Hemispheric Integration Therapy is becoming increasingly popular due to its success with treating children with Autism Spectrum Disorders. Autism spectrum disorders include A.D.D.,A.D.H.D., Sensory Integration Disorder, Processing Disorders, Asperger’s Syndrome, O.C.D., Tourette’s Syndrome and Autism. Business dictionary.com defines integration as the process of attaining close and seamless coordination between several groups, departments, organizations or systems. Hemispheres relates to the right and left halves of the cerebral cortex, the highest part of the brain that makes us most human and is different from other animals. Thus, Hemispheric Integration Therapy aims to coordinate different areas and systems within the brain both in the cortical hemispheres and between them in order to get the most efficient function possible.
Integrating the cerebral hemispheres in order to optimize communication between the right and left sides of the brain to improve neurological function is part of Functional Neurology. Functional Neurology deals with not just evaluating the nervous system for disease states such as tumors, infections, strokes, etc. but evaluating the function of the nervous system as a continuum that starts with optimal function and ends in a disease state. Thus, the Functional Neurological examination will not only evaluate if a task can be performed but how well that task can be performed. The quality of that performance will give the Functional Neurologist clues as to how close that system or pathway is to optimal functionality. As an example, a Functional Neurologist will evaluate not only if the eyes can move in different planes, as a yes or no, but the quality of those movements. Are the movements synchronized and smooth? Is there any breakdown in these movements? This will give clues as to how well the systems involved in the different eye movements are working.
Based on the findings of the examination, the Functional Neurology practitioner will look to localize a functional lesion. In a functional lesion, “the wires are there but they are not transmitting signals properly or efficiently.” Another example may relate to a nerve center not integrating the information it receives well and thereby passing on the appropriate information. A Functional Neurologist will try to find one area of the brain or pathway that explains all or most of the symptoms that the patient is complaining of.
Similar to looking at a map, the Functional Neurologist is familiar with the neurological pathways/roadways and will find the roadblock that would disrupt function downstream from that roadblock. He will then develop a specific treatment program to stimulate that particular area or pathway of the brain that is under functioning and/or conversely inhibit a pathway or area that may be over functioning.
These types of lesions are termed functional lesions as opposed to ablative lesions. An ablative lesion can be seen on standard imaging such as MRIs. Only with the advent of the SPECT scan and functional MRIs was neuroscience able to localize what areas of the brain are activated while certain functions are being performed. That is, we can ask the patient to do math or sing a song and see what areas of the brain are activated when these tasks are performed on these newer imaging techniques. This type of research, which blossomed more so in the 90s, termed “the decade of the brain,” led to great advances in neuroscience and the clinical application of these findings and techniques to remedy these functional lesions “Functional Neurology.” at present SPECT scans and functional MRIs are typically only available at the research level. In clinical practice, a Functional Neurological examination performed by qualified practitioner should determine where the functional lesion is without the need for the research type imaging studies.
Functional Neurology has its roots in Chiropractic Neurology. Dr. Frederick Robert Carrick created the Chiropractic Neurology program in the late 1980s. Dr. Carrick is considered the father of Chiropractic Neurology and Functional Neurology. Classes in Functional Neurology are taught through the Carrick Institute and can lead to a Diplomate of the American Chiropractic Neurology Board. These classes also qualify you toward the newer multidisciplinary American College of Functional Neurology.
With that background and history here are the questions I would suggest you ask a doctor if you are interested in “Hemispheric Integration Therapy” and/or “Functional Neurology.”
1. Is he/she a Diplomate of the American Chiropractic Neurology Board? The Diplomate program and Chiropractic Neurology takes approximately 3 years to complete and therefore one of the most important factors for your consideration.
2. How long have they been board-certified?
3. How much of their practice is devoted to Functional Neurology and/or Hemispheric Integration Therapy?
4. Are they a fellow of the American College of Functional Neurology, a newer multidisciplinary group?
5. If you’re looking for a doctor to treat a child on the autism spectrum, ask how long they have been treating children with Hemispheric Integration Therapy?
6. Especially with regard to a child on the autism spectrum, ask if you can speak to a current or past parent whose child has been treated.
I wrote this article because there are very few experienced doctors with this specialized training and therefore, our office gets a lot of calls and e-mails asking if I know of a doctor using Hemispheric Integration Therapy to treat children from places like Iowa and France. I do treat patients that travel from a distance but many times that is not a practical option. With that in mind, these are questions I recommend you consider when doing your research.