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Hi everyone. My name is Dr. Jordan Kovacs. I’m a chiropractor and fellow in Primary Spine Care here in Eatontown, New Jersey. Unfortunately, Dr. Mark Studin was unable to do his show today, so he asked me to fill in mark as a mentor and a friend, I’m incredibly honored. I. So thank you, mark. I’m also excited to share something that’s near and dear to my heart.
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But first I’d love to give a big thank you to ChiroSecure for allowing me to step in last minute and for all they do for the wonderful profession of chiropractic. They’re a great company to work with. So today I’m gonna be talking about how chiropractic offices can be a little bit more welcoming to individuals on the spectrum autism spectrum patients, both child and adult alike.
So this is near and dear to my heart, as I said, because I’m talking to you not only as a chiropractor, but as a parent. My son, who’s almost 19 now has significant autism and as a parent I’ve navigated healthcare with him and. Been in incredibly unwelcoming, anxious inducing environments that hopefully I can shed a little bit of light on that your offices can remove some of those barriers because really what we’re gonna be talking about today is easy and simple, thoughtful and meaningful changes that you can implement tomorrow with no extra specialized training.
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No extra money, no overhaul of major systems. We just need to remove a few barriers to access and it can make a world of difference. And I’ll give you a very real world example. I had a great relationship with an ENT, Urin noses and throat doctor, who’s phenomenal clinician. I respect him immensely.
I probably sent him no less than 30 patients over the years because he had operated on my wife. We had discovered she had a thyroid issue and when, sorry. When she and I were first dating, she had thyroid cancer. He did such a good job with her that she had this aberrant post-op test result. They were expecting to see something.
They didn’t see it. Long story short, we wound up Memorial Sloan Kettering in New York City. We saw the top specialist, the top thyroid guy scanned her up and down left and right and came in the room and said, look, your surgeon was just fantastic. He did a great job. This is like a false, it’s a false negative, false positive, whatever it was, whatever triggered it.
I see one or two cases a year, go home, be happy. And we were, and when my son developed some hearing issues and some hearing sensitivity, of course, we went right back to that ENT and everything was fantastic. Again, full trust. Everything was great until. They went corporate, they sold their office. He went from being one in three providers to one in 156 providers.
Lord knows they’re probably up to 400 providers by now. Massive conglomerate. And the staff changed the tone changed everything changed about that office and the staff was so cold, so unwilling to be flexible, so unwilling to offer any accommodations or modifications that I told the doctor as much as I loved them.
I’m never coming back and I never did. And this is someone that, like I said, I sent over 30 patients, including other family members too, and I trusted implicitly. So when I say that, a little bit of culture and a little bit of a change in your perception of how to handle things in patients, whether it’s autism or not, frankly can be a huge practice booster.
And that’s what we’re gonna look at today. So what we’re not gonna be talking about is actual autism treatment. Holistic providers like us leaky gut, dietary changes, heavy metal toxicity, screens candida issues, enzyme supplementation, all of that great stuff. I. All phenomenal.
Not what we’re talking about. If you have protocols in place, if these are the individuals that, that’s fantastic. That is not what we’re talking about. We’re not talking about autism treatment or treating autism. We’re gonna be talking about treating a patient that happens to have autism.
I don’t know if you’re aware of this, but patients with autism have a spine and they get subluxations, biomechanical dysfunction, spinal trauma, car accidents, posture related issues, whatever you want to call it. All of the meat and potatoes of what chiropractic treats is present in this population. But often they go untreated because it’s so anxiety inducing, either for an autistic adult to get healthcare or for a parent with a child.
So that’s what we’re gonna be talking about, is trying to remove these barriers. And a little bit about physiology and how chiropractic is so uniquely qualified to help these individuals. So quick, anatomy, physiology, refresher for those who fell asleep in those classes in neurology, like I did in second quarter, way back when.
All these joints in our body have all these great mechanical receptors, Meisner core muscles, which are light touch sens, light touch sensors, rini endings, which are skin and fascia tension sensors, merkel’s disc, which do sustain pressure. Bassenian core les are vibration and pressure.
And then in the muscles and ligaments we have Golgi tendon organs, which sets the tension muscle spindles, which sets length. So it’s estimated that the brain. Receive 60 to 80% of its total function of proprioceptive and mechanoreception input from the spine, 60, 80%. That really does put us in a unique position.
When the spine has proper function, proprioceptors and mechano receptor signals are sent up to the brain through the dorsal column, medial Lemniscus pathway into the thalamus and into the somato sensory cortex. Or they could go up through the dorsal and ventral spinal. Cerebellar tracts right up to the cerebellum.
This is providing background tone for your brain. Sets the foundation for all other signal processing. Reciprocally, sensors or rather ether motor signals are sent back to the body from the brain down the corticospinal and extra pyramidal pathways. To the local musculature surrounding the joint, and that’s the neuromuscular reflux loop that contributes to joint stabilization, coordinated movement, maintenance of resting muscle tone.
I was at life very straight school. It has nothing to do with that. But they talked about the safety pin cycle. That’s the safety pin cycle in anatomical term rather than, signal disrupted signal, not. So chiropractic adjustments. When we deliver a chiropractic adjustment, we’re restoring that proper joint mechanic and we’re gonna restore and engage those nerve endings and that mechano receptive transmission up to the brain ultimately.
Then chiropractic sensory processing therapy for everyone. And so when we adjust the spine, we’re not just restoring motion, we’re giving that brain high quality, proprioceptive, mechano receptive input that can really help with the sensory chaos that autism individuals typically feel. I.
So again, we talked about why more people on the spectrum may not be seeking cha or seeking healthcare. Here are some of the reasons, and it may not be through any fault of your own, but brighter flickering lights, particularly fluorescence unexpected or loud noises, long or difficult intake forms, fast talking staff strong or unfamiliar, smells crowded, busy waiting areas.
The great answer is that there’s a solution and it’s really easy because ultimately we don’t want caregivers or parents to decide that the anxiety of the appointment isn’t worth the benefit that they perceive they might get. Especially if they haven’t tried before, they’re not sure.
They’re very unsure of what to expect, and they’re not sure if it’s worth going through, frankly, and it’s our job to educate them that, educate everybody that yeah, we offer a benefit and here’s how we can help. So right off the bat, super easy things. One of which I learned right outta COVID was create a calm waiting area, but or let the patient wait in the car.
I had never thought of that before COVID and the lockdowns that we had here in New Jersey, but what a genius idea. Calm, as soon as they’re ready, my parking lot’s not that far, but you can call, Hey, come on in, we’re ready for you. Into the room. You could schedule times for when, the office will be a little bit slower, whether that’s around lunch, first thing in the morning, last thing at night, whatever it might be.
The biggest thing is gather all of the information from a caregiver that you can ahead of time. Now, I realize you may not know some of the questions to ask, so let’s talk about it. What do you need to make this successful? Will he and she, the patient, hurt himself or be a danger to others? Are the directions better given by the caregiver or the medical staff or our staff?
For instance, I have a number of individuals where. It’s either mom or sometimes it’s the sister or the dad that needs to tell the child to do what we need to do. I actually don’t say anything. I just do my job. I do the chiropractic, and they are the ones who handle the directives. In other situations, I find that it’s easier if I direct the child or the young adult, let the parents be out of the room, watching from the hallway, leaving the door open, and it just it’s a smoother transition.
We need to know what are the cues for when they’re getting upset? So we know, it’s called quits. What are some of the things that they’re interested in trying to create a common bond? What upsets or scares them? What else do we need to know? Just gather that basic intel. If it’s truly overwhelming and your office doesn’t feel like it can accommodate.
That’s fine. Say that upfront. Everybody appreciates honesty. So if there’s a, particularly like a really challenging individual that has, quite aggressive behaviors, you’re worried that you might not be able to handle it, that’s fine. I could tell you as a parent, I would always rather be told the truth, then be told to lie, and then find out that you were lie, lying afterwards.
I’ll never forgive you, especially when it comes to a child. For communications, when you are talking directly to an individual on the spectrum, use calm, concrete language, short and clear sentences. Avoid sarcasms. Don’t use metaphors or idioms. There may be a processing delay, so you know, short, clear, and don’t pile up demands.
Do one thing at a time. Tell them what you want to do in concrete. Yes. Terms not what you do not want them to do. Don’t use double negatives. It’s very difficult to process. So simple, clear. Sit here, lay here. Face that way. Show them, direct them. Offer clear choices when you can. Don’t do the classic, question.
It phrased like a question, but you’re really not offering a choice. So if they need an X-ray, don’t ask if they’re ready for an x-ray. If they have to have an x-ray, it’s now it’s time to do the x-ray. We’ve moved on. If you offer the choice and say, are you ready for the x-ray? And they say no, you better be prepared that the answer is now no and that x-ray will not happen.
Office intel allow patients to gather some office intel, maybe schedule a pre-visit or a walkthrough. Let them see what the office looks like without any commitment to a visit. Some offices have a prep box. Now this is difficult in the chiropractic setting. This is general advice that I’ve gathered through, multiple organizations and resources.
But a prep box in a doctor’s office might have a blood pressure cuff or a stethoscope or, some of the tools we use. Obviously in chiropractic, we’re not gonna be able to just have spare parts of all of this, but take pictures of it. You can have a flip book, a quick photo album. It doesn’t have to be fancy, just print on regular paper a picture.
If you’re using, for instance, a thermography tool or a Surface EMG tool, or an x-ray or an activator, or an arthro stim, or whatever it might be, so that the parent and the child and or the individual can look through and desensitize themselves to what they might expect, and at least they’re familiar with things prior to their entry to the office.
There’s a very useful tool called a social story. It’s the same idea. It’s a storybook with pictures to allow someone to know what to expect. There’s one available on Amazon for 99 cents. If that’s the biggest investment you make today, I guarantee you’ll get it back. The fact that you have a social story speaks volumes to the autism community.
Ask about, lights on or off. If you have a migraine headache patient in your office, you’d probably turn off the overhead lights. I know I do. So lights on or off door, open or closed, et cetera. So if you’re really looking to grow your practice, I’ll tell you this, serving the autism community is one of the most meaningful and underdressed ways to do it.
Most chiropractors are not doing this, and honestly, it, I don’t want to make it sound so flippant, and I don’t want anybody to abuse this. If you’re not feel comfortable, by all means, do not do it, but there is no greater way to engender trust and loyalty and word of mouth communications than by being open and accessible to this type of work families.
Are loyal to those providers who get it if they feel comfortable and secure. They will never leave. You will turn treating one of the, their loved ones into treating mom, dad, grandma, sister. Their neighbor, their mail carrier. Everyone they know will love you and will speak volumes about you.
And it’s easy to get started. There are nonprofits all around the country that can help you with resources. Local community hubs, generally Facebook or nextdoor groups. These are simple. You can make a simple post. Hey local chiropractor. I did some training. I think I’d like to open up my practice to treating patients with, AU autism.
So if you’re a parent or a caregiver. Or you yourself have autism and would like to discuss a visit, talk with my staff, have a pre walkthrough, we just wanna let you know we’re open to it. Network with, and you’ll get calls right from that local occupational therapists, speech therapists, a, b, a providers.
These are all people that work with this community to begin with. They’re always looking to refer out pediatricians, family, doctors. You can. If you were marketing specifically, you can create content on your Facebook, your Google, whatever your TikTok about, inclusion and how this has become a part of your practice.
You could partner with special needs schools or the special needs programs within the schools. Schools, I will say, can’t really give out direct referrals in most areas. I in New Jersey, they’re not allowed to by law. I don’t know about other states, but the other easiest thing is put up some signage in your office.
If this is something you want to attract, just say hey, just to let our patients know we’re, now offering care to, individuals on the spectrum, or we welcome individuals on the spectrum. Ask us, about getting started. What the first steps might be.
Once you’re, I guarantee you have patients in the office that know someone and love someone with autism. It’s such a prevalent condition that just the mere mention of, oh, Dr. So and So is open to this. This is gonna be a no brainer and you can get started. Simple as that. Because lemme say thank you because every individual has a spine, whether they have autism or not.
This is a giant marketing opportunity for you. If you’re serious about serving your community, this is not a population we can afford to leave out. I hope I gave you some clear and simple ways to get started. This is a, an easy it’s not a get rich quick scheme, but it is a simple and brick by brick method of being able to build a steady base of loyal patients.
Hard to go wrong with that, right? I hope you found this a value. I hope it’s given you an idea of some of the types of things you could do in your office. Of course, I again, want to thank Dr. Student for allowing me to have this opportunity to bring this to the chiropractic profession. It means a lot.
And again, of course, a big heartfelt thank you to ChiroSecure for spreading this message. Which of course is near and dear to my heart. But, they do such great things for the profession. It is meaningful to me on ways that. They may not even understand how far reaching it goes. So thank you all.
Take care. Best of luck.
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