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Notes from the Practice of Harold Goodman, D.O.

Osteopathy and Autism  Sunday, August 23, 2009

There is so much that osteopathy has to offer the autistic spectrum patient.

I am currently treating a 21 year old man who has been labeled autistic for much of his life.

He did not use words when I first met him.

Most of his actions are disjointed and spirited with a lot of jumping, chewing, self-mutilation, rapid and loud outbursts as well as seemingly constant tension.

Off and on over the last eighteen years I have had patients who had been given the label autism.

They had little in common once I began to dig beneath the surface.

However, they all seem to have major issues in communication.

My impression is that they communicate quite well.

Unfortunately, many of the people in their lives don't realize this.

Their caregivers seem to believe that if the person labeled autistic doesn't communicate like they do then they don't communicate.

This is absolutely wrong.

If a Chinese speaker can't communicate in English must we conclude that they can't communicate?

If a deaf person can't speak as others do, is it appropriate to assume that they not only can't communicate but, as many formerly concluded, that they are actually dimwitted?

For example, the languages created by deaf people to communicate amongst themselves, the various sign languages, have proven to be highly complex ways of interchange which, in many cases, go way beyond the possibilities inherent in spoken languages.

It is the same with the so-called autistic people.

How do I know this?

I just asked my patient.

His family is very concerned for his well being. They truly love him and he loves them, too. It is quite obvious to anyone who spends even minimal time with them.

After a hiatus of seven years he returned as a patient.

During those seven years a lot of major changes had occurred in my life.

As a result, my entire approach to working and communicating with my patients is different.

I love to see some of the patients who haven't come in for many years. It is like seeing an entirely new patient, someone whom I have never met before.

Indeed, I never had met the person who is now standing before me asking for help.

How do you communicate with a neonate who can't speak?

What would you do to really understand their needs?

It has been repeatedly stated that over 94% of our communication is non-verbal.

Much of this is completely non-physical.

Have you ever been in a room and become aware while you were engaged in speaking with someone that someone else had entered the room?

You hadn't seen or heard the newcomer; you just knew that something had changed, that someone was in the room who hadn't been there before.

There is a part of our awareness that is beyond our everyday consciousness. It is from this awareness that we can track or tune into these phenomena.

Hunters use it. Aborigines do so. And we can,too.

I have a way of using this so that I am able to ask and receive information from patients without verbal speaking.

I asked my patient what he most wanted.

He replied, " To be acknowledged as a human being, as I am."

I asked him if there was some way we, his care givers, could support him in this.

" Just treat me as one of you. Whatever you do, don't treat me like damaged goods, like someone with a problem. I don't have a problem; I am just very different in some ways than you. My frustration is that I am trying, in the only way I know, to be with you. This is not acknowledged or welcomed. I feel very, very isolated and alone. You can't imagine my frustration. I feel lost."

I worked during that visit to support him according to the feedback he was providing me with.

He noticeably calmed down. His parents remarked on this.

When I next saw him his father mentioned repeatedly that he had never seen his son so calm, responding to cues and commands so well. In addition, he had said his first word.

He said, " Hi."

It was a long and drawn out, " Hi". He looked directly into my eyes when he said it. He was smiling.

I use my osteopathic skills to reduce the tremendous stress in the dural membranes of the cranium which I often find in these patients.

I have also started the father and another caregiver in the use of baby sign language to speak with him. We are just using a few signs for now. When these are assimilated we shall build on them. Many of my pediatric patients have greatly benefited from this approach,too.

However, the mainstay of my work is building meaningful communication with him.

I am very excited about this breakthrough.

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