The other week after my blogging about dyspraxia and such, hubby found an article in wired blogs (“Hacking My Child’s Brain”) and a recent article in the New York Times, “The Disorder Is Sensory; the Diagnosis, Elusive”. Although sensory integration remains a vaguely-defined albeit real disorder, treatments are highly varied and disputed. Some treatment approaches lack rigorous testing for efficacy, creating difficulties for insurance coverage.
One approach mentioned in the former article is from the Sensory Learning Center in Boulder, Colorado (US), and is described as suitable for a long list of issues: autism, Asperger’s Syndrome, acquired brain injury, developmental delays, birth trauma, behaviour problems, ADHD, and for “learning enhancement”. Their Web site is rife with testimonials from clients and practitioners.
Well, testimonials don’t sway me, I want evidenced-based medicine/ practice. Curiously, a search of PubMed doesn’t bring up anything under the founder’s name, Mary Bolles. Even looking up the method name doesn’t bring up any research. Looking at the company’s information page about Bolles reveals that she has a BA, which would explain why her name is missing from the standard medical research database — she’s apparently not done postgraduate research work. For someone who’s an expert in a field that she has created nearly by herself, there’s an amazing dearth of evidence to the fact. In science, the goal is to share research results and thus increase the understanding of processes within a given field. (Hence the incredible number of science research journals out there.)
The biography also notes that Bolles is an associate member of the “College of Syntonic Optometry”, which if one looks through that Web site, shows that their research apparently runs into the realm of the silly, with patients’ perceptions of specific colors of light as indicating problems with different body organs, and likewise exposure to different colors of light are treatments for various health issues. Which brings us back to the SLC, where their method is not described specifically. But there is an article (“Mind-boggling Therapy” from the Flint Journal, 21 June 2004) that describes the process:
This table slowly moves in a gentle, rotating motion, sometimes from left to right and other times from “head to toe.” At the same time, headphones placed over the child’s ears play music, but with the input going in the right ear twice that of the left. According to some theory, this “right ear dominance” stimulates the left side of the brain, where the language and communication centers are located. The only thing the child sees during this process is a circle of light shining directly overhead, with the color of the light changing over the course of the sessions.
(Whee! Maybe I just need to find a playground with an old-fashioned merry-go-round and play with my equilateral prism … )
Now, it’s not news that multisensory learning (seeing, hearing, doing) works better for most people; that’s why including visuals and labs with lecturing helps students understand and learn things better. Nor is it a secret that people differ in their abilities to learn from different modalities. This is especially true for people with sensory-related disabilities, where the sensory inputs and/or the perceptual processing does not work optimally. But a few sessions with a light and sound augmented tilt-a-wheel is probably not going to reconfigure someone’s sensory processing. The program’s description page even says that, “The Sensory Learning Program is not a treatment. It is not a curative.”
$3,000 is a lot of money to drop on a non-treatment non-cure that is unproven. And when people start talking about “subtle” improvements seen, this suggests a number of (unconscious) cognitive biases, such as selective perception, investment bias (post-purchase rationalisation — we value something more when we’ve spent a lot of money on it), and/or placebo effect. And sometimes there’s just plain ol’ maturation. It’s easy to forget that many children (especially those with developmental disabilities) don’t mature evenly, and will often achieve things later, and will improve and make gains in abilities in spurts. In other words, children naturally show what the SLC refers to as “changes in cumulative skills unfolding over the following weeks or months”. People want to see their children improve, so they associate positive changes with any previous treatment, or treatments, as some people will employ several at once in desperate efforts for something to cure the problem.
When I find Web pages where treatments are full of testimonials based upon subjective evidence, and the treatment is hawked as having the ability to fix any number of problems, and the company is selling program franchise (to almost any sort of professional or interested business person, regardless of training), and the founder is a pioneer in some unheard-of field without credits in refereed research journals, well, I get suspicious.
I’m not saying that all therapies are bogus. For example, studies have shown that phototherapy is helpful with Seasonal Affective Disorder. And it may be that some aspects of this therapy are useful for some things. But who’s to know? How can we sort out bogus therapies, even those that are derived from earnest efforts? After all, good intentions plus no results still equals no real results. We need objective measures, and double-blind testing to sift out the unconscious biases (that’s one reason why we invented statistics).
I would like for there to be some good treatments to resolve various issues. But wanting doesn’t make it so, and it’s unhelpful to conflate proven therapies with nonsense. What we as therapists, parents, and clients really need are for different approaches to be objectively evaluated and tested, and for good research to determine more concrete ætiologies of different issues so better therapies can be developed.
Otherwise people are just spinning rainbow-colored promises and making money off of desperation.