Complementary and Alternative Medicine (CAM)
- Natural Products include a variety of herbal medicines (also known as botanicals), vitamins, minerals, and other "natural products," many of which are sold over the counter (OTC) as dietary supplements. (Some uses of dietary supplements – e.g., taking a multivitamin to meet daily nutritional requirements or calcium for bone health – are not thought of as CAM.) This category also includes probiotics—bacteria that are similar to those normally found in the human digestive tract and that may have beneficial effects. Probiotics are available in foods (e.g., yogurts) or as dietary supplements. Prebiotics are non-digestible food ingredients (primarily soluble fiber found in many vegetables and other plants) intended to stimulate the activity of bacteria already present in the intestines.
Essential Oils or aromatherapy is the use of plant-derived aromatic oils to promote a physical or psychological effect. An example would
be use of peppermint in the treatment of nausea.
Use of CAM natural products has grown considerably. The 2007 National Health Interview Study (NHIS) found that 17.7% of American adults had used a non-vitamin/non-mineral natural product and that these were the most popular form of CAM among both adults and children. The most commonly used product among adults was fish oil/omega 3s (reported by 37.4% of adults who used natural products); popular among children who used natural products were Echinacea (37.2%) and fish oil/omega 3s (30.5%). For more information see The 2007 National Health Interview Study (NHIS) [Centers: 2007].
Mind and Body Medicine focuses on the interactions among the brain, mind, body, and behavior, intending to use the mind to improve physical functioning
and promote health. Variations of this are the basis for many CAM practices.
- Meditation techniques include special postures, focused attention, or an open attitude toward distractions. People use meditation to increase calmness and relaxation, improve psychological balance, cope with illness, or enhance overall health and well-being.
- Various styles of yoga are used for health purposes, typically combining physical postures, breathing techniques, and meditation or relaxation. People use yoga as part of a general health regimen, and also for a variety of health conditions.
- Acupuncture comprises a number of procedures that involve the stimulation of specific points on the body using techniques such as penetrating the skin with needles that are then manipulated by hand or by electrical stimulation. It is one of the key components of traditional Chinese medicine, and is among the oldest healing practices in the world.
- Other examples include deep-breathing exercises, guided imagery, hypnotherapy, progressive relaxation, qi gong, and tai chi.
- Mindfulness-based stress reduction is based on the cultivation of mindfulness – an intentional focused awareness – or a way of paying attention on purpose in the present moment. It is described as a consciousness discipline. [Greco: 2008]
- Several mind and body approaches ranked among the top 10 CAM practices reported by adults in the 2007 NHIS. The survey found that 12.7% of adults had used deep-breathing exercises, 9.4% had practiced meditation, and 6.1% had practiced yoga; use of these had increased significantly since the previous (2002) NHIS. Deep breathing and yoga ranked high among children. Acupuncture had been used by 1.4% of adults and 0.2% of children. Use of CAM in the U.S. (NCCAM/NIH)
Manipulative and Body-Based Practices focus primarily on the structures and systems of the body, including the bones and joints, soft tissues, and circulatory
and lymphatic systems. Two commonly used therapies fall within this category:
- Spinal manipulation is practiced by chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners use their hands or a device to apply a controlled force to a joint of the spine. The goal is to relieve pain and improve physical functioning. Spinal manipulation is often used by people with low-back pain—a very common condition that can be difficult to treat.
- Craniosacral therapy involves gentle manual pressure applied to the skull, spine, and membranes to restore rhythmic flow to the craniosacral system. It is classified as a touch therapy.
- Massage therapy encompasses many techniques. In general, therapists press, rub, and otherwise manipulate the muscles and other soft tissues of the body. People use massage for a variety of health-related purposes, including to relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety and depression, and aid general well-being.
Other CAM Practices include:
- Movement therapies—a broad range of Eastern and Western movement-based approaches used to promote physical, mental, emotional, and spiritual well-being. Examples include the Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration. According to the 2007 NHIS, 1.5% of adults and 0.4% of children used movement therapies.
- Practices of traditional healers using methods based on indigenous theories, beliefs, and experiences handed down from generation to generation. A familiar example in the United States is the Native American healer/medicine man. The 2007 NHIS found that 0.4% of adults and 1.1% of children had used a traditional healer.
- Manipulation of various energy fields to affect health. Practices based on veritable (measurable) forms of energy include those involving electromagnetic fields (e.g., magnet therapy and light therapy). Practices based on putative (yet to be measured) energy fields (also called biofields) are based on the concept that human beings are infused with subtle forms of energy – qi gong, Reiki, and healing touch are examples of such practices. The 2007 NHIS found relatively low use of putative energy therapies. Only 0.5% of adults and 0.2% of children had used energy healing/Reiki (the survey defined energy healing as the channeling of healing energy through the hands of a practitioner into the client's body).
- Whole medical systems – complete systems of theory and practice that have evolved over time in different cultures and apart from conventional or Western medicine – may be considered CAM. Examples of ancient whole medical systems include Ayurvedic medicine and traditional Chinese medicine. More modern systems include homeopathy and naturopathy. The 2007 NHIS found relatively few respondents who had used Ayurveda or naturopathy, but homeopathy ranked 10th in usage among adults (1.8%) and 5th among children (1.3%).
- Nutrition therapy – CAM approaches to nutrition might be summarized by the phrase “food is medicine.” Good nutrition is necessary for all children to achieve their physical and developmental potential, but CSHCN are at increased risk for such nutrition-related problems as delayed growth, medication/nutrient interactions, and altered feeding interactions. Use of supplements or special diets may require special monitoring. Any type of restrictive diets, e.g. vegetarianism, paleo, or nightshade elimination, should be discussed with your health care provider and /or a registered dietician to ensure that all essential needs are met.
- Music therapy and sound healing [Ellis: 1996] [Warwick: 1995]
- Was it published in a peer-reviewed journal?
- Was it a large, well-designed study?
- Was a control group used?
- Were the subjects blinded to whether or not they were receiving a treatment?
- What did the researchers use to determine the effect (outcome) of the treatment?
- Claims of a high success rate
- Promises of rapid or instant effect
- Promoters who benefit financially from use of the therapy
- Testimonials rather objective scientific evidence
- Promoters who resist objective evaluation
- Ignoring or resisting negative findings from studies
Determine if a treatment is effective for your child’s specific problems
- Describe the problem and think about how to objectively measure it. For example:
- Repetitive behavior: count the number of occurrences in a given 30-minute period each day
- Sleep: grade nightly on a 0-3 scale
- Melt-downs: keep record of number per day, duration and intensity (0-3 scale)
- As you implement the treatment, use your measures to evaluate the impact:
- Record data on a regular basis
- Review records to assess changes
- Keep track of when new treatments are initiated or discontinued
- Institute one new treatment or change at a time
- Finding and sharing research on treatments and helping to understand the quality of that research
- Identifying potential harmful effects. Sometimes not sharing this information may be dangerous as there can be interactions between therapies or dosage adjustments that may be required based on your individual child’s situation
- Avoiding dismissal of alternative strategies in a way that conveys insensitivity
- Helping to monitor responses to treatments
What is Complementary and Alternative Medicine? (NCCAM/NIH)
National Center for Complementary and Alternative Medicine, of the National Institutes for Health defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine as practiced by holders of MD (medical doctor) or DO (Doctor of Osteopathic Medicine) degrees or their allied health professionals, such as physical therapists, psychologists, and registered nurses.
Complementary and Alternative Therapies (MedlinePlus)
Information about therapies including accupuncture, herbal medicine, dietary supplements, and more.
National Center for Complementary and Alternative Medicine (NIH)
NCCAM, one of the National Institutes of Health, offers a wealth of information and research for patients and clinicians about the use and safety of CAM.
Studies of Complementary & Alternative Medicine (clinicaltrials.gov)
A current list of studies of CAM therapies and utilization registered with ClinicalTrials.gov
Sawni A, Breuner CC.
Complementary, holistic, and integrative medicine: depression, sleep disorders, and substance abuse.
Pediatr Rev. 2012;33(9):422-5. PubMed abstract
Promoting a healthy mind, body, and spirit in children is important in developing emotional stability. Achieving this goal involves good nutrition, exercise, a healthy environment, proper sleep hygiene, and supportive family, friends, and community. Integration of CAM therapies such as mind-body therapies (meditation, yoga, self-hypnosis, relaxation), herbs and supplements, and massage may be helpful.
Adams D, Dagenais S, Clifford T, Baydala L, King WJ, Hervas-Malo M, Moher D, Vohra S.
Complementary and Alternative Medicine Use by Pediatric Specialty Outpatients.
Pediatrics. 2013;. PubMed abstract
Complementary and alternative medicine (CAM) use is high among children and youth with chronic illnesses. The objective of this study was to assess the prevalence and patterns of CAM use in 10 subspecialty clinics in Canada and to compare CAM use between 2 geographically diverse locations.
|Contributing Author:||Lynn A. Gershan MD, CM, 2/2013|
|Content Last Updated:||2/2013|
Centers for Disease Control and Prevention.
National Health Interview Survey, 2007 Data Release.
CDC. 2007. / http://www.cdc.gov/nchs/nhis/nhis_2007_data_release.htm
Layered Analysis: A Video-based Qualitative Research Tool to Support the Development of a New Approach for Children with Special Needs.
Bulletin of th eCouncil for Research in Music Education. 1996;n130:65-74. / Full Text
Describes an experiment documenting the musical sounds made by children with severe and profound and multiple learning disabilities. Production of these sounds is made by synthesizers and an EMS Soundbeam device that registers sounds created by body movement. Discusses the analysis of these sounds and their use in subsequent therapy.
Greco LA, Hayes SC. (Saltzman A, Goldin P) .
Acceptance and Mindfulness Treatments for Children and Adolescents: A Practitioner's Guide.
Chapter 7 ed. New Harbinger Publications Incorporated; 2008. 1572245417 http://books.google.com/books?id=cgjm98t9KDUC&pg=PA139&dq=Acceptance+a...
Mindfulness-based stress reduction for school-aged children.