See also
- Attention deficit hyperactivity disorder management – Practices with established treatment efficacy for ADHD
- List of alternative therapies for developmental and learning disabilities
Alternative therapies for developmental and learning disabilities include a range of practices used in the treatment of dyslexia, ADHD, autism spectrum disorders, Down syndrome and other developmental and learning disabilities. Treatments include changes in diet, dietary supplements, biofeedback, chelation therapy, homeopathy, massage and yoga. These therapies generally rely on theories that have little scientific basis, lacking well-controlled, large, randomized trials to demonstrate safety and efficacy; small trials that have reported beneficial effects can be generally explained by the ordinary waxing and waning of the underlying conditions. [1]
There are a number of non-standard treatments for developmental and learning disabilities. There is a call for alternative therapies particularly when a condition lacks a reliable remediation. For example, there is no cure for autism; the main goals of mainstream behavioral and medical management are to lessen associated deficits and family distress, and to increase quality of life and functional independence. [2] Some alternative therapies, such as gluten-free, casein-free diets, may be appealing to some parents because the treatment recommended by most experts is thought to be "cold and manipulative". [3] Parents may also consider a drug treatment for attention deficit as avoidable. Alternative treatments to a stimulant medication range from natural products to psychotherapeutic techniques and highly technological interventions. It has been argued that although texts that promote alternative therapies do not directly accuse parents of inadequacy, the claims that the disability is caused by certain factors, such as poor nutrition, supports the culture of mother-blame. [4]
From 12% to 64% of families of a child with ADHD use an alternative therapy,[ where? ] with the lower estimates likely come from narrower definitions of complementary and alternative medicine (CAM). [1] School teachers, family and friends are the most common source of suggestion of alternative therapies for ADHD. [5] In 2003, 64 percent of families of a child with special health care needs reported that they use alternative therapies. These therapies included spiritual healing, massage, chiropractic, herbs and special diets, homeopathy, self hypnosis and other methods of complementary and alternative medicine. The need for an alternative therapy was related to the child's condition and to its evaluation as repairable or not. [6] A 2008 study found that about 40% of Hong Kong children with autism spectrum disorder were treated with CAM, with the most popular therapies being acupuncture, sensory integration therapy, and Chinese herbology; the 40% is a lower prevalence than in Canada and the U.S., where biological-based therapies such as special diets predominate. [7] In the U.S. CAM is used by an estimated 20–40% of healthy children, 30–70% of children with special health care needs, and 52–95% of children with autism, and a 2009 survey of U.S. primary care physicians found that more of them recommended than discouraged multivitamins, essential fatty acids, melatonin, and probiotics as CAM treatments for autism. [8]
Complementary and alternative medicine often lacks support in scientific evidence, so its safety and efficacy may be questionable.
While some experts encourage parents to be open-minded, others argue that treatments and services with no proven efficacy have opportunity costs because they displace the opportunity to participate in efficient treatments and services. [9] According to Scott O. Lilienfeld,
many individuals who spend large amounts of time and money on ineffective treatments may be left with precious little of either. As a result, they may forfeit the opportunity to obtain treatments that could be more helpful. Thus, even ineffective treatments that are by themselves innocuous can indirectly produce negative consequences. [10]
There is often little or no scientific evidence for effectiveness of alternative therapies. [1] [11]
Because many alternative therapies have not been evaluated in scientific studies there may be no guarantee for their safety. In most countries, with the exception of osteopathy and chiropractic, complementary medical disciplines have not been state registered. This means there is no law to forbid anyone from setting up as a practitioner even with no qualification nor experience.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally-inappropriate.
Developmental disorders comprise a group of psychiatric conditions originating in childhood that involve serious impairment in different areas. There are several ways of using this term. The most narrow concept is used in the category "Specific Disorders of Psychological Development" in the ICD-10. These disorders comprise developmental language disorder, learning disorders, developmental coordination disorders, and autism spectrum disorders (ASD). In broader definitions, attention deficit hyperactivity disorder (ADHD) is included, and the term used is neurodevelopmental disorders. Yet others include antisocial behavior and schizophrenia that begins in childhood and continues through life. However, these two latter conditions are not as stable as the other developmental disorders, and there is not the same evidence of a shared genetic liability.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder that begins in early childhood, persists throughout adulthood, and is characterized by difficulties in social communication and restricted, repetitive patterns of behavior. There are many conditions comorbid to autism spectrum disorder, such as attention deficit hyperactivity disorder, anxiety disorders, and epilepsy.
The neurodiversity paradigm is a framework for understanding human brain function that recognizes the diversity within sensory processing, motor abilities, social comfort, cognition, and focus as neurobiological differences. This diversity falls on a spectrum of neurocognitive differences. The neurodiversity paradigm argues that diversity in human cognition is normal and that some conditions generally classified as disorders, such as autism, are differences and disabilities that are not necessarily pathological. Neurotypical individuals are those who fall within the average range of functioning and thinking.
High-functioning autism (HFA) was historically an autism classification to describe a person who exhibited no intellectual disability but otherwise showed autistic traits, such as difficulty in social interaction and communication, as well as repetitive, restricted patterns of behavior. The term is often applied to autistic people who are fluently verbal and of at least average intelligence. However, many in medical and autistic communities have called to stop using the term, finding it simplistic and unindicative of the difficulties some autistic people face.
Vision therapy (VT), or behavioral optometry, is an umbrella term for alternative medicine treatments using eye exercises, based around the pseudoscientific claim that vision problems are the true underlying cause of learning difficulties, particularly in children. Vision therapy has not been shown to be effective using scientific studies, except for helping with convergence insufficiency. Most claims—for example that the therapy can address neurological, educational, and spatial difficulties—lack supporting evidence. Neither the American Academy of Pediatrics nor the American Academy of Ophthalmology support the use of vision therapy.
The following outline is provided as an overview of and topical guide to autism:
Behavior modification is a treatment approach that uses respondent and operant conditioning to change behavior. Based on methodological behaviorism, overt behavior is modified with (antecedent) stimulus control and consequences, including positive and negative reinforcement contingencies to increase desirable behavior, as well as positive and negative punishment, and extinction to reduce problematic behavior.
The Dore Method, named after its creator, businessman Wynford Dore, is a method for improving skills such as reading and writing, attention and focus, social skills and sports performance through targeted physical exercises.
Autism therapies include a wide variety of therapies that help people with autism, or their families. Such methods of therapy seek to aid autistic people in dealing with difficulties and increase their functional independence.
Despite the scientifically well-established nature of attention deficit hyperactivity disorder (ADHD), its diagnosis, and its treatment, each of these has been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, stated that the current treatments and methods of diagnosis are based on the dominant view of the academic literature.
Auditory integration training (AIT) is a procedure pioneered in France by Guy Bérard. Bérard promoted AIT as a cure for clinical depression and suicidal tendencies, along with what he said were very positive results for dyslexia and autism, although there has been very little empirical evidence regarding this assertion. AIT typically involves 20 half-hour sessions over 10 days listening to specially filtered and modulated music. It was used in the early 1990s as a treatment for autism. Since, it has been promoted as a treatment for ADHD, depression, and a wide variety of other disorders. AIT has not met scientific standards for efficacy that would justify its use as a treatment for any condition.
Developmental coordination disorder (DCD), also known as developmental motor coordination disorder, developmental dyspraxia or simply dyspraxia, is a neurodevelopmental disorder characterized by impaired coordination of physical movements as a result of brain messages not being accurately transmitted to the body. Deficits in fine or gross motor skills movements interfere with activities of daily living. It is often described as disorder in skill acquisition, where the learning and execution of coordinated motor skills is substantially below that expected given the individual's chronological age. Difficulties may present as clumsiness, slowness and inaccuracy of performance of motor skills. It is often accompanied by difficulty with organisation and/or problems with attention, working memory and time management.
Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism, Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.
Autism, or autism spectrum disorder (ASD), is a neurodevelopmental disorder characterized by repetitive, restricted, and inflexible patterns of behavior, interests, and activities, as well as deficits in social interaction and social communication. Autism generally affects a person's ability to understand and connect with others, as well as their adaptability to everyday situations, with its severity and support needs varying widely across the underlying spectrum. For example, some are nonverbal, while others have proficient spoken language.
Sensory processing disorder is a condition in which multisensory input is not adequately processed in order to provide appropriate responses to the demands of the environment. Sensory processing disorder is present in many people with dyspraxia, autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). Individuals with SPD may inadequately process visual, auditory, olfactory (smell), gustatory (taste), tactile (touch), vestibular (balance), proprioception, and interoception sensory stimuli.
Weighted vests for children and similar therapeutic weighted clothing are sometimes used to try to treat symptoms of certain developmental disorders such as attention deficit hyperactivity disorder or autism in children. There is however no evidence that they are useful for this purpose.
Deaf and hard of hearing individuals with additional disabilities are referred to as "Deaf Plus" or "Deaf+". Deaf children with one or more co-occurring disabilities could also be referred to as hearing loss plus additional disabilities or Deafness and Diversity (D.A.D.). About 40–50% of deaf children experience one or more additional disabilities, with learning disabilities, intellectual disabilities, autism spectrum disorder (ASD), and visual impairments being the four most concomitant disabilities. Approximately 7–8% of deaf children have a learning disability. Deaf plus individuals utilize various language modalities to best fit their communication needs.
Jan K. Buitelaar is a Dutch medical doctor, psychiatrist, author, and academic. He is a professor of psychiatry and child and adolescent psychiatry at Radboud University Medical Centre and former Head of Child and Adolescent Psychiatry at Karakter Child and Adolescent Psychiatry.