- The Institutes for the Achievement of Human Potential
The Institutes for The Achievement of Human Potential is a non-profit organization providing teaching programs and literature which it promotes as improving the health and neurological development of normal children and of children who have sustained a brain injury.
Although the institute's programs were supported by some notable individuals such as Linus Pauling (1901–1994) and Raymond Dart (1893–1988), their programs for brain injured children have been widely criticized. According to the American Academy of Pediatrics, the institute's patterning treatment is based on an outmoded and oversimplified theory of brain development, its effectiveness is not supported by evidence-based medicine, and its use is unwarranted.
IAHP has its own journal titled In-Report, which publishes results that are to be shared among fellow professionals.
Founded in 1955, the Institutes for The Achievement of Human Potential (IAHP, also known as "The Institutes") is located in Wyndmoor, Pa., a suburb of Philadelphia, Pennsylvania. The founder, Glenn Doman (a physical therapist), together with Carl Delacato (an educational psychologist), developed an approach to treating children with brain injury, published in 1960 in the Journal of the American Medical Association (JAMA). Glenn Doman received his degree in Physical Therapy from the University of Pennsylvania in 1940. Their work drew heavily on the ideas of Temple Fay (a neurophysiologist), who was head of the Department of Neurosurgery at Temple University Medical School and president of the Philadelphia Neurological Society. Fay believed that the infant brain evolves (as with evolution of the species) through stages of development similar to a fish, a reptile, a mammal and finally a human. This idea, encapsulated as "ontogeny recapitulates phylogeny", also known as the recapitulation theory, is considered obsolete by modern mainstream biologists. The IAHP claim that brain injury at a given level of neurological development prevents further progress. The IAHP states that its therapies are based on the theory of neuroplasticity, or the brain’s inherent ability to grow both functionally and anatomically. It claims that traditional medicine has attempted to treat brain injured children by medicating them, and that such medications can have negative side effects. The IAHP claims that due to neuroplasticity, their programs of increased sensory stimulation can actually physically grow the brain and produce improved neurological function in their patients. Another aspect of the IAHP's theories is that a lack of oxygen to the brain is a key cause of many problems in brain-injured children. The IAHP asserts that their program includes techniques that improve this oxygen supply, and that increased oxygen to the brain will help their patients recover.
Glenn Doman published the book What To Do About Your Brain-Injured Child in 1974, which describes the ideas and techniques used by IAHP. The subtitle of the book or your Brain-damaged, Mentally Retarded, Mentally Deficient, Cerebral-Palsied, Epileptic, Autistic, Athetoid, Hyperactive, Attention Deficit Disordered, Developmentally Delayed, Down’s Child lists the many conditions the author regards as being encompassed by "brain injured" – the term favoured by IAHP. Since 1964, Glen Doman (later also Janet and Douglas Doman) has published a number of books in the "Gentle Revolution Series", a line of books for parents of normal children, covering topics such as reading, math, intelligence, and swimming. Programs for "well children" are a significant aspect of the IAHP's promotional material, literature and web site.
Programs for brain-injured children
Before initiation of an IAHP program with their "brain-injured" children, parents attend a five day seminar that the IAHP presents called the "What To Do About Your Brain-Injured Child Course". The IAHP states that this course gives a good basis of understanding of their programs to parents. This course is presented in Philadelphia, Italy, Japan, Mexico, and Singapore.
The program for "brain-injured" children includes:
- Patterning – manipulation of limbs and head in a rhythmic fashion
- Creeping – forward bodily movement with the abdomen in contact with the floor
- Crawling – forward bodily movement with the abdomen raised from the floor
- Receptive stimulation – visual, tactile and auditory stimulation
- Expressive activities – e.g. picking up objects
- Masking – breathing into a rebreathing mask to increase the amount of carbon dioxide inhaled, which is believed to increase cerebral blood flow
- Brachiation – swinging from a bar or vertical ladder
- Gravity/Antigravity activities – rolling, somersaulting and hanging upside down.
(The above is taken from Understanding Mental Retardation, page 185-186.)
The program is designed to be used by a parent at home. Patterning is perhaps the key technique. IAHP state "if we have to put everything we do on one hook, patterning is really not a bad place to hang our hat" and "that if these patterns were applied rigorously, on a specific schedule, and done with a religious zeal, brain-injured kids improved." They believe the order of brain development occurs as higher brain stages are successively brought into play.
Programs for well children
The IAHP also provides programs and literature to the parents of well children. Glenn Doman believes that because the neurological development of brain injured children could be speeded, that the same should be true of well children. The IAHP provides a series of books and early education kits called the "Gentle Revolution Series", which state that their use will accelerate development of well children. For example, one program is "How to teach your baby to read"http://www.gentlerevolution.com.
The IAHP teaches a week-long seminar called the "How To Multiply Your Baby's Intelligence Course", which provides demonstrations of children taught with the IAHP's methods. The IAHP claims that at the course, "parents learn how to teach their children to read, how to learn a foreign language...mathematics, and music appreciation. Parents learn about sensory and motor development and the fundamentals of a good nutritional program for the family."
The IAHP requires that all brain-injured children be gradually weaned off anticonvulsants. They claim that seizures are a "natural reflex defense response to a lethal threat to the brain", but that the seizures themselves are not directly harmful to the brain. Instead of placing children on anticonvulsant medications, the IAHP claims that resources should be directed at "developing methods and bioactive agents that promote neuroplasticity", the brain's ability to grow and change. The IAHP asserts that status epilepticus can be caused by anticonvulsants and may be best left untreated by them. Instead, they believe that seizures can be reduced or eliminated by a "masking" program, which they claim periodically reduces oxygen intake and increases carbon dioxide intake. The IAHP also claims that seizures can be reduced by decreasing intake of salt and fluids, supplements of magnesium calcium and pyridoxine, and a healthy diet and environment.
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 and repeated in 1982. Their latest cautionary policy statement was in 1999, which was reaffirmed in 2002 and 2005. It stated:
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.... [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.
Since 1960 the IAHP has published multiple studies professing to show the effectiveness of the program. These studies, upon review, have not stood up to scientific scrutiny and have not been reproduced by other sources. In 1978, Sara Sparrow (professor emerita and senior research scientist at Yale Child Study Center) and Edward Zigler (professor emeritus at the Department of Psychology at Yale University, one of the principle architects of the US federal Head Start program and recipient of the 2008 APA Award For Outstanding Lifetime Contribution To Psychology) evaluated patterning as a treatment for retarded children. They concluded that no evidence was found for an improvement over that which would be expected of children given attention or that expected of any child as they mature; the patterning method cannot be recommended for seriously retarded children. Zigler wrote a 1981 editorial entitled "A plea to end the use of the patterning treatment for retarded children", which emphasized the harmful effect the treatment has by raising false hopes and increasing parental guilt. According to Edward Zigler and Robert Hodapp, in their book Understanding Mental Retardation, the Doman-Delacato method has major flaws:
- The recapitulation theory it is built upon has been discarded by the natural sciences.
- The suggestion that motor development has stages, which depend on earlier developments, is not supported by evidence.
- There is no evidence that passive movements by a child, forced to engage in crawling movements, affects neurological organization.
- Children who voluntarily perform an activity (such as sitting or walking) before mastering preceding stages, are prevented from doing so by the IAHP—possibly harming the child.
- The only scientific paper published by Doman on patterning (in 1960) contains many methodological errors and overstatements of findings. The study had no control group so was unable to compare with children who would naturally show some developmental progress over time. When independent scientists compared the results with the progress made by untreated children, the "results of patterning appear singularly unimpressive".
- The patterning procedure may be harmful to its participants (the parents experience guilt at being unable to achieve the intensive program required) and other family members through neglect.
- It is cruel to offer hope through a program that is impossible to fully carry out.
In addition to the American Academy of Pediatrics, a number of other organizations have issued cautionary statements about claims for efficacy of this therapy. These include the executive committee of the American Academy for Cerebral Palsy, the United Cerebral Palsy Association of Texas, the Canadian Association for Retarded Children the executive board of the American Academy of Neurology, and the American Academy of Physical Medicine and Rehabilitation.
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 and has not been replicated.
Kathleen Ann Quill, in her book Teaching children with autism: What parents want, says "thousands of families have wasted time and money to follow Doman's methods." She goes on to say "Professionals have nothing to learn from Doman's pseudoscientific treatments, but they have plenty to learn from his marketing strategy", which is aimed at parent's "hopes and fantasies".
Martha Farrell Erickson and Karen Marie Kurz-Riemer discuss Early Intervention with "Normal Infants and Toddlers" in their book "Infants Toddlers and Families". They claim Doman "capitalized on the desires of members of the "baby boom" generation to maximise their children's intellectual potential" and "encouraged parents to push their infants to develop maximum brain power". However his programs were "based on shaky or nonexistent research evidence" and "most child development experts at the time described many aspects of the program as useless and perhaps even harmful."
Martin Robards also cites widespread criticism in his book Running a Team for Disabled Children and Their Families but concedes that Doman and Delacato caused paediatricians and therapists to recognize that early intervention programs are needed.
The Doman-Delacato patterning technique is premised on a bankrupt and discarded theory and has failed when tested under controlled conditions. Its promotion with unsubstantiated claims can cause significant financial and emotional damage. Such claims can instill false hope in many people who are already plagued by guilt and depression, setting them up for a further disappointment, guilt, and feelings of inadequacy. The process can also waste their time, energy, emotion, and money. These resources may be taken away from their children. Parents can also be distracted from dealing with the situation in other practical ways and coping psychologically as a family with the reality of having a brain-injured or mentally retarded child. Parents are encouraged, in fact, to remain in a state of denial while they are pursuing a false cure.
A few notable individuals have expressed support for the IAHP.
Physicist Linus Pauling presented a talk on the "Orthomolecular enhancement of human development" in 1978 at a conference on human neurological development co-sponsored by the IAHP. In his opening remarks, he praised his hosts: "I admire the work that has been done in these Institutes very much. I know that considerable emphasis is placed on good nutrition for the people who come to the Institutes and that large doses of vitamin C are given to them."
Anthropologist Raymond Dart spent the last 20 years of his life dividing his time between South Africa and the IAHP. Dart supported the "ontogeny recapitulates phylogeny" premise behind the IAHP's work. Dart stated that "the development of the individual does, indeed, recapitulate the evolution of the species."
- ^ a b Robards, Martin F (June 1994). Running a Team for Disabled Children and Their Families. Cambridge University Press. p. 150. ISBN 0-901260-99-1.
- ^ a b c Committee on Children with Disabilities, American Academy of Pediatrics (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. http://pediatrics.aappublications.org/cgi/content/full/104/5/1149.
- ^ "IN-REPORT", Institutes for The Achievement of Human Potential
- ^ Doman RJ, Spitz EB, Zucman E, Delacato CH, Doman G (1960). "Children with severe brain injuries. Neurological organization in terms of mobility". JAMA 174: 257–62. PMID 13817361.
- ^ SQUAREONE PUBLISHERS http://www.squareonepublishers.com/gen_authors.html#Doman
- ^ The Society of Neurological Surgeons: http://www.societyns.org/society/bio.aspx?MemberID=7450
- ^ Scott F Gilbert (2006). "Ernst Haeckel and the Biogenetic Law". Developmental Biology, 8th edition. Sinauer Associates. http://8e.devbio.com/article.php?id=219. Retrieved 2008-05-03. "Eventually, the Biogenetic Law had become scientifically untenable."
- ^ Scherzer, Alfred L (November 2000). Early Diagnosis and Interventional Therapy in Cerebral Palsy. Marcel Dekker. p. 376. ISBN 0-8247-6006-9.
- ^ Glenn Doman and Dr. Ralph Peligra, "Ictogenesis: the origin of seizures in humans. A new look at an old theory." Medical Hypotheses Volume 10, Issue 1. pp. Pages 129-132 (January 2003)
- ^ Glenn Doman (2005-04-25) . What To Do About Your Brain-injured Child (Revised ed.). Square One Publishers. ISBN 0-7570-0186-6.
- ^ Glenn Doman, Janet Doman (2005-10-12) . How To Teach Your Baby To Read (Revised ed.). Square One Publishers. ISBN 0-7570-0185-8.
- ^ Glenn Doman, Janet Doman (2005-08-30) . How To Teach Your Baby Math (Revised ed.). Square One Publishers. ISBN 0-7570-0184-X.
- ^ Glenn J. Doman, Janet Doman (2005-11-05) . How To Multiply Your Baby's Intelligence (Revised ed.). Square One Publishers. ISBN 0-7570-0183-1.
- ^ Douglas Doman (2006). How to Teach Your Baby to Swim: From Birth to Age Six. Square One Publishers. ISBN 075700198X.
- ^ "IAHP website". Iahp.org. http://www.iahp.org/What-To-Do-About-Your-Brain-Inju.28.0.html. Retrieved 2010-03-09.
- ^ "Upcoming Courses". iahp.org. http://www.iahp.org/Upcoming-Courses.37.0.html. Retrieved 2010-03-09.
- ^ a b Zigler, Edward; Hodapp, Robert M (August 1986). Understanding Mental Retardation. Cambridge University Press. p. 306. ISBN 0-521-31878-5.
- ^ Janet Doman in an article "The Honorable Corps of Patterners" on the IAHP website.
- ^ The Institutes Developmental Profile, on the IAHP web site.
- ^ The IAHP website:http://www.iahp.org/How-to-Multiply-Your-Baby.328.0.html
- ^ a b Glenn Doman and Dr. Ralph Peligra, "Ictogenesis: the origin of seizures in humans. A new look at an old theory." Medical Hypotheses Volume 10, Issue 1. pp. Pages 129-132 (January 2003)
- ^ Roselise H. Wilkinson, MD. "Detoxification from anticonvulsants: 25 years of experience with brain-injured children". IAHP. http://www.iahp.org/Detoxification.302.0.html. Retrieved 2008-04-29. "...our rationale is also based on our strong belief that seizures serve a physiological function, as do the many other defense mechanisms of the body. Coughing, vomiting, diarrhea, fainting, and fever could also be viewed as dysfunctions, but we know that they are designed to protect the organism. So also are seizures. A seizure is an activity of great metabolic activity of the brain, and during its presence cerebral blood flow increases, providing more oxygen and glucose and increasing excitatory amino acids necessary for establishing the neuronal wiring and function."
- ^ Roselise H. Wilkinson, MD. "Detoxification from anticonvulsants: 25 years of experience with brain-injured children". IAHP. http://www.iahp.org/Detoxification.302.0.html. Retrieved 2008-04-29. "Additional measures are: I. Optimize respiratory function to increase oxygen availability. II. Masking--a procedure of rebreathing for short periods to gain CO2 enrichment resulting in a favorable acid base balance and to increase cerebral circulation. This technique is useful to shorten individual seizures as well. III. Restriction of sodium and liquids to prevent fluid retention and increased intracranial pressure. IV. Excellent nutrition to maintain good health and structures and to provide for energy and all needed vitamins, minerals, and neurotransmitter precursors. V. Magnesium and calcium supplements to promote central nervous system membrane stability. VI. Pyridoxine to support GABA and to increase the efficient use of oxygen by the brain. VII. Control the environment: Pollution, toxins, hyperthermia, reduced oxygen availability. VIII. Maintain excellent health--avoidance of infections, etc."
- ^ American Academy of Pediatrics. Doman-Delacato treatment of neurologically handicapped children. AAP Newsletter. June 1, 1968(suppl)
- ^ American Academy of Pediatrics, Committee on Children With Disabilities. The Doman-Delacato treatment of neurologically handicapped children. Pediatrics. 1982; 70:810-812. PMID 6182521
- ^ a b Holm VA (1983). "A western version of the Doman-Delacato treatment of patterning for developmental disabilities". West J Med 139 (4): 553–6. PMC 1021589. PMID 6196919. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=1021589.
- ^ "Sara S. Sparrow, Ph.D., Yale Child Study Center: Yale School of Medicine". Childstudycenter.yale.edu. http://childstudycenter.yale.edu/faculty/sparrow.html. Retrieved 2010-03-09.
- ^ "Edward F Zigler, Yale Psychology Faculty". Yale.edu. http://www.yale.edu/psychology/FacInfo/Zigler.html. Retrieved 2010-03-09.
- ^ Edward Zigler Receives 2008 APA Award For Outstanding Lifetime Contribution To Psychology Medical News Today. 14 August 2008.
- ^ Sparrow S, Zigler E. Evaluation of a patterning treatment for retarded children. Pediatrics. 1978; 62:137-150. PMID 693151.
- ^ Zigler E A plea to end the use of the patterning treatment for retarded children. Am J Orthopsychiatry. 1981; 51:388-390. PMID 7258304
- ^ 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
- ^ United Cerebral Palsy Association of Texas. The Doman-Delacato Treatment of Neurologically Handicapped Children [information bulletin, undated]. Austin, TX: United Cerebral Palsy Association of Texas
- ^ Canadian Association for Retarded Children. Institutes for the Achievement of Human Potential. Ment Retard. Fall 1965:27-28
- ^ American Academy of Neurology and American Academy of Pediatrics Joint Executive Board Statement. The Doman-Delacato treatment of neurologically handicapped children. Neurology. 1967; 17:637
- ^ American Academy of Physical Medicine and Rehabilitation. Doman-Delacato treatment of neurologically handicapped children. Arch Phys Med Rehabil. 1968; 49:183-186. PMID 4296733
- ^ Malkowicz DE, 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.
- ^ Quill, Kathleen Ann (June 1995). "page 57". Teaching Children With Autism. Thomson Delmar Learning. p. 336. ISBN 0-8273-6269-2.
- ^ Erickson, Martha Farrell; Kurz-Riemer, Karen Marie (March 2002). "page 17". Infants Toddlers and Families. Guilford Press. p. 204. ISBN 1-57230-778-1.
- ^ a b Novella S (2008). "Psychomotor patterning: a critical look". Quackwatch. http://quackwatch.org/01QuackeryRelatedTopics/patterning.html. Retrieved 2008-10-23.
- ^ Pauling, Linus (November 1978). Ralph Pelligra, ed.. ed. "Orthomolecular enhancement of human development" (PDF). Human Neurological Development: Past, Present, and Future. A Joint Symposium Sponsored by NASA/Ames Research Center and the Institutes for the Achievement of Human Potential. NASA CP 2063: 47–51. http://profiles.nlm.nih.gov/MM/B/B/K/G/_/mmbbkg.pdf.
- ^ Review by Jean Clark of "Dart: Man of Science and Grit" by Frances Wheelhouse and Kathaleen S. Smithford, published in STATNews vol. 6, issue 11, September 2003.
- ^ "Palm Springs Life". Officiallizaminnelli.com. http://www.officiallizaminnelli.com/careerarchive/articles/2007-November-PPS.html. Retrieved 2010-03-09.
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