A year of Occam's Donkey

Well, Occam's Donkey has survived its first year intact.

I have found the experience of blogging and following other blogs enormously enriching. I have been forced to blow the cobwebs of years of neglect from an ageing brain and hopefully detached and untangled some of the plaques and tangles(metaphorically). I have enjoyed being a thorn in the side of some of the South African quackeries.

Has this blog (and thousands of others like it) made a difference? Is pseudoscience and quackery on the retreat? Is there an upward trend in the use of critical thinking and evidence supported practice? In the immortal words of Shrek's Donkey:

"Are we there yet?"

Dr. Ben Goldacre and one of his commenters supplied the answer in Bad Science:

"It’s only when you line these jokers up side by side that you realise what a vast and unwinnable fight we face."

and

"I sometimes think the woos have won and we’re fighting a guerilla campaign in occupied territory."

I'm afraid gullibility still rules and will continue to do so in the foreseeable future, especially in my field of interest, education. Quackery, especially those with neuroscience pretentions, often aided and abetted by the educational authorities and the teacher unions, flourish. Let's see what we can do about it in 2009.

Cartoon (somewhat altered) from Philosophy and Reasoning Network.

Welsh rugby and papal deaths

Rugby (the religion of Wales) and its influence on the Catholic church: should Pope Benedict XVI be worried?. This authors of this tongue-in-the-cheek article in the British Medical Journal investigated a Welsh urban legend that:

"... every time Wales win the rugby grand slam, a Pope dies, except for 1978 when Wales were really good, and two Popes died."

A graphic from the article, indicating the winners of the Six Nations Championship (its current name), grand slams achieved (winning all the games) and papal deaths.


The authors' conclusion?

"We found a borderline significant (P=0.047) association between Welsh performance and the number of papal deaths but no significant associations between papal mortality and performance of any other home nation."

They believe that the pontiff should just be a wee bit concerned, considering Wales' dominance in the Six Nations this year. Its less sterling performance against the Southern teams such as the Springboks and All Blacks was not considered.

Not to be outdone, a group of medical doctors from Italy, one of them on the Vatican medical team, commented that they were more worried about the general performance of the Welsh rugby team than about the health of the pope!

Hat tip to Dave Snowden for this story. As he pointed out, it is a satire on the old correlation proves causation fallacy.

Bringing this closer to home, with the current ascendancy of the South African rugby and cricket teams, similar correlations could "cause" a veritable massacre. The sorry record of our soccer team, however, should allow one to cherry pick suitable celebrities who should put their trust on the Bafana Bafana's continued poor performance. Their only achievement of any note was winning the African Nations' Cup in 1996. Francois Mitterrand died during the tournament, but I sure Nicholas Sarkozy will not lose any sleep about it.

Metaphors for woo and war

My previous post was about the use of metaphor and framing in the fight against pseudoscience. I continue this theme with some amusing examples of metaphor and onomatopoeia for woo and war.

Woo

I'm using the word woo as a synonym for pseudoscience and quackery (and because it rhymes better with war than bullshit).

Quack

Quack is short for quacksalver, which is derived from the Dutch kwakkensalver. Kwakken refers to boasting, salve an ointment. Quacksalver therefore literally boasting about an ointment. The term therefore was literal initially. Somewhere along the line it became associated with the sound ducks make, therefore quacking like a duck. The initial literal kwakkenzalver became the metaphor quack. See for instance this image of a duck on Dr Stephen Barrett's well-known website Quackwatch:

Based on the sound it makes and its flocking behaviour, South Africans know of an equally appropriate avian simile or metaphor for quacking, the Redbilled Woodhoopoe, or the more telling Afrikaans name, the "kakelaar" (literal English translation, the cackler). This is how it's described in Newman's Birds of Southern Africa:

"The call is a high-pitched cackling started by one and taken up by others to produce a cacophony of hysterical laughter similar to but more musical, less mechanical-sounding than the Arrowmarked Babbler (see Katlagter later in post). Fly from tree to tree in a straggling procession, settling low down and working their way to the top before flying of to the next tree."

A single kakelaar. Their crazed cackling and seemingly senseless scurrying behind each other from the the bottom to the top of a tree before flying off to the next, make for great entertainment. An appropriate metaphor for a quacking granfalloon? (Did I mention that kakelaars stink?)

War

The Devil's Paintbrush

Some years ago I did research on the use of Maxim machine-guns in the Anglo-Boer War (1899 - 1902). The Maxim was the first really effective mass-produced machine-gun. Hiram Maxim, an American, invented it after being told by friend that the way to get rich was to:

"... invent something that will enable these Europeans to cut each other's throats with greater facility."

The Vickers-Maxim machine-gun and its licenced German version, the Spandau, were in large part responsible for the horrible slaughter that occurred in no-man's land between the opposing trenches of the First World War. This earned the Maxim the grim nickname and descriptive metaphor, the Devil's Paintbrush.

A Maxim Extra-Light Model 1895 used by Boer forces.

The "katlagter" (literally, the laughing cat)

Maxim's machine-guns were used extensively by both sides in the 2nd Anglo-Boer War. Some interesting similes, metaphors and onomatopoeia describing Maxim's machine-guns and their effect, arose during the conflict. One of the Boer soldiers' names for the Maxim .303 caliber machine-gun, was the katlagter. It is the Afrikaans name of a bird, the Arrow-marked Babbler. Roberts Birds of South Africa describes its call as follows:

"... a grating churr which is uttered by all the birds in a party one after the other. The effect is a whirring, grating, crescendo of sound, getting louder and louder as each bird joins in and dying away as they stop one by one."

Some years ago a friend and I went hunting in the Northern Tranvaal (a bushveld area of South Africa). At our campsite, I suddenly heard a racket exactly as described above. It sounded exacly like a machinegun and I knew it had to be katlagters (babblers). I scanned the noisy culprets through my binoculars and checked my Roberts bird book. Yes, they were Arrow-marked Babblers. The nickname my Boer ancestors had given the Maxim machine-gun was quite appropriate.

A katlagter (Arrow-marked Babbler), thank you to Dries vd Merwe's photostream.

The Pom-Pom

The Maxim-Nordenfelt, or Pom-Pom, was an overgrown Maxim machine-gun that fired one pound shells. It was quite ineffective, but scared the enemy and was a great morale booster on your side. Its nickname was an onomatopoeia, based on either the sound of the shells being fired, or the explosion of its shells one after the other. Here are some more descriptions of the Pom-Pom, rich in figurative language:

Arthur Conan Doyle (describing how hardened soldiers):

"... found a new terror in the malignant 'ploop-plooping' of the automatic quick-firer".

In another account Pom-Pom shells are described as having:

"... flapped and clacked along the ground in a straight line like a string of geese".

A Boer War Maxim-Nordenfelt Pom-Pom.

To call a quack a quack has become politically incorrect and even illegal in some places. A war a hundred years ago provides us with some alternatives. How do cacklers, babblers and pom-poms sound?

Metaphors for countering pseudoscience

Kruglanski and others have an interesting article in the October/November 2008 edition of Scientific American Mind on the use of metaphor to determine framing in countering terrorism. It holds some lessons for those of us who try to counter pseudoscience and quackery in education and other related fields. The article is not fully available online and I shall therefore summarise it briefly.

Kruglanski et. al. point out that terrorism and counterterrorism was framed differently by successive US administrations, especially by the use of different metaphors when discussing these issues. These metaphors and the resulting framing influenced the actions taken against terrorism. Presidents Nixon and Reagan used disease metaphors. Clinton used justice metaphors, while Bush used war metaphors. According to Kruglanski et. al., framing couterterrorism as war has certain costs:

"It threatens to corrupt society's values, disrupts its orderly functioning and reshuffles its priorities. War calls for the disproportunate investment of a nation's resources, with correspondingly less left for other concerns, including the economy, health care and education."

This was clearly written from a specific ideological perspective and someone else may have concluded differently about the implications of the war metaphors being used. The fact is, however, that the metaphors used had some influence on the actions of participants.

There is a great deal of controversy in Psychology on issues of metaphor and framing. To misquote Bob Sutton, this is a field where strong opinions are strongly held. I am not current with the details of disagreements in this field. Different views that need to be considered are those of Steven Pinker, George Lakoff and Daniel Kahneman. A much discussed debate between Pinker and Lakoff, with some informative comments, can be found at this link. Chris at Mixing Memory commented extensively, if somewhat ad hominem, on the debate.

Framing the fight against pseudoscience

In using the word fight, I am already framing the action against pseudoscience as a war. In fact, it it difficult to avoid war metaphors. In a recent post on the blog Neurologica, neurologist Steven Novella made extensive and conscious use of war metaphors. He justified it thus:

"We are also in the midst of an endless culture war, a struggle between two aspects of human nature. On the one hand are the proponents of mysticism, superstition, pseudoscience, and anti-science. On the other are the defenders of science and reason.

Some of my skeptical colleagues have objected to the military analogy, but we are engaged in a real struggle, and we are fighting over more than bragging rights. The stakes are real: control of resources, support and recognition of government, the running of institutions, access to the media and to the halls of academia and education."

I believe that war metaphors are inevitable in this "fight". This holds the danger of alienating possible converts to science and reason, but there is hopefully little chance that the war metaphor will become literal.

A second frame is that of ridicule. Examples of this are to be found in many posts on the blog Bad Science by Ben Goldacre. Words (not necessary metaphoric) that signal a frame of ridicule include bullshit, nonsense, woo, quack, granfalloon, gullibility and so forth. The danger of using this frame is the thin line between legitimately ridiculing the opponent and his/her position on the one hand, and the use of ad hominem and straw man fallacies on the other (not Goldacre, just generally). Ridicule, even more than using the war metaphor, will harden attitudes and may prevent converts to science and reason. Having said that, the chance of converting the pseudoscience huckster gurus is slim. The targets for conversion should be the camp-followers (i.e. franchise holders) and the consumers (i.e. parents, teachers, schools). Well directed ridicule (against the gurus) may sway their attitudes. An example here was the ridicule Paul Dennison, the founder of Brain Gym, was subjected to on television.

A third and last frame (I'm sure there are more) is education. Words that would signal an educational frame include information, knowledge, evidence, training, science and so forth. A good example of an organisation that operates according to an educational frame, is Sense about Science in Britain. The targets of activities from within an educational frame would mainly be the potential consumers of pseudoscientific approaches. The vehicles through which education should proceed include the mass media, the internet and blogs such as this one. Education has the problem that it often assumes pre-existing knowledge and attitudes that its targets do not always have, often because of inadequate school and tersiary education. These include inadequate knowledge of science and scientific methods, of critical thinking, added to which a general lack of mindfullness and questioning attitudes.

In conclusion, different metaphors and frames should be geared to the intended targets one wishes to influence. There is a place for war talk, ridicule, education and probably for many additional frames I did not think about. So let the fight against pseudoscience continue (metaphorically)!

More views on metaphors and framing:

Grey, W. (2000). Metaphor and Meaning.

Iyengar, S. (2005). Speaking of Values: The Framing of American Politics.

Ward et al. (2008). Metaphors are mindfunnels (Mainly reflecting George Lakoff's views). Hat tip to Sonja from Narrativelab for this last reference.

Neuromythologies in Education

I place this abstract as a whole and unchanged, as it reflects much of what this blog is about and says it better than I can. Hat tip to Monica Pignotti, contributing to Psychologists Educating Students to Think Skeptically (PESTS-I) , for this reference and abstract.

Geake, J. (2008). Neuromythologies in Education. Educational Research, 50, 2 123 – 133.

Abstract:

Background: Many popular educational programmes claim to be 'brain-based', despite pleas from the neuroscience community that these neuromyths do not have a basis in scientific evidence about the brain.

Purpose: The main aim of this paper is to examine several of the most popular neuromyths in the light of the relevant neuroscientific and educational evidence. Examples of neuromyths include: 10% brain usage, left- and right-brained thinking, VAK learning styles and multiple intelligences

Sources of evidence: The basis for the argument put forward includes a literature review of relevant cognitive neuroscientific studies, often involving neuroimaging, together with several comprehensive education reviews of the brain-based approaches under scrutiny.

Main argument: The main elements of the argument are as follows. We use most of our brains most of the time, not some restricted 10% brain usage. This is because our brains are densely interconnected, and we exploit this interconnectivity to enable our primitively evolved primate brains to live in our complex modern human world. Although brain imaging delineates areas of higher (and lower) activation in response to particular tasks, thinking involves coordinated interconnectivity from both sides of the brain, not separate left- and right-brained thinking. High intelligence requires higher levels of inter-hemispheric and other connected activity. The brain's interconnectivity includes the senses, especially vision and hearing. We do not learn by one sense alone, hence VAK learning styles do not reflect how our brains actually learn, nor the individual differences we observe in classrooms. Neuroimaging studies do not support multiple intelligences; in fact, the opposite is true. Through the activity of its frontal cortices, among other areas, the human brain seems to operate with general intelligence, applied to multiple areas of endeavour. Studies of educational effectiveness of applying any of these ideas in the classroom have failed to find any educational benefits.

Conclusions: The main conclusions arising from the argument are that teachers should seek independent scientific validation before adopting brain-based products in their classrooms. A more sceptical approach to educational panaceas could contribute to an enhanced professionalism of the field.

Have leadership myths brought us to the brink?

In a deliciously bitter post, Donald Clark slates leadership theories and asks whether leadership training was the cause of the global economic meltdown.

"Has the cult of ‘leadership’ contributed to megalomaniac behaviour that ultimately led to the financial crisis? All of this leadership lark is quite recent. For years we got by with management training, good old sensible stuff about being nice, clear and organised. Then, around the Millennium, the training world went all evangelical about ‘Leadership’."

Clark echoes many of the thoughts of Francis Wheen in an equally delicious chapter, Old snake-oil, new bottles, in his book How mumbo-jumbo conquered the world.



Clark continues and points out that leadership training has:

"... no solid core of theory it’s a potpourri of ideas. The cult of leadership, a relatively recent phenomenon, was grabbed with glee by the training community. A mishmash of management theory, culled from a few airport management books, they put their slides together and became leadership zealots, simply padding out the word ‘Leadership’ into a course, a miscellany of mumb-jumbo."

He has particularly harsh words for leadership gurus:

"I‘d call these false prophets, as they are basically song and dance men, all performance and no substance. It’s good old fashioned preaching with stories, parables, miracle cures, and live performance."

Though he does not draw the link specifically, this last quote illustrates something I've referred to before, the misuse of the look and feel of religion, sometimes even the substance, as a tool for manipulation and marketing. ENRON was a good example.

Donald Clark continues and questions the popular distinction between management and leadership. He points out that mission statements and hubris have replaced intellectual analysis and common sense. Peter Drucker and Jim Collins according to him had it right, good leadership is no more than good management.

I recall that some years ago the educational authorities in South Africa got on to the vision/mission/leadership bandwagon and exhorted school principals to become CEO's and inspirational leaders. Fortunately sanity prevailed, for as Jeffrey Pfeffer and Bob Sutton pointed out in their book, Hard facts, dangerous half truths and total nonsense: Profiting from evidence-based management, such jobs come with much responsibility, but little authority and few resources. School principals remained just ordinary managers, hopefully still inspiring the odd child or teacher.



In another context Bob Sutton quotes the populiser of the management / leadership distinction, Warren Bennis:

"Managers are people who do things right and leaders are people who do the right thing."

I wonder what the victims of the subprime crisis, of ENRON and Worldcom, of Fidentia in South Africa, would say to that? Are the mining magnates of the mining companies that are raping South Africa's water resources by strip mining pristine wetlands for coal doing the "right thing"? How about the executive mayors of towns and cities that are flooding our rivers with raw sewerage. Or have they read the latest management tomes in airport bookshops, Hitler's guidelines for inspirational leadership and Manage like Mugabe?

Typing this blog

You can now have your blog typed at Typealyzer, as in Myers-Briggs. Hat tip to Dave Snowden and the Neurocritic. Just like the Myers-Briggs, it should not be taken too seriously. So, what's the verdict?

This blog (and the blogger, I quess) is of the INTP type:

"The logical and analytical type. They are especialy attuned to difficult creative and intellectual challenges and always look for something more complex to dig into. They are great at finding subtle connections between things and imagine far-reaching implications.

They enjoy working with complex things using a lot of concepts and imaginative models of reality. Since they are not very good at seeing and understanding the needs of other people, they might come across as arrogant, impatient and insensitive to people that need some time to understand what they are talking about."

Well, it seems that no more than 20% of this blogger's brain is active. Right side is a bit neglected. The rear is a dead loss. An excellent case study for the whole-brain half-witters.

CSIR suspends scientist

In my previous post I reported on the executive board of the Council for Scientific and Industrial Research (CSIR) suppressing the keynote address that one of its scientists, Dr Anthony Turton, would have delivered at its biennial Science: Real and Relevant conference. The board of the CSIR has now followed up its ill-considered action with the suspension and planned disciplinary hearing of Dr Turton. Not only this, it has vindictively forced him to vacate his office, surrender his computer and terminate his internet access.

A number of prominent scientists and environmental activists has expressed their disgust about these events, including Drs Carl Albrecht (CANSA), Francois Durand (University of Johannesburg) and Ms Mariette Lieferink (Federation for a Sustainable Environment). All expressed their concern about the suppression of science and scientists.

According to IOL, Dr Turton is to be charged with insubordination and bringing the CSIR into disrepute. If anyone brought the organisation in disrepute, however, it would seem to be its executive board for bowing to whatever political and/or corporate pressures it is being subjected to and for not standing by its scientists and their scientific findings.

CSIR suppresses science

In news just in this week, the Council for Scientific and Industrial Research (CSIR), has muzzled and seems to be victimizing one of its own scientists. I quote from the newspaper article in the Cape Times, available online on IOL:

The Council for Scientific and Industrial Research (CSIR) has prevented one of its scientists from delivering the keynote address at its conference in Pretoria.

Dr Anthony Turton, of the CSIR's natural resource and environment unit, was to deliver a 19-page address on water quality, entitled A Clean South Africa, as the keynote address in the CSIR's Science Real and Relevant conference on Tuesday.

On Monday, Turton was told he could not give the address.

"I was told it had been pulled, and I was instructed not to be on the premises. I was given three different reasons by three different people," Turton said.

According to the newspaper article the CSIR alleged that the address was withdrawn because certain statements "could not be sufficiently substantiated". This is doubtful, however, as the address was subjected to a peer review process and no scientific objections were raised.

Reading between the lines, the real reason seems to be reflected in the last paragraph of the newspaper article, which is paraphased from Dr Turton's banned address:

A reason was that funding was from private contracts, not the government, exposing the CSIR to the risk of being "hijacked by private interests".

"We cannot allow this to happen, because (it would erode) science, engineering and technical capacity."

Was Turton's address suppressed at the demand of some corporate sponsors of the CSIR, such as the mining houses that are now strip mining coal from our pristine wetlands in Mpumalanga province? Did his address hit too close to the truth for the greedy mining magnates?

This cartoon (slightly altered) from the Union of Concerned Scientists seems appropriate.

The CSIR describes itself as "... one of the leading scientific and technology research, development and implementation organisations in Africa." What is to be said of its ethics and scientific integrity if it suppresses science and scientists due to pressure from corporate sponsors? Even if its assertion of unsubstantiated statements in Turton's address was true (which I doubt), it should have been left to scientists to deal with the inaccuracies. After all, it is said that science is the only field of human endeavor that is self-correcting.

Consider also the disciplinary action against environmental scientists in Kimberley for opposing greedy developers and corrupts politicians. This pattern of victimisation of scientists by administrators and politicians is unacceptable.

Mind myth 7: Learning styles and multiple intelligences

This is the seventh mind myth in my series of mind myths applicable to education. It relates to two related ideas that are popular with "progressive" educators and educational policy makers the world over. The twin ideas that major individual, meaningful differences exist in children's (and adults') learning styles and multiple intelligences, have served to hide the unfortunate reality that some individuals struggle to learn whatever the input; and that some individuals lack mental capacity. Do individuals differ in terms of learning styles and multiple intelligences and can catering to such differences improve instruction methods in schools and colleges?

Learning styles

So-called learning styles are a mixed bag of different concepts - Coffield et al. (2004) identified more that 70 different and sometimes competing learning styles. Many of these are commercially based and offer expensive proprietary tests and training, trust the hucksters not to miss an opportunity for profit.

Stahl (1999) tried to order the field somewhat by differentiating between learning preferences, cognitive styles, personality types and aptitudes. He had to concede, however, that the learning style concept had much in common with fortune telling. Though he did not label it such, what he referred to is known as the Forer effect - where ambiguous statements that are hard to disagree with are made. The validity of different learning styles and the validity and reliability with which they can be assessed are equally a mixed bag.

Let us accept that some learning styles are valid concepts and can be validly and reliably assessed. The question then arises whether knowing learners' learning styles and adapting your instructional methods to complement those styles is feasable and effective? The answer is unfortunately an unequivocal NO. It sounds good in theory, but is does not work. Hattie (1999) showed that the effect size of individualization in schooling across 180 000 studies (no, not a typing error) was only 0.14 of a standard deviation, which is trivial. There are numerous other studies that come to the same conclusion, individualised instruction based on some putative characteristic of the learner does not work. Let me put it more bluntly, the evidence shows that catering your instructional methods according to the known learning styles of the learners in front of you is ineffective and a waste of time and energy. That also applies to the most widely spread learning style based methods used in teaching, the so-called visual-auditory-kinesthetic modality or VAK approach.

Another line of research that applies to both learning styles and multiple intelligences is the largely futile search for Cronbach's aptitude by treatment interactions (ATI's). In 1956 Lee Cronbach called for a combination of experimental and correlational research designs to address complex realities in fields such as education. This line of research came to be knowns as the study of ATI's. By 1975 Cronbach conceded that the search for ATI's had been unsuccessful. This is part of a much larger debate about the philosophy of science and scientific paradigms. Suffice to say, attempts to taylor instruction (treatment) to the personal characteristics (aptitude) of learners have been largely unsuccessful. For a discussion of some of these issues see a discussion by Cunningham.

It has been suggested that the learning style movement (and multiple intelligences) may lack scientific credibility and evidence for effectiveness, but that it has served to alert teachers to the fact that a repertoire of teaching methods is needed and that issues such motivation and emotions are important for learning. I largely agree with this and my questioning of the usefulness of these concepts is not a call for the exclusive use of so-called "chalk-and-talk" teaching methods (they have their place). The point is that teaching methods should be adjusted according to the nature of the subject matter, not based on putative individual learning styles.

Multiple intelligences

Gardner's multiple intelligence theory has been and still is very influential in education worldwide. It was also made to measure for the commercial educational solutions industry, eight intelligences to improve and make money from!

Gardner's theory is sometimes used in opposition to theories of intelligence that are based on factor analysis of ability tests and that emphasize a general intelligence factor, g. This is a complex and controversial field and I cannot begin to do justice to it in a blog posting. A good review by Prof. Daniel Willingham can be found online. Willingham argued that Gardner's theory is inconsistent with current views of intelligence as a hierarchical construct. Willingham questioned whether some of Gardner's "intelligences" should not rather be described as aptitudes or talents. Why only these eight intelligences? Willingham, and in another context Arthur Jensen, asked why not also olfactory, criminal and sexual intelligences?

Intelligence as a concept is generally associated with the kind of thinking capacity that make for success as school. Gardner's labeling the aptitudes he proposed as intelligences, naturally led teachers to erroneously assume that they were fungible (one could substitute for another) and should be taught to. Willingham pointed out that Gardner himself had doubts about the functional application of his ideas in school settings.

I believe that the issue of ATI's referred to above, is also applicable to multiple intelligences. There is just very little evidence that teaching should be adjusted according to putative characteristics of learners.

Further reading on learning styles and multiple intelligences:

Cunningham, J.W. (2001). The National Reading Panel Report. Reading Research Quarterly, 36(3), 326–335.

Professor pans 'learning style' teaching method. Telegraph, July 2007.

Geake, J. (2008). Neuromythologies in Education. Educational Research, 50, 2 123 – 133.

Reschly, D.J. (2004). Commentary: Paradigm Shift, Outcomes Criteria, and Behavioral Interventions Foundations for the Future of School Psychology.School Psychology Review, Vol. 33.

Sternberg,R.J. et al. (2008). Styles of Learning and Thinking Matter in Instruction and Assessment. Perspectives on Psychological Science. Vol. 3. Just for balance, a view from the very influential Robert Sternberg supporting teaching according to learning styles.

Hattie, J. (1999). Influences of student learning: Inaugural Lecture: Professor of Education, University of Auckland

Willingham, D.T. (2004). Check the facts: Reframing the Mind.

Carte Blanche, Mind Moves and Brain Gym

Well, I suppose I should consider it a breakthrough for blogging in South Africa. Last Sunday I appeared briefly (58 seconds to be exact), as an educationist and a blogger, on a prominent South African television news programme, Carte Blanche. The programme was on Mind Moves, a controversial therapy programme. Prof. Faith Bischof of the physiotherapy department of the University of the Witwatersrand and I were the sole two token skeptics on the programme; between us we contributed less than two minutes to the eleven minute programme. The time disparity between the pro (9 minutes) and con (2 minutes) is indicative of the bias of the programme. Carte Blanche prides itself on its balanced presentation, I suppose having token skeptics helps to preserve that image.

The programme showed a four year old girl, Teagan, who suffered a serious anoxic incident shortly after birth, resulting in serious diffuse brain damage and cerebral palsy. In the programme it was claimed that various conventional therapies were tried, but only after starting Mind Moves was improvement noted. The founder of Mind Moves, Dr. Melodie de Jager, testified to its effectiveness, as did the Teagan's parents and various other Mind Moves practitioners in various other settings.

In my 58 second slot I equated Mind Moves with Brain Gym and declared it to be pseudoscientific nonsense. I subsequently received an e-mail from Dr. De Jager correcting me about it being identical to Brain Gym and I am glad to place her correction (translated from the original Afrikaans):

"I would like to bring to your attention that Mind Moves/BabyGym is not Brain Gym, but is scientifically based as can be seen on www.mindmoves.co.za."

Dr Melodie De Jager was for many years the public face and guru of Brain Gym in South Africa and I naturally associated her with Brain Gym. What I saw on her website was also very similar to Brain Gym. Based on what is on the Mind Moves website, I would dispute her claim that it is in any way more scientifically based that Brain Gym. A more detailed analysis of Mind Moves, however, will have to wait for a later post.

Since the Carte Branche programme was televised, I received about 150 related hits from South Africa (a substantial number for this humble blog), so at least some people took the trouble to check the claims made in the programme. The almost 200 comments on Carte Blanche's website, however, were invariably positive about Mind Moves, with not a single gullible soul asking for even a shred of evidence. Not even a professor "nogal" (nogal - an Afrikaans word, the closest translation being "for heaven's sake"). The following comment reflect the general tone of the comments:

"WOW! This show was incredible but why so short? PLEASE give us more info about this ladys work. PLEASE! PLEASE! PLEASE!"

Many of the comments were from Mind Moves and Brain Gym consultants who used the opportunity to advertise their services cheaply. Many of these were former educators who trained to become consultants in these techniques. This brings about a serious concern - what training in human anatomy, neurology, neurophysiology and so forth did these people receive in order to qualify them for treating cerebral palsy? Physiotherapists receive four years training at university and are eventually registered with the Health Professions Council. What (if any) body controls Brain Gym, Mind Moves and other similar "alternative therapists" and who checks the efficacy and ethics of their treatment? Brain Gym in the past mainly consisted of physical exercises performed by their "clients", typically physically normal children with learning problems. What was shown on Carte Blanche was a child with cerebral palsy receiving physical manipulations by the therapist. One wonders what the Health Professions Council's view on this would be?

One of the visitors to this blog left a comment that alerted me to the fact that Teagan was receiving other therapies in addition to Mind Moves. This was important information. The Carte Blanche programme was a classic correlation eguals causation confusion from the onset. The fact that Teagan was receiving other therapies as well, should have caused even the most gullible observer to question whether the perceived improvement in her could ascribed to Mind Moves with any degree of certainty. I quote from the accurate transcript on the Carte Blanche website (emphasis mine):

Presenter: "Before seeing Melodie, what types of therapies did you try?"

Mother"We've done physical therapy, occupational therapy, speech therapy... and with Melodie's therapy it's basically incorporating all of that but actually in what you really need to do to get up and to move and to play properly and to learn."

... Presenter: "But this (the sceptics' concerns) doesn't explain Teagan's extraordinary progress or the improvements other teachers and children are experiencing. After just a few months of treatment, Teagan is already able to walk unassisted; she's starting to crawl, and is relating to toys and starting to feed herself."

This was misleading, to say the least. The typical viewer would have come to the incorrect conclusion that the other therapies preceded Mind Moves and were replaced by Mind Moves, after which progress accelerated greatly.

The following comment by Dr. De Jager on the Carte Blanche website in reaction to the enthusiastic responses by viewers, indicated to me that she too became aware of the incorrect impression that was created in the programme:

"A WORD OF CAUTION Mind Moves does NOT replace any other therapy, it does however make the brain and body more receptive to other therapies when done in the beginning of a therapy session."

I'm not suggesting that there was a deliberate attempts to mislead, I accept that it was just an error that slipped in. It was a serious error, however, and Carte Blanche owes it to its viewers to correct it and also to explain the significance of the error. I'll wait to see when that happens.

What are some of the questions that could have been asked from a scientific point of view to determine the accuracy of the claims for Mind Moves?

This is an individual case and essentially an anecdote. What independent, experimental evidence which has been published in reputable peer-reviewed journals, exists to support the use of Mind Moves in similar cases?

How reliably and validly was the improvement documented and how was confirmation bias prevented? Confirmation bias refers to a tendency to notice and to look for evidence that confirms one's views, and to ignore evidence that contradicts one's views.

How do we know that Teagan's perceived progress was actually the result of the Mind Moves programme, especially in view of the fact that she was also receiving other therapies?

Some possibible anwers could be:

Her progress was due to natural neurological maturation and not to any therapy.

Her progress could have been due to any, all, or none of the therapies she is/was receiving.

Her progress was due to receiving concentrated attention, a so-called Hawthorne or participation effect, any therapy programme with the same amount of attention could have had the same effect.

Her progress could have been the result of unrelated issues such as getting a new puppy, granny coming to visit, a new school, etc. This is not meant to be facetious, such factors could combine to contribute to a participation effect.

The point is that the whole programme essentially committed the correlation implies causation or cum hoc ergo propter hoc fallacy. Because one event (improvement) follows or occurs together with another (therapy) does not, in the absence of other evidence, prove that the one caused the other. This can be demontrated by an example. Does the simultaneous decrease in the number of storks and the human birth rate in Europe over the past 60 years, imply that storks bring babies? Of course not, but that is essentially the Carte Blanche argument about Mind Moves.

By televising an inherently biased propaganda piece for Mind Moves, Carte Blanche missed a valuable opportunity to educate its viewers to be able to judge the scientific merits of all the therapies on offer for developmental disabilities. One would trust that future programmes of this nature would look in greater depth at the science and make less use of propaganda techniques such as appeal to pity and appeal to the emotions.

Mind myth 6: Synchronizing and boosting the brain

This is the sixth post in the series on mind myths especially applicable to education and training. It relates to products that claim to manipulate and synchronize brain wave activity. Again the late Barry Beyenstein (in Della Sala, 1999, p. 61) perfectly described the pedlars who produce and market these types of products:

"New Age hucksters are repackaging shopworn folk psychology with cheap mysticism and giving it a gloss of scientific respectability by claiming unearned affiliation to neuroscience."

Beyerstein described how quack practitioners initially used EEG biofeedback as a shortcut to altered mind states that meditation was purported to produce. In a classic correlation equals causation confusion, they assumed that alpha brain waves associated with meditation produced a special state of consciousness meditators were assumed to have achieved. The alpha-wave hacks ignored some inconvenient facts, such as that animals who presumably are incapable of higher planes of consciousness also readily produce alpha waves, that most people produce alpha waves by merely closing their eyes and that ADHD children readily produce alpha waves. When research eventually showed that the generation of alpha waves held no benefit, the hacks moved their attention to theta waves. That was also soon shown to have no benefit. Predictably, that did not stop the brain wave enhancement industry.

"Tuning" the brain gave way to synchronizing the brain. Beyerstein pointed out that these were modernized versions of ancient sensory bombardment rituals. One of these was the so-called "hemi-sync" technology of the Monroe Institute, which also found its way into South Africa. They claim that their auditory tapes (now CD's) produce binaural beats which synchronize the two hemispheres of the brain. Binaural beats are subjective phenomena that had been known to science for decades, but no scientist has found any practical use for them. That had to wait for Monroe, however, without any evidence. As indicated before on this blog, the brain does not need to be synchronized and there's no evidence that such attempts would have any beneficial result. Beyerstein pointed out that the most synchronous states of the brain occurred during sleep and coma, not exactly periods of peak performance.

See more on the Monroe Institute in Wikipedia. In this case, however, the Wikipedia entry reads more like an advertisement than a serious encyclopaedic entry. I found it interesting to note that the institute's trainers engage in "astral projection and disembodied spirits" and that the founder, David Monroe, may still control the institute from the "other side" (he's somewhat dead).

There are various products currently on the South African market that claim to enhance learning through somehow directly influencing or synchronizing the brain. One that is widely and aggressively marketed is Beta Study Methods, also known as the Betakit Study System. They claim to do this through so-called modulated offset harmonic frequencies, which seems exactly the same thing as binaural beats; no acknowledgement to the Monroe Institute is to be found on their website, however. The only evidence that is advanced by Betakit Study System that their products work as claimed and are in any way effective, are from testimonials by satisfied customers. As has been pointed out on this blog before, anecdotal evidence is of little value. They would also obviously not place testimonials from unsatisfied customers. Interestingly, Beta Study Methods takes pains to emphasize that their techniques are not New Age based and that the music they use on some of their tapes is not New Age music (whatever that is), which they claim is harmful.

More on issues discussed in this post can be found in:

Beyerstein, B.L. 1999. Pseudoscience and the brain: Tuners and tonics for aspiring superhumans. In S. Della Sala (Ed.), Mind myths: Exploring popular assumptions about the mind and brain. New York: John Wiley & Sons.

Druckman, D. & Swets, J.A. 1988. Enhancing Human Performance: Issues, Theories, and Techniques. (Online)

Previous posts in the series on mind myths were:

The 10% myth

The left brain right brain myth

Energy and the brain myth

The downshifts and blockages myth

The brain profiling myth

The power of realistic thinking

Barbara Ehrenreich, recently wrote an Op-Ed piece in the New York Times, The power of negative thinking. She pointed out the mess the combination of greed and positive thinking landed us in. She linked Oprah Winfrey, megachurch pastors and the New Age self-help industry through their mindless wishfull thinking delusions. According to Ehrenreich:

"It’s a message (positive thinking) companies relentlessly reinforced — treating their white-collar employees to manic motivational speakers and revival-like motivational events, while sending the top guys off to exotic locales to get pumped by the likes of Tony Robbins and other success gurus. Those who failed to get with the program would be subjected to personal “coaching” or shown the door."

The issues she riles against are common in South Africa as well. Mindless positive thinking abound in megachurches and businesses from small to large. Mainstream Christian churches seem to be losing ground to charismatic megachurches with the "positive" message that God wants the congregants to have it all, especially the pastors. In many cases the line between church and business has becoming thin and permeable, some business get-togethers resemble church revival meetings. A friend dragged me to a meeting of the consultants of a multi-level marketing organisation some time ago. Speaker after speaker stood up trying to outdo each other with essentially the same message: "Last year I made x amount of money; Praise the Lord!". This sickening, somewhat blasphemous, message eventually got to me and I found something urgent to do elsewhere.

One would have to see whether mindless positive thinking survives the current worldwide financial crisis and the ENRONs and Worldcoms before it. We are hearing calls from some churches for a return to soberness and a Calvinistic work ethic. Corporates may also be returning to more realistic, even negative attitudes - at least till fear subsides and greed takes over again.

Mind myth 5: Brain profiling

This continues the series on mind myths especially applicable to education and training. The fifth mind myth relates to so-called brain profiles that have very little bearing on the brain, except in the very general sense that we all have brains and that all our behaviours are mediated by our brains. Brain profiles are favourite instruments for a variety of practitioners, many of whom use them as bait to involve gullible clients into pseudoscientific self-improvement schemes and quack therapies. They are widely used in schools and in the corporate sector.

My two previous posts on brain profiles described the pseudoscience concepts in more detail and can be found at Brain profiling - science or pseudoscience? and "Genetic" brain profiling in rugby. I described a brain profile as follows:

"A brain profile assessment is not as one may imagine a neurological or neuropsychological examination of brain function. As envisaged here, it is a questionnaire of thinking and behavioural preferences, putatively representing underlying differences in brain organisation. The questionnaire is sometimes combined with simple tests of motor and sensory dominance (hand, foot, eye, ear) (Brain Gym calls this a dominance profile)."

Brain profiles of this kind all involve some version of the left brain right brain mind myth, sometimes combined with the downshifts and blockages mind myth. Brain profilists essentially pretend to test the brain as pop-psychologists 40 years ago thought Roger Sperry thought it was organised, but did'nt. Ned Herrmann admitted that this view could only be a metaphor, but his later followers were careful to downplay that - such a view not being good for business. People who undergo brain profile tests after all, expect to learn something about their brains, not about the profilists' inaccurate metaphors for the brain.

A typical pseudoscience brain profile test comprises a number of simple questions about thinking or behavioural preferences and lasts about 30 minutes. Brain profiling instruments mostly seem to be derived from either Ned Herrmann's HBDI or a shorter "test" by Paul Torrance, the "Your Style of Learning and Thinking" (SOLAT).

While pseudoscience brain profiles have little value in my opinion, many find them amusing, even useful. Should amusement be your motivation to do a brain profile, there's a number of free brain profiles that can be done online. Do one for amusement value. Just don't get carried away and start referring to yourself as left brained or right brained, revealing yourself in the process to be no-brained. Here are some links for free online brain profiles, Brainworks; Hemispheric Dominance Test. Be reminded, however, that free tests are often bait to involve you in other activities you have to pay for.

Some people who have done brain profiles, quite seriously declare them accurate and useful. I believe that a number of cognitive effects, biases and logical fallacies play a role here.

Firstly a combination of gullibility and the power of suggestion. Gullible clients buy into the pretence of neuroscience and the suggestions offered to them by the profilists. It comes as no surprise that some brain profilists are good motivational speakers.

Secondly, the Forer effect. According to the Skeptic's Dictionary, the Forer effect "... refers to the tendency of people to rate sets of statements as highly accurate for them personally even though the statements could apply to many people." This could also be more specific, i.e. an engineer would see himself as ordered and logical, answer the brain profile questions (which tend to be quite transparent) accordingly, be classified in a left brain quadrant, the description of which he will find accurate. It's circular reasoning and also a Forer effect. Confirmation bias could also play a role, with people just ignoring results that do not fit their preconceptions.

Thirdly, cold reading may play a role. Cold reading is a style of telling someone something about themself that seems more accurate than it actually is by using ambiguous generalities. Dr. Terry Sandbek, in discussing brain typing (similar to brain profiles), indicated how cold reading could be at work in these type of instruments by " ... (giving) enough positive, but ambiguous, information for (them) to be influenced by the Forer Effect."

Blogger Sean Carmody at Stubborn Mule connected the dots and pointed out the similarities between brain profiling and astrology. Hat tip to him for this amusing image of a brain profiles encircled by astrology symbols.

While brain profiles may be of amusement value to adults, I believe that they are potentially harmful applied to children. It should be remembered that brain profiles are often just the bait for pseudoscientific therapy programmes. Parents of children who require evidence supported therapies, may be duped into enrolling their children into quack therapies, wasting valuable time and resources in the process. These children could also fall prey to the pseudoscientific beliefs or belief systems underlying these therapies - consider this statement by Sense about Science about children involved in Brain Gym: "These exercises are being taught with pseudoscientific explanations that undermine science teaching and mislead children about how their bodies work."

Another danger for children concerns Gattaca-esque notions that sometimes form part of brain profiling. Consider Naas Botha, an ex Springbok rugby player turned sports commentator, gushing here about "genetic" brain profiles for children in sport:

"It’s very, very scary. It’s also very exciting. I can see a future where we will establish at the age of five or six exactly who has the brain profile to make it to the top and in what position. The potential is absolutely amazing. ...I had my whole family brain-profiled and was amazed... "

Scary indeed. Gattaca-esque selections are scary enough when based on science, based on pseudoscience they're downright frightening. Consider the plight of a child of an overambitious parent, selected at an early age and programmed for "greatness". Consider also the child not selected or excluded for a team or a sport due to not having the "right" brain profile. As a parent I have no problem if my child is not selected for a sports team for valid reasons. I would have a major problem, however, should he or she not be selected because of not having the right brain profile. In today's high stakes sports environment, I would not be surprised if litigation followed the exclusion of competitors based on this kind of pseudoscience practice.

Keep in mind that not all brain profiles are pseudoscientific. Neuroscientists sometimes refer to large datasets of information about patients' brains as brain profiles. Here is one example (contrast these scientific neuropsychological assessments of more than eight hours duration, typically done in at least two sittings, with pseudoscientific brain profiles described above):

"The Brain Profiling Group (BPG) specializes in the testing and evaluation of brain function, for the purpose of detecting and quantifying abnormalities arising from psychological disorders or physical trauma. BPG provides this specialist service for professionals, medical and legal practitioners and patients seeking clarification of psychological and organic trauma, and others who seek to obtain peak brain performance."

In closing, spare a thought for brain profiling consultants who "innocently" became involved with this pseudoscience practice. Many of these are teachers or ex-teachers. Yes, they should have known better, but neuroscience, critical thinking and evidence supported practice have never featured strongly in teacher training. I can't be as charitable to the originators of these practices.

Other mind myths in this series were:

The 10% myth

The left brain right brain myth

Energy and the brain myth

The downshifts and blockages myth

Dore has arrived in South Africa

Well, it's arrived, as I knew it would (well, it's actually been here since 2006, just did not know about it). It's the Dore therapy programme for developmental disabilities. I've no personal experience of it, but I can read and I've also followed the exposés about it in several blogs, especially Ben Goldacre's Bad Science. Its rationale is unproven and there is no plausible evidence for its effectiveness.

Educational fads from America and Britain inevitably land up in South Africa (and it seems Australia). With every successive unproven fad the education system becomes more dysfunctional and more learners need therapy. We seem to have a symbiotic relationship between imported educational fads on the one hand and imported bullshit therapies on the other. Maybe the one causes the other. And yes, I know about correlation and causation.

Well, having got that off my chest, let's get back to Dore.

The Dore programme purports to treat dyslexia and other developmental disorders. It was founded by paint tycoon Wynford Dore and is based on theories on the involvement of the cerebellum in the learning process. Note that the independence of the authors of this article linked to, Nicolson and Fawcett, have been questioned - see the second link at the end of this post.

In Britain Dore was characterised by aggressive, celebrity based marketing and the bad habit of threatening critics with legal action. It was very expensive and typically required upfront payment from parents. I'm using the past tense because Dore has gone into legal administration in Britain, Australia and the USA.

Strangely enough, the South African Dore website is silent about the problems its international partners are experiencing. Where does that leave desperate parents in South Africa who may wish to consider Dore? I would suggest doing the following:

First, check the evidence, or rather lack thereof.

Should you still wish to continue, ask about their future in South Africa.

Do not agree to make upfront payments (it costs R23 000,00 for a treatment course). Let the risk be theirs, not yours.

Hold them responsible for progress, don't fall the age old scam: "Its not working because you do not have faith or are not working hard enough at it".

Here are links from various blogs and newspaper articles on Dore:

South Africa: Learning Disorder 'Miracle Cure' in Spotlight
Scientists quit in dyslexia "cure" row
Dore - The miracle cure for dyslexia
Dore - The media's miracle cure for dyslexia
Blogs vs mainstream media
Dore - The vultures start to circle
Dore shut

Mind myth 4: Downshifts and blockages

I'm continuing my series on mind myths especially applicable to education and training. This one is a lucrative favourite of many brain based pseudosciences. They typically claim that people's brains get blocked when under stress and that only their brand of snake oil can get it unblocked again. This goes far beyond the generally accepted effects of stress triggering the fight or flight response. Consider this claim about rugby players from a pseudoscientific technique called genetic brain profiling:

"There are 32 different combinations of dominance between the left and right brain and the ear, eye, hand and foot, and each has implications for the way a stressed player will perform. Lotter assesses players and is able to predict the “blockages” they would suffer as a result.

For example, in an age-group provincial team she recently assessed, she found a tighthead prop with four blockages (“basically, he was unable to function under pressure”), while the fly-half and inside-centre were among those with three blockages (“key decision makers would lose the ability to communicate and perform under stress”)." (See article here).

Where do these ideas come from and is the any evidence to back them?

It starts with another popular myth called downshifting. This mixed metaphor is based on a car's gear system on the one hand and the triune brain model on the other.

Image from The Architect of Life


The hypothesized downshifting response is seen as a negative response to even mild stress in which the brain shifts down to "lower" brain formations where primitive survival modes predominate – and then remains stuck there. Supporters of the downshifting hypothesis then each have their own special techniques to get the brain unstuck. These may be simple motor movements to activate certain brain areas, or the drinking of water in order to "instantly oxygenate" the brain and allow it to upshift again.

The triune brain is a model of brain function developed by Paul MacLean. He suggested three basic brain formations based on evolutionary history, namely a reptilian formation (brainstem structures), early mammalian formation (midbrain/limbic) and neomammalian formation (neocortex). MacLean's triune brain model is influential, but quite controversial, see some of the issues (not really applicable to this post) in this discussion by Jaak Panksepp. I have always found the triune brain model quite useful and was saddened by the way it was diminished by being appropriated by pseudoscience hucksters. The chapter by Panksepp does provide another perspective from within neuroscience itself.

Many brain based pseudoscientific techniques, such as in the rugby example referred to earlier, extend the downshift hypothesis to include the left brain right brain myth and then propose that based on the putative pattern of brain dominance, parts of the brain switch off, or become blocked. Thirty two potential brain blockages should certainly be much more lucrative to "cure" than only a few.

Little evidence is to be found in MacLean's own work to support such simplistic interpretations of his model. His triune brain is an integrated system in which the three brain formations exchange information and the whole functions better that the sum of its parts. The reaction of the brain to stress is a well studied area (see here and here, for instance), but there is no evidence to support the idea of semi-permanent downshifting and of brain blockages that would require outside intervention to upshift or clear.

Concurring with this, in a critique of Brain Gym, neurobiologist Dr Stan Lazic writing for the British organization Sense about Science, stated that:

"... in reality the only time a neurological signal would become "jammed”,“blocked” or “switched off" is during a pathological event such as a seizure, stroke, head trauma, or perhaps due to a neurodegenerative disorder."

A further critique of the downshifting concept was provided by Prof Robert Sylwester and can be read here.

Bio-Strath for ADD/ADHD?

There has lately been a spate of very expensive, full-page colour advertisements in national South African newspapers touting a product called Bio-Strath® as a solution for ADD/ADHD and learning problems in children. No specific mechanism through which Bio-Strath should work for ADHD was suggested, except its nutritional value. As a result of the advertisements, I received many enquiries from parents of children who are currently on medication such as Ritalin and Concerta. All wanted to know whether this "natural" product could be a suitable replacement. I referred them to their medical practitioners, but at the same time decided to look into the research evidence for Bio-Strath as a treatment for attention deficit and attention deficit hyperactivity disorder (ADD/ADHD).

The full text of the advertisement can be seen here.

The advertisements referred to a 2006 study in an European journal, Pädiatrie. A homeopath, Irma Schutte, made the following claims and comments about this study:

"A ground-breaking clinical trial recently revealed that Bio-Strath Elixir led to an 76% improvement in the ADD/ADHD symptoms of the children participating in the study... The clinical proof that Bio-Strath taken three times daily can solve almost 80% of these children's problems is staggering news! It would be a grave oversight if children were given medication which could carry risk and has known side effects when Bio-Strath could easily have been the answer."

Strong words indeed, but does the research referred to justify her confidence? I was unable to access the journal article in an Internet search. I then e-mailed SA Natural Products, the South African distributors of Bio-Strath, for more information. They had no problem supplying me with English copies of said article, as well as various other reprints of articles about Bio-Strath. The detail of the particular article is:
König, S. & Joller, P. 2006. Influence of a food supplement on the behaviour of children with attention deficit disorders (ADD/ADHD): Application study with the herbal yeast preparation Bio-Strath® in children. In Pädiatrie 1/2006. (no more info on page numbers, volume, etc.).

Does the article support the strong claims in Bio-Strath's advertisements? Unfortunately not. Here is why:

Author not independent

At least one of the article's authors seemed to have links with Bio-Strath. Dr. Peter Joller authored numerous other articles on Bio-Strath. Another blogger, Frank Swain of SciencePunk, questioned Joller's independence and never received an answer. There was, however, no acknowledgement of a possible conflict of interest in the article.

Was it peer-reviewed?

The lack of scientific rigour evident from the article (see below), suggests that it may not not have been peer-reviewed. A peer-review process would have given one more confidence in the findings.

Inadequate research design

Let us now consider the research itself. The research design was a simple pre-experimental one-group pretest-posttest design. This is considered a very weak design, prone to numerous threats to internal and external validity. Suffice to say, this kind of research without blinded, random assignment to experimental, control and placebo groups, is really not capable of proving anything. Bio-Strath has been on the market for more than 50 years and the first claims that it could improve concentration in children date back at least 40 years. Surely decent, so called gold standard research is long overdue?

The participants in the research were selected based on scores on an ADD/ADHD rating scale of unknown reliability and validity. The rating scale was translated from English into German, but there's no indication of adequate translation controls (i.e. a back-translation process). The participants were subjected to pretests and posttests six weeks apart on the Integrated Visual and Auditory Continuous Performance Test (IVA CPT). The IVA CPT seems to be a valid, well standardised test.

The small number of participants (18) and large number of tested variables (19), increased the probability of chance effects. The uncontrolled test-retest design is prone to many confounding effects, including history, maturation, test-retest practice, and so forth. The fact that the experiment was not blinded, made it prone to participation effects such as placebo and Hawthorne effects (and yes I know that there is some doubt about the Hawthorne experiments).

Misleading reporting

The reporting protocol used in the research was certainly very strange and misleading. It seems very much as if they cherry-picked which results to report on and how.

The results were tabled in a 18 x 19 matrix, with the participants ranked in terms of the number of variables they improved upon. König and Joller reported that 12 of the 18 subjects improved on at least one of the variables. According to their criteria, that meant that 66% of the participants improved! The range of reported improvement was from improvement on one variable, to improvement on 15 of the variables. Though not explicitly reported, the average improvement for all candidates, was on only four of the variables, or 21%. Some of the variables were composite scores, which add to questions of the appropriateness of the reporting. The authors did not distinguish between ADD, ADHD, or HD in their analysis.

They further reported 116 statistically significant changes, 93 positive, 23 neutral or negative. There was no indication how the statistical significance was determined. A neutral "change" makes no sense and I fail to see how it can be statistically significant, maybe I'm missing something. According to their criteria, 93 out of 116 represent an 80% improvement. What they seem to be ignoring, however, is the 226 scores which showed no significant change {(18 x 19) - 116}! Taking that into consideration, the percentage change would be 27% (93/342). Yes, I know this kind of reporting makes no sense, but I followed their reporting procedure.

The "statistical" analysis was followed by an anecdotal discussion of the subjective improvements (as reported by the parents) shown by the two top ranked participants, who respectively improved on 15 and 13 scores. This discussion was clearly of little value, as the parents' report was subject to among other things, confirmation bias. The limitations of anecdotal evidence are well known.

These were just some of the limitations of the research. There are also other, older studies available. These studies seem to suffer from the same limitations. The study that is hyped in the newspaper advertisements, is the one discussed here.

Why take the trouble to do such inadequate research about a product that has presented as a solution for ADHD for more than 40 years? Steven Novella on his blog, Neurologica, explains this phenomenon better than I can (I've just replaced the word "accupuncture" with "Bio-Strath"):

"Poor studies that are virtually guaranteed to generate a positive result (like this one) are also useful for marketing propaganda. They create great headlines - and most of the public are not going to read much beyond the headlines and so will be left with the sense that there is more and building evidence that Bio-Strath works. As propaganda this study is very effective."

Conclusion

The advertisement was misleading to say the least. The heading in huge, bold letters claims: "76% Improvement in ADD/ADHD symptoms". I've shown that to be incorrect - the study is of little value and does not support that claim. Even taking the study at face value, at most an improvement of 27% can be claimed and even that is highly debatable. The ADD/ADHD symptoms referred to, are from the test used and may not directly translate to real world problems.

I believe that Bio-Strath South Africa, knowingly or unknowingly, placed an advertisement that deceived many parents. The ethical thing for them to do would be to withdraw this advertisement immediately and publically admit that there is very little evidence that Bio-Strath is effective for ADD/ADHD.

See a later post on Bio-Strath for cognitive enhancement at Bio-Strath is at it again.

Mind Myth 3: Energy and the brain

This is the third in my series on mind myths. I'm dealing with those myths mainly applicable to the educational arena and often found in alternative medicine and controversial therapies.

Some years ago a parent requested me to excuse her child from school as she was taking him to an enerologist. Because her child was attending our incontinence clinic, I initially thought she was referring to either a urologist or gastro-enterologist. It turned out that enerologist was a misleading term for a quack energy healer, in this case one who specifically claimed to be able to manipulate the brain by manipulating psychic energy. He no doubt believed that he could share in the status of mainstream medical science by using a term that sounded similar to that used by medical specialists.

References to energy and energy meridians (also known as acupuncture points or chakras) in any educational product or therapy that claims to affect the brain in some way, should immediately set the alarm bells ringing. What is referred to is psychic energy, sometimes also called chi, prana, etc. These are not scientific concepts and cannot be detected or measured by scientific means. This "energy" is referred to in practices such as homeopathy, some types of chiropractic and other forms of alternative medicine, but have no role to play in neuroscience.

Image from Scientific American.

















Practitioners of brain based pseudoscience sometimes deliberately or through ignorance confuse the scientific concept of energy and psychic energy. They may by design neglect to inform clients of the origin of some of their activities, i.e. have children press certain buttons (energy meridians) without informing them or the parents that the brain is supposed to be activated by the channelling of psychic energy. This reticence seemed to develop after parents of specific religious persuasions objected to psychic energy based activities.

Confusion through ignorance is often found where practitioners invoke Einstein's famous equation E = mc2 to prove the point of our "unlimited" capabilities. Fernando Sarav (see reference below) pointed out that they are confusing a simple combustion process occurring metabolically in the body with the transformation of matter into energy. The difference is staggering. One mole of glucose (180 g) would yield about 3,1 kJ through combustion, but 1,62 x 1013 kJ if transformed into energy. That amount of energy would power a mid-sized city for a year.

When these practitioners are honest about the origins of their techniques, they often invoke the "it can't be wrong, the Chinese have been using it for 5 000 years" argument. I quote Dr. Paul Dennison, the Brain Gym guru, from his embarrassing British television interview (see it here in a previous post):

"There are studies to show that we are electrical. Acupuncture and other procedures are based on the fact that there are electrical circuits in the body and we are building on the shoulders of these people have been doing this for thousands of years."

This is a fallacious argument, the so-called Argument from Age (Wisdom of the Ancients) fallacy.

In an excellent recent blog post on acupuncture, neurologist Steven Novella points out that Western societies had their own pre-scientific theory of disease:

"An example from Western culture of philosophy-based medicine was the humoral theory - the notion that health was the result of the four bodily humors being in proper balance while illness reflected one or more humors being out of balance. Treatments therefore sought to increase or decrease one or more of the humors (such as the practice of blood-letting) to re-establish balance. The humoral theory survived for several thousand years in Western societies, perpetuated by culture and the power of deception inherent in anecdotal evidence."

I would submit that the only reason for psychic energy based theories to be preferred to humoral theories (in the absence of evidence), would be another logical fallacy, the genetic fallacy. Could a reversed not made here bias be the only reason to prefer Eastern origin psychic energy theories to Western origin humoral theories?

For further reading, see:

Sarav, F.D. 1999. Energy and the brain: Facts and fantasies. In S. Della Sala (Ed.), Mind myths: Exploring popular assumptions about the mind and brain. New York: John Wiley & Sons.

Also see Robert Todd Carroll's Energy Healing: Looking in All the Wrong Places

Other posts in the Mind Myth series:

The 10% myth
Left brain right brain

Schools' rugby concussion outrage

I have often been horrified by the lack of care shown by schools and parents when children are injured in school sport, especially in rugby. This, however, goes beyond even the worst that I've seen before.

A 16 year old school boy, playing rugby for his school, was assaulted after the game by two parents. The two adults hit and kicked him in the face and on the head. He suffered severe concussion, was hospitalized and treated with cortisone to prevent brain edema (swelling). A doctor quoted after the incident mentioned the danger of brainstem herniation.

Despite what was clearly a serious concussion, the boy was playing again a week later in the final match of the Beeld Trophy. That was three days after his discharge from hospital.

Read the newspaper reports here and here (the last in Afrikaans).

School boy, Lee-Jay Kotze, playing the rugby final a week after suffering severe concussion.

The parents and coach would have been advised by the neurologist of the dangers of concussion and the consequences that repeated concussions hold for the developing brain. The child wanted to play, but surely the adults should have exercised greater responsibility. Their actions to my mind border on criminal negligence.

Read more on concussion in childhood in Can we manage sport related concussion in children the same as in adults?

An excellent local (South African) resource on concussion in sport is Sports Concussion South South Africa.

School sport in many South African schools is very competitive. Schools' reputations and the future teaching careers of teacher coaches depend on the performance of their teams. This is especially the case in rugby, a national sport and for some almost a religion.

Rich schools buy often buy players with bursaries and other incentives, stripping poorer schools of their players and the opportunity to perform well. They also pay professional coaches and reward teacher coaches with incentives. This is one way in which less wealthy parents can get their children into top schools, but often at high cost to the children. They are removed from their circle of friends and often experience huge pressure to perform from the schools who paid to get them. Their parents, especially fathers, often also put pressure on them, vicariously achieving through their children what they could not when they were at school. The know-all, beer-bellied fathers who heckle referees and constantly admonish their sons, sometimes getting into fights with other parents and even players, are common sights next to South African school boy rugby games.