Osteopathic Manipulative Medicine and Autism Spectrum Disorder Raymond J. Hruby, DO, MS, FAAO
Osteopathic Medicine is a distinct form of medical practice in the United States. Osteopathic physicians, also known as DOs, provide all of the benefits of modern medicine including medications, surgery, and the use of technology to diagnose health problems. DOs also offer the added benefit of hands-on diagnosis and treatment through a system known as Osteopathic Manipulative Medicine. DOs emphasize helping each person achieve a high level of wellness by focusing on health promotion and disease prevention.
Osteopathic medicine was founded in 1874 by Andrew Taylor Still, MD, who recognized that the medical practices of the day were often more harmful than beneficial. He developed an approach to medical care that focused on the body’s innate ability to heal itself. He called this system of medicine Osteopathy, now known as Osteopathic Medicine.
DOs work in partnership with their patients. They consider the impact of body, mind and spirit on the health of each individual, and they work to break down barriers to good health. DOs are licensed to practice the full scope of medicine in all 50 states. They practice in all types of environments, including the military, and in all types of specialties, from family medicine to obstetrics, surgery, pediatrics, and many others. DOs look at the whole person, which means they see each person as more than just a collection of organ systems and body parts that may become injured or diseased. This holistic approach to patient care means that the DO learns to integrate the patient into the health care process as a partner.
Osteopathic Medicine is based on the following four principles:
- The body is a dynamic unit; the person is a fully integrated being consisting of body, mind, and spirit
- The body has an inherent capability for self-regulation and self-healing
- Structure and function are intimately interconnected; things that affect the structure of the body can affect how the body functions, and things that affect the body’s organs and functions can be reflected in the body’s structural system
- Any rational treatment for a patient relies on the application of the above principles
How do we apply these osteopathic principles to the patient who has the condition known as autism spectrum disorder (ASD)?
First, according to the holistic viewpoint, osteopathic practitioners would not think in terms of treating autism, but rather in terms of treating a patient who has the signs and symptoms of autism. Osteopathic philosophy also states that the physicians’ job is to assist the patient in finding health. The overarching goal of Osteopathic treatment is to help the patient to achieve maximum structural, physiological and emotional potential. Osteopathic physicians work to determine the most effective treatment approach for each patient by considering all of the physical, mental, emotional, psychological and spiritual factors that may be affecting the patient. The osteopathic practitioner considers every patient to be unique. While we all want the best possible outcome for every patient, the goal of osteopathic treatment is not focused in the traditional sense on “curing” autism, but rather on helping the patient to reach his or her optimum potential.
With respect to the structure-function connection already mentioned, osteopathic practitioners know that any kind of illness or condition a patient may have is reflected not only in the internal organs of the body that may be affected, but also in the musculoskeletal, or structural, system of the body as well. Of particular interest with patients with ASD, osteopathic physicians know that birth trauma has been shown to be a factor related to the development of this condition. More specifically, when birth trauma affects the normal position and motion of the bones of the skull, this leads to interference with the proper arterial blood flow to the brain, and the venous drainage from the brain structures. All of this can lead to different types of neurological and developmental problems, including ASD. Osteopathic physicians can use their knowledge of the musculoskeletal system to diagnose these structural problems, and they can use a form of osteopathic manipulation, called cranial osteopathy, to remove these structural problems. This allows for normal motion of the cranial bones, resulting in improved arterial and venous flow to and from the brain. The end result is that we often see marked improvements in the child with ASD in areas such as language, coordination, and learning ability.
Cranial Osteopathy was developed many years ago by an osteopathic physician by the name of William Sutherland. Today, in addition to osteopathic physicians who can provide cranial osteopathy, there are also non-physician practitioners, such as massage therapists or physical therapists, who sometime provide a type of cranial therapy based on Dr. Sutherland’s techniques. This is referred to as craniosacral therapy.
Finally, osteopathic physicians recognize that treatment of the child with ASD is a team effort. In order to maximize the child’s self-healing cababilities, the osteopathic physician knows that, in addition to treatment of the structural problems described above, other forms of treatment will also be necessary. This may include medications, nutritional counseling, physical therapy, and many other possible options. To achieve this requires an open mind and close work and communication with a team of healthcare workers. The ultimate goal is to provide the child with ASD the best possible environment in which to achieve his or her maximum health.
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