Louisa Silva | Western Oregon University (original) (raw)
Papers by Louisa Silva
Sveikatos mokslai, 2013
Acupuncture is one of the oldest complementary therapies used to treat chronic pain. WHO in Revie... more Acupuncture is one of the oldest complementary therapies used to treat chronic pain. WHO in Review and Analysis of Reports on Controlled Clinical Trials about Acupuncture note that researches on acupuncture are extremely difficult to conduct. It is already proved that acupuncture analgesia works better than a placebo for most kinds of pain [1]. Since the l970's there has been a sharp increase in global scientific acupuncture research . However, in Lithuania we still lack both research and training programs for physicians at University level. Klaipeda University Health Sciences Faculty wished to conduct a pilot test of the feasibility of providing acupuncture training in the rehabilitation hospital setting. Method. Ten patients received a short course of acupuncture at the Rehabilitation Center at Klaipeda Seamen's Hospital. Interested physicians were invited to observe. Pre-and post-qualitative data were collected. Results and conclusions. Patients reported positive experiences with acupuncture and improvement of symptoms. Physicians reported growing professional interest in acupuncture. No barriers to providing acupuncture training in the setting of a Rehabilitation hospital were identified.
Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age ... more Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age six. Cronbach's alpha was .827. As a measure of parenting stress specific to core and co-morbid symptoms of autism, the APSI is unique. It is intended for use by clinicians to identify areas where parents need support with parenting skills, and to assess the effect of intervention on parenting stress. Mean parenting stress in the autism group was four times that of the typical group and double that of the other developmental delay group [F(2,272) = 153; p \ 001]. An exploratory factor analysis suggested three factors impacting parenting stress: one relating to core deficits, one to co-morbid behavioral symptoms, and one to co-morbid physical symptoms.
Sensory and self-regulatory symptoms make up most of the comorbid symptoms in autism and are asso... more 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);
Cronbach’s 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 (b) 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.
Autism is commonly associated with disturbances of the sensory nervous system, digestion and slee... more Autism is commonly associated with disturbances of the sensory nervous system, digestion and
sleep. This manuscript presents a randomized controlled study evaluating the effect of a fivemonth
intervention directed towards improving measures of sensory impairment, digestion and
sleep in 46 children with autism under six years of age. The intervention, Qigong Sensory
Training (QST) is a qigong massage intervention based in Chinese Medicine. It is two-pronged,
with trainers working with children directly 20 times over the five months, and parents giving the
daily massage protocol to their children. Improvement was evaluated in two settings: the preschool
and home, by teachers (blind to group) and parents. Teacher evaluations showed that
children receiving the QST intervention had significant classroom improvement of
social/language skills, and reduction in autistic behavior compared to wait-list controls. Parent
data confirmed the findings in the teacher data, indicating that the gains had generalized across
contexts. A model for understanding and treating sensory and self-regulation problems in autism
is advanced, outcomes data supporting the model are presented, and the limitations of the
research discussed.
Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of he... more 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 ( ). 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.
International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, 2013
Following the inclusion of sensory abnormalities in the diagnostic criteria for autism, evidence ... more Following the inclusion of sensory abnormalities in the diagnostic criteria for autism, evidence has emerged showing that tactile abnormalities in young children with autism are severe, universally present, and directly related to delay of early self-regulation milestones required for social development. Parent touch is the most effective means of stimulating early self-regulation, yet parents of children with autism avoid touch because their children respond abnormally to it. This suggests that tactile abnormalities pose a barrier to parent touch in autism, and that treatment of tactile abnormalities may improve developmental outcomes. We have developed a qigong massage treatment for tactile abnormalities in young children with autism. Here we evaluate whether tactile abnormalities decrease following treatment, and whether treatment results in improved self-regulatory outcomes. We retrospectively analyzed our qigong massage database for treatment effect on tactile abnormalities, self-regulatory delay, and parenting stress. Five-month interval data were available for 129 children with autism aged 3-6 years. Of these 129, 97 received treatment and 32 were in the wait-list control condition. There were no differences between treatment and control groups by age, gender, or severity of tactile impairment. Treatment resulted in significant decreases of tactile impairment, self-regulatory delay, and parenting stress (p &amp;amp;amp;amp;amp;amp;amp;lt; .001 on all paired t-tests); mean decreases were 25.5%, 24.5%, and 35.8%, respectively. Results were significant compared to controls [F(3,122) = 11.27, p &amp;amp;amp;amp;amp;amp;amp;lt; .001]. In the pretreatment data, tactile impairment was directly related to self-regulatory delay; post-treatment, both variables decreased proportionally. Results demonstrate that tactile impairment in young children with autism is treatable with a qigong massage protocol. The direct relationship between tactile impairment and self-regulatory delay pretreatment, and the proportional decrease of both following treatment, suggest that tactile impairment is a cause of self-regulatory delay, and that qigong massage is a promising avenue to improve developmental outcomes in autism.
Journal of Autism and Developmental Disorders, 2012
Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age ... more Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age six. Cronbach&amp;amp;amp;amp;amp;amp;amp;#39;s alpha was .827. As a measure of parenting stress specific to core and co-morbid symptoms of autism, the APSI is unique. It is intended for use by clinicians to identify areas where parents need support with parenting skills, and to assess the effect of intervention on parenting stress. Mean parenting stress in the autism group was four times that of the typical group and double that of the other developmental delay group [F(2,272) = 153; p &amp;amp;amp;amp;amp;amp;amp;lt; 001]. An exploratory factor analysis suggested three factors impacting parenting stress: one relating to core deficits, one to co-morbid behavioral symptoms, and one to co-morbid physical symptoms.
Early Child Development and Care, 2013
ABSTRACT
Tactile abnormalities are severe and universal in preschool children with autism. They respond we... more 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.
American Journal of Occupational Therapy, 2011
A recent randomized controlled trial (RCT) of a dual parent and trainer-delivered qigong massage ... more A recent randomized controlled trial (RCT) of a dual parent and trainer-delivered qigong massage intervention for young children with autism resulted in improvement of measures of autism as well as improvement of abnormal sensory responses and self-regulation. The RCT evaluated the effects of the parent-delivered component of the intervention. Forty-seven children were randomly assigned to treatment and wait-list control groups. Treatment group children received the parent-delivered program for 4 mo. Trained therapists provided parent training and support. Improvement was evaluated in two settings--preschool and home--by teachers (blind to group) and parents. Results showed that the parent-delivered program was effective in improving measures of autism (medium effect size) and sensory and self-regulatory responses (large effect size). Teacher data on measures of autism were confirmed by parent data. Results indicate that the parent-delivered component of the program provided effective early intervention for autism that was suitable for delivery at home.
Tactile abnormalities are severe and universal in preschool children with autism. They respond we... more 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%, ), autistic behavior (32%, ), total sensory abnormalities (38%, ), tactile abnormalities (49%, ), and decreased autism severity (medium to large effect size, ). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, ). 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.
Chinese Journal of Integrative Medicine, 2011
Objective To present a model for autism showing that impairment of sensory and self-regulation is... more Objective To 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. Methods Children 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. Results The 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. Conclusions Sensory 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.
Sensory impairment is a common and significant feature of children on the autism spectrum. In 200... more Sensory impairment is a common and significant feature of children on the autism spectrum. In 2005, a qigong massage intervention based on Chinese medicine and delivered by a doctor of Chinese medicine was shown to improve sensory impairment and adaptive behavior in a small controlled study of young children with autism. In 2006, the Qigong Sensory Training (QST) program was developed to train early intervention professionals to provide the QST intervention. This article describes the preliminary evaluation of the QST program as piloted with 15 professionals and 26 children and outcomes testing using standardized tests of sensory impairment and adaptive behavior. Results of outcomes comparing delivery by QST-trained therapists with delivery by a doctor of Chinese medicine showed that both groups improved and that there was no difference in outcome between the two groups. The intervention and training program are described, and implications for future research are discussed.
American Journal of Chinese Medicine, 2007
In clinical research, sensory impairment is considered one of the core deficits in autism and is ... more 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 five months. Compared with untreated children, treated children experienced significant improvement of their sensory impairment (p<.01), and demonstrated increased social skills (p<.04) and basic living skills (p<.02) on standardized measures. In addition, all of the children with bowel and sleep abnormalities demonstrated improvement following treatment.
A Medical Qigong protocol was applied to a group of 8 autistic children under the age of 6. The c... more A Medical Qigong protocol was applied to a group of 8 autistic children under the age of 6. The children received Medical Qigong Massage twice weekly from the physician and daily Qigong Massage from the parents for a five week period, followed by daily parent massage for an additional four weeks. Standardized tests showed a decrease in autistic behaviors and increase in language development in all the children, as well as improvement in motor skills, sensory function and general health.
With the inclusion of sensory abnormalities in the DSM-V criteria for autism, the multifocal touc... more With the inclusion of sensory abnormalities in the DSM-V criteria for autism, the multifocal touch/pain abnormalities reported in young children with autism are no longer comorbid symptoms, and it has become an urgent priority to identify their nature and significance. A recent study differentiated children with autism from typical and otherwise developmentally delayed groups on the two-fold basis of mixed allodynia and hypoesthesia, and severe global self-regulatory delay. In this study, we retrospectively analyzed case records for 266 pre-school children with autism and typical development to verify recent findings, assess the prevalence and location of tactile abnormalities in the autism group, and explore the relationship between tactile abnormalities and self-regulatory delay. Results differentiated the autism group by severity of tactile abnormality [F(1,262) = 172.8, p < .001] and self-regulatory delay [F(1,262) = 232.8, p < .001]. Allodynia was reported in 100% of the autism group by parent report and 98% by therapist report; hypoesthesia was present in 65% by parent report. Tactile abnormalities were directly, linearly related to self-regulatory delay (r = .727, p < .001) in both groups. The sense of touch has not been fully evaluated in autism, and there is insufficient quantitative evidence to conclude that it is intact. Mixed allodynia and hypoesthesia are typical signs of sensory neuropathy. Evidence of their near universal presence in young children with autism, and direct relationship to self-regulatory delay underscores the urgent need to fully evaluate the sense of touch in autism and rule out sensory neuropathy.
Sveikatos mokslai, 2013
Acupuncture is one of the oldest complementary therapies used to treat chronic pain. WHO in Revie... more Acupuncture is one of the oldest complementary therapies used to treat chronic pain. WHO in Review and Analysis of Reports on Controlled Clinical Trials about Acupuncture note that researches on acupuncture are extremely difficult to conduct. It is already proved that acupuncture analgesia works better than a placebo for most kinds of pain [1]. Since the l970's there has been a sharp increase in global scientific acupuncture research . However, in Lithuania we still lack both research and training programs for physicians at University level. Klaipeda University Health Sciences Faculty wished to conduct a pilot test of the feasibility of providing acupuncture training in the rehabilitation hospital setting. Method. Ten patients received a short course of acupuncture at the Rehabilitation Center at Klaipeda Seamen's Hospital. Interested physicians were invited to observe. Pre-and post-qualitative data were collected. Results and conclusions. Patients reported positive experiences with acupuncture and improvement of symptoms. Physicians reported growing professional interest in acupuncture. No barriers to providing acupuncture training in the setting of a Rehabilitation hospital were identified.
Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age ... more Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age six. Cronbach's alpha was .827. As a measure of parenting stress specific to core and co-morbid symptoms of autism, the APSI is unique. It is intended for use by clinicians to identify areas where parents need support with parenting skills, and to assess the effect of intervention on parenting stress. Mean parenting stress in the autism group was four times that of the typical group and double that of the other developmental delay group [F(2,272) = 153; p \ 001]. An exploratory factor analysis suggested three factors impacting parenting stress: one relating to core deficits, one to co-morbid behavioral symptoms, and one to co-morbid physical symptoms.
Sensory and self-regulatory symptoms make up most of the comorbid symptoms in autism and are asso... more 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);
Cronbach’s 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 (b) 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.
Autism is commonly associated with disturbances of the sensory nervous system, digestion and slee... more Autism is commonly associated with disturbances of the sensory nervous system, digestion and
sleep. This manuscript presents a randomized controlled study evaluating the effect of a fivemonth
intervention directed towards improving measures of sensory impairment, digestion and
sleep in 46 children with autism under six years of age. The intervention, Qigong Sensory
Training (QST) is a qigong massage intervention based in Chinese Medicine. It is two-pronged,
with trainers working with children directly 20 times over the five months, and parents giving the
daily massage protocol to their children. Improvement was evaluated in two settings: the preschool
and home, by teachers (blind to group) and parents. Teacher evaluations showed that
children receiving the QST intervention had significant classroom improvement of
social/language skills, and reduction in autistic behavior compared to wait-list controls. Parent
data confirmed the findings in the teacher data, indicating that the gains had generalized across
contexts. A model for understanding and treating sensory and self-regulation problems in autism
is advanced, outcomes data supporting the model are presented, and the limitations of the
research discussed.
Evaluation for sensory impairment is a routine part of autism diagnosis. Sensory impairment of he... more 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 ( ). 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.
International Journal of Therapeutic Massage & Bodywork: Research, Education, & Practice, 2013
Following the inclusion of sensory abnormalities in the diagnostic criteria for autism, evidence ... more Following the inclusion of sensory abnormalities in the diagnostic criteria for autism, evidence has emerged showing that tactile abnormalities in young children with autism are severe, universally present, and directly related to delay of early self-regulation milestones required for social development. Parent touch is the most effective means of stimulating early self-regulation, yet parents of children with autism avoid touch because their children respond abnormally to it. This suggests that tactile abnormalities pose a barrier to parent touch in autism, and that treatment of tactile abnormalities may improve developmental outcomes. We have developed a qigong massage treatment for tactile abnormalities in young children with autism. Here we evaluate whether tactile abnormalities decrease following treatment, and whether treatment results in improved self-regulatory outcomes. We retrospectively analyzed our qigong massage database for treatment effect on tactile abnormalities, self-regulatory delay, and parenting stress. Five-month interval data were available for 129 children with autism aged 3-6 years. Of these 129, 97 received treatment and 32 were in the wait-list control condition. There were no differences between treatment and control groups by age, gender, or severity of tactile impairment. Treatment resulted in significant decreases of tactile impairment, self-regulatory delay, and parenting stress (p &amp;amp;amp;amp;amp;amp;amp;lt; .001 on all paired t-tests); mean decreases were 25.5%, 24.5%, and 35.8%, respectively. Results were significant compared to controls [F(3,122) = 11.27, p &amp;amp;amp;amp;amp;amp;amp;lt; .001]. In the pretreatment data, tactile impairment was directly related to self-regulatory delay; post-treatment, both variables decreased proportionally. Results demonstrate that tactile impairment in young children with autism is treatable with a qigong massage protocol. The direct relationship between tactile impairment and self-regulatory delay pretreatment, and the proportional decrease of both following treatment, suggest that tactile impairment is a cause of self-regulatory delay, and that qigong massage is a promising avenue to improve developmental outcomes in autism.
Journal of Autism and Developmental Disorders, 2012
Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age ... more Data validating the Autism Parenting Stress Index (APSI) is presented for 274 children under age six. Cronbach&amp;amp;amp;amp;amp;amp;amp;#39;s alpha was .827. As a measure of parenting stress specific to core and co-morbid symptoms of autism, the APSI is unique. It is intended for use by clinicians to identify areas where parents need support with parenting skills, and to assess the effect of intervention on parenting stress. Mean parenting stress in the autism group was four times that of the typical group and double that of the other developmental delay group [F(2,272) = 153; p &amp;amp;amp;amp;amp;amp;amp;lt; 001]. An exploratory factor analysis suggested three factors impacting parenting stress: one relating to core deficits, one to co-morbid behavioral symptoms, and one to co-morbid physical symptoms.
Early Child Development and Care, 2013
ABSTRACT
Tactile abnormalities are severe and universal in preschool children with autism. They respond we... more 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.
American Journal of Occupational Therapy, 2011
A recent randomized controlled trial (RCT) of a dual parent and trainer-delivered qigong massage ... more A recent randomized controlled trial (RCT) of a dual parent and trainer-delivered qigong massage intervention for young children with autism resulted in improvement of measures of autism as well as improvement of abnormal sensory responses and self-regulation. The RCT evaluated the effects of the parent-delivered component of the intervention. Forty-seven children were randomly assigned to treatment and wait-list control groups. Treatment group children received the parent-delivered program for 4 mo. Trained therapists provided parent training and support. Improvement was evaluated in two settings--preschool and home--by teachers (blind to group) and parents. Results showed that the parent-delivered program was effective in improving measures of autism (medium effect size) and sensory and self-regulatory responses (large effect size). Teacher data on measures of autism were confirmed by parent data. Results indicate that the parent-delivered component of the program provided effective early intervention for autism that was suitable for delivery at home.
Tactile abnormalities are severe and universal in preschool children with autism. They respond we... more 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%, ), autistic behavior (32%, ), total sensory abnormalities (38%, ), tactile abnormalities (49%, ), and decreased autism severity (medium to large effect size, ). In addition, parents reported improved child-to-parent interactions, bonding, and decreased parenting stress (44%, ). 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.
Chinese Journal of Integrative Medicine, 2011
Objective To present a model for autism showing that impairment of sensory and self-regulation is... more Objective To 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. Methods Children 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. Results The 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. Conclusions Sensory 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.
Sensory impairment is a common and significant feature of children on the autism spectrum. In 200... more Sensory impairment is a common and significant feature of children on the autism spectrum. In 2005, a qigong massage intervention based on Chinese medicine and delivered by a doctor of Chinese medicine was shown to improve sensory impairment and adaptive behavior in a small controlled study of young children with autism. In 2006, the Qigong Sensory Training (QST) program was developed to train early intervention professionals to provide the QST intervention. This article describes the preliminary evaluation of the QST program as piloted with 15 professionals and 26 children and outcomes testing using standardized tests of sensory impairment and adaptive behavior. Results of outcomes comparing delivery by QST-trained therapists with delivery by a doctor of Chinese medicine showed that both groups improved and that there was no difference in outcome between the two groups. The intervention and training program are described, and implications for future research are discussed.
American Journal of Chinese Medicine, 2007
In clinical research, sensory impairment is considered one of the core deficits in autism and is ... more 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 five months. Compared with untreated children, treated children experienced significant improvement of their sensory impairment (p<.01), and demonstrated increased social skills (p<.04) and basic living skills (p<.02) on standardized measures. In addition, all of the children with bowel and sleep abnormalities demonstrated improvement following treatment.
A Medical Qigong protocol was applied to a group of 8 autistic children under the age of 6. The c... more A Medical Qigong protocol was applied to a group of 8 autistic children under the age of 6. The children received Medical Qigong Massage twice weekly from the physician and daily Qigong Massage from the parents for a five week period, followed by daily parent massage for an additional four weeks. Standardized tests showed a decrease in autistic behaviors and increase in language development in all the children, as well as improvement in motor skills, sensory function and general health.
With the inclusion of sensory abnormalities in the DSM-V criteria for autism, the multifocal touc... more With the inclusion of sensory abnormalities in the DSM-V criteria for autism, the multifocal touch/pain abnormalities reported in young children with autism are no longer comorbid symptoms, and it has become an urgent priority to identify their nature and significance. A recent study differentiated children with autism from typical and otherwise developmentally delayed groups on the two-fold basis of mixed allodynia and hypoesthesia, and severe global self-regulatory delay. In this study, we retrospectively analyzed case records for 266 pre-school children with autism and typical development to verify recent findings, assess the prevalence and location of tactile abnormalities in the autism group, and explore the relationship between tactile abnormalities and self-regulatory delay. Results differentiated the autism group by severity of tactile abnormality [F(1,262) = 172.8, p < .001] and self-regulatory delay [F(1,262) = 232.8, p < .001]. Allodynia was reported in 100% of the autism group by parent report and 98% by therapist report; hypoesthesia was present in 65% by parent report. Tactile abnormalities were directly, linearly related to self-regulatory delay (r = .727, p < .001) in both groups. The sense of touch has not been fully evaluated in autism, and there is insufficient quantitative evidence to conclude that it is intact. Mixed allodynia and hypoesthesia are typical signs of sensory neuropathy. Evidence of their near universal presence in young children with autism, and direct relationship to self-regulatory delay underscores the urgent need to fully evaluate the sense of touch in autism and rule out sensory neuropathy.