Parent
The background Acupuncture is a wonderful complementary
therapy for young people and, as the long
term effects are to balance and strengthen
them both physically and emotionally, it creates the
opportunity for some young people to engage in
school life in a much more positive way than they
might otherwise do so. ‘Space for Acupuncture�?BR>at Stanchester Community School in Somerset is
an exciting and innovative new project that brings
acupuncture into the curriculum as part of the wider
specialist support for Special Educational Needs
within the school. Having been a teacher of Special
Educational Needs for over twenty years (working
at this school for ten years), I found myself in the
unique position of being both a teacher and qualified
acupuncturist with postgraduate experience of
treating young people. Throughout my career as a
teacher I have always engaged with young people
in a holistic way so it seemed a natural progression
to treat them with acupuncture. Being a member of
a school community meant that it was possible to
offer a service for young people in the place where
they spend the majority of their time - at school. The
wonderful simplicity of the project comes from the
fact that I am able to practise acupuncture during my
teaching time so the families invited to take part in the
project do not need to pay for the service - it is offered
as part of the support for students with individual
needs. This embeds the service as part of the school’s
special educational needs provision rather than it
being an ‘add on�?facility.

Identification and assessment
Students and families who are identified with
difficulties such as anger management, anxiety and
stress and ADHD (Attention Deficit Hyperactivity
Disorder) are invited to join the project. Students are
offered a course of acupuncture sessions during the
school day. Each treatment session lasts about an hour,
the length of one lesson, and it is hoped that a member
of the family is able to attend. The full permission of
the parent(s) and the positive permission of the young
person are always sought and if at any point it is felt
that the young person does not want to be treated
or does not understand what is happening, then the
treatment does not proceed. A course of treatment
consists of up to ten sessions, with flexibility for
further courses as desirable. Many positive changes
are in fact seen within four to six sessions.

The project needed to have some kind of objective
assessment before and after a course of treatment and,
in talking to the educational psychologist working
alongside many of the students and families involved,
a ‘Rating Scale of Behaviour at Home and School�?was
devised based on an ADHD Rating Scale used by
Educational Psychology Services. The questionnaire
was written in such a way so that it could be
completed by both a parent/guardian at home and
by a teacher or other adult working with the young
person at school. This way a comparable assessment
could be made as to how the treatment was helping
the child both in and out of school. Examples of the
kinds of questions are as follows:

The number is circled which best describes the
child (0 = not at all, 1 = occasionally, 2 = quite often, 3
= most of the time):
�?Is easily distracted: 0 1 2 3
�?Often shifts from one uncompleted activity to
another: 0 1 2 3
�?Often talks excessively: 0 1 2 3
�?Often gets frustrated: 0 1 2 3
�?Has difficulty moving on from a confrontational
situation: 0 1 2 3

As a young person embarks on a course of treatment
it is usual to find a marked improvement in general
well being. Sleep, energy, immunity, happiness and
self-esteem can all improve, and so on a regular
basis students and their families are also asked about
changes they feel are taking place as the acupuncture
treatment progresses. A 0-10 assessment scale is
used for this and the questioning is much more
individualised and informal in style. For example, if
a pupil finds it difficult to sleep I may ask how he or
she perceives the problem on a scale of 1-10 with 1
being able to sleep well and 10 being never able to
sleep. I may ask this same question at the start of each
acupuncture treatment and this way I can measure,
in an informal, subjective way, any changes that are
taking place. A future development will be the use of
a self-esteem questionnaire alongside the ‘Behaviour
Rating Scale�? As this is such an important aspect of
the work, I would like it to be measured in a more
objective way.

The students themselves are also given a ‘Tell Me
What You Think�?questionnaire to complete on a
regular basis throughout their course of acupuncture.

They are given a choice of words and phrases and
asked to circle three that best describe how they felt
during a particular treatment. Choices include: loved
it, hated it, comfortable, bored, listened to, OK, happy,
nervous, scared, interested, enjoyed it, great! They
are also asked to identify one thing they have really
enjoyed about the session that day, one difference in
how they might feel and one thing they may have
learned. They do seem to love learning the names
of the points and all of them could tell you where
the extra point ‘Yintang�?is and why Zusanli ST-36 is
called ‘Leg Three Miles�? We now call it ‘Stanchester’s
Marching Needle�?

The acupuncture
Much research was undertaken before the start of the
project to decide the kind of acupuncture treatment
method that would be used. Dr. Michael Smith
of Lincoln Hospital, New York, USA describes a
protocol for treating ADHD using a type of auricular
magnetic pellet which is applied to the surface of
the ear by adhesive tape. The treatment location
is on the posterior surface of the external ear, just
opposite to ‘Shenmen�?on its anterior surface. The
Reed Academy, a widely acclaimed residential school
for boys with serious behavioural health problems,
describes its experience following this protocol and
reports significant sustained improvement for most of
the boys as a result of the bead use. (For the Lincoln
Hospital ADHD research and the Reed Academy
ADHD research please follow the link at www.snhac.
com).

After consideration I decided, however, to use
body points because of their versatility, especially
for young people presenting with mixed patterns. I
also decided that treatment plans for each student
would be individualised according to the information
given at the initial consultation with the young
person and the parent/guardian attending and also,
of course, according the presentation of their tongues
and pulses. Each young person is offered treatment
by acupuncture needles or by the stimulation of
acupuncture points by an electro-magnetic pen. After
discussions with other acupuncturists who have
employed alternatives to acupuncture needles, and
my own experience of the marvellous results that can
be obtained by the employment of non-penetrating
methods, it was felt that the electro-magnetic pen
would be a good alternative for those students who
were genuinely frightened of needles and would
otherwise not take part in the project. In fact almost
all students prefer to use needles. I change the make
of needles every so often which keeps their interest,
some liking the purple-handled needles and some
enjoying the iridescent quality of other needles. It is
explained how acupuncture needles will be placed at
selected points and then manipulated to obtain ‘deqi�?
producing a warm or tickly sensation. They like
trying to describe these feelings and are fascinated by
how they can change from point to point and session
to session. It was decided to only use acupuncture
points on the head, the lower arms and hands and
the lower legs and feet, which means of course that
they do not have to undress, but just roll up trousers
or skirts and sleeves. It was also decided not to use
moxibustion as I was worried about the risk of pupils
suddenly changing position during a treatment.

Attention Deficit Hyperactivity Disorder (ADHD)
“Professor Lai Xin-sheng from Guangzhou Chinese
Medical University has many years of experience in
the treatment of ADHD with acupuncture. It is his
belief that the treatment effect of western drugs is
limited to the time period the child is actively taking
them and that the recurrence rates after discontinuing
the medications are high. He has found acupuncture to
be the most stable and effective treatment for children
with ADHD�?and it deserves to be popularised.�?

“The term ‘hyperactive�?is used to describe a whole
spectrum of behavior in children ranging from very
energetic to disruptive and rude and to positively
violent. From a Chinese point of view the categories are
very clear, and although there may be slight overlaps,
the main problem is usually easily identified. This is
one of the great strengths of Chinese medicine and is
part of the reason that hyperactivity can be treated so
well with acupuncture. To be able to identify the cause,
and to treat the condition, we can cure the child. This
is in stark contrast to conventional medicine, where
the cause is unknown, and there are few tools with
which to help these children other than drugs.�?

In my experience young people diagnosed with
ADHD present with underlying Spleen qi deficiency
and/or Kidney qi deficiency. Interestingly the basis of
the patterns is deficiency even though they appear to
have lots of energy. Those with ‘hyperactive�?Spleen qi
deficiency tend to have poor appetites and other signs
of Spleen deficiency. Those with Kidney deficiency
tend to become hyperactive when they are tired or
excited; the Kidneys cannot hold down the energy so
it rises up to the head. With careful questioning, some
young people I have worked with who have ADHD
say that they become extremely tired during their
lessons and the hyperactivity comes as an attempt to
keep awake. It is interesting to note that the drugs
that are commonly prescribed for ADHD are in fact
stimulants. Points that I use regularly are Sanyinjiao
SP-6 to tonify the Spleen, Zusanli ST-36 to tonify the
Spleen and Stomach, Taichong LIV-3 to calm the
spirit and regulate the circulation of energy and Taixi
KID-3 to tonify the Kidney. One young person has
been taught to massage Yongquan KID-1 at home to
help calm him before bed-time and he seems to enjoy
the fact that he can take some responsibility for his
treatment himself.

Anxiety and stress: anger management with acupuncture
Writing for The Journal of Chinese Medicine in the
article “Treating Young Adults with Acupuncture�?BR>Lynne Grant discusses the use of acupuncture with
‘problem�?teenagers and young people. She explains
how the young people using the service offered by
RPS Rainer in one project in SE London were happy
with the treatment and could easily define its benefits,
namely improvements in mood, sleep, appetite,
energy levels and overall well being.3

From a Chinese medicine point of view, anger and
frustration come when the circulation of qi is blocked
and cannot flow smoothly throughout the body.
Young people with anger management difficulties
will benefit from acupuncture to help smooth their
flow of energy and in particular to calm the Liver and
move Liver qi stagnation. One seemingly simple yet
extraordinarily sophisticated combination of points
used for this is Taichong LIV-3 and Hegu L.I.-4:
the Four Gates. This combination is renowned for
activating the free passage of qi and blood through the
body. Some young people have responded incredibly
well to this prescription with sustained results being
noted within three to four treatments. One reports
how he can play football now without losing his
temper every time he is tackled.

It is possible, however, that by using this
combination, the unblocking of energy can cause a
sudden outburst of anger and this is exactly what
happened for one young person after an acupuncture
session. This kind of release is a pattern that he does
often display �?however its occurrence immediately
after treatment needed explaining to several
adults who had become involved. I explained that
acupuncture would not cause a loss of temper by
itself, that the anger and ‘blockage�?of energy had to be
there in the first place, and that the acupuncture had
more than likely acted as a safety valve. The pupil has
had further treatments and his mother reports that his
anger is becoming easier to manage at home. He is
not arguing as readily and accepts that he must stay
within the boundaries of the home rules, for example
the time he was expected to come home one evening
was accepted without an argument.

Almost all of the young people treated have a red
tongue tip, often in the absence of any other Heart
signs and symptoms. As the Heart is the centre of the
emotional self and is ‘attacked�?by negative emotions,
I almost always include a point to treat the Heart
in my prescriptions. This is mostly Shenmen HE-7
which is primarily used to calm the spirit. Another
very important point is Yintang (M-HN-3), used for
its calming properties. The young people are always
amazed at how relaxed it makes them feel and they
are encouraged to simply hold or massage the point
at home before sleep, or in stressful situations. One
young person, who noticeably held his anger and
tension in his arms and hands by clenching his fists,
became quite bemused after his first treatment because
he felt he could no longer move his hands to clench
his fists and he thought there was something wrong.
I think he genuinely had no experience of how it felt
to have relaxed arms and hands.

The politics of acupuncture in school
To set the project up needed thorough consultation
with the County Council (local government
authority), and receiving positive support from the
Head teacher was crucial in this process. The County
Council Insurance Department covered the practice
of acupuncture, subject to a detailed and favourable
Somerset County Council Health and Safety Risk
Assessment. The comprehensive nature of this was
essential and needed to deal with hygiene, premises,
cross-infection, safety of equipment and storage, and
consent. Under section 15 of the Local Government
(Miscellaneous Provisions) Act 1982 the practice of
acupuncture can only take place if it is registered with
the Local Authority and so both the school and myself
have been licensed.

It became apparent that there was one potentially
worrying political issue: that acupuncture could be
portrayed by others, including the media, as a return
to corporal punishment, that is, an invasive treatment
applied as a result of bad behaviour. In fact the media
coverage we have attracted has been enormously
positive and has prompted referrals from parents and
some young people themselves. Another concern
involved the communication links between myself and
other professionals involved with the young people,
the worry being that the effects of acupuncture might
be perceived as interfering with other treatment the
child was receiving. Meetings were set up with other
professionals such as the Educational Psychologist
and Consultant Child and Adolescent Psychiatrist,
and the project has enjoyed a great deal of support
from them. Some of the students are on medication
and it has always been stressed to the families and
doctors involved that the acupuncture is seen as a
complementary therapy alongside such treatment.
It is never suggested that medication be changed or
stopped and it is made clear to parents that this would
only be done by the primary prescribing doctor on the
basis of clear changes in the clinical picture.
The school staff themselves have supported the
project with enthusiasm and this has been a rock for
the success of the project. One thing that has surprised
me a great deal is the improved sleep the young
people are now enjoying after acupuncture treatment
and I think this demonstrates how fundamentally
tired young people do get with the stresses of their
everyday lives. One student overslept after his first
few sessions and was late for school the next day. It
was important, of course, that this was not met with
criticism at school. Students can be tired immediately
after treatment and if they then need to go onto a
lesson without a break, this needs managing in a
supportive way. The managers of the Social Inclusion
Room, (essentially a time-out facility), and the Special
Educational Needs Co-ordinator are marvellous with
their help.

The politics of kids
Young people in school love encouragement, support
and ‘positive strokes�? It is incredibly important for
their self-esteem and confidence, and much research
documents how important this is for their learning. The
students are ‘rewarded�?for their involvement in the
project since school staff have been enormously positive
about changes they have seen in behaviour in and out of
the classroom and have passed their praise on to the young
people themselves. Certificates are awarded after a course
of treatment and mugs and pens with the project title have
been enthusiastically received. We are lucky to have the
use of a physiotherapy room where the acupuncture takes
place. The young people have been encouraged to take
ownership of the room and help with its decoration. One
young person purchased a beautiful Chinese calligraphy
poster, two small Buddhas and some chopsticks.

Conclusion
As a practitioner of acupuncture I am passionate about the
use of Chinese medicine as part of our everyday lives. It is
a safe natural treatment for all the family. This project is still
in its early days and already I have been amazed at how
young people involved have taken acupuncture to their
hearts, enthusing about its benefits to family and friends.
Many of them easily identify a marked improvement in
well-being, happiness, sleep and energy. They feel more
relaxed and more able to cope. My hope is that as they
become adults and have families of their own they will
feel empowered to take a greater responsibility for their
health and happiness and use Chinese medicine because
they know this will have a profound effect on their well
being. Additionally my hope is that as they choose
acupuncture within their own families and communities,
the culture of Chinese medicine will become comfortably
and systemically embedded in Somerset.
Heather Rabone has been a teacher of Special Educational needs
for over twenty years and has been involved in complementary
health care for over ten years. She is a practitioner of Acupuncture
and Aromatherapy and has taught natural health to both young
people and adults. In September 2004 she was a postgraduate
student at Zhejiang University, China, specialising in the practice
of acupuncture with children. Heather is passionate about the use
of Chinese Medicine and Acupuncture as part of our everyday
lives.

Notes
1 Becker S. A (2001). “A Ritalin Alternative: Acupuncture in the Treatment of ADHD�?in Chinese Medical Psychiatry: A Text Book and Clinical Manual. Blue Poppy Press: Boulder.

2 Scott J & Barlow T. (1999). Acupuncture in the Treatment of Children. Eastland Press, Seattle. p377.

3 Grant L (2003). “Treating Young Adults With Acupuncture�? The Journal of Chinese Medicine, Hove, 73: 5.

Photo 1:  Yintang

By: Heather Rabone

From:   http://www.jcm.co.uk/media/cms/File/JCM81-41.pdf?fe=4984265ab4dba94a05d68a03467909d1

Journal of Chinese Medicine �?Number 81 �?June 2006