Several posts ago, I referred to the complementary/alternative practice known as "patterning". This method was introduced in the 1960s as a technique for helping brain-injured children, including those with cerebral palsy, and has more recently re-emerged as a treatment for autism. Patterning has twice been rejected by policy statements of the American Academy of Pediatrics, but has continued to have advocates among groups like the Institutes for the Achievement of Human Potential in Philadelphia.
A reader of that post commented on a book describing a family's experience with patterning and its various difficulties. While looking for that book at my public library, I stumbled across another account, this one enthusiastic in its praise for the effect of patterning on a child with cerebral palsy. This 1966 publication, by Marilyn M. Segal, is entitled "Run Away, Little Girl" and published by Random House. Interestingly, the copyright-holder is the Mailman Foundation, an organization well-known then and now for support of education about child development and treatment.
Patterning is a program involving passive movement of a child's body (that is, other people hold and move body parts), and other forms of treatment including eye exercises and sound stimulation of one ear or the other may be included. This program is based on several basic assumptions that may appear plausible but in fact do not gibe with much that is known about early development. Here are three of these assumptions that are mentioned in "Run Away, Little Girl":
1. The human brain is like a computer, and the more input into it, the greater will be the output (that is, stimulation from the environment causes improved brain functioning). The facts are, however, that although environmental stimulation guides some aspects of early development, like the ability to combine the images from the two eyes into one perception, there is no simple relationship between stimulation and brain activity that holds for all parts of the nervous system.
2. A human being uses only a very small proportion of total brain capacity, and therefore unused brain cells can take over functions of damaged areas. But the fact is that all brain cells have their own functions; none are just sitting there inactive. Although there are times when a brain-injured person can develop new ways to do things that normally depend on now-damaged areas, and although young babies can recover remarkably well from some kinds of damage, there is no magic routine that can call in unused cells to do the job of damaged ones.
3. One side of the brain should be dominant-- everyone should have a strong hand preference, and the same preference for a foot to use (in kicking a ball, for instance) as well as for the dominant eye. Having consistent dominance means that the brain is well-organized, according to this view. In fact, however, "mixed" dominance is as common as any other arrangement, with about 50% of the population showing differences between their hand and foot preferences. Many people, especially lefties, do not show a very strong dominance pattern.
"Run Away, Little Girl" describes the methods used to try to cure the effects of Debbie Segal's cerebral palsy. These emphasized sensory stimulation, including the kind that comes from limb and head movement. But in addition to patterned movement several times a day, the not-quite three-year-old was presented with large flash cards with words printed on them in red. She was given a "laterality program" to increase her left-side dominance. "Debbie was given new eye exercises geared toward left-eyedness. We were told to keep cotton in Debbie's right ear and whisper into the left. Music, because it stimulates the subdominant side, could be used only during patterning. Debbie had to wear a glove on her right hand so she would use her left hand exclusively, and at night she had to be placed in a left-sided sleep position" (p. 115). Other practices included watching television through red or green lenses. She was also to be limited to 20 ounces of fluid a day to prevent the dulling of brain activity by excess fluid and breathe with a special plastic mask every half hour so she rebreathed her carbon dioxide for 60 seconds.
No one will be surprised to hear that in addition to being implausible, these methods are without empirical support. But Debbie's mother was convinced that they helped Debbie, and according to her account, Debbie's condition did improve considerably during her treatment. And this raises the important question for all complementary/alternative treatments: if the methods don't work, why does the child get better?
There are two answers to this question. The first applies to all kinds of interventions: most interventions include general factors like attention, excitement, and enthusiasm that can make people feel better and be motivated to perform better, but those improvements are not due to the specific nature of a treatment. Second-- and especially important in the case of patterning-- children do not stop developing when they are injured or traumatized. However severe the injury to brain or other part of the body, as long as the child lives, growth and maturation will continue, although at a slower pace or in an atypical pattern. To measure whether an intervention helps handicapped children, we must collect information from a control group that shows us how much change came from maturation alone rather than from the treatment. This is as true today as it was when Debbie Segal was "patterned", and as true of autism as it is of cerebral palsy.
