Studiu „Auriculoterapia in Autism”

In anul 2014, incepand cu luna Februarie, cu sprijinul parintilor din Asociatia Help Autism am realizat un studiu stiintific. Scopul acestui studiu a fost stabilirea efectului pe care Auriculoterapia Stiintifica il are in AUTISM. Acest studiu a fost realizat sub coordonarea si indrumarea  domnului Prof. Dr. David Alimi, a doamnei Dr. Claire Marie Rangon si a doamnei Dr. Christine Pailler. Acest studiu a fost publicat pe pagina Societatii Franceze de Auriculoterapie in anul 2015.

Mentionez insa ca din paginile acestui studiu am scos protocoalele de tratament, iar graficele si tabelele nu am reusit sa le incarc.

In speranta ca aceasta lucrare va v-a fi de folos, spor la citit!

Dr. Raluca Elena Fustasu

 

 

I feel honored that I had the chance to meet Prof. Dr. David Alimi as a doctor and later as a trainer in this wonderful therapy. I would like to express all my respect and admiration for his dedication in enriching this science every day. Dr. Alimi has enriched me as a doctor and has inspired me as a person.

Please receive the expression of all my esteem and gratitude.

 

 

 

I would like to thank to my daughter Maria who made ​​me discover this wonderful specialty, to my husband for his supportive love along this road, to Help Autism Association for being close to me and supporting me unconditionally in conducting this study.

 

 

CONTENTS:

I.  Autism Spectrum Disorders………………………………………………………… 2

1.      General information……………………………………………………………… 2

2.      Causes and Treatment …………………………………………………………… 7

3.      Connection with Scientific Auriculotherapy and explanations of the chosen points……………………………………………………………………………. 10

II.   Clinical Cases ………………………………………………………………..……. 16

1.      Materials and the Method ……………………………………………………… 16

2.      Cases presentation………………………………………………………………. 17

III.             Results and Discussion ……………………………………………………….…… 39

IV.             Conclusions…………………………………………………………………………. 47

V.                Bibliography……………………………………………………………………….. 48

 

I.       Autism Spectrum Disorders

1.      General information

The word Autism is a generic name used to describe a range of complex behavioral disorders. Symptoms are similar and revolve around certain core symptoms, but the organic substrate remains not enough revealed. Multiple theories are available, extensive research studies are intending to reveal Autism neurophisiopatology, a complex pathology with multiple etiologies, extremely diverse brain malfunctions and an impressive diversity of cases.

Autism Spectrum Disorder, Pervasive and specific development disorders, Neurodevelopmental Disorders, Autistic Disorders or simply Autism are names for the same pathology, which was first described in the 30s as follows:

Asperger called it in 1938 „Autistic Psychopaty” or Asperger Syndrome

Kanner in 1943, as „Early Infantile Autism” or Autistic Disorder

Rank in 1943, as „Atypical Personality Development”

Rett in 1966, as Rett Syndrome

For the first time, in 1980, these disorders were systematized and enter in DSM III as the “Pervasive developmental disorders”, bringing together:

– Infantile Autism,

– Asperger’s Disorder,

– Rett Disorder

– Childhood Disintegrative Disorder

Since 1983, the favorite name of this pathology tends to become Autistic Spectrum Disorder (ASD) due to the many facets of this disease.

 

Definitions:

Definition: Pervasive developmental disorders are a group of neuropsychiatric disorders characterized by impairment of communication and social interactions, accompanied by stereotyped repetitive behaviors with onset in early childhood (up to 5 years)[1].

Definition: “a developmental disability significantly affecting verbal and nonverbal communication and social interaction, usually evident before age 3 that adversely affects a child’s educational performance. Other characteristics often associated with ASD are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experience”[2].

Definition: Complex development Syndrome with neurobiological origin and similar symptoms, but multiple biological etiologies[3].

Definition: Autism Spectrum Disorders is delays or abnormal functioning before the age of three years in one or more of the following domains: 1) social interaction; 2) communication; 3)restricted, repetitive, stereotyped patterns of behavior, interests and activities.[4]

 

Currently there are two internationally recognized diagnostic scales:

DSM = Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, the latest version DSM – 5 was published on May, 18th, 2013

ICD = International Classification of Disease, published by the World Health Organization (WHO), that reached the version ICD – 10

 

According to the DSM-5, Autism Spectrum Disorder includes:

– Asperger Disorder

– Childhood disintegrative disorder

– Pervasive developmental disorder not otherwise specified (PDD-NOS)

According to the ICD – 10 Autism Spectrum Disorder includes:

–          Infantile Autism – F84.0

–          Atypical Autism – F84.1

–          Rett Syndrome – F84.2

–          Childhood disintegrative disorder – F84.3

–          Asperger Syndrome – F84.4

In fact, this diagnosis is based on the existence of one or more core symptoms onset in early childhood:

– Deterioration of the quality of social interaction;

– Impairment of communication and language;

– Repetitive, reduced and stereotyped behaviors and interests;

– Phobias, eating and sleep disorders, poor impulse control (aggression)

 

Comorbidities:Autism Spectrum Disorders tend to be highly comorbid with other disorders. Unfortunately, the association with other diseases may worsen evolution and can make treatment more difficult. Also it makes the diagnosis more difficult.

–          ADHD with attention deficit

–          Hypoton/neuromotor delay

–          Speech and language disorders

–          Mental retardation

–          Eating disorders

–          Sleep disorders

–          Aggressivity

–          Sensory problems

–          Anxiety, Depression,

–          Epilepsy,

–          Ocular Pathology

 

Description:

Infantile Autism: – onset before the age of 3 years, at least 6 of the following symptoms:

– The child cannot and do not know how to properly use facial and body messages in expressing emotions;

– The child cannot acquire the ability to relate with people of the same age, they don’t show the joy and interest inplaying with other children;

– Integration in the social context is made through improper and chaotic communication;

– Emotional spontaneity is almost absent;

– Verbal language is insufficiently developed and is not accompanied by non-verbal language;

– Inability and failure in initiating and sustaining a conversation;

– The language is stereotyped and repetitive;

– Imitative game is poor;

– Concerns and interests abnormal in content and in the intensity of expression;

– Exaggerating daily routines and his own rituals;

– Stereotyped and repetitive motor behaviors, stereotyped games.

 

Rett Syndrome: diagnostic criteria appeared by the age of 2-5 years:

– Apparently normal development up to five months, normal head circumference at birth;

– Between 5 months and 4 years, there’s a loss of the acquisitions in the use of hands, deficit in motor coordinationof the torso;

– Deficit in communication and social interaction;

– Severe impairment of receptive and expressive language, with a loss of the acquisitions already made;

– The occurrence of repetitive stereotyped hand movements.

Childhood Disintegrative Disorder:

– Necessarily involves a period of normal development of the child even for 2-3 years;

– Existence of a period of loss of the acquired skills;

– Manifestations are accompanied by gradual loss of interest in the environment, stereotypes and alteration of communication;

– Intellectual impairment is important.

 

Asperger Syndrome: there is a so-called symptomatic triad:

– Deficit of communication and emotional reciprocity;

– Social deficit;

– Restricted specific interests, but well-defined;

– The language is not affected, nor the cognitive development;

– Sometimes motility is impaired;

– Functioning at extremes: very sad/very indifferent; hypersensitive/hiposensitive; maximum abilities/totally annulated.

 

Assessment Tools:

Diagnosis should be done by multidisciplinary teams: pediatrician, psychologist, psychiatrist, speech therapist etc., which use validated diagnostic tools such as:

– ADI – Autism Diagnostic Interview,

– ADOS – Autism Diagnostic Observation Scales

– BSE – Behavioral Summarized Evaluation

– CARS – Childhood Autism Rating Scale

– CHAT – Checklist for Autism in Toodlers

– CCITSN – The Carolina Curriculum for Infants and Toodlers with Special Needs,

– DISCO – Diagnostic Interview for Social and Communicative Disorders

– ESAT – Early Screening for Autistic Traits

– GARS – Gillian Autism Rating Scale

– Leiter Test

– PEP – Psycho-Educational Profile

– PPVT – Peabody Picture Vocabulary Test

– Reynell Test

– STAT – Screening Tool for Autism in Children and Young Toodlers

– VABS – Vinelend Adaptive Behavioral Scale

– WISC Test

A complete and correct assessment, an early diagnosis and establishment of specific therapies can make huge differences in the evolution of these patients.

 

The incidence:

It is clear that the incidence of autism has increased over the past 40 years. It is unknown whether this is caused by the improvements in diagnosis methods, parent’s awareness regarding the disease and early diagnosis, or just a real increase in its incidence due to a genetic complex – environmental factors.

Also, it is obvious that this pathology is 4 times more common to boys than girls, but the degree of impairment at girls is higher and the IQ lower.

In 1970 the incidence of autism in the U.S.A. was 2.5/10000, in 1989 it reached 4/10000, in 1997 in France 5.3/10000, and after some Japanese studies, the incidence of autism is going somewhere to 13.9/10000. There are data that raises incidence to 60-70/10000 for all the spectrum of autistic disorders.[5]

 

2.      Causes and Treatment

Autism etiology is not completely known, but several risk factors have been identified:

– Genetic factors: research studies conducted by now have determined that there is not only one gene to be incriminated in causing ASD. There were identified more than 15 genes (7q, 12q, 16p, cz. X, HOXA1, NLGN3, NLGN4, neurexin) whose mutations are causing ASD, and a modest number of anomalies that are not causal, but that increase susceptibility to occurrence of ASD;

– Prenatal factors: maternal infections, parental age (above 30 years) – in particular of men;

– Perinatal factors: fetus exposure in utero to different viruses, ethanol, Valproic acid, to thalidomide, etc., can cause autism;

– Neuroanatomical abnormalitis: different brain areas malformed, brain injury of different etiologies (AVC, trauma at birth or postnatally, tumors) may give autistic pathologies;

– Environmental factors: as pollution, radiation, etc., in a particular context may increase susceptibility to autism. We can say that the interaction of the external environment with human biology on a genetic potential can contribute to cause autism.

 

There are a number of substantiated theories, sometimes controversial, but unfortunately not fully comprehensive, which try to explain the development of ASD:

– The controversial theory of vaccination;

– The theory of connection between immune dysfunction and ASD;

– The theory of postnatal intraneuronal chlorine level growth;

– The theory of testosterone level increase in amniotic fluid;

– The theory of Hyper-reactivity and Hyper-connectivity;

– The theory of the increased number of neurons;

– The theory of increased levels of serotonin, opioids or peptides;

– Various complex disorders of the digestive tract with autistic behavioral consequences.

What’s also known is that the manifestation of pathology has definitely an abnormal biological substrate. Recent research supplemented by modern neuroimaging techniques prove disruptions of: hippocampus, amygdala, cerebellum Purkinje neurons, frontal lobe or temporal lobe, some brain areas hypotrophy accompanied by hypertrophy in other brain areas, dysfunction in mirror neural system,dysfunction at mitochondrial level, in the corpus callosum, at neurotransmitters level so in the transmission of information, vermis hypoplasia, the entire left hemisphere dysfunction. Each patient shows an abnormality or more, combined in various ways, which explains ASD variety of facets.

There are theories that consider cerebral dysfunction as causing autism, but there are also others that link central level dysfunction (CNS) with abnormalities of other systems, resulting in complex system theory more than in localized brain ones. [6]

Some theories consider that an initial minor brain injury that occurred in utero or soon after birth, therefore early in the formation of the nervous system, involve, succesively, poor development of all structures connectedin the formation of the injured brain area. This theory may again explain the variability of ASD.[7]

Treatment:

The range of therapies for this pathology is extensive, but unfortunately not curative, rather targeting the improvement of some symptoms, the diminishing of unwanted characters with the ultimate goal: the individual independence. One of the most used therapy and with satisfactory results is ABA (Applied Behavioral Analysis). In addition we mention:

– TEACCH – Treatment and Education of Autistic and Communication Handicapped Children;

– PECS – Picture Exchange Communication System;

– The Hanen Program;

– Social Stories;

– The Option Institutes Son – Rise Program;

– Sensory Integration Therapy;

– Auditory Integration Therapy;

– Occupational Therapy;

– Animal Therapies;

– Music and art therapy;

– Language and communication therapy;

– Kinetotherapy.

 

There are also a number of medications, supplements, or diets in order to attenuate neurological or psychological disorders that generate ASD:

– Multivitamin therapy;

– Dimethylglycina (DMG);

– Gluten-free and casein-free diet (Yeast free diet);

– Serotonin;

– Precursors of GABA;

– Antipsychotics;

– Antidepressants;

– Anticonvulsants;

– Amphetamines;

– Pre and probiotics;

– Supplements based on omega 3,6,9;

– Homeopathic Products.

 

Here we mention as a treatment possibility, Scientific Auriculotherapy, a therapy with quite deep and fast effects that cannot be neglected. Certainly the effects will continue in time, with cortical structures deeply restructured, resulting the fair conclusion that the full effects are likely to be visible in a year after the therapy starts.

 

3.      The connection with Scientific Auriculotherapy and the explanation of the chosen points

Medical sciences have evolved over time in a stunning rhythm. Some theories have been disproved, others fully understood and eventually substantiated, ancient practices were combined with modern methods of investigation and generated therapies with undeniable results. Auriculotherapy is one of them, practiced since the ancient times, rediscovered, reinvented and renamed by Dr. Paul Nogier in the ‘50s and not least medical substantiated by modern imaging methods.

A spectacular leap in the neurofunctional substrate understanding of Auriculotherapy was made by Professor Dr. David Alimi who managed to reveal the complex and refined connectivity of the auricle and the cerebral hemispheres, the link that makes the auricle a privileged diagnosis and treatment place.

Definition: Scientific Auriculotherapy is a therapeutic technique that aims to treat sick people by physical stimulation of auricle reflex areas. It is part of the alternative medical sciences, completing or adjusting where allopathic medicine finds its limits.

In 1951 Doctor Paul Nogier discovered by chance and reinvent this beautiful discipline, establishing the first medical arguments.

Doctor Paul Nogier called this disciplinein 1956, Auriculotherapy- meaning „ear treatment”.

The year 1987 brought Auriculotherapy official recognition OMS.

In 1990 it was created the first International Nomenclature of Auricular points (92 points) by Doctor Paul Nogier.

In 1994 took place the first International Symposium in this field at Lyon.

Constant evolution of this science, demonstration and arguments provided, made possible its introduction to be studied in the university since 2005. Scientific Auriculotherapyis studied as Diplome Inter Univesitaire d’Auriculotherapie (DIU)–at the Faculty of Medicine in France for two years, aiming to deepenand understand the neurophysiological basis of auricular treatment.

Diplome Inter Univesitaired’Auriculotherapie is the only recognized diploma in this field and is received by the practitioner after the specific training:

– 2 years of study (228 ore course);

– Internships in the hospital;

– Drafting a research study.

 

In 2010 Doctor David Alimi has created a new International Nomenclature of Auricular points (196 points).

The ear is a pair organ located on the sides of the head. It consists of: the inner ear, middle ear and external ear or the auricle.

The role of the ear is complex: hearing, an important organ in maintaining equilibrum, and not the least, a touch screen for Auriculo treatment.

For us, the auricle is of great interest.

The auricle:

– Has an external face (anterior) and an inner one (posterior or mastoidian);

– Has a final size (reached around the age of 8 years) of 7 cm vertical/3.5 cm horizontal with an external surface of about 21cmp/ear;

– Consists of lobe and lobul.

 

The auricle vascularization is provided by the external carotid artery that divides into:

– Superficial temporal artery with lower, middle and upper branches;

– Posterior auricular artery with lower, middle and upper branches.

 

Venous return is realized in the external jugular vein in which drains

-Superficial temporal vein for external face;

-Posterior auricular vein and mastoid emissary vein for the inner face.

Lymphatic drainage is achieved:

-For external face by pretragus, mastoid and parotid lymph nodes;

-For internal face by mastoid and parotid lymph nodes;

discharging into the deep side lymph nodes of the neck.

The complex sensitive and motor innervation is given by the nerve 5 of the first brachial arch, by the nerve 7 of the second brachial arch and by resurgences from the nerves 3,9,10 and PCS (cervical superficial plexus).

The embryological origin

The auricle is formed from six hillocks from the mesoderm issued on the first and the second brachial arch around the first brachial groove in the 40th day of the embryonic life. The derivatives of these hillocks keep the brachial arches innervation from which they were born, as follows: the nerve 5 for the first brachial arch, and the nerve 7 for the second brachial arc.

Complex movement of cephalic area, lead to compression of the brachial arches, resulting in the merger of the arches 4 and 6, with the disappearance of the arch 5. This process favors the merge of the nerve elements of different origins, generating complex innervation of the auricle.

From embryological point of view, the cartilaginous blade forming the auricle skeleton has mezodermic origin; nervous elements and epidermal shell have ectodermic origin. Overall, the auricle has mezectodermic origins.

Special feature display the nerves 5, 7, 9, 10, the only nerves in our body that possess a bidronic flow, in other words, in both ways – which is due to electrical synapses. These are the nerves that innervate the auricle, a major advantage in the information transfer.

The mechanism of Scientific Auriculotherapy is explained by the neurophysiology laws, which, without exceptions, are respected:

Hilton Law–of specific nerve energy – a specific receptor stimulation always give the same specific sensory perception, because – the receptor is stimulated by a single type of stimulus, which always follows the same nervous path, always projected in the same cerebral area, always coded by the same electric potential. This law ensures stability of the cartography.

The three laws of Kahler:

1.      Entering into the marrow, the information is completing each other’s from outside to inside and from bottom to the top.

2.      Convergence Law = all structures of a metamer sums the information at the same neural unit.

3.      In case of problems, the brain reverts to the last, the best configuration (homeostasis) known.

Hebb’s Law = cellular assembly law is the law applied to synapses.

Into a neuronal ensemble each neuron detains the information of the other neurons. Complete information activates the entire neuronal circuit. When information is incomplete, due to memory and interconnections between network neurons, the brain rebuilds complete sensation by reactivating the whole ensemble.

 

Neuroanatomy

Auricle is connected through the reticular substance to the cerebral hemispheres. This special connection makes that, from all information transiting reticulate substance with upward and downward direction, 70% from it to transit by the auricle, in this way, each ear becoming the deposit of a motor and sensitive somatotopia identical to that one of the brain. There is a myelo-reticulo-auriculo-cerebral circuit, thus:

Right ear is connected to the left cerebral hemisphere.

Left ear is connected to the right cerebral hemisphere.

Information in its upward path crosses at the thalamus level (except olfaction sense), which makes the right half of the body to be projected on the left cerebral hemisphere, and he left half of the body to be projected on the right cerebral hemisphere.

Thus we understand why pathology in the right hemi-body will be searched and treated on the right ear.

The richness and complexity of the innervation of the ear, positioning and direct connection to the cerebral hemispheres and reticular substance, identical somatotopy to that projected on the cerebral hemispheres, make from auricle a special place of diagnostic evaluation and therapeutic action.

Direct access to the cerebral hemispheres, makes from Scientific Auriculotherapya technique with a strong impact in pathologies of cerebral nervous origin, hence the therapeutic potential in Autism.

Understanding the therapeutic potential of Scientific Auriculotherapyand evaluating the complexity of Autism neuropathology, we tried to find simple basic elements to influence successively the other elements of the whole.

 

Purpose:

We analyzed the cases proposed to be treated and decided to aim:

– Improving connectivity with the outer world;

– Decreasing the stereotype behavior, the hiper-kinetism, and the aggressivity;

– Improving mental and speech delay.

We have considered that, if we improve these three areas, the patient evolution will increase exponentially.

Taking into account that patients are children aged between 5 and 11 years old, we found very important to use a minimum of (auricular) points hoping maximum effect.

Two items caught our attention and influence us to draft the following three protocols:

1. Taking into account that there may be multiple areas damaged (hippocampus, amygdala, frontal lobe, temporal lobe, cerebellum, combinations of several areas with lesions, lack of connectivity), and being impossible to tackle them one by one, we decided that one of the protocols to follow the stimulation of cerebral plasticity (….).

2. The mirror neurons dysfunction. Mirror neuron system is involved in learning new motor patterns, in social imitation, in language acquisition, in complex imitation and in social judgment, in conclusion in social-communicative functioning. The mirror neurons system is placed in the temporal lobe, parietal lobe and frontal lobe, the system activating him self during observation and imitation of an action. There are studies showing that the mirror neuron system is not native, but is formed through learning processes in strict correlation with the outside. In the case of children with autism, insufficient development of this system is caused by the low interest in the outside world. We found (…..) point very interesting to be used due to its valence to open outward a person, aiming as effect the development of mirror neurons, and also in getting empathy, the social valences and the imitative learning.

Summarizing, we decided to use as therapeutic points:

(…..)

 

II.               Clinical cases

1.      Materials and the method

Materials:

Scientific Auriculotherapy is a medical act par excellence, therefore, asepsia was rigorously respected, this means auricle alcohol desinfection. Considering that all patients are children, we conducted treatment using exclusively the Cryospray (a device produced by Cryoalfa and used for medical purposes in auriculopuncture). We considered that the classic ASP would have been easily removed by the children, shortly after the treatment.

Selection criteria and the method used:

Patient recruitment was done through Help Autism Association, an association founded to support autistic children. We did a briefing to explaine the potential benefits of this therapy on children with autism, targeting the parents of the autistic children from this Association. Some of the parents have agreed to participate in this study; therefor, a written agreement was signed.

Treatment started on February the 1st, 2014, the order of the cases presented in this study being the order the children came to be treated.

Patient’s selection criteria to be included in this study were chosen in order not to affect the final result and were as follows:

– The children should have been diagnosed by a complex medical team and especially by a neuropsychiatrist– psychologist;

– ABA therapy started at least six months previously;

– New stress factors in the child’s family were not accepted (such: pregnant mother close to give birth to a new baby, imminent change of residence or the therapist, divorce etc.)

– We have requested that on the period of project development, no change in the applied therapies or medications administered will be proceded.

To achieve early medical evaluation, we have asked for MRI / CT, EEG in sleeping time, blood tests, psychological evaluation in the beginning and at the end of the project.

Treatments were performed once every month, the changes in child behavior being assessed by the parents once a week and recorded in a table by giving scores from 0 to 10, where 0 means the total absence of the element evaluated, and 10 means the maximum intensity of the element evaluated.

2.      The presentation of clinical cases

In this study were involved 16 children, 5 of which were excluded to fit the criteria of homogeneity.

There will be presented 11 cases, 2 girls and 9 boys, aged 5.5 to 11 years. Four children were diagnosed with Infantil Autism (F 84.0) and 7 children with Atypical Autism (F84.1)

Pathologies tracked and targeted by the therapy:

– Communication/interrelations/empathy deficiency;

– Stereotypes;

– Language delay/total absence of language;

– Cognitive delay;

– Hyperactivity and lack of attention;

– Aggressivity (not as a feature of autism behavior, but because of high incidence).

 

Treatments performed are:

Treatment no. 1: (….)

Treatment no. 2: (…)

Treatment no. 3: (…)

Treatment no. 4: (…)

Treatment no. 5: (…)

The treatments were performed bilaterally with start on the (…) of the laterality because of the Limbic component of autism, every month (4 weeks in between).

The first 3 treatments were considered to be of inducing, the 4thwas performed for consolidation and the 5th treatment as rappel (consolidation) after 7 months (for (…) chronobiology). The 5th treatment offered us the opportunity to evaluate the patients 7 months after the begining of the treatment.

 

Patient no. 1: B.E girl, 5 years

Case history: pregnancy and childbirth have evolved normally, prolonged icterus up to 1 month;

– Seat positioning – 6 months and a half;

– Wasn’t able to stand up, at 1 year and 4 months started kinetotherapy, being able to walk alone at 2 years and 8 months;

– From 1 year and 10 months diagnosis of retardation;

– From 4 years Atypical Autism Diagnosis.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: ADHD, attention deficit, retardation, ocular pathology, aggressivity.

Investigation: normal blood tests, MRI – incomplete myelinated temporo-parietal bilateral areas.

Therapies and treatments on going: ABA for 1 year, kinetotherapy, speech therapy, behavioral therapy, cod liver oil, Clopixol (1 drop in the morning/1 drop in the evening), Tonotil (1 bottle/every day for 10 days).

The evaluation found: eye contact present, acceptable nonverbal communication, poor verbalization, neuromotor delay, attention deficit and hyperactivity, stereotypes and aggressivity present.

Treatment no.1: was conducted on February the 1st, 2014

Improvement – on communication, verbalization, memory, motor skills, attention

Unchanged – hyperactivity, stereotypes, aggressivity

Treatment no.2: was conducted on March the 1st, 2014, (….)

Improvement– on communication, verbalization and motor skills (jumps on 2 feet)

Increasing –hyperactivity and aggressivity

Treatment no.3: was conducted on March the 29th, 2014

Improvement- great verbalization, great motricity, improved communication and cognitive function.

Increasing – aggressivity and hyperactivity

Treatment no.4: was conducted on April the26th, 2014 (…).

Final evaluation of the case: evaluation of the coordinator psychotherapist establishes that B.E. no longer have autistic type of behavior, the only remaining problem of this child is hyperactivity combined, from time to time, with aggressivity, for wich we requested endocrine evaluation.

Treatment no.5: was conducted on September 5, 2014 (…)

Evaluation after 7 months establishes that B.E shows:

Eye contact present, interest for the exterior and for the people; the child is willing to spend time with other children.

Motricity is acording with biological age.

Verbalization is significantly improved: repeats sentences, spontaneously formulate 5 words sentences, verbally request of anything she needs.

Improved attention, hyperactivity decreased to a minimum level (we believe that she is no longer hyperactive, but her mother declare that she still has such moments)

Aggressivity decreased to very rare crisis in terms of high frustration.

Stereotypes still exist but have slightly decreased.

The child became curious, manages to learn, to assimilate information.

Shows moments of absence that combined with a modified EEG generated the administration of Depakine by the neuropsychiatrist (we suspect epilepsy diagnostic – the child under evaluation).

Endocrine evaluation has not been made.

The child shows microcephaly with intellectual retardation.

Conclusion:    – autistic behavior no longer present

– Comorbidities improved

– Epilepsy under evaluation.

 

Patient no.2: C.M, boy, 5.5 years

Case history: pregnancy and child birth have evolved normally, physiologic icterus for a few days;

– Seat positioning – 6 months and a half;

– Stand up, at 7 months;

– Between 2 years and 2.5 years begins regression, does not respond any more, he is losing acquisitions;

– From 2 years and 8 months Atypical Autism Diagnosis.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: Severe retardation, eating disorders.

Investigation: none.

Therapies and treatments on going: ABA for 3 years, speech and language therapy.

The evaluation found: no eye contact, nor communication, concerning the verbalization – no words, lack of attention, stereotypes present, high cognitive deficiency (intellectual retardation), no ability to learn and assimilate.

Treatment no.1: was conducted on February the 1st, 2014

Improvement – on communication, interrelations, attention.

Unchanged – language and stereotypes.

Treatment no.2: was conducted on March the 1st,2014,(…)

Improvement – slow, verbalization – start to repeat words, „he is more present” – says the mother

Unchanged- stereotypes

Treatment no.3: was conducted on March the 31st, 2014

Improvement–on communication, better attention and concentration, on motricity

Unchanged- stereotypes

Treatment no.4: was conducted on April the 26th, 2014

Improvement – continuous but slow, more aware of things around

Unchanged– stereotypes

Positive evolution on cognition and opening to the outside, but overall minimal changes.

Treatment no.5: was not performed because of the unavailability of his parents, but the evaluation was made. According to the mother statements, C.M. start learning began to evolve (which does not happen before). Thus he managed to learn sequences of activities that once learned, are no longer forgotten, but always respected and followed exactly. He came to make puzzle of 9 pieces. Evolution remains low, but there are changes even in this case, small, but there are improvements.

 

Patient no. 3: P.E, boy, 9.5 years

Case history: toxic pregnancy, cesarean delivery, and prolonged icterus emphasized (a month and a half);

– Seat positioning- 7 months;

– Stand up, at 8 months;

– Was able to walk alone at 1 year;

– After the age of 1 year have begun fixations and stereotypes;

– From 3 years and 11 months Atypical Autism Diagnosis and ADHD.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: ADHD, cognitive delay, speech disorders, aggressivity.

Investigation: normal blood tests, skull CT – no detectable changes.

Therapies and treatments on going: ABA, swimming, Rispolept (0.25 mg), anxiofit, Biomax, DHA soft gel, Rodiola.

The evaluation found: no eye contact, poor communication, concerning the verbalization – no more than 25 words in his vocabulary, doesn’t make sentences, shows no spontaneous speech, lack of attention, stereotypes, hyperactivity and aggressivity (unable to stand still for one second, we were careful not to be attacked,hit in the head, grabed by hair, have broken things –this was a stressful evaluation, because the child was extremely agitated and uncooperative).

Treatment no.1: was conducted on February the 1st, 2014

Improvement – on communication, the child opened outwards, he is more interested in the things around, improved attention, show empathy and love for the people he knows, hyperactivity and low stereotyping from 10-6, aggressivity decreased (no more than one crisis per week, from daily crisis). At the first treatment he wasn’t able to stay still for a second, at the second one, he stood for 10 minutes in the chair and watched us filling the papers without wanting to leave. Regarding verbalization it was obtained minimal effect.

Treatment no.2: was conducted on March the 1st, 2014, (…).

Improvement – continuous improvement but slow, careful and more open to the outside.

Increasing –hyperactivity and aggressivity.

Treatment no.3: was conducted on March the 29th, 2014

Improvement – continued and slow, the child is curious about external things, has moments of spontaneity, understand better what is happening around and what is said, and begin to verbalize.

Still high: – hyperactivity and aggressivity, appears lack of inhibition (pee in the middle of the therapy room).

Treatment no.4: was conducted on April the 26th, 2014

Improvement – slow, better communication, better reasoning and speech improvement

Decreased – hyperactivity and stereotypes.

Overall evolution was very good on cognition, socialization, verbalization and attention; satisfactory concerning the stereotypes and hyperactivity.

Treatment no.5: was conducted on September the 3rd, 2014 (…)

Seven months evaluation established that P.E.:

Eye contact, interest to the surrounding world, good and constant interaction with the outside.

Much improved cognition: listen and understand what is happening around, understand and comply with requests, make jokes (hide things and return them when the mother demands), cooperative to requirements and demands.

Crises of aggresivity and frustration significantly diminished in intensity and frequency.

Hyperactivity decreased to a tolerable level, the child sits on a chair at each therapeutic meeting; accept treatment with minimal opposition – with explanations.

Attention has improved, stereotypes diminished.

In the context of this good therapeutic evolution, Rispolept was gradually removed completely.

Verbalization is the only element that remained unsatisfactory. There is a low improvement; there is neither spontaneous speech, nor verbal communication but only on request. For this reason we added treatment of (…).

An excellent overall evolution from chaos, aggression and maximum agitation to cooperative behavior; the child can understand and is able to communicate.

 

Patient no. 4: M.A-M, girl, 5 years

History: pregnancy without problems, but with natural birth and circular ombilical cord;

– Seat positioning- 8 months;

– Stand up – at 1 year;

– Was able to walk alone at 1 year and 3 months;

– From 1 year and a half Atypical Autism Diagnosis and ADHD with lack of attention.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: ADHD with lack of attention, cognitive delay, speech disorders, aggressivity.

Investigation: the blood tests found elevated plasma ammonia (134.7 micromol / l – VN = 11-51)

Therapies and treatments on going: ABA, kinetotherapy, Rispolept (0.5 mg), Romparkin (0.25), Vitamin B complex, Tonotil – 10 days / month, cod liver oil

The evaluation found: no eye contact, poor relational abilities, concerning the verbalization – no more than 10 words in her vocabulary, attention deficit, stereotyps, hyperactivity and aggressivity present.

Treatment no.1: was conducted on February the 1st, 2014

Improvement – slow, a little on communication, a little on spontaneous verbalization, fine motricity improved, slightly lower stereotypes and aggressivity

Decrease – attention and concentration

Increase – hyperactivity

Treatment no.2: was conducted on March the 1st, 2014, (…)

Improvement – better evolution, more attentive to the requests, better understanding regarding what people say to her, answer better to meet requests, increased affectivity, and decreased stereotypes

Begin to grow – hyperactivity

Treatment no.3: was conducted on March the 29th, 2014

Improvement – continuous and slow, increase the number of words, their understanding and the context in which they are used, ​​more aware of the environment, began to express affection, decreased stereotypes, and hyperactivity begins to decrese too. Aggressivity low.

Treatment no.4: was conducted on April the 26th, 2014

Improvement – slow and continuous, the child is quiet but social interact well.

Overall, good continuous improvement in all areas involved.

Treatment no.5: was performed on September the 10th2014 (…).

Seven months evaluation has found:

Overall evolution is below expectations. The 2nd treatment had a large effect, then began to regress gradually.

Made on levels – verbalization improved, repeat everything, has even spontaneous speech, hyperactivity diminished considerably, response to frustration through aggressivity diminished too, but attention, focus and cooperation during the hours of therapy is considered unsatisfactory by the parents and developments expected by the therapists is minimum. Communication and relationship with others is also still poor, though there is a slight curiosity for new people, but insignificant.

It is possible that parents evaluation to be distorted by their high expectations, but therapist evaluation established minimal evolution on every level. Ammonia level is still increased, so the child is on Ornitina every day. Taking into consideration the poor child evolution and all the information provided by the mother related with some medical simptoms we have recommended child extensive medical evaluations. That is also why we added to the treatment (…).

 

Patient no. 5: H.M, boy, 9 years and 3 months

History: normal pregnancy, natural child birth at term but with forceps application, resulting in cerebral hemorhage, intubated eight days, seizures, left facial paralysis;

– Seat positioning – mother no longer remembers;

– After 1 year and 8 months hospitalization for assessment – diagnosis of atypical autism, mental delay.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: ADHD with lack of attention, retardation, speech disorders.

Investigation: IRM 2006 – Interfrontal enlarged crack, lateral ventricles and the third ventricles – marked enlarged, numerous hypodense areas, confluent – bilateral parietal. 1/3 anterior hipogenezia of corpus callosum, internal triventricular hydrocephalia, nonactive, nonobstructive.

IRM – 2007 – brain abiotrophia, sequels areas at the level of the right temporal lobe, left frontal, right parietal.

IRM – 2011 – supratentorial injuries at frontal and temporal bilateral lobe and right parietal, secondary atrophy of the corpus callosum.

Found in blood tests with elevated plasma copper and with urine copper decreased.

Therapies and treatments on going: Rispolept (0,25×2/day), Fevarin 50mg (1/2cpx2/day), Mentat (1cp/day)

The evaluation found: eye contact present, acceptable nonverbal communication, poor verbalization, he does not understand the meaning of words and statements, hyperactivity, stereotypes present – but not disturbing, and aggressivity – high in the absence of drug treatment, poor memory.

Treatment no.1: was conducted on February the 1st, 2014

No change!

Treatment no.2: was conducted on March the 1st, 2014, (because it wasn’t noticed any change due to the specific protocol, and taking into account the hemorrhagic stroke at birth, we decided to apply the protocol for recovering stroke sequelae (…).

Improvement – important in all areas – the communication, the stereotypes, motricity – better equilibrium (jumps over obstacles), better coordination (play the ball)

Treatment no.3: was conducted on March the 29th, 2014 (the proper treatment to the project)

Improvement–significant concerning the verbalization (he repeats sentences, speaks words spontaneously), opens outwards, curious about the things around, motricity in continuous improvement, decreased stereotypes, appear habits, calm and does different actions in order.

Treatment no.4: was conducted on April the 26th,2014,(…) to stimulate verbalization)

Good continuous improvement.

Treatment no.5:was conducted on August the 4th 2014 at the express request of the parents – to improve the memory, planning to carry out 7 months treatment in September, according to the schedule (…).

At 6 month evaluation it was found good continuous evolution on every level – verbalization improved – spontaneously formulate sentences of 3 words, repeate words and has much better understanding of what is said and what is required; he is cooperative to claims, decreased hyperactivity, aggressivity decreased significantly. Memory remained troubled; the parents said that what is learned is forgotten until the next day and is seen as new. For this reason parents asked a new intervention before 7 months, and asked help in removing Rispolept. We established two treatment sessions, one in August to stimulate cognition and memory, and one in September when the dose of Rispolept reaches the minimum dose.

Treatment no.6: – was conducted on September the 13th, 2014 (…)

7 months evaluation has found:

Following the decrease of Rispolept dose, the treatment was applied to an extremely happy child, full of energy, continuously talking and commenting on what was discussed, having fun and making jokes.

Interacts very well, is open and communicative, cognition much improved, the memory protocol applied in August had visible effects until the Rispolept dose diminished until there appeared crises of violence and aggression. The child don’t sleep any more, neither at night, nor at noon. From this point of view there is no control, any discontent, or limitation of his wishes is received with maximum violence and aggressivity. For this reason the treatment was changed in aiming to diminish aggressivity, simpaticotonia and adjust the sleeping program.

 

Patient no. 6: P.A, boy, 8 years and 3 months

History: complicated pregnancy with gestational pyelonephritis in the 8thmonth, fever for 2 weeks, hospitalization with venous antibiotic treatment;

– Premature birth at 36 weeks;

– Seat positioning- 6 months;

– Stand up – at 7-8 months;

– Was able to walk alone at 9 months, evolution and acquisitions according to the age;

– Vaccination at 12 months, after which: evolution stopped, broke strabismus, refusing solid food, disparate words, impaired fine motricity.

– Between 3 and 4 years is conducted psychological evaluation due to the absence of verbalization and was set ADHD diagnosis with autistic notes.

Principal Diagnosis: Autistic notes.

Secondary Diagnosis: ADHD, speech delay.

Investigation: no IRM, EEG – without pathological changes, blood tests: iron increased – 165μg/dl (VN = 27-96), copper in urine / 24h decreased

Therapies and treatments on going: ABA for 3 years, psychotherapy, swimming, omega 3 supplements.

The evaluation found: eye contact and verbalization obtained by ABA therapy, difficulties to set relations, doesn’t answer to requirements, hyperactive and lack of attention, there are stereotypes, high aggressivity to frustration (throw and destroy the toys).

Treatment no.1: was conducted on February the 15th, 2014

Improvement – more cheerful, more sensitive and empathic to the suffering of others, accept to do what was asked, verbalises much better, more attentive, more focused and more involved in school activities.

Treatment no.2: was conducted on March the 15th, 2014, (…)

Improvement – continuous but slower, better eye contact, he enlarges his interests, verbalization in continuous development, began repairing toys broken when he can, became obedient to carry out what is requested, does what is asked to do.

Treatment no.3: was conducted on April the 19th, 2014

Improvement – continuous improvement in all areas, no longer crying when frustrated

Treatment no.4: was conducted on May the 24th, 2014

Good continuous improvement in all areas assessed (verbalization, communication, empathy, motor skills, attention and cognition).

Treatment no.5: was conducted on September the 3rd, 2014 (….)

7 months evaluation has found:

The child evolved very well on every level, understands everything is discussed, has spontaneous and complex verbalization, rich vocabulary, still makes grammar mistakes that he corrects if prompted, interacts very well with his school teacher and classmates, responds to questions within hours, has no aggressive reactions with colleagues in times of frustration. During classes sit nicely in the bank and resolve the required activities (so far stood up and tried to evade).

On behavioral and emotional level there are significant changes, he is more quiet, more calm, more patience, is no longer destroing toys, doesn’t make frustration crisis. He is able in some cases to empathize with other children, is more interested in his colleagues feelings especially in conflict situations. Better express his emotions, cry without restraint when sad, enjoy and laugh when playing with other children, actively participate in games, sometimes he wishes to engage in some particular games.

He gained rich imagination; create scenarios for him and the others, role playing games with animals.

Concerning motility, he reached his age level, has very good balance and coordination (is able to run very well on scooter).

Parents believe that he still need help on concentration and communication, which is why it was applied (…).

Overall he has great evolution on every level evaluated.

 

Patient no. 7: S.A, boy, 11 years

History: pregnancy and child birth without special problems;

– Seat positioning – 5 months and a half;

– Stand up – at 11 months;

– Was able to walk alone at 11 months and a half;

– At 2 years of age he did not respond to the call, had few words in vocabulary;

– At 2 years and 2 months sent to boarding school – total blockage of language;

– At 3 years and 2 months – atypical autism diagnosis;

– At 3 years and 6 months started ABA with very good results.

Principal Diagnosis: Atypical Autism (F 84.1).

Secondary Diagnosis: ADHD, lack of attention, retard, delay in language development.

Investigation: no IRM, other investigations within normal limits.

Therapies and treatments on going: ABA, Mentat (2cp/day), Pure DHA (2/day).

The evaluation found: eye contact present, but difficult to achieve, absence of nonverbal communication, poor verbalization, stereotypes, few words in vocabulary, hyperactivity with lack of attention, many stereotypes, little aggressivity.

Treatment no.1: was conducted on February the 15th, 2014

Improvement – the child opens outward, is more interested in what happens, see things that didn’t interested him before, he is more attentive, begin to say simple sentences spontaneously, improved thinking, better understand and accept to do what is required, stereotypes and hyperactivity decreased, has stronger emotions – happiness, anger, ask to be consoled and comforted when hits himself. Parents expressed spectacular effect „he is a different child!”

Treatment no.2: was conducted on March the 15th, 2014,(…)

Improvement – continuous improvement but slow on communication and verbalization, better empathy, respond well to therapy classes.

Increasing – hyperactivity and stereotypes, is pretty agitated at home and disobedient, he has difficult behavior and is hard to manage him on the street.

Treatment no.3: was conducted on April the 19th, 2014.

Improvement – continuous concerning interrelations, verbalization, improved attention despite agitation, responds well and is cooperating in therapy, becomes curious and spontaneous in actions.

Increasing – hyperactivity, stereotypes, lack of inhibition occurs (jumps in the street screaming very loud).

Treatment no.4: was conducted on May the 10th, 2014 earlier than planned because child hyperactivity, stereotypes, and lack of inhibition that exceeded the bearable limit of the parents.

Decreases hyperactivity and further improve the communication, socialization and verbalization. Very good evolution in general.

Treatment no.5: was conducted on September the 10th, 2014 (…)

7 months evaluation has found:

Communication –he is aware of what is said, is listening what’s going on, sits and processes, and, with a delay of a few seconds, respond or react. On vacation he played with other children interacted well to people. Significant improvement.

Cognitive improvement is noticed; also he understands everything that discussed, what is asked, reasoning and responds well to demands.

Stereotypes decreased, but remained 2, connected ruther with joy than with frustration.

Hyperactivity diminished, manifested only under extreme stress conditions, attention improved.

Verbalization improved, enriched vocabulary, uses words correctly according to their meaning, make meaningful and even spontaneous sentences,verbal request of everithing he needs.

Empathy – expresses both his positive and negative feelings; when sadness occurs, he askes to be comforted. Do not empathize to the others suffering not even to his mother’s.

Overall improvement is very good on all levels evaluated, continuously evolving very well.

 

Patient no. 8: B.A, boy, 7 years

History: pregnancy and child birth without special problems;

– Seat positioning-5 months;

– Stand up- at 6-7 months;

– Was able to walk alone at 1 year;

– Up to 1 year and 6 months develops normally, verbalization according to the age;

– Up to 2 years lose all acquisitions, it starts stereotypes;

Principal Diagnosis: Infantil Autism (F 84.0).

Secondary Diagnosis: ADHD, lack of attention, speech disorders, intake obesity, astigmatism.

Investigation: within normal limits.

Therapies and treatments on going: ABA, speech and language therapy, Tonotil (1 bottle/day for 15 days), Magne B6.

The evaluation found: poor eye contact, interrelations and communication difficult to obtain, poor verbalization, hyperactivity, stereotypes present and aggressivity.

Treatment no.1: was conducted on February the 15th, 2014.

Improvement – on all levels, decreased stereotypes, empathy and affectivity appeared, is opened to the outside and more focused.

Treatment no.2: was conducted on March the 15th, 2014,(…)

Improvement – continuous on all levels, better socialization, even with unknown people, empathic, begins to make sentences of 3 words, stereotypes and aggressivity diminish.

Treatment no.3: was conducted on April the 19th, 2014

Improvement – continue on all levels, attention, cognition and motor skills, communicate better and more coherent in speech, is curious.

Treatment no.4: was conducted on May the 24th, 2014

Overall evolution and constant improvement is very good.

Treatment no.5: was conducted on September the 13th, 2014 (…)

7 months evaluation has found:

Good eye contact, communication is good but there is room for improvement, better manifestation of emotions, more spontaneous, show more affection. Better cognition, is reasoning, understand everything, do arithmetical operations, learn poems, learn how to read. The verbalization is also improved; pronunciation is clear and makes sentences of 7 words, spontaneously. Pays attention to his homework, manifest ambition and if he fails to complete perfect the tasks he become self aggressive (he hits his head with his palm–it is the only form of aggression that still exists). He has no stereotypes. Since starting therapy his evolution was slow but steady and without recourse moments, and definitely better than in the previous years.

 

Patient no. 9: B.G., boy, 9 years and 4 months

History: pregnancy and child birth (by cesarean delivery) without special problems;

– Seat positioning- 6 months;

– Stand up- 7 months;

– Was able to walk alone at 1 year;

– At 2 years of age the parents raise themselves their first questions because eye contact is absent, the child is withdrawn and introverted, does not answer to the call. Neuropsychiatrist assessment – all normal;

– At 3 years and a half he gets in the community, is assessed by another neuropsychiatrist and receive- Infantile Autism diagnosis;

– Starts ABA to 6 years of age.

Principal Diagnosis: Infantil Autism (F 84.0).

Secondary Diagnosis: ADHD, lack of attention, mental retardation.

Investigation: he doesn’t have, don’t do.

Therapies and treatments on going: ABA, swimming, piano, Pure DHA, Mentat.

The evaluation found: eye contact difficult to achieve, poor communication and interrelations, poor verbalization (doesn’t make sentences), hyperactivity with lack of attention, stereotypes and self aggressivity.

Treatment no.1: was conducted on February the 22nd, 2014.

No change after 1 month!

Treatment no.2: was conducted on March the 15th, 2014, (since it wasn’t found another pathology in the child history to relate to, it was applied (…))

Improvement – becomes more present, is more attentive to what is happening around, perform faster requirements, improved spontaneous speech, improvement in communication, better understanding of what is happening around (thinking better).

Unchanged: hyperactivity and stereotypes.

Treatment no.3: was conducted on April the 26th, 2014

Improvement– on cognition, better understanding, becomes spontaneous in attitudes.

Unchanged– hyperactivity and verbalization

Treatment no.4: was conducted on May the 24th, 2014

Clear improvement but slow, without major changes in between treatments. He opened outwards, improving cognition and appearance of spontaneity.

Treatment no. 5: it will be applied on September the 20th, 2014, we made the assessment to complete this study.

7 months evaluation has found:

Opening to exterior has not changed, only interacting with adults, not interested in children; interact with them only at the request of the therapist.

Increasing verbalization by increasing the number of words in the vocabulary, the number of words in a sentence and shows increased spontaneous speech.

Stereotypes are the same, if one disappears is replaced by another, finally remaining a constant number.

Good cognitive evolvution, understand what is said and react accordingly. Do what is required without needing for insistence and without gesture exemplifications.

Empathy exists, sometimes he comforts his crying sister and sometimes he doesn’t notice her. Laugh and have fun to the jokes of the others.  When he causes funny situations he is the first to laugh and be amused. He began to be ashamed and hide himself when there are new people around. Shows the same level of aggressivity; hyperactivity only when he gets home after a long and tiring day.

Becomes spontaneous, sometimes ask things that are obviously necessary but he does not enjoy them (if dirty asks to be washed). Answer to the questions that are pronounced on normal tone without being necessary to be stressed.

Parents say that the whole evolution is slow and steady. Initially it was hard to make a connection of the improvements with Auriculotherapy treatment, but later they decided that the evolution was more sustained, more visible, constant and faster in time.

Good overall evolution.

 

Patient no. 10: V.A., boy, 10 years and 7 months

History: pregnancy without special problems, child birth in term, without fetal distress;

– Seat positioning- 6 months;

– Stand up- 7 months;

– Was able to walk alone at 11months;

– Was able to count by himself at the age of 1 year and 1 month;

– At 1 year and a half made the vaccine – sudden onset pathology – eye contact is absent, introverted, does not respond when called, communication became more and more difficult.

– At 4 years and a half received the diagnosis of Infantile Autism, ABA two years without any effect.

– Make daily crises of agitation with sympathicotonia aspect (rapid pulse, increased heart rate, sweating very abundant – wet from head to toe) – with a duration up to 2 hours.

Principal Diagnosis: Infantil Autism (F 84.0).

Secondary Diagnosis: ADHD, lack of attention, mental retardation, speech disorders.

Investigation: IRM – discrete lateral ventricle asymmetria, accentuation of pericerebellar areas.

Therapies and treatmentsongoing: psychopedagogy, kinetotherapy, swimming, Waldorf pedagogy, Rispolept (0.25 x2/zi), carbamazepine 200 (1/2 cp evening).

The evaluation found: significant and continuous agitation and aggressivity (mother declares that he is not able to sit still for 30 seconds at the table to eat), lack of communication, interrelation, eye contact, delay in verbalization, altered sensory (doesn’t bear pants on, pull them down continuously to undresses), stereotypes, lack of attention, difficult to work with him at therapy because he is moving continuously.

Treatment no.1: was conducted on March the 1st, 2014

Improvement – Spectacular from the second day after!! He is able to stay an hour at the table and eat quietly, sit to therapy up to 2 hours and is focused on the proposed activities, accept something thicker under trousers without being bothered, communicate with other children at school, stereotypes diminish to minimum, hyperactivity disappears, his walk becomes quiet and orderly, the sympathicotonia crises disappear, verbalization improves. Duration of improvement 3 weeks, after which, tendency to regress.

Treatment no.2: was conducted on March the 30th, 2014, (…)

Improvement – very good for a week, then two days and a half is in continuous agitation. After that everything comes back to normal, he is calm, continuous improvement on every area, very very good weeks, followed, from time to time, by a day when everything is agitation and constant movement.

Treatment no.3: was conducted on April the 19th, 2014 (the treatment to stimulate brain plasticity wasn’t applied because of the agitation effect obtained in other cases; it was conducted directly treatment no. 4 to consolidate the effect obtained)

Improvement – very smooth and continuous at all levels. Three weeks of peace and harmony, cooperation and communication. Improves cognition, responding to requests. 4thweek recourse on hyperactivity and aggressivity.

Treatment no.4: was conducted on May the 24th, 2014(was applied (…), hoping to fall sympathicotonia and maintain good effect of the treatment for more than 3 weeks).

Conclusion after 4 treatments: In this case improvements are spectacular, hyperactivity minimal, very good communication and socialization, empathy and cooperative in therapy, sensorial perception attenuated. But this effect lasts for three weeks.

Treatment no.5: was performed on September the 3rd, 2014 (…)

7 months evaluation has found:

Good cognitive evolution, understands everything that happens, communicate or is planned around.

Empathize better with the others, enjoys his parents return from work (absent behavior before) and enjoys the presence of his brothers and sisters.

Hyperactivity decreased to minimum, reached an order and harmony that are disturbed only by the presence of many people around. However he does not crisis and scenes any more.

The verbalization start to improve significantly from speaking one word very rarely he become to combinea couple of words. Rare spontaneous speech, stereotyped speech improved.

He manages to sit at the table to eat or to perform various topics.

The difference from the beginning is impressive, from total chaos, endless and frequently daily crisis he reached a stage of collaboration, with slight verbalization, absence of crises and the improvement of sensorial perseptions. He is able to follow a schedule and a sequence of daily activities without opposition.

 

Patient no. 11: A.M., boy, 5 years and 6 months

History: pregnancy without problems, child birth in term (by cesarean section), without fetal distress;

– Seat positioning- 4 months;

– Stand up- 9 months;

– Was able to walk alone at 9 months and a half;

– Normal development up to 2 years of age, question marks appeared as the baby didn’t speek at all (not even a word);

– 2 years and 2 months Autism notes diagnosis;

– 3 years and a half Infantil Autism diagnosis, begins ABA – no improvement concerning verbalization;

– After half a year, the therapy team was changed and the child started to speak, good improvement.

Principal Diagnosis: Infantil Autism (F 84.0).

Secondary Diagnosis: Hyperactivity, speech delay.

Investigation: don’t have IRM, EEG – no pathological changes, blood tests normal.

Therapies and treatments on going: ABA, swimming, Biokult a year and a half for digestive disorders, cod liver oil, B complex, magnesium.

The evaluation found: hyperactivity, eye contact present, has vocabulary but the connection between words is made ​​difficult, speaks only in a whisper (never spoke in a different way – he did not speak at all or spoke in a whisper).

Treatment no.1: was conducted on March the 15th, 2014.

Improvement – on all levels: decreased hyperactivity and increased attention, better communication, began to speak loud, normal, acquisitions in the number of words, spontaneity.

Treatment no.2: was conducted on April the 19th, 2014, (was applied directly the treatment for brain plasticity because there were no particular problems to be solved).

Improvement – He opens more outward, becomes curious about the things around, he is curious and he wants interaction with other children, has spontaneous reactions, attention remains good, continuous improvement in verbalization –  vocabulary and voice intensity. Began to sing.

Increasing – hyperactivity, aggressivity, stereotypes

Treatment no.3: was conducted on May the 9th, 2014 (earlier than planned because his hyperactivity reached the tolerance limit of his parents „he is on the ceiling”), and we performed the treatment protocol no.4)

Improvement – continuous and constant on all levels, adjusts his sleep – he is less tired, becomes more peaceful and more cooperative.

Treatment no. 4: was conducted on June, the 25th 2014 (…).

Conclusion after 4 treatments:

A good evolution on all levels from the first treatment; started talking loudly, and he adjusted sleep. Hyperactivity started to decline but is still high; we requested an endocrinological evaluation to assess thyroid function. We recommended holiday (cessation of all activities and therapies for at least two weeks), because in the weekend the child is much quieter and more cooperative as when the week and the activities begins and the child becomes unmanageable in his behavior.

Treatment no. 5: was performed on September the 5th, 2014 (…).

The evaluation has found:

Endocrine evaluation determines that there is no thyroid dysfunction.

Parents respect requested vacation and cease any specific recovery activity all August. In this context the child evolution is absolutely amazing, he settles down, becomes cooperative verbalises increasingly better, make spontaneous sentences, pronounce words clearly, ask for everything he needs, empathize and play with other children, whose presencehe enjoys (laugh, having fun – express his emotions). Sleep was adjusted. No more frustration and crying crisis.

Hyperactivity decreased to a minimum, became spontaneously funny, cheerful and cooperative.

From stereotypes remained only one that occurs only if there are many people around (in stores).

Evolution is very good, constant in time and on all levels.

 

 

TABLE NO. 1 – The presentation of clinical cases

 

 

III.           Results and Discussion

This study aimed to evaluate the effectiveness of Scientific Auriculotheraphy applied to patients (children) with autism and the extent it can improve/eliminate its characteristic symptoms and possible comorbidities.

From the 11 cases of the study, 2 recorded after applying the 5 treatment protocols minimum improvement, 5 cases recorded good improvement, and 4 cases excellent improvement. We can thus assert that in 82% of cases, Scientific Auriculotherapy treatment generated a good and excellent evolution of Autism patients, while in 18% of cases, pathology symptoms improvement was minimal.

We will present results obtained regardin the evolution of the four symptoms monitored (communication, stereotypes, verbalization, cognition) and the evolution of three comorbidities kept in attention (hyperactivity, lack of attention and aggressivity).

 

1.      Communication:

Communication, along with verbalization, cognition and lack of attention are four parameters analyzed with spectacular improvements of the pathology in all 11 cases in treatment as a result of the 4 treatment sessions. More than three-quarters (77%) of the 44 evaluations conducted have shown good and excellent effects, 16% of the evaluations revealed minimal effects on patients, while in 7% of assessments were recorded lack of any effect. More than two thirds of patients’ effects were good and very good (cases 1, 3, 4, 6, 7, 8, 10, 11).

 

2.      Stereotypes

Regarding stereotypes, 43% of the 44 evaluations revealed good and excellent effects,  27% ​​of the evaluations revealed minimal effects on patients, while 21% of assessments recorded lack of any effect. In the case of stereotypes there were highlighted aggravations of symptoms in 9% of the ratings. In this context, a quarter of patients experienced temporary worsening and by the end of the study, they evolved toward improvement. Also one of the patients did not record any effect on any of the four treatments evaluated at this level.

 

3.      Verbalization

In the case of verbalization we can assert that the results are excellent along with communication, cognition and lack of attention. In more than two thirds (68%) of the 44 assessments, effects were good and excellent, 21% of the assessments showed minimal effects, while 11% of them actually recorded no effect. None of the patients showed worsening of pathology.

More than two thirds of patients (cases 1, 4, 5, 6, 7, 8, 10, 11) experienced significant improvement on this level.

 

4.      Cognition

Cognition is the third parameter that recorded excellent results in the first 4-treatment assessments. Nearly three-quarters (72%) of the 44 assessments showed good and excellent improvement, while 23% of them experienced minimal improvement and 5% no effect. Nor communication, verbalization, and lack of attention, neither cognition evaluation register aggravation of patient status.

More than one third of patients experienced excellent improvements and overall we can say that two thirds of patients have progressed well.

 

5.      Comorbidities:

5.1.Hyperactivity

Hyperactivity represents the parameter with the lowest rate of pathology improvement evaluated that shows also worsening episodes. Thus, from the 40 assessments (one patient did not show pathology), 40% experienced good symptom relief, 27% minimal effects and 13% no therapeutic effect. In 20% of evaluations were found different degrees of agravation. Half (5 patients) of patients experienced varying degrees of improvement, while the other half shows episodes of worsening, even if some presented overall good / satisfactory evolution.

 

5.2. Lack of attention

Lack of attention is the 4th parameter with spectacular evolution, along with communication, verbalization and cognition. Almost two thirds (61%) of the 44 evaluations recorded good and excellent effects to the patients, 34% showed minimal effects, and 5% no effect, as a result of the treatment. As communication, cognition and verbalization, lack of attention evaluations did not register any aggravation of patient status.
More than one third of patients experienced excellent improvements and overall we can say that two thirds of patients have progressed well.

 

5.3. Aggressivity

 

Aggressivity, along with stereotypes is the recorded parameters that show satisfactory effects of the therapy applied. In 47% of the 36 evaluations (two patients do not manifest the pathology) effects were good and very good, 31% showed minimal effects and 11% no effect at all. In 11% of evaluations were recorded aggravating episodes in various stages of evolution.

A third of the 9 patients experience worsening symptom moments, but overall, even their evolution can be considered good.

 

 

 

IV.           Conclusions

1.      Every child with autism is different, pathology manifests itself differently from one case to anotherand therefore, the treatment protocol should be adapted from case to case depending on the severity and intensity of the clinical manifestations. A child verbalises another not, a child is hyperactive another is hypotonic, a child is intellectually retarded but having a perfect memory, while another has a satisfactory intellect but his memory is erased at the end of each day. In this context, although we tried to keep 5 preset protocols, the practice forced us to adjust and add or remove one or two points. We did this because the purpose was to prove that the pathology can be enhanced and not to see the effect of a particular protocol. Conclusion: The protocol should be individualized in autism.

2.      The basic problem of autism – respectively the openness outwards – networking – was improved significantly from the first treatment. The spectacular changes have occurred in this regard, in consequence has resulted the changes in the chain of all pathologies involved. This made us think that the theory of mirror neurons could be true, the improvement of the openness onwards improving the learning through the possible restarting of this system.

3.      This study proves that Auriculotherapia helps enormously in some cases, satisfactory in others, but definitely change something in the existence of these children and their parents.

4.      Restarting produced through Auriculotherapy sustained by intensive behavioral therapy and / or speech and language therapy can make a huge leap in the evolution of these children.

After 7 months of treatment half of the families involved declare: it is a miracle, we have a different child!!! and these words were the evidence of the effectiveness of Scientific Auriculotherapy.

 

V.               Bibliography

1.      Auriculotherapy courses year I and year II

2.      Burton Scott E.- The Miracle of my child cure , For you Publishing House, 2011

3.      Dobrescu I. Psychiatry Manual of Child and Adolescent – volume 1,volume 2, InfoMedicaBucurestiPublishing House, 2010

4.      Gardner N. – A friend like Henry, London, Hodder PublishingHouse, 2008

5.      Motet D. – Speech disorders at children,  SemnEPublishing House,  2012

6.      Rohen/Yokochi  – Color Atlas of Anatomy , Igaku-Shoin Publishing House, 1988

7.      Secara O., Social Brain: autism, neurosciences, therapy, Artpress Publishing House, Timisoara, 2007

8.      Stillman W., Essence of the Autism,Daath BookPublishing House, 2013

9.      Tammet  D. – I was born on a blue day, Philobia Publishing House, 2012

10.  The Carolona Curriculum for Preschooers with Special Needs – Brookes PublishingHouse

11.  The Carolona Curriculum for Infants and Toddlers with Special Needs – Brookes Publishing House

 

[1]Dobrescu I.– Manual of Child and Adolescent Psychiatry – Medical Publishing House, Bucharest, 2010
[2]IDEA – Individuals with Disabilities Education Act – Definition of Autism, available at link: http://idea.ed.gov/explore/view/p/,root,regs,300,A,300%252E8,c,
[3]Secara O. – Social Brain –Artpress Publishing House, Timisoara, 2007
[4]WIKIPEDIA – The Free Encyclopedia, available at link: http://en.wikipedia.org/wiki/Autism_spectrum
[5]Dobrescu I.– Manual of Child and Adolescent Psychiatry – Medical Publishing House, Bucharest, 2010
[6]www.autismspeaks.org
[7]Secara O. – Social Brain –Artpress Publishing House, Timisoara, 2007
[8]Rohen/Yokochi  – Color Atlas of Anatomy, Igaku-Shoin Publishing House, 1988
[9]Rohen/Yokochi  – Color Atlas of Anatomy, Igaku-Shoin Publishing House, 1988