Complementary+and+alternative+therapies+for+children


 * There are a variety of complementary and alternative therapies available to children with special needs and their families. Use this wiki to compile resources on various alternative therapies and evidence on whether those therapies seem to be effective or valid. Each group member must contribute at least two unique items to this wiki by 5:00 pm on October 28. The discussion board tab is optional, but may be used to discuss various alternative therapies.

You may want to think about the following questions as you build this wiki:
 * What are some of the more common alternative therapies utilized by children with special needs and their families?
 * If one of your patient's parents approaches you for advice about one of these interventions, what would you say?
 * Where and how can you find good, evidence-based information on complementary and alternative therapies?
 * How do you determine which alternative therapies are valid and which are not?

I'll start by posting a brochure on the Therasuit method from www.suittherapy.com For parents who are new to alternative therapy or would just like more information about what complementary and alternative medicines are, this website is a good quick reference. []#

One of the big problems with CAM is the lack of reliable research into each of the therapies and each of the possible diagnoses that can be treated. The most reliable research into CAM therapies is completed by the National Center for Complementary and Alternative Medicine at the National Institutes of Health. Parents and health care providers can find information on both different therapies and different diagnoses on their website: [] Here is a link to a fact-page about children and CAM within the same website. []

According to data from the NCCAM at NIH in 2007, the six most common conditions in children that are treated with CAM include: 1. Back/neck pain 2. Head or chest cold 3. Anxiety/stress 4. Other musculoskeletal 5. ADHD 6. Insomnia

According to the previous study, the top ten CAM therapies that children receive include: 1. Natural Products 2. Chiropractic & Osteopathic 3. Deep Breathing 4. Yoga 5. Homeopathic Treatment 6. Traditional Healers 7. Massage 8. Meditation 9. Diet-Based Therapies 10. Progressive Relaxation

This is a good article that looks at the frequency and type of complementary and alternative medicines (CAM) that parents used with their special needs kids. I was surprised by the number of people that have used CAM (64%). It also says that the parents were referred to CAM by either a family member or a health care provider. So its really important that we have knowledge of CAM and any research on it. @http://www.pediatricsdigest.mobi/content/111/3/584.full

This is a community blog for parents of kids who have used alternative therapies and it would be a good website to suggest to parents that might have questions for other parents that have tried alternative therapies, or just want to be connected to other parents of kids with special needs. @http://community.babycenter.com/groups/a55105/alternative_therapies_for_children_with_special_needs

This is a good resource to give to parents if they have questions about CAM or just want more information. There is also a tab for healthcare providers that has links to research articles about CAM. @http://nccam.nih.gov/health/decisions/

For health care providers who would like more information about CAM therapies, this article is a great reference. It includes information about insurance coverage, treatment in special populations, common CAM therapies, research of CAM, licensing of CAM providers, legal/ethical issues and even how to talk to parents about CAM therapies! []

=Following is information about multiple CAM therapies applicable to children:= =**__Acupuncture__**= Acupuncture is one of the oldest alternative medicines used in the history of the world. It has been practiced in East Asia for thousands of years and for many different ailments. The premise of acupuncture is to restore the yin(cold, slow, and passive principle) and yang (hot, fast, and active principle) balance in the body. The imbalance are from blockages of your "qi" or energy along pathways called meridians. The Acupuncturist will delicately pierce the skin with specialized needles at various meridian points on the bottom to correct the flow of energy. Here are 2 resources that provide a great introduction/over of acupunture:
 * __What is it?__**

1) Introduction to Acupuncture - CMS media type="youtube" key="wXgVz4ZqAxo" height="315" width="420"

2) National Center for Complementary and Alternative Medicine []

__**Is it safe to do on children?**__ It is important to note that acupuncture is a very low risk treatment in adults. Well, what about children? A study by Jindal and Manksy looked at the safety and efficacy of acupuncture in children and found that //"... acupuncture is a safe complementary/alternative medicine modality for pediatric patients on the basis of the data we reviewed."// See the article: []

__**What is Acupunture used for?**__
 * Eye, Ear, Nose, Throat Disorders**
 * Sinusitis
 * Sore Throat
 * Hay Fever
 * Earache
 * Nerve Deafness
 * Ringing in the Ears
 * Dizziness
 * Poor Eyesight
 * Circulatory Disorders**
 * High Blood Pressure
 * Angina Pectoris
 * Arteriosclerosis
 * Anemia
 * Gastrointestinal Disorders**
 * Irritable Bowel Syndrome
 * Spastic colon
 * Colitis
 * Constipation
 * Diarrhea
 * Food Allergies
 * Ulcers
 * Gastritis
 * Abdominal Bloating
 * Hemorrhoids
 * Gynecological / Genitourinary Disorders**
 * Premenstrual Syndrome (PMS)
 * Irregular, Heavy or Painful Menstruation
 * Endometriosis
 * Menopause
 * Fibroids
 * Chronic Bladder Infection
 * Complications in Pregnancy
 * Morning Sickness
 * Kidney Stones
 * Impotence
 * Infertility in Men and Women
 * Sexual Dysfunction
 * Immune Disorders**
 * Candida
 * Chronic Fatigue
 * HIV and AIDS
 * Epstein Barr Virus
 * Allergies
 * Lupus
 * MS
 * Hepatitis
 * Addiction**
 * Smoking Cessation
 * Drugs
 * Alcohol
 * Emotional and Psychological Disorders**
 * Anxiety
 * Insomnia
 * Depression
 * Stress
 * Musculoskeletal and Neurological Disorders**
 * Arthritis
 * Neuralgia
 * Sciatica
 * Back Pain
 * Bursitis
 * Tendonitis
 * Stiff Neck
 * Bellâ€™s Palsy
 * Trigeminal Neuralgia
 * Headaches and Migraines
 * Stroke
 * Cerebral Palsy
 * Polio
 * Sprains
 * Muscle Spasms
 * Shingles
 * Respiratory Disorders**
 * Asthma
 * Emphysema
 * Bronchitis
 * Colds and Flus
 * Acupuncture Also Treats**
 * Chemotherapy/Radiation Side Effects
 * Diabetes
 * Dermatological Disorders
 * Weight Control

credits to []+

It even is used to treat children with drooling problems! Check it out: []
 * Traditional chinese medicine ( tongue acupuncture) in children with drooling problems**

This is a good website that explains how hippotherapy can be utilized to treat various disorders. This is especially good with children because they movements of the horse mimmic the natural gait pattern and it is repetitive and rhythmic.

http://www.americanhippotherapyassociation.org/

General Indications for Hippotherapy **Population** – children and adults with mild to severe neuromusculoskeletal dysfunction

**Medical Conditions** **Impairments** > arousal and attentional skills Hippotherapy is a physical, occupational, and speech-language therapy treatment strategy that utilizes equine movement as part of an integrated intervention program to achieve functional outcomes.Equine movement provides multidimensional movement, which is variable, rhythmic and repetitive. The horse provides a dynamic base of support, making it an excellent tool for increasing trunk strength and control, balance, building overall postural strength and endurance, addressing weight bearing, and. motor planning. Equine movement offers well-modulated sensory input to vestibular, proprioceptive, tactile and visual channels. During gait transitions, the patient must perform subtle adjustments in the trunk to maintain a stable position. When a patient is sitting forward astride the horse, the horse’s walking gait imparts movement responses remarkably similar to normal human gait. The effects of equine movement on postural control, sensory systems, and motor planning can be used to facilitate coordination and timing, grading of responses, respiratory control, sensory integration skills and attentional skills. Equine movement can be used to facilitate the neurophysiologic systems that support all of our functional daily living skills. **Physical Therapists:** The physical therapist can overlay a variety of motor tasks on the horse’s movement to address the motor needs of each patient and to promote functional outcomes in skill areas related to gross motor ability such as sitting, standing, and walking.
 * Autism Spectrum Disorder
 * Cerebral Palsy
 * Developmental Delay
 * Genetic Syndromes
 * Learning Disabilities
 * Sensory Integration Disorders
 * Speech-Language Disorders
 * Traumatic Brain Injury/Stroke
 * Abnormal muscle tone
 * Impaired balance responses
 * Impaired coordination
 * Impaired communication
 * Impaired sensorimotor function
 * Postural asymmetry
 * Poor postural control
 * Decreased mobility
 * Limbic system dysfunction related to

http://www.youtube.com/watch?v=NlkhBKAOFIM - here is a great video with a physical therapist talking about her experience with HIppotherapy.

http://www.ncbi.nlm.nih.gov/pubmed/21729249 - Here is a link to a meta-analysis on the effects of Hippotherapy on postural control and balance for kids with CP. Results after reviewing 8 studies - "Although the generalization of our findings may be restricted by the relatively small sample size, the results clearly demonstrate that riding therapy is indicated to improve postural control and balance in children with CP."

I have come across several site that promote hyperbaric oxygen therapy treatments for children with various disorders as an alternative therapy. There are some recent claims that HOT can help with Autism and cerebral palsy. Here is a website that has a lot of information on this new topic for treatment and is very easy to navigate.

http://www.chamberofhope.org/

Nutritional therapy can be used as an alternative to pharmacological treatments to help alleviate symptoms of several pediatric disorders. The site below focuses on children with Autism; it outlines the supplements and vitamins that can help with symptoms of the disorder along with the foods they can be found in. Symptoms such as; irritable digestion, suppressed immune system, poor behavior, and frustration may be better controlled by making changes in the diet. This site is very easy to navigate, and also provides some information on how long it will take for the child to experience the changes in symptoms after beginning the treatment.

[]

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[] Water Therapy: Drinking large amounts of water throughout the day to replenish and flush the system.

Herbal Medicine includes dietary supplements people take to improve their health. They are sold as tablets, capsules, powders, teas, extracts and fresh or dried plants. However, some can cause health problems, some are not effective at all, and some may interact with other drugs you are taking. Herbal product regulation falls under the Dietary Supplemental Health and Education Act of 1994. This act requires that producers ensure safety and appropriate labeling of a product. The producers are not required to actually demonstrate safety or efficacy of the product before placing it on the market.This means the producers can ensure while not actually demonstrating safety which potentially allows herbal products to enter the market without having to provide actual evidence of safety or efficacy. The FDA doesn’t become involve until after there are reports about adverse events related to products that are already in the marketplace. Here are some statistics healthcare professionals should be aware of regarding pediatric herbal medicine found by this study []: Here’s a good website to give to parents if they are considering or report giving their child herbal medicine: []
 * 77% of caregivers did not believe or were unaware if herbal products had any side effects.
 * 66% of caregivers did not know if herbal products could interact with over-the-counter or prescription medication.
 * 45% of caregivers giving their child herbal therapy reported discussing the issue with their primary care physician.

=__**Epsom Salts (Magnesium Sulfate)- Biomedical Intervention**__=

Children with autism have been found to relax, increase concentration, and sleep better due to absorption of epsom salts. Epsom salt is thought to be effective by increasing a person's ability to detoxify harmful chemicals affecting emotions and concentration. Phenol sulfotransferase, or PST is low in children with autism, causing decreased language skills, behavioral disruptions, and concentration difficulties. By increasing magnesium sulfate in the body, it is thought that PST levels can more easily be regulated.
 * Application Methods: salt baths, sprays, lotions, skin patch, oil mixture, sponge bath, foot soak.
 * These types of applications are often therapeutic by themselves.

[] [] (Link to Video) []

__ Laughter Yoga __ What is it? -An exercise routine for a complete well-being workout, it combines unconditional laughter with Yogic breathing. Laughing for no reason is simulated in a group with eye contact and childlike playfulness; it is based on the fact that the body cannot distinguish fake from real laughter.

-Laughter Yoga has been proven to:
 * Lower the levels of stress hormones in the blood (epinephrine and cortisol)
 * Foster positive attitudes
 * Make it less likely for people to succumb to stress or feelings of depression

Who can benefit? -Laughter Yoga has been incorporated into schools, work environments, prisons, cancer centers, and skilled care facilities. -Specifically, children with physical or mental disabilities have shown significant improvements in their motor and expressive skills, and in their overall physical and mental health. -It has also been introduced in schools for the blind, deaf and mute.

The site below provides videos, research studies, tips, descriptions and benefits along with how to locate these types of services. The site is also easy to navigate and understand.

[]

I also found a YouTube video that shows one of the laughter yoga classes for children, it gives the names of some of the activities they do. This would be good to watch just to get an idea of what you would be getting into before the class. [|Laughter YouTube Video]

=__**Robotic Therapy**__=

Robotic therapy involves the use of external robotic attachments, which allows patients with neurological movement disorders to experience normal movement patterns. Walking or the correction of gait abnormalities is the area of greatest interest to the research. An example of one such product is the Locomat. It facilitates the walking motion by assisting the body to achieve a normal gait dynamic through the guided movement of a robotic exoskeleton, offering a wide range of training possibilities. The Lokomat, a Driven Gait Orthosis (DGO) stimulates the brain, spinal cord and muscles in a manner that encourages muscle growth and improves neurological functioning which essentially forces the brain to “catch up”. []

Uses of Robotic therapy in Pediatric Rehab:
 * Gait training
 * Upper extremity dysfunction (Range of motion limitations, coordination, strength, sensory impairments)
 * Shoulder, Elbow, Wrist control and movement
 * Lower extremity dysfunction (Range of motion limitations, coordination, strength, sensory impairments)
 * Hip, Knee, and Ankle control and movement



Huge Benefit of Robotic Therapy:
 * Increase participation and motivation
 * The robotics are attached to game like displays that make the training fun, but still give the therapist measurable outcomes.

Here is a link to an article produced by MIT which includes a video of some of the types of robotic therapy that is being tested for use with children. []

__What Some Research says__...


 * **Improvement of walking abilities after robotic-assisted locomotion training in children with cerebral palsy by: Meyer-Heim et al.**
 * Published in the Archives of Disease in Childhood February 2009. (PMID: 19208675)
 * Looked at the functional gait improvements in children with Cerebral Palsy (CP) who used robotic assisted locomotion training.
 * Results:
 * Researchers found that they were able to increase average gait speed by about 15% in 3 to 5 weeks of 3 to 5, 45-60 min sessions.
 * Concluded:
 * Robotic assisted locomotion training may be an effective therapy option to improve aspects of gait function because it was able to allow for increased gait practice which could lead to possible neural reorganization.


 * **Sustainability of motor performance after robotic -assisted treadmill therapy in children : an open, non-randomized baseline-treatment study. By:**Borggraefe et al.
 * Published in the European Journal of Physical Rehabilitation Medicine June 2010 (PMID:20485217)
 * The aim of the study was to investigate the sustainability of motor improvements achieved after a three week trial of robotic assisted treadmill therapy in children and adolescents with central gait disorders within a follow up period of about six months.
 * Results:
 * Improvements were seen in Dimension D and E of the Gross Motor Function Measure with retention of 56.8% and 43.3 % at the 6 month follow up. Gait speed improved from 0.80 m/s to 1.01 m/s after the trial and was 1.11 m/s at the follow-up visit at six months. Similar results were obtained for endurance.
 * Concluded:
 * The improvements of motor function after a three-week trial of robotic -assisted treadmill therapy appear to be sustained after a mean period of six months.


 * ** Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot. By: Wu et al.**
 * Published in Neurorehabilitation and Neural Repair May 2011 (PMID: 21343525)
 * The aim of this study was to look at the efficacy of combined passive stretching and active movement training with motivating games using a portable rehabilitation robot to motivate motor control and control passive stretching.
 * Results:
 * Significant increases were observed in dorsiflexion PROM, AROM, and dorsiflexor muscle strength. Spasticity of the ankle was significantly reduced. Selective motor control improved significantly.
 * Functionally, participants showed significantly improved balance and increased walking distance within 6 minutes.
 * Concluded:
 * They demonstrated improvements in joint biomechanical properties, motor control performance, and functional capability in balance and mobility.

=Massage Therapy= Massage is reported to be the oldest known intervention in the world, with documented use in some of the oldest civilizations including Egypt & China. Is it safe for children? Current evidence is supportive.

Article - "Massage and Touch Therapy in Neonates: The Current Evidence
http://www.indianpediatrics.net/sep2010/771.pdf PMID: 21048258
 * "Benefits of massage include stimulation of circulatory and gastrointestinal systems, better weight gain, lesser stress behaviour, positive effects on neurological and neuromotor development and infant-parent bonding, and improved sleep. Massage with oil results in improved skin condition (increased hydration and surface lipid content) and barrier function, resulting in reduced loss of transepidermal water and improved thermoregulation, transcutaneous absorption of fatty acids contributing to improved nutrition and better somatic growth. Massage therapy is considered a safe practice and there are no significant harmful effects, if performed appropriately."

Article - "Effects of massage therapy of asthmatic children on the anxiety level of mothers"
http://www.ncbi.nlm.nih.gov.proxy.kumc.edu:2048/pmc/articles/PMC3093168/?report=printable PMID: 21589776
 * "The anxiety level of mothers can be reduced by effective utilization of daily child massage therapy and giving an active role to the mothers in caring and treating the child. Daily massage helped mothers to have more sense of participation in caring their children and as a non-pharmacological method can be accompanied with pharmacological methods."

Article - "Infant massage in the NICU. Interview by Deb Discenza."
http://www.metapress.com.proxy.kumc.edu:2048/content/m4h572336213u321/fulltext.pdf PMID: 20829181
 * "Babies and children need to be touched, held, and responded to. When they know their needs will be met, they are more confident and ready to learn. When children have been held, rocked, massaged and breastfed, they are more compassionate, cooperative, less aggressive and violent. When parents interact in this way with their babies and share their experiences with other parents, we can create more caring communities. Infant Massage USA can be found online at www.infantmassageusa.org."

=Music Therapy=

Article - "Auditory-motor mapping training as an intervention to facilitate speech output in non-verbal children with autism: a proof of concept study."
http://www.ncbi.nlm.nih.gov.proxy.kumc.edu:2048/pmc/articles/PMC3183050/pdf/pone.0025505.pdf PMID: 21980480
 * "After therapy, all children showed significant improvements in their ability to articulate words and phrases, with generalization to items that were not practiced during therapy sessions. Because these children had no or minimal vocal output prior to treatment, the acquisition of speech sounds and word approximations through Auditory-motor mapping training (AMMT) represents a critical step in expressive language development in children with autism.

[] [|Cochrane Database Syst Rev.] 2006 Apr 19;(2):CD004381.
 * Article - "Music therapy for autistic spectrum disorder."**
 * Main Results: "Music therapy was superior to "placebo" therapy with respect to verbal and gestural communicative skills... Effects on behavioural problems were not significant."
 * ==== Author's Conclusions: "The included studies were of limited applicability to clinical practice. However, the findings indicate that music therapy may help children with autistic spectrum disorder to improve their communicative skills." ====

[|http://www.ncbi.nlm.nih.gov/pubmed/2193889]
 * Article - "History of music therapy treatment interventions for children with autism."**

=Drama/Play Therapy=

[] Pediatric Dramatherapy: They Couldn’t Run, So They Learned To Fly written by Dr. Carol Bouzoukis
 * Used drama reenactments to help decrease stress of chronically ill or physically challenged patients (6-12 years old).
 * By decreasing stress, this can lead to decreasing sensitization of pain.

Article - "Type Of Play Therapy Raises IQ Scores In Autistic Children."
[]

===Article - "Randomized, Controlled Trial of an Intervention for Toddlers With Autism: The Early Start Denver Model." PEDIATRICS Vol. 125 No. 1 Jan 1, 2010 === [] This 2 year study follows a similar approach to the drama therapy by Dr. Bouzoukis by incorporating time to play to help children learn normative behaviors in children with autism.
 * "...[This RCT was the first to] demonstrate the efficacy of a comprehensive developmental behavioral intervention for toddlers with ASD for improving cognitive and adaptive behavior and reducing severity of ASD diagnosis."
 * "Children who received [comprehensive developmental behavioral intervention] also were more likely to experience a change in diagnosis from autism to pervasive developmental disorder, not otherwise specified, than the comparison group."

=Animal/Pet Therapy=
 * decreases stress
 * nonjudgemental companion
 * opportunity for sensory integration
 * motivation to perform skills
 * increase attention to tasks

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