Interesting archive I found from 2007 (when NACD was first brought up)

[Guest guest]

Many long links you'll have to cut and paste -but you'll get the point

From:

[mailto: ] On Behalf Of

Spencer

Sent: Tuesday, October 09, 2007 11:48 PM

Subject: [ ] NACD

Hello all,

I don't want to rain on anyone's parade, but if you are planning on

looking into NACD for your child and family, please check out this

website. I am a firm believer in alternative treatments, and have

founds some that have worked with no explanation for my 6 yo apraxic

son. However, I do believe that anyone interested in this should go

in with their eyes wide open. The site below is the website for the

American Academy of Pediatrics. It contains the following article:

AMERICAN ACADEMY OF PEDIATRICS:

The Treatment of Neurologically Impaired Children Using Patterning

Committee on Children With Disabilities

http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/1149

in peace,

mom to Jonah

FW: [ ] NACD

Wed Oct 10, 2007 10:15 am

llangley@...

THE THEORY

Neurologic organization, the principle central to the patterning theory of

brain functioning, is an oversimplified concept of hemispheric dominance and

the relationship of individual sequential phylogenetic development.16

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B16> 23-25

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B23> This theory also states that failure to complete properly any stage

of neurologic organization adversely affects all subsequent stages and that

the best way to treat a damaged nervous system is " to regress to more

primitive modes of function and to practice them. " 17

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B17> According to this theory, the majority of cases of mental

retardation, learning problems, and behavior disorders are caused by brain

damage or improper neurologic organization, and these problems lie on a

single continuum of brain damage, for which the most effective treatments

are those advocated by patterning.3

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B3> ,16

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B16>

Current information does not support these contentions. In particular, the

lack of dominance or sidedness probably is not an important factor in the

cause of, or the therapy for, these conditions.3

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B3> ,16

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B16> ,17

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B17> Several careful reviews of the theory have concluded that it is

unsupported, contradicted, or without merit based on scientific study.16

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B16> ,17

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B17> ,23

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B23> ,25

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B25> Others have described the hypothesis of neurologic organization to

be without merit23

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B23> and concluded that the theoretical rationale for the treatment is

inconsistent with accepted views of neurologic

development.24,27(pp207-235)28(pp207-247)

http://aappolicy.aappublications.org/icons/toc/rarrow.gif

STATUS OF CLAIMED THERAPEUTIC RESULTS

Results published on patterning have been inconclusive.29-31

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B29> Although reports of improvement in reading ability after treatment

have been heralded as support for the theory,32

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B32> ,33

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B33> statistical analysis revealed few demonstrable benefits.34

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B34> ,35

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B35> Controlled studies of reading skills have shown little or no

benefit from treatment.,16(pp333-352)36-38

Some disabled children who purportedly benefited from treatment had been

given a misdiagnosis or an unduly pessimistic prognosis. The course of

maturation in children with neurologic impairments varies, which leads to

unwarranted claims that improvements in their conditions were the result of

a specific form of treatment.17

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B17> ,39

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B39> Some of the cases publicized involved children with traumatic brain

injury or encephalitis, who may make substantial health improvements without

special treatment.

A well-controlled investigation40

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B40> compared 3 groups of children, all of whom were severely mentally

disabled and institutionalized. One group received patterning, a second was

treated by motivational techniques, and a third received routine care. Using

a wide variety of behavioral measures, the investigators found no

significant differences among the 3 groups. On the basis of this study, the

investigators found nothing to recommend patterning treatment over routine

care.40

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B40> They concluded that patterning cannot be considered superior to any

other method of treatment for institutionalized mentally disabled children.

Other less well-designed studies41

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B41> ,42

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B42> also investigated the effect of patterning therapy on children with

a heterogeneous range of disabilities. One showed a significant, but

short-term, effect on developmental progress in comparison with that

attained by children receiving traditional programs in New Zealand.41

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B41> The investigators disclosed that the relative success of the

program was linked to the families' desire to take greater responsibility

for their children's education. Another investigation demonstrated no

significant progress in the development of mentally disabled children who

had undergone patterning therapy.42

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B42> A review of the use of patterning to arouse children in a coma and

for sensory stimulation in brain-injured children and adults also gave no

scientific evidence or theoretical rationale for its use.43

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/11

49#B43>

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CONCLUSION AND RECOMMENDATION

Pediatricians need to work closely with the families of their

patients with

neurologic disabilities and ensure that they have access to all

standard

services available in their communities. After the proper diagnosis

is made,

physicians should discuss controversial treatments as part of the

child's

initial management plan. Pediatricians, therefore, need to be

acquainted

with routine and controversial treatments, schedule ample time for

their

discussion, and explain to parents the placebo effect and the

importance of

basing treatment decisions on controlled research trials.

Treatment programs that offer patterning remain unfounded; ie, they

are

based on oversimplified theories, are claimed to be effective for a

variety

of unrelated conditions, and are supported by case reports or

anecdotal data

and not by carefully designed research studies. In most cases,

improvement

observed in patients undergoing this method of treatment can be

accounted

for based on growth and development, the intensive practice of certain

isolated skills, or the nonspecific effects of intensive stimulation.

Physicians and therapists need to remain aware of the issues in the

controversy over this specific treatment and the available evidence.

On the

basis of past and current analyses, studies, and reports, the AAP

concludes

that patterning treatment continues to offer no special merit, that

the

claims of its advocates remain unproved, and that the demands and

expectations placed on families are so great that in some cases their

financial resources may be depleted substantially and parental and

sibling

relationships could be stressed.

COMMITTEE ON CHILDREN WITH DISABILITIES, 1999-2000

Philip R. Ziring, MD, Chairperson

Dana Brazdziunas, MD

W. Carl Cooley, MD

Theodore A. Kastner, MD

n E. Kummer, MD

Lilliam González de Pijem, MD

D. Quint, MD, MPH

S. Ruppert, MD

D. Sandler, MD

LIAISONS

C.

Social Security Administration

Polly Arango

Family Voices

Burgan, MD, PhD

Social Security Administration

Connie Garner, RN, MSN, EdD

US Department of Education

Merle McPherson, MD

Maternal and Child Health Bureau

Michaud, MD

American Academy of Physical Medical/Rehabilitation

Marshalyn Yeargin-Allsopp, MD

Centers for Disease Control and Prevention

SECTION LIAISONS

P. , MEd, MD

Section on Children With Disabilities

Lani S. M. Wheeler, MD

Section on School Health

http://aappolicy.aappublications.org/icons/toc/rarrow.gif

FOOTNOTES

The recommendations in this statement do not indicate an exclusive

course of

treatment or serve as a standard of medical care. Variations, taking

into

account individual circumstances, may be appropriate.

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ABBREVIATIONS

AAP, American Academy of Pediatrics.

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REFERENCES

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#Top> http://aappolicy.aappublications.org/icons/toc/uarrow.gifTop

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#Abstract>

http://aappolicy.aappublications.org/icons/toc/uarrow.gifAbstract

http://aappolicy.aappublications.org/icons/toc/dot.gifReferences

1. Institutes for the Achievement of Human Potential. Informational

Bulletin. Available at: http://www.iahp.org. Accessed August 8, 1999

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<http://aappolicy.aappublications.org/cgi/ijlink?

linkType=ABST & journalCode=a

rchpedi & resid=134/5/487>

3. American Academy of Pediatrics, Committee on Children With

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handicapped

children. Pediatrics. 1982; 70:810-812 [Abstract/

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linkType=ABST & journalCode=p

ediatrics & resid=70/5/810> Free Full Text]

4. Landman GB. Alternative therapies. In: Levine MD, Carey WB, Crocker

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Co; 1992:754-758

5. Nickel RE Controversial therapies in young children with

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6. American Academy for Cerebral Palsy. Doman-Delacato treatment of

neurologically handicapped children. Statement of Executive Committee.

Rosemont, IL: American Academy for Cerebral Palsy; February 15, 1965

7. United Cerebral Palsy Association of Texas. The Doman-Delacato

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undated]. Austin, TX: United Cerebral Palsy Association of Texas

8. Canadian Association for Retarded Children. Institutes for the

Achievement of Human Potential. Ment Retard. Fall 1965:27-28

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1, p

1, sec A

13. Spigelblatt L, Laine-Ammara G, Pless IB, Guyver A The use of

alternative medicine by children. Pediatrics. 1994; 94:811-814

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ediatrics & resid=94/6/811> Free Full Text]

14. Zigler E A plea to end the use of the patterning treatment for

retarded children. Am J Orthopsychiatry. 1981; 51:388-390 [Medline]

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nk_type=MED>

15. Freeman RD Controversy over " patterning " as treatment for brain

damage in children. JAMA. 1967; 202:385-388 [CrossRef]

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nk_type=MED>

16. Cummins RA. The Neurologically Impaired Child: Doman-Delacato

Techniques Reappraised. New York, NY: Croom Helm; 1988

17. Chapanis NP. The patterning method of therapy: a critique. In:

Black

P, ed. Brain Dysfunction in Children: Etiology, Diagnosis, and

Management.

New York, NY: Raven Press; 1982:265-280

18. Doman G. How to Teach Your Baby to Read: The Gentle Revolution.

Garden City Park, NY: Avery Publishing Group; 1994

19. Doman GJ. Teach Your Baby Math. New York, NY: Simon and Schuster;

1979

20. Doman G, Doman J. How to Multiply Your Baby's Intelligence. Garden

City Park, NY: Avery Publishing Group; 1994

21. Doman G, Doman J, Aisen S. How to Give Your Baby Encyclopedic

Knowledge. Garden City Park, NY: Avery Publishing Group; 1994

22. Doman G, Doman D, Hagy B. How to Teach Your Baby To Be Physically

Superb: More Gentle Revolution. New York, NY: Doubleday; 1988

23. Robbins MP, Glass GV. The Doman-Delacato rationale: a critical

analysis. In: Hellmuth J, ed. Educational Therapy. Seattle, WA:

Special

Child Publications; 1968

24. Cohen HJ, Birch HG, Taft LT Some considerations for evaluating the

Doman-Delacato " patterning " method. Pediatrics. 1970; 45:302-314

[Abstract/

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linkType=ABST & journalCode=p

ediatrics & resid=45/2/302> Free Full Text]

25. Silver LB Controversial therapies. J Child Neurol. 1995; 1:S96-

S100

26. Zigler E, Seitz V On " an experimental evaluation of sensorimotor

patterning " : a critique. Am J Ment Defic. 1975; 79:483-492 [Medline]

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access_num=1121975 & li

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27. Molfese DL, Segalowitz SJ. Brain Lateralization in Children:

Developmental Implications. New York, NY: Guilford Press; 1988

28. Springer SP, Deutsch G. Left Brain, Right Brain. New York: WH

Freeman; 1989

29. Institutes for the Achievement of Human Potential. A Summary of

Concepts, Procedures, and Organization. Philadelphia, PA. Institutes

for the

Achievement of Human Potential; 1964

30. Doman RJ, Spitz ER, Zucman E, Delacato CH, Doman G Children with

severe brain injuries: neurological organization in terms of

mobility. JAMA.

1960; 174:257-262

31. Freeman RD. An investigation of the Doman-Delacato theory of

neuropsychology as it applies to trainable mentally retarded children

in

public schools. J Pediatr. 1967;71:914-915. Book review

32. Delacato CH. The Diagnosis and Treatment of Speech and Reading

Problems. Springfield, IL: C. Publishers; 1963

33. Delacato CH. Neurological Organization and Reading. Springfield,

IL:

C. Publishers; 1966

34. Neman R, Roos P, McCann RM, Menolascino FJ, Heal LW Experimental

evaluation of sensorimotor patterning used with mentally retarded

children.

Am J Ment Defic. 1975; 79:372 [Medline]

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nk_type=MED>

35. Money J. Reading disorders in children. In: Brenneman-

Practice

of Pediatrics, IV. Hagerstown, MD: B. Hoeber Inc; 1967;chap

14A:1-14

36. Robbins MP A study of the validity of Delacato's theory of

neurological organization. Except Child. 1966; 32:517-523 [Medline]

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37. Robbins MP Creeping, laterality and reading. Acad Ther Q. 1966;

1:200-206

38. Robbins MP Test of the Doman-Delacato rationale with retarded

readers. JAMA. 1967; 202:389-393 [CrossRef]

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access_num=10.1001/ja

ma.202.5.389 & link_type=DOI> [Medline]

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access_num=6072493 & li

nk_type=MED>

39. Masland RL Unproven methods of treatment. Pediatrics. 1966;

37:713-714 [Abstract/

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linkType=ABST & journalCode=p

ediatrics & resid=37/5/713> Free Full Text]

40. Sparrow S, Zigler E Evaluation of a patterning treatment for

retarded children. Pediatrics. 1978; 62:137-150 [Abstract/

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linkType=ABST & journalCode=p

ediatrics & resid=62/2/137> Free Full Text]

41. Bridgman GD, Cushen W, DM, RJ The evaluation of

sensorimotor-patterning and the persistence of belief. Br J Ment

Subnormality. 1985; 31:67-79

42. MacKay DN, Gollogly J, Mc G The Doman-Delacato methods, I:

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principles of neurological organization. Br J Ment Subnormality. 1986;

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43. Cummins RA Coma arousal and sensory stimulation: an evaluation of

the Doman-Delacato approach. Aust Psychol. 1992; 27:71-77

_____

Pediatrics (ISSN 0031 4005). Copyright ©1999 by the

<http://aappolicy.aappublications.org/terms.shtml> American Academy of

Pediatrics

Statement of reaffirmation:

AAP Publications Retired and Reaffirmed

American Academy of Pediatrics

Pediatrics 2006 117: 1846-1847. [Extract]

<http://pediatrics.aappublications.org/cgi/content/extract/pediatrics;

117/5/

1846> [Full

<http://pediatrics.aappublications.org/cgi/content/full/pediatrics;117

/5/184

6> Text]

This article has been cited by other articles: (Search Google Scholar

for

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<http://aappolicy.aappublications.org/cgi/external_ref?

access_num=http://aap

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ype=GOOGLESCHOLAR> )

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W. C. Cooley and and Committee on Children with Disabilities

Providing a Primary Care Medical Home for Children and Youth With

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Pediatrics, October 1, 2004; 114(4): 1106 - 1113.

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<http://pediatrics.aappublications.org/cgi/content/abstract/114/4/1106

>

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L. J. Michaud and Committee on Children With Disabilities

Prescribing Therapy Services for Children with Motor Disabilities

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<http://pediatrics.aappublications.org/cgi/content/abstract/113/6/1836

>

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_____

http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/1149

This statement reviews patterning as a treatment for children with

neurologic impairments. This treatment is based on an outmoded and

oversimplified theory of brain development. Current information does

not

support the claims of proponents that this treatment is efficacious,

and its

use continues to be unwarranted.

Patterning has been advocated for more than 40 years for treating

children

with brain damage and other disorders, such as learning disabilities,

Down

syndrome, cerebral palsy, and autism.1-5

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B1> A number of organizations have issued cautionary statements

about

claims for efficacy of this therapy,6-10

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B6> including the American Academy of Pediatrics (AAP) in 1968 and

1982.3

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B3> ,11

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B11> Media coverage,12

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B12> inquiries from parents and public officials, the use of

alternative

forms of treatment by parents for their children,13

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B13> and the existence of a new generation of pediatricians who

may be

unaware of the programs that involve patterning have prompted the AAP

to

review the current status of this controversial treatment.

Patterning is a series of exercises designed to improve

the " neurologic

organization " of a child's neurologic impairments. It requires that

these

exercises be performed over many hours during the day by several

persons who

manipulate a child's head and extremities in patterns purporting to

simulate

prenatal and postnatal movements of nonimpaired children.14

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B14> Concern about patterning has been raised because promotional

methods have made it difficult for parents to refuse treatment for

their

children without questioning their motivation and adequacy as

parents.3

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B3> Moreover, dire health consequences for children are implied if

parents do not make arrangements to have their child begin patterning.

Several treatment options are offered, ranging from a home program to

an

intensive treatment program, which states that each succeeding option

" offers greater chance of success. " Participation in the intensive

treatment

program requires completion of 3 of the 5 preceding programs, is by

invitation only for the " most capable families, " and potentially could

deplete substantially a family's financial resources. The regimens

prescribed can be so demanding, time-consuming, and inflexible that

they may

place considerable stress on parents and lead them to neglect other

family

members.15,16(pp251-252)

Patterning programs use a developmental profile designed by the

Institute

for the Achievement of Human Potential both to assess a child's

neurologic

functioning and to document change over time.16(p40)17

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B17> However, the validity of using this profile for these domains

has

not been demonstrated, nor has it been compared with currently

accepted

methods of measuring a child's development. In addition to making

claims

that a number of conditions may be improved or cured by patterning,

proponents of the program assert that patterning can make healthy

children

superior in physical and cognitive skills.18-22

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B18>

The aims of treatment programs include attainment of normality of

physical,

intellectual, and social growth in children with brain injuries.

According

to providers of patterning therapy,1

<http://aappolicy.aappublications.org/cgi/content/full/pediatrics%

3B104/5/11

49#B1> the majority of children treated are claimed to achieve at

least 1

of those goals. To our knowledge, however, no new data have been

presented

to support the use of patterning since the AAP reissued its policy

statement

in 1982. The lack of supporting evidence for the use of this therapy

brings

into question once again its effectiveness in neurologically impaired

children.

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From:

[mailto: ] On Behalf Of

Spencer

Sent: Tuesday, October 09, 2007 11:48 PM

Subject: [ ] NACD

Hello all,

I don't want to rain on anyone's parade, but if you are planning on

looking into NACD for your child and family, please check out this

website. I am a firm believer in alternative treatments, and have

founds some that have worked with no explanation for my 6 yo apraxic

son. However, I do believe that anyone interested in this should go

in with their eyes wide open. The site below is the website for the

American Academy of Pediatrics. It contains the following article:

AMERICAN ACADEMY OF PEDIATRICS:

The Treatment of Neurologically Impaired Children Using Patterning

Committee on Children With Disabilities

http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3B104/5/1149

in peace,

mom to Jonah

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