LD and chiropracty–NOT

Chiropractors are likely to complain about the treatment that their methods receive in posts on this blog. I’ve posted recently that I find wanting the bases for the the (currently-on-tour, see-’em-in-your-neighborhood-soon) Brain Balance Music program. This post will be even more alarming to supporters of those sorts of treatments for LD.

The fundamental problem with the therapies for Learning Disabilities recommended by some chiropractors is that those therapies are bogus. They may be advocated by people who honestly believe that they’re recommending helpful stuff. The hypothetical relations among the neurological and behavioral factors may sound sensible, but that is, in large part, because we’re listening to the words rather than the facts. The folks may have seen what they believe are legitimate improvements in children’s academic and social behavior after the children received the therapy. Parents may have told them how much better the children seem.

None of that counts as scientific (i.e., objective, generalizable, refutable) evidence of benefits. The advocates may be as seriously misled as they mislead their potential clients. They just don’t have the data. Their explanations are post hoc and untested, at best.

In addition to the probably benign Brain Balance Music methods, consider one of the other chiropractic therapies: Cranio-sacral therapy: The hypothesis is that something about the connection between the child’s head and tail causes learning problems (even mental retardation and autism!) and it can be corrected by chiropractic manipulations.

In the 1980s, Dr. Carl A. Ferreri suggested a variation on chiropractic treatment as a way to address Learning Disabilities. Dr. Ferreri and Richard B Wainwright—their book title Breakthrough For Dyslexia and Learning Disabilities turns up in greater than 300 links on Google—promoted the Neurological Organization Technique (N.O.T.).

What is the N.O.T.? It’s a tad hard to say definitively. However, folks at a site called “K Zone” (the “K” probably stands for “kinesiology”) from High Wycombe (UK) have a brief statement also entitled “Breakthrough For Dyslexia and Learning Disabilities,” and it gives some basic background.[1]

In 1982 Dr. Carl A. Ferreri, D. C., in researching the Applied Kinesiology concepts in relatian to the survival mechanisms of the human body, recognized the relationship between his Neural Organisation Techniques and the symptomatology of Dyslexia and Learning Disabilities. Combining the organisational effects of the centring and righting reflex systems of the Cloacal, Labyrinthine and Ocular reflex mechanisms; the specific cranial faults found in all Dylexics and Learning Disabled; and a unique eye muscle fault found only in Dyslexics and the Learning Disabled, has led to an asounding reversal of all the problems found in the Dyslexic and Learning Disability Condition.

Whatever that is, the therapy is to manipulate (in the chiropractice sense of the word) parts of the cranium. It’s called “craniosacral therapy.” What’s that? Here’s a hint from Dr. Michael Kern, an osteopath affiliated with the Biodynamic Craniosacral Therapy Association of North America

The emphasis in Biodynamic Craniosacral Therapy is to help resolve the trapped forces that underlie and govern patterns of disease and fragmentation in both body and mind. This involves the practitioner “listening through the hands” to the body’s subtle rhythms and any patterns of inertia or congestion. Through the development of subtle palpatory skills the practitioner can read the story of the body, identify places where issues are held and then follow the natural priorities for healing as directed by the patient’s own physiology.

The intention of treatment is to facilitate the expression of the Breath of Life and so enhance the body’s own self-healing and self-regulating capabilities. This is done in a non-invasive way as the practitioner subtly and gently encourages the conditions that allow for the reemergence of primary respiratory motion. Furthermore, the practitioner’s deep and clear quality of presence can become a reflective mirror for the patient and an invaluable cue for their potential for change.

In practice, the therapist applies very slight pressure (~5 grams) on parts of the patient (or, in our case, the individual with LD). This massage is supposed to affect the alignment of the bones in the patient’s skull and, through the spine, the sacrum (a bone at the base of the spine).

So, what’s the matter with this? Well, it’s worse than simply being benign (a la music). Consider the story of Del Norte (CA, US) local educational agency, which elected to have N.O.T. provided to its students with disabilities.

Despite an absence of scientific evidence, and lack of endorsement by any recognized organization that deals with learning disorders, Ferreri was able to convince the school psychologist, Roy Krause, of the Del Norte school district (Crescent City, Calif) that his method held promise for the learning disabled children of his district. Krause convinced the school board to allow Ferreri to set up a research project in which chiropractors would manipulate children’s skulls in an attempt to rid them of their learning difficulties. Rather than focusing upon a single type of problem, the children included a mix of disorders. The method involved holding the child in a headlock and pressing on the roof of their mouths with the hope a achieving a click. Thumbs were also pressed into the children’s eye-sockets. Parents were assured that the method would only possibly cause “momentary and temporary discomfort” in the consent forms they were asked to sign. The reality turned out to be far different. One parent, who helped restrain her child during therapy, testified that the chiropractors applied such tremendous pressure to her son’s skull and roof of mouth that they would break into a sweat and shake with exertion. Children were exposed to such pain that children who had never had seizures, had them now. Children with a history of seizures, were having increased episodes of these. A lawsuit brought against Ferreri by the parents resulted in a $565,000 judgment for damages, plus attorney’s fees.

What more does one need to know? Consult the following non-exhaustive list of sources for additional information. I’m not making this up. It’s an example of how wrong things can go when people do not defer to evidence.

If you know someone who’s pursuing these sorts of treatments for LD, please encourage them to reconsider; they can review the sources here. If you know some school people who are promoting these sorts of treatments for LD, please blow the whistle…call “Bologna!”

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Link to WorldCat entry on the Ferreri-Wainwright book: Ferreri, C. A., & Wainwright, R. B. (1984). Breakthrough for dyslexia and learning disabilities. Smithtown, NY: Exposition.

http://www.neuralorganizationtherapy.com.

Link to the K Zone site and a PDFs of articles “Breakthrough” and “Basis of N.O.T.

There’s a Web site for an organization called Biodynamic Craniosacral Therapy Association of North America

There are a shipload of videos on YouTube about craniosacral therapy.

Larry Silver, a physician who has been contributing to the literature on Learning Disabilities since the 1960s, critiqued Dr. Firreri’s ideas in the International Dyslexia Association newsletter, Perspectives in 2001 (available here).

Link to Liz Ditz’s post that mentions Dr. Silver’s column.

McWilliam, R. A. (2000). Controversial practices: The need for a reacculturation of early intervention fields. In W. Dunn (Ed.), Bringing evidence into everyday practice: Practical strategies for healthcare professionals (p. 326-334). Thorofare, NJ: SLACK.

Jarvis, W. T. (2001). Some notes on cranial manipulative therapy. National Council for Against Health Fraud.

N.O.T. is included in Stephen Barrett’s summary of Mental Help: Procedures to Avoid

Worrall, R. S. (1990). Neural Organizational Technique, treatment or torture? Skeptical Inquirer, 15, 40-50.

Notes

1 I do not know to what extent the people at K Zone (Johnathan Stewart and Rowena Williams) advocate the use of chiropractic techniques for correcting dyslexia and LD; they may have the paper there for historic or other reasons. Also, note that “K Zone” is also or now known as “Blue Lotus Therapies.”

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