Using a Multi-Disciplinary Approach for a Spectrum of Disorders

This spring I returned to Boston for my 30th college reunion. I was disappointed to find that some of my old haunts had vanished, but thrilled to find that others were still there. A visit to what was once Kennedy Hospital for Children, where I began my first job in 1969 as a staff psychologist, resulted in my reminiscing about my career odyssey. It was here that the dream that was to become the DDR began to percolate. This remarkable institution was the genesis of my focus on the concept of a multi-disciplinary team. How fortunate I was to have worked with the best doctors and therapists.Every Monday a group of five children entered the hospital as inpatients. Each department did a comprehensive evaluation and on Friday met to discuss findings. An overall treatment plan included such innovative techniques as a ketogenic nutrition diet, intensive vestibular stimulation, play therapy or cord lengthening. This individualized plan, a predecessor to in the IEP focused on the whole child, not just his seizures, self-stimulatory behaviors or toe-walking. We were all idealistic new graduates, sure that our magic could rehabilitate the once brilliant child who had become aphasic because of chicken pox encephalitis. In those days, autism was a rarity, while learning disabilities or head injuries were more common. However, we considered autism no more a challenge than a reading disability We treated them both with the same set of interventions that focused on causes. As we collaborated, using a multi-disciplinary approach, we performed and witnessed miracles.

Two weeks after my college reunion. I spoke at the First World Conference on Non-Pharmacological Therapies for ADD, ADHD, Learning and Developmental Delays, sponsored New York-based ADD Action Group. Mark Ungar, the charismatic executive director, had brought together the best and the brightest from medicine, homeopathy, biofeedback, nutrition, chiropractic medicine and optometry. Each speaker tied his or her field to others, and described the synergy of complementary approaches.

Just last weekend, I exhibited DDR materials at the annual conference of the Feingold Association. I enjoyed meeting many DDR members who took the time to introduce themselves and to tell me about their positive experiences using the information they have gained from our newsletter. Topics ranged from food additives to boosting the immune system, Again, I was impressed by the range of disciplines and disabilities which were represented.

Like the DDR, both the Feingold Association and the ADD Action Group view ADD, ADHD, LD, PDD and autism as being on a continuum of disorders from minimal to severe. At both conferences, social-emotional disabilities, such as obsessive compulsive disorder, Tourette’s syndrome and schizophrenia were also discussed. The idea of a continuum is gaining wider acceptance. I have written two papers, published in the Journal of Behavioral Optometry,* addressing the causes and treatments for ADD to Autism, as a spectrum of disorders.

The DDR is Kennedy Hospital revisited 30 years later. My experiences allow me to impart two important lessons:

1) Whether you are a parent or professional, consider combining key therapeutic interventions, such as nutrition and sensory integration (see page 6), or movement with language, This integrated approach frequently results in better outcomes than individual therapies alone. Although it is sometimes difficult to pinpoint which therapy makes the difference, that determination is not as important as a child’s improvement

2) When reviewing the efficacy of a therapy, consider that some of the same components of this multi-disciplinary approach are as applicable for a child on one end of the continuum as on the other. Techniques will be, somewhat difficult but the philosophy will not. It is meaningless to ponder whether a child with autism might have an attention deficit. It is assumed that he/she does, because of the continuum model. Remember that the ultimate outcome of treatment is more important than the label.

[New Developments: Executive Director’s Column, Summer 1998]

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