Rehab

There was an interesting article on the CNN website that lamented that Lohan and Spears were making a "mockery" of the entire rehab process.

Did it really take a strung out actress and a singer past her prime to do that?

Not that I feel bad for them, but really - how much of this is the fact that two good-looking girls are going all out and crazy as opposed to two guys?

There is hardly a tree in the New York suburb of Suffolk that has not been crashed into by a car owned by Bily Joel. And hardly a drug that Robert Downing Jr. has not used to excess.

I wonder about rehab. Does it really work? Are there studies out there that allow us to examine the efficacy and effectiveness of the most commonly used procedures in drug and alcohol treatment? Alcoholics Anonymous does not allow for independent research to examine these aspects of their treatment.

Furthermore, any individual who does question AA is often sent for re-training (at least here in New York). These re-training sessions are similar to the re-education camps that Mao Zedong sent those who opposed the Communist party.

At its core, rehab attempts to stop behaviors, and gives very few skills to replace behaviors. I mean, seriously, does playing squash really take the place of a good drink? (see the ads of TV and in our schools: "Do sports, don't drink").

Rehab is in essence a bunch of DRA procedures- a differential reinforcement of alternative behaviors. People are reinforced for playing ping pong as opposed to drinking or smoking pot.

The problem is that you can do both at the same time. Hey - just look at Sunday softball games - they are designed so you can drink and play at the same time. And Keith Hernandez, legendary baseball player of the 80's used to pop into the dugout between innings to down a cold and snort a line or two.

The issue which people in the rehab treatment community don't really get is that there is really nothing out there which is as reinforcing as drugs or alcohol. There is nothing really that can replace it.

Maybe it might be better to help these people change their environment, permanently. Rehab is a place that these people use which (to borrow a word from the field) "enables" these people. It changes their environment temporarily, allows people to feel falsely secure in this new environment, and discourages people from actually making changes.

It does, however, allow these people to talk about the changes that they want to make. But talking isnt doing.

So, when we blame Brittney Spears or Lindsay Lohan for "making a mockery" of rehab, consider that maybe the intervention of rehab is flawed. Where is the evidence?

When should school districts pay for private special education?

The New York Times ran an interesting article about a case to appear in front of the Supreme Court.

Tom Freston, the former chief executive of Viacom, the company that runs MTV and Comedy Central is worth $85 million. In 1997, his son, then 8, was found to be lagging in reading. The NYCDOE offered his son a coveted spot in the Lower Laboratory School for Gifted Education, a competitive school on the Upper East Side that also has classes for students with moderate disabilities. He would have been placed in a classroom with 15 students, and given speech and language therapy.

Freston chose to place his child in the Stephen Gaynor School on the Upper West Side, where students, in Gaynor’s language, display “learning differences.” While the city is required by federal law to pay for private programs for disabled children when it cannot provide appropriate programs, city officials said the Lab program was suitable for Mr. Freston’s son and wanted him to try it. After two years of reimbursing the Frestons for a large part of the private school tuition, the city stopped.

Now Freston wants his due.

Although the Supreme Court will hear this particular case, it has implications which are far-ranging. The real question is: Do school districts have to pay for private school for disabled children if the families refuse to try out public programs?

The answer should not be an over-powering "yes" or "no"; the Supreme Court would do well to decide this case in a narrow judgement. That is to say, they should decide whether the city owes Freston the money or not, but should go on to state that each case must be decided independently.

Let me indicate some points. There is no evidence that the program that the city offered was bad or inappropriate to the Freston's son's learning needs. Therefore, I truly think that the Frestons should have attempted a trial run of approximately 3 months before making the decision to switch over (that could have been a good time to use many of the tracking programs that are out there such as Aimsweb or DIBELS).

However, I see that many programs that Local Educational Agencies (LEA's) offer are often staffed by poorly trained teachers, with little or no support to deal with special educational issues. I have gone in to see many programs that deal with children with autism which are so inappropriate. In these instances, it is necessary that parents DO NOT take the chance to enroll their children in those programs.

Why is CHC Theory Not Accepted by Mainstream Media?

I was going through a few online things, and stumbled upon the about:psychology site. I checked the Theories of Intelligence page. This page (and site) is targeted to laypersons and is by no means a substitute for psychology training.

Curiously absent is CHC Theory. CHC (which stands for Cattell-Horn-Carroll theory after the three theorists which have helped to advance it) is a topic which I have not blogged about for a while, but I have actually had several discussions about why CHC as a theory of intelligence (or cognitive abilities) is not more widespread.

It is important to promote CHC Theory as it has demonstrated the most reliability and validity when compared to other intelligence theories. This is an important fact in the age of "evidence-based" practices. It also operates on an almost "open-source" model in which it is open to a vast amount of people who seem to research small tracts of the theory in order to add to the collective whole (by the way, this is actually the way that science needs to work).

For those of you who have attempted to read up on CHC theory, you will be the first to agree that there are few, if any primers on the theory. There are no websites with snippets of information on the theory, what it is all about, and how it might be applied.

Why not? Let me know.

Phonics is good, no matter what you say...

There was an article which cam out yesterday (3/9/07) in the New York Times (click the title for the link) highlighting the phonics-whole language debates.


I think that this is silly.


Children taught with a phonics approach are at an advantage when they are asked to perform tasks sch as fluency and comprehension. Additionally, phonics instruction also benefits comprehension as shown by the Comprehensive Leadership Program







As can be seen, there significant comprehension benefits to phonics instruction.

As I have made my point previously when discussing evidence based interventions for children with autism, not providing children with evidence based interventions amounts to educational neglect and some of the worst violations of social justice.

People in the article cited improvements using techniques that are not evidence based - however, their data are based on one district's one-year improvement - even after they changed their method of assessment (they changed their test).

Click here for the National Reading Panel's video entitled Teaching Children to Read. Although one may purchase it, it is available for free as a streaming download - just scroll down.

What is a school psychologist?

Sorry all for my departure - I was quite sick for some time and I had some problems installing Windows Vista on one of my computers.

I wanted to start to begin to answer the question in my title - what is a school psychologist. It is a particularly difficult profession to define - even its members are currently engaged in a debate as to what a school psychologist is.

Historically, the first school psychologists were teachers who were re-trained in psychology. These school psychologists were to consult with teachers regarding difficult learning and behavioral issues.

As the testing craze hit its phase, school psychologists because primarily evaluators.

Currently, this is how I would define the term. A school psychologist is:

1. An applied educational psychologist
2. A professional who is versed in child pathology so that s/he may prevent problems in the school setting.
3. A consultant to teachers, administrators and professionals for learning and behavior problems.

One of the things which strikes me is how professionals may not be willing to consult with school psychologists as they assume that they do not know the current research on evidence based practice in educational settings. Hopefully this will change.

For more information please consult the NASP Website page: Who are School Psychologists?

Autism and Evidence Based Interventions: A Matter of Social Justice

I recovered my mail this morning and saw a flyer for a conference here in New York City on Autism and Early Childhood/Interventions. I was pretty interested, until I opened up the pamphlet to read what was being presented.

There is a full-day presentation on the Son-Rise program, and another one on the PLAY program. There were various break-out sessions on DIR (the Developmental, Individualized and Relationship Oriented model of Stanley Greenspan). There was also a seminar on the integration of chiropractic care in the treatment of autism.

These programs, models and various types of care have no evidence to support them. There is no study that has documented that any or all of these studies will work better than Applied Behavior Analysis, which is the treatment of choice for children with autism.

I do not have a child with autism. I cannot imagine fully the extent that these parents suffer and how they yearn for a treatment that will solve everything, immediately. However, there is no evidence that any of the treatments I mentoned before (e.g., Son-Rise, DIR, chiropractic treatment) do anything to help children with autism. In fact, since the implementation of these strategies means displacing strategies that do work (i.e., Applied Behavior Analysis), it is most possible that these new strategies could be damaging.

Imagine if you were diagnosed with a very bad case of diabetes, and you stumbled upon an ad online which reads, "Stop your insulin right now, and try this new technique, which will help you cure your diabetes". Would you do it?

Would you still try the new treatment if there were no studies to document that the treatment actually did anything to improve diabetes? OK, so how about this question: will you risk being off the treatment that works (e.g., insulin medication managament) in order to try the new medication/treatment?

The answer is no.

Not implementing evidence based interventions is also dangerous when viewed through a social justice framework. These interventions cost a great deal of money, and people who are not financially capable may be pressed into undue economic stress in order to implement programs and expensive consultations which they believe may help their children.

For example, a prominent school in Manhattan which implements DIR techniques costs over $70,000/ year. While parents can petition their school districts to re-pay the money, the school demands this money up front.

This means that people who do have a child with autism (and have been duped into believing that DIR does work) will be forced to do things they may not normally do (dip into college funds, life insurance policies, etc.) because they have been given wrong information. None of those treatments listed in the second paragraph have been demonstrated, scientifically, to work better than other treatments out there.

It is society's responsibility to ensure a basic quality of life for all its citizens, especially those with disabilities. In this society, those who have a degree and purport that these technologies work are acting unethically and immorally. Those people have a moral responsibility to report that which treatments work and which do not.

In order to do so, we need to implement ideas, interventions, and treatment programs that will work effectively and will not strain those in economic hardship.

National Reading Panel report

In 1997, Congress asked the “Director of the National Institute of Child Health and Human Development (NICHD), in consultation with the Secretary of Education, to convene a national panel to assess the status of research-based knowledge, including the effectiveness of various approaches to teaching children to read.”

This panel was charged with providing a report that “should present the panel’s conclusions, an indication of the readiness for application in the classroom of the results of this research, and, if appropriate, a strategy for rapidly disseminating this information to facilitate effective reading instruction in the schools. If found warranted, the panel should also recommend a plan for additional research regarding early reading development and instruction.”


http://www.nichd.nih.gov/publications/nrp/intro.htm