Myths, scams, shams, and BS
How should we recognize faulty recommendations?
Among the categories of disabilities included in special education, learning disabilities and autism have probably had more than their share of myths, scams, shams, bologna, and horse pucky. These misrepresentations are widespread in our culture. Some of them are relatively harmless but others are potentially harmful. Both the harmless and the harmful need to be recognized and avoided, and we people concerned about children’s disabilities should discuss them openly.
Some myths seem virtually unsinkable, and I’m sorry to admit that I’m nearly exhausted from debunking them. For example, even though there is no credible evidence that reversing letters and numerals is a diagnostic indicator of learning disability, that connection is repeated so often that it has great currency. The topic of reversals deserves an entire post of its own, but suffice it to say that the observed connection between reversals and disability is mostly predicated on an illusory correlation; in a nutshell, kids with LD may make more reversal errors, but they only make more such errors because they make more errors overall. Proportionally, the number of reversal errors to overall errors is the same for disabled individuals and those who have no disability.
But there are more problemsome concerns about misinformation. Here’s a sampling focusing on LD and autism:
Chiropractic therapy for reading?
Some scams are pretty obvious. For example, few people would probably expect that an adjustment of a child’s spine will help her learn to form grapheme-phoneme connections or blend sounds more smoothly. Well...apparently enough people would believe it might help that there are many chiropractors offering such services. Honest. Try a search of the Web for “chiropractor ‘dyslexia’” (put quotes on the second word; that’ll save you from retrieving all the chiropractors’ Web sites). I think you’ll find lots of offers to take your $$.
You’ll find proposals that chiropractic therapy might reduce stress (maybe?) and that it will alter the flow of neurons through the spine to the cranium and, therefore, the brain. Lots of theory. But will one find evidence that kids who get such therapies read better?
Reasonably, one might be thinking, “Oh, what if it works?” I have found no credible evidence that chiropractic services improve reading performance. In fact, I found an article by an advocate (Pauli, 2007) that questions those practices’ efficacy. Pauli’s review listed seven studies of effectiveness, but the studies employed very weak methods. The review is not something I’d recommend for publicaion in an academic journal, but even he didn’t find credible evidence: “...from a clinical outcome point of view, the research reviewed in this article belongs to the lowest level of evidence and demonstrates numerous methodological weaknesses that prevent us from drawing definite conclusions” (p. 9) and, “we therefore conclude from this review that evidence for the effect of chiropractic care in children suffering from LD and dyslexia has to be considered preliminary” (p. 9).
Heavy metals and autism
Some people promote the idea that autism is caused or exacerbated by heavy metals in children’s bodies. Those heavy metals get there, according to advocates, because of pollution, diet, vaccinations, or other sources.
Most readers of SET will know that these ideas have been thoroughly debunked. To be sure, there are risks associated with, for example, pollution (and they should be addressed), but recommending detox therapies like chelation to relieve them of disabilities is a bridge too far. A review by James et al. (2015) found one study and essentially no evidence of effectiveness in clinical trial research. The review is modest in quality, though, what is worse is that there are cases in which the chelation process raised concerns about it killing children (Brown et al., Sinha, 2006)
Thinking a bit
Why are such therapies untenable. Well, please start with the absence of evidence that the therapies help children. And then follow up with the evidence that those procedures are actually harmful. If we pay for therapy-program-method #8 and it has no benefits, should we keep paying for it?
Usual concerns about research methods apply. For example, some studies used by advocates to argue their theories or therapies are beneficial are suspect. They are self-published (they didn’t go through peer review); others depend on methods (i.e., case studies) that don’t permit strong inferences about effectiveness; some used participants who came back repeatedly for therapy, essentially eliminating non-responders; others used measures of outcome (e.g., participants’ self-reports about “things being better”); etc. In essence, most of the tests of alternative therapies such as chiropractic, optometric, and similar quasi-medical therapies have a theoretical basis on which to stand, but few (if any) have shown that they have evidence of helping kids in important ways (i.e., actually reading, writing, or behaving better). At best, they have evidence that kids say they feel better.
Many sham therapies are hawked by people who adopt actual scientific terms. For example, diagnoses (e.g., “cerebellar-vestibular dysfunction” or “cranio-sacral disorder”) and scientific sounding names for therapies (e.g., “Neural Organizational Technique” or “syntonics”) are a part of their pitch. They even refer to research using fMRI techniques or demonstrating the benefits of their therapies. They’re misappropriating the terminology and the techniques. Just ask a reputable psychologist at nearby universities (get two so you don’t find one who’s been hoodwinked).
These examples of the misrepresentation of LD are pretty easy to debunk. A careful reader can shoot holes in the research—when there is any research—without much trouble. In addition, there are reputable sources that show the problems with some of these therapies.
Other diagnoses and therapies are a little less obvious. For example, sensory integration therapy and optometric training have been the focus of research. Few rigorous studies have been conducted, and those that have been done provide equivocal support, at best. Anecdotal evidence sustains these practices. Those with a scholarly bent will find the book “Controversial Therapies for Developmental Disabilities: Fad, Fashion, and Science in Professional Practice,” edited by the late John W. Jacobson, Richard M. Foxx, and James A. Mulick [Mahwah, NJ: Erlbaum, 2005] informative.
These misrepresentations are discouraging when one realizes how much we actually know about autism and LD these days. Thanks to rigorous and sustained research, we have very solid ideas about fundamental reading instruction (“phonemic awareness” and “phonics”), the importance of providing adequate practice trials (“opportunities to respond”), teaching students to approach and complete tasks systematically (“learning strategies”), and etc.
So, before we have our students staring through colored overlays at blinking lights while strapped into chairs that rotate or while balancing on alternating feet, let’s remember what we do know about teaching students with disabilities: It takes hard work over extended periods of time with careful attention to the quality of the instruction.
I think there are some markers about interpretationa and treatments that can alert us to BS. Now, my analysis is preliminary; I haven’t conducted a formal exanination. But it seems to to me like many bologna therapies use language like conspiracy theories. Lots of sham treatments seem to use hints and innuendos. They frequently use weasel words such as “may,” “people say,” “a gowing body of evidence shows,” “some,” “a bit” and other ways to avoid making a definitive statement. They say that there is secret knowledge (e.g., Greutman, 2017) that has been obscured from parents and teachers. They obfuscate their recommendations by referring to lots of semi-scientific gobbledygook.
I say, “Watch out for that bologna!”
In my view, we need to communicate this idea to parents parents, educational colleagues, and the general public.
Greutman, H. (2017, 17 October). The secret sensory culprit that makes reading and writing challenging for your child. Growing Hands-on Kids. https://www.growinghandsonkids.com/the-secret-sensory-culprit-that-makes-reading-and-writing-challenging-for-your-child.html
James, S., Stevenson, S. W., Silove, N., & Williams, K. (2015). Chelation for autism spectrum disorders (ASD). Cochrane Library. https://doi.org/10.1002/14651858.CD010766.pub2
Joseph, M. R. (1989). Dyslexia--the chiropractic approach. Education, 109(4).
Pauli, Y. (2007). The effects of chiropractic care on individuals suffering from learning disabilities and dyslexia: A review of the literature. Journal of Vertebral Subluxation Research. http://adhdwellnessexpert.s3.amazonaws.com/Library%20Vault/Dyslexia.pdf
Sinha, Y., SilSinha, Y., Silove, N., & Williams, K. (2006). Chelation therapy and autism. BMJ, 333(7571), 756. https://doi.org/10.1136/bmj.333.7571.756
Note: I published an earlier version of this post on LDBlog years ago—JohnL.