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Alternative therapies for developmental and learning disabilities

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This is an old revision of this page, as edited by Gerfinch (talk | contribs) at 21:50, 10 October 2007 (removed proven benefits section - why does it consist of one study which showed no proven benifits? some author quoting their own work i guess). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Template:ActiveDiscuss Alternative therapies for disabilities, such as learning disabilities and developmental disabilities, include a wide range of practices that make claims for efficacy in the treatment of dyslexia, ADHD, Asperger syndrome, autism and others. An alternative therapy generally has little or no support in research, but is proposed by a number of scholars, clinicians or non-experts and is being used in the remediation of one or many conditions. Such therapies are usually based on theories that have not gained widespread acceptance. As such, those applying scientific skepticism may use the terms "fad" "controversial" "pseudoscientific" or "dubious" therapies as synonyms.

Need for a treatment

There is a call for alternative therapies particularly when a condition lacks a reliable remediation. For example, in 1987, applied behavior analysis (ABA) which is regarded as the most effective therapy for autism, was reported to help only 47% of the patients, and there is currently a debate whether the effectiveness has been exaggerated. On the other hand, some alternative therapies, such as gluten- and casein- free diets, may be considered more comfortable or humane than a treatment supported by most experts. [1] Parents may also consider a drug treatment for attention deficit as avoidable. Alternative treatments to a stimulant medication range from natural products to psychotherapeutic techniques and highly technological interventions. It has been argued that although texts that promote alternative therapies do not directly accuse parents of inadequacy, the claims that the disability is caused by certain factors, such as poor nutrition, supports the culture of mother-blame. [2]

In 1993, as many as 64 percent of families of a child with ADHD used an alternative therapy instead of, or in addition to, prescribed medication. School teachers, family and friends were the most common source of suggestion of alternative therapies. [3] In 2003, 64 percent of families of a child with special health care needs reported that they use alternative therapies. These therapies included spiritual healing, massage, chiropractic, herbs and special diets, homeopathy, self hypnosis and other methods of complementary and alternative medicine. The need for an alternative therapy was related to the child’s condition and to its evaluation as repairable or not. [4]


Critical view

Disadvantages

While some alternative treatments may be harmful, ineffective treatments and services have opportunity costs because they displace the opportunity to participate in treatments and services that have proven efficiency. [5] More specifically, "many individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either. As a result, they may forfeit the opportunity to obtain treatments that could be more helpful. Thus, even ineffective treatments that are by themselves innocuous can indirectly produce negative consequences" [1].

It is also argued that public funding for the treatment of learning disabilities and developmental disabilities should support effective strategies that lead to improved academic and skill performance; this, however, is not always the case. [6]

Subclasses

Instead of using the more neutral term alternative, skeptics may call these therapies fad, dubious, controversial, pseudoscientific or politically correct.

A therapy or treatment is classified as dubious or controversial in any the following cases:

  • (a) its underlying theoretical rationale is baseless or requires assumptions of the effectiveness.
  • (b) there is little or no unambiguous evidence of its benefits.
  • (c) the research underlying its use does not meet conventional standards of quality or specificity,

or

  • (d) there are simpler and better verified explanations for apparent, superficial effects of its use.

Some advocates for such therapies point out that scientific methods cannot formally disprove a premise that a therapy ”works”. Many of the therapies have, however, been directly criticised in scientific publications, and either their stated theoretical rationales have been effectively disproven or their claimed benefits have been found, in evaluative and controlled research, to be evanescent or nil.

Pseudoscientific practices persist in circumstances where practitioners adhere to applying outdated methods of clinical service that have been disconfirmed by subsequent research.

Politically correct treatments are based on somewhat scientific, nonscientific, pseudoscientific or even antiscientific rationales, and are adopted because they resonate with the ideological perspectives of their proponents. Such treatments are meant to enhance the status of people with disabilities but lack support in research. [7]

Characteristics

G Emerson Dickman identifies the following characteristics as common to alternative or controversial therapies.

  • Intuitive appeal: these therapies are based on theories that seem to make sense for non-experts giving simple answers to complex questions.
  • Anecdotal record of success: there are satisfied customers willing to speak in favor of a treatment on the base of their own experience. The positive outcome of the treatment, however, is likely to be due to factors that are unrelated to the therapeutic intervention. Such factors include the placebo effect, the Hawthorne effect and the customers' willingness to be rewarded for their effort and expenditure.
  • Guru factor: the proponent of the therapy is knowledgeable and charismatic, with the ability to clear up the parents confusion and guilt.
  • No unexplained failures: if the treatment does not help, the failure is explained by external influences, such as the parent misunderstanding the goal of the therapy or not sufficiently following through the program; or the therapy providing the groundwork for future, not immediate growth; or the child being lazy and unmotivated.
  • The lack of research-based support is due to professional jealousy: the therapy is said to be so good that it threatens the position of mainstream scholars and treatment providers. The proponents claim to ”think out of the box”, defying rigid old paradigms.
  • All forward progress is related to the therapy even though there may be several other factors behind it, such as maturization of the child, exposure to other educational opportunities, and suggestive effects.

Many of the characteristics are related to the self-serving bias of the human nature. An experienced clinician can also seem to be aware of the problems and describe the characteristics of a child after 15 minutes of discussion and make the parents believe he or she knows their child. This knowledge is based on experience, not research; knowing the question does not mean knowing the answer [8].

List of controversial therapies

Template:TotallyDisputed-section

Name Proposed for Explanation for being non-standard
Applied Kinesiology Learning disabilities and developmental disabilities Generally classified as pseudoscience. [9] [10] No evidence for efficiency while some applied kinesiology methods may be harmful. [10]
Cerebellar-vestibular dysfunction
Davis Dyslexia Correction Dyslexia, ADD, ADHD "There does not appear to be literature to support the orientation disorientation theories". "Available reports at this time are largely anecdotal". "The concern with this research design is that the program is a developmental one and will be used before children have easily identified learning deficits". "Actual teaching to read or even teaching to learn seems to be absent from Davis' teachings" [11]
Dore programme (aka DDAT)
EEG Biofeedback
Fast ForWord Dyslexia Insufficient support for effect in reading remediation. [12] [13]
Ingestive treatments for learning disorders
Irlen filters (tinted lenses and overlays) Learning disabilities and autism Insufficient support for the theoretical basis. Helps some people with vision problems, but the diagnosis suffers from poor reliability. [14] [15]
Optometric visual training
Patterning
Sunflower therapy Learning disabilities No effect on academic skills. [16]

Counter-criticism

Alternative therapy adherents propose lists of research that supports their interventions, but they tend to be considered to be controversial by reviewers. Fast ForWord, for example, was developed through collaboration of scientific researchers, such as Rutgers University neuroscientist Paula Tallal. The Fast ForWord web site lists more than 100 scientific journal article which are claimed to support its program, including 52 authored or co-authored by Tallal.[2] Another web site, maintained by The Optometrists Network, lists more than 140 research journal articles purportedly evaluating or supporting vision therapy.[3]

The International Dyslexia Association advocates methods based on Orton-Gillingham principals, which are supported primarily by anecdotal evidence and have been determined to have insufficient research support to draw any conclusions as to their efficacy.[17][18]

Peer-reviewed journals

References

  1. ^ Vyse, Stuart (2005), "Where Do Fads Come From?", in Jacobson, Foxx & Mulick (ed.), Controversial Therapies for Developmental Disabilities. Fad, Fashion, and Science in Professional Practice., Lawrence Earlbaum Associates, ISBN 0-8058-4192-X.
  2. ^ Malacrida (2002). "Alternative Therapies and Attention Deficit Disorder: Discourses of Maternal Responsibility and Risk". Gender & Society. 16 (3): 366–385.
  3. ^ Stubberfield (1999). "Utilization of alternative therapies in attention-deficit hyperactivity disorder". Journal of paediatrics and child health. 35 (5): 450–453.
  4. ^ Sanders; et al. (2003). "Use of Complementary and Alternative Medical Therapies Among Children With Special Health Care Needs in Southern Arizona". Pediatrics. 111 (3): 584–587. {{cite journal}}: Explicit use of et al. in: |last= (help)
  5. ^ Newsom C. and Hovanovitz C. A. (2005), "The Nature and Value of Empirically Validated Interventions", in Jacobson, Foxx & Mulick (ed.), Controversial Therapies for Developmental Disabilities. Fad, Fashion, and Science in Professional Practice., Lawrence Earlbaum Associates, ISBN 0-8058-4192-X.
  6. ^ Zane T. (2005), "Fads in Special Education: An Overview", in Jacobson, Foxx & Mulick (ed.), Controversial Therapies for Developmental Disabilities. Fad, Fashion, and Science in Professional Practice., Lawrence Earlbaum Associates, ISBN 0-8058-4192-X.
  7. ^ Jacobson, Foxx & Mulick (2005), "Preface", in Jacobson, Foxx & Mulick (ed.), Controversial Therapies for Developmental Disabilities. Fad, Fashion, and Science in Professional Practice., Lawrence Earlbaum Associates, ISBN 0-8058-4192-X.
  8. ^ Dickman, G. Emerson (2001). "Did you know?". Perspectives. 27 (3): 31–32.
  9. ^ Carroll, Robert T. "The Skeptic's Dictionary: Applied kinesiology". . Retrieved 2003. {{cite web}}: Check date values in: |accessdate= (help)
  10. ^ a b Barrett, S. "Applied Kinesiology: Muscle-Testing for "Allergies" and "Nutrient Deficiencies"". Quackwatch. Retrieved 2007-9-28. {{cite web}}: Check date values in: |accessdate= (help)
  11. ^ Cicci, Regina (Summer 2001), "The Gift of Dyslexia by Ronald D. Davis" (PDF), Perspectives, vol. 27, no. 3, International Dyslexia Association, pp. 10–11, retrieved 2007-07-27 {{citation}}: Cite has empty unknown parameter: |1= (help)
  12. ^ Macaruso and Hook (Summer 2001), "Auditory Processing: Evaluation of Fast ForWord for Children with Dyslexia" (PDF), Perspectives, vol. 27, no. 3, International Dyslexia Association, pp. 5–8 {{citation}}: Cite has empty unknown parameter: |1= (help)
  13. ^ Gillam, Loeb & Friel-Patti (2001). "Looking Back - A Summary of Five Exploratory Studies of Fast ForWord". American Journal of Speech-Language Pathology. 10 (August): 269–273.
  14. ^ Helveston, Eugene M. (Summer 2001), "Tinted Lenses" (PDF), Perspectives, vol. 27, no. 3, International Dyslexia Association, pp. 12–13
  15. ^ Hollis & Allen (2006). "Screening for Meares-Irlen sensitivity in adults: can assessment methods predict changes in reading speed?". Ophthalmic & physiological optics. 26 (6): 566–71.
  16. ^ Bull, L. (February 2007). "Sunflower therapy for children with specific learning difficulties (dyslexia): A randomised, controlled trial". Complementary Therapies in Clinical Practice (1): 15–24.
  17. ^ "Orton-Gillingham Approach" (PDF). Florida Center for Reading Research. Retrieved 5/23/07. {{cite journal}}: Check date values in: |accessdate= (help); Cite journal requires |journal= (help)
  18. ^ Ritchey, K.D. (2006). "Orton-Gillingham and Orton-Gillingham Based Reading Instruction: A Review of the Literature". The Journal of Special Education. 40 (3): 171–183. {{cite journal}}: |access-date= requires |url= (help); Text "http://www.ingentaconnect.com/content/proedcw/jse/2006/00000040/00000003/art00005" ignored (help)
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