The Appeal of Unvalidated Treatments

Report
The Appeal of Unvalidated
Treatments
BY CAITLIN LABARBERA
ABA 553 ASSESSING AUTISM
INTERVENTIONS
Introduction
 With the rise of autism and other developmental
disabilities there is a new claim for a cure around
every corner.
Introduction
With all these new “fad” treatments, we as
professionals need to be able to identify
interventions that are both validated and
plausible.
Validated Treatments
 Scientifically Valid Treatments
 Involve
Increasing skills in specific areas
 Improving functioning in every day situations
 Contain controlled studies
 Consistent with previous knowledge
 Treatments with solid scientific support:
 Applied
Behavior Analysis
 Psychotropic Medication
Unvalidated Treatments
 Pseudoscientific Treatments
Interventions that are considered to have little
to no scientific basis
Appealing because they are advertised as
 Cures
 Fast and Easy
 “Deeper” Benefits
 Natural
How can you determine if a treatment is both
validated and plausible, or if it is just another
fad?
Tristram Smith gives us several key pointers on picking out
Scientifically Valid Treatments while weeding out
Pseudoscientific Interventions.
Cure
We found a cure…
 Popular interventions that “found a cure” included:
 Facilitated
Communication
 Auditory Integration Training
 Gentle Teaching
All were found to be infective and some proved to
create problems instead of eliminating them.
Important Sounding but Vague
Benefits
Important Sounding but Vague Benefits
 Lack scientific evaluations
 Lack controlled studies
 Benefits are so vague that testing them
would be difficult if not impossible.
 http://www.youtube.com/watch?v=8JdDU0Ql8EI
Controlled vs. Uncontrolled Studies
 ABA and Psychotropic Medication – Scientifically
rigorous and controlled studies
 Unvalidated treatments – Make no distinction
between rigorous and nonrigorous studies
Uncontrolled
 Lack objective measures

 Megavitamin Therapies
Technology
 Technology has extraordinary uses in science but
having technology in a treatment does not mean that
the treatment is ligament.
 Is the technology used reliable and does it support
the study?
Criticisms of Validated Treatments
 Criticism may be used to justify implementing their
own interventions
 Using criticism to hide one of their own faults
 “Criticisms of one treatment or its practitioners do not
constitute evidence for the effectiveness of another
treatment (Smith 2005) .”
Subjective Evidence
 Unvalidated interventions tend to rely on
 Testimonies
 Case
from parents
studies
 Surveys
 Popularity
 Longevity
 These things cannot be substitute for a controlled
study
 http://www.youtube.com/watch?v=3qR6aDkVjYY
Example: Diets – Eliminating Dairy and Wheat.
 Is it really the diet?
 Parents
desire to see gains
 Protein deficiency
 Spending more time with child
 Deprivation – Motivation
 Other environmental changes
Core Deficits
 Once the deficit is corrected there will be global
improvements in functioning
 Two believed deficits include:
 The lack of ability to form reciprocal relationships
 Problem in processing or sensory input
 Proposing that changes in one behavior will by
itself lead to changes in other behaviors goes
against a large body of research on humans and
other organisms in both clinical and laboratory
settings (Detterman&Sternberg,1995).
Natural Therapies
 “Natural Therapies”
 Special
diets to eliminate food additives
 Cut out wheat a dairy
 Chelation therapy
 Antifungal medications
 Shunning vaccinations
 “Natural” does not mean safe or effective.
Treatment Combinations
 Treatments are often combined in hopes to
accelerate and maximize treatment
 Some treatments encourage combinations
 Megavitamins
 Reality - combining treatments have no effect and
can even reduce effectiveness of treatments.
Experimenting
 Implementing a new treatment
 First,
make only one treatment change at a time
 Second, Identify specific target behaviors
 Use objective measures to obtain a baseline
 Finally, monitor changes in the target behavior
on an on going basis with objective measures
obtained by raters who are blind to treatment.
• HYMAN AND LEVY (2000)
 http://www.youtube.com/watch?v=qbhkX2oBmJ
Y
 What would be appealing?
 How many red flags can you pick out?
Evaluating Treatments
 Treatments that are both validated and plausible
 Treatments that are Unvalidated and implausible
Reference
 Jacobson, J. W., Foxx, R. M., & Mulick, J. A. (2005).
Controversial therapies for developmental
disabilities, fad, fashion, and science in professional
practice. Lawrence Erlbaum.
 http://www.youtube.com/watch?v=s6Svp81lPhQ

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