Dos and Mds Take Fresh Look at Venerable OMT Techniques for Children

ART OF HEALING PERFORMING OMT ON CHILDREN

DOs and MDs take fresh look at venerable OMT techniques for children

CAROLYN SCHIERHORN or the past 15 years, pediatricians tion to skull asymmetry involves fit- Fand family physicians have exhort- ting afflicted children with uncom- ed parents to place infants to sleep on fortable corrective helmets, notes Dr their backs, not their bellies, to pre- Blood, a former president of the Amer- vent sudden infant death syndrome ican Academy of Osteopathy (AAO), (SIDS). While the American Academy he and others who perform OMT on of Pediatrics (AAP) claims that this children have found that cranial treat- practice has reduced the number ment can correct plagiocephaly. of SIDS deaths by more than 50%, With microbes becoming more resis- supine sleeping has created a new prob- tant to antibiotics due to their overuse, lem: deformational plagiocephaly— ear infections are another affliction on specifically, flat heads. the rise in kids. Indeed, acute otitis Other modern trends, such as media—which can cause severe pain, women delaying childbirth and under- behavioral problems and hearing going fertility treatments, have con- impairment—is the leading illness for tributed to the rise of plagiocephaly which parents seek medical attention from intrauterine trauma, with more for young children in the United States, first-time mothers giving birth to twins points out Karen M. Steele, DO, the and triplets, who can injure one anoth- associate dean for osteopathic medical er in the womb. In addition, skull asym- education at the West Virginia School metry is a frequent consequence of of Osteopathic Medicine (WVSOM) birth trauma from prolonged labor and in Lewisburg. forceps-assisted delivery. Otitis media is also the leading Stephen D. Blood, DO, a family reason Dr Blood performs OMT on physician from Alexandria, Va, toddlers. Stephen D. Blood, DO, treats a 6 year old observes that plagiocephaly is the main By age 3, between 50% and 70% of for a cerebral concussion and contusion condition for which he performs osteo- children have had at least one episode of the skull incurred six months prior. pathic manipulative treatment on of acute middle-ear inflammation, while (Photo courtesy of Dr Blood) infants. While the usual medical solu- one-third have had more than three episodes, Dr Steele elaborates. In 70% of children with otitis media, fluid remains in the middle ear for two weeks or more after the onset of an ear infection. In 40% of these children, the fluid is still present at one month. Known as effusion, this persistence of fluid impairs the tympanic membrane’s ability to vibrate and transmit sound, Dr Steele explains. The most common medical intervention for acute otitis media is still to prescribe antibiotics, whether the inflammation is due to bacterial or viral infection. Children with recurrent inflammation or chronic effusion typically undergo surgery—myringotomy (also known as tympanostomy) with

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Otitis media study to measure OMT’s effects on effusion

Karen M. Steele, DO, and Jane E. Carreiro, DO, are embarking on a randomized con- Family physician Stephen D. Blood, DO, of trolled study that could have significant Alexandria, Va, performs osteopathic implications for the profession, empha- manipulative treatment on a patient with sizes Dr Carreiro, who chairs the Depart- otitis media. (Photo courtesy of Dr Blood) ment of Osteopathic Manipulative Medicine at the University of New Eng- land College of Osteopathic Medicine (UNECOM) in Biddeford, Maine. Their study, which will begin enrolling subjects this fall, will measure the effects of osteopathic manipulative treatment on the duration of middle-ear effusion in infants and toddlers with acute otitis media. “If we show that performing OMT on someone with an acute infection can change the course of the disease, that would have enormous significance,” Dr Medicine (WVSOM) in Lewisburg. tioning. In addition, the subjects’ parents Carreiro observes. She notes that previ- Children with acute or chronic otitis will be given acoustic reflectometers so ous OMT efficacy studies have demon- media often have hearing impairment they can take daily measurements at strated OMT’s effectiveness in alleviating and behavioral problems in addition to home. musculoskeletal problems, while small severe pain. Moreover, these children “We’re enlisting help from the par- studies have suggested OMT’s efficacy in frequently undergo surgery—typically ents to get more precise measurements,” combating visceral diseases. myringotomy (also known as tympanos- explains Dr Carreiro, who serves on the Several pilot studies have indicated tomy) and drainage tube insertion. The AAO Board of Trustees. “By having parents that OMT can reduce the recurrence of surgery is invasive, costly and not always measure ear pressure, we’ll know exactly otitis media, but recurrence directly effective, notes Dr Steele, the 2005-06 when the problem resolves.” involves the musculoskeletal system. Chil- president of the American Academy of The subjects in the intervention group dren prone to middle-ear infections often Osteopathy (AAO). Sometimes performed will receive the same OMT protocol, which have musculoskeletal dysfunction of the multiple times on a child, the surgery can will consist of soft-tissue techniques appro- eustachian tube, the temporal bone, the itself have side effects. priate for infants such as rib raising and pharynx and adjacent tissues, Dr Carreiro suboccipital raising. explains. Study design In the study, OMT providers will be If OMT is shown to shorten the dura- Funded with a $100,000 grant from the blinded to the subjects’ clinical courses, tion of an acute infection, that would AAO, the study will take place at two sites: and referring primary care physicians will indicate that OMT can be more than an WVSOM and UNECOM. To have at least 60 not know whether their patients are adjunctive therapy in combating infec- subjects complete the study, Dr Steele assigned to the intervention group or the tions, she suggests. and Dr Carreiro plan to enroll 80 subjects control group. between the ages of 6 months and 2 “Many DOs feel that OMT can reduce Major health problem years. The prospective study is expected the duration of fluid and the need for Children stand to gain the most from the to conclude 12 months after the first sub- drainage tubes in children with recurrent investigators’ otitis media research. jects are enrolled. otitis media,” Dr Steele says. But the osteo- Otitis media affects two out of three Diagnosed with otitis media and pathic medical profession needs additional children in the first three years of life. In referred by their primary care physicians, scientific data to back up what many 70% of these afflicted children, fluid the subjects will be randomly assigned to physicians who perform OMT on children remains in the middle ear for two weeks either the intervention group receiving have long observed. or more after the onset of an ear infection. OMT or the control group not receiving And if Dr Steele and Dr Carreiro Effusion interferes with the tympanic OMT. Both groups will receive the stan- demonstrate scientifically that OMT short- membrane’s ability to vibrate and trans- dard of care for otitis media from their ens the course of acute ear infections, the mit sound, explains Dr Steele, the study’s primary care physicians. ramifications may extend well beyond the principal investigator and the associate At the study sites, the researchers will care of children with otitis media, the dean for osteopathic medical education at use tympanometers and acoustic reflec- investigators maintain. the West Virginia School of Osteopathic tometers to examine middle-ear func- —Carolyn Schierhorn

THE DO August 2007 Pediatric OMT 25 ART OF HEALING

drainage-tube insertion—and often Dr Frymann’s articles explore palpation, more than once. OMT in pediatric populations Dr Blood, Dr Steele and others who practice osteopathic manipulative med- The demand for evidence-based medicine in the 21st century has spurred calls for icine have long observed that OMT more research on the efficacy of osteopathic principles and practice, particularly osteo- reduces the need for antibiotics and pathic manipulative treatment. But more than 40 years ago, Viola M. Frymann, surgical intervention for children with DO, the founder of the Osteopathic Center for Children & Families in San Diego, began pioneering evidence-based research on OMT and palpatory diagnosis. Much otitis media. Scientific research is begin- of her work was published in JAOA—The Journal of the American Osteopathic ning to confirm their observations. Association and other publications. Pilot studies have indicated that A former president of the American Academy of Osteopathy (AAO) and The Cra- OMT can reduce the recurrence of oti- nial Academy, Dr Frymann, conducted research correlating disturbances in craniosacral tis media, points out Jane E. Carreiro, mechanisms to such newborn symptoms as vomiting, hyperactive peristalsis and irri- DO, who serves on the AAO Board of tability. She demonstrated that skeletal distortion due to birth trauma plays a role Trustees and chairs the OMM depart- in the development of learning problems. And she documented that OMT can ment at the University of New Eng- improve children’s neurologic development. land College of Osteopathic Medicine Dr Frymann also spearheaded research on palpation and OMT’s impact on car- (UNECOM) in Biddeford, Maine. This diac and pulmonary problems. Her published articles and other writings have been is not surprising, she maintains, because gathered in The Collected Papers of Viola M. Frymann, DO—Legacy of Osteopathy to Children, which the AAO published in 1998. musculoskeletal dysfunction—of the eustachian tube, the temporal bone, Passion for children the pharynx and adjacent tissues— “Dr Frymann produced significant clinical research,” wrote Hollis H. King, PhD, plays a significant role in both recurrent DO, the associate executive director of the professionwide Osteopathic Research and chronic otitis media. Center, in the “Editor’s Foreword” to The Collected Papers. “This research is cited With $100,000 in funding from the in virtually every book on osteopathy in the cranial field published since the 1960s.” AAO, Dr Steele, the principal investi- “The great passion of Dr Frymann’s life has been her work with children,” con- gator, and Dr Carreiro, the co-investi- tinued Dr King, who is also an associate professor of osteopathic manipulative gator, are about to conduct a ran- medicine at the University of North Texas Health Science Center—Texas College of domized, blinded study to evaluate Osteopathic Medicine in Fort Worth. “This passion was in part prompted by the loss whether OMT also affects the dura- of her first child [who had a cone-shaped skull] and the subsequent realization that osteopathic manipulative medicine, particularly in the cranial field, might tion of effusion. have prevented this loss.” “If we can show that OMT can actually change the course of an acute Icon infection, that will have huge implica- Many members of the AAO revere Dr Frymann as a pioneer in the field of OMM. tions,” emphasizes Dr Carreiro, the “We members of the AAO all aspire to accomplish a portion of what Viola has author of the book An Osteopathic accomplished in her long career,” emphasizes Stephen D. Blood, DO, a family Approach to Children, published by physician from Alexandria, Va, who served as the AAO’s 2004-05 president. Elsevier in 2003. (For more on Dr Steele “Dr Frymann is considered an icon,” adds Karen M. Steele, DO, the AAO’s 2005- and Dr Carreiro’s otitis media study, see 06 president and the associate dean for osteopathic medical education at the West the accompanying article on Page 25.) Virginia School of Osteopathic Medicine in Lewisburg. “Her innovative approach Plagiocephaly and otitis media are to patient care combines OMT with homeopathy, music therapy and other com- plementary therapies.” just two of the many pediatric prob- Members of the profession can order The Collected Papers by visiting the AAO’s lems observed to respond well to OMT. Web site at www.academyofosteopathy.org and clicking on the “Publications” Other such conditions include infant link on the home page followed by the link titled “AAO Book Catalogue.” latching and sucking problems, colic, torticollis (wryneck), gastroesophageal —Carolyn Schierhorn reflux, asthma, migraine headaches, sensory integration dysfunction, developmental delays, scoliosis, cerebral palsy, anxiety and some symptoms of autism. OMT can also play a role in pediatric palliative care, says pediatric psy- chiatrist Jimmie P. Leleszi, DO, an asso-

26 Pediatric OMT THE DO August 2007 ART OF HEALING ciate professor of psychiatry and behav- homa State University Center for 1952-53 president of the American ioral neurosciences at the Wayne State Health Sciences (OSU-CHS) in Tulsa. College of Osteopathic Pediatricians University School of Medicine in “I felt better the moment I got off the (ACOP) and the founding dean of what Detroit. table,” Dr Mills recounts. “Dr Gra- is now the Nova Southeastern Univer- While members of the AAO and ham continued to treat me for several sity College of Osteopathic Medicine in many traditional DO pediatricians have years, and he encouraged me to fur- Fort Lauderdale, Fla. always been convinced of OMT’s ben- ther my knowledge of osteopathic “But determining how and when to efits for young children, pediatricians manipulative medicine.” use OMT requires the hands—and trained in the past 20 years—MDs as In 1991, Dr Mills took an OMT brain—of a competent osteopathic well as DOs—are increasingly looking course offered by the Sutherland Cra- physician,” cautions Dr Melnick, a toward manual medicine as a way to nial Teaching Foundation. Since then, columnist for The DO. “Some chil- relieve these ever-common, vexing, she has obtained additional training in dren will need OMT as their sole treat- sometimes tragic childhood maladies. OMT through the AAO and The Cra- ment. Some will need OMT in com- Most important, contends Ali M. nial Academy, and she has taken cours- bination with other treatments, such Carine, DO, a Columbus, Ohio, pedi- es with first- and second-year OSU- as medication, physical therapy and atrician and OMM specialist, the pedi- COM students. psychological guidance. And many may atric profession as a whole has started Today a clinical professor of OMM not need OMT at all.” to appreciate OMM’s ability to enhance at OSU-CHS, Dr Mills has conducted Dr Leleszi concurs that the decision the overall well-being of children. research on pediatric OMT. She served to perform OMT should be based on as the principal investigator of a study the needs of the individual patient. MDs show interest that assessed the efficacy of OMT as a In the second half of the 20th cen- UNECOM’s Dr Carreiro reports that treatment for children with recurrent tury—as immunization and antibiotics most referrals to her Maine OMM spe- otitis media—research that added to conquered the most deadly and virulent cialty practice come from MD pedia- earlier pilot studies conducted by Dr childhood illnesses and as DOs strove tricians. In addition, more and more Steele. Published in the September 2003 to gain parity with MDs—the OMT allopathic pediatricians are perform- issue of Archives of Pediatric & Ado- techniques developed by A.T. Still and ing manual medicine, observes Shawn lescent Medicine, Dr Mills’ study helped other pioneers in the profession large- K. Centers, DO, the clinical director inspire Drs Steele and Carreiro to ly fell into an adjunctive role in osteo- and staff pediatrician for the Osteo- undertake additional research. pathic pediatrics. pathic Center for Children & Fami- Dr Mills, who has a certificate of Today, however, the pendulum is lies, founded by Viola M. Frymann, proficiency from The Cranial Academy, swinging back toward the basics of DO, in San Diego. has also studied the effects of OMT OMM, points out ACOP President “While many osteopathic medical on colicky infants, building on research Robert W. Hostoffer Jr, DO. But many students seem to be embarrassed by that Dr Frymann conducted in the DO pediatricians lack sufficient train- OMT, many MDs are intrigued by it,” 1960s. ing in palpatory diagnosis and OMT. observes Dr Leleszi, who has twice As more DO graduates serve pediatric served as the president of the American Convergence residencies accredited solely by the College of Osteopathic Neurologists Historically, OMT has been integral Accreditation Council for Graduate and Psychiatrists. to the osteopathic medical profession’s Medical Education (ACGME), they do A case in point, Miriam V. Mills, care of children. After all, Andrew Tay- not develop the skills needed to become MD, a pediatrician from Tulsa, Okla, lor Still, MD, DO, established osteo- proficient and confident in perform- is a vocal proponent and enthusiastic pathic medicine due to his disenchant- ing OMT, observes Dr Hostoffer, who practitioner of OMT techniques, includ- ment with 19th-century mainstream practices pediatric allergy and immunol- ing cranial treatment. Her personal medicine after losing three of his pre- ogy in Euclid, Ohio. experience with receiving OMT con- teen children to spinal meningitis and Responding to increased interest verted her to an osteopathic medical a 1-year-old daughter to pneumonia, all from its members, the ACOP recently mind-set after several years of practic- in one month in 1864. developed a nine-module, CD-ROM ing allopathic pediatric medicine. Veteran osteopathic pediatricians, titled “Pediatric Osteopathic Manip- Suffering musculoskeletal trauma such as Arnold Melnick, DO, tend to ulative Treatment” (POMT). Spear- from a car accident, Dr Mills sought view OMT as an important modality headed by Dr Hostoffer, this training treatment 20 years ago from Kenneth in osteopathic pediatrics. “In my 30 program has separate modules on sinus E. Graham, DO, today an associate years of pediatric practice, I found drainage, cervical techniques, thoracic clinical professor of OMM at the Okla- OMT to be quite valuable,” says the techniques, scoliosis, osteopathic struc-

THE DO August 2007 Pediatric OMT 27 ART OF HEALING

tural examinations, lumbar techniques, knee problems, neonatal OMT, and lower-extremity problems in infants. The modules are designed to be used by residents in ACGME-accredited, AOA- approved, dually approved and paral- lel pediatric residency programs. “We’re trying to provide basic training, practical OMT for residents,” Dr A fellow of the American Hostoffer explains. “For example, all Academy of Osteopathy, pediatricians should be able to perform Stephen D. Blood, DO, performs osteopathic structural examinations on osteopathic manipulative young children. treatment on twins who have torticollis (wryneck) and “Our hope is that POMT will be plagiocephaly. Twins and other integrated into allopathic, as well as multiples frequently sustain osteopathic, pediatric residency pro- intrauterine trauma because grams.” they injure one another in the The ACOP introduced POMT at womb. (Photo courtesy of Dr Blood) its conference held June 28 to July 1 in Orlando, Fla—the first major meeting the ACOP has conducted jointly with the AAP. “The AAP has a DO subcommittee that is trying to bridge the gap between DO and MD pediatricians,” Dr Hostoffer explains. “Sens- ing increased interest in osteopathic principles and practice on the part of MDs, the AAP contacted us about holding a joint meeting. We’ve agreed panacea, admonishes Stanley E. Grogg, function, OMT may play a key role in to meet with the AAP every other year.” DO, a former ACOP president and a their improvement.” At the maiden ACOP-AAP meeting professor of pediatrics at OSU-CHS. in Orlando, Dr Carine led an OMT “Usually OMT is an adjuvant thera- Osteopathic structural examination workshop that attracted approximately py and may not be a cure-all,” he says. Whether or not they perform OMT, 160 participants. “It was the best- “For instance, one may use OMT to pediatricians and other primary care attended session at the meeting,” notes reduce stress in children with atten- physicians who treat children should Dr Hostoffer, who estimates that MDs tion-deficit hyperactivity disorder learn how to conduct osteopathic struc- made up 20% of the physicians who (ADHD), but these patients will still tural examinations, contends Kenneth took part in the workshop. need other modalities as part of their J. Lossing, DO, a family physician from While some osteopathic physicians treatment regimen.” San Rafael, Calif, who is AOA board- who perform OMT on children wel- But Dr Blood, Dr Centers and many certified in both family medicine and come the increased interest in OMT other physicians who perform cranial neuromusculoskeletal medicine. “All by both DO and MD pediatricians, manipulation view OMT as more than osteopathic pediatricians and family others are worried that physicians with an adjunctive therapy for children with physicians should be doing well-child insufficient training could cause harm ADHD. osteopathic structural examinations as to children by trying to perform diffi- “In my practice, I have hundreds of part of their well-child checkups,” Dr cult techniques. patients who have been diagnosed with Lossing emphasizes. To perform cranial manipulative ADHD and other developmental Dr Carreiro stresses that conduct- techniques, for example, physicians issues,” Dr Centers points out. “In the ing osteopathic structural exams on need training and practice, warns Dr majority of these patients, we have seen newborns is particularly important. Blood, a former president of The Cra- marked improvement in ADHD symp- “Every newborn should be evaluated to nial Academy. toms in those children who have under- find out whether he or she needs to be What’s more, physicians shouldn’t gone OMT. For children with ADHD treated,” she says. be led into thinking that OMT is a who have significant structural dys- “Every newborn should be given an

28 Pediatric OMT THE DO August 2007 ART OF HEALING osteopathic structural examination,” manually for asymmetry and restric- A technique known as Galbreath agrees Dr Centers, the lead author of tion of motion. mandibular drainage helps drain mid- the “General Pediatrics” chapter of the dle ear structures via the eustachian second edition of the AOA’s Founda- ● Examine the patient’s sacrum for tube and lymphatic system. And rib tions for Osteopathic Medicine text- interosseous and lumbosacral com- raising, which assists lymph drainage, book, published in 2002 by Lippincott pression and torsion patterns. can be used to treat children who have Williams & Wilkins. “Birth itself can otitis media, sinusitis, influenza, pneu- be traumatic. “Pediatric palpatory diagnosis isn’t monia and asthma. “As a consequence of the birth easy,” Dr Blood observes, “especially “In my experience, one of the best process, the newborn’s muscles can be when you have a squirming infant who indications for OMT in children is asth- stretched. Connective tissue can be doesn’t want to be held down on the ma,” Dr Melnick relates. “Almost all pulled. Often the newborn’s neck gets table.” Physicians need to be flexible children will improve—and many times hyperextended as the obstetrician tries and patient, as well as playful, and not recover—with the application of the to get the baby out of the mother as force infants into compliance, he says. lymphatic pump.” quickly as possible.” “Some of these youngsters will also Although musculoskeletal problems Gentle techniques require medication—epinephrine, cor- from vaginal birth trauma are usually For children up to age 6, Dr Blood gen- ticosteroids or inhalants,” Dr Melnick more obvious to the eye, delivery by erally uses direct OMT techniques. emphasizes. “But every osteopathic cesarean section can cause significant “We engage the barriers directly and try physician can report cases that totally trauma to newborns, Dr Centers main- to establish symmetry in motion and respond to the lymphatic pump with- tains. A C-section delivery doesn’t allow function,” he says. “Indirect techniques out anything else.” a newborn’s cranium to go through can be used on older children.” Dr Melnick notes that he has taught the natural molding process of com- Only gentle techniques should be the parents of children with asthma to pression and expansion, he explains. used on young children, Dr Centers apply the lymphatic pump technique “As a result of a C-section, abnor- adds. “High-velocity, low-amplitude at home. “This way, children can get mal pressures can occur on one side techniques should never be used with treatment several times a day—with- of the skull, whereas vaginal delivery infants, whose bodies consist largely out having to wait for the next doc- can be pressure-equalizing,” Dr Centers of soft tissue,” he says. “For infants, tor’s visit,” he says. observes. use gentle soft-tissue techniques, such Dr Lossing has trained parents of The “General Pediatrics” chapter as myofascial release and rib raising.” children with long-term respiratory in Foundations offers the following Although they agree that it is espe- problems to perform the pedal pump general guidelines for evaluating infants cially important to be gentle when per- technique, a relatively simple OMT and older children for structural prob- forming OMT on young children, technique involving moving an infant’s lems: physicians may differ on their or toddler’s feet. approaches and techniques. Dr Steele, an OMM specialist whose ● Examine each child’s range of motion A member of the AAO Board, Dr practice at WVSOM is based on refer- regionally rather than examining indi- Lossing observes that osteopathic physi- rals, notes that many childhood con- vidual vertebral units segmentally. cians can take advantage of the natur- ditions can be resolved with just a few al movement of infants and toddlers applications of OMT. For infants with ● Build rapport with a child before during treatment. “With most young colic, for example, three treatments beginning the examination by being children, try to engage them in a way may be all that is needed, she says, playful and smiling often. that allows them to move around and whereas torticollis typically requires not feel controlled,” he advises. four to eight treatments and plagio- ● Depending on a child’s age, observe “Whether they’re kicking or turning cephaly approximately eight treatments. him or her lying on the examination their heads, use their movement to help table, nursing, sitting, crawling and them heal themselves.” Promoting lifelong health walking—to gain useful information For newborns and other infants, Dr An increasingly prevalent problem, about the patient’s structural and func- Lossing uses articulatory techniques. autism is a developmental disability tional status. “I find an area that is restricted and that can leave its sufferers unable to move it through the restriction,” he communicate or form relationships. ● Assess the cranium visually first, explains. “With children, the forces Dr Carine has 30 patients with autism, checking for signs of gross structural are so much lighter and the restrictions all of whom were symptomatic before asymmetry. Then assess the cranium disappear more easily.” she became their pediatrician. She

THE DO August 2007 Pediatric OMT 29 ART OF HEALING reports that by performing cranial and Learn more about pediatric OMT other OMT techniques on these patients, she has been able to reduce During the 112th Annual AOA self-stimulating behavior and other Convention and Scientific Seminar, symptoms of autism. which will be held Sept 30 to Oct 4 in But she wishes she could do more. San Diego, the American College of “When I see kids with autism for the Osteopathic Pediatricians (ACOP) first time at age 5 or older, I wonder will conduct a pediatric osteopathic how much I could have helped them at manipulative treatment workshop and a younger age,” she reflects. laboratory on Wednesday, Oct 3, at the Dr Carine believes that by providing San Diego Convention Center. OMT to infants and toddlers, she may The OMT workshop will take place be preventing some of them from devel- from 1 pm to 2 pm and the laboratory from 2 pm to 3 pm. They will be led by oping autism and other neurological Shawn K. Centers, DO, the clinical director disorders. “I can’t tell you how many and staff pediatrician for The Osteopathic kids are prevented from having neu- Center for Children & Families in San rological disorders due to regular osteo- Diego. Shawn K. Centers, DO, performs pathic structural exams and OMT,” Members of the osteopathic medical osteopathic manipulative treatment on a she says, “but I do know that I haven’t profession can register for the AOA con- 5-year-old boy at the Osteopathic Center diagnosed any new cases among those vention by visiting DO-Online, located for Children & Families in San Diego. patients I’ve been treating since early at www.do-online.org, and clicking on (Photo courtesy of Dr Centers) infancy. the “AOA Convention” link on the home “I’d like to do a prospective study of page. children who’ve been receiving osteo- November course for pediatricians ● Pediatric Osteopathic Manipulative Treat- pathic structural exams and OMT since On Nov 5-9, the Osteopathic Center for ment (POMT), a nine-module CD-ROM birth.” Children & Families will conduct a course program created by the ACOP. For more Dr Carine believes strongly that chil- in San Diego titled “Dispelling Some of information on POMT, readers can visit dren benefit from regular OMT and the Myths of Osteopathy in the Pediatric the ACOP’s Web site at www.ACOPeds that they will become healthier adults Field.” The course will address using OMT .org. because of it. to treat children with such conditions as “Osteopathic medicine optimizes cerebral palsy, plageocephaly, torticollis, ● The Collected Papers of Viola M. Fry- people’s ability to live well,” she scoliosis, fetal alcohol syndrome, Down’s mann, DO—Legacy of Osteopathy to Chil- observes. “While modern allopathic syndrome, autism and epilepsy. dren, published in 1998 by the American medicine is good at preventing death, For more information, members of the Academy of Osteopathy (AAO). This book what traditional osteopathic medicine profession can visit the center’s Web site, can be ordered through the AAO’s Web located at www.osteopathiccenter.org, site at www.academyofosteopathy.org. brings to healthcare is its focus on and click on the “Courses” link on the (See the accompanying article on Page improving the quality of life and its home page. 26.) success in enhancing the health and functioning of individual patients. Other resources ● The Cranial Academy’s pediatric “I’m very proud of what I do. It’s Readers who would like to learn more brochures, including “Osteopathic Treat- wonderful to see increasing interest in about performing OMT on children can ment for Children With Down Syndrome,” pediatric OMT. Our patients will only also consult the following resources: “Osteopathic Treatment for Digestive benefit—throughout their lives.” Problems,” “Osteopathic Treatment for ● An Osteopathic Approach to Children, Ear Infection,” “Osteopathic Treatment a textbook written by Jane E. Carreiro, for Orthodontia,” “Osteopathic Treat- DO, and published in 2003 by Elsevier. ment for Orthopedic Problems,” “An Osteopathic Treatment of the Newborn” ● “General Pediatrics,” a chapter in the and “Respiratory Health Through Osteo- second edition of the AOA’s textbook pathic Treatment.” These brochures can be Foundations for Osteopathic Medicine, ordered through The Cranial Academy’s Carolyn Schierhorn is the senior edi- published in 2002 by Lippincott Williams Web site by logging onto www.cranial torial project manager in the AOA & Wilkins. Dr Centers served as the lead academy.org and clicking on the “Books” Department of Publications. author of this chapter. link on the home page.

30 Pediatric OMT THE DO August 2007