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.