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, 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 are often 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] It may be difficult to separate the success of a specific treatment from natural development or from the benefits of the individual's positive attitude. Some phenomena that can explain positive results are the placebo effect, the Hawthorne effect and different types of attentional and motivational effects. People with disabilities may benefit from some alternative therapies, at least for relaxation, social interaction, personal development and self-esteem.[ citation needed ]
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 excessive amounts of inattention, carelessness, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-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, motor disorders, and autism spectrum disorders. In broader definitions 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.
Adult attention deficit hyperactivity disorder is the neurological condition of attention deficit hyperactivity disorder (ADHD) in adults. About one-third to two-thirds of children with symptoms from early childhood continue to demonstrate ADHD symptoms throughout life.
High-functioning autism (HFA) is an autism classification where a person exhibits no intellectual disability, but may exhibit deficits in communication, emotion recognition and expression, and social interaction. HFA is not included in either the American Psychological Association's DSM-5 or the World Health Organization's ICD-10, neither of which subdivides autism based on intellectual capabilities.
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 disabilities, 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.
A reading disability is a condition in which a person displays difficulty reading. Examples of reading disabilities include: developmental dyslexia, alexia, and hyperlexia.
The Institutes for The Achievement of Human Potential (IAHP), founded in 1955 by Glenn Doman and Carl Delacato, provide literature on and teaches a controversial patterning therapy, which the Institutes promote as improving the "neurologic organization" of "brain injured" and mentally impaired children through a variety of programs, including diet and exercise. The Institutes also provides extensive early-learning programs for "well" children, including programs focused on reading, mathematics, language, and physical fitness. It is headquartered in Philadelphia, Pennsylvania with offices and programs offered in several other countries. Pattern therapy for patients with neuromuscular disorders was first developed by neurosurgeon Temple Fay in the 1940s. Patterning has been widely criticized and multiple studies have found the therapy ineffective.
Autism therapies include a wide variety of therapies that claim to help people with autism, or their families. Such methods of therapy also seek the increase of functional independence in autistic people. Many therapies marketed towards autistic people and/or their parents claim outcomes that have not been supported by Level of Research (LOE) Level 1 Level 1 research includes evidence from a systematic review or meta-analysis of all relevant RCTs or evidence-based clinical practice guidelines based on systematic reviews of RCTs or three or more RCTs of good quality that have similar results.
Despite the scientifically well-established nature of ADHD, its diagnosis, and its treatment, each of these have 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, states that the current treatments and methods of diagnosis are based on the dominant view of the academic literature. In 2014, Keith Conners, one of the early advocates for recognition of the disorder, spoke out against overdiagnosis in a The New York Times article. In contrast, a 2014 peer-reviewed medical literature review indicated that ADHD is underdiagnosed in adults.
Auditory integration training (AIT) is a procedure pioneered in France by Guy Bérard, who promoted it 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. It 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; 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 skilled motor movements per a child's chronological age interfere with activities of daily living. A diagnosis of DCD is then reached only in the absence of other neurological impairments such as cerebral palsy, multiple sclerosis, or Parkinson's disease.
Attention deficit hyperactivity disorder management options are evidence-based practices with established treatment efficacy for ADHD. The American Academy of Pediatrics recommends different treatment paradigms depending on the age of the person being treated. For those aged 4–5, the Academy recommends evidence-based parent- and/or teacher-administered behavior therapy, with the addition of methylphenidate only if there is continuing moderate-to-severe functional disturbances. For those aged 6–11, the use of medication in combination with behavior therapy is recommended, with the evidence for stimulant medications being stronger than that for other classes. For those aged 12–18, medication should be prescribed with the consent of the treated adolescent, preferably in combination with behavioral therapy. The evidence for the utility of behavioral interventions in this aged group was rated only "C" quality, however.
Kanner autism, or classic autism, is an outdated neurodevelopmental diagnosis which is now considered part of autism spectrum disorder. The term 'autism' was historically used to refer specifically to classic autism, but it is now more commonly used for the spectrum at large.
The autism spectrum is a range of neurodevelopmental conditions generally characterized by difficulties in social interactions and communication, repetitive behaviors, intense interests, and unusual responses to sensory stimuli. It is commonly referred to as autism and in the context of a professional diagnosis — autism spectrum disorder (ASD), but the latter term is not a meaningful description of someone outside of a diagnosis, and remains controversial among neurodiversity advocates, neurodiversity researchers, and many autistic people due to the use of the word "disorder".
Metadoxine, also known as pyridoxine-pyrrolidone carboxylate, is a drug used to treat chronic and acute alcohol intoxication. Metadoxine accelerates alcohol clearance from the blood.
Katya Rubia is a Professor of Cognitive Neuroscience at the MRC Social, Genetic and Developmental Psychiatry Centre and Department of Child and Adolescent Psychiatry, both part of the Institute of Psychiatry, King's College London.
Sensory processing disorder (SPD) 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 with Autism spectrum disorders and Attention Deficit Hyperactivity Disorder. Individuals with SPD may inappropriately 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.