Understanding Controversial Therapies for Children with Autism, Attention Deficit Disorder, and Other Learning Disabilities

A Guide to Complementary and Alternative Medicine

Lisa A. Kurtz

• Publisher: Jessica Kingsley Publishers
• Year: 2008
• Print ISBN: 9781843108641
• eBook ISBN: 9781846427619
• Topic: Education
• Subtopic: Learning Disabilities

Offering a balanced overview of complementary and alternative therapies, this book will be useful for parents of children with autism, ADD or other learning disabilities.

The book covers a wide variety of mind-body interventions and manipulative techniques, as well as energy therapies, biologically based methods, and alternative medical systems. For each approach, the author provides a detailed description of what the treatment involves, which professionals will be working with the child, and an explanation of the rationale behind the therapy. She also offers advice on who to approach for treatment, and includes a list of recommended resources and useful contacts for further information.

This book will be a valuable source of information for parents and professionals working with children who have disabilities that impact their learning or behavior.

PART 1

INTRODUCTION

Chapter 1

INTRODUCTION

Children with disabilities are at risk for experiencing problems in many aspects of their lives, including becoming independent in daily living skills, meeting academic expectations, learning to communicate, maintaining emotional and behavioral regulation, adapting to the social demands of society, and developing motor proficiency. Among children with disabilities, those with autism spectrum disorders, attention deficit disorders (ADD), and specific learning disabilities have received particular attention in the literature, and pose significant challenges to parents, teachers, and other professionals who hope to provide them with interventions that best ameliorate their difficulties.

Professionals who diagnose these disorders understand that certain defining traits or characteristics are used to determine if a child “fits” the criteria for a particular diagnosis, and have developed protocols for testing and clinical assessment that can strongly suggest or confirm a diagnosis. For example, all children with autism spectrum disorders demonstrate problems impacting social reciprocity, communication, and behavior. Children with ADD display developmentally inappropriate levels of inattention or hyperactivity that are not related to medical or social-emotional factors, and that cause impaired adaptive performance at home, in school, or in situations requiring social interaction. Children with specific learning disabilities demonstrate a significant discrepancy between their ability to learn (based upon measures of intelligence) and their actual learning, and this discrepancy cannot be attributed to medical, economic, cultural, or social disadvantages that might account for the discrepancy. However, within each of these diagnostic groups, an enormous number of individual differences exist. Some children with autism learn to talk, while others must be trained to use non-verbal forms of communication. Many children with ADD are hyperactive, but others have under-responsive attention systems, and are lethargic and slow to respond to learning challenges. Children with specific learning disabilities exhibit wide variability as to their cognitive strengths and weaknesses, learning styles, and response to various curricula and instructional methods. Some children struggle with motor coordination or speech articulation, while others do not. Furthermore, some children with developmental disabilities may have related or concomitant disorders that complicate their individual profile. The presence of hearing or vision impairments, emotional disturbances, or other medical conditions greatly influences the impact of the disability on the child’s ability to cope and to learn. Finally, factors such as the child’s personality and temperament, emotional resilience, the strength and commitment of family support, and the availability and affordability of appropriate services can also greatly influence the unique prognosis for each individual child.

With such wide variety in the learning styles and differences among these children, it is no surprise that professionals have yet to agree upon the best practices for intervention. Certainly, guidelines do exist. There is significant pressure within medical and educational communities to provide treatment that is based upon scientific evidence of success and that focuses on relevant outcomes (sometimes called evidence-based practice). This typically requires that the specific intervention is isolated from other interventions, and is then subjected to a controlled study in which researchers look at the outcome of children who are randomly selected to receive the targeted intervention as compared with children who receive an alternative or no intervention. Because the researchers are not told which children are receiving the targeted intervention, this is known as a blind study. Treatments that have been subjected to multiple blind studies that successfully document effectiveness, and that are then put through rigorous review and critique by professional peers so that the results can be published in reputable journals are often then accepted into conventional or mainstream medical or educational practices. However, many types of intervention for children with developmental disabilities do not lend themselves easily to this type of study. Because of the variability of individual characteristics in children with disabilities, it is often hard to put together a group of children who are similar enough to be considered a “unique” group. If there is too much variability in the study group, and some subjects improve while others do not, it is hard to know whether the changes that are observed relate to the intervention or to individual differences among members of the study group. Also, many studies take place over a period of weeks, months, or longer. If improvement occurs, it is difficult to demonstrate whether improvement is attributable to normal maturation as opposed to the effects of the intervention. Furthermore, many interventions for developmental disabilities are dynamic in nature, requiring the development of a therapeutic rapport with the child, along with active participation on the part of the child, family, and others involved with the child. These personal variables are difficult to control in a scientific study. This makes scientific study of developmental interventions potentially more complicated than the study of effectiveness of a specific drug, exercise, surgery, or other more concrete type of intervention.

The interventions that are commonly recommended by professionals may be governed by a variety of regulatory practices that have been developed in consideration of scientific evidence. In the United States, federal and state regulations offer standards and guidelines for providing services within early intervention and educational settings (see Individuals with Disabilities Education Improvement Act (IDEIA) 2004). In the United Kingdom, a government code of practice, the Special Educational Needs and Disability Act 2001, offers guidance to local education authorities and state schools on how to identify, assess, and monitor students with special learning needs. Professionals who are licensed or otherwise regulated in their practice must operate within the scope of practice as defined by their profession or by local regulatory agencies. Also, the specific interventions recommended by professionals may or may not be covered under various insurance or other reimbursement agencies. All of these regulatory practices are designed to help to assure that children have access to treatments that meet approved standards of care and are likely to be effective.

This book is intended to offer parents and professionals a brief overview of certain non-conventional, controversial interventions that may be considered for children with developmental disabilities including autism spectrum disorders, attention deficit disorders, and specific learning disabilities. Its purpose is to help readers to understand the basic theory behind each intervention, the typical procedures involved, and where to go for more information about the intervention or about the qualifications of professionals using the intervention. It is in no way meant to endorse or condemn any of the interventions described, nor to offer medical or educational advice, but simply to help readers to expand their knowledge of available interventions. The interventions discussed offer a representative, but not comprehensive, overview of available therapies at the time this book was written. Resources listed in the appendix can offer readers a mechanism for staying informed about controversial therapies as scientific evidence is gathered about those interventions included in this book, or as other interventions become available.

REFERENCES

US Department of Education (2004) Individuals with Disabilities Education Act (IDEIA). Available at http://thomas.loc.gov/cgi-bin/query/z?c108:h.1350.enr:, accessed on 3 December 2007.

Special Educational Needs and Disability Act (2001) London: The Stationery Office. Available at www.england-legislation.hmso.gov/acts.acts2001/ukpga_20010010_en_1, accessed 17 December 2007.

DISCLAIMER

This book is intended for informational purposes only, and is not meant to provide specific medical or psychoeducational advice. Opinions expressed are those of the author, and should not be taken as an endorsement nor condemnation of any intervention method or procedure. All decisions about treatment for children with disabilities should be made in consideration of the available scientific evidence for effectiveness and safety, and should be discussed with the child’s pediatrician and other qualified professionals involved in the child’s care. The author disclaims all liability, loss, injury, or damage incurred directly or indirectly as a result of use of any information contained in this book.

Chapter 2

THINKING OUT OF THE BOX

An Overview of Complementary and Alternative Medicine Approaches

Medicine can be described as the practice of maintaining or restoring health through the study, diagnosis, and treatment of disease and injury. Conventional medicine refers to the provision of medical care as shared by doctors (Medical Doctors or MDs, and Doctors of Osteopathy or DOs) and by allied health professionals, including nurses, psychologists, occupational therapists, speech-language therapists, physical therapists, and others. The practice of conventional medical care is regulated through various professional licensing and credentialing boards that assure the public of the competency of members. In conventional medicine, practices and interventions are based upon sound scientific research that proves both the efficacy and safety of the intervention. These interventions are therefore widely accepted among the broad medical community. Conventional medicine may also be referred to as Western medicine, orthodox medicine, mainstream medicine or allopathy.

Complementary and Alternative Medicine (CAM) refers to a diverse array of health care systems, practices, and interventions that are not considered to be part of conventional medicine. Although interventions included in this category may have undergone research and may have popular acceptance among consumers, there are generally insufficient data available to assure the outcome and safety of the interventions. Training in the use of CAMs can be highly variable, in some cases leading to credentialing, such as licensure for massage therapists, or voluntary certification in certain auditory training programs. Unfortunately, however, it is not uncommon for professionals to incorporate use of CAMs as part of their practice with little or no formal training. In fact, some lay personnel practice interventions with virtually no formal professional training or credentialing, and with a very limited understanding of the basic concepts underlying the health and psychosocial well-being of their clients. The list of interventions that are considered to be CAMs undergoes continual change as some are proven effective and are adopted by conventional medical practice, while newer therapies and interventions are proposed and introduced to the public.

Although complementary and alternative medical practices are often referred to together as CAMs, there are important distinctions between the two. Complementary medicine refers to interventions that are used along with more conventional treatment. For example, yoga might be used to achieve a calm and relaxed state prior to a challenging physical therapy exercise program, or aromatherapy might be used to promote alertness prior to a reading instruction session for a child with learning disabilities. The practice of using safe combinations of conventional and non-conventional medicine is sometimes referred to as integrative medicine. Alternative medicine is used to describe interventions that take the place of traditional medicine, for example, seeking treatment from a homeopathic physician instead of an MD or DO, or using elimination diets as a substitute for prescription medication to reduce hyperactivity in children with attention deficit disorder. The use of CAMs has gained increasing popularity in recent years, especially as there is greatly increased access to information about therapeutic options through the Internet. For parents of children with lifelong developmental differences, frustration with slow progress using more traditional approaches, or limited access to those services, may encourage them to seek other answers. Parents may also choose to explore the use of CAMs based upon the recommendations of friends or professionals they trust, or based upon personal beliefs and traditions. For example, less invasive therapies may be attractive to parents who fear the potential side effects of drugs used in conventional medicine, or they may find it easier to support a therapeutic intervention that is consistent with their own activity preferences, such as music, dance or martial arts. In fact, according to the National Institutes of Health, more than one-third of adults in the United States use some form of complementary or alternative medicine (Barnes et al. 2004). Most doctors of conventional medicine are open to discussing the use of CAMs with patients and their families, and some will consider making a referral under the right circumstances. Other physicians, however, are cautious about recommending alternative treatments due to their susceptibility for medical liability (American Academy of Pediatrics 2002).

In 1992, the United States Congress created the National Center for Complementary and Alternative Medicine (NCCAM) as one component of the National Institutes of Health. This organization classifies CAM therapies into five categories or domains. The subsequent chapter presents a description of selected CAMs organized according to this model. The five domains are described as follows:

1.Alternative Medical Systems, based upon complete systems of theory and practice, such as homeopathic medicine or Ayurveda.

2.Mind-body Interventions. These use a variety of techniques designed to enhance the mind’s capacity to affect bodily functions and symptoms (for example, meditation or creative arts therapies).

3.Biologically-based Therapies, which use substances found in nature, such as herbs, foods, and vitamins.

4.Manipulative and Body-based Methods, which are based on manipulation and/or movement of one or more parts of the body, such as chiropractic or massage.

5.Energy Therapies, involving th...

Table of contents

• Cover Page
• Title Page
• Copyright
• Contents
• Part I: Introduction
• Part II: Selected Interventions
• Part III: Resources for Children with Autism, Attention Deficit Disorders, and Other Learning Disabilities
• Subject Index
• Author Index
• Back Cover