Tag Archive for 'interventions'

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Additional weak evidence about chiropractic treatment

Over the holiday weekend, Liz Ditz sent me the reference to a study that I have now downloaded and read. I’m reporting my notes here. I see that she has a related post over on her blog, I Speak of Dreams.

In “Developmental Delay Syndromes: Psychometric Testing Before and After Chiropractic Treatment of 157 Children,” Scott Cuthbert and Michel Barras present the results of an analysis of pretest-posttest scores for children who received chiropractic treatment at a clinic in Lausanne (CH). They reported that the children had higher scores after treatment, leading them to conclude that “This report suggests that a multimodal chiropractic method that assesses and treats motor dysfunction reduced symptoms and enhanced the cognitive performance in this group of children.”

Here is the abstract for this report. After it, I’ll explain why I find this study provides uncompelling evidence in support of chiropractic treatment for Learning Disabilities.
Continue reading ‘Additional weak evidence about chiropractic treatment’

Parents’ and children’s views

The US Public Broadcasting System has two articles that will be of interest to some readers of LD Blog. The titles of them tell enough about the contents, each of which has four subparts, that I can simply list them here:

Flash of the electrons to to Leila over on Special Ed and Me, whose post entitled “Inside the Mind of Someone with a Learning Disability” led me to the articles.

AAP and AAO on vision therapy


Interview with: Walter M. Fierson, MD,
Chair of Learning Disabilities Subcommittee
of Ophthalmology Section, American Academy
of Pediatrics

In “Groups Assail Vision Therapy as Remedy for Learning Disabilities,” Crystal Phend of MedPage Today reported that the American Academy of Pediatrics and American Academy of Ophthalmology jointly issued a statement calling the use of well-known vision therapies unfounded and ineffective.

SAN FRANCISCO, July 27 — Behavioral vision therapy, eye exercises, and colored lenses have no role in treatment of dyslexia and other learning disabilities, according to the American Academy of Pediatrics.

The academy came down hard on these “scientifically unsupported” alternative treatments in a joint statement with the American Academy of Ophthalmology and other vision organizations.

The AAP, which has published many valuable statements about Learning Disabilities in the past, made unequivocal statements about the problems with these therapies. In the accompanying audio clip, Dr. Walter Frierson provides good explanation of the rationale for the recommendations.

Learning disabilities, including reading disabilities, are commonly diagnosed in children. Their etiologies are multifactorial, reflecting genetic influences and dysfunction of brain systems. Learning disabilities are complex problems that require complex solutions. Early recognition and referral to qualified educational professionals for evidence-based evaluations and treatments seem necessary to achieve the best possible outcome. Most experts believe that dyslexia is a language-based disorder. Vision problems can interfere with the process of learning; however, vision problems are not the cause of primary dyslexia or learning disabilities. Scientific evidence does not support the efficacy of eye exercises, behavioral vision therapy, or special tinted filters or lenses for improving the long-term educational performance in these complex pediatric neurocognitive conditions. Diagnostic and treatment approaches that lack scientific evidence of efficacy, including eye exercises, behavioral vision therapy, or special tinted filters or lenses, are not endorsed and should not be recommended.

Pediatrics 2009;124:837–844

Faithful readers of LD Blog will remember that there have been perhaps a half-dozen posts here on the mistaken (at best) therapies promoted to families of individuals with Learning Disabilities. It is valuable to have prestigious organizations such as the AAP and AAO issue statements that support the observations presented here.

Teachers, psychologists, and school administrators: Please advise the parents of your students with reading problems not to waste time and money on colored lenses, eye tracking and eye teaming, and other similar therapies.

Read Ms. Phend’s report. Download the full statement by the AAP. Visit the AAP Web site, especially its section on Learning Disabilities.

Think Aloud redux

Over on Twitter, friend of LD Blog Liz Ditz retweeted this:

RT @Includekidswdis: Stop, Think, Do a program by Lindy Petersen http://is.gd/1FQ0h which can really help children with #ADHD

I took a quick look and immediately remembered the work of Bonnie Camp and her colleagues (especially Mary Ann Bash) during the previous millennium. Dr. Camp and her group developed, researched, and refined methods for teaching children with learning and behavior problems, including attention deficit disorders, to manage their behavior. The Think Aloud program was at the forefront of the cog-mod mania that swept through child clinical psychology and special education in the 70s and 80s.

THINK ALOUD is a psychoeducational training progtam designed to enhance social and cognitive problem solving skills for increasing prosocial behavior and decreasing impulsivity. Much of the program content was chosen to correct cognitive deficits displayed by young aggressive boys. (1,2) Research on verbal mediation indicated that before internal controls could be established, many children needed first to establish effective control by verbalizing aloud then fading to a silent level. The Think Aloud Program was designed to teach children a problem solving process (including problem identificaton, generation of alternative solutions, predicting consequences and evaluating outcomes), how to verbalize aloud, how to apply this process in both cognitive and social situations, then move to silent direction and control of behavior. The original research with the program was conducted in two controlled trials and one refresher program with pairs of 6-8 year old boys rated as hyperaggressive by their teachers. (3,4,7,8,9,12) The manual for this program, along with details of research findings, is presented in Think Aloud: Small Group Program (11).

The numerals in the quote are footnotes (not surprisingly). They refer to only a few of the dozens of sources Dr. Camp provides.

Although it is a bit rough as a Web site, Dr. Camp has created an Internet site for Think Aloud. It features citations for those sources as well as some of the original materials. In addition, she has made some new materials for the program available as downloads.

Link to the Think Aloud site.

About on Irlen

Whoever writes the section of About on Learning Disabilities provides support for Irlen Syndrome. Although there are two sentences expressing reservation and it doesn’t flatly commend the idea, there are 100s of words describing it and making fact-like statements such as “It often runs in families and typically goes mis-diagnosed as a learning disability or dyslexia.”

Here are the two disclaiming statements:

  • “Research in this area, however, is quite limited.”
  • “It is important to note that Irlen syndrome and visual treatments are unproven and not recognized by the major academic Pediatric Organizations in the US(AAP, AOA, and AAO.)”
  • At least there are those two sentence. Still, why report all the other stuff uncritically? But, perhaps I’m misreading the entry or over-reacting. I invite readers to check it (link to the entry) and then vote in this poll.

    [poll id=”7″]

    Functional Disconnection Syndrome

    Here’s one for the faithful: “functional disconnection syndrome.” Let Dr. Kurt W. Kuhn, D.C. and Ph.D. explain:

    Functional Disconnection Syndrome is a condition where there is a functional breakdown in the neurological pathways of the body causing the brain and its neural net to function asynchronously, at a decreased frequency of firing or at a functional level that is below that required for higher cognitive and health requirements.

    A quick review of the medical literature will find the term “functional disconnections” used for all sorts of conditions that are the affect [sic] of neurological dysfunction. Symptoms ranging from behavioral and learning problems to pain and conditions of reduced general health. Functional disconnections can be caused by genetic, environmental, nutritional, stress, toxins, spinal subluxations and other causes.

    Just for grins, I took the challenge. I searched the health sciences databases available via EBSCO, the venerable information management system that says it works with 79,000 publishers. I found one citation referring to “Functional Disconnection Syndrome”; it was a case study describing a psychiatric problem of a 23-year-old woman (Simon, Walterfan, Petralli, & Velakoulis, 2008, Neuropsychobiology, 58).
    Continue reading ‘Functional Disconnection Syndrome’

    Research on chiropractic effects on LD

    Somewhere someone who’s read my two earlier entries about chiropracty and Learning Disabilities probably said, “How can he say chiropractic treatment of LD is ‘bogus?’ Hasn’t he read the research?” Well, I actually did read what research I could find.

    I looked for studies about the effects of chiropracty and LD. I didn’t find any credible studies demonstrating the benefits of chiropractic treatment for LD or related problems. Indeed, the studies I found used inadequate research methods (unrepresentative samples; weak measures; designs that do not permit causal inferences; etc.). I was pleased to learn that my quick review agreed with a review reported by Yannick Pauli.
    Continue reading ‘Research on chiropractic effects on LD’

    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.

    Continue reading ‘LD and chiropracty–NOT’

    NJCLD on adolescent literacy

    The National Joint Committee on Learning Disabilities (NJCLD) held a symposium regarding the release of “Adolescent Literacy and Students with Learning Disabilities: Building Effective Programs and Partnerships Adolescent.” Invited guests representing various US agencies, organizations, and interest groups joined delegates from the organizations that are members of NJCLD the afternoon of Friday 5 June 2009 for the session.

    Mary Beth Klotz, chair of the NJCLD, introduced the session and individual speakers. Froma Roth, a representative of the American Speach-Language-Hearing Association and one of the writing team that prepared the statement, began the session with a brief recapitulation of its contents. Brett Miller followed Professor Roth with an overview of current research supported by the Reading, Writing, and Related Learning Disabilities of the National Institute of Child Health and Human Development, US Department of Health and Human Services. Nancy Hennesy, of the Council for Learning Disabilities and also a member of the writing group, described the complex and challenging context for addressing deficits in adolescent literacy.

    These are the folks who participated in the panel:

    • Mary Beth Klotz (National Association of School Psychologists);
    • Nancy Hennessy (International Dyslexia Association) ;
    • Amanda Karhuse (National Association of Secondary School Principals);
    • Brett Miller (National Institute of Child Health and Human Development);
    • Barbara J. Moore (Anaheim Union High School District, CA);
    • Patti Ralabate (National Education Association);
    • Froma P. Roth (American Speech-Language-Hearing Association); and
    • Kippi Sutphen (Parent Representative).

    Link to the NJCLD Web site (maintained by LD Online). Watch for the slides and other materials from the symposium to be posted there. Meanwhile, download a copy of the NJCLD document.

    Free Current Practice Alerts

    It’s sometimes hard to sort through the rhetoric about different methods used in teaching students with Learning Disabilities. However, two groups within the Council for Exceptional Children have made the task considerably easier. In a series of publications now numbering 16, the Division for Learning Disabilities and the Division for Research cut through the bologna to provide quick reviews about the effectiveness of current educational practices. These Current Practice Alerts, which are readily accessible for general readers, cover familiar topics including these:

    • Class-wide Peer Tutoring
    • Co-Teaching
    • Cooperative Learning
    • Direct Instruction
    • Fluency Instruction
    • Formative Evaluation
    • Functional Behavioral Assessment
    • Graphic Organizers
    • High-Stakes Assessment
    • Mnemonic Instruction
    • Phonics Instruction
    • Phonological Awareness
    • Reading Comprehension Instruction
    • Reading Recovery
    • Social Skills Instruction

    They are succinct and faithful to the research evidence. They even make explicit recommendations about whether to use the practice. What’s the hitch? Well, they’re free, so see for yourselves.

    Link to the Web page listing these resources.