaining of an earache. At that point the earache may not be an ear infection; it may be a congested ear, the ear drum may look red, but it is a response to the fact that the temporal bone which holds the ear has become reduced in its normal physiologic motion. If that structural problem can be corrected the earache disappears. This is not uncommon. So if you begin to think of the injury and the effect, and the child does come down with an earache or acute infection, just think back to what has happened in the last two or three weeks which might be a factor contributing to this.
Let us consider another sort of manifestation of acute episodes. That is an asthmatic attack. An asthmatic attack can be a very frightening experience. It is usually more frightening for the parents than for the child. Children tend to take these crises in stride much better than their parents do. We have found that children who have had a fall landing hard on the buttocks, will often precipitate an attack of asthma if they have a predisposition.
One little boy we have treated, who had a lot of asthma before we saw him, had been doing very well and I hadn’t seen him for nine months. One day his mother called to say he had suddenly developed an acute attack of asthma. I asked her if he had had any injuries, and she said no, he hadn’t. I asked her if she were sure he hadn’t had any injuries. When he came in I said to him, “Have you sat down hard somewhere?” He said, “Yes,” and I said, “What did you do?” He said, “I fell off the donkey.” “Didn’t you tell your mother?” “No, because I wasn’t supposed to be on the donkey.” So you may not always know the injury that preceded that is causing the trouble.
We are not concerned only with respiratory problems like the colds or the asthma or the flu, sore throats, but there are gastrointestinal upsets - the acute diarrhea, the acute vomiting episode. Here it is important to think about what has precipitated this. With little children who are just beginning to get onto solid food, this may be a reaction from pushing them onto the solid food a little too fast, and so a very good rule for introducing new foods to babies is to do it in very small amounts. Give one teaspoon of a new food once a day for three days. If that is acceptable and causes no adverse effects, gradually increase the quantity. Then introduce one teaspoon of another new food once a day for three days. Thus over 15 days you will have introduced five food which are now well tolerated. This is a good rule when you are introducing any new food to children. Then you will find you won’t get to that point where they just refuse to eat it. Later make sure they get a little taste of whatever food you are serving. Making it a little harder to get makes it more desirable.
There are some very simple home measures which you can use to help an acute episode of vomiting or diarrhea. If it continues to go on, a very valuable remedy is in the water in which brown rice has been cooked. Feed that at about one teaspoon every ten minutes. It is important that you don’t give more at any one time because if you put a volume of fluid into the stomach it will come right back. Then follow the rice water with some of the brown rice, which can be pureed in the blender or through a sieve, with just a touch of honey to make it a little more tasty and feed that, again in very small quantities. This is for vomiting primarily.
With diarrhea, the body is probably trying to get rid of something which shouldn’t be there. One cause of diarrhea in small children is that the food which has been given to them is not prepared finely enough. The body does not yet have the equipment to digest it, or maybe they don’t chew it adequately. Corn is one thing that will often be found almost unchanged. That means the child should not be having corn because the body cannot yet handle it. It is too coarse for this body to cope with. The same for raisins or any coarse food which the child does not digest. These foods should be ground or soaked or pureed until the child’s body can handle them.
Once you have addressed the cause of the problem, the rice water and the rice may be very helpful here too. Another valuable remedy is to take a ripe apple and scrape it with a spoon, so that it is the consistency of apple sauce but it is a raw apple. Then, when you are over the acute phase, use Meusli. The Meusli is an old, old recipe that comes from Switzerland, which was used by the shepherds in the mountains, and it is still available in almost every cafe in Switzerland. It is a staple food, and by no means a unique health food. Its basis is raw oats that have been soaked to which is added apple and banana, raisins and some ground nuts, a little lemon juice and a little honey. This is a wonderful food for quieting down digestive difficulties at any age in life. Any chronic distress in the digestive system or even an ulcer can be helped by a steady diet of Meusli, even for several weeks at a time, with absolutely fantastic results in quieting down digestive difficulties.
In the immediate post-war period in England there was a representative from Switzerland who came to the Hospital for sick Children in London, which is renowned throughout the world for its expertise in solving children’s problems. He treated children with celiac disease which is a severe disturbance of the digestion of foods which occurs in children. Their measure for treating these children was the use of Meusli. This work was not published for one simple reason: all the children got better. That’s not possible according to the usual standards - that every child would have got better.
Why is it that simple measures can be so profoundly effective in these episodes? It is because the healing process comes from within the body, not from outside the body. We don’t heal anybody, neither do you. It is the patient who heals himself. All we do is give him a little assistance, set the stage, clear away the things that were in error and permit the healing process to take place.
I can’t emphasize enough how important it is to realize that the child has the capacity to overcome his problem inside himself if we will set the stage and create the circumstances in which he can do so.
All of the minerals in the body must be in balance. Calcium must be in relationship to phosphorus and vitamin D so the body can absorb it. If one is missing you may not be utilizing something else. We can see children who are not utilizing calcium, who have calcium deposits in their hair which are a thousand times more than they ought to be. It is not that they are not getting enough calcium, it is that their bodies are not doing the right thing with the calcium.
Here we come back again to how the body is functioning on the inside to make the best use of what we put into it.
Let’s consider another area of factors which may manifest themselves in illness in the child. They come under that very broad heading of “stress.” Stress may be directly on the child, as for instance, a parent who is too demanding - demanding performance that is perhaps beyond the age or the capacity of the child. The pressure may be at school or the child may believe that there is pressure for performance. Sometimes I talk to parents about this and we hear, “No, we have never bugged him about grades.” But if I talk to the child, he says, “Well, I’d better get good grades or I will get into trouble.” That may or may not be true but it is how he perceives the parents’ approach toward his performance in school. Sometimes we need to look at ourselves through the eyes of our children. How do they interpret what we say or what we do to them? That is what influences their reaction to circumstances.
How often do you praise your child? How often do you tell him how good he is? How often do you tell him how bad he is, how naughty he is, how incorrigible? If you were to turn a tape recorder on in your house for a few hours and listen to what is said, you might learn a great deal about the way your family functions. That is one of the best therapeutic measures that I know of. Just let a tape recorder run when nobody knows it is on, and then play it back. You will be astonished at what you hear, but you will learn so much. You will find, I’m sure, as most of us do, that he says this, .she says that, and I say this. And the script rarely changes because we don’t hear the script. We only feel motivated to react to this or to that in an endeavor to shut them both up and it doesn’t work.
The stress that is put on a child is sometimes quite unconscious, and more seriously, unrecognized. If we can look through a mirror at ourselves and all the circumstances that surround this child we will find out where the stress is coming from.
There may be stress on the child which is indirect, which isn’t directed to the child at all. There may be stress between the parents or between the parents and the grandparents, or stress between the parent and somebody who takes care of the child. The child is in the middle there, and receives that tension that is around him. Children are like reflectors of their parents, and particularly their mothers. I’m sure you have had the experience that when mother isn’t feeling very well the children are unbearable. It is not the child’s fault, it is because the security which is the center of that family has suddenly been pulled out and they are trying to make the best they can of it. Mother is the central figure in the child’s security. Father contributes to it, yes, but you will find that mother being sick or mother being pulled out of the family is a major problem for that child, whether it be for a day or for a much longer period.
If parents are in conflict, this reflects on the child. How does the child deal with difficult or unpleasant circumstances? If the child has a problem at school - he’s not getting along very well with the teacher - what do we do about it? Do we talk to the teacher or to the principle and endeavor to have the child removed from that teacher? We often do that. Just project into the future another fifteen years, when your child has a job and he doesn’t get along very well with his boss. Is Mother or Dad going down to talk to the president of the firm and say, “Well, he didn’t get along very well. I think we’d better move him.” You know what he will say, don’t you? That’s the end of that job.
When do we start to deal with difficult or challenging or uncomfortable circumstances? Can we help our child to handle a difficult situation at school? Can we teach our child to recognize that perhaps this teacher has some problems at home, that this teacher is doing the best he can under the circumstances? Or is this teacher challenging the child a little bit more than he thinks he can handle, but will in the end, produce performance in this child which wouldn’t have been produced otherwise?
It is a well known fact that the teacher you remember is the teacher who demanded performance from you. You may have thought at the time that he was mean. Those are the teachers you remember, aren’t they? Do you remember the teachers who were very kind and sweet and who put up with anything you did? You can’t even remember their names in many instances. The teachers who demanded performance - these we remember. In the great majority of instances, it isn’t the teacher who is the problem, it is learning how to cope with a difficult situation. This doesn’t mean that we don’t have to make sure there is nothing of a more serious nature. If we can teach a child how to deal with a difficult or challenging situation he won’t be stressed by it and he will have learned a very important lesson in how to deal with the problems he will be confronting later in life.
Praising a child, accepting a child, encouraging a child is so important, no matter where they stand in life. If a child is handicapped he needs all of the acceptance, the encouragement, the stimulation we can give him. You know we all thrive on praise. If someone is constantly beating us down with “Well, you didn’t do this and why didn’t you do that, pick up your clothes, and wash your face,” and are constantly at it, none of us does very well under those circumstances. We need praise, we need some one to tell us we did a good job, or we tried hard and have done better today than we did yesterday. These are the things that make children strive to do better.
Another problem, which sometimes is unavoidable, is repeated changing or moving in a child’s life. Children thrive on stability, on security. They like to sleep in the same place, have their own little corner where their possessions are. If moves are unavoidable, then endeavor to establish a close little niche in the new location as you had in the old one, so they can quickly relate to a home-like feeling. We see children who are in Service families, constantly uprooted every year or two. This is very hard on children. They need as much stability as we can possibly give them under those circumstances. It isn’t easy for any of us to be moved around a lot. Particularly is this true of a child.
An extension of this is having people around that the child can relate to. Sometimes it is unavoidable, perhaps, that a baby sitter has to be changed a series of times. No matter how good the sitter may be, if the child is going through a constant need to relate to a new person, it is another hurdle he has to get over. The fewer the times we have to produce these challenges to a child, the better he will do. This doesn’t mean that it isn’t of value to leave a child with somebody else at times. It is important that a child can learn to be with other people. At the same time try to maintain that undergirding, stable environment rather than a lot of change.
The need for consistency of rules and regulations: A child needs to know his boundaries. There are times when that is difficult, times when he doesn’t choose to conform to those boundaries, and that cuts right across your plans for the day. What are you going to do about it? Are you going to let down on the rules and regulations? Are you going to say, “Well, just this once we won’t bother?” Or are we going to go through some inconvenience so that the child realizes that rules are there to be kept, not to be broken? Sometimes this can be a real cause for confusion, disturbance, and all your plans are thrown out because Johnny doesn’t choose to put his shoes on this morning. It is so much easier to do it for him. If you do it for him today you might find yourself doing it for him tomorrow too, and so it goes on.
Routine is a great help to children. It gives them stability. If they get up at the same time, eat at approximately the same time, they have the same sort of activities at about the same time gives them a sort of rhythm in their life. And rhythm on the outside helps to establish rhythm on the inside. Again, this is not absolutely rigid, but if they become accustomed to a rhythm and routine, you will find that life is less stressful to them.
The emotional environment: Have fun! Get down on the floor and play with the children. Have time when the children can tell you what to do in a play and fun situation because you will find they will be much more willing to listen to you when you have something to tell them. Laugh with your children, have fun. Sometimes one of the best ways to overcome their behavior is to laugh. If a child is mad about something and you laugh at him his madness doesn’t carry much weight. If a child can get mad and upset you he has won the day. But if he gets mad and you laugh at him, he realizes it isn’t doing any good, and soon the anger begins to break up. That isn’t easy but you will find it will work.
Anxiety and fear on the part of parents is picked up by children. The fear may have something to do with them or it may have nothing to do with them. They may not understand the fear, but they pick it up and they respond to it.
Thus, children present us with very great demands, not demands necessarily for what we do to them but demands for what we are, because our children demand of us a growth on the inside, a stability, a harmonious state within ourselves and the people we interact with. That is what establishes a healthy environment for that child.
These are some of the thoughts I would like you to take with you and think about, and see how they may fit into your situation at home.
The Osteopathic Approach to Seizures
by Viola Frymann, D.O., F.A.A.O., F.C.A.
Seizures may occur at any stage in life from newborn to old age. But the etiology or underlying cause may vary from patient to patient. Rare causes are organic brain diseases.
For the child who develops seizures such conditions may be ruled out by elector-encephalogram, (EEG) computerized tomography (C.T.) scan or magnetic resonance imaging (M.R.I.).
Another causative factor may be trauma, a head injury following a car accident, bicycle accident, football or other high speed sports mishaps, a fall from a tree, or even an upper bunk especially if there is a door knob or hard table obstructing the fall and causing a focal blow to the head.
Such injuries will be identified in the course of history-taking and confirmed in many instances by X-ray (C.T. or M.R.I.). A far more common traumatic factor, and far less easily identified injury may have occurred during the process of birth.
The nine months of pregnancy is arranged anatomically and physiologically to provide the utmost protection to the developing baby within the mother's abdomen.
The process of labor whereby the baby is delivered into this world is also designed to bring the baby into this world without injury.
However modern "civilization" with high heeled shoes, refined, processed flavored, colored foods, chemical solutions in place of wholesome healthy drinks of spring water, exposure to toxic chemicals in the workplace as well as the stresses on the job may all bring detrimental influences to the developing baby within mother's body.
The period of pregnancy may be a healthy, happy, joyous experience until the expected date of delivery draws near. Labor begins, or at least the contractions seem like labor. Contractions continue, somewhat erratically for a few hours or days only to reveal themselves as false labor. The baby in the womb has been compressed by the uterine contractions on his buttocks and sacrum (the large bone at the base of the spine), and his head may have been compressed as it was pushed into the pelvis before the birth canal opened to permit an easy passage.
On the other hand there may have been no false labor, and the real labor begins according to expectation. Then mother experiences severe back pain, which suggests that the baby has turned face forward instead of face backward.
Progress is retarded because this position makes passage through the birth canal more difficult. This is but one of the possible traumatic events that can occur during the birth process and affect the delicate musculoskeletal mechanism of the baby.
Perhaps you can see that your baby has a crooked or asymmetrical head, perhaps your baby throws his head back forcibly and screams. This is like a cramp in the neck, and it hurts! But these are indications that the delicate nervous system within the skull and spine has suffered some degree of trauma.
There are many degrees and varieties of trauma that may occur during the birth process. Ten percent of babies may suffer visible, obvious trauma. Ten percent of babies may be perfect with free physiological motion and function throughout. But about 80% of new born babies may have less visible, but nevertheless significant strain factors within their body mechanism.
Some of these produce microscopic injuries to areas of the brain which may manifest exteriorly as jerking of muscles, spasms in parts of the body with or without changes in consciousness, and even full seizures affecting the whole body.
Other children may vomit after many feeds or they may have been slow to learn to suck effectively, they may cry inconsolably, their muscle tone may be markedly increased, and tense or limp or flaccid. There are other signs that may appear later in childhood that indicate that microscopic injury may have occurred during the birth process, but in areas of the brain that do not come into full function at the time of birth.
The osteopathic physician is trained to identify these subtle changes in the musculoskeletal system and apply gentle manipulative skills to correct them.
In many instances the neurological problems can be profoundly benefited by such treatment. The earlier in life the treatment can be given the better the results.
The magnitude of the brain injury is also a factor in the degree of response. When a child is diagnosed as having a seizure disorder various diagnostic tests will be performed and in many instances anticonvulsant medication will be prescribed. Progress under osteopathic treatment will be measured by reduction in intensity and frequency of seizures and in positive changes in the EEG.
However the objective of treatment regardless of the intensity or severity or the problem is to enable this child to function at the maximum of his/her potential.
The Osteopathic Approach to the Child with Scoliosis
by Viola Frymann, D.O., F.A.A.O., F.C.A.
The term scoliosis means a distortion of the body structure into a curvature. This is usually recognized in the spine but may also be found in the pelvis, and occasionally in the mechanism of the cranial bones.
Spinal scoliosis may be structural due to a bony developmental defect as for example the absence of a rib on one side, or an incomplete development of a vertebra. It may be the result of a neuromuscular disease such as cerebral palsy in which the spinal muscles are more spastic on one side than the other or a paralytic condition in which the muscles are much weaker on one side. In these conditions the spinal muscles exert a greater contraction or side-bending force on one side of the spine than the other. Abdominal surgery in infancy or childhood may leave a scar on one side of the abdominal wall which may, as the child grows, cause a curvature in the back because the soft tissues around the scar are hardened with fibrous tissue and cannot lengthen equally with those of the other side.
But these structural causes of scoliosis are rare. Far more common are the idiopathic adolescent functional spinal curvatures. "Idiopathic" means that the cause is unknown, "adolescent" implies that it is most commonly found as the child enters the adolescent or teenage years; and functional indicates that there is no bony deformity.
There are however some causative factors recognized by the osteopathic physician that are responsive to osteopathic manipulative treatment. In order to appreciate them regard this patient as a dynamic unit of function from head to feet and not merely a vertebral column with an unusual curve in it. Examining the standing patient from the back the level of ears, the shoulders, the scapulae or shoulder blades, the crests of the ilia are noted for their symmetry, is one side higher than the other. If the patient then bends one knee but keeps the weight equally on two feet it is possible to observe side-bending in the lumbar area - do they move symmetrically or is the side bending greater to one side. Next ask the patient to balance on one leg and note how far the pelvis drops on the opposite side. Is the range of motion equal to that when standing on the other leg. Less motion indicates restriction of physiological motion in the sacroiliac joint. How far can the patient bend forward toward touching the toes without bending the knees. As the patient uncurls note whether the rib cage is symmetrical on the two sides. A prominence of one side may be the earliest evidence of a scoliosis of the spine. Is there freedom of motion to permit elevation of the straight arms beside the head.
Is the scoliosis still evident when the patient is seated? Standing behind the seated patient place hands on the front of the chest or the sides of the chest to note whether the ribs move symmetrically. Asymmetric expansion on one side may be due to scoliosis. The patient is then examined lying on the back, to evaluate leg length symmetry, pelvic balance, symmetrical motion of the sacrum within it, and to evaluate the spinal muscles for symmetrical tension or vertebral rotation.
The cranial mechanism is then palpated for distortion of position or asymmetry of motion. The question may be asked, what has the head to do with a spinal curvature. From a functional point of view the body hangs from the head and distortion of the cranial mechanism, commonly from a long or traumatic birth, predisposes to curvature in the spine by way of unequal fascial drags on the body. Orthodontic treatment which endeavors to change and intends to improve the relationship of the jaws may also induce or aggravate spinal curvatures.
The diagnosis will also include a standing X-ray which not only evaluates the nature and degree of the spinal curvature, but also provides a study of the equality of leg lengths.
The treatment will include osteopathic manipulative treatment to the pelvis and the head, the rib cage, the abdominal wall and the fascial mechanism of the body as well as the area manifesting the spinal curve. If there is an anatomical shortness of one leg a corrective lift might be added to that shoe. In addition to, but not in place of the manipulative treatment some simple exercises may be given to perpetuate the benefit of the treatment.
Carrying a backpack must be carefully monitored. If used it must not be overloaded and must be equally balanced across both shoulders.
The fitting of a brace may be indicated in a severe structural scoliosis. Surgery may be indicated if the condition has rapidly deteriorated or structural anomalies exist. But in our experience if osteopathic treatment is administered first these more drastic measures are needed less frequently.
Vision Enhancement
by Robert B. Sanet, O.D., F.C.O.V.D. and Carl G. Hillier, O.D., F.C.O.V.D.
Between 60% and 90% of the information comes into our brain through the visual system. Interference in optimal visual function will reduce the efficient processing of visual information.
20/20 Is Not Enough!
It is estimated that 20% of children and adults have a vision problem which interferes with optimal function. Many measure 20/20 sight yet have an undetected vision which will reduce their ability to achieve full potential.
Working Too Hard
Many people know how to read yet are slow or inefficient. Others read well but have difficulty keeping their place or with reading comprehension and memory. These people may get good grades or perform well at their job yet do so with great effort. This may produce either an underachievement or overachievement syndrome.
Computers - Generators of Visual Stress
The human visual system was not designed to spend long hours looking at a computer screen. Studies have shown that 80% of computer users experience visual stress.
Treatment for computer visual stress may include visual stress-relieving lenses, visual-ergonomic instruction and/or a program of Optometric Vision Therapy.
Symptoms of Visual Efficiency Difficulty
* Average or above-average intelligence but working too hard
* Achievement below potential
* Loss of place when reading
* Transposes words or numbers
* Headaches
* Visual fatigue
* Visual discomfort
* Short attention span
* Mind wanders when trying to concentrate
* Reduced comprehension or memory
What Should Be Done?
A comprehensive Visual Efficiency Evaluation is the only way to determine if a visual problem is interfering with an individual's ability to achieve to potential.
Individualized Diagnostic Approach
Our doctors combine specialized training with the most modern equipment and techniques available to evaluate vision as it relates to academic achievement and job-related performance.
The comprehensive vision analysis includes an in-depth evaluation of visual tracking, focusing, eye coordination, and the underlying visual-perceptual and visual-integrative abilities necessary for efficient learning.
Individualized Therapeutic Care
Written reports and personal conferences are scheduled so that all concerned will understand the evaluation results and treatment recommendations.
Treatment may include stress-reducing lenses, a program of Optometric Vision Therapy and structuring the classroom and home or work environment for maximum visual learning.
Optometric Vision Therapy is individually designed to meet the patient's specific visual needs. The length of the therapy program will vary depending upon the type and severity of the visual problem.
What is Optometric Vision Therapy?
Optometric Vision Therapy is a treatment program designed to eliminate visual problems, reduce visual stress and discomfort, and increase visual performance. Optometric Vision Therapy provides the visual abilities necessary for more efficient learning and performance in all areas of life.
Scientific research and more than 60 years of clinical experience have proven Vision Therapy to be extremely effective!
Help At Any Age
Many patients in Vision Therapy are adults with symptoms when reading or who have visual problems which make learning more difficult. Symptoms may include loss of place, visual fatigue, blur, headaches, reduced comprehension, and difficulty concentrating.
What is Osteopathic Manipulation?
by Viola Frymann, D.O., F.A.A.O., F.C.A.
The human body is a living machine which is supremely adaptable to changes within and around it. For example, if you shift your weight from two feet to one, a series of complex changes will occur within the muscular and bony systems of the body from head to foot to enable you to establish balance under the new circumstances.
A similar complex adaptation mechanism goes into operation in response to an injury. However, if the injury produced a local change which passed beyond the limit of spontaneous resolution, the various adaptations made in all other parts of the body structure persist as new demands are made upon this living mechanism.
In response to these numerous structural changes, changes in circulation and nerve impulses also occur which in turn produce areas of greater susceptibility to infection, or hypertrophy or degeneration. The whole range of these later changes makes up the diverse and complex array of human disease.
This is the osteopathic concept of disease- an effect, which is the climax to a whole series of changes in response to the various stresses of life superimposed on an original cause.
In the treatment of the patient - attention is given to the total patient and not just to this manifested effect. The osteopathic physician searches for these fundamental causes while he is also alleviating the local, presenting complaint. Through the use of his trained, perceptive, discriminating fingers he will search for, find, and endeavor to correct the fundamental causes thus producing a more enduring and complete change within the body which will permit a reversal of those adaptive changes and restoration of health. At the same time he many employ in addition any of the modern methods of treatment, medicinal or surgical , as indicated, to alleviate the local distress, but the need for these is reduced because of his attention to first causes.
The injuries sustained at birth ranging from the imperceptible which can only be detected by trained skillful fingers, to the gross which are immediately obvious to the naked eye may provide the first cause on which numerous adaptive effects are superimposed. A car accident in which a whiplash type of injury was sustained is another of these often obscure primary causes which through the years accumulates adaptive changes until the time comes when the accumulation of effects manifests as a gastric ulcer, a heart condition, an arthritis, a colitis, or any other named disease.
Numerous less well-defined complaints such as nervousness, fatigue, insomnia, indigestion, backache, headache, etc. may have persisted so long that they have been taken for granted. But when the structural disturbances produced by that original injury are corrected, the patient is surprised to find that those persistent, habitual complaints have gone.
These are but two examples of the influence of causes in the production of effects namely early injuries and second disease. Their number can be multiplied indefinitely by the multitude of diverse mishaps that occur to human beings and the unlimited range of combinations and variations which may accumulate as the body strives to adapt and accommodate to the stresses and needs of daily life. These effects may be further complicated by nutritional deficiencies, toxic influences such as smog, disinfectants, pesticides, drugs and so on, and by emotional and mental circumstances. Such factors as these must all be considered, by those primary causes need to be found and eliminated if a state of positive health rather than a mere absence of disease is to be achieved.
This is the purpose of osteopathic manipulation, namely the diagnosis and treatment of the structural and functional changes within the body by the trained, perceptive, discriminating skillful hands of the physician- the mechanic of the human machine.
For more information
Smart In Everything But School?
by Robert B. Sanet, O.D., F.C.O.V.D. and Carl G. Hillier, O.D., F.C.O.V.D.
20/20 Is Not Enough!
Studies show that 20% of school age children have a problem which interferes with learning.
Many people mislabeled as lazy, dyslexic, or attention deficit disorder (ADD) may actually be suffering from an undiagnosed Learning-Related Vision Problem. This may be true even though they have 20/20 sight!
Symptoms of Learning Related Vision Problems
* Loss of place when reading
* Skipping, re-reading, or substituting words
* Confusing similar words
* Difficulty retaining what is seen or read
* Failure to recognize same word in next sentence or page
* Reversal of letters in reading or writing
* Smart but working too hard to keep up
* Poor handwriting
* Short attention span
* Headaches
* Blurred or double vision
* Frequently rubbing eyes
* Achievement below potential
What Should Be Done?
A comprehensive Learning Related Vision Evaluation is the only way to determine if a child or adult has a visual problem which is interfering with learning.
Individualized Diagnostic Approach
The doctors at The San Diego Center for Vision Care - P.C. have specialized training to evaluate vision as it relates to academic achievement.
This comprehensive vision analysis includes an in-depth evaluation of visual tracking, focusing, eye coordination, and the underlying visual-perceptual and visual-integrative abilities necessary for efficient learning.
Individualized Therapeutic Care
Written reports are provided and personal conferences are scheduled so that all concerned will understand the evaluation results and the treatment recommendations.
Treatment may include visual stress-reducing lenses, a program of Optometric Vision Therapy, and the structuring of the classroom and home environment for maximum visual learning.
Optometric Vision Therapy is individually designed to meet the patient's specific visual needs. The length of the therapy program will vary depending upon the type and severity of the visual problem.
What is Optometric Vision Therapy?
Optometric Vision Therapy is a treatment program designed to eliminate visual problems, reduce visual stress and discomfort, and increase visual performance. Optometric Vision Therapy develops the visual abilities necessary for more efficient learning and performance in all areas of life. Scientific research and more than 60 years of clinical experience have proven Optometric Vision Therapy to be extremely effective!
Help At Any Age!
Many of our patients in Vision Therapy are adults with symptoms when reading or with visual problems which make learning more difficult. Symptoms may include slow reading speed, loss of place, visual fatigue, blur, headaches, reduced comprehension and difficulty concentrating.
Interdisciplinary Approach
Communication and inter-referral with other professionals ensure that the patient receive comprehensive care. Reports and specific recommendations help the classroom teacher meet the patient's specific visual needs.
Bright Futures Optometric Vision Therapy develops better vision for more efficient learning. When the Learning Related Vision Problem is remediated, the child's or adult's vision is more efficient at processing information and learning is easier.
Steps You Can Take at Home
by Viola Frymann, D.O., F.A.A.O., F.C.A.
A program of monthly meetings was instituted at the Osteopathic Center for Children & Families to provide informative lectures on various aspects of the work of the Center allowing for plenty of time for questions, discussion and valuable contributions from other parents whose personal experiences helped the newcomers. These were essentially extemporaneous talks, sometimes illustrated with slides, and occasionally with practical demonstrations of a child being examined or treated. These were not written lectures but from time to time a zealous parent would make an audiocassette for her friends. A few of these tapes were transcribed. I trust you will read them as if you were sitting in a group of parents eager to learn what happens to “my child” at the O.C.C. and how can this approach help him?
The subject I would like to discuss today is, “What can I do at home?” What we do in the Center is only a small part of the whole program. What we do in one-half hour a week needs to be supported by what you do on the twenty three and a half hours on that day and all the rest of the days between your visits here. In addition, there are acute episodes that come up and parents so often wonder, “Well, what can I do right now to cope with these acute episodes?” So I thought we might talk about a few of these things. Perhaps, as we go along questions will occur to you so don’t hesitate to interrupt if you have a question.
First of all, why do acute episodes occur? This is rather a fundamental concept of disease and health. We often seem to act as if these various bugs are floating around in the air and all of a sudden they decide to settle somewhere. If you happen to be the one they settle in, that’s just too bad. So you pull out some kind of shotgun to destroy that invader. We tend to say, “Well, he caught something,” and so you try to find something to combat the bugs. Isn’t that just about how it comes over to you most of the time?
Did it ever occur to you to ask yourself, “What is the purpose of this acute episode - the cold in the head, tonsillitis, digestive upset or whatever - what is the purpose of it? What is it there to accomplish? Is it just there to irritate the patient and distress the parents? Can we look at these acute episodes as a healing experience?” The body is trying to bring about a change, and, therefore, it has to produce a sort of eruption of some kind within the body’s physiology in order to bring that about. Have you ever thought of a child’s cold in the head as a healing episode?
A. No, I consider it somewhat of a nuisance. It just causes more trouble. (from the audience)
I agree it is inconvenient. Yes. That’s not the question. There are many things in life that are inconvenient but a lot of good may come out of them, nevertheless. Let’s consider for a moment why we tend to get colds. We get colds very frequently when our resistance is lowered,perhaps from wandering from good food or not getting enough rest or being under great stress. The cold takes us out of circulation for perhaps 24 or 48 hours, and forces us to rest, forces us to pour fluids into the body and so we begin to get better.
These acute episodes can if they are handled wisely, form stepping stones to better health. Let’s look at some of the symptoms that occur. Fever: It is universally taught via that box you have in your house, namely the TV, that if you have a fever you take something to lower the fever, Tylenol, aspirin, whatever. The first thing is to lower the fever. But the fever is one of the body’s efforts to combat the infection. The fever is the manifestation of the body’s immunity at work. The child who is sick without a fever gives us far more concern than the child who is sick with a fever. If the child doesn’t have a fever when there should be a fever, that indicates that the body is not putting up the resistance that is necessary in order to overcome this problem. I’m not talking about the fever that goes up to 104-106, I’m talking about the average fever of 101, 102, 103 which accompanies in most instances the flu, ear infection, the common infectious diseases of childhood. The fever is very important. So we do not address the fever, we address the cause of the fever, which is a different approach.
How about pain? What should we do about pain? The pain of an ear infection or a throat infection? It is generally assumed, often naturally so, that heat is more comforting than cold. The very thought of heat is much more soothing than is ice. Ice has the effect of stimulating the active circulation, whereas heat draws passive congestion. Just imagine for a moment that you soaked your finger in a cup of hot water - for 10 or 15 minutes. What would it be like when you took it out of the water? It would be swollen, red, probably throbbing, and it would be stiff. Is that what you would want to produce in your child’s ears or your child’s throat? He has enough congestion there already and that is why it hurts. If we can use ice or a cold compress, which means a cloth wrung out of ice cold water, in the immediate application you disperse the blood in the area, but almost immediately there is a reaction in the body that brings active circulation into the area, and that active circulation is part of the healing process.
If, in the event of an earache you use an application of cold instead of heat, it will have helped the process to turn around and begin to clear. If you use heat you tend to increase the congestion and in the end make the infection worse. Never use heat by itself. We may sometimes use heat alternated with ice to enhance the difference between the two.
I had one teacher who used to say, “Before you start treating the patient, get him to throw the heating pad out.” The only thing the heating pad is good for is keeping your feet warm in bed at night, but not to put on some local area of your body. That is also true for sprains, whether it be a back or an ankle. Put ice on it, put cold on it, and the swelling will be decreased, you will increase the motion, and it will begin to feel better.
Keep one of the ice packs which you can buy for the picnic basket in the freezer. Then you will always have a cold application if and when needed. It will be much more convenient and easier to use than ice. If there is an acute throat infection, wring a cloth out of ice water and wrap it around the neck. It is cold as it is put on, but as it draws the circulation into the area it becomes hot, very hot. You will often find that as the tonsils get better you will see a little rash on the skin, which is showing you the direction of the body’s reaction. In a very short time the rash on the skin disappears.
If, at the very first sign of a sore throat, you push the fluids, wrap a cold pack around the throat, you will find very often that in 24 hours it will be gone. Put cold fruit juices on the inside of the throat and cold packs on the outside.
What about sinus infection? The same basic principle applies. Just place the ice pack across the face. At first it may be difficult to bear the cold. It may be only a few minutes at a time, but you will begin to feel the congestion breaking up.
These suggestions don’t mean that you are going to be able to solve every problem at home. But if, instead of acting as if it weren’t there, you proceed actively at the beginning with the measures of pushing the fluids, applying the cold applications locally and encouraging rest, many of the minor problems come under control without any major complications. The longer you leave it untreated the harder it is to clear it.
Now let’s consider the relationship of injuries to acute episodes. Very often an acute episode will follow an injury of some kind, either immediately or a week or two afterwards. Some of the things we talked about in the past probably led you to begin to understand why this is so.
Never forget that the body is put together like a delicately designed piece of machinery, and every part of the body is designed to move, to move in relationship to every other part. You have a very delicately integrated, moving piece of machinery. And if something happens to that moving machinery and interferes with its free motion in some area, that in turn interferes with the circulation of arterial blood, the drainage of venous blood, the drainage of lymphatic fluid from the area and the actual motion of the area itself. That, in turn, produces stasis or stagnation in the area, it permits congestion to occur and then it becomes a fertile field for any organism that is in the area.
We find not infrequently that a child has a blow on the head and, before very long he is complaining of an earache. At that point the earache may not be an ear infection; it may be a congested ear, the ear drum may look red, but it is a response to the fact that the temporal bone which holds the ear has become reduced in its normal physiologic motion. If that structural problem can be corrected the earache disappears. This is not uncommon. So if you begin to think of the injury and the effect, and the child does come down with an earache or acute infection, just think back to what has happened in the last two or three weeks which might be a factor contributing to this.
Let us consider another sort of manifestation of acute episodes. That is an asthmatic attack. An asthmatic attack can be a very frightening experience. It is usually more frightening for the parents than for the child. Children tend to take these crises in stride much better than their parents do. We have found that children who have had a fall landing hard on the buttocks, will often precipitate an attack of asthma if they have a predisposition.
One little boy we have treated, who had a lot of asthma before we saw him, had been doing very well and I hadn’t seen him for nine months. One day his mother called to say he had suddenly developed an acute attack of asthma. I asked her if he had had any injuries, and she said no, he hadn’t. I asked her if she were sure he hadn’t had any injuries. When he came in I said to him, “Have you sat down hard somewhere?” He said, “Yes,” and I said, “What did you do?” He said, “I fell off the donkey.” “Didn’t you tell your mother?” “No, because I wasn’t supposed to be on the donkey.” So you may not always know the injury that preceded that is causing the trouble.
We are not concerned only with respiratory problems like the colds or the asthma or the flu, sore throats, but there are gastrointestinal upsets - the acute diarrhea, the acute vomiting episode. Here it is important to think about what has precipitated this. With little children who are just beginning to get onto solid food, this may be a reaction from pushing them onto the solid food a little too fast, and so a very good rule for introducing new foods to babies is to do it in very small amounts. Give one teaspoon of a new food once a day for three days. If that is acceptable and causes no adverse effects, gradually increase the quantity. Then introduce one teaspoon of another new food once a day for three days. Thus over 15 days you will have introduced five food which are now well tolerated. This is a good rule when you are introducing any new food to children. Then you will find you won’t get to that point where they just refuse to eat it. Later make sure they get a little taste of whatever food you are serving. Making it a little harder to get makes it more desirable.
There are some very simple home measures which you can use to help an acute episode of vomiting or diarrhea. If it continues to go on, a very valuable remedy is in the water in which brown rice has been cooked. Feed that at about one teaspoon every ten minutes. It is important that you don’t give more at any one time because if you put a volume of fluid into the stomach it will come right back. Then follow the rice water with some of the brown rice, which can be pureed in the blender or through a sieve, with just a touch of honey to make it a little more tasty and feed that, again in very small quantities. This is for vomiting primarily.
With diarrhea, the body is probably trying to get rid of something which shouldn’t be there. One cause of diarrhea in small children is that the food which has been given to them is not prepared finely enough. The body does not yet have the equipment to digest it, or maybe they don’t chew it adequately. Corn is one thing that will often be found almost unchanged. That means the child should not be having corn because the body cannot yet handle it. It is too coarse for this body to cope with. The same for raisins or any coarse food which the child does not digest. These foods should be ground or soaked or pureed until the child’s body can handle them.
Once you have addressed the cause of the problem, the rice water and the rice may be very helpful here too. Another valuable remedy is to take a ripe apple and scrape it with a spoon, so that it is the consistency of apple sauce but it is a raw apple. Then, when you are over the acute phase, use Meusli. The Meusli is an old, old recipe that comes from Switzerland, which was used by the shepherds in the mountains, and it is still available in almost every cafe in Switzerland. It is a staple food, and by no means a unique health food. Its basis is raw oats that have been soaked to which is added apple and banana, raisins and some ground nuts, a little lemon juice and a little honey. This is a wonderful food for quieting down digestive difficulties at any age in life. Any chronic distress in the digestive system or even an ulcer can be helped by a steady diet of Meusli, even for several weeks at a time, with absolutely fantastic results in quieting down digestive difficulties.
In the immediate post-war period in England there was a representative from Switzerland who came to the Hospital for sick Children in London, which is renowned throughout the world for its expertise in solving children’s problems. He treated children with celiac disease which is a severe disturbance of the digestion of foods which occurs in children. Their measure for treating these children was the use of Meusli. This work was not published for one simple reason: all the children got better. That’s not possible according to the usual standards - that every child would have got better.
Why is it that simple measures can be so profoundly effective in these episodes? It is because the healing process comes from within the body, not from outside the body. We don’t heal anybody, neither do you. It is the patient who heals himself. All we do is give him a little assistance, set the stage, clear away the things that were in error and permit the healing process to take place.
I can’t emphasize enough how important it is to realize that the child has the capacity to overcome his problem inside himself if we will set the stage and create the circumstances in which he can do so.
All of the minerals in the body must be in balance. Calcium must be in relationship to phosphorus and vitamin D so the body can absorb it. If one is missing you may not be utilizing something else. We can see children who are not utilizing calcium, who have calcium deposits in their hair which are a thousand times more than they ought to be. It is not that they are not getting enough calcium, it is that their bodies are not doing the right thing with the calcium.
Here we come back again to how the body is functioning on the inside to make the best use of what we put into it.
Let’s consider another area of factors which may manifest themselves in illness in the child. They come under that very broad heading of “stress.” Stress may be directly on the child, as for instance, a parent who is too demanding - demanding performance that is perhaps beyond the age or the capacity of the child. The pressure may be at school or the child may believe that there is pressure for performance. Sometimes I talk to parents about this and we hear, “No, we have never bugged him about grades.” But if I talk to the child, he says, “Well, I’d better get good grades or I will get into trouble.” That may or may not be true but it is how he perceives the parents’ approach toward his performance in school. Sometimes we need to look at ourselves through the eyes of our children. How do they interpret what we say or what we do to them? That is what influences their reaction to circumstances.
How often do you praise your child? How often do you tell him how good he is? How often do you tell him how bad he is, how naughty he is, how incorrigible? If you were to turn a tape recorder on in your house for a few hours and listen to what is said, you might learn a great deal about the way your family functions. That is one of the best therapeutic measures that I know of. Just let a tape recorder run when nobody knows it is on, and then play it back. You will be astonished at what you hear, but you will learn so much. You will find, I’m sure, as most of us do, that he says this, .she says that, and I say this. And the script rarely changes because we don’t hear the script. We only feel motivated to react to this or to that in an endeavor to shut them both up and it doesn’t work.
The stress that is put on a child is sometimes quite unconscious, and more seriously, unrecognized. If we can look through a mirror at ourselves and all the circumstances that surround this child we will find out where the stress is coming from.
There may be stress on the child which is indirect, which isn’t directed to the child at all. There may be stress between the parents or between the parents and the grandparents, or stress between the parent and somebody who takes care of the child. The child is in the middle there, and receives that tension that is around him. Children are like reflectors of their parents, and particularly their mothers. I’m sure you have had the experience that when mother isn’t feeling very well the children are unbearable. It is not the child’s fault, it is because the security which is the center of that family has suddenly been pulled out and they are trying to make the best they can of it. Mother is the central figure in the child’s security. Father contributes to it, yes, but you will find that mother being sick or mother being pulled out of the family is a major problem for that child, whether it be for a day or for a much longer period.
If parents are in conflict, this reflects on the child. How does the child deal with difficult or unpleasant circumstances? If the child has a problem at school - he’s not getting along very well with the teacher - what do we do about it? Do we talk to the teacher or to the principle and endeavor to have the child removed from that teacher? We often do that. Just project into the future another fifteen years, when your child has a job and he doesn’t get along very well with his boss. Is Mother or Dad going down to talk to the president of the firm and say, “Well, he didn’t get along very well. I think we’d better move him.” You know what he will say, don’t you? That’s the end of that job.
When do we start to deal with difficult or challenging or uncomfortable circumstances? Can we help our child to handle a difficult situation at school? Can we teach our child to recognize that perhaps this teacher has some problems at home, that this teacher is doing the best he can under the circumstances? Or is this teacher challenging the child a little bit more than he thinks he can handle, but will in the end, produce performance in this child which wouldn’t have been produced otherwise?
It is a well known fact that the teacher you remember is the teacher who demanded performance from you. You may have thought at the time that he was mean. Those are the teachers you remember, aren’t they? Do you remember the teachers who were very kind and sweet and who put up with anything you did? You can’t even remember their names in many instances. The teachers who demanded performance - these we remember. In the great majority of instances, it isn’t the teacher who is the problem, it is learning how to cope with a difficult situation. This doesn’t mean that we don’t have to make sure there is nothing of a more serious nature. If we can teach a child how to deal with a difficult or challenging situation he won’t be stressed by it and he will have learned a very important lesson in how to deal with the problems he will be confronting later in life.
Praising a child, accepting a child, encouraging a child is so important, no matter where they stand in life. If a child is handicapped he needs all of the acceptance, the encouragement, the stimulation we can give him. You know we all thrive on praise. If someone is constantly beating us down with “Well, you didn’t do this and why didn’t you do that, pick up your clothes, and wash your face,” and are constantly at it, none of us does very well under those circumstances. We need praise, we need some one to tell us we did a good job, or we tried hard and have done better today than we did yesterday. These are the things that make children strive to do better.
Another problem, which sometimes is unavoidable, is repeated changing or moving in a child’s life. Children thrive on stability, on security. They like to sleep in the same place, have their own little corner where their possessions are. If moves are unavoidable, then endeavor to establish a close little niche in the new location as you had in the old one, so they can quickly relate to a home-like feeling. We see children who are in Service families, constantly uprooted every year or two. This is very hard on children. They need as much stability as we can possibly give them under those circumstances. It isn’t easy for any of us to be moved around a lot. Particularly is this true of a child.
An extension of this is having people around that the child can relate to. Sometimes it is unavoidable, perhaps, that a baby sitter has to be changed a series of times. No matter how good the sitter may be, if the child is going through a constant need to relate to a new person, it is another hurdle he has to get over. The fewer the times we have to produce these challenges to a child, the better he will do. This doesn’t mean that it isn’t of value to leave a child with somebody else at times. It is important that a child can learn to be with other people. At the same time try to maintain that undergirding, stable environment rather than a lot of change.
The need for consistency of rules and regulations: A child needs to know his boundaries. There are times when that is difficult, times when he doesn’t choose to conform to those boundaries, and that cuts right across your plans for the day. What are you going to do about it? Are you going to let down on the rules and regulations? Are you going to say, “Well, just this once we won’t bother?” Or are we going to go through some inconvenience so that the child realizes that rules are there to be kept, not to be broken? Sometimes this can be a real cause for confusion, disturbance, and all your plans are thrown out because Johnny doesn’t choose to put his shoes on this morning. It is so much easier to do it for him. If you do it for him today you might find yourself doing it for him tomorrow too, and so it goes on.
Routine is a great help to children. It gives them stability. If they get up at the same time, eat at approximately the same time, they have the same sort of activities at about the same time gives them a sort of rhythm in their life. And rhythm on the outside helps to establish rhythm on the inside. Again, this is not absolutely rigid, but if they become accustomed to a rhythm and routine, you will find that life is less stressful to them.
The emotional environment: Have fun! Get down on the floor and play with the children. Have time when the children can tell you what to do in a play and fun situation because you will find they will be much more willing to listen to you when you have something to tell them. Laugh with your children, have fun. Sometimes one of the best ways to overcome their behavior is to laugh. If a child is mad about something and you laugh at him his madness doesn’t carry much weight. If a child can get mad and upset you he has won the day. But if he gets mad and you laugh at him, he realizes it isn’t doing any good, and soon the anger begins to break up. That isn’t easy but you will find it will work.
Anxiety and fear on the part of parents is picked up by children. The fear may have something to do with them or it may have nothing to do with them. They may not understand the fear, but they pick it up and they respond to it.
Thus, children present us with very great demands, not demands necessarily for what we do to them but demands for what we are, because our children demand of us a growth on the inside, a stability, a harmonious state within ourselves and the people we interact with. That is what establishes a healthy environment for that child.
These are some of the thoughts I would like you to take with you and think about, and see how they may fit into your situation at home.
The Osteopathic Approach to Seizures
by Viola Frymann, D.O., F.A.A.O., F.C.A.
Seizures may occur at any stage in life from newborn to old age. But the etiology or underlying cause may vary from patient to patient. Rare causes are organic brain diseases.
For the child who develops seizures such conditions may be ruled out by elector-encephalogram, (EEG) computerized tomography (C.T.) scan or magnetic resonance imaging (M.R.I.).
Another causative factor may be trauma, a head injury following a car accident, bicycle accident, football or other high speed sports mishaps, a fall from a tree, or even an upper bunk especially if there is a door knob or hard table obstructing the fall and causing a focal blow to the head.
Such injuries will be identified in the course of history-taking and confirmed in many instances by X-ray (C.T. or M.R.I.). A far more common traumatic factor, and far less easily identified injury may have occurred during the process of birth.
The nine months of pregnancy is arranged anatomically and physiologically to provide the utmost protection to the developing baby within the mother's abdomen.
The process of labor whereby the baby is delivered into this world is also designed to bring the baby into this world without injury.
However modern "civilization" with high heeled shoes, refined, processed flavored, colored foods, chemical solutions in place of wholesome healthy drinks of spring water, exposure to toxic chemicals in the workplace as well as the stresses on the job may all bring detrimental influences to the developing baby within mother's body.
The period of pregnancy may be a healthy, happy, joyous experience until the expected date of delivery draws near. Labor begins, or at least the contractions seem like labor. Contractions continue, somewhat erratically for a few hours or days only to reveal themselves as false labor. The baby in the womb has been compressed by the uterine contractions on his buttocks and sacrum (the large bone at the base of the spine), and his head may have been compressed as it was pushed into the pelvis before the birth canal opened to permit an easy passage.
On the other hand there may have been no false labor, and the real labor begins according to expectation. Then mother experiences severe back pain, which suggests that the baby has turned face forward instead of face backward.
Progress is retarded because this position makes passage through the birth canal more difficult. This is but one of the possible traumatic events that can occur during the birth process and affect the delicate musculoskeletal mechanism of the baby.
Perhaps you can see that your baby has a crooked or asymmetrical head, perhaps your baby throws his head back forcibly and screams. This is like a cramp in the neck, and it hurts! But these are indications that the delicate nervous system within the skull and spine has suffered some degree of trauma.
There are many degrees and varieties of trauma that may occur during the birth process. Ten percent of babies may suffer visible, obvious trauma. Ten percent of babies may be perfect with free physiological motion and function throughout. But about 80% of new born babies may have less visible, but nevertheless significant strain factors within their body mechanism.
Some of these produce microscopic injuries to areas of the brain which may manifest exteriorly as jerking of muscles, spasms in parts of the body with or without changes in consciousness, and even full seizures affecting the whole body.
Other children may vomit after many feeds or they may have been slow to learn to suck effectively, they may cry inconsolably, their muscle tone may be markedly increased, and tense or limp or flaccid. There are other signs that may appear later in childhood that indicate that microscopic injury may have occurred during the birth process, but in areas of the brain that do not come into full function at the time of birth.
The osteopathic physician is trained to identify these subtle changes in the musculoskeletal system and apply gentle manipulative skills to correct them.
In many instances the neurological problems can be profoundly benefited by such treatment. The earlier in life the treatment can be given the better the results.
The magnitude of the brain injury is also a factor in the degree of response. When a child is diagnosed as having a seizure disorder various diagnostic tests will be performed and in many instances anticonvulsant medication will be prescribed. Progress under osteopathic treatment will be measured by reduction in intensity and frequency of seizures and in positive changes in the EEG.
However the objective of treatment regardless of the intensity or severity or the problem is to enable this child to function at the maximum of his/her potential.
The Osteopathic Approach to the Child with Scoliosis
by Viola Frymann, D.O., F.A.A.O., F.C.A.
The term scoliosis means a distortion of the body structure into a curvature. This is usually recognized in the spine but may also be found in the pelvis, and occasionally in the mechanism of the cranial bones.
Spinal scoliosis may be structural due to a bony developmental defect as for example the absence of a rib on one side, or an incomplete development of a vertebra. It may be the result of a neuromuscular disease such as cerebral palsy in which the spinal muscles are more spastic on one side than the other or a paralytic condition in which the muscles are much weaker on one side. In these conditions the spinal muscles exert a greater contraction or side-bending force on one side of the spine than the other. Abdominal surgery in infancy or childhood may leave a scar on one side of the abdominal wall which may, as the child grows, cause a curvature in the back because the soft tissues around the scar are hardened with fibrous tissue and cannot lengthen equally with those of the other side.
But these structural causes of scoliosis are rare. Far more common are the idiopathic adolescent functional spinal curvatures. "Idiopathic" means that the cause is unknown, "adolescent" implies that it is most commonly found as the child enters the adolescent or teenage years; and functional indicates that there is no bony deformity.
There are however some causative factors recognized by the osteopathic physician that are responsive to osteopathic manipulative treatment. In order to appreciate them regard this patient as a dynamic unit of function from head to feet and not merely a vertebral column with an unusual curve in it. Examining the standing patient from the back the level of ears, the shoulders, the scapulae or shoulder blades, the crests of the ilia are noted for their symmetry, is one side higher than the other. If the patient then bends one knee but keeps the weight equally on two feet it is possible to observe side-bending in the lumbar area - do they move symmetrically or is the side bending greater to one side. Next ask the patient to balance on one leg and note how far the pelvis drops on the opposite side. Is the range of motion equal to that when standing on the other leg. Less motion indicates restriction of physiological motion in the sacroiliac joint. How far can the patient bend forward toward touching the toes without bending the knees. As the patient uncurls note whether the rib cage is symmetrical on the two sides. A prominence of one side may be the earliest evidence of a scoliosis of the spine. Is there freedom of motion to permit elevation of the straight arms beside the head.
Is the scoliosis still evident when the patient is seated? Standing behind the seated patient place hands on the front of the chest or the sides of the chest to note whether the ribs move symmetrically. Asymmetric expansion on one side may be due to scoliosis. The patient is then examined lying on the back, to evaluate leg length symmetry, pelvic balance, symmetrical motion of the sacrum within it, and to evaluate the spinal muscles for symmetrical tension or vertebral rotation.
The cranial mechanism is then palpated for distortion of position or asymmetry of motion. The question may be asked, what has the head to do with a spinal curvature. From a functional point of view the body hangs from the head and distortion of the cranial mechanism, commonly from a long or traumatic birth, predisposes to curvature in the spine by way of unequal fascial drags on the body. Orthodontic treatment which endeavors to change and intends to improve the relationship of the jaws may also induce or aggravate spinal curvatures.
The diagnosis will also include a standing X-ray which not only evaluates the nature and degree of the spinal curvature, but also provides a study of the equality of leg lengths.
The treatment will include osteopathic manipulative treatment to the pelvis and the head, the rib cage, the abdominal wall and the fascial mechanism of the body as well as the area manifesting the spinal curve. If there is an anatomical shortness of one leg a corrective lift might be added to that shoe. In addition to, but not in place of the manipulative treatment some simple exercises may be given to perpetuate the benefit of the treatment.
Carrying a backpack must be carefully monitored. If used it must not be overloaded and must be equally balanced across both shoulders.
The fitting of a brace may be indicated in a severe structural scoliosis. Surgery may be indicated if the condition has rapidly deteriorated or structural anomalies exist. But in our experience if osteopathic treatment is administered first these more drastic measures are needed less frequently.
Vision Enhancement
by Robert B. Sanet, O.D., F.C.O.V.D. and Carl G. Hillier, O.D., F.C.O.V.D.
Between 60% and 90% of the information comes into our brain through the visual system. Interference in optimal visual function will reduce the efficient processing of visual information.
20/20 Is Not Enough!
It is estimated that 20% of children and adults have a vision problem which interferes with optimal function. Many measure 20/20 sight yet have an undetected vision which will reduce their ability to achieve full potential.
Working Too Hard
Many people know how to read yet are slow or inefficient. Others read well but have difficulty keeping their place or with reading comprehension and memory. These people may get good grades or perform well at their job yet do so with great effort. This may produce either an underachievement or overachievement syndrome.
Computers - Generators of Visual Stress
The human visual system was not designed to spend long hours looking at a computer screen. Studies have shown that 80% of computer users experience visual stress.
Treatment for computer visual stress may include visual stress-relieving lenses, visual-ergonomic instruction and/or a program of Optometric Vision Therapy.
Symptoms of Visual Efficiency Difficulty
* Average or above-average intelligence but working too hard
* Achievement below potential
* Loss of place when reading
* Transposes words or numbers
* Headaches
* Visual fatigue
* Visual discomfort
* Short attention span
* Mind wanders when trying to concentrate
* Reduced comprehension or memory
What Should Be Done?
A comprehensive Visual Efficiency Evaluation is the only way to determine if a visual problem is interfering with an individual's ability to achieve to potential.
Individualized Diagnostic Approach
Our doctors combine specialized training with the most modern equipment and techniques available to evaluate vision as it relates to academic achievement and job-related performance.
The comprehensive vision analysis includes an in-depth evaluation of visual tracking, focusing, eye coordination, and the underlying visual-perceptual and visual-integrative abilities necessary for efficient learning.
Individualized Therapeutic Care
Written reports and personal conferences are scheduled so that all concerned will understand the evaluation results and treatment recommendations.
Treatment may include stress-reducing lenses, a program of Optometric Vision Therapy and structuring the classroom and home or work environment for maximum visual learning.
Optometric Vision Therapy is individually designed to meet the patient's specific visual needs. The length of the therapy program will vary depending upon the type and severity of the visual problem.
What is Optometric Vision Therapy?
Optometric Vision Therapy is a treatment program designed to eliminate visual problems, reduce visual stress and discomfort, and increase visual performance. Optometric Vision Therapy provides the visual abilities necessary for more efficient learning and performance in all areas of life.
Scientific research and more than 60 years of clinical experience have proven Vision Therapy to be extremely effective!
Help At Any Age
Many patients in Vision Therapy are adults with symptoms when reading or who have visual problems which make learning more difficult. Symptoms may include loss of place, visual fatigue, blur, headaches, reduced comprehension, and difficulty concentrating.
What is Osteopathic Manipulation?
by Viola Frymann, D.O., F.A.A.O., F.C.A.
The human body is a living machine which is supremely adaptable to changes within and around it. For example, if you shift your weight from two feet to one, a series of complex changes will occur within the muscular and bony systems of the body from head to foot to enable you to establish balance under the new circumstances.
A similar complex adaptation mechanism goes into operation in response to an injury. However, if the injury produced a local change which passed beyond the limit of spontaneous resolution, the various adaptations made in all other parts of the body structure persist as new demands are made upon this living mechanism.
In response to these numerous structural changes, changes in circulation and nerve impulses also occur which in turn produce areas of greater susceptibility to infection, or hypertrophy or degeneration. The whole range of these later changes makes up the diverse and complex array of human disease.
This is the osteopathic concept of disease- an effect, which is the climax to a whole series of changes in response to the various stresses of life superimposed on an original cause.
In the treatment of the patient - attention is given to the total patient and not just to this manifested effect. The osteopathic physician searches for these fundamental causes while he is also alleviating the local, presenting complaint. Through the use of his trained, perceptive, discriminating fingers he will search for, find, and endeavor to correct the fundamental causes thus producing a more enduring and complete change within the body which will permit a reversal of those adaptive changes and restoration of health. At the same time he many employ in addition any of the modern methods of treatment, medicinal or surgical , as indicated, to alleviate the local distress, but the need for these is reduced because of his attention to first causes.
The injuries sustained at birth ranging from the imperceptible which can only be detected by trained skillful fingers, to the gross which are immediately obvious to the naked eye may provide the first cause on which numerous adaptive effects are superimposed. A car accident in which a whiplash type of injury was sustained is another of these often obscure primary causes which through the years accumulates adaptive changes until the time comes when the accumulation of effects manifests as a gastric ulcer, a heart condition, an arthritis, a colitis, or any other named disease.
Numerous less well-defined complaints such as nervousness, fatigue, insomnia, indigestion, backache, headache, etc. may have persisted so long that they have been taken for granted. But when the structural disturbances produced by that original injury are corrected, the patient is surprised to find that those persistent, habitual complaints have gone.
These are but two examples of the influence of causes in the production of effects namely early injuries and second disease. Their number can be multiplied indefinitely by the multitude of diverse mishaps that occur to human beings and the unlimited range of combinations and variations which may accumulate as the body strives to adapt and accommodate to the stresses and needs of daily life. These effects may be further complicated by nutritional deficiencies, toxic influences such as smog, disinfectants, pesticides, drugs and so on, and by emotional and mental circumstances. Such factors as these must all be considered, by those primary causes need to be found and eliminated if a state of positive health rather than a mere absence of disease is to be achieved.
This is the purpose of osteopathic manipulation, namely the diagnosis and treatment of the structural and functional changes within the body by the trained, perceptive, discriminating skillful hands of the physician- the mechanic of the human machine.
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