Upledger Institute Case Study CranioSacral Therapy Autism Spectrum Disorder Tami Goldstein, WLMT, CST T, BCTMB Case Report: Hannah Introduction Craniosacral therapy has been shown to help individuals with autism. Craniosacral therapy was developed in the mid 70 s by Dr. John E. Upledger. His foundational treatments involved individuals with severe autism. The craniosacral system anatomy includes the brain, the meninges membrane system that surrounds and protects the brain and spinal cord the cerebrospinal fluid in the brain, the bones of the skull, face, mouth, and spine down to the sacrum. It is reasonable to say that if the tissues surrounding the brain are restricted, fluid movement in the brain could be compromised. Blocked fluid prevents nutrients, oxygen, and hormones from reaching the brain; removal of waste and toxins is compromised as well. A primary focus of craniosacral therapy is enhanced membrane motion, which improves cerebrospinal fluid movement. A study published in 2016 in the Journal of Bodywork & Movement Therapies entitled The Use of Craniosacral Therapy for Autism Spectrum Disorders: Benefits from viewpoints of Parents, Clients, and Therapists, describes clinical findings and behavioral improvement supporting the use of craniosacral therapy for autism treatment. The intention of this case report is to present what occurred for one individual on the autism spectrum with the application of multi-hand craniosacral therapy. History Hannah s date of birth is July 5, 2012 She was born healthy. At 24 months, diagnosed non-verbal, speech apraxia.
Age 3, August 2015, diagnosed mild to moderate ASD. Mother informed author that Hannah was not connecting with others, but would engage in play. Hannah only made eye contact with her mother Therapies Utilized Occupational therapy for feeding issues; speech therapy 2 times per week starting at 18 months, Applied Behavioral Analysis, (ABA Therapy) one-on-one, four hours per day / 5 days per week for 1 year. Parents consulted a number of professionals for biomedical supports. Craniosacral therapy. Hannah receives U-CST from another Craniosacral therapist monthly and has for a year. Hannah s developmental pediatrician was evaluating Hannah every 6 months to track her developmental. Upon her last evaluation, Hannah no longer met the criteria for autism spectrum disorders but continued to have speech delays. Out of pocket cost totaled $20,000.00, in a two-year period; ABA therapy was covered by insurance for an estimated cost of over $100,000.00 per year Observation Observation reflected that the symmetry in Hannah s body was good, but I this therapist noticed a compression along her nasal suture. Evaluation and Treatment Evaluations and monitoring of the craniosacral rhythm, arcing, and 10-step protocol were facilitated. Hannah was open to receiving mouth work; the author evaluated and facilitated therapy on the hard palate, vomer, palatines, and underside of her tongue. Hannah received one, one-hour session on April 23, 2017. Right lumbar sacrum restriction presented and was superior through the hyoid diaphragm, (minimal restriction was found in the respiratory and thoracic
diaphragms). Restriction was noted on her hyoid attachments, left side of her retro-hyoid muscles, supra-hyoid muscles and into the hard palatine. Hannah s vomer was compressed and out of sync. The author notes that while facilitating therapy the tissues pulled toward the vomer; 2 grams of Direction of Energy were provided to release the vomer. The author released restriction to soft tissue under the tongue. Therapy was concluded with lateral decompression of the temporal bones. Outcomes The vomer release appeared to unlock other restriction patterns within the cranium. Cranium expansion was felt: anterior, posterior, and lateral. The mother commented that this was the first CST session during which mouth work was introduced. Perceived Behavioral Outcomes Hannah exhibited a greater articulation of speech within 3 days of CST treatment. Hannah appeared to be more sensory-sensitive but resolved within 10 days of treatment. Hannah s father and teachers commented on Hannah s improved articulation. After this session, Hannah s sleep improved. She began sleeping separated from her mother, in her own bed, approximately 2 nights per week. Hannah hugged and kissed the author after her session. Discussion Continued craniosacral therapy is recommended to accommodate changes that may occur due to growth. Continuation of therapy is advised to maintain optimum function of the craniosacral system. In her review of the brain abnormalities in ASD, MR Hebert wrote, that the autistic brain is not simply wired differently, but that neuro-inflammation is a part of the pathology in autism from childhood through adulthood. Her comments appear in Large brains in autism: the challenge of pervasive abnormality.
Releasing strain on the craniosacral system, improves how the brain functions; the neuro-destructive effects of chronic inflammation are also improved and this allows for improved developmental outcomes. Susan Vaughan Kratz, OTR, CST-D wrote in The Autism File Magazine, that CST does not treat the behaviors of autism, it does, however, treat the brain dysfunction of autism. Quantifiable and behavioral outcomes carry the same importance when the quality of life is at stake. Anecdotal data reflects support for craniosacral therapy. This case report is not intended to reflect benefits to all individuals with autism. However, it recommends further cases studies, documentation, and research into the benefits of craniosacral therapy for autism clients. Works Consulted Bradstreet, J.J., Pacini, S., Ruggiero, M., 2014. A new methodology of viewing extra-axial fluid and cortical abnormalities in children with autism via transcranial ultrasonography. Front. Hum. Neurosci. 7, 934. http://doi.org/10.3389/fnhum.2013.00934 Upledger, J.E., 2000. Autism: observations, experiences, and concepts. An etiologic model for autism. In: Testimony before the U.S. House of Representatives 106 th Congress. April 2000. http://www.iahe.com/images/pdf/3524_001.pdf The Use of CranioSacral Therapy for Autism Spectrum Disorders, Benefits from viewpoints of Parents, Clients & Therapists, Journal of Bodywork and Movement Therapies, Elsevier, LTD, Susan Vaughan Kratz, OTR, CST., Jane Kerr, Bsc, (Hons, MSP, HCP, Lorraine Porter, Bsc, (Hons) (2017) 21, 19-29 Upledger, John E., D.O., F.A.A.O. (1983). Craniosacral Therapy. Seattle, WA: Eastland Press. Upledger, John E., D.O., F.A.A.O. (1987). Craniosacral Therapy II Beyond the Dura. Seattle, WA: Eastland Upledger, John E., D.O., O.M.M. (1990). Press.
CranioSacral Therapy: Touchstone for Natural Healing. Berkeley, CA: North Atlantic Books Neuroglial activation and neuroinflammation in the brain of patients with autism. Vargas DL, Nascimbene C, Krishnan C, Zimmerman AW, Pardo CA Ann Neurol. 2005 Jan; 57(1):67-81. Large brains in autism: the challenge of pervasive abnormality. Herbert MR Neuroscientist. 2005 Oct; 11(5):417-40.