TheDoman-Delacato Treatment of Neurologically Handicapped ...

AMERICAN ACADEMY OF PEDIATRICS 0

Policy Statement

The Doman-Delacato Treatment of

Neurologically Handicapped Children

Over the past two decades, the Institutes for the has even been published, nor is there evidence of

Achievement of Human Potential and their affihi- any attempt to validate it by comparison with any

ates have made continuing claims for the efficacy accepted methods.

of their methods of treatment for brain damage and Claims have been made for a substantial number

other disorders.”2 A number of organizations have of cures,2 and the claims have extended beyond

issued cautionary statements regarding these therapy for disease states, asserting that the treat-

claims,8 including a formal statement by a consor- ment can make normal children superior,2’#{176}”7’9

tium of American and Canadian organizations pub- ease world tensions,2 and possibly “hasten the evo-

lished by the American Academy of Pediatrics on lutionary process.”2’’#{176}

June 1, 1968. Recent media coverage and an in- Without supporting data, Doman and Delacato

creasing number of inquiries from parents and pub- have indicated many typical child rearing practices

lic officials dictate that the Academy review the as limiting a child’s potential, thereby increasing

current status of the controversy, update and mod- the anxiety of already-burdened and confused par- 0

ify the 1968 statement, and propose some recom- 2,19

mendations. Notwithstanding these dramatic claims, we are

The reasons for concern include the following: aware of only one study2’ since 1967 that has sug-

The promotional methods employed by the In- gested small functional improvements in some pa-

stitutes’#{176}” make it difficult for parents to refuse tients receiving patterning. The fact that virtually

such treatment without calling into question their no new data have been presented since 1967 to

adequacy and motivation as parents. support the Doman-Delacato treatment is by itself

The regimens prescribed by the Institute are so cause to question the extensive claims made for

demanding and inflexible’0”2 that they may place patterning.

considerable stress on parents and lead to their

neglect of other family members’ needs.’3 THE THEORY

Advocates assert that the child’s potential will be The theory, which is alleged to be universally

reduced if therapy is not carried out as rigidly applicable,2’8’2223 is based largely on oversimplified

prescribed and that less than 100% effort is useless concepts of hemispheric dominance and the rela-

and is the cause of any failure of the treatment tionship of individual sequential phylogenic devel-

approach. ‘a” opment.22’23 According to the theory, the great ma-

Restrictions are often placed on age-appropriate jority of cases of mental retardation, learning prob-

activities of which the child is capable, such as lems, and behavior disorders are caused by brain

walking or listening to music,’3”4 although these damage or “poor neurological organization,”5 and

restrictions are not supported by data or long-term all these problems lie somewhere on a single contin-

results published to date. uum of brain damage, for which the only effective

Claims are made for rapid and conclusive diag- treatment is that advocated by the Institute.2”#{176}

nosis’5 based on a “Developmental Profile” utilized The information currently available does not sup-

by the Institutes.’6 However, no basis for the Profile port these contentions. In particular, the lack of

uniform dominance or sidedness is probably not a 0

PEDIATRICS (ISSN 0031 4005). Copyright © 1982 by the significant factor in either the etiology or the ther-

American Academy of Pediatrics. apy of these conditions.2429

810 PEDIATRICS Vol. 70 No. 5 November 1982
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Cultural and anthropologic differences have also dren, the investigators concluded that patterning

been “explained” by the theory. For example, the cannot be considered superior to any other method

lack of a written language in some primitive tribes of treatment.

0 is attributed to restrictions on crawling and creep- Previous cautionary statements have emphasized

ing,3#{176a} very narrow and questionable view. the need for well-controlled studies of the effects of

One careful review of the theory has led to the the treatment. Conducting a study of all aspects of

conclusion that “the tenets are either unsupported the Institutes’ claims presents many theoretical and

or overwhelmingly contradicted when tested by practical difficulties (B. S. Rosner, unpublished

theoretical, experimental, or logical evidence from data, 1967). A well-designed, comprehensive study

the relevant sctritific literature. As a scientific hy- (supported by both federal and private agencies)

pothesis the theory of neurological organization was in the final planning stage when the Institutes

seems to be without merit.”22 Another review3 con- reportedly withdrew their original agreement to

cluded that the theoretical rationale for the method participate.44 With the failure of this attempt, the

was not consistent with generally accepted views burden of proof for claimed results lies with the

about the nature of neurologic development. Institutes, particularly as a more recent, smaller

controlled study43 demonstrated no particular bene-

CURRENT STATUS OF CLAIMED THERAPEUTIC fit from patterning treatment.
RESULTS

SUMMARY

Results published by or for the Institute have

been inconclusive.1531’32 Many reports of improve- The Institutes for the Achievement of Human
other groups
ment in reading ability after treatment have been Potential differ substantially from

heralded as support for the theory,’8 but statis- treating developmental problems in (1) the exces-

tical analysis reveals few demonstrable benefits.2135 sive nature of their poorly documented claims for

Controlled studies of the Doman-Delacato treat- cure and (2) the major demands placed on parents

ment with respect to reading claims have shown in unswervingly carrying out an unproven tech-

little or no benefit from the treatment.39 mque to the smallest detail.

It has been pointed out repeatedly that some In most instances, improvement observed in pa-

0 handicapped children who purportedly benefited tients undergoing this method of treatment can be

from treatment had had their condition misdi- accounted for on the basis of growth and develop-

agnosed or had been given unduly pessimistic prog- ment, the intensive practice of certain isolated

noses. The course of maturation in these children skills, or the nonspecific effects of intensive stimu-

is varied, leading to unwarranted claims that im- lation.

provements were due to a specific form of treat- Physicians and therapists should acquaint them-

ment’2’22’4#{176}’4’Some of the cases dramatically publi- selves with the issues in the controversy and the

cized by the Institutes have been children with available evidence. Based on past and current anal-

traumatic brain damage or postencephalitis, who yses, studies, and reports, we must conclude that

may make substantial gains without any special patterning treatment offers no special merit, that

treatment. the claims of its advocates are unproven, and that

Three years after a 1975 critique of an experi- the demands on families are so great that in some

mental evaluation of sensorimotor patterning,42 in- cases there may be harm in its use.

vestigators undertook a controlled study.43 This

study compared three groups of children, all of

whom were severely mentally retarded and insti- REFERENCES

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patterning treatment over standardized care.43 dren. Information Bulletin, undated

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PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication, it
has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked by the
American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois, 60007.
Copyright © 1982 by the American Academy of Pediatrics. All rights reserved. Print ISSN: 0031-4005.
Online ISSN: 1098-4275.

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The Doman-Delacato Treatment of Neurologically Handicapped Children
Pediatrics 1982;70;810

The online version of this article, along with updated information and services, is located on
the World Wide Web at:
/content/70/5/810

PEDIATRICS is the official journal of the American Academy of Pediatrics. A monthly publication,
it has been published continuously since 1948. PEDIATRICS is owned, published, and trademarked
by the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village,
Illinois, 60007. Copyright © 1982 by the American Academy of Pediatrics. All rights reserved. Print
ISSN: 0031-4005. Online ISSN: 1098-4275.

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