Hi, We are also looking for what people think of The Institutes for the Achievement. Glenn Doman from IAHP is one of the original creators of. – Glenn Doman. Do parents make good teachers? 'Mothers and kids are the most dynamic learning combination possible. The process of learning is a joyous and intimate one for mother and child. Mothers are the best teachers.' – Glenn Doman 'At The Institutes we have learned to listen to mothers.
Psychomotor Patterning: A Critical Look Steven Novella, M.D.In the 1960s, psychomotor patterning was proposed as a newtreatment modality for people with mental retardation, brain injury,learning disabilities, and other cognitive maladies. The methodwas subjected to controlled trials and found to be of no value.It was debated in the scientific literature up until the early1970s, when the scientific medical community arrived at the consensusthat is should be discarded as a false concept with no therapeuticrole. Its use, however, has not stopped.The concept of patterning was invented by Glenn Doman and C. Delacato andis therefore often referred to as the Doman-Delacato technique 1. Theirtheories are primarily an extension of the outdated concept that ontogeny(the stages through which organisms develop from single cell to maturity)recapitulates phylogeny (the evolutionary history of the species). Thus theneurodevelopmental stages of crawling, creeping, crude walking, and maturewalking through which normal children develop is directly related to theamphibian, reptilian, and mammalian evolutionary human ancestors 2.Doman and Delacato postulated that mental retardation represents a failureof the individual to develop through the proper phylogenetic stages.
Theirtreatment modality supposedly stimulates proper development of these stages,each of which must be mastered before progress can be made to the next stage.This stimulation is done through what they call 'patterning,' inwhich the patient moves repeatedly in the manner of the current stage. Inthe 'homolateral crawling' stage, for instance, patients crawlby turning their head to one side while flexing the arm and leg of that sideand extending the arm and leg of the opposite side. Patients who are unableto execute this exercise by themselves are passively moved in this mannerby 4-5 adults, alternating back and forth in a smooth manner. This must berepeated for at least 5 minutes, 4 times per day.
This exercise is intendedto impose the proper'pattern' onto the central nervous system. In the full treatmentprogram, the exercises are combined with sensory stimulation, breathing exercisesintended to increase oxygen flow to the brain, and a program of restrictionand facilitation intended to promote hemispheric dominance 3. Advocates claimthat patterning enables mentally retarded and brain injured children to achieveimproved, and even normal, development in the areas of visuo-spatial tasks,motor coordination, social skills, and intellect. They also claim to promotesuperior development in a normal child 4.The theoretical basis of psychomotor patterning is therefore based on twoprimary principles, the recapitulationist theory of ontogeny and phylogeny,and the belief that passive movements can influence the development and structureof the brain.
As Delacato stated in 1963:Man has evolved phylogenetically in a known pattern. The ontogenetic developmentof normal humans in general recapitulates that phylogenetic process. Wehave been able to take children who deviate from normal development (severebrain injured) and through the extrinsic imposition of normal patternsof movement and behavior have been able to neurologically organize themsufficiently so that they can be placed within a human developmental patternof crawling, creeping, and walking 3.Medical treatments are evaluated on two criteria, their theoretical basisand their empirical value. The scientific community has rejected patterningon both counts. By the 1960s, it became clear that recapitulation it is basedon an incorrect linear concept of evolution. Evolutionary lines continuouslybranch and deviate, forming a complex bush of relationships, not a linearladder of descent.
Embryological development does not reflect the maturestages of other distant branches of this evolutionary bush. Studying theembryology of the developing fetus also does not reveal any evidence of successivestages reflecting past evolutionary ancestors.There is also no theoretical basis for the belief that patterns can be impressedupon the developing cortex. Brain development is genetically driven and involvesa complex sequence of cell growth, migration, organization, and even programmedcell death. Abnormalities in this process can be caused by genetic flaws,toxic insults, infection, or biochemical abnormalities. There is no modelby which any of these disparate causes can be influenced by passive, or evenactive, movement of the neck and limbs.
Thirty years of subsequent neurological,embryological, and medical progress have failed to lend any theoretical orclinical support for Doman and Delacato's principles.Their use of breathing exercises to promote oxygen delivery to the brainalso lacks an acceptable theoretical basis. The brain and the cardiovascularsystem are designed to give highest priority to oxygen flow to the braincells. Elaborate and powerful feedback mechanisms ensure adequate delivery.It is true that carbon dioxide retention, in this case achieved through breathingtechniques, does increase blood flow to the brain. There is absolutely noreason to believe, however, that this helps the developing brain.In 1982, the American Academy of Pediatrics issued a concluding that 'patterning' has no special merit,that its proponents' claims are unproven, and that the demands on familiesare so great that in some cases there may be actual harm in its use. TheNational Down Syndrome Congress endorsed this statement and displayed iton its Web site for several years 5.Of course, if clinical evidence could demonstrate that patterning improvesneurological development, it would be still accepted and used.
Many mainstreaminterventions lack a fully understood theoretical basis. Physicians are,at their heart, practical individuals, and if something works, it works.They require proof, however, that an intervention does indeed work and issafe.On this score, patterning has just not delivered. During approximatelyten years in the late 60s and early 70s, dozens of clinical trials comparedgroups of developmentally delayed children given patterning treatment tocomparable who received no treatment but similar amounts of attention 2,6-8.None confirmed the claims of Doman and Delacato.
Some found modest improvementsin motor or visuo-spatial skills, but none showed improved intellectual development.The few positive studies were neither impressive nor reproducible. Eventually,such clinical trials stopped and the scientific community abandoned the techniqueas a blind alley.The tragedy of this story does not stem from the fact that patterning isa failed theory. It is regrettable that patterning did not deliver as promised,for any legitimate treatment for brain injured and retarded children wouldbe most welcome. The real tragedy began, however, when Doman and Delacatoreleased their claims for a new dramatic treatment before their theorieshad been scientifically validated.
This behavior, similar to the'cold fusion' fiasco, is more than just professionally irresponsible.In physics, such behavior is merely bad form; when dealing with the desperateparents of brain injured children, it should be considered cruel. Doman andDelacato were widely criticized for publicizing their unsubstantiated claimsand giving false hope to vulnerable parents and their afflicted children.The saga, however, did not end with the scientific death of patterning.Doman, Delacato, and their associates incorporated the patterningtechnique into their program at the (IAHP), which was establishedin Philadelphia in the 1950s and still operates today. A second facility,the in Huntsville, Utah, offerspatterning as part of their treatment program. The NACD is run by RobertDoman, the nephew of Glenn Doman, although both institutions state that thereis no association between the two.On August 8, 1996, NBC aired a program titled 'Miracle Babies,' hostedby Kathy Lee Gifford. The program included a segment portraying an apparent 'miraclecure' of a child suffering from moderate mental retardation.
As is typicalof the lay media, Kathy Lee provided an emotionally appealing view of patterningwithout even a hint of skepticism. The segment did bring out the desperatenessof the parents. They were clearly devastated, as any parents would be, bythe need to finally accept that their child was not developing normally.In their desperation, they sought any possible hope, and it was offered tothem by the IAHP. The hope that they purchased, however, came at a heavyprice, both financial and emotional.The IAHP and the NACD both rely heavily on the family as the primary deliverersof the patterning treatment. In order to even reach the stage where theirchild can be enrolled into the aggressive treatment program, they must firstcomplete a training and evaluation course that begin with purchasing andlistening to a set of audiotapes. The IAHP states in their literature thatonly the most dedicated and capable parents will make it to the final stageof treatment.
The NACD appears less demanding, but follows the same principle.The program requires families to alter their lives to institute a daily programof patterning exercises, breathing exercises, and sensory stimulation. Themother interviewed by Kathy Lee stated that the program was so demandingthat it dominated her life, resulting in emotional and physical exhaustion.The program also illuminated another important feature of the patterningphenomenon, the difference between anecdotal and scientific evaluation ofits effectiveness. Most children, even severely mentally retarded children,still grow and develop, although more slowly than average. Therefore, anychild admitted into any treatment program will make some progress as an inevitableconsequence of time and their natural development, even if that treatmentprogram is completely worthless. Without adequate controls, it is thereforeimpossible to evaluate any such treatment. Of course, Kathy Lee and the parentsof the child on the program reported remarkable progress.
Whether or notthe treatments played any role, however, cannot be known. The viewers, however,were encouraged to believe that they had witnessed a miracle cure.NACD and IAHP literature both caution that individual results will vary.It also implies that if the patient fails to make significant progress, theparents are to blame. The NACD also embraces other scientifically questionablepractices.
Its Web site offers the following screening test for 'foodsensitivities':Check the following list. If three or more applyto your child, food sensitivity may be a problem:. Sometimes congested.
History of ear infections. Behavior: frequent ups and downs. Poor attention span at times.
Night or morning coughing spells. Variable hearing, sometimes good, sometimes poor. Post-nasal drip.
Headaches. Periods of restlessnessAlthough the problems listed above undoubtedly have a number ofpossible causes, food sensitivities must be considered as one ofthe most likely 9.Food sensitivties have no proven relationship to behavior, and most of theabove symptoms are not related to food sensitivity.
The NACD has also offereda consultation with an 'orthomolecular physician' and a 'holisticnutritionist.' Such practitioners are clearly outside of the scientificmainstream. Current AAP PositionReacting to promotion through the media, the American Academy of Pediatricspublished an updated review in 1999 that it reaffirmedin 2006. This review concludes:Treatment programs that offer patterning remain unfounded; ie, they arebased on oversimplified theories, are claimed to be effective for a varietyof unrelated conditions, and are supported by case reports or anecdotal dataand not by carefully designed research studies. In most cases, improvementobserved in patients undergoing this method of treatment can be accountedfor based on growth and development, the intensive practice of certain isolatedskills, or the nonspecific effects of intensive stimulation.Physicians and therapists need to remain aware of the issues in the controversyover this specific treatment and the available evidence.
On the basis ofpast and current analyses, studies, and reports, the AAP concludes thatpatterning treatment continues to offer no special merit, that the claimsof its advocates remain unproved, and that the demands and expectationsplaced on families are so great that in some cases their financial resourcesmay be depleted substantially and parental and sibling relationships couldbe stressed 10. The Bottom LineThe Doman-Delacato patterning technique is premised on a bankrupt and discardedtheory and has failed when tested under controlled conditions. Its promotionwith unsubstantiated claims can cause significant financial and emotionaldamage. Such claims can instill false hope in many people who are alreadyplagued 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 theirchildren. Parents can also be distracted from dealing with the situationin other practical ways and coping psychologically as a family with the realityof 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. References.
Doman RJ, Spitz EB, Zucman E, Delacato CH, Doman G. Children with severebrain injuries: Neurologic organization in terms of mobility. JAMA 174:257,1960. Cohen HJ, Birch HG, Taft LT.
Some considerations for evaluating the Doman-Delacato 'Patterning' method.Pediatrics 45:302- 14, 1970. Delacato CH. The Diagnosis and Treatment of Speech and Reading Problems.Springfield, Illinois: Charles C Thomas, 1963. Doman G, Delacato CH.
Train your baby to be a genius. McCall's magazine,March 1965, p 65. American Academy of Pediatrics. Pediatrics 70:810-812, 1982. Neman R and others. Experimental experimental evaluation of sensorimotorpatterning used with mentally retarded children. American Journal of MentalDeficiency 79:372-84, 1975.
Ziegler E, Victoria S. On 'An experimental evaluation of sensorimotorpatterning': A Critique. American Journal of Mental Deficiency 79:4. Freeman RD. Controversy over 'patterning' as a treatment forbrain damage in children. JAMA 202:83-86, 1967. Doman RJ.
Journal of the National Academyof Child Development 4(2): 1984. Committee on Children with Disabilities.
Pediatrics104:1149-1151, 1999.Reaffirmed Jan 2006.Dr. Novella, a member of Quackwatch's advisory board, is Assistant Professorof Neurology at Yale University School of Medicine and president of. This article is adapted from an articlein The Connecticut Skeptic, Vol. 1 Issue 4, Fall 1996.This article was revised on February 9, 2008.
Directions From Philadelphia International AirportMost major domestic carriers have flights to Philadelphia. In addition, British Airways flies to Philadelphia International Airport from London.From JFK International Airport, New YorkThe following limousine companies will take passengers from JFK International Airport, New York, to The Institutes:Dave’s Limousine Service:800-255-BEST (2378)Reservations are required. All limousine services must be contacted in advance and given the passengers’ names, airline, flight number, and time of arrival.By Airport Rail Line from Philadelphia AirportSouth Eastern Pennsylvania Transportation Authority (SEPTA) Airport line is the best and least expensive way to get to Center City, Chestnut Hill, and The Institutes.SeeThe Institutes is located down the street from the Septa Chestnut Hill East station.Trains generally depart every 30 minutes from the four domestic airport terminals. Trains stop at 30th St. Station, Suburban Station, and Market East Station. Connecting trains from Chestnut Hill can be taken from any of these three stations, as described below.By TrainThe Chestnut Hill West Station is on Germantown Avenue and is served by trains from three Center City railway stations:Market East (12th and Market Streets)Suburban Station (16th Street and J.F Kennedy Blvd.)30th Street Station (30th and Market Streets)Trains depart about every 60 minutes. The ride takes about 35 minutes.
The Institutes is a short taxi ride, or half-mile walk, from the Chestnut Hill West Station.The Chestnut Hill East Station is served by trains from the same stations. The schedule is slightly different and the terminus is closer to The Institutes. Once you arrive at the Chestnut Hill East Station, leave the station from the entrance facing Bethlehem Pike. Turn right onto Newton Street (this is a very short street, terminating at Stenton Avenue).
You can actually see the walled entrance of the Institutes from the station end of the street.For Details, contact: South Eastern Pennsylvania Transportation Authority (SEPTA): (215) 580 – 7800By TaxiIf taking a taxicab from the airport, we suggest approaching the taxicab starter, advising him of your destination, and asking the approximate charges. Then let the driver know that you will need a receipt for your records, as this will lessen the chances of overcharging.
You can also insist that the meter be used. Tell the driver that the address is 8801 Stenton Avenue, Wyndmoor, PA 19038 near the intersection of Stenton Avenue and Bethlehem Pike. It may be wise to show him the map located here.Local Taxicab CompanyThe following taxicab company can be called for transportation from Fort Washington to The Institutes, or from Philadelphia to The Institutes:Montco Suburban Taxicab Co. (215) 572 – 6100Automobile Rental InformationRental agencies are located within the Philadelphia Airport.
For worldwide reservations:Hertz Rent A Car: (800) 654 – 3131Avis Rent A Car: (800) 331 – 1212Budget Rent A Car: (800) 527 – 0700National Rent A Car: (800) 227 – 7368By AutomobileFrom the West, North or East:Take the Pennsylvania Turnpike to the Fort Washington Exit (Exit 339). After exiting from the turnpike, follow Route 309 South to the Paper Mill Road (Springfield) Exit. Go right onto Paper Mill Road to the fourth traffic light at Stenton Avenue. Make a left turn onto Stenton Avenue. The Institutes are 200 yards up Stenton Avenue, on the left.From the South:Take Route 95 North to Route 476 north.
Go 19.2 miles and exit at Germantown Pike (Plymouth Meeting). Turn right at the traffic light and travel east on Germantown Pike for 3.5 miles. Turn left onto Northwestern Avenue. At the first light (Stenton Avenue) turn right and go to the second traffic light. Turn right to continue on Stenton Avenue.
The Institutes are 200 yards up Stenton Avenue, on the left.MapsClick to download a Map to The Institutes:You will need to have the Adobe Acrobat Reader on your computer to view the map.