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Chronologically Controlled Developmental Therapy for Physical Disability

Laurance Johnston, Ph.D.

There are no miracles, only unknown laws. - St. Augustine

Chronologically controlled developmental therapy (CCDT) has considerable potential for treating physical disability, including spinal cord injury (SCI) and post polio syndrome. Because CCDT consists of a combination of fairly standard, widely accepted physical therapy techniques, it really should not be considered an alternative medicine treatment. CCDT’s uniqueness is related to how these techniques are applied, the sequence in which they are applied, and the patient’s passive involvement. Futures Unlimited, a clinic in Columbus, Miss., carries out this treatment.

The facility’s director is Ed Snapp, a physical therapist who acquired polio at the age of 18. HisEd Snapp and chronologically controlled developmental therapy for spinal cord injury (SCI), physical disability, and post polio syndrome impressive credentials include extensive experience with most commonly used physical therapy techniques. He has been a member of many national and regional committees and has made numerous presentations at professional meetings. Early in his career, he had a key role in establishing the nationally recognized Texas Institute of Rehabilitation and Research (TIRR) in Houston.

Snapp has an almost Zen-like appreciation of the human body. Through assessing the subtlest aspects of one’s movement and reactions to stimulus, he obtains an array of valuable diagnostic information. His abilities remind me that in this era of impersonal high-tech medicine, true healing skill is more than a science learned in books or a classroom.  It is an art that is learned through experience and, more importantly, receptivity to the experience.

Perhaps due to the understanding acquired through his own disability, he is a compassionate man with great empathy towards his patients. He combines this compassion with a sharp, eclectic intellect that is consistently attempting to integrate and expand concepts from a variety of disciplines. Through a why-not, ”just-do-it” attitude, hope seems to re-emerge like a Phoenix from the ashes - even from cynics.

Columbus is the birthplace of Pulitzer Prize winning playwright Tennessee Williams. Although some airlines serve this small city, visitors often fly to other cities, such as Birmingham or Memphis, and drive to the clinic.  Columbus’s relative geographical inaccessibility is offset by a low cost of living, which facilitates a much more affordable treatment program.

The Treatment:

The clinic targets a wide-ranging variety of neurological disorders, including post polio syndrome (PPS), spinal cord injury, head injury, cerebral palsy and various developmental disorders.  The clinic has been especially successful treating post polio syndrome symptoms and claims that 85% of the patients have had some functional improvement. In some cases, progress has been profound, including individuals who no longer need ventilators or scooters. Even when improvements are modest, Snapp notes that they can result in greatly increased independence and quality of living.

Chronologically controlled developmental therapy consists of a number of physical therapies performed in a specific, defined sequence. These include, but are not limited to, pressure stimulation, hydrotherapy, light-touch massage, movements on an oil table, and rest in a sling apparatus that mimics a fetal position.  People carry out the program twice daily for two-weeks. To further build on progress made at the clinic, a home-therapy program is designed that does not require technical expertise. Periodic visits to the clinic will further augment the progress.

Unlike many rehabilitation programs, the therapies are passive - the therapy is done to you; you exert no effort. You receive encouragement to let go of any conscious effort to control the situation. To keep your nervous system from being distracted from non-therapy stimulation, the procedures occur in an environment that minimizes distractions (e.g., under dim light, no talking, etc.).

Firsthand Experience:

To get a better feel for the process, I subjected, myself, to some of the program. The hydrotherapy was especially interesting. With the support of virtually imperceptible harnesses and slings, I became immersed, floating in a tank with only my face out of body-temperature water.  With the exception of a gentle flow of water that would periodically change directions, my body was deprived of virtually all sensations. Under these conditions, I was soon adrift in the twilight between consciousness and sleep.  I can only imagine how I would feel if I did this for two weeks. As discussed below, these conditions are meant to mimic the womb’s environment.

Patient’s Reactions:

During my visit, I interacted with several patients. Julia, a charming seven-year old girl with haunting blues eyes, has cerebral palsy. She has been coming to the clinic since she was two.  Her mother, Marilyn, indicated that before starting the program, Julia almost seemed to be regressing (e.g., becoming more spastic). Once Julia started therapy, she made tremendous progress. Marilyn is convinced “all improvement is due to the treatment.” Julia achieved more balance, more dexterity, and flexibility. She had an overall personality change: for the first time, she “started giggling.”  She enjoys her visits to the clinic because she is the center of attention.

Nancy, a photographer and teacher, has post polio syndrome. Before the treatment, she used to wake up late and feel tired. “Now I am in the habit of getting up at 6:00 a.m.,” she says.

She says that her improvement is in places that only she can see, such as the back and hips. “I can keep my balance in my wheelchair much better than before. And I can keep going day after day, unlike recent years when I had to take every other day off.  That’s the best.”  Although enjoying her treatment, she missed sunlight  “The staff had lunch on the patio overlooking the woods, but we were inside in the dark with blue lights and instructions not to talk.”

Regarding Snapp, Nancy states “This guy has his whole heart and soul in his work.  He's charismatic - and a genius at his theory.” 

Nancy says, “[I am] appalled at how little interest there is back home from the medical community.  I am now getting an education in the schism between traditional and alternative medicine.  This seems so unnecessary and blind. When something works, it ought to be emulated and investigated, not just shrugged off as a fluke.  Although I have not seen my physiatrist yet, I hope he will accept my results.”

During my visit, several individuals with spinal cord injury were being treated at the clinic, but I did not have the opportunity to speak with them. Although progress is often slower, Snapp has had some notable success treating SCI. For example, Nick fell 25 feet from a hunting platform and crushed his spine in the thoracic/lumbar region. Although two years later his legs were jammed with extreme spasms, after several years of treatment, Nick was walking with crutches and short braces.

Measurement of Improvement:

These examples, of course, do not proof effectiveness according to scientific standards. A frequent criticism of any potential treatment concerns how improvement is measured. Snapp recognizes that this is a tough, but valid issue. However, he says that the restored function that he sees is often so overt, (e.g., patients no longer needing scooters or ventilators) that effectiveness cannot be denied. To ensure objectivity, he ideally would prefer that the patient’s own neurologist independently measure improvement after treatment.

He also says that the use of extensive sophisticated assessment procedures would greatly increase the treatment costs. “My foremost goal is to help people, not to do a scientific study.”

Treatment Theory:

Although the clinic’s procedures are relatively straightforward, the theory behind them is not. Snapp emphasizes that restored function is not due to neuronal regeneration. Basically, he focuses on activating intact - but dormant - neurons and pathways.

A growing base of scientific knowledge indicating that the nervous system is much more complicated and sophisticated than previously thought supports this focus. In the case of spinal cord injury, scientists now conclude that most non-penetrative injuries (i.e., other than gunshots or stabbing) that have been classified as complete in terms of physical function are neuronally incomplete injuries.  In other words, usually there are intact neurons that cross the spinal cord injury site that have been turned off by the injury process. In animal models, the spinal cord needs only about 5% neuronal functioning to have substantial physical function. Theoretically, if we can activate even a small percentage of dormant, intact neurons, considerable function could potentially be regained.

Snapp speculates that more regeneration may occur after injury than previously thought, but the regenerated neurons have not been turned on. As a consequence, even if successful, current research efforts that target neuronal regrowth may have minimal benefit if activation is not considered.

Paraphrasing the famous movie line, the prevailing scientific assumption that “ if we build it, it will conduct” may be fundamentally flawed.

Snapp’s program for activating neurons is based on a rather complicated thought-provoking theory encompassing concepts of evolutionary development. He believes that turning on dormant neurons requires a sequence of cues that mimic events from our early fetal and infant development.  In turn, these developmental cues reflect a genetic memory of our evolutionary development.

If a fully developed neuron has been turned off, its reactivation requires that it receive and sense external cues in a defined sequence that are correlated to the neuron’s initial development. There is no avenue to deliver these cues except through the peripheral senses - the basis of Snapp’s physical therapy program. Out-of-sequence cues will not work. This, according to Snapp, is why many standard physical rehabilitation programs are so limited in outcome. As a professional with a disability, he believes “most standard rehabilitation policies make robots.”

Snapp compares his process to pulling a computer’s plug. The computer’s circuits remain intact, but the program is lost. To be reinstated, the program must reboot, which involves a sequential series of steps.

Likewise, Snapp believes that a significant proportion of neurological dysfunctions result from a deprogramming of specific portions of the central nervous system. In the same fashion that a disk can reboot a computer program, an appropriate external cue will trigger information residing within a nervous system’s genetic code. This information will then be reprogrammed back into the operating system in the same order as it was learned in the embryonic nervous system.

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Adapted from an article appearing in the July 1998 issue of Paraplegia News (For subscriptions, contact

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