Thesis, Learning Disabilities Osteopathic Relation To Cervical and Thoracic Spine, by France Champagne

Osteopathy and Learning Disabilities
DO YOUTH DIAGNOSED WITH LEARNING DISABILITY HAVE SIMILAR

DYSFUNCTION IN THE CERVICAL AND UPPER THORACIC SPINE
By
France Champagne
Thesis submitted in partial fulfilment of
the requirements for the diploma of,
Master of Osteopathic Manipulative
Science
The Canadian Academy of Osteopathy &

Holistic Health Sciences
2012
Approved by: Brandon Stevens, DDO-MTP, M.OMSc, MICO.

Chairperson of the Supervisory Committee: Professor
Program Authorized To Offer Diploma,

The Canadian Academy of Osteopathy & Holistic Health Sciences, Inc.
Date March 15, 2012
ii
DO YOUTH DIAGNOSED WITH LEARNING DISABILITY HAVE SIMILAR

DYSFUNCTION IN THE CERVICAL AND UPPER THORACIC SPINE
By
France Champagne
Chairperson of the Supervisory Committee: Professor Brandon Stevens, DDO-MTP, M.OMSc.,

MICO.
Department of Osteopathic Principles & Practices
ABSTRACT
The purpose of this paper is to determine whether youth diagnosed with Learning Disability have
common cervical and upper thoracic vertebral dysfunctions, to document any observed
dysfunctions, and, with an Osteopathic approach, to explore the correlation between any
observed dysfunction and Learning Disability.
iii
TABLE OF CONTENTS
Title page ..
Abstract ..
ii
Table of Contents.
iii
List of Figures...
iv
Acknowledgements ..
Glossary.
Vi
Preface ..
Thesis Question
Introduction ..
Understanding Learning Disabilities ...
The Anatomy and Physiology of Learning Disabilities
Agraphia ..
Dyslexia ..
11
Dyscalculia. 13
Working memory
14
Attention Deficit and Hyperactivity Disorder
16
The well-functioning brain and its supporting structures
18
The dural venous sinus ..
23
The vertebral vein and the inter-vertebral venous plexus ..
25
The cervical spine ..
27
The superior cervical ganglion
28
In early osteopathy ..
32
iv
The research project ..
34
Analysis results
38
Limitations
39
Conclusions 40
Appendix 48
iv
LIST OF FIGURE
Figure
Page
Neurons, dendrites and synaptic connections....................................
Arcuate fasciculus...
Hearing spoken language and reading written language.........
Brocas, Wernickes area and perisylvian area.....................
Agraphia cognitive information processing model of spelling and writing......................
10
Thalamus projections to cerebral cortex.
12
The relationship between the procedures involved in reading...
13
Presence of new brain cells, in the hippocampus
14
Thalamus nucleus.
16
10
Midbrain, the hemispheres, corpus callosum...
19
11
Dural venous sinus flow...
21
12
Dural venous sinus...
22
13
Areas of the brain used in reading, listening, processing and generating words....
24
14
Suboccipital cavernous sinus....
25
15
Vertebral veins and internal jugular veins .
26
16
Superior Cervical Ganglion, Posterior neck dissection....
28
17
Cerebral arteries....
29
18
Carotid sinus and carotid canal.
30
19
Watershed areas, thoracic head .anchor.
32
20
The common compensatory pattern: origin and relationship to the postural mode.
33
21
Osteopathic Structural Diagnostic (OSD) assessment..
35
ACKLOWLEDGEMENTS
The author wishes to thank the Canadian Academy of Osteopathy and Holistic Health Sciences,
for keeping the integrity of Osteopathy and teaching Osteopathy with the same integrity. I would
also like to thank Donna Champagne, my sister in law, for all the guidance she provided during
the writing of this research paper.
vi
GLOSSARY
Acalculia
Math disabilities resulting from a brain injury
Agraphia
Disorder of spelling and writing caused by neurological damage. Some variation

include: Lecxical Agraphia- eg. oshen vs. ocean; Phonological Agraphiaeg. stair vs.stare; Semantic Agraphia- eg. daysvs. week. Also known as
Dyscalculia
Corpus callosum
Connects the left and right hemisphere
Cyngulate gyrus
Above the corpus callosum, connecting the hemispheres
Dyscalculia
Innate difficulty in learning or comprehending arithmetic
Dyslexia
An impairment in reading with associated deficit in oral language acquisition

(dysphasia) writing (dysgrphya) mathematic (dyscalculus) motor coordination
(dyspraxia), temporal orientation (dyschronia), visuospacial abilities
(developmental right-hemisphere syndrome)and attentional abilities
(hyperactivity and attention deficit disorder) . Aspect of dyslexia :
deep dyslexia eg. bicycle vs tandem, single vs. singal, visual dyslexia eg
land vs lend, phonologic dyslexia eg. comb vs. cobe, surface dyslexia eg
flude vs.flood , stake vs. meat, attentional dyslexia eg but, big hut vs.
pot, big,hut
Glia
Nerve cells that dont carry nerve impulses. Glia meaning glue perform many
important functions related to homeostasis, form myelin, provide support and
nutrition and more. Glia cells makes up to 90 % of brains cells . Also known
as Glial or Neuroglia
vii
Graphemic
Working memory system that temporarily stores abstract orthographic
buffer
representations while they are being converted into codes appropriate for various
output modalities ( i.e. writing, oral spelling, typing, or spelling with anagram
letters)
Learning
Learning disability refers to a number of disorders which may affect the
Disability
acquisition, organization, retention, understanding or use of verbal or nonverbal

information. These disorders affect learning in individuals who otherwise
demonstrate at least average abilities essential for thinking and/or reasoning. As
such, learning disabilities are distinct from global intellectual deficiency.
Long term
LTP is a enhancement in signal transmission between two neurons that results
potentiation
from stimulating them synchronously. One of several phenomena underlying
(LTP)
synaptic plasticity( the ability of chemical synapses to change their strength)

Major cellular mechanism of learning and memory
Magnocellular
Neurons located within the magnocellular layer of the lateral geniculate nucleus
cell ( M-cells_
of the thalamus. The cells are part of the visual system, concerned mostly with
movement detection. The nerve endings at the back of the retina relay to the Mcells of the Thalamus.
Neuroplasticity
Synaptic plasticity, the property of a neuron or synapse to change its internal

parameters in response to its history, permits learning
Suboccipital
Also known as atlanto occipital joint membrane
cavernous sinus
Synaptic Pruning
Refers to neurological regulatory processes, which facilitate a change in neural

structure by reducing the overall number of neurons and synapses leaving more
efficient synaptic configurations.
viii
Synaptic
Ability of chemical synapses to change their strength, involved in learning and
plasticity
memory
Preface
Prior to beginning studies in Osteopathy I had worked for 20 years with families and children at risk of
developmental delay. During that time I observed that some of the children who had the most difficulties
were those who appeared to have a good or above average intellect, yet some rudimentary concepts
seemed to evade them. Throughout my journey into Osteopathy, my interest in youth remained strong,
specifically for those youth with learning disabilities (LD). One day a patient left me the following
message: my eyesight is down, I dont hear as good and my brain is foggy, my neck must be crooked
again, can I get in for a treatment?
Understanding the body as a dynamic unit functioning in concert with all its parts is an important
principal of Osteopathy. The necks relationship to sight, hearing and clear thinking enticed me to
ponder an observation of LD youth I had treated in my practice, considering the presence of somatic
dysfunction. A somatic dysfunction is an impaired or altered function of related components of the
body. These two events catalyzed my interest in the potential link between cervical and thoracic
dysfunction and learning disabilities (LD), particularly in youth.
Thesis Question
Do youth diagnosed with Learning Disability have a similar somatic dysfunction in the cervical and
upper thoracic spine?
Introduction
Osteopathy is a drugless manipulative medicine. It was developed, in the late 1800s, by Andrew T Still.
In early 1900, there was a 2 year influenza pandemic (1918-1919); more than 28% of the population
died of the disease. The United States medical hospital reported a 30 to 40% mortality compared to
.25% mortality in the Osteopathic hospital (Magoun H. I Jr, 2004). This is a difference of from 29.7539.75% less mortality, which is significant and cannot possibly be linked to chance. Surprisingly,
despite this remarkable statistic, Osteopathy has since been largely forgotten and not well understood by
the general public; although its premise that a well aligned body structure will permit immunity and selfhealing had been so strongly supported by these disparate catastrophic events. Osteopathy benefits may
be very widespread in keeping the body aligned and well-functioning. An exploration of conditions that
are neither well understood nor treated, together with whether mal-alignment is a contributing factor,
could benefit society overall. One example of a condition that costs society and individuals throughout a
lifetime is known as learning disability.
Understanding Learning Disabilities

Learning disabilities are not visible. An individual with learning disabilities may have average or above
average intelligence, yet a 2006 statistical study showed over 40% of those diagnosed with LD were not
in the labour force in that year. The same study found that 120,000 children aged 5-14 were diagnosed
with LD in 2006 (Bernnan S., 2006).This represented over 3% of all children in that age group in
Canada, and most of these children were enrolled in school. As students show disabilities in school
related learning, their general performance is questioned, and an assessment plan is establish. Sometimes
this plan includes independent professional psychological assessment. In the event that a student did not
have an assessment, The Canadian Study Grant acknowledged the extent of the problem and includes a
one-time only $1,200 grant to cover a learning assessment for students enrolled in post-secondary
education (National Education Association of Disabled Students, 2000). This clearly speaks to the high
numbers of students who struggle with learning challenges and its overall costs to society.
A substantial number of students with LD drop out of school; over half of those diagnosed with learning
impairments were found to have no more than a high school education. Study subjects reported that their
disabilities influenced their choice of course, choice of careers, time it takes to finish their education and
their needs for additional support. Employment was reported to be restricted in the 15 to 64 year age
group and over four in ten reported not being in the labour force (Brennan S., 2006).
The cost of LD is substantial. It is estimated that the simple incremental cost of LD from birth to
retirement is $455,208 per person. Individuals with LD and their families shoulder about 60% of the cost
and public programs carry the remainder (The Roeher Institute, 2007) .
Presently the services offered to students with learning disabilities are mainly of strategic learning
techniques and training, also known as cognitive training or cognitive behavioural therapy. An
adjunctive support to this cognitive training could be the use of integrative manual therapy such as
Osteopathy.
This research project targeted a specific search for presence or absence of structural dysfunction in
students diagnosed with learning disabilities. Subjects were recruited through health practitioners and
personal referral. Seven students aged 6 to 14 diagnosed with learning disabilities were assessed
following the Osteopathic Structural Diagnostic (OSD) method of evaluation; they received a
subsequent treatment to address their somatic dysfunctions. All the subjects revealed asymmetry, tissue
texture changes, restriction of motion, and sensorial changes in the occipital and first cervical vertebra,
mid-cervical and upper thoracic spine, and lower lumbar and sacrum.
The Anatomy and Physiology of Learning Disabilities

At birth our brain is wired in a network of neuron cells that transmit nerve impulses, and glia, from a
word meaning glue, which support these cells. Together these form the two main components of the
brain (Harun K.M Yusuf, 1992). Glia do not carry nerve impulses, yet they communicate with other
glial cells (Fields D.,Stevens-Graham B., 2002) and can affect neuronal activity, that is, excitability and
communication between cells, or synaptic transmission. While neurons peak in numbers during
gestation, their numbers and size change as their cable-like projections, known as axons, thicken, and as
their body cells branch forming dendrites. This increase in dendrite numbers and synaptic connections
continues to undergo changes through development. (See figure 1) Over time as neurons are not used
there is a reduction in their numbers after birth. The structural changes in neuron size are determined by
the dynamic relationship between glial cell, decreased numbers of neurons and the increase in size of the
remaining neurons. At time of birth, mammalian neurological development includes a structural
regulator that functions by reducing the overall numbers of neurons and synapses to make way for more
efficient synaptic configurations. This synaptic pruning is complete by the time of sexual maturation in
humans (Iglesias J, 2005) and is thought to be regulated by hormones and nutritional factors
(P.Vanderhaeghen et al., 2010) . The ability of the neuron to change the efficiency of its synaptic
transmission, known as neuroplasticity, permits a network of information to be sorted and retrieved
using pathways established and modified according to the function and the structure of the neurons.
Information storage and retrieval are essentially the components of learning and reclaiming or sharing
what has been stored, or learned. Without retrieval, the information stored is trapped. This describes the
essential brain activity related to learning without which the environment for learning is diminished,
inaccessible or impossible.
Figure 1 Neurons, dendrites and synaptic connections

Learning changes the neural pathways in the brain. For example, when learning a new language or new
words, neurons are recruited from the visual centers to recognize spelling, in the auditory centers to
distinguish sound, and in the association centers to relate words with existing knowledge. It is by
repeating new words or new learning over and over that the strength of the connection is established
over various circuits of the cortex.
The establishment of those association pathways and their strength may depend on several factors. One
of these factors is long-term potentiation (LTP). LTP is a process in which synapses are strengthened
between two neurons that are simultaneously stimulated; or it can be the activity of several neurons
converging onto a single neuron strengthening the synapses. LTP occurrence is the chief player in the
great deal of plasticity observed in the hippocampus and its relationship with memory (Dubuc). (See
figure 2)
Figure 2 Arcuate fasciculus, Diffusion Tensor imaging showing right and left arcuate fasciculus
New information learned is perceived through the senses as processed by different responsible parts of
the brain. Visual input is transmitted from the eyes to the midbrain, to the thalamus then transferred to
the primary receiving area in the neocortex of the occipital lobe. Auditory input is transmitted from the
inner ears to the brainstem, midbrain, and thalamus, and then transferred to the primary auditory
receiving area within the neocortex of the temporal lobe. From the primary areas these signals are then
transferred to the `association centre where simple precepts become more complex by affiliation. The
frontal lobe is the senior executive, or manager, of the brain. It is where executive functions involving
the ability to reason, to plan, to solve problem, to modulate emotion, move voluntarily, and a small
region in the left frontal lobe converts thoughts into words. The primary auditory cortex is located in the
temporal lobe and is important in processing meaning of both speech and vision. The temporal lobe also
contains the hippocampus that plays a key role in the formation of memory and learning. It is in the
parietal lobe where information is integrated from different sensory stimuli such as taste, temperature,
and pain. The parietal lobes are responsible for auditory and visual association with memory to give the
signals meaning. The parietal lobes permit language comprehension while the occipital lobes mainly
decode visual information; a visual processing center associating visual perceptions with remembered
images to identify and recognize objects. Together these would work thus: you are walking in a field,
you see (visual input from eyes to midbrain to visual cortex) a flower (visual cortex to hippocampus and
association center) you decide to pick a bouquet of flowers (frontal lobe higher cognitive function
process, to motor neuron so your hand can pick the flowers) and the whole process together permits
learning. Any gap in this process may interfere with the ability to learn. (See figure 3) While these gaps
are all specified as different learning disorders, the facts of missing linkages in this process shared.
Figure 3 Hearing spoken language and reading written language
Learning disability refers to a number of disorders which may affect the acquisition, organization,
retention, understanding or use of verbal or nonverbal information. These disorders affect learning in
individuals who otherwise demonstrate at least average abilities essential for thinking and/or reasoning.
As such, learning disabilities are distinct from global intellectual deficiency (Official Definition of
Learning Disabilities, 2002).
Difficulty with spelling and writing words, Agraphia, is related to the function of the left temporoparietal-occipital junction. The involved site overlaps the angular gyrus (Hinshelwood J., 1900), left
posterior parietal cortex, temporal gyrus, the perisylvian language zone, including Wernickes area, the
supramarginal gyrus and in some cases Brocas area. Some areas may be spared depending upon the
form of agraphia (M.L.Henry et al., 2008). (See figure 4)
Figure 4 Brocas, Wernickes area and perisylvian area

The verbal working memory system seems to play an important role in all aspects of agraphia as it
activates a phonological loop between the Brocas and the Wernickes. Studies suggest it is located
below the frontotemporoparietal area with spatial attention (S. M. Szczepanski, et al., 2010) . (See
figure 5)
10
Auditory input
Temporoparietal occipital junction
Angular gyrus, Brodman area 39,
posterior middle and inferio temproa gyrus are 37
Perisylvian language zone, Wernicke's some time Broca
Acoustic
analysis
Auditory
Input
lexicon
D
Phonological
Output
Lexicon
Phonological
buffer
Sementic
system
C
PhonemeGrapheme
conversion
A
Graphemic
Output
Lexicon
Graphemic
Buffer
Allographic
Conversion
Oral Spelling
Typing
Anagram Letters
Allographic
Memory
Store
Grapgic
Motor
Programs
Graphic
Inventory
Patterns
Speech
Writing
Figure 5 Agraphia cognitive information processing model of spelling and writing

Some studies have postulated that visual spatial memory is associated with a region of the occipital
cortex. The memory is related to the hippocampus where its neurons have the ability to remodel
themselves due to their high plasticity (long term potentiation). From the hippocampus it loops to other
areas involved with language. This is where neurons create new connections of association for new
knowledge; somewhat like connecting the dots to create a new picture. Agraphia is defined by a
11
difficulty with producing written words, with the phonological loop playing a significant role in this
particular learning impairment, as it does in dyslexia. While there are many brain dysfunctions that
impair learning, dyslexia is one that most people have some knowledge or understanding of. Yet it is
still not well understood. Dyslexia is an impairment of cognitive function involved in the process of
reading. Studies have shown that the impairment stems from the cortical areas involved in reading,
object naming and verbal working memory. Researchers define the phonological processing system as
spanning multiple cortical and subcortical regions, including the temporoparietal junction, the insula and
the inferior frontal gyrus (Eden G. F. and Zeffiron T. A., 1998) . There is growing evidence that
dysfunction in magnocellular (M cell) pathways are responsible for visual motion detection difficulties
in Dyslexics and some forms of learning disabilities as demonstrated by a number of studies (Duff,
2009). These M cells are located in the magnocellular layer of the lateral geniculate nucleus of the
thalamus and are part of the visual system which is directly connected by the optic radiation to the
primary visual cortex. Impairments of these areas may mean interference in how the brain processes the
visual appearance of words or letters, the catalyst of learning disabilities in Dyslexia. Dysfunctions of
the visual word system are located in the left inferior occipital, the left inferior temporo-occipital and the
inferior parietal cortical cortex (angular gyrus and supramarginal gyrus area) (Eden G. F. and Zeffiron T.
A., 1998). The left occipital cortex is responsible for the analysis of visual stimuli as is the lateral
geniculate nucleus of the thalamus (M cells) and the white matter including the callosal fibers (corpus
callosum). Both these structures provide input to vision and its associated regions of the brain. (See
figure 6)
12
1- Thalamus,
2- Anterior thalamic radiation to frontal lobe
3- Superior thalamic radiation to parietal lobe,
4- Posterior thalamic radiation to occipital lobe
-- Inferior thalamic radiation to temporal lobe
26- Cut corpus callosum
Figure 6 Thalamus projections to cerebral cortex
In Dyslexia, there is a disconnection between the visual information presented to the right hemisphere
and the left angular gyrus that is assumed to be a critical part of recognition of words. There may also be
interference from the left occipital cortex responsible for the analysis of visual stimuli (H. Branch
Coslett, 2002). (See figure 7) It is believed that Dyslexia results from either a block of direct visual
13
input to the mechanism that processes printed word in the left hemisphere or a disruption of the visual
word system. Dyslexia is very often the umbrella term used by the general public to refer to reading,
writing, and even arithmetic difficulties, the latter of which is a separate learning disability in and of
itself.
Written Word
Visual Analysis
Visual Word
Form System
Cognitive System
Print to Sound
Converstion
Phonological
Output Lexicon
Superio temrporal gyrus
Lateral sulcus of parietal lobe
Speech
Figure 7 The relationship between the procedures involved in reading

The inability to perform number related tasks can be as devastating to an individual as the impaired
function of reading. Dyscalculia, akin to dyslexia, is the difficulty to understand numbers, how to
14
manipulate numbers, mathematics and a number of related symptoms such as difficulties with spatial
reasoning. Scientists suggest Dyscalculia manifest in the supramarginal and angular gyri at the junction
between the temporal and inferior parietal lobule of the cerebral cortex (Maye E.r et al., 1999). Folks
affected with Dyscalculia may have difficulties with arithmetic, reading analog clocks, mentally
estimating measurement, or distance, or judging time. The ability to manipulate numbers and time
require the use of many areas including a well-functioning working memory, as the different aspects of
learning implies juggling particles of information and comparing it to what we already have stored away
in our memory.
Figure 8 The figure shows the presence of new brain cells, labeled with GFP (green), among older ones
(red) in the hippocampus (Scellig S. D. Stone)
The mammalian brain requires the use of special functions managed by distinct structures, including an
effective working memory. Working memory is manifested in recruiting several modalities such as the
15
amygdala, the cingulate gyrus and the hippocampus which are all parts of the limbic lobe and together
they play a significant role in the acquisition of language. The amygdala and the hippocampus display
synaptic plasticity and dendritic proliferation, and will grow additional dendritic spine in response to
new learning (Engert F, Bonhoeffer T., 1999). (See figure 8) This long term potentiation (LTP) is how
we form new memory. Another special structure involved in juggling of information is the central hub.
The thalamus is the center of neurological input, receiving information from the senses, and then
relaying that information to different processing areas of the brain, made possible due to its division into
sub sections related to specific sections of the cerebral cortex. Various subdivisions of the thalamus,
such as the lateral geniculate nucleus (LGM), the medial geniculate nucleus (MGN) and the dorsal
medial nucleus (DMN) play a significant role in learning by transmitting the sensory input to the proper
cortical region. (See figure 9) Straddling the thalamus is the caudate nuclei, important to the brains
attention, learning and memory systems. The caudate nuclei is innervated by dopamine neurons and
input from various association cortex. Dopamine is essential to the normal functioning of the central
nervous system. A reduction in its concentration within the brain is associated with Parkinsons disease
while high dopaminergic activities are seen in individuals with Attention Deficit with Hyperactivity
Disorder.
16
1- Thalamus,
2- Anterior thalamic radiation to frontal lobe
3- Superior thalamic radiation to parietal lobe,
4- Posterior thalamic radiation to occipital lobe
-- Inferior thalamic radiation to temporal lobe
26- Cut corpus callosum
Figure 9 Thalamus nucleus

The American Psychiatric Association defines Attention Deficit and Hyperactivity Disorder (ADHD)
(American Psychiatric Association, DSM-5 Development, 2010) as characterized by age inappropriate
symptoms of inattention and/or hyperactivity or impulsivity which occur for at least six months in at
least two domains of life and begin prior to the age of seven. Functional imaging studies have provided a
strong foundation for a network or several networks of neurobiological abnormalities resulting in
17
ADHD symptomatology. The imbalance in noradrenergic and dopaminergic systems, ideal targets for
pharmacological treatments of ADHD symptoms, are showing the right caudate nucleus of the basal
ganglia, which is highly innervated by dopamine, as being involved in ADHD. Studies have revealed
structural abnormalities in those with ADHD in the posterior vermis of the cerebellum, the splenium of
the corpus callosum, right caudate nucleus and various prefrontal regions (Eve M. Valera, et al., 2007).
People with ADHD also seem to be afflicted by additional learning disabilities such as those associated
with the language center. The dynamic between the brains function and its structure is an important
component to understanding when we are contemplating finding ways to facilitate learning in people
with LD. It is this complexity of learning and gaps in learning that has inspired the current research
project.
18
The well-functioning brain and its supporting structures

Osteopathy views the anatomy and physiology of the body in a similar, yet somewhat different fashion
than does traditional medicine. While both acknowledge the interplay between the bodys parts and how
they support one another, in traditional medicine there is a practice of treating one part of the body, or its
ailments, separately from the rest. This may mean with pharmaceutical or it may be with surgery,
physiotherapy or other interventions. In Osteopathy, the principle is that a body is a dynamic unit of
function so that an ailment is then seen as a dysfunctional symptom. In a well-functioning body, the
structure supports appropriate function, and appropriate function maintains an appropriate structure. In
other words, any changes in the structure will impose a change in the function and any changes in the
function will reciprocally change the structure. The structure is required to have a free flow of
movement in order to maintain its proper function; if the structure is inadequate, the function will be
impaired. But we might wonder how important and exacting must the structure be for optimum
function? We all know of people who have very disabled bodies that function at a surprisingly high
level. Yet which of us would ever presume that these same bodies, if rendered whole in structure would
not function even more highly? The same is true for the brain as an entity.
Perhaps a brief look at how the brain functions can illustrate some specific areas that may impair a brain
from, for the purpose of this paper, its full learning function. The brain is a network of neurons
receiving, processing, storing and analysing information acknowledged through our senses. It is divided
into two hemispheres. Each hemisphere is further divided into four lobes; the frontal, parietal, temporal
and occipital lobes. The hemispheres are interconnected to each other by corpus callosum which is made
of white matter. (See figure 10) The hemispheres are linked to the spinal cord through the midbrain, the
pons, and the brain stem. The midbrain contains the thalamus, the hippocampus and many other
structures.
19
Figure 10, Midbrain, the hemispheres, corpus callosum

A closer review of the brain demonstrates that these parts of the brain need nourishment and cleansing in
order to function just as any other part of the body does. The brain is nourished, cleansed and cooled
through the venous system, or through the arterial blood supply taking nutrients and oxygen to the brain,
and through the veins returning waste for disposal from the brain. If this drainage is impaired, there are
consequences. The venous channel must be free of impediments so its flow may be constant and its
function of picking up just enough metabolic waste and carrying it back to the heart and lung to be
oxygenated may be fulfilled. The intense neuronal activity within the brain when we learn creates an
increase in arterial flow which in turn creates an increase in metabolic waste to be transported out and
drained, which is of utmost importance to brain function. The dual role of the brains venous system
would be to cool the brain and drain its waste so the neurons can function adequately. In this way the
flow in the brain is maintained within very narrow parameters. There is little room for excess or paucity.
This intracranial circulatory flow is controlled through two mechanisms, one through the venous system,
20
the other through the arterial. The venous system controls its pressure by releasing venous blood through
the inter-vertebral venous plexus (slow release) and the internal jugular vein (rapid release) connected to
the dural venous sinus. This function is very precarious; the venous system in the brain and spinal cord
has no valves, so venous blood can travel up or down. Conversely the arteries have the ability to change
by increasing up to 4 times in diameter when needed, providing a second way of auto-regulating
intracranial flow. However, when the brain is very active this regulation is challenged since arterial
blood flow can elevate by from 30-50%. (Schmidt F., 1999)
Intracranial circulation requires a stable acid-base balance, otherwise known as pH level; the measure of
acidity or alkalinity of a substance. When blood flow is obstructed, it slows down, decreasing the venous
pH level of blood which remains in the veins longer, allowing acidic metabolic waste to be in contact
with surrounding tissue for longer periods, increasing the excitatory environment for the nerve cells,
which in effect impacts their action potential either by decreasing the threshold potential and/or the
refractory period (Zhao H, et al., 2011). With respect to learning disabilities, this excitatory
environment can be an additional burden on the already altered neuronal communication network.
Clearly, sufficient drainage of the brain is crucial to optimal functioning. This may be even truer for the
person who struggles to learn because of the increased activity for someone whos learning processes
may require extra energy because of gaps in learning links.
The venous system stores between 65-75% of the bodys blood volume, acting as a reservoir. Venous
walls distend and contract in response to the amount of blood available in the circulation. However, the
function of the cerebral veins differs slightly in this regard in that they provide cooling for the brain and,
contrary to the rest of the body, drainage in the brain and spine occurs from deep to superficial. In the
brain, the dural venous sinuses take over the function of venous drainage. These sinuses are channels
found within the layers of the dura mater in the brain. They receive blood from the internal and external
21
veins of the brain and cerebrospinal fluid from the arachnoid space, and ultimately drain into the internal
jugular vein. (See figure 11) With respect to learning disabilities, some dural sinuses are more important
due to their anatomical position and function. In order to understand their pathways, it is helpful to
review the dural sinuses as a whole. (See figure 11-12)
Sup. Sagital sinus

Inf. Sagital sinus
Sphenoparietal sinus
Straight sinus
Transverse sinus
Suo. Petrosal sinus
Cavernous sinus
Sigmoid sinus
Inf.. Petrosal sinus
Internal Jugular vein

Figure 11 Dural venous sinus flow
Figure 12 Dural venous sinus
22
23
The dural venous sinus contains the superior and inferior sagittal sinus, the cavernous, the straight,
transverse and the sigmoid sinuses. The superior sagittal sinus drains the frontal lobes, the lateral aspect
of the anterior cerebral hemispheres and the cerebrospinal fluid to the confluence of sinuses, and has
been seen in neuroangiogram studies to be increased in size together with a dominant cavernous sinus,
usually indicating an increment of drainage from the deep structures that feed into the cavernous sinus
(M. Shapiro, 2010). These areas refer to the language center.
The inferior sagittal sinus is responsible for collecting fluid from the tributaries of the corpus callosum
and cingluate gyrus regions which it then drains into the straight sinus. The corpus callosum and the
cingulate gyrus receive input from the thalamus and project to the higher function in the cerebral cortex,
therefore playing an important role in the neuronal communication of learning, and enhancing drainage
which in turn aids pH balance and proper function.
Somewhat more complex is the cavernous sinus, made up of a collection of thin-walled veins creating a
nook bounded by the temporal and sphenoid bones, whose volume of drainage may influence the size of
the superior sagittal sinus and its tributaries: the superior & inferior ophthalmic veins, the sphenoparietal
sinus, and the superficial middle cerebral veins it drains. The influence on these four tributaries comes
from the structures they drain; for instance the sphenoparietal sinus collects blood from the sylvian
veins, which collect blood over the area of the sylvian fissure including the perisylvian area containing
the planum temporale, the inferior frontal gyrus, the posterior supramarginal gyrus and the angular
gyrus. These areas, in the left hemisphere, are otherwise known as the language center. It is possible to
extrapolate that an increase in neuronal activity in those centres, as when one is struggling to
comprehend a concept, would have a similar physiological response to any other area of the body by
providing more blood to an area of high activity, thereby implying an increase in metabolic waste and
drainage.
24
Conversely, the transverse sinuses run laterally in a groove along the inferior surface of the occipital
bone, passing forward of the petrous portion of the temporal bone where it attaches to the tentorium
cerebelli and drains into the sigmoid sinuses originating beneath the temporal bone, following a tortuous
course to the jugular foramen, at which point the sinus becomes the internal jugular vein. (See figure 13)
Figure 13 Areas of the brain used in, reading, listening, processing, generating words
25
The slower drainage process of the vertebral vein and the inter-vertebral venous plexus also has a dual
role of drainage and cooling. The circulatory system of the brain drains into two principal venous
outlets, through the internal jugular veins and through the vertebral venous plexus. The vertebral venous
plexus is an immense network of small size valveless veins located within the spinal canal and extending
from both the proximal and distal ends of the spinal cord. This system drains waste from the superficial
layer of the head and face and is connected to the dural venous system via the suboccipital cavernous
sinus, also known as the atlantooccipital membrane, located just outside the skull between the first
cervical vertebra and the occipital bone. Although outside the skull, it is part of the intracranial dural
sinuses since it has similar construction and functions of drainage and cooling. The vertebral vein
originates in the suboccipital cavernous sinus, formed of the small branches which spring from the
internal vertebral venous plexuses. (See figure 14)
Figure 14 Suboccipital cavernous sinus

The vertebral veins unite with small veins from the deep muscles at the upper part of the back of the
neck, and form a vessel which enters the foramen in the transverse process of the atlas, and descends,
26
forming a dense plexus around the vertebral artery, in the canal formed by the transverse foramen of the
cervical vertebrae. This vessel ends in a single trunk, emerging from the transverse foramen of the sixth
cervical vertebra, opening at the root of the neck into the brachiocephalic vein near its origin, its mouth
being guarded by a pair of valves. The trajectory of the vertebral vein within the transverse foramen of
the cervical vertebral becomes obstructed when a vertebra subluxates, meaning a vertebral segment
becomes limited in its palpable motion. The internal jugular vein, originating in the posterior
compartment of the jugular foramen at the base of the skull runs laterally down to the neck where it
connects with the common, internal, and carotid arteries by the carotid sheath composed of three major
fascial layers of connective tissue in the neck. The prevertebral layer of the carotid sheath encloses the
sympathetic trunk. The internal jugular vein unites at the root of the neck with the subclavian veins. (See
figure 15)
Figure 15 Vertebral veins and internal jugular veins
One can see from the preceding description of the route of the venous system the significance of
constant drainage for optimal brain function. This whole drainage process is enhanced by movement of
27
the skeleton and muscles which act as a pump for the valveless venous system. Conversely, lack of
sufficient movement, or alteration of structural movement, subluxation, will restrict or reduce drainage
of the venous system from the brain. Stagnation or decrease in venous flow creates a vicious cycle;
sluggish drainage decreasing the pH level, which in turn generates excitatory stimuli to the surrounding
neurons, in turn producing a surge of activity, subsequently increasing the metabolic waste and
intensifying heat created by the residual activity of the excited brain neurons. This entire process can
begin, quite simply, with a subluxation of a cervical vertebra, detrimentally affecting the brains venous
drainage. A similar notion of cerebrospinal venous insufficiency and its effect on neurological function
is currently being investigated in Multiple Sclerosis, although the experimental surgical treatment plan
remains controversial (Zamboni P et al., 2008).
The cervical spine can be anatomically divided into two levels, the upper, C1 and C2 and the lower, C3C7. The third and fourth cervical vertebrae have a similar physiological impact. The third cervical
vertebra, possibly due to its fragility compared to others, is the most common subluxation where it is
either forced forward, backward, or in torsion and both its superior and inferior facets are involved. This
is the only vertebra seen to have both upper and lower facets involved in a subluxation (Marion E. Clark,
1906). A subluxation of the third cervical vertebra would create changes in many tissues. The ligaments
would become thicker and tender; this would move the vertebra closer, showing a visible change in the
structure of that part of the neck. These structural changes would produce a functional variation in the
neurological feedback loop. The muscles, in response to this variation in neurological communication
would contract; the contraction further limiting the communication flow of the nerves, arteries, and
veins, circulation thereby decreasing nutrient feed to those structures. The third cervical vertebra is in
very close proximity to the superior cervical vertebra ganglion. Compressing the area of a sympathetic
ganglion tends to create excitatory results.
28
15
1
14
13
12
3
6
11
10
1-superior cervical
ganglion
2- spinal ganglion
cervical nerve VI
3- trapezius muscle
cut
4- internal jugular v.
6- articular surface
T-1
7- spinal cord
8- C-7 arch cut
9- semispinalis
cevicis m, &
multifidus m.
10- C-3 arch cut
11- internal jugular

v
12- levator scapula

muscle
13- C-4 body
14- splenius capitis
15- anterior margin

of foramen
magnum
Figure 16 Superior Cervical Ganglion, Posterior neck dissection (Stanford school of Medicine)
The superior cervical ganglion (SCG), just behind at the angle of the jaw, is in proximity to the third
cervical vertebra. (See figure 16) The superior cervical ganglion is part of the sympathetic nervous
system (SNS). This system is responsible for the fight or flight response, controlling hormonal and
physiological responses to perceived threats from the environment. This response results in respiratory
rate increases, blood shunting from the digestive tract to muscles and limbs, increased awareness, sight,
energy and other series of responses to prepare the body to fight an enemy/threat or flee from it. This
response is important in learning, particularly when the threat may be a perceived fear of interpreting
and understanding data. The SCG receives fibers from the first four cervical vertebral nerves and cranial
nerves nine, ten and twelve. It exerts a vasoconstriction on the arteries of the head and neck (Tasker D.
D. , 1913). The constrictor influence of the superior cervical ganglion comes from the second, third and
fourth dorsal sympathetic chain ganglion. The sympathetic nervous system has a plexus surrounding the
29
carotid arteries and exerts its control through the -1 adrenergic receptors. SNS stimulation produces
vasoconstriction and increased vascular resistance, thereby increasing the blood pressure in the carotid
arteries. The excitatory stimulus travels, with the carotid arteries, along its sinuous journey. The carotid
arteries originate from the common carotid artery at the level of the third cervical vertebra where it
bifurcates in the external and internal carotid. At its origin, a dilation named the carotid sinus, through
its role as a baroreceptor, helps to maintain proper blood pressure. The internal carotid, via the neck,
enters the skull through the carotid sinuous canal and travels through the cavernous sinus where it gives
rise to the ophthalmic segment, and the communicating segment. The communicating segment branches
contain the posterior communicating arteries, the anterior choroidal arteries and anterior & middle
cerebral artery; the latter two serving the area of the temporal and parietal lobes related to languages
processing. (See figure 16) A subluxation of the third vertebra would cause a compressive force on the
superior cervical ganglion. In most cases this would stimulate the sympathetic tone of the internal
carotid arteries causing a decrease in the size of the arteries (vasoconstriction) which in turn would
decrease the flow of blood to the language center, which in turn would decrease nutrient availability to
the neurons subsequently decreasing the function of the neurons in the language processing center.
Figure 17 Cerebral arteries

From the brain, through the neck, the circulation flows into the spinal cord, where blood vessels are
valveless and blood can flow either upward or downward freely. Proper motion of the vertebra is
30
essential to facilitate adequate circulation, through its pump-like action. When a body part is either feed
or drained by two vessels, this area is called watershed. When this area is compressed either by
contracted musculature or due to a restriction in motion or any physiological impediment, the blood
circulation to this area will be restricted, making the area more susceptible to ischemia. In reference to
the spine, decreased motion would reduce the blood supply to an area, reducing oxygen and nutrient
supply to the surrounding tissues such as muscles, ligaments, connective tissue, vessels, nerves and
lymph nodes within those tissues. Subsequently, contracture would settle in the area, further limiting the
circulation. In the spine these watershed areas are found in the cervical vertebra upper thoracic and
lower thoracic regions (C4-T3-T4, and T8-T9). (See figure 17)
Carotid sinus
Carotid canal
Figure 18, Carotid sinus and carotid canal

Some parts of the spine are anatomically prone to alter blood supplies. Because blood can flow either
upward or downward in the anterior and posterior spinal arteries, the tissues at greatest risk of blood
31
flow variation are those at border zones between the distributions of two adjacent supplying arteries.
Since any variation in the motion of the vertebrae can infringe on those arterial vessels, the tissues they
supply would be malnourished, perpetuating the vicious cycle that maintains subluxation. (See figure
18) A decrease of vertebral motion in these areas, C4, T3-4, and T8-9, increases the chances of venous
congestion and subsequent arterial starvation of the surrounding tissues. These watershed areas correlate
with anatomical zones under higher structural stress. For instance, the third and fourth thoracic vertebrae
anchor the head and neck; when the head is carried in a forward manner, muscles attached to the base of
the skull pull on the attached vertebral body. As a result, the third and fourth thoracic vertebrae are
closely related to neck dynamics. An altered motion in this area changes the blood circulation impact by
twofold due to its watershed region being supplied by joining arteries. (See figure 18)
Figure 19 Watersheds area, thoracic head anchor
32
In early osteopathy, the third and fourth thoracic spinal segments were identified as the origin of many
disorders, partly due to their neurological influence on organs such as the lungs and heart in addition to
their fibrous contribution to the superior cervical ganglion. John Martin Littlejohn referred to the area of
the second and fourth thoracic vertebrae as a physiological center for superficial circulation (CAO-HHS,
207-2012). Marion Clark described these same two vertebrae as having an effect upon nutrition of the
whole body due to their control of the circulation to the heart, oxygenation of the blood and influence on
absorption from ingested food (Marion C., 1906). Tasker supported the importance of this area in that he
said that the upper cervical ganglion receives fibers from the second, third and fourth thoracic
sympathetic chain ganglion (Tasker D., 1913). Osteopathys adage that it is necessary to treat the whole
body from the bottom up and middle out is still very relevant as subluxation of the third cervical
vertebra could have its origin in the fourth thoracic vertebra. The latter dysfunction could be influenced
by a lower thoracic compression, which in turn would be a response of a deviation of the thoracolumbar
region, which ultimately would be consequent to a distortion of the pelvis, articulating the importance of
detail of the dynamics between each vertebrae and their relationship to each other and to their group
dynamic. All of which speaks to the significance of the body constantly compensating to maintain health
and wellness. These fundamental principles are still relevant today; from them we can hypothesise that a
change in function of the third cervical vertebra and fourth thoracic vertebra can ultimately have an
impact on neurological function of the brain and influence the conditions of learning.( See on figure 19)
33
Dural venous system
Figure 20 The common compensatory pattern: origin and relationship to the postural mode , (Ross E.
Pope)
34
The research project

Seven male students, aged from 6 to 14 and diagnosed with learning disabilities, were recruited for this
project. All were assessed using the Osteopathic Structural Diagnostic (OSD) method, looking
specifically for somatic dysfunction. A somatic dysfunction is an impaired or altered function of related
components of the bodys somatic system which includes the skeletal, arthrodial, fascial, vascular,
visceral, lymphatic and neural elements. (Bezilla T, 2007-2011) Any presence or absence of somatic
dysfunction was recorded and the students received an osteopathic integrative treatment.
The OSD of these seven students showed similarities in somatic dysfunction at the level of the occiput
on the atlas, the third and fourth cervical vertebrae, the upper thoracic vertebra, mid lumbar spine and
the sacrum. There was a commonality in the anterior curves, with the third and fourth vertebrae having
similar dysfunction in the cervical and the lumbar spine. Asymmetry, tissue texture change, restriction in
motion and sensorial changes, commonly known as somatic dysfunction, are the key component of
osteopathic diagnostic assessment and treatments. (See figure 21)
35
Osteopathic Structural Diagnostic results

Age
Diagnostic
Rhythm &
Cranium
Occipital/Atlas
Cervical
OB- 10 Gifted/ LD
/dysgraphia
E R torsion
SlRr
J -12
ADHD/LD
F rSR
J-10
LD/ Dyslexia
M-10
Thoracic
Ribs
Lumbar
Sacrum
C3-7 SlRl T-3 Rr

C3-4
T-8 Rr
(A/E)
T-12 E
TTC B
R rib 6
exhaled
Lower
lumbar
SrRl
Counter
nutate
L/L
SlRr
C 3-4
T3 SlRr
(A/E) SlRl T7 FSl
T9 ESr
R rib 4
exhale
L3 E
L4-5 F
Counter
nutate
L/L
F lSR
Extended
C4-5 Sl
T1 SrRl,
C3 TTC B T2 SlRr
T5-8 FRl
compress
T12 Rl
L & R rib
dysfunction
T-5-8
L1 SlRr
Nutate L/L
LD//ADHD/
Asperger
Syndrome
F lSR
Temporal Sl
SlRrl
TTC B
AA- Rr
C-5-7 SlRl T4E

C3-4
(A/E)
TTC B
BL rib 4
dysfunction
L 3-4
compress
Nutate L/L/
J -6
LD/ADD
E BL parietal
bone
compression
E SlRr
C4 Sl
(A/E)
C 3-7 Sl
T1-2-3 Rr
R rib 1-2-3
inhale
L4
compress
Counter
nutate L/L
Z-14
LD/ Dyslexia
F superior
E Sl
vertical shear AA Rr
C 4-7
SlRl,
C3 Rr
(P/F)
T1-2-3
SrRl
T5 F Sr
T7-6 F
T8 F Sl
L rib 1 inhale L3 Sl
R rib 2 in
L1-5 Sr
exhale
L rib 4-5-6 in
ehale
S9
LD/Gifted/
sensory
integration
R
Unilateral
flexion
(shear)
E R torsion
SrRl
C-4-7 SlRl T1 SlRr
L rib 1
Lower L
Counter
Right
C3-Sl
T 2-3 SrRl inhale
SrRl
nutate
temproal in
(A/E)
T4 E
BL rib 4
L\L
inferior
inhale
rotation
ADHD; attention deficit disorder with hyperactivity, LD; learning disabilities, AA: atlas and axis complex, (A/E) :
anterior/extend, (P/F) posterior/flex R; rotated, S side bend, E : extended, F: flex, r: right , l: left, L/L left rotation
on a left axis,SRr : right side bending with rotation , TTC B: tissue texture changes bogginess
Figure 21 Osteopathic Structural Diagnostic (OSD) assessment
36
Analysis of the results demonstrated a common dysfunction of the occipital bone on the atlas, with all
but one subject displaying a side bend left and rotation right. The third cervical vertebra showed either
an anterior or posterior translation (flexion or extension) with or without tissue texture changes
(congestion/bogginess) in all but one subject. One out of the seven subjects showed somatic dysfunction
at the level of fourth cervical vertebra. Every subject showed somatic dysfunction in the upper thoracic
vertebra and upper ribs. Five had some dysfunction of the third thoracic vertebra while four showed
dysfunction at the third or fourth lumbar vertebrae. All but one student had a left rotated sacrum on a left
axis.
In this research project, six out of seven subjects demonstrated some degree of somatic dysfunction at
the mid cervical vertebrae. The third cervical vertebra was identified as being slightly different from its
counterparts, four to seven of the cervical spine. In this research project, it was observed that all but one
subject had a subluxation of the third vertebra and almost half of these subluxations were accompanied
by bogginess, no doubt due to congestion with all but one subject showing somatic dysfunction in the
area of fourth thoracic.
These findings demonstrate compensation in the patterns of dysfunction in the subjects. This is
indicative of a natural tendency of the body to adapt, although by adaptation the structures of the body
may create restriction in areas, increasing the chances of generating predisposed genetic or structural
impediments ( such as learning disabilities, diabetes, high blood pressure, etc.) In adapting, the body
will always find the weakest link and there express symptoms. In people with LD, a normal structural
adaptation of the body could decrease enough of the nutritional supplies and drainage to the brain to
action the predisposed neurological challenges.
37
There are few researchers who have examined youth diagnosed with LD with a view toward osteopathy
as a treatment. Of those available, most are simply case studies much like what has been undertaken in
this thesis. For Example, Viola Freeman pioneered cranio-sacral treatment in affected children and
documented academic improvements as a marker of successful treatments (Frymann V., 1976). One
study showed the effect of osteopathic treatments on orthographic skills (Knzig M. et al, 2006).
Chiropractic research has shown success in manipulative treatment of the cranial bone and the atlantooccipital complex (M.D. Thomas et al., 1992). The research undertaken for this paper considered
subjects holistically with a view toward finding physiological impediments to optimum learning
function.
As Dr Still, the grandfather of osteopathy wrote in the 1800s Healthy action of brain with its
magnetic and electrical forces to the vital parts which sustain life, memory and reason, depend directly
and wholly upon unlimited freedom of the circulatory systems of nerves, blood, and cerebral fluid Not
much has changed in the reasoning of this 19th century physician.
38
Limitations
For the scope of this research project, a small, non-randomized review of patients served the study
purpose. However, a well conducted study would include significantly more subjects of both sexes, and
random ages, who would be chosen by an outside agent, and would include a random sample of
individuals, including some with learning disabilities. These individuals diagnostics and learning
abilities would be blinded to the researcher until the study had been concluded. There would be an
opportunity to add in full osteopathic therapy together with learning and social indicators through a
third, also blinded research partner so that the effects of osteopathic treatment on learning disabilities,
inclusive of both academic and social indicators could be documented and found credible. The field,
while very exciting and with potential for significant societal impact, is not well studied and the future
of study is open to an innovative team.
39
Conclusions
In conclusion, this research reviewed the potential for osteopathy to offer a drugless intervention to the
many people who suffer from learning disabilities, particularly those in whom somatic dysfunction is
identified. While early osteopathy studies indicated the power potential of this alternative intervention, it
has not been widely uptaken in our society.
Learning disabilities have been identified as linked mainly to the left hemisphere of the brain, where the
language center is situated. Proper communication between the communicating neurons of the brain is
essential to a well-functioning system. Adequate feed and drainage to the brain is closely linked to
optimal function, with these functions being supported by the anatomy and physiology of the structures,
without which learning becomes more challenged.
This study provides a preliminary finding to influence future studies in the area of somatic dysfunction,
its osteopathic interventions, and the potential effects on learning.
Given that if the structures of the neck and thorax are altered, any somatic dysfunction involving tissues
texture changes, asymmetry, restriction of motion and sensory changes, would have an impact on the
spinal segment producing a cascade of events restricting the nerves, veins, arteries and lymph vessels.
These constraints in turn create contracture in the muscles and further restrict the nutritional supplies to
the area thus impairing the nutrient exchange route to and from the brain. The subjects of the research
demonstrated some structural impairment of the neck and thorax which may be linked with nutrient
deficiency to the brain, contributing to learning disabilities. It will be interesting in the future to examine
whether osteopathic manual integrative treatments will have an effect on learning capacity for
individuals who have been diagnosed with learning disabilities.
40
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43
APPENDICES
Appendix A 44
Appendix B ...48
Appendix C ...49
Appendix E ... 50
44
APPENDIX A
45
APPENDIX A
46
APPENDIX A
47
APPENDIX A
48
APPENDIX B
49
APPENDIX C
50
APPENDIX D
Learning Disability definition:
Learning disorder / Learning Disabilities or Specific Learning Disability is a group of disorders

characterized by difficulties in learning basic academic skills, that are not consistent with the person's
chronological age, educational opportunities, or intellectual abilities. Basic academic skills refer to
accurate and fluent reading, writing, and arithmetic. (DSM-5 development proposed revision)1
Learning disabilities: World Health Organization 2
'' a state of arrested or incomplete development of mind''
Learning disability is a diagnosis, but it is not a disease, nor is it a physical or mental illness,
Unlike the latter, so far as we know it is not treatable.
Internationally three criteria are regarded as requiring to be met before learning disabilities can
be identified:
intellectual impairments ( mild: 50-70, moderate : 35-50, severe :20-35, profound :

below 20 IQ)
social or adaptive dysfunctions early onset
World Health Organization3 refers to ''Disorder of Psychological Development

F81 - Specific developmental disorder of scholastic skills
F81.0 specific reading disorder
F81.1 specific spelling disorder
F81.2 specific disorder of arithmetical skills
F81.3 mixed disorder of scholastic skills
F81.8 other developmental disorders of scholastic skills
F81.9 developmental disorder of scholastic, unspecified
F82 Specific developmental disorder of motor function
1
2
http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=429#
British Institute of Learning Disabilities http://www.bild.org.uk/docs/05faqs/Factsheet%20Learning%20Disabilities.pdf
The ICD-10 Classification of Mental and Behavioural Disorders. Clinical description and diagnostic guidelines , World
Health Organization
51
F83 Mixed specific developmental disorders

F84.0-1-2-3-4-5-6-7-8-9 Pervasive development disorders
F88 Other disorders of psychological development
F90-F98 Behavioural and emotional disorders with onset usually occurring in childhood and
adolescence
F90- Hyperkinetic disorder (as ADD- ADH)
F99 - Unspecified mental disorder

Thesis, Learning Disabilities Osteopathic Relation To Cervical and Thoracic Spine, by France Champagne

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Thesis, Learning Disabilities Osteopathic Relation To Cervical and Thoracic Spine, by France Champagne

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Osteopathy and Learning Disabilities

DO YOUTH DIAGNOSED WITH LEARNING DISABILITY HAVE SIMILAR

The Canadian Academy of Osteopathy &

Approved by: Brandon Stevens, DDO-MTP, M.OMSc, MICO.

Program Authorized To Offer Diploma,

Date March 15, 2012

Osteopathy and Learning Disabilities

DO YOUTH DIAGNOSED WITH LEARNING DISABILITY HAVE SIMILAR

Chairperson of the Supervisory Committee: Professor Brandon Stevens, DDO-MTP, M.OMSc.,

Department of Osteopathic Principles & Practices

Osteopathy and Learning Disabilities

Understanding Learning Disabilities ...

The Anatomy and Physiology of Learning Disabilities

Attention Deficit and Hyperactivity Disorder

The well-functioning brain and its supporting structures

The dural venous sinus ..

The vertebral vein and the inter-vertebral venous plexus ..

The cervical spine ..

The superior cervical ganglion

Osteopathy and Learning Disabilities

The research project ..

Osteopathy and Learning Disabilities

Neurons, dendrites and synaptic connections....................................

Hearing spoken language and reading written language.........

Brocas, Wernickes area and perisylvian area.....................

Agraphia cognitive information processing model of spelling and writing......................

Thalamus projections to cerebral cortex.

The relationship between the procedures involved in reading...

Presence of new brain cells, in the hippocampus

Midbrain, the hemispheres, corpus callosum...

Dural venous sinus flow...

Dural venous sinus...

Suboccipital cavernous sinus....

Vertebral veins and internal jugular veins .

Superior Cervical Ganglion, Posterior neck dissection....

Carotid sinus and carotid canal.

Watershed areas, thoracic head .anchor.

Osteopathic Structural Diagnostic (OSD) assessment..

Osteopathy and Learning Disabilities

Osteopathy and Learning Disabilities

Math disabilities resulting from a brain injury

Disorder of spelling and writing caused by neurological damage. Some variation

Connects the left and right hemisphere

Above the corpus callosum, connecting the hemispheres

Innate difficulty in learning or comprehending arithmetic

An impairment in reading with associated deficit in oral language acquisition

Osteopathy and Learning Disabilities

Working memory system that temporarily stores abstract orthographic

Learning disability refers to a number of disorders which may affect the

acquisition, organization, retention, understanding or use of verbal or nonverbal

LTP is a enhancement in signal transmission between two neurons that results

from stimulating them synchronously. One of several phenomena underlying

synaptic plasticity( the ability of chemical synapses to change their strength)

Synaptic plasticity, the property of a neuron or synapse to change its internal

Also known as atlanto occipital joint membrane

Refers to neurological regulatory processes, which facilitate a change in neural

Osteopathy and Learning Disabilities

Ability of chemical synapses to change their strength, involved in learning and

Osteopathy and Learning Disabilities

Osteopathy and Learning Disabilities

Osteopathy and Learning Disabilities

Understanding Learning Disabilities

Osteopathy and Learning Disabilities