Dore (dyslexia treatment)

The Dore programme, previously known as DDAT (Dyslexia Dyspraxia Attention Treatment) is a drug-free course of treatment for dyslexia and other learning difficulties which has aroused controversy among researchers and doctors in Britain and elsewhere. It consists of a series of exercises designed to develop the functions of the cerebellum. Dore was developed on the principle that the cerebellum coordinates brain functions and therefore plays an essential role in the learning process.

In May 2008 Dore Australia went into voluntary administration; [http://dore.co.uk/doretalk/forums/p/713/3579.aspx#3579] [http://www.woodgateco.com.au/creditorinfo/Creditor%20Information%20-%20Dore%20Group%20(Australasia)%20Ltd.pdf] [http://www.woodgateco.com.au/creditorinfo/Creditor%20Information%20-%20Dore%20Group%20(Australasia)%20Ltd%20-%20First%20Notice%20to%20Creditors.pdf] later in the same month Dore closed all their UK centres due to financial problems. [http://icwales.icnetwork.co.uk/news/wales-news/2008/05/24/dyslexia-programme-firm-hit-by-financial-trouble-91466-20968282/] [http://www.badscience.net/?p=705]

Introduction

The development of DDAT was initiated by businessman Wynford Dore. It is reported that when his daughter was diagnosed with severe dyslexia and he saw the negative impact the condition had on her life he decided to invest in research to try to find an effective drug-free treatment.

According to Dore, conditions such as dyslexia, dyspraxia, ADD, Aspergers Syndrome and ADHD were linked to Cerebellar Developmental Delay (CDD) [http://www.dore.com.au/howdoesitwork/] , a condition in which neural pathways between the cerebrum and cerebellum do not develop fully, leading to an impairment of the brain’s ability to coordinate nerve impulses. Dore states that he believed that it could be possible to treat some learning difficulties by developing these neural pathways, and that he hired specialists to develop a programme of practical exercises targeted towards cerebellar development.

The Dore method

The theory behind the Dore method is that skills such as reading and writing become automatic because the learning process eventually leads to the development of neural pathways specifically for these tasks. Its proponents argue that research suggests that while the cerebellum becomes less active once a skill has been learned, it nonetheless retains much of its neural plasticity i.e. the ability to develop new synaptic connections and neural pathways. They claim to be able to stimulate the development of the pathways affected by CDD and to strengthen the connections between the cerebrum and cerebellum.

The programme consists of a series of balance and coordination exercises which are carried out twice a day, typically for around twelve months. The programme is individually designed for each patient based on interpretation of the results of tests of cerebellar function. These tests are designed to measure balance (posturography) and eye tracking (Electronystagmography). Changes in the patient's abilities are charted by repeating these tests regularly throughout the program.

Effectiveness

No studies on efficacy with the target clinical groups have been published in a peer-reviewed medical journal, and where control data are available there is no credible evidence of significant gains in literacy associated with the Dore programme.cite journal |journal= J Paediatr Child Health |date=2007 |volume=43 |issue=10 |pages=653–5 |title= Curing dyslexia and attention-deficit hyperactivity disorder by training motor co-ordination: miracle or myth? |author= Bishop DV |doi=10.1111/j.1440-1754.2007.01225.x |pmid=17854448]

Criticism

Of the treatment

The treatment has been much criticized, for two main reasons:

First, Dore's research [cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=1 |pages=48–71 |title= Evaluation of an exercise-based treatment for children with reading difficulties |author= Reynolds D, Nicolson RI, Hambly H |doi=10.1002/dys.235 |pmid=12625376 |url=http://abc.net.au/4corners/content/2007/20070806_dore/FirstReynoldsNicolsonDyslexia2003.pdf |format=PDF |accessdate=2008-04-10] was poorly conducted. For example, it did not make effective use of its control group. There is also no independent rigorous research. This means that there is no reliable evidence about the effectiveness of the Dore method. A number of papers published in the [http://www.bdadyslexia.org.uk/ British Dyslexia Association's] journal have found the only piece of apparently independent academic research Dore initially offered in support of their treatment to be poorly designed and unreliable. According to an article published in the "Times Educational Supplement" in 2004, many of Britain's foremost academics maintain that the results are inconclusive. Critics have also pointed out that the research was carried out by a previous director of another Wynford Dore company, and so may not be independent. Several bodies, including the Dyslexia Action, have recommended that the exercises in DDAT be shared so that they can be tested objectively in a clinical-type trial with proper sample quality and control groups.

Second, there is no evidence that motor training influences higher-level skills; for example, if training coordination, balance, and motor skill had the hypothesized effect, then children good at sports like skateboarding should have a low rate of dyslexia and ADHD, an effect that has not been observed. One reviewer concluded, "It is important that family practitioners and paediatricians are aware that the claims made for this expensive treatment are misleading."

The cost involved in following the Dore programme has also been criticised. [cite news|title=UK company claims breakthrough ADHD treatment|publisher=ABC|url=http://www.abc.net.au/7.30/content/2006/s1703314.htm|date=08-01-06]

Of misleading claims

Claims were made and widely publicised that the Dore method used physical training methods for astronauts used by the US National Aeronautics and Space Administration (NASA) [http://www.dyslexia-teacher.co.uk/NASA.html] . NASA responded to that claim, saying that they were not conducting research into dyslexia, and had no evidence that any of their interventions might be effective in treating dyslexia [http://lizditz.typepad.com/i_speak_of_dreams/2006/02/wynford_dore_an.html] .

The UK's Independent Television Commission and Ofcom upheld complaints made about a 2002 news item on British television in which Sir Trevor McDonald hailed DDAT as a "breakthrough in the treatment of dyslexia". It repeated this decision about a later item on Richard and Judy, and found a television commercial made by DDAT to be in breach of Advertising Standards Code Rules for creating a false impression of the medical evidence, and implying that professional medical advice and support would be part of the treatment.In all these cases, however, they stated that: "the ITC does not express, nor does it seek to express, any view whatsoever on DDAT as an organisation or the relative efficacy of its treatment for dyslexia, neither of which was the subject of this finding." [cite news|title=TV Complaints Upheld About DDAT|author=Chris Tregenza|date=06-07-2004|publisher=Myomancy|url=http://www.myomancy.com/2004/07/tv_complaints_u.html] The complaints were mainly about claims that this was new and pioneering research when many elements date back to at least 30 years before the DDAT was founded. [cite news|title=Balancing act|date=07-16-02|publisher=The Guardian|url=http://education.guardian.co.uk/schools/story/0,5500,755624,00.html] ]

After the British journal "Dyslexia" published one paper about the Dore program in 2003, [cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=1 |pages=48–71 |title= Evaluation of an exercise-based treatment for children with reading difficulties |author= Reynolds D, Nicolson RI, Hambly H |doi=10.1002/dys.235 |pmid=12625376 |url=http://abc.net.au/4corners/content/2007/20070806_dore/FirstReynoldsNicolsonDyslexia2003.pdf |format=PDF |accessdate=2008-04-10] the paper was followed by ten critical commentaries [Critical commentaries of Reynolds "et al." 2003:
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=2 |pages=122–3 |title= Commentaries on the Reynolds "et al." article |author= Miles TR |doi=10.1002/dys.250 |pmid=12775084
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=2 |pages=123–4 |title= Commentary |author= Peer L |doi=10.1002/dys.246 |pmid=12775084
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=2 |pages=124–6 |title= Evaluation of an exercise based treatment for children with reading difficulties |author= Stein J |doi=10.1002/dys.247 |pmid=12775085
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=2 |pages=127–33 |title= A critique of claims from Reynolds, Nicolson & Hambly (2003) that DDAT is an effective treatment for children with reading difficulties—‘lies, damned lies and (inappropriate) statistics?’ |author= Snowling MJ, Hulme C |doi=10.1002/dys.245 |pmid=12775086 |url=http://abc.net.au/4corners/content/2007/20070806_dore/SnowlingCritiqueDyslexia2003.pdf |format=PDF |accessdate=2008-04-10
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=137–9 |title= The who, what, why and how of intervention programmes: comments on the DDAT evaluation |author= Rack J |doi=10.1002/dys.255 |pmid=12940295
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=140–5 |title= Reading intervention: a ‘conventional’ and successful approach to helping dyslexic children acquire literacy |author= Hatcher PJ |doi=10.1002/dys.254 |pmid=12940296
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=146–50 |title= Science, sophistry and ‘commercial sensitivity’: comments on ‘Evaluation of an exercise-based treatment for children with reading difficulties’, by Reynolds, Nicolson and Hambly |author= Richards IL, Moores E, Witton C "et al." |doi=10.1002/dys.258 |pmid=12940297
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=152–60 |title= Measurement mischief: a critique of Reynolds, Nicolson and Hambly (2003) |author= Singleton C, Stuart M |doi=10.1002/dys.256 |pmid=12940298
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=161–3 |title= A commentary on an article published in the February 2003 edition of ‘Dyslexia’, ‘Evaluation of an exercise-based treatment for children with reading difficulties’ (Reynolds, Nicolson, & Hambly) |author= McPhillips M |doi=10.1002/dys.259 |pmid=12940299
*cite journal |journal=Dyslexia |date=2003 |volume=9 |issue=3 |pages=164–6 |title= Reynolds, D., Nicolson, R. I. and Hambly, H. (2003). Evaluation of an exercise-based treatment for children with reading difficulties |author= Whiteley HE, Pope D |doi=10.1002/dys.257 |pmid=12940300] and one commentator resigned from "Dyslexia"'s editorial board.In 2006, five members of the board of directors resigned in protest of the publication of a followup article highly favorable of Dore, citing concerns about the methodology used in the study and financial conflicts of interest due to Dore's involvement in funding the research. [cite news |author= Swinford S |title= Scientists quit in dyslexia ‘cure‘ row |date=2006-11-26 |work= Sunday Times |url=http://www.timesonline.co.uk/tol/news/uk/article650136.ece |accessdate=2008-04-10] The editor of "Dyslexia" defended the decision to publish. [ [http://www.assemblywales.org/bus-home/bus-committees/bus-committees-third-assem/bus-committees-third-els-home/bus-committees-third-els-agendas.htm?act=dis&id=63637&ds=12/2007 EL(3)-09-07 : Paper 2 : Evidence to the Committee on Dyslexia Support in Wales - Professor Angela Fawcett - Director of the Centre for Child Research, Swansea University ] ]

A detailed criticism of the company's efforts to direct and control discussion was published by Ben Goldacre. [ [http://www.guardian.co.uk/commentisfree/2008/may/24/1 Goldacre article] ]

References

* [http://www.tes.co.uk/search/story/?story_id=397354 A Remedy Without Rigour - Times Educational Supplement article]
* [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12775086&dopt=Citation 'Lies, damned lies and (inappropriate) statistics' - Dyslexia journal reference]
* [http://www.timesonline.co.uk/article/0,,2090-1825506,00.html How I tackled 30 years of secret shame. "The Sunday Times", October 16, 2005]
* [http://www.mirror.co.uk/news/tm_objectid=16708277&method=full&siteid=94762&headline=dyslexia-cost-leo--fortune---name_page.html Dyslexia cost Leo fortune. "The Mirror", 16 February 2006]
* [http://www.myomancy.com/2006/02/ask_wynford_dor_1.html Ask Wynford Dore: The Ten Answers "Myomancy: Exploring the Science and Treatment of ADHD, Autism and Dyslexia", 27 February 2006]
* [http://www.dyslexiaaction.org.uk/Administration/uploads/DOREresponse.doc Follow-up of an exercise-based treatment for children with reading difficulties, "Dr John Rack, Head of Assessment and Evaluation, Dyslexia Action Professor Margaret Snowling and Professor Charles Hulme,Department of Psychology, University of York"]
* [http://www.mentalhealthwatch.org/reports/dore.shtml Controversial Therapy (Dore Program) Lacks research Basis] International Dyslexia Association News Release, October 23, 2004
* [http://www.bcap.org.uk/asa/adjudications/non_broadcast/Adjudication+Details.htm?Adjudication_id=43979 ASA Adjudication citing Kenny Logan as Dore employee]

Notes

External links

* [http://dore.co.uk/ Dore UK website]
** [http://www.dore.co.uk/International.aspx All Dore websites]