Chapter 4 Re

view:

The Appeal o

f

Unvalidated

Treatments

ToniAnne Giunt

a

Caldwell Colle

ge

Overview

Opening Activity: Appealing or Not Opening Activity: Appealing or Not Appealing? That is the question! Appealing? That is the question!

Claims About TreatmentsClaims About Treatments

Evaluating InterventionsEvaluating Interventions

Closing Activity: Effective or Not Closing Activity: Effective or Not Effective? That is the REAL question!Effective? That is the REAL question!

Jacobson (2000)Jacobson (2000)

Carey (2009)Carey (2009)

Koegel & LaZebnik Koegel & LaZebnik (2004)(2004)

Freeman (2007)Freeman (2007)

Apsell (1993)Apsell (1993)

Appealing or Not Appealing? That is the question!

Appealing or Not Appealing? That is the question! ““This This treatment treatment will will curecure your your child.”child.”

Appealing or Not Appealing? That is the question! ““This treatment This treatment will provide will provide enhanced enhanced learninglearning, , increased focusincreased focus, , improved body improved body awarenessawareness, , greater well-greater well-beingbeing, and a , and a greater sense of greater sense of selfself.”.”

Appealing or Not Appealing? That is the question! ““StudiesStudies on on this this treatment treatment have been have been thoroughly thoroughly conducted.”conducted.”

Appealing or Not Appealing? That is the question! ““This This treatment treatment uses only uses only the most the most sophisticatsophisticated ed equipmentequipment..””

Appealing or Not Appealing? That is the question! ““So many So many other parents other parents have reported have reported this this treatment to treatment to be helpful be helpful with their with their children’s children’s diagnoses.”diagnoses.”

Appealing or Not Appealing? That is the question! ““Your child has a Your child has a single single core core deficitdeficit. Once . Once corrected with corrected with this treatment, this treatment, there will be there will be global global improvements in improvements in all aspects of all aspects of functioningfunctioning..””

Appealing or Not Appealing? That is the question! ““This This treatment treatment is is naturalnatural, , which means which means that it is that it is safesafe.”.”

Claims About Treatments(Smith, 2005)OutcomesOutcomes

Cure Cure

Healing, miracle, breakthroughHealing, miracle, breakthrough

Important-sounding but vague benefitsImportant-sounding but vague benefits

Should translate to improvements in Should translate to improvements in everyday functioningeveryday functioning

Claims About Treatments(Smith, 2005)

EvidenceEvidence

Uncontrolled studiesUncontrolled studies

Do not include controls, objective measures, Do not include controls, objective measures, or observable behaviors or observable behaviors

Opposition from the “establishment”Opposition from the “establishment”

Diversion tacticDiversion tactic

TechnologyTechnology

Only reliable when controlled studies support Only reliable when controlled studies support its use for a specific problem its use for a specific problem

Claims About Treatments(Smith, 2005)EvidenceEvidence

Criticisms of validated treatmentsCriticisms of validated treatments

A selling point for interventionsA selling point for interventions

Subjective evidenceSubjective evidence

Diet exampleDiet example

Claims About Treatments(Smith, 2005)TheoryTheory

Core deficitsCore deficits

Simplifying treatmentsSimplifying treatments

Natural therapiesNatural therapies

““Too much water causes drowning” (p. 53)Too much water causes drowning” (p. 53)

Evaluating Interventions(Smith, 2005)Treatment combinationsTreatment combinations

Do the treatments have tangible effects Do the treatments have tangible effects when presented alone?when presented alone?

Detrimental effectsDetrimental effects

Evaluating Interventions(Smith, 2005)ExperimentingExperimenting

1. Make only one treatment change at a time1. Make only one treatment change at a time

2. Identify target behaviors to be 2. Identify target behaviors to be addressedaddressed

3. Objectively measure the behavior before 3. Objectively measure the behavior before and during treatment phasesand during treatment phases

4. Have blind raters also objectively 4. Have blind raters also objectively measure the target behaviormeasure the target behavior

Appealing or Not Appealing? That is the question!

Appealing or Not Appealing? That is the question!

<not<REAL

Effective or Not Effective?

Effective or Not Effective? That is the REAL question!““This This treatment treatment is is scientificscientifically ally validatedvalidated..””

Effective or Not Effective? That is the REAL question!““The The treatment treatment has been has been designed designed around around plausible plausible theoriestheories.”.”

Effective or Not Effective? That is the REAL question!““This treatment This treatment has a has a high high probability of probability of success success in in increasing many increasing many functional functional skills, including skills, including in communication, in communication, social social interaction, interaction, self-help, and self-help, and leisure areas.”leisure areas.”

Question period

ReferencesApsell, P. S. (Producer). (1993). Apsell, P. S. (Producer). (1993). Secrets of the psychics Secrets of the psychics [VHS]. [VHS].

Available from Available from http://www.amazon.com/

Carey, B. (2009, December 19). Study finds increased prevalence of Carey, B. (2009, December 19). Study finds increased prevalence of autism. autism. The New York TimesThe New York Times. Retrieved from . Retrieved from http://www.nytimes.com/

Freeman, S. K. (2007). Freeman, S. K. (2007). The complete guide to autism treatments: A The complete guide to autism treatments: A parent’s handbook: Make sure your child gets what works! parent’s handbook: Make sure your child gets what works! Lynden, Lynden, WA: SKF Books, Inc. WA: SKF Books, Inc.

Jacobson, J. W. (2000, Spring). Is autism on the rise? Jacobson, J. W. (2000, Spring). Is autism on the rise? Science in Science in Autism Treatment, 2Autism Treatment, 2(1). Retrieved from (1). Retrieved from http://asatonline.org/

Koegel, L. K., & LaZebnik, C. (2004). Koegel, L. K., & LaZebnik, C. (2004). Overcoming autism. Overcoming autism. New York, NY: New York, NY: Penguin Books.Penguin Books.

Smith, T. (2005). The appeal of unvalidated treatments. In J. W. Smith, T. (2005). The appeal of unvalidated treatments. In J. W. Jacobson, R. M. Foxx, & J. A. Mulick (Eds.), Jacobson, R. M. Foxx, & J. A. Mulick (Eds.), Controversial Controversial therapies for developmental disabilities: Fad, fashion, and science therapies for developmental disabilities: Fad, fashion, and science in professional practice in professional practice (pp. 45-57). Mahwah, NJ: Lawrence Erlbaum (pp. 45-57). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.Associates, Inc.