The Institutes for the Achievement of Human Potential

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The Institutes for the Achievement of Human Potential
AbbreviationIAHP
Formation1955
FounderGlenn Doman
TypeNon-profit Organization
PurposeTreatment of "brain injured" children
Headquarters Philadelphia, Pennsylvania, U.S.
Region
Worldwide
Director
Janet Doman
Website iahp.org

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, known as motor learning, 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. [1] [2] 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, with offices and programs offered in several other countries. [2]

Contents

Pattern therapy for patients with neuromuscular disorders was first developed by neurosurgeon Temple Fay in the 1940s. [3] [4] Patterning has been widely criticized and multiple studies have found the therapy ineffective. [5] [6] [7] [8]

History

The Institutes for the Achievement of Human Potential (IAHP, also known as "The Institutes") was founded in 1955. [9] It practices pattern therapy, which was developed by Doman and educational psychologist Carl Delacato. [10] Pattern therapy drew upon the ideas and work of ideas of neurophysiologist Temple Fay, former head of the Department of Neurosurgery at Temple University School of Medicine and president of the Philadelphia Neurological Society. [10] [11]

In 1960, Doman and Delacato published an article in the Journal of the American Medical Association (JAMA) detailing pattern therapy. [12] The methodology of their study was later criticized.

Philosophy

The philosophy of the Institutes consists of several interrelated beliefs: that every child has genius potential, stimulation is the key to unlocking a child's potential, teaching should commence at birth, the younger the child, the easier the learning process, children naturally love to learn, parents are their child's best teacher, teaching and learning should be joyous and teaching and learning should never involve testing. [13] This philosophy follows very closely to the Japanese Suzuki method for violin, which is also taught at the institute in addition to the Japanese language itself. The Institutes consider brain damage, intellectual impairment, "mental deficiency", cerebral palsy, epilepsy, autism, athetosis, attention deficit hyperactivity disorder, "developmental delay", and Down syndrome as conditions encompassing "brain injury", the term favored by IAHP. [14]

Much of the work at The Institutes follows from Dr. Temple Fay who believed in recapitulation theory, which posits that the infant brain evolves through chronological stages of development similar to first a fish, a reptile, a mammal and finally a human. This theory can be encapsulated as "ontogeny recapitulates phylogeny". Recapitulation theory has been largely discredited in biology. [15] [16]

According to a 2007 WPVI-TV report, IAHP uses the word "hurt" to describe the children they see "with all kinds of brain injuries and conditions, including cerebral palsy, mental retardation, epilepsy, Down's syndrome, attention deficit hyperactivity disorder, and autism". [17] Glenn Doman described his own personal philosophy for treating patients as stemming from his WWII veteran officer motto: "Leave no injured behind." [14]

Programs

Programs for brain-injured children

IAHP’s program begins with a five-day seminar for the parents of "brain injured" children, because the program is carried out by parents at their homes. [17] Following the seminar, IAHP conducts an initial evaluation of the child. [17]

The program described in the 1960 JAMA paper (Doman, et al.) for "brain-injured" children included:

The IAHP holds that brain injury at a given level of neurological development prevents or slows further progress. [14] [9] [19]

Other therapies utilized by IAHP include eye exercises for children who have an eye that converges more than the other when looking at an object in the distance and those who have one eye that diverges more than the other when an object is moved slowly toward the bridge of the nose. IAHP also recommends stimulating the eyes of children with amblyopia by flashing a light on and off. For children with poor hearing, IAHP recommends auditory stimulation with loud noises, which may be pre-recorded. Brain-injured children may also be taught to identify by touch alone various objects placed in a bag. [1]

IAHP recommends dietary restrictions, including reduced fluid intake for brain-injured children in an attempt to prevent "the possible overaccumulation of cerebrospinal fluid". Alongside fluid restriction, IAHP recommends a diet low in salt, sweets, and other "thirst provoking" foods. [1]

Scientific evaluation and criticism

The Institutes model of childhood development has been criticized in the scientific community. [20]

American Academy of Pediatrics position statement

According to the American Academy of Pediatrics, patterning treatment is based on an oversimplified theory of brain development and its effectiveness is not supported by evidence-based medicine, making its use unwarranted. [21] The American Academy of Pediatrics Committee on Children With Disabilities issued warnings regarding patterning, one of the IAHP's therapies for brain injured children, as early as 1968 [22] and repeated in 1982. [23] Their latest cautionary policy statement was in 1999, which was reaffirmed in 2010 [24] states:

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.... [T]he 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. [21]

Others

In addition to the American Academy of Pediatrics, a number of other organizations have issued cautionary statements about claims for efficacy of this therapy. [21] These include the executive committee of the American Academy for Cerebral Palsy, [25] the United Cerebral Palsy Association of Texas, [26] the Canadian Association for Retarded Children, [27] the executive board of the American Academy of Neurology, [28] and the American Academy of Physical Medicine and Rehabilitation. [29] Hornby et al. call R.A. Cummins 1988 book The Neurologically Impaired-child: Doman-Delacato Techniques Reappraised (Croom Helm, ISBN   9780709948599), "The most comprehensive analysis of the rationale and effectiveness of the Doman-Delacato programme to date" and state Cummins uses neuroanatomy and neurophysiology to demonstrate that there is no sound scientific basis for the techniques used by the IAHP and concludes any benefit is likely due to increased activity and attention. Hornby et al. conclude, "It is now clear that the only results supporting the effectiveness of the programme come from a handful of early, poorly controlled studies." [5] Kavale and Mostert and others also identified serious problems with the early research on the IAHP program. [6] [10] An analysis of higher quality studies found that students not receiving the treatment had better outcomes than those who were treated by the IAHP. [6] A 2013 study found the claims of superior results of treatment by the IAHP were not substantiated. [8]

A 2006 retrospective study of 21 children by the IAHP and others of children with cortical visual impairment found significant improvement after use of the program the study had no control group. [30]

Doctors Martha Farrell Erickson and Karen Marie Kurz-Riemer wrote that IAHP "capitalized on the desires of members of the 'baby boom' generation to maximize their children's intellectual potential" and "encouraged parents to push their infants to develop maximum brain power". But most contemporary child development experts "described many aspects of the program as useless and perhaps even harmful". [31] Kathleen Quill concluded that "professionals" have nothing to learn from pattern therapy. [32] Pavone and Ruggieri have written that pattern therapy does not have an important role in treatment. [33] Neurologist Steven Novella has characterized pattern therapy as being based on a discarded theory and a "false cure". [34] He also wrote that IAHP's unsubstantiated claims can cause both financial and emotional damage. [34] While detailing criticism of pattern therapy, Robards also wrote that the therapy caused pediatricians and therapists to recognize that early intervention programs are necessary. [7]

The American Academy of Pediatrics and other organizations have criticized the IAHP's claims of effectiveness, theoretical basis and the demands placed on parents by IAHP programs. [21] [22] Early studies originating from IAHP appeared to show some value of their program but were later criticized as significantly flawed. [6] [9] Kenneth Kavale and Mark Mostert have written that later studies they believe to have better design and more objectivity have shown pattern therapy "to be practically without merit". [6]

In their book Controversial Issues in Special Education, Garry Hornby, Jean Howard and Mary Atkinson state the program also includes "gagging" in which the child breathes into a plastic bag until gasping for breath. This is based on the belief that it will cause maximum use of the lungs and thus maximize oxygen circulation to the brain. [5] The book concludes that pattern therapy is ineffective and potentially damaging to the functioning of families. [5]

Attitude to scientific evaluation

In the 1960s, IAHP published literature that appeared to demonstrate the effectiveness of the program. However, they subsequently instructed parents of children in their program not to take part in any independent studies designed to evaluate the program's effectiveness. [5] The IAHP withdrew its agreement to participate in a "carefully designed study supported by federal and private agencies" when the study was in its final planning stages. [10] According to Herman Spitz, "The IAHP no longer appears to be interested in a scientific evaluation of their techniques; they have grown large, wealthy, and independent, and their staff is satisfied to provide case histories and propaganda tracts in support of their claims." [10] Terrence M. Hines then stated that they "have shown very little interest in providing empirical support for their methods". [9]

Related Research Articles

<span class="mw-page-title-main">Cerebral palsy</span> Group of movement disorders that appear in early childhood

Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sensation, vision, hearing, and speaking. Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age. Other symptoms include seizures and problems with thinking or reasoning, each of which occur in about one-third of people with CP. While symptoms may get more noticeable over the first few years of life, underlying problems do not worsen over time.

Hypotonia is a state of low muscle tone, often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength. Hypotonia is a lack of resistance to passive movement, whereas muscle weakness results in impaired active movement. Central hypotonia originates from the central nervous system, while peripheral hypotonia is related to problems within the spinal cord, peripheral nerves and/or skeletal muscles. Severe hypotonia in infancy is commonly known as floppy baby syndrome. Recognizing hypotonia, even in early infancy, is usually relatively straightforward, but diagnosing the underlying cause can be difficult and often unsuccessful. The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. Some disorders have a specific treatment but the principal treatment for most hypotonia of idiopathic or neurologic cause is physical therapy and/or occupational therapy for remediation.

Václav Vojta was a renowned Czech medical doctor who specialized in the treatment of children with cerebral palsy and developmental disorders. He discovered the principle of reflex locomotion, which is used to treat various physical and neuromuscular disorders through the stimulation of the human sensomotoric system's reflex points. Originally used in the treatment of spastic children, the technique is now used on babies and adults.

The Bobath concept is an approach to neurological rehabilitation that is applied in patient assessment and treatment. The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation and function. This is done through specific patient handling skills to guide patients through the initiation and completing of intended tasks. This approach to neurological rehabilitation is multidisciplinary, primarily involving physiotherapists, occupational therapists, and speech and language therapists. In the United States, the Bobath concept is also known as 'neuro-developmental treatment' (NDT).

bibic is a small charitable organization based in the United Kingdom that supports children, young people and their families deal with a number of different conditions. The charity was founded by the late Keith Pennock who had a daughter with a learning disability. The work was derived from Glenn Doman's The Institutes for The Achievement of Human Potential (IAHP) in Philadelphia, USA.

<span class="mw-page-title-main">Periventricular leukomalacia</span> Degeneration of white matter near the lateral ventricles of the brain

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<span class="mw-page-title-main">Kennedy Krieger Institute</span> Hospital in Maryland, United States

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<span class="mw-page-title-main">Management of cerebral palsy</span>

Over time, the approach to cerebral palsy management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person's independence and community engagement. Much of childhood therapy is aimed at improving gait and walking. Approximately 60% of people with CP are able to walk independently or with aids at adulthood. However, the evidence base for the effectiveness of intervention programs reflecting the philosophy of independence has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa. Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.

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<span class="mw-page-title-main">Ataxic cerebral palsy</span> Medical condition

Ataxic cerebral palsy is clinically in approximately 5–10% of all cases of cerebral palsy, making it the least frequent form of cerebral palsy diagnosed. Ataxic cerebral palsy is caused by damage to cerebellar structures, differentiating it from the other two forms of cerebral palsy, which are spastic cerebral palsy and dyskinetic cerebral palsy.

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<span class="mw-page-title-main">Spastic hemiplegia</span> Medical condition

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<span class="mw-page-title-main">Psychomotor patterning</span>

Psychomotor patterning, rarely referred to as the Doman-Delacato technique, is a pseudoscientific approach to the treatment of intellectual disabilities, brain injury, learning disabilities, and other cognitive diseases. The treatment is based on the largely-discredited hypothesis that ontogeny recapitulates phylogeny.

<span class="mw-page-title-main">Sensory processing disorder</span> Medical condition

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<span class="mw-page-title-main">Diane Damiano</span> American biomedical scientist and physical therapist

Diane Louise Damiano is an American biomedical scientist and physical therapist specializing in physical medicine and rehabilitation approaches in children with cerebral palsy. She is chief of the functional and applied biomechanics section at the National Institutes of Health Clinical Center. Damiano has served as president of the Clinical Gait and Movement Analysis Society and the American Academy for Cerebral Palsy and Developmental Medicine.

References

  1. 1 2 3 Evan W. Thomas. Brian-Injured Children. Charles C. Thomas. ASIN   B000L3PVNC.
  2. 1 2 "About Us". iahp.org. The Institutes for the Achievement of Human Potential.
  3. ↑ "Temple Fay, MD". societyns.org. The Society of Neurological Surgeons.
  4. ↑ "Fay Reflex Therapy". cirrie.buffalo.edu. Cirriel.
  5. 1 2 3 4 5 Hornby, Garry; Howard, Jean; Atkinson, Mary (2013). Controversial Issues in Special Education. Routledge. pp.  5–7. ISBN   9781134094387.
  6. 1 2 3 4 5 Kavale, Kenneth A.; Mostert, Mark P. (2004). The Positive Side of Special Education: Minimizing Its Fads, Fancies, and Follies. Rowman & Littlefield Education. pp. 146–57. ISBN   9781578860975.
  7. 1 2 Robards, Martin F. (1994). Running a Team for Disabled Children and Their Families. Cambridge University Press. p.  83. ISBN   978-0901260994.
  8. 1 2 von Tetzchner, S.; Verdel, M; Barstad, B.G.; Gravås, E.M.; et al. (2013). "The effect of interventions based on the programs of The Institutes for the Achievement of Human Potential and Family Hope Center". Developmental Neurorehabilitation . 16 (4): 217–29. doi:10.3109/17518423.2012.739211. PMID   23834196. S2CID   29810390.
  9. 1 2 3 4 Hines, T.M. (2001). "The Doman-Delcato patterning treatment for brain damage". Scientific Review of Alternative Medicine. 5 (2): 80–9.
  10. 1 2 3 4 5 Spitz, Herman H. (2013) [1986]. The Raising of Intelligence: A Selected History of Attempts To Raise Retarded Intelligence. Routledge. pp. 183–7. ISBN   9781136562075.
  11. ↑ "Temple Fay, MD". The Society of Neurological Surgeons.
  12. ↑ Doman, R.J.; Spitz, E.B.; Zucman, E.; Delacato, C.H.; et al. (1960). "Children with severe brain injuries. Neurological organization in terms of mobility". JAMA . 174 (3): 257–62. doi:10.1001/jama.1960.03030030037007. PMID   13817361.
  13. ↑ "The Early Learning Experts: Glenn Doman". brillbaby.com. 2017.
  14. 1 2 3 Doman, Glenn (2005) [1974]. What To Do About Your Brain-injured Child (Revised ed.). Square One. ISBN   978-0757001864.
  15. ↑ Gilbert, Scott F. (2006). "Ernst Haeckel and the Biogenetic Law". DevBio a Companion to: Developmental Biology, 9th edition. Sinauer Associates. Archived from the original on 2008-02-03. Retrieved 2008-05-03. Eventually, the Biogenetic Law had become scientifically untenable.
  16. ↑ Payne, David G.; Wenger, Michael J. (1998). Cognitive Psychology. Houghton Mifflin College Division. p. 352. ISBN   9780395685730.
  17. 1 2 3 "Controversial treatment for brain-injured children". WPVI Action News: HealthCheck. Philadelphia, PA. December 1, 2007. American Broadcasting Company (ABC). WPVI . Retrieved 2014-03-04.
  18. ↑ Zigler, Edward; Hodapp, Robert M. (1986). "Searching for Miracle Cures". Understanding Mental Retardation. Cambridge University Press. pp.  185–6. ISBN   9780521318785.
  19. ↑ Scherzer, Alfred L. (2000). Early Diagnosis and Interventional Therapy in Cerebral Palsy: An Interdisciplinary Age-Focused Approach (3rd, Revised ed.). Taylor & Francis. p. 376. ISBN   9780824760069.
  20. ↑ Myles, Brenda Smith; Swanson, Terri Cooper; Holverstott, Jeanne; Duncan, Megan Moore (2007). Autism Spectrum Disorders: A Handbook for Parents and Professionals. Greenwood. pp. 243–6. ISBN   9780313336324.
  21. 1 2 3 4 Committee on Children with Disabilities, American Academy of Pediatrics; Ziring, P.R.; brazdziunas, D.; Cooley, W.C.; et al. (1999). "The treatment of neurologically impaired children using patterning". Pediatrics . 104 (5 Pt 1): 1149–51. doi: 10.1542/peds.104.5.1149 . PMID   10545565.
  22. 1 2 American Academy of Pediatrics (1 June 1968). "Doman-Delacato treatment of neurologically handicapped children". AAP Newsletter.
  23. ↑ American Academy of Pediatrics, Committee on Children With Disabilities (1982). "The Doman-Delacato treatment of neurologically handicapped children" (PDF). Pediatrics. 70 (5): 810–2. doi:10.1542/peds.70.5.810. PMID   6182521. S2CID   38331238.
  24. ↑ American Academy of Pediatrics (2010). "AAP publications reaffirmed and retired". Pediatrics (Policy Statement). 126 (4): e994. doi: 10.1542/peds.2010-2212 .
  25. ↑ American Academy for Cerebral Palsy (February 15, 1965), Doman-Delacato treatment of neurologically handicapped children. Statement of Executive Committee, Rosemont, IL: American Academy for Cerebral Palsy.
  26. ↑ United Cerebral Palsy Association of Texas, The Doman-Delacato Treatment of Neurologically Handicapped Children (information bulletin), Austin, TX: United Cerebral Palsy Association of Texas.
  27. ↑ Canadian Association for Retarded Children (Fall 1965). "Institutes for the Achievement of Human Potential". Ment Retard: 27–8.
  28. ↑ American Academy of Neurology and American Academy of Pediatrics Joint Executive Board Statement (1967). "The Doman-Delacato treatment of neurologically handicapped children". Neurology. 17 (7): 637. doi:10.1212/wnl.17.7.637. S2CID   79862057.{{cite journal}}: |author= has generic name (help)
  29. ↑ American Academy of Physical Medicine and Rehabilitation (1968). "Doman-Delacato treatment of neurologically handicapped children". Archives of Physical Medicine and Rehabilitation . 49 (4): 183–6. PMID   4296733.
  30. ↑ Malkowicz, D.E.; Myers, G.; Leisman, G. (2006). "Rehabilitation of cortical visual impairment in children". Int J Neurosci. 116 (9): 1015–33. doi:10.1080/00207450600553505. PMID   16861165. S2CID   1486751.
  31. ↑ Erickson, Martha Farrell; Kurz-Riemer, Karen Marie (2002). Infants Toddlers and Families. Guilford Press. pp. 17, 204. ISBN   978-1572307780.
  32. ↑ Quill, Kathleen Ann (1995). Teaching Children With Autism. Thomson Delmar Learning. pp. 57, 336. ISBN   978-0827362697.
  33. ↑ Prendergrast, M. (2006). "The Neurology of Autism". Developmental Medicine & Child Neurology (book review). 48 (5): 400.
  34. 1 2 Novella, S. (2008). "Psychomotor patterning: A critical look". Quackwatch . Retrieved 2008-10-23.

Further reading

Bratt, Berneen (1989). No Time for Jello: One Family's Experiences with the Doman-Delacato Patterning Program . Brookline. ISBN   9780914797562.

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