O02 04 os 10 12 14 CONTENTS THE STORY BEGINS AUTISM: A GROWING PHENOMENON HEARING THE CALL DID SHE MAKEA DIFFERENCE? LOOKING AT IMPACT CALMER WATERS FURTHER READINGTHE STORY OF A TOUCH-BASED TREATMENT FOR AUTISM CREATED BY DR. LOUISA SILVA IT’S ALMOST IMPOSSIBLE TO SUCCESSFULLY TREAT A CONDITION WITHOUT UNDERSTANDING THE CAUSE. BUT SOMETIMES, WHEN WATCHING A CONDITION GET BETTER YOU CAN SEE WHAT WAS WRONG IN THE FIRST PLACE. SUCH WAS DR. LOUISA SILVA'S EXPERIENCE WITH AUTISM. AS IT HAPPENED, THE CAUSE WAS IN PLAIN VIEW ALL ALONG.1 THE STORY BEGINS Louisa Silva didn’t start her medical career with a desire to do university-based, integrative medicine research on autism. No, she started with taking care of people. Dr. Silva’s first passion was working at a free clinic in Los Angeles. She loved the mission of providing safe, affordable treatment to those who really need it. Her father had been a dentist in South Africa under apartheid, and she once visited a public health dental clinic that he had started for Zulu women. The women had vitamin deficiencies, but didn’t like to take pills. Inside the clinic, chairs were lined up for people to wait their turn. But just outside, there was a courtyard where about 20 women were sitting in a circle, talking, laughing, nursing their babies and drinking liquid vitamins from large brown bottles. 21 Afterwards they came inside to have their teeth worked on. There was something about that natural joyful vision of community healthcare that stayed with her. Chinese medicine was far from Louisa's mind while she was in medical school at UCLA, but when the surgery department brought a team of physicians over from China and did a radical mastectomy under acupuncture anaesthesia - without any drugs - the seed was planted. Over the years, as she reached the limits of what Western medicine could do for her patients, she studied osteopathic medicine and herbal medicine. But it wasn’t until she studied Chinese medicine that she hit the jackpot for safe and effective treatments. After working in India, Ireland and rural Kentucky, Dr. Silva settled down to do family practice in Salem, Oregon. She was contentedly practicing her own blend of Chinese medicine, osteopathic medicine and Western medicine, when in 2000 something happened that took her life in a totally unexpected direction.2 AUTISM: A GROWING PHENOMENON All around the world, cases of autism were popping up. When she was in medical school, autism was so rare it was barely mentioned, but by 2.000, the incidence was approaching 1 in 500 children. Autism is a developmental disability in which behaviour is abnormal, and social and language development are delayed. It is a spectrum disorder, meaning that there are huge differences between children and it can be mild, moderate or severe. Nonetheless, all children avoid touch and eye contact and are unreceptive to social interactions. And all children have difficulty adjusting to change and managing stress. Tantrums, aggression and self-injury are common and can be severe.3 HEARING THE CALL The son of a dear friend wasn’t developing normally. He was four and had no language. He wasn’t sleeping and was easily overstimulated to the point of meltdown. Ordinary family events like meals, gatherings, or outings were major struggles. Despite the fact that both parents were skilled communicators, they couldn’t communicate with him, or even reach him most of the time. It was difficult to moderate his energy or regulate his behaviour. He could not be soothed or redirected. Simply keeping him from being a danger to himself was an exhausting, all-consuming task. Louisa had been aware of the difficulties her friends had endured - the months they’d spent visiting specialists to find out what was wrong, how hard it was to get through each day.3 But when the diagnosis of autism finally came, what caught her square between the eyes was how little relief this ‘answer’ brought them. Instead, the information sent her friends into a tailspin of despair that dragged the whole family down. Up to this point it had taken all of her friends’ energy to keep their son contained and safe while they waited for a diagnosis and treatment that could finally help. But when they got the diagnosis, their hope evaporated. They were told that autism is a lifelong disability and there was nothing they could do. There is no known cause, no known cure. The only treatment was the early intervention services he was already receiving. Dr. Silva couldn’t just stand by and watch her friends suffer. She remembered watching her Chinese medicine professor, Dr. Anita Cignolini, give a massage to a four-year-old autistic boy. Within a few days worth of massages he had begun to make eye contact and roll a ball back and forth with her. She thought that this massage technique might help her friend’s son. Little did she know what was starting.3 Dr. Cignolini’s treatment incorporated qigong massage, a specialised form of Chinese massage that works on restoring the flow of qi (vital energy) through the major energy channels (also called meridians, or acupuncture channels) in the body. The idea that we can restore health and improve circulation by working with these energy channels has been the basis of Chinese medicine for over 3.000 years. Dr. Silva flew to California and typed while Dr. Cignolini dictated her protocol. The massage was a series of eleven movements. It took about 15 minutes to pat down the energy channels of the body from head to toe. The doctor advanced the cause by giving the expert version of the massage ten times over five weeks, while the parents, who learned the treatment from the doctor, maintained the gains by giving it at home daily. When Dr. Silva returned home she taught the treatment to her friends. They tried it on their son and it worked. He calmed down and his behaviour became more manageable.3 And then it hit her - there were thousands of children whom this massage could help, but no-one would believe her if she went around saying that you could treat a neurological disorder like autism with massage, even if it was a specialised massage. She was going to have to prove this scientifically. At the time she was working on a Masters in Public Health and Preventive Medicine. A few years previously Dr. Silva had started a clinic to serve the local migrant population. They were integrating Western and Chinese medicine approaches to find inexpensive, effective ways of treating chronic conditions. The timing was perfect. She needed a research project for her degree, and no research had been done on qigong massage for autism. Her thesis project was literally in her hands. Dr. Silva contacted the local intervention services for the autism programme, and they helped her locate eight children. An occupational therapist and a speech therapist volunteered their services to do the pre- and post-treatment testing. She taught the parents the massage and met with them weekly to provide ongoing support.3 At the end of ten weeks children were more social, made more eye contact, were eating and sleeping better, and parents were less stressed. All of the developmental measures had improved and the occupational therapist reported that children were easier to touch. This would later prove to be a vital clue towards unravelling the puzzle of autism. Dr. Silva finished her Masters programme and submitted the study for publication in a British autism journal. The reviewers turned it down, questioning her background and telling her the article wasn’t up to their standards. She resubmitted the manuscript to the American Journal of Chinese Medicine, and it was accepted. It was her first lesson in the difficulty of publishing qigong massage research in mainstream journals. The experience didn’t temper her desire though to get the word out and the next 18 years she would go ona quest of scientific research proving that qigong massage actually works for autism.4 DID SHE MAKE A DIFFERENCE? LOOKING AT IMPACT What has been the impact of all this? Quite a lot really: Dr. Silva and her team brought the qigong massage treatment from theory to evidence-based treatment for autism. They’d carried out and published more than a dozen research studies showing that five months of treatment resulted decreased severity of autism by 1/3, improved touch responses by %, decreased parenting stress by 44%, and improved social and language skills. In the process, they’d empowered thousands of parents to help their own children, seen reduced stress in the families, and helped children onto a better developmental path.4 They had developed onsite and online training programs for professionals, and made them available in the US, Europe and South America. The way that autism was being thought about and treated was changing. In the process, they’d brought together Chinese medicine ideas with Western scientific ideas and introduced some of the most beautiful parts of Chinese medicine to Western families and Early Intervention programs.5 CALMER WATERS Dr. Silva and her team have crossed a lot of bridges to get to where we are today. When they started, there was no published scientific literature showing the effectiveness of qigong massage treatment for autism or any other condition in the West or in China. There was no public awareness of qigong massage. There were no theories for autism that included problems with touch and self- regulation, and no way to measure whether treatment helped the problems. Apart from Dr. Cignolini and herself, there were no practitioners of qigong massage for autism, and no training programmes for practitioners and parents. All of that has changed.5 Her own belief systems have been challenged and she's had to rethink three myths that she formerly believed. 1/ The first is that you have to be a doctor to practice Chinese medicine and assist healing. Not true, the early intervention people are doing a great job with the massage. 2/ The second is that parents cannot provide treatment for a neurological handicap. Also not true - no one but a parent can give the massage day in and day out for the length of time required. 3/ The third is that treatment for a serious neurological condition like autism must surely be complicated and expensive. As it turns out, this treatment is relatively easy to teach parents and nearly free to dispense.6 FURTHER READING Make Children Better® offers education programs and professional training on Qigong Massage Therapy for autistic children and children with ADHD, ADD, Down syndrome or Sensory Impairment. On their website under the tab "resources" you will find a wealth of Qigong information. From key concepts in QM work to research in the Qigong field, and much more - you'll find videos, articles, and book recommendations. You can replay our Community Conversations, review tools for your practice, and read information from our partners. https://www.makechildrenbetter.orgBooks written and published by Dr. Silva + "Qigong Massage for Your Child with Autism: A Home Program from Chinese Medicine." Louisa Silva « "My Child's First Year of Qigong Massage: A Parent Workbook and Companion Volume to Qigong Massage for Your Child with Autism." Louisa Silva and Pam Tindall « "An At-Home Guide to Children's Sensory and Behavioral Problems. Qigong Sensory Treatment for Parents and Clinicians." Linda Garofallou and Louisa Silva