Blog, Chirosecure Live Event October 30, 2023

Chiropractic Malpractice Insurance – Developmental Delays Can Pediatric Chiropractic Help?

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This is Drew Rubin. I am so appreciative of ChiroSecure for bringing you guys more and more pediatrics out there. There’s, to me, nothing more important than taking care of our kids, of our future. Today I’m gonna be talking about my disruptive pediatric concept. And our concept today is going to be developmental delays and how we take care of kids with developmental delays and how we look at them.

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To determine what I call their brain age versus their chronological age. So let’s go to the slides. And the first step that we see with these kiddos, I should turn this thing on. The first step that we see with these kiddos to understand is to get like where I’m getting a lot of this information from and I love making sure that you guys have the books and the.

Resource that you guys need to further your own chiropractic education. So these two books, highly recommended. First is What To Do About Your Brain and Your Child by Glenn Doman. He passed away back in like 2013. So he was an amazing occupational therapist, wrote a whole bunch of books. Now has the Institute for Advancement Human Potential in Philadelphia where they specialize in taking care of kids with severe developmental delays and also in like making the best babies possible.

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The best kids Possible. Says another book that he and his daughter wrote. How smart is your baby? Not only is this amazing for kids who have developmental issues, it’s actually also amazing for, I have patients who’ve done this amazing for parents who want to like, make their kids the best and start teaching them stuff like really early.

So I recommend highly both of these the, these books through the Domin Institute. So let’s talk about this first off there. According to Dr. Doman, there are five important stages and I want you really to think about this the five important stages of. Like motor development. And the first is moving without mobility.

And what does that mean? What that means is when a baby is first born, what they do is and sorry about that, A neurotypical baby. That baby is going to be moving, but without purpose. In other words, the baby is lying in the car seat or in mom or dad’s arms, but the baby’s head’s moving and the baby’s arms are moving and legs moving, but there’s no purposeful movements for those things.

There is a purpose right now. They may not be purposeful and say I’m going to reach for this thing, but there is a purpose, and the purpose actually of those movements is to build synapses. It’s actually to build brain patterns and brain waves and neural connections. I. So that’s the first step is movement without mobility.

Another term or another thing we see in movement without mobility are primitive reflexes. So when you put your finger in a baby’s hand, they go like this. That is a primitive reflex. That is a forced movement. So the brain has in it, these forced movements that make it work, even if it’s not like doing something purposeful.

But this is much more purposeful, right? I put something in a baby’s hand, bam, it closes. That’s how you know it’s that the baby’s nerve system is working good because it’s print reflexes. Just a stage one or step one. A step two is crawling. Now understand that Dolman was a occupational therapist.

So what they call crawling is what we call like commando crawling, which is on the belly. So their crawling is really the commander crawling. So when a baby is smooshing along on his belly and hasn’t raised itself up on his hands and knees, that’s what crawling is in this stage. Funny.

But the crawling and number three, stage creeping, and I am not gonna go into this, I said I’m not gonna, I, okay. I have to mention a little bit. I’m sorry. The C. D. C took this out, right? And the American Academy of Pediatrics took this out last year of developmental milestones. They don’t think that this is important anymore.

Like somehow connecting the corpus callosum isn’t really a thing that needs to be done when you’re a little baby. I’m not gonna go into it. I’m not gonna go into it. I’m not it. But cross the next. So the next stage is creeping. Now what you and I call crawling is creeping in a OT perspective. Remember he was an ot.

In an OT perspective, creeping is on all fours. So that picture I’m showing you there, that’s a kid on all fours. The fourth stage is walking, and I’m going to tell you that walking is supposed to occur around one year old. I know that the new milestones say the new milestones say that maybe between 15, 16 months or so is acceptable.

But I’m telling you after 33 years of being in practice and I’m sure most of my . Esteemed colleagues who speak for ChiroSecure would say the same thing. 12 months is really where the benchmark should be, and I’m really not interested in what these other people say. And then of course, running.

So these things have to occur in a step-by-step process. And the reason that’s important is because that’s how the brain turns on. So the brain turns on. So step one of the brain turning on is not moving with any purposeful movement, doing just the prima reflexes and just these spontaneous, movements.

And then the crawling, the creeping, the walking, the running. That’s how the brain turns on. That’s the bottom up pathway that the brain uses, starting at the brainstem with the primal reflexes and working its way up. What we see in a lot of kids, regardless of whether they have significant injuries like cerebral palsy, which I see it quite a bit of, or they have autism, which really is this something going on with this kid, but let’s kind call it a brain injury.

Like a kid with CP most likely had some sort of trauma during birth or right before birth, or right after birth. Kids with autism may not have a, actually had a trauma based birth, although it is not unlikely that they had a challenging birth. But there’s still what they call, what Doman calls the roadblock injury.

The roadblock injury is like the lowest common denominator. In other words, let’s say a child had some issues with crawling and they did not go and they went right from, which I see quite frequently is they go, a kid goes from, being on the floor mushing around in their belly and then suddenly standing themselves up and doing some kind of cruising and then walking and steps crawling altogether.

The roadblock injury is that they missed crawling. What happens if they have trouble rolling? That’s the roadblock injury. These are the things that we need to figure out. This is why I see so many kids. The number one reason why I see a kid between the age of six months and a year is because of some kind of roadblock injury where I.

If they’re not progressing they, they have developmental delays because they’re not crawling, they’re not rolling they’re not lifting their head up. Just as an example, amazing example. We had a kid come in with cerebral palsy last year. And actually it wasn’t last year. I’m thinking this is the 2024.

It’s not, it’s still 2023. It was the beginning of this year and he was a nine-year-old child in a wheelchair and and was not walking and not talking. Nine years old. One of the first things we did is to find the roadblock injury. The roadblock injury we did is we took, we said to the mom, get him out of his wheelchair, and we put some gowns on the floor.

He said, put ’em face down on the floor and let’s see what he does. Guess what he didn’t do? Face down. He could not even lift his head up.

He could not even lift his head up off the floor. That’s a roadblock injury. If you can’t lift the head up off the floor, you can’t walk right? You have to get gravity. You gotta change the whole gravitational sense. So if you’re faced down like this and you can’t lift your head up, you’re not walking.

Three months time, this kid went from face down on the ground. Pushing himself up. Finally lifting, retrain the mom and adjusted the kid and trained the mom how to get him to do this. He started lifting his head up. He started rolling. He went through all the stages they should have gone through in his first year.

He went through it his ninth year, he started rolling. He started crawling right on the floor, and he took his first steps by three months and six months before they moved away. He was taking steps not independently yet, but he was actually taking steps. So we can take him from the adjusting bench over here to the desk over there.

That is amazing. But the first thing you have to do is get to the roadblock injury and all the other therapists he was, that they were using, which are great therapists, but they were not addressing the first step, the foundation, they were addressing the last thing. Let’s get ’em to walk, let’s get ’em to walk, let’s get ’em to walk.

But you can’t get ’em to walk until you do that first, right? And I, what Dr. Doma says is, the brain child who could not walk, should spend their entire day on the floor in face down position. Exceptions were feeding bathrooms, sleeping, and being held. And which is absolutely true. We’ve gotta get the kid face down in order to get them standing up, right?

And one begets the other. And one thing Dolman says all the time, I’m paraphrasing, is the greater the injury, the more the work, right? So what was happening with that, this youngster I just mentioned, was that the, they would go to physical therapist, they go to occupational therapist, they go to speech therapist once or twice a week.

So they maybe do four or five, six hours a week. How many hours are there in a week, right? A hundred and something hours, right? Insufficient. Insufficient. The greater the injury, the more the work. So you get a kid like this with this sort of injury, you gotta do a lot of work. So I told him, mom, you can, you at home with your partner at your spouse, you gotta do minimum hour plus a day, right?

So we need, so he might do six hours of therapy in an office, but you’ve gotta do six hours at home minimum. If not more. And that’s what she started doing. And that’s why we started seeing results between the adjustments that we gave her and the exercises that we showed them to do. That’s what really made the difference in this kid.

And that’s what I’m teaching this now. So another thing that Doman talks about is the six functions that only a human has all existing in the cortex, which is we can read, we can speak or understand speech, we can discriminate objects through our touch. Like I know this is a one of those. Laser pointer, clicky thingies.

And I’ll have a look at it. I just know that is, is this the ability to walk upright, the ability to speak and the ability to do this, the oppose the thumb and forefinger or index finger, which results in writing and other holding of other sort of tools and utensils. What happens though is that there are if there’s an injury or a roadblock injury, we talked about before, the roadblock injury happens at a certain stage, we’ll see certain things.

So if you’re hopping in the, if it, the roadblock injury is in the brainstem or the cord, they’re gonna have issues in just the reflexive, moving the early stuff. So these are the kids who can’t even lift up their head right off the, so we know that’s his roadblock injury. Or her roadblock.

Or their roadblock. Injury is in the brainstem. It’s in the brainstem, which is why they couldn’t even lift up their head. The next thing is the early subcortical areas. So this is the stage that it was associated with crawling on the floor and now crawling. Remember in the occupational therapy world, crawling, I see that with this baby is doing this baby in this picture is doing what they call crawling.

We call it commando crawling, like on their bellies, right? But that’s what they should be doing in that early I. Subcortical, area. That’s how if they can’t do this right, so if you can’t, if they can’t lift their head up, which I should be a picture, they can’t lift their head up like this.

That’s where the brainstem is, where their injury is. They can’t move on the ground on their bellies, early subcortical area. They can’t crawl on or creep as they call it, on their hands and knees. It’s a midbrain, higher cortical area. The basal gang, Alam cerebellum, those are the areas that are aiding the child in getting what to what they call anti-gravity position.

The, in other words, in order for you to go from on your belly to on hands and knees like this little salamander thing is you gotta defy gravity, right? You’re ’cause, because you’re not just on the floor, right? You might be able to get your head up, which is great, but now you actually to lift yourself up, that’s gravity working right there.

. So it’s an amazing accomplishment to actually start if you really think about the brilliance of the body that we’re, what we’re able to do is quite cool. And it’s, so the critical thing is to understand that where the injury is and what you need to start working on, the roadblock injury is in that area.

I. And the last thing is the frontal cortex, especially the prefrontal cortex and the cortical area. This is where all the big stuff occurs, right? But this is different ages. These things turn on, right? So when a baby’s first born, it’s just a brainstem. Then it has the lower subcortical areas, then it has the higher subcortical areas, and then it has the cortex, and then the prefrontal cortex start kicking in.

And when the prefrontal cor cortex starts kicking in, now . You’re gonna start to have top-down regulation, as Dr. Millo calls it, top-down regulation, right? So their brain goes from the bottom up, but then you get the top-down regulation, which turns off the primitive reflexes, which allows for anti-gravity, et cetera.

But if you don’t allow for this kind of stuff, that’s how a lot of these kids, especially with more severe brain injuries, will have more significant problems and why they need more work to do stuff. So Dolman came up with this thing called the developmental profile, which it’s in his books and I’m not allowed to share it.

The exact profile, but if you get either one of the books I showed you it, it’s in there. But I’m gonna describe them to you and describe how we are gonna use them. So the six parts of the domain, developmental profile, number one is mobility moving, right? And how do we assess this? We’re gonna assess this by, can they raise their head?

Can they roll? Can they sit, can they crawl, can they walk by one year old? Okay, language. So how do we know there’s a language? The Moreau response is probably one of the most primitive ways, right? So we, we take the baby, we drop, them gently down like this in our arms. Actually, I usually have the parents do it honestly.

And usually the baby does this and maybe cries out a little bit. That’s language. And then they start cooing. I ha I was justing. Oh my god. Such beautiful little girl yesterday, brand new thing. This, she’s two months old. Going on three months and she just, she sits there and imitates when I talk to her mouth moves.

She’s imitating me. She’s cooing the whole time. Ugh. Oh, I just love it. I just, it’s, there’s nothing better than adjusting a kid to watch their brains like, turn on. Wow. And then the first words by a year old. I know CDC doesn’t say that anymore. They’re saying it’s 18 months or so. But I’m telling you, it should be around a here manual.

In other words, hand, like the hands AP grasp is the initial . Onset of of manual development. So that should be there instantaneously. Then after a couple of months, like when a baby’s first born, it’s like this with, thumb inside like this. When it’s after it’s a couple of months old, by two, three months it should start to release, right?

I’ve seen kids like this kid with cerebral palsy. His hands are like this. His hands are like this. That means he’s stuck like way down in, in like brainstem, primitive reflex world, right? Nobody’s ever even looked at these sort of things. And then the ProMag release turns into this. It turns into this.

So you need these three steps to get to these places. Visual. In the beginning when you’re a newborn, the light and blink reflexes, right? So you shine a light in their eye cover one eye and watch the, to see how the pupils constrict. And do the blink reflex shine a one bright light right in both their eyes at the same time and they should blink, right?

That’s a newborn response. Then tracking. You wanna start to assessing tracking and all the pupils both in the same direction. There’s this thing that they’re calling pseudos strabismus mouth. It’s this latest, greatest thing that everybody’s calling it. And so I’m seeing babies probably one of every three when I have four babies.

Instead of their, both their eyes like this one eye is turned in a little bit. One eye turned in over here. Oh, no big deal. No big deal. You know what they, they say it’s, they’re gonna outgrow it, and it’s certainly possible that they may outgrow this pseudo strabismus. What I’m telling you is what happens if they don’t?

Because then what happens is now your old is still have this pseudo strabismus, but now it’s a problem. Why don’t you spend a year working on it by helping the kid track, taking a crunchy toy, or clicky pan click. And that’s a great way to make sure that you strengthen these kids’ eyes.

Why? Wait, that’s always my thought. Next is auditory acoustic blink. You go like this, the baby should jump and close their eyes. That’s the acoustic blink. Re reflex. Can they follow a crunchy pen or a clicky pen? A crunchy book or a clicky pen that’s tracking. It’s obviously working with the eyes, but it’s also, can they hear it, right?

So you might start over here and, you know the crunchy books. I don’t know what on earth they put in those things, but there’s some, it’s sounds like Rice Krispies, when they move it around, that’s the kind of thing that you want to, to test their hearing with. And the last thing is tactile.

That’s the babinsky response on the foot, with the feet going like this and the pom grasp going like this. That’s how, and then how that progresses so that they eventually can figure out things in their hand without actually. Knowing, like without seeing it, they could put a blindfold on and you could tell, oh yeah, I’m holding it clicker, kind of thing.

So this is from the How Smarts Your Baby book. It is a very simplified version of the developmental profile. But what I want to do with you is explain to you, and it shows you, the thing I like about this is it shows you the brain, ages of the kid. And that’s what I wanna talk about now as I wrap up, is brain age versus chronological age.

Let’s say you have a six year old kid who comes into your practice like I do all the time, who’s minimally speaking. I just suggested a boy yesterday six new kiddo, six years old, minimally speaking, great kid, but hardly says words very echo. In other words, he’ll mimic what I say and he might say some odd words out of, but nothing really purposeful.

So he’s chronologically six years old, but how old is he neurologically? How old is he? Neurologically. So let’s think about it. So he’s not speaking okay. Or he is only speaking a few words. So at what age is a kid only speaking a few words? A one-year-old. A one-year-old says die that mom. A few other words, right?

So maybe one and a half year old maybe. ’cause he could say a few other words. So he’s six chronologically, but neurologically he’s maybe like a year and a half. His verbal ability. Do you get what I’m saying? And what you can do is you can place them where they, where the child is, brain age versus chronological age.

And I tell the pa, the parents, my job is to try to raise their brain age, raise their neurological age. Okay. As another example, three year old CP who’s not walking, let’s say other nine year old that I’d mentioned before, not walking. Let’s change that nine year old who’s not walking right? And now he’s walking, but when before he could not even lift his head off the ground.

So where is that? So how old should you be to lift your head up with a gun? Two months old. Two months old. Wow. So he’s nine years old. Chronologically, he’s two months old. Neurologically in, in his ability to, in manual co not manual tactile competence and mobility. Wow. Wow. So what we say to the mama is we want to get their brain age and their chronological age closer to each other.

Right now with a kid with cerebral palsy like that, can you get them equal? Probably not a kid with who’s six years old. Minimally speaking, you are gonna get ’em to be, have a complete neurotypically functional, probably not, but you can make changes and it is amazing what is possible. And that’s what chiropractic offers.

That’s what neurologically based chiropractic offers. So you wanna learn more about this. I speak for the ICPA, and this is the exact topic I speak for, is how to get . The kids are all the things you need to get the kids to be neurologically and physiologically and chiropractically changed. So we talk about prim of reflexes.

We talk about special kind of adjusting for these kids, talk about nutrition for these kids. So check it out. There’s the QR code. I speak with Dr. Porsches I with Polyvagal Institute. So if you wanna check that out. All about polyvagal safety and how to make sure that your adjustments.

Are making the kids feel safe. And the last thing is I have a podcast Powercast It. It is been going on for, let’s see, 2015. Eight years now. Over 500 episodes. Totally free. If you like this kind of stuff, this is the kind of stuff that we like posting. And let’s check it out. It’s on every kind of, major podcast that it’s on Amazon, Stitcher, SoundClouds, actually Stitchers, I dunno, stitch anymore, Spotify, all those different things.

So ultimately. We wanna protect our future and how do we protect our future? Adjust more kiddos. You want to get ahold of me, Ruben You look at my website, the I wanna thank ChiroSecure so much for having me on this. I feel like I’m standing on the shoulders of giants.

There’s some amazing pediatric speakers that _ChiroSecure_ brings to you. I think Dr. Hoffman is incredible speaker. I just saw him at the Life University full extravaganza and he has just had an amazing talk. ChiroSecure really does a great things for our profession, and I appreciate that, which is why I have used their malpractice insurance ever since I started practice in 1989.

Soon as I graduated, it was the first phone call I made. So thank you guys so much and I’ll see you next time.

Today’s pediatric show Look to the Children was brought to you by ChiroSecure.


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