Louisa M. T. Silva

Improvement in Sensory Impairment and Social Interaction in Young Children with Autism Following Treatment with an Original Qigong Massage Methodology

In clinical research, sensory impairment is considered one of the core deficits in autism and is associated with impaired socialization, behavioral disturbances and bowel and sleep problems. The effectiveness of the Cignolini methodology, an original Qigong massage methodology, in treating sensory impairment in young children with autism was evaluated in a small, controlled study. Thirteen children with autism between the ages of three and six received daily treatment according to the methodology for 5 months. Compared with untreated children, treated children experienced significant improvement of their sensory impairment (p < 0.01), and demonstrated increased social skills (p < 0.04) and basic living skills (p < 0.02) on standardized measures. In addition, all of the children with bowel and sleep abnormalities demonstrated improvement after treatment.

Sense and self-regulation checklist, a measure of comorbid autism symptoms: initial psychometric evidence.

Sensory and self-regulatory symptoms make up most of the comorbid symptoms in autism and are associated with increased autism severity. We validated a parent-caregiver measure of comorbid symptoms in autism, the Sense and Self-Regulation Checklist (SSC), in 265 children <6 yr with typical development (n = 138), autism (n = 99), or other developmental delay (n = 28); Cronbachs α was .87. We report two new findings discriminating autism from other groups: (1) multifocal tactile sensory impairment, characterized by hyporeactivity to injurious stimuli and hyperreactivity to noninjurious stimuli (F[2, 262] = 86.8, p < .001) and (2) global self-regulatory delay (F[2, 262] = 122, p < .001). Both findings suggest an explanation for social delay in children with autism. The SSC reports a prevalence of sensory and self-regulatory findings approaching 100% in the autism group (96% and 98%, respectively), raising the possibility that sensory and self-regulatory difficulties represent a core part of autism.

A model and treatment for autism at the convergence of Chinese medicine and Western science: First 130 cases

ObjectiveTo present a model for autism showing that impairment of sensory and self-regulation is the core deficit that underlies delays in social/language skills and abnormal behavior in autism; and to demonstrate the efficacy of a treatment for autism based on Chinese medicine.MethodsChildren with autism under 6 years of age were assigned to treatment or wait-list conditions. A total of 130 children were treated and the results compared with 45 wait-list controls. Treatment is a tuina methodology directed at sensory impairment—Kai Qiao Tuina. The treatment was a five-month protocol that was implemented daily by trained parents via trained support staff. The effects of treatment on the main symptoms, autistic behavior, social/language delay, sensory and self-regulatory impairment, as well as on parenting stress, were observed and compared.ResultsThe treatment had a large effect size (P<0.0001) on measures of sensory and self-regulation. The evaluations done by pre-school teachers demonstrated improvement in the measures of autism (P<0.003), and were confirmed by evaluations done by parents (P<0.0001). There was a large decrease (P<0.0001) in parenting stress.ConclusionsSensory and self-regulatory impairment is a main factor in the development and severity of autism. Treatment of young children with autism with Kai Qiao Tuina resulted in a decrease in sensory and self-regulatory impairment and a reduction in severity of measures of autism.

Early Intervention with a Parent-Delivered Massage Protocol Directed at Tactile Abnormalities Decreases Severity of Autism and Improves Child-to-Parent Interactions: A Replication Study

Tactile abnormalities are severe and universal in preschool children with autism. They respond well to treatment with a daily massage protocol directed at tactile abnormalities (QST massage for autism). Treatment is based on a model for autism proposing that tactile impairment poses a barrier to development. Two previous randomized controlled trials evaluating five months of massage treatment reported improvement of behavior, social/communication skills, and tactile and other sensory symptoms. This is the first report from a two-year replication study evaluating the protocol in 103 preschool children with autism. Parents gave daily treatment; trained staff gave weekly treatment and parent support. Five-month outcomes replicated earlier studies and showed normalization of receptive language (18%, P = .03), autistic behavior (32%, P = .006), total sensory abnormalities (38%, P = .0000005), tactile abnormalities (49%, P = .0002), and decreased autism severity (medium to large effect size, P = .008). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, P = .00008). Early childhood special education programs are tasked with addressing sensory abnormalities and engaging parents in effective home programs. Until now, they have lacked research-based methods to do so. This program fulfills the need. It is recommended to parents and ECSE programs (ages 3–5) at autism diagnosis.

Qigong Massage for Motor Skills in Young Children With Cerebral Palsy and Down Syndrome

In this article, we present a small randomized controlled study evaluating the effect of a dual parent- and trainer-delivered qigong massage methodology on motor skills and sensory responses in 28 children under age 4 with developmental delay and motor tone abnormalities. Fourteen children had high motor tone as a result of cerebral palsy (CP), and 14 children had low motor tone as a result of Down syndrome. Multivariate analysis and post hoc analysis of variance showed large effect-size improvements in Peabody Gross Motor Scale (PGMS) Object Manipulation scores (p < .01) and large effect-size improvements in overall PGMS scores (p < .04) in treatment versus control groups after 5 mo intervention. Follow-up evaluation 10 mo from the start indicated continued improvement. Sensory responses showed no treatment effect. The results suggest further investigation of qigong massage as a promising avenue for research to improve motor skills in young children with CP and Down syndrome.

First Skin Biopsy Reports in Children with Autism Show Loss of C-TactileFibers

Autism is the most common developmental disability, affecting 1/45 children. Its cause remains unknown. Clinically, it is defined by the appearance of social/language delay, unusual, repetitive behavior, and abnormal sensory responses by the age of 3. Abnormal responses to touch are amongst the earliest and most universally prevalent of abnormal sensory symptoms. In 2013, when abnormal sensory responses were reclassified from co-morbid symptoms of two core diagnostic symptoms, the need for definitive evaluation of the sense of touch was recognized. Children with autism are distinguished both by lack of interest in affective and affiliative touch and by a generalized pattern of allodynia and hypoesthesia affecting multiple areas including the face, mouth, hands and feet.

About Face: Evaluating and Managing Tactile Impairment at the Time of Autism Diagnosis

Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of hearing, vision, or touch results in developmental delay and must be addressed before delay can resolve. Recent studies confirm that tactile impairment is present in autism and can be effectively treated with a tactile stimulation protocol. The research suggests a change in management at the time of autism diagnosis to include evaluation and treatment of tactile impairment. Here we validate screening and management tool for tactile impairment, the Autism Touch and Self-Regulation Checklist, in 404 typical and autistic preschool children. The tool assesses tactile impairment by location and severity. Autistic children were distinguished by mixed pain and numbness on multiple areas including the face and mouth (F = 412.1 (1,402);p < .000). Oral-facial tactile impairment interferes with the tactile stimulus to orienting. We hypothesized that oral-facial tactile impairment and difficulty orienting are predictive of ASD and that severity of tactile impairment is predictive of severity of ASD. Questions evaluating oral-facial and orienting responses correctly predicted 91% of the autism group. Severity of tactile impairment correctly predicted 81% of mild versus severe ASD. Results underscore the importance of evaluating and treating tactile impairment at the time of autism diagnosis.

One- And Two-year Outcomes of Treating Preschool Children with Autism with a Qigong Massage Protocol: An Observational Follow-along Study

Background: Randomized controlled trials have repeatedly demonstrated that treatment with a five-month qigong massage protocol significantly reduces the severity of autism. The treatment protocol is known as Qigong Sensory Training (QST) autism massage and is given daily by parents and weekly by therapists for five months. Treatment reduces the tactile abnormalities that are universal in young children with autism and results in improved social skills, language and behavior. At five months, tactile abnormalities are reduced by 1/2, autistic behavior is reduced by 1/3, autism severity is reduced by 16%, and 6% of children have moved off the spectrum. What has not yet been done is to measure outcomes with longer-term treatment. This observational study investigates outcomes with up to 24 months of treatment. Methods: 75 children entered this observational study upon completion of five months of treatment with the QST protocol. They received daily parent treatment and monthly therapist treatment for the balance of the first year, and daily parent treatment without therapist support for the second year. Sequential evaluations were conducted at baseline (n=75), five months (n=75), 12 months (n=67) and 24 months (n=31). Results: Continued treatment resulted in continued improvement. At 12 and 24 months, mean tactile responses normalized by 57% and 72%, with 24% and 32% falling into the normal range; mean autism severity decreased by 27% and 44%, with 12% and 26% of children moving out of autistic range. Conclusions: Results demonstrated that longer-term treatment resulted in resolution of tactile impairment and continued improvement of social skills, language and behavior. The rate of coming off the spectrum (1 in 4 children by year-2) was far higher than the natural history of ASD would predict. Results support earlier recommendations to treat tactile abnormalities at the time of autism diagnosis in order to improve autism outcomes.

Improved Speech Following Parent-Delivered Qigong Massage in Young Children with Down Syndrome: A Pilot Randomised Controlled Trial.

Qigong massage is an eastern form of massage that can be delivered by western parents to their children with appropriate training and support. It has been shown to improve developmental measures in young children with autism when given daily for five months. A recent trial evaluating its effect on motor development in young children with Down syndrome reported anecdotal observations of increased speech beginning in the first weeks of massage. This pilot randomised controlled trial (RCT) was conducted to formally assess the effect of qigong massage on speech in young children with Down syndrome. Twenty children with Down syndrome under age 4 were randomly assigned to treatment and control groups. The treatment group was assigned to receive a programme of daily parent-delivered qigong massage for five months. Parents were provided with training and weekly support for the first two months by trained staff. Data analysis using pre- and post-treatment testing with the Bayley Scales of Infant and Toddler Development showed a large improvement in expressive language (p < 0.02). Results are consistent with published reports of improved communication in young children with autism following massage, and suggest that a larger RCT with young children with Down syndrome is warranted.