Introduction:

Asperger’s syndrome is considered a high-functioning autism [1] and since its exact
cause is unknown some research supports the likelihood of a genetic basis. It differs from
other autism spectrum disorders by its relative preservation of linguistic and cognitive
development. Although not required for diagnosis, physical clumsiness and atypical use
of language are frequently reported [2]. There is no single treatment, and the
effectiveness of particular interventions is supported by only limited data. Intervention is
aimed at improving symptoms and function. The mainstay of management is behavioral
therapy, focusing on specific deficits to address poor communication skills, obsessive or
repetitive routines, and physical clumsiness. A 2003 review of epidemiological studies of
children found prevalence rates ranging from 0.03 to 4.84 per 1,000, with the ratio of
autism to Asperger’s syndrome ranging from 1.5:1 to 16:1[3]. The field of chiropractic
may play a part in the treatment of autism spectrum disorders [4] and sacro occipital
technique (SOT) and cranial techniques have been found to be of promise for improving
symptoms and function [5].

Case History:

A six year old male patient was brought to my office on October 2000 for evaluation and
treatment for several medically diagnosed conditions that had not responded to standard
medical care. The patient had seen another chiropractor for 6 months who then referred
the patient for SOT and cranial chiropractic care at this office.
His initial complaints included: Asperger’s Syndrome that resulted in uncontrollable
“rocking, jumping and flapping” of his hands, asthma triggered by exertion, seasonal
allergies and colds or bronchial congestion, and severe allergies to mold, dust, animal
dander and seasonal triggers. Standard medications for the Asperger’s “made his asthma
and allergy symptoms worse.” Therefore at the time of his initial office visit he was only
taking asthma medication (Intal and Albuteral) and a multivitamin. His Asperger’s
symptoms started at age 3 and he had asthma and allergy symptoms since early
childhood.

Methods – Treatment/Intervention:

A standard chiropractic, orthopedic and neurological exam was performed on the patient
as well as a specific SOT (Sacro Occipital Technique) spinal and cranial evaluation.
Cranial and spinal subluxations patterns were detected and a treatment program was
implemented to address these patterns using SOT protocols and procedures.
Initially treated as a category two (sacroiliac joint hypermobility) with active occipital
fibers line two T3 and T7. His occiput was determined to be in left lateral flexion, he had
right temporomandibular joint dysfunction (TMD) and cervical subluxations at C2 and
C1. The category two stabilized in 3 weeks corresponding with improvement of his
Asperger’s symptoms. Initially cranial adjustments focused on the occiput, spinal
adjustments to the upper cervical spine (C1 – C2), pelvis (Category II protocols) and
thoracic regions (T3 and T7). Viscerosomatic reflexes relating to T3 and T7 were
balanced utilizing chiropractic manipulative reflex technique (CMRT).
By the second month the patient was treated as a category one (sacroiliac joint fixation,
pelvic torsion, and altered sacral nutation) and the cranial imbalance began to resolve.
His office visits were reduced from every 3-5 days to every 7-10 days until May 2001
and following that time was shifted to be seen every two weeks.

Results:

The patient and family reported that the Asperger’s Syndrome symptoms “settled down
within the first week of care.” While first seen in October 2000 by January 2001 his
Asperger’s symptoms had been stabilizing and was off medications for asthma and
allergies. Initially he was seen at the office in October 2000 every 3 to 5 days. From
November 2000 to May 2001 he was seen at the office every 7-10 days. Following the
May 2001 he was reduced to 2 times per month and was put on a wellness treatment
schedule which for him was 1-2 times per month.
During that first year he was seen for 2 exacerbations through summer 2001. In the first
three years of care there were some minor exacerbations however he would be seen for
chiropractic care at this office and treatment would resolve his symptoms never needing
medication. His Asperger’s symptoms continued to improve and only occurred
infrequently when under extreme stress.
While his asthma and allergies responded positively within the first few weeks of care in
August 2001 he had an asthma flare-up. Allergy testing revealed an allergy to mold so he
was given a homeopathic allergen to help treat the condition and he responded well to
this intervention. Presently the patient is 15 years old and has not needed any medication,
nor has his Asperger’s symptoms returned during the past 7 years. At the present time
this patient is being seen on a wellness/maintenance chiropractic care program. There has
not been any significant flare-up of his Asperger’s, asthma, or allergies since the summer
of 2001.

Discussion:

It is of interest that there appears to be a temporal relationship between SOT spinal and
cranial therapy and the patient’s Asperger’s symptoms and ability to function. When
there were flare-ups of behavior and treatment was rendered the patient’s symptoms
would subside. While it is possible the patient had a variation of Asperger’s no prior
treatment or medication affected his symptoms and in fact tended to exacerbate his other
conditions. Also it is not common for Asperger’s syndrome to “just go away,” as it
appears to have happened with this patient. Therefore there may be a subset of children
diagnosed with Asperger’s syndrome that have a mechanical or neurological component
that will respond to specific types of chiropractic interventions.

Conclusion:

Further research is needed into the relationship between SOT spinal and cranial care for
Asperger’s and other autistic spectrum disorders. With the risk benefit ratios associated
with the reduced risk of chiropractic care with increased risk of the typical medications
used for this condition, a trial of chiropractic care for children or adults with this
condition may yield important information. It is difficult to extrapolate extensively from
a single case study but the findings of this case should encourage further research into
SOT spinal and cranial treatment of Asperger’s or autism spectrum disorders.

References:

1. Klin A (2006). Autism and Asperger’s syndrome: an overview. Rev Bras
   Psiquiatr 28 (suppl 1): S3–S11.
2. Baskin JH, Sperber M, Price BH (2006). Asperger’s syndrome revisited. Rev
   Neurol Dis 3 (1): 1–7.
3. Fombonne E, Tidmarsh L (2003). Epidemiologic data on Asperger’s disorder.
   Child Adolesc Psychiatr Clin N Am 12 (1): 15–21.
4. Gleberzon BJ. Chiropractic and the management of children with autism [review]
   Clin Chiropr. 2006 Dec;9(4):176-181.
5. Bloink T. Autism and language delay, integration of SOT cranial therapy and
   tomatis auditory therapy to stimulate the auditory cortex: A case report. J Vert Sublux
   Res. May 2008;(7):17.