from the ABR DENMARK webpage

ABR and the Special Needs Child

Essentially all special needs children suffer from compressional weakness.

This weakness is generally global, but can be more pronounced in certain areas of the body as in the case of the hemiplegic child where one of the sides is more affected.

In severe cases this weakness is more pronounced – in less severe cases it is nevertheless present and in a high enough degree to inhibit a child’s general function.

Compressional weakness is present in the core structures, but also in soft tissues such as the joint capsules. These are all structures that cannot be trained through physical training, but are dependant upon a technique that can initiate an automatic response.

Therefore the ABR Technique is equally applicable for children with mild and severe developmentary disorders.

The Quadriplegic Child

The majority of children in the ABR Program have the diagnosis of quadriplegic. This diagnosis refers to the outer extremities and suggests that both the arms and legs have been effected.

ABR recognizes that in order for these children to achieve functional improvement of the arms and legs, it is necessary to focus ones initial attention upon two fundamental functional elements:

• Head control
• Trunk strength and stability

Without acquiring significant head control and without having stability and strength within the trunk of the body, any discussion about weight bearing (internal Link zur Weight Bearing) upon the arms or upon the legs is fruitless. And weight-bearing ability always precedes the development of movement function!

No one would choose to build a twenty story building upon a foundation designed for a one family ground level dwelling. Yet the attempts to require a child with significant trunk instability or compressional weakness to stand or to walk could be compared to the described constructional fiasco.

In fact, it is the compressional weakness within the thorax and abdomen that result in the:

• lack of stability of head positioning
• insufficient range of movement of the head
• no head counter balancing movements

The same compressional weakness, on the other hand results in an obvious rigidity of the spinal column.

This spinal column rigidity ensures that the child exhibits:

• No side bending
• Limited rotational movement in the vertebral column
• Limited forward and backward movement of the trunk
• Difficulties with counter balancing

The description above outlines the initial targets of ABR work for quadriplegic individuals. Without improvements in these areas, it cannot be expected that such children can gain improvements in arm or leg function.

Countless ABR parents can confirm that improvements in the structural dysfunctions described above lead to improvements in the function and usage of the outer extremities for quadriplegic children.

Premature Infant or the Child Born with Birth Trauma

Due to the relative immaturity not only of the lungs themselves but also of the entire thoracic structure and the upper airways, the premature infant often suffers from respiratory distress. This immaturity results in compressional weakness within the thorax and abdomen prohibiting the proper establishment of one of the earliest vital functions – respiration.

The soft tissue matrix that stabilizes and anchors the trachea to the mouth floor and within the neck is insufficiently developed. As a result, these structures cannot provide enough resistance when the diaphragm contracts downwards within the thorax during inhalation. Diaphragm contractions cause the upper airways to wobble. Instability within the mouth floor results also in wobbliness of the trachea and bulging of the mouth floor and anterior neck.

The upper thorax, instead of rising towards the neck during inhalation begins to be sucked in and downwards towards the diaphragm. It depresses. Thus the paradoxical pattern of breathing is established.

Upon inhalation one sees:

• Instability within the mouth floor and trachea connections
  
• Depression of the upper or mid-thorax
  
• Lateral expansion of the weak lower ribs
  
• Bulging of the diaphragm
  

Upon exhalation however:

• The upper thorax expands to its neutral position
  
• The abdominal bulge relaxes
  

The paradoxical breathing leads to further structural impairments in a cascading effect, such as:

• Stiffening of the upper intercostals muscles
  
• Thoracic deformations
  
• Downwards orientation of the ribs
  
• Shifts in the placement of the clavicles and entire shoulder girdle
  
• Collapse and shift of the jaw and jaw joint (TMJ)
  
• Shortening of the posterior neck
  
• Change in the head positioning at the base of the skull and C1-C2 connections
  

Unfortunately as theses structural impairments occur, a child can no longer “grow out” of the situation and a life-long disability is the usual outcome.

ABR is the only method that both successfully and safely targets internal soft tissues structures within the thorax and the mouth floor. The strengthening and conditioning of effect of the applications allow for a reversal of the paradoxical mode of breathing, thus normalizing respiration. Chest deformations are both prevented and reversed.

In this situation the wise saying applies: Prophylaxis is preferable to treatment.

Not only the premature child, but also children within a wide diagnostic spectrum of congenital and early life disorders can be effectively supported through an early intervention and administration o f the ABR Therapy and can be applied by the parents even in a hospital setting.

Autism or ADHD

Both Autism and ADHD (Attention Deficit Hyperactivity Disorder) are regarded as disorders with primarily psychological or psychiatric components.  In this respect the internal structural deficiencies common to all children with these or related developmental disturbances is widely overlooked.

Children with the above named disorders suffer from an insufficiently developed proprioception.  Due to global structural disorders, the internal sensation of their own “body map” has never been properly established during the early childhood phases.

As early as in 1998 Phillip Teitelbaum from Gainsville University in Florida observed deficient motor development in infants that later received the diagnosis of autism.   In the article titled:  Movement analysis in infancy may be useful for early diagnosis of autism  (to be found at: http://www.pnas.org) he described typical movment disturbences observed in these children and concludes:

“Our findings support the view that movement disturbances play an intrinsic part in the phenomenon of autism, that they are present at birth, and that they can be used to diagnose the presence of autism in the first few months of life.”

Broad ABR based muscular skeletal testing show consistent disruptions in the following areas:

• Basic counter balancing disturbances at all bodily levels – specifically:
  
  • Head/Neck
  • Trunk
  • Waist
  • Pelvis
  • Peripheries – Arms and Legs
• Limitations of mobility in the spinal column
• Weak and unstable joints – hyper mobility in the limb joints

The above named disturbances reveal a lack of bodily segmentation.  For example, the head cannot be moved separately from the rest of the body - slight movements of the head disrupt the balance of the trunk and legs.  Or the movements of the legs are not sufficiently distinguishable from the movements of the trunk - meaning that leg movements also tend to disrupt the trunk stability.

More clearly stated, the above named difficulties give the child complications in performing simple daily tasks - not to mention the monumental obstacles that arise, should the child be faced with more strenuous activities such as running, hopping, climbing or jumping.  Even an uneven terrain or stairs can present the child with sufficient or insurmountable difficulties.

These elements combine to constitute the underlying cause for the coordination deficits that these children experience. 

It is a well-established fact that the proprioception of the body serves to create the internal “body map” that is established in early childhood.  This process reaches a certain peak when the child comes to the upright position.  Nevertheless, the earlier stages must have been fully and successfully achieved before the child can be fully competent in the upright position. 

The stages that are necessary for mastering the upright position are the successive components of weight bearing starting with:

• Supine position
• Side position
• Prone position
• Elbow support
• Quadruped position
• Sitting
• Kneeling
• Standing

Combined together these elements serve as the underlying basis for weight bearing on one foot as the basis for walking.

The completion of the body map becomes the basis for further developmental steps in the healthy child.  If the child only partially completes a significant number of these stages, then the basis for basic coordination as well as for further developmental steps is insufficient. 

Social problems and learning difficulties are the foreseeable outcome.

The specially designed ABR Technique assists the child in making improvements at the soft tissue level. This results in both improved joint stability as well as mobility.

As a result, general coordination, counter-balancing and weight bearing elements are improved. 

Improvements at these elementary levels free the child for further development both socially and cognitively. 

Enhanced concentration, interest for the world, communication and speech progress as well as improved social behaviour are some of the predictable and consistent results achieved by children with similar diagnosis’ in the ABR Program.

ABR and Speech

Speech impairment can occur through a wide variety of causes. Whatever the original cause may be, the ABR Method provides a unique and highly effective means of improving a patient’s speech ability.

Speaking involves a complex synchronized sequence of subtle movements involving all the participating structures within the speech organism. When coordinated function is available, these combined movements serve to form the airflow into recognizable sounds. When structural deficiencies are present, coordination of the multiple levels involved becomes difficult or impossible.

The structurally determined problems lead to slurred or unclear speech as well as limited sound production.

Structural deficiencies are typically present as:

• an underdeveloped mouth floor
• underdevelopment of the mimic muscles
• blockage or limited mobility of the TMJ – (jaw joint)
• weakness of the trachea/larynx and surrounding soft tissue structures
• weak attachment of the hyoid bone
• weakness of the thorax resulting in uncoordinated respiration

A child who is born with such structural impairments may not even make an effort to speak. Children with lesser impairments may achieve a slurred and difficult to understand speech.

Even when undergoing extensive speech therapy, it is often impossible for stroke or accident victims to regain clear and flowing speech.

In such cases ABR targets the organs of speech formation directly. Applications to the neck area – including trachea and larynx, the mouth floor, jaw joint, and the areas of the mimic muscles bring structural improvements that in turn allow for intelligible articulation. Applications to the thorax in turn, serve to strengthen the thoracic musculature, and the soft tissue structures responsible for the bronchial passages and the lungs. These applications strengthen and regulate the airflow allowing for stronger sound production and improved intonation.

ABR can be successfully applied for brain injury related speech problems as well as speech development difficulties such as stuttering and lisping.

all this information can be found on www.abr-denmark.com