PODCAST TRANSCRIPT - FEATURING ALLYSON CHRYSTAL
The purpose of this presentation is to convey information. It is not intended to diagnose, treat or cure your condition. Featuring natural health experts from around the world, we share information, tools, products and strategies for living better lives in the areas of physical, chemical/nutritional and emotional/spiritual well-being.
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Dr. De Koyer: Hello and welcome back to Beyond Your Wildest Genes
podcast, my name is Dr. Noah De Koyer and I am your co-host. Today I’m super excited to have Allyson Chrystal as our guest.
Allyson is an occupational therapist and a clinical instructor specializing in pediatrics. In her clinical work and research, Allyson has focused on sensory integration and self-regulation in children with behavioral and developmental disorders. More recently she has expanded her work with self-regulation to typically developing children in adolescents. Allyson is also currently completing a Master’s degree in Functional Medicine and Clinical Nutrition.
How are you today Allyson?
Allyson: I am great, how are you?
Dr. De Koyer: Great. You know, we met about a month ago at the Functional Forum Christmas party in New York City.
Allyson: Yes.
Dr. De Koyer: Well, in fact we both did a Functional In 5 talk. I thought your presentation was the best by far and I knew I had to have you on. Thanks for your time today.
Allyson: Oh, well I appreciate that. You were actually the first one on that stage and I think you did a good job of raising the bar for the rest of us, so it was a great night for sure.
Dr. De Koyer: You know, James said, “Noah, do you know when you want go?” and I’m like, “You can put me anywhere,” and sure enough he put me on first.
Allyson: Famous last words.
Dr. De Koyer: Yeah. So, I like our audience to hear from the person about their backstory, so how about a little bit about yourself?
Allyson: Sure, so kind of an abbreviated version. My current role, as an OT, in in pediatrics and I’m combining that now with a functional medicine piece, but leading up to that, I was definitely in the realm of wanting to go into more traditional allopathic medicine as an undergrad and wanted to go into pediatrics and I’d had some experiences as a medic and some part-time jobs that really made me rethink whether that traditional medical model was one that I could embrace and have a long term career at. I was definitely leaning towards more of an ongoing relationship with patients and clients in a healing capacity.
So, let led me to rehab and more specifically OT, and my history in occupational therapy has been really concentrated in pediatrics and I’ve been fortunate enough to work in several different environments where I can care for kids, whether it be at those very beginning stages of life in Neonatal Intensive Care or in early intervention, in home-based therapy, in schools, in hospitals and out-patients.
So, I feel like I’ve gotten a really nice wide variety of patients and clients and in recent years, as I have found functional medicine, I have really been able to address some of what I felt all along in OT and in rehab, was really a void. In rehab we have this kind of idea that when there’s dysfunction and when there is disability, we either remediate and try and fix it, or we compensate and adapt the environment around the person so they can still be functional. Although those two things are incredibly powerful, I think the functional medicine lends as much more depth to that process, in terms of how we heal folks from the inside out.
So, I feel like now that I’m able to kind of marry those two, from a rehab OT perspective and then a functional medicine perspective and then a kid perspective, so I guess there’s the marrying of three, the opportunities for helping kids has just been outstanding.
So, I feel like I’m in the right place now and coming at the pediatric therapy role with a little bit of a different lens in functional medicine, but one that really is a good fit.
Dr. De Koyer: Yeah, I think your perspective of occupational therapy combined with functional medicine is extremely unique and for our audience, how about just in the beginning, specifically defining occupational therapy, because I think people are more familiar with physical therapy, I even employ a physical therapist at our office, but occupational is a little bit different.
Allyson: You’re exactly right and it’s one that I think people have a hard time understanding and I’ve gotten questions like, “So, you get kids jobs?” And I’m like, “No, no, no, it’s really that.”
So what the role of an OT is, is similar to PT and kind of parallel to PT, we are brought into a patient’s life when there is disability or dysfunction that’s impacting their ability to do the things they need and want to do and OT’s kind of take that into a little more functional role and our job is really to look at, okay, what are the things that this person does throughout the day that are important to them in their role as a mother or a father or a student or a community member or an employee, and has is that disability or dysfunction getting in the way of their success doing the things they need to do? Their occupation, as we say, are daily living.
So, from an OT perspective, I look at pediatrics and I address situations with kids and disability and dysfunction from a functional perspective, so I’m looking at, what are the cognitive, psychological, physical, socioemotional, behavioral barriers to a child really being successful in their roles as a peer, daughters, students, a player, community member, all of those things and how can I provide support or the mediation or the adaptations in order to help the kids really do the things they need and want to do to be successful.
So, kind of a long-winded definition, but basically, how do I help kids do all the things that kids need to do and be successful at them?
Dr. De Koyer: Yeah, I think that’s a great explanation. My experience with occupational therapy, I take care of special needs children and “typical children” and pregnant mothers in my office and over the years I’ve taken care of a lot of kids that have had speech delays, just could not speak or could not even formulate words and after I started adjusting them they started to speak more.
Allyson: Yes.
Dr. De Koyer: So, recently, this year I’ve had two patients that have been referred to me, specifically for this, from occupational therapists, and from my perspective I love that, because I think we all need to work together, for the betterment of children across the board.
Allyson: I couldn’t agree with you more. It’s so interesting you bring that up, because I was in Denver at the Ancestral Health Society presenting this summer, and after my talk a chiropractor came up, it’s on YouTube, you can her his question because it’s so in line with what you’re saying, but he came up and he said, “There is this thing that happens when we as chiropractors address proprioception from an adjustment perspective and there is a development piece there that helps kids,” and my presentation was all about proprioception and behavior and he kind of zoomed out and went, “Wow, I’m providing adjustments and now we’re getting skills that are emerging, like language, like behavioral changes.”
So, there’s something there and you can actually speak to that a lot more eloquently than I could from a chiropractic standpoint, but yes, that correlation is a fascinating one.
Dr. De Koyer: Yeah, now I think this all has to do with sensory integration.
Allyson: Yes.
Dr. De Koyer: So, could you explain what that is and what that means?
Allyson: Absolutely. SI or sensory integration or sensory integration dysfunction is kind of a niche for OT. So, it’s something we spend a lot of time in graduate school, both learning and both in treatment and in theory and basically sensory integration, you know, we know about the five senses in kindergarten that we have, but there’s also internal senses, like proprioception, meaning like kind of that joint position and body awareness and space as well as the vestibular sensation, which is that sensation of movement and then there’s a whole other tactile world of touch and how you can register touch and then act on that, that we often don’t necessarily address directly. Sensory integration is the concept of taking, not only those five senses, but also those additional three that I just mentioned, and in the brain, making sense of what’s happening to your body in its own environment and having a response that’s adaptive.
So, one of the examples I like to use, if you’re walking down a pier and there’s a canoe and you have to get into the canoe without falling over and spilling yourself in the drink, you’re not going to jump into the canoe, you’re not going to take a flying leap, you’re probably going to read your own cues from your body and maybe squat down a little bit, maybe walk in carefully, you’re going to modulate how much pressure you’re putting on parts of the canoe, your balance, your vision, all of that is coming together and integrating in the adaptive response of sitting successfully in the canoe without going overboard and we do that every day, I mean, we’re doing that now, kids do that in classrooms, on the playground.
So, it’s something that happens for normal function on a daily basis and we do it well, but when it gets out of whack, so when some of those senses maybe we are hypersensitive to or maybe we’re not balanced in, then we start seeing things that look a little odd or quirky. So, the kid that walks into the classroom and slams his stuff down on his desk and things go everywhere and he walks with really, really stomping feet or he walks on his tippy toes, or he has to touch the wall as he’s walking down the hall, those are kids that their senses are not integrating the information from their environment and their body successfully in that moment, so we start to see things that look like imbalance and dysfunction.
So, sensory integration is something we all do on a daily basis, but it very easily can get out of whack and that’s when we start to see some signs of problem.
Dr. De Koyer: So, in your perspective, how do you treat this or deal with this or remedy this or improve upon it?
Allyson: That is the million-dollar question. So, whenever I have a kid come to me and it could be a referral through parents or a hospital or through teachers, my first question, my first point of contact, my first concern is, “What is this kid not able to do successfully? Where are the barriers to successfully playing and being a student and interacting positively with peers and being a great family member that gets along well with everyone? So, where are the problems? Then, I take those specific, kind of, like what are the first battles we’re going to pick and I look at what’s causing behavior or dysfunction that’s not appropriate to that environment and I look at what the kid’s doing.
So, your question about, how do I address sensory integration, it really depends on what I’m seeing as the issue. So, if a kid, for example is a mover and a shaker, a motor driven kid as I would say, so if there’s a kid and he can’t sit still in the classroom that can’t, you know, we hear the word focus all the time, that can’t focus, that can’t follow along with a lesson, that can’t interact successfully, socially, because he’s impulsive in what he’s saying and it offends the other kids, that it might be difficult for him to keep personal space and he might be the kid that’s touching all the other kids’ supplies. So, that to me, I would register as seeking sensory input and my perception or my therapy for him would have to do with providing him appropriate sensory input, so that all of those systems that I just discussed would then integrate and then support behavior that’s appropriate to the environment.
So, that’s a roundabout way of looking at it, but really the first step is assessment and where are the sensory imbalances and it’s kind of like looking at a nutritional profile, right? Like, what is too low, what is too high, what’s out of whack and then how do we equilibrate those and balance out those inputs so that the system work in balance, and that’s kind of what we do from a sensory perspective too?
Dr. De Koyer: When I talk to my patients about this, I use the term GIGO, Garbage In, Garbage Out.
Allyson: Yes.
Dr. De Koyer: If your brain is not receiving the right input, whether it’s through the spine or whether it’s from the eyes or whether it’s from the stomach and what they’re digesting, you can’t get the right output.
Allyson: I love that.
Dr. De Koyer: So, it’s as simple as, everybody can look at it through a computerized model or a computer model and you know, if you put a wrong compute program in a computer, you’re not going to get the right response back, and our brain and our nervous system works the same way.
Allyson: Absolutely, I love that analogy and that’s actually one I can use with my kids that’s very digestible and their terms and I think the other piece of that is that my disposal, my system, doesn’t work the same way yours does. So, you and I could take the same garbage, but our responses of what goes out might be very different because my processing is different and my history is different and my makeup is different. So I think that individualization is exactly what you’re doing and similar to what I’m doing as well with the kids that I treat.
Dr. De Koyer: That’s clearly why there’s got to be an integrative approach because everybody is so different, functions differently, has different genetic makeup, different epigenetic signaling, everybody’s different but it takes a teach approach for sure.
Allyson: Absolutely, absolutely I couldn’t agree more.
Dr. De Koyer: Now, I have two sons, I have an eleven-year-old and a six-year-old and I look at them and how they play and how they use their electronics and then I think back how I played, probably how you played as well, and it’s totally different.
Allyson: It is.
Dr. De Koyer: In fact, it drives me bonkers. There’s got to be an effect here right, I mean there’s got to be something going on and happening because of this.
Allyson: There are so many effects. So, it’s kind of like any other system of toxic exposure and detoxification. So, my ability to maybe spend five hours a day, I’ll exaggerate, five hours a day in front of the computer and get zero movement whatsoever, that’s going to cause a different response in me that it might in you, who can probably tolerate that and still be functional as an adult. For me, my system might go crazy and I would end up crawling off the walls.
So, from an evolutionary perspective, we know that kids were wired to move and to survive and to be very, very engaged in their naturalistic environment and that included so much physical movement; hanging and climbing and running and chasing and wrestling and all those things. So, we are wired, from an ancestral health perspective, to need all of that input in order to be successful in our environment and to be regulated, or to be ready to learn and to grow and to interact.
So, when we don’t get those inputs, dysregulation occurs and it’s creeps up to the surface in really unique and different ways. Some kids, it’s a shutdown and it looks like apathy and disengagement. Some kids, it’s a hyper response and it looks like lots and lots and lots of excessive movement and impulsivity.
So, I think from the perspective of our evolution of play, we are much more still and much more disengaged than we ever were and we’re seeing milestones that are changing. I mean, I have kids, and you might know actually, more about this than me, but there’s a convergence insufficiency issues that, from the visual perceptual sense, happens when you spend too much time looking at a screen and suddenly your reading skills, even your vision might test as normal, these kids will have reversals in their reading and their capability to read is decreased and it looks like a learning disability. Then, that actually is highly correlated with ADHD.
So, there’s this cascade of domino affects that happens when we have kids that are both still and in front of that screen and in small doses, I’m not certainly trying to demonize screens, that’s part of, certainly everyday life, but I do think that we, as parents, need to really be intuitive about looking at the cues that our kids are giving and if they’re starting to seek out movement, in really maladaptive, we need to really, kind of raise our hand and address the issue of, how do I give this kid what he’s seeking out, in ways that are going to help him have that piece of self-regulation so they can be successful in social environments in the classroom and in family situations.