Now, here’s today’s host, Dr. Monika Buerger.
Hello everybody and welcome to another Chiro Secure’s Look To The Children show. I’m your host, Dr. Monika Buerger, and you do not want to leave us today because I have the amazing Dr. Amy Spoelstra from Northern Idaho. I’m in Southeastern Idaho, and for the first time I have somebody hanging out with me in my own state. Amy, hi.
Hi. Happy to be here. I think it’s super cool that we have you in the south of Idaho and I’m the north of Idaho. Two strong women doing work in this field, so cool. Happy to be here.
Baboom, baboom. I know you had to really tweak your schedule to be here and we really thank you for that. Little bit about the amazing Dr. Amy. She graduated from Sherman in 2008. She has a booming, thriving, awesome kick butt peds pregnancy practice, oh say that, peds pregnancy practice, up in Coeur d’Alene with a focus on neurodevelopmental disorders. She’s got an amazing program out. She’s doing a class actually tomorrow and Saturday in your office.
Up in Coeur d’Alene. She’s been out on the road spreading the word of heard awesomeness and really digging in to try to help other docs really understand the fundamentals on children with neural developmental disorders and development in general. Bless you for being here, girlfriend. I know you’ve got a lot on your plate, but we need to spread the word. Let’s do it.
Well, thank you. Thank you for having me and thank you for your influence on me and our profession and the work that you’re doing. So important and so great, so thank you.
Right back at you girlfriend.
Since we’re kind of on that same wavelength about wanting to change the tide, let’s talk a little bit about holes in development. We know that those little fiddle farts, especially in utero, in fetal development, and those first couple of years of life, they undergo different neuroplastic changes than adults do. There’s like five different kinds of type of neuroplastic changes they undergo. I think as chiropractors, we really filter across the adaptive, the developmental, and the reactive. I wanted to pick your amazing brain kind of focusing on that reactive neuroplastic changes and sensory deprivation. You come from a background, let me back up guys. Sorry, I didn’t give her the proper intro that I should have. She comes from a background of neuro optometry. Correct? Your Dad was a neuro optometrist.
So, she sees things. Ha ha. I’m sure you haven’t heard that before.
From a different vantage point. Kind of what I wanted to throw into the mix here is this reactive neuroplasticity can be a lot from sensory deprivation like amblyopia and so forth. From a chiropractic standpoint, I look at it as abhorrent afferent information coming into the CNS from the spinal joints and the associated muscles. Can we pick your brain on the spin of things from a visual standpoint? From amblyopia?
Yeah. I think that’s great. I also, because I’m a chiropractor, my background, I always say hey I have a unique life perspective and experience, or I have a unique perspective because of my experience, rather because I grew up in this neuro optometry world. I had a brother with challenges, behavioral, learning, socialization, gut, aggression, socialization, a lot of challenges, like these kids and adults that we work with. My dad was a classical optometrist, my mom’s a school teacher. It really shifted their view on what was happening in his brain and development, and it changed the course of my dad’s life and therefore our lives into the neuro optometry field. Where they practice vision therapy, and he became a leader in that field and contributed a lot there worldwide. Really got me thinking about brain development from a really early age. Which is super strange, but it’s like these people in chiropractic that are like born into chiropractic, they just a part of them, it’s a part of their paradigm, their belief system and just who they are and how they’ve used things.
That’s how neuro optometry was for me. I didn’t know how to view the world not through the developmental neurobiology optometric lens. Then I became a chiropractor, which was really cool because then I didn’t know that the two fields went together. I just thought it sounded really cool to help people with back pain, honestly. I didn’t know until then my field doctor taught me about [inaudible 00:06:11] intelligence, about the nervous system. Then I went to Sherman. I’m sitting in Sherman quarter one learning about the philosophy and some of the basic neurology, and I’m like, wait a minute, these two worlds need to come together. Then I knew at that moment that was my life’s purpose and path.
It’s interesting because yes, to go back around to answering your question, I think that it is important to look at the visual perceptual changes that we can have, but I view them differently than a neuro optometrist would. I work with neuro optometrists now and we have this conversation. Actually, one’s speaking at my seminar. Where they say, hey, we maybe have amblyopia or monocular vision, or we have some visual perceptual or visual functional change in the way we’re using our eyes and perceiving visual input. They, even though they’re very, they’re more wholistic in looking at vision than like a traditional optometrist, they still have this viewpoint, from my understanding and experience in that field, of this is just the way it is and we need to use apparatuses, prisms, lenses to change their visual experience.
My contribution to that is, but it’s all about the brain. If we’re getting, if we’re having abnormal afferent input from muscle spindle fibers, let’s take that one small little piece, conversation, if we’re having that input, which is changing the way the brain is receiving, processing, integrating information, of course they’re going to have visual perceptual changes and they’re going to present just as somebody would present with a symptom like a headache or back pain. They may, it may be contributing to their presentation of the way they’re using their eyes, which then could come around to well then that would create a sensory deprivation, I suppose you could say, or an alteration of their sensory field in the visual sense. Which I know we agree on this, is that we then have to put these together.
We can’t just say it’s like chicken and egg, which came first. Well we don’t know, but we do know we have to start with pillar one, which is hey if we want to make changes with the visual perception, which is really important in total brain function which we know, then we need to first make sure that we’re receiving and processing, integrating, and sending appropriate information within the central nervous system.
Because I always talk about the sensory motor loop. I think I don’t necessarily like the term sensory processing disorder because it’s really a sensory motor loop.
If your abhorrent information in, my motor output is going to be dysfunctional too.
What does that look like? Hey, we keep on coming back to that. Look, the vision, what does that look like? That may look like they can’t converge or diverge, and their eyes don’t work together. It’s a motor dysfunction.
Let me pick your brain some more. For all the amazing docs out there, when you walk into a room, you walk into for the first time with a little fiddle fart. You walk into the room, are there one, two, three red flags that, I mean, you walk in and you look at a couple things and you’re like, boom, boom, boom? Give us the pearls, baby.
Yeah, it’s like the gift and the curse, right?
It’s like a chiropractic standpoint just in even the traditional chiropractic, which I don’t consider us traditional chiropractors I guess. I wish this was traditional, but you see a head tilt and you think of an atlas or you think of the subluxation. It’s like you can’t [inaudible 00:09:52] them all and not see the head tilts everywhere. Kind of like it is a gift and a curse. That’s kind of the same thing with this is when we learn about brain development processing and what I call it deflective disorders, it’s really impossible not to see them everywhere you go in adults and kids. People always just think kids.
That’s a pretty complex question because one of the things is that I like to talk about is when we talk about neurodevelopmental disorders and neuro deflectic disorders, when you ask somebody who doesn’t think that they engage in this demographic much, they think of one thing. What did they think of, they think of severe, I don’t love that term, but like a severely affected autistic individual. They think maybe verbal, maybe non verbal, maybe aggressive, maybe locked in, maybe avoiding visual engagement, maybe stimming. They’re seeing this scenario.
Yeah, we see that. So, you’re looking at things like are we stimming, do we have excessive need to auditory verbally stim, are we doing a loop and feeding the brain in an auditory way, are we deflecting from central vision, or are we deflecting from peripheral vision because that can be the case as well. Especially in ADD, ADHD more presentation, we’ll get that tunnel vision, so a deflection of that dorsal stream. So it can be a lot of different ways.
The biggest thing I want to say just on this topic is that I think understanding that you could have a child or an adult that doesn’t fit that typical mold that you need to learn how to recognize that they’re having the same challenges. You could have, one thing we see a lot and I know you do too, is maybe a teenager or a young adult who has this deflection from processing their own body and their own self. You know the way they present, they look rude, they look like they aren’t taking showers because they’re lazy, they have bad poor hygiene. This is what they look like. They look like a defiant, lazy child. I hate even those words coming out of my mouth, but the thing is, is that’s what society, and that’s what we, and unless you know more, that’s how we label them. But this could be a very disorganized child or adult that really doesn’t have a good sense of awareness of cells because of gaps in development. That’s it.
They don’t have that self-perception.
Yeah, I look at that a lot with proprioceptive and interoception or neurovisceral. Thank you for bringing this up because this is really cool. This is how it’s like how are we going to fit this all into this.
But I had a group of docs out here last week, but the last several times on the road, I really want to hit home that interoceptive sense, that neurovisceral system because, like we said, for every sensory input there’s a motor output. That might look like poor visceral afferent information, primarily from vagal tone, then the abhorrent motor output might be constipation, might be bed wetting, might be because it might be not enough stomach acid or enough bile. Again, getting into that concept of for every sensory input there’s a motor output. If that loop is not working, what does that present like.
Right. I love that.
Yeah. Thank you for bringing that up because it’s poor self-perception. Do I have to go to the bathroom or do I not? Do I need to eat? Am I hungry, am I not? It’s not just necessarily tracking or vestibular, or I can’t balance. We have to think beyond that [crosstalk 00:13:46].
On that point, I love that and you are the leader in that field of looking at the neuro metabolic piece. I always say like, hey, like with the methylation and the gut healing, that’s an important piece of this puzzle. We have to put it in perspective, which you do very well and you have a great contribution to that, so I appreciate that.
One other piece of that that I always look at just because I feel like connection and brain-based parenting, brain-based mentoring, that’s a whole part of our program, it’s our fourth pillar, is so important in recognizing that when we do lack, or when we have this disorganization, or we have these deflections in processing and gaps in development, we then have an inability sometimes, oftentimes, and it can present in different ways, that’s where we have to break this down, but it can present in this deflection from processing self, own body. But then, of course that’s the foundation for processing and engaging and connecting outside of body to others. The first person to connect outside of body with this, of course, mom, or the person closest to you, and then others.
When we have say an adolescent who is having anxiety, social anxiety, trouble with friends, getting bullied, trouble making connections, picking up on verbal nonverbal cues, more visual processing stuff, we then have to go, look, we’re not treating these things, but we’re looking at the whole picture, the whole brain and where they were and how they were affected in early life, in early brain development that may be creating these deflectic patterns later. It’s really all about like what you said, and we are on the same mission here, it’s like teaching chiropractors that it’s about that input that then creates the output.
So we have foundational basis. If there, especially in those early years of neuroplastic changes on these different realms, if there’s holes, if they’re not meeting certain milestones, if they don’t build those foundations, it might not appear as a problem at that time. But then as they get older, high school age, or adulthood, that’s when those gaps really start to become more noticeable.
We want to kind of back the cart up. I even say now pre preconception care. Back the cart up on how can we make sure that we build those concrete foundational bases so that there isn’t this behavior down the road. Because you and I both know that those kiddos getting diagnosed as teenagers with the mental health disorders, that just drives me bananas. But that there’s something, there’s gaps, there’s holes that have been missed down here and they just become evident.
Right, and they present later. It’s like we always say, end organ manifestation of some disease process or some imbalance, or a challenge earlier. We can understand that. We can grasp that from a more traditional pathophysiology way, or a diagnosis of something like heart disease or headaches or cancer, but it’s the same thing here. Yeah, we’re on the same page with that.
One of the concerns I have actually and see quite often is, well, a couple of things. One, it’s like this work, and you probably get this a lot too, is that people, doctors, are thinking well I don’t work with kids with these challenges, or I don’t work with individuals with these challenges. My response to that is do you work with people, you work with people with these challenges. You just may not know how to spot it because it doesn’t look like that typical presentation like we talked about in the beginning. There’s a lot of these deflections because of all the stressors and lack of adaptation we have now.
One of the challenges that I find really troubling, and a very presentation, and I know that you find this as well, is what I call a deep dive in development in a area that’s maybe leaving bigger gaps, like some of these kids that maybe … We get this in in a musculoskeletal sense as chiropractors. If they skip crawling and they walk, we’re like oh, well that’s not good because we need that crawling because it has something to do with the brain, and so that’s a good thing. Well, these kids that read really early and they deflect these other areas, but that’s a deep dive into more abstract processing and neglect sometimes of early brain development. These are the kids that present, like you said, later in life, in adolescents or adulthood, with I have found to be very true here with more severe mental health challenges and major anxieties. That’s a big challenge that we need to know what’s happening there so that we can be the team leaders for these people. Not the only person on the team, but the team leaders.
Yeah. Thank you for bringing that up too because I think as we’re hopefully moving into an area of more brain-based chiropractic that we will see more people in our profession kind of taking that helm and taking that lead in whatever term we want to use, functional wellness or whatever the term is, but we know that one in five children in this country are said to have a mental illness and that’s not okay.
We understand, like you say, if we understand what’s going on from a developmental status, what some of these little subtlety signs or symptoms, and these red flags, and putting the whole picture together and being the leaders in that, and talking to other professionals about what we do and how we fit into that, it’s going to be huge.
Yeah. That’s a big one is making those relationships with other professionals. I think when we know more, and I know you and I are on the same page because we do a ton of collaboration and that’s what it’s all about is, we don’t have to be, and we shouldn’t be, the end all be all, we have all the answers, it’s about our egos. It’s all about what do we know about brain development and about these challenges, and what is our contribution. I think when we know that, then we know that our contribution should be foundational for everybody in this realm, everybody, but everybody in this demographic and realm.
Then it’s really easy because you’re not leading with hey chiropractic is treating any of these this and then you try to bridge that relationship with other practitioners. You say, hey, here’s brain development, here’s what I know about brain development, and oh by the way, the way we work on that is through correcting subluxation. Then they’re like, that makes sense. Here’s what I do. I mean, lead with the brain.
Exactly. Yeah, exactly. Beautiful. Beautiful darling. Beautiful.
What would you say is maybe your biggest challenge with working with this parent, with this group? Let’s go with that right now.
Oh boy. From my perspective, I think a lot of people think it’s hard to actually work and engage with these kids because there are very specific behaviors and deflections that are challenging. Yeah, I’ve been spit on. Yeah, I’ve been head butt. Yeah, all these things happen. That’s not what I find to be the biggest challenge, although I like to teach doctors how to try to avoid those things by understanding [crosstalk 00:21:28].
Over the years-
Concussion, a broken nose. Been there, done that.
You know, it’s like it happens less now right because we know how to engage, but sometimes you’re going to get it.
I think one of the biggest challenges for me is, well it’s heartbreaking, and I think the biggest challenge is that when one parent gets it and one parent, and I hate to say it but usually it’s dad who doesn’t see the challenges and then they come later in life and then they start to see them, because I think it’s really … It is really hard. Being a mom, I get it. It’s hard to see the challenges in your own kids. It’s very hard. It’s scary. What I’ve learned is the way to work with that is we just have to give them a lot of love and connection to the parents, understand where they are neurologically and where they are in processing because they’re in chronic stress and fear as well. And give them a lot of information, empower them with information before they even engage in a clinical relationship with you.
Then they make the choice, which is engaging their prefrontal cortex anyways when they make the choice. Then we continue to educate. But I think that’s the hardest thing because it breaks your heart. You can see it just like you see the head tilt and you know I know that person’s life would be better if I just adjusted their atlas. That’s I think that.
Absolutely. I have a saying that I tell the docs that I mentor with is, I’ve been in practice 29 years and it, sometimes, I hate to use the analogy of being an emergency room doc or something because you do want to save the world right and it can become a very big emotional, literally you walk into the room and this is heartbreaking. I have a new patient coming in this afternoon and I’m like, just reading their history, I’m like already heartbroken. But I say care, but don’t carry.
Because if we try to carry and convince and make those debt … And I agree with you, it’s usually the dads-
And especially dads with sons because you know …
That’s a whole nother conversation.
Yeah. But I try to tell docs care, but don’t carry that load because it will eat you up. What will happen is when you can do that and you free up space, those people that are meant to be in your practice, those kids and families that are meant in your practice, we have a waiting list practice now, like a year waiting list, they will be there, and they will be committed, and they will stay, and they will do what you want. Then ultimately you’re self-fulfilled because that’s when you can feel you make a difference in life.
Yeah. Great Advice. That was a gem. I hope everybody caught that.
One last question. I know you’ve got to go, sorry. See, I could be here with you forever.
I know. This is what we like to talk about.
Is there a pearl or two that you can give the audience, like how to connect? Just one key connection because we know we have to connect with these kiddos. We have to calm them, sensor them, and then be able to connect with them in order to get the chiropractic in. Do you have a quickie pearl?
Yeah. Well one thing is we have to understand that just on the chiropractic side, a lot of these kids, if you’re not sure or you’re not feeling super confident in what techniques do you use and how to adjust them or whatever, have objective measures, and less is more. If you’re not sure, don’t just go adjusting more areas. I think this goes for all humans, but especially these ones. So, just that. On connection, the biggest thing I teach people in the hierarchical approach, we have this hierarchy system of looking at brain development and processing, and the biggest thing is with connection is understand where they’re putting their processing. What is their primary seat of processing?
We do that by looking at hierarchy, but you can do it quickly. If you walk into a room and you see that somebody is, let’s say they’re moving around a lot, their presentation would be like hyper activity or they’re moving, they’re deflecting eye movement, this is their primary seat of attention, maybe their primary way of processing the world because they’re not as efficient in the other systems, so this is one way to look at this, look at that, understand that, and then you try to engage them there as opposed to trying to shut down their primary way of processing and engaging them in a different way.
Example, we have a kid who’s doing this, deflecting from eye movement. Do not try to get them to look at you in the eyes. “Look at me, listen to me.” Don’t do that. I would recommend not making direct eye contact with them. Actually standing next to them or doing peripheral vision with them, not even looking at them. I would decrease your auditory verbal. I would decrease the words that you’re using. I would use low tone, as low as possible. I would lower your body to decrease the visual simulation and visual processing demand. And I would engage more in movement. Then I would do that until we start to make that connection and get their prefrontal active more active. Then I would start to start to engage with them in the way and guide them in the way that we need to work with them.
You can learn to do that really quickly, as you know, but it’s all about understanding where the processing is and where they’re efficiently processing and where they’re not, and then meeting them there as opposed to trying to change them and get them to come to you because that’s not where they are. Eventually they will get there, but that’s not where they are right then.
Beautiful. Beautiful. Yeah. Their neuro expression is giving you a window into their neurological integrity.
If they can’t handle eye contact or whatever it be, or sitting still, that-
Don’t demand it.
You’ll just see an increase in the deflective behaviors. That’s how you’re going to get kicked.
But again, thank you so much. Contact Information, Dr. Amy …
You can see me at CDA Health. CDA is short for Coeur d’Alene. CDAHealth.com is our website, but there’s a for doctors section on there. You can go there and you can email us. Dr. Amy Spoelstra on Facebook. I have a Dr. Amy focus page. You can get a hold of me any of those ways.
Or get a hold of Monika. She’ll hook you up.
And I know where to get a hold of you at too.
That’s right, yeah. Monika has my cell phone.
I truly appreciate it. I know this was an effort, but we could not pass up your brilliance, so thank you again and we may be calling on you again to do round two.
Great. Thank you so much for everything you do. Thanks for having me on. I like that Idaho is full of strong women doing this work.
There we go. Double Idahoans right there.
Hey, have a great weekend. Thanks for what you do. Thanks for helping the world and changing lives. We owe you baby.
Thank you. Have a great one.
Hey, so this is Dr. Buerger signing out for this month. Join me next month. I’m the third Thursday of every month, 11:00 AM Mountain Standard Time. Next month we have an incredible treat to help you to connect with teachers and learn about some of these little fiddle farts and their actions in the classroom and what they need and what they don’t need and how we can help out. Make sure you join the first Thursday. A special guest host for the Look To The Children Show. That’s the first Thursday of every month.
Again, I want to thank Chiro Secure for their undying dedication to our profession, and especially those of us that are out in the trenches wanting to make a change and wanting to make a difference. Their support has been phenomenal. Thank you Chiro Secure. We appreciate all that you do to help us change lives and change the future. Until next time. You guys go out and keep saving lives, and we’ll see you next month.
Today’s pediatric show, Look To The Children, was brought to you by Chiro Secure and the award-winning book I Am A Lovable Me. Make sure you join us next week, right here at the same time. See you next week.