The Institutes for The Achievement of Human Potential

The Institutes for The Achievement of Human Potential is a non-profit organization providing teaching programs and literature which, it claims, improve the health and development of children who have sustained a brain injury. The accelerated development of normal children is also promoted. The IAHP's methods have, however, been widely criticized by the medical establishment.

History
"The goal of The Institutes is to raise significantly the intellectual, physical, and social abilities of all children." – www.iahp.org.

Founded in 1955, the Institutes for The Achievement of Human Potential (IAHP, also known as "The Institutes") is located in a suburb of northwest Philadelphia, Pennsylvania. The founder, Glenn Doman (a physical therapist) worked with Carl Delacato (an educational psychologist) and developed an approach to treating children with brain injury. This was published in 1960 in the journal JAMA and remains the IAHP's only independently published research in a peer-reviewed journal. Their work drew heavily on the ideas of Dr. Temple Fay (a neurophysiologist), who believed that the infant brain evolves (as with evolution of the species) through stages of development similar to a fish, a reptile, a mammal and finally a human. This idea, encapsulated as "Ontogeny recapitulates phylogeny" was briefly popular then but has never been mainstream embryology. Brain injury at a given level of brain evolution prevents further progress. These ideas have not found common acceptance amongst neurologists. Doman and Delacato's treatment is often termed "patterning", but is referred to in some literature as the "Doman-Delacato" method. Another aspect of their theories, is that a lack of oxygen to the brain is a key cause of many problems and their program includes techniques that claim to improve this oxygen supply.

In 1964 Doman published the book How to Teach Your Baby to Read. This was followed in 1979 by Teach Your Baby Math and How to Multiply your Baby's Intelligence in 1983. These were also aimed at parents of normal children. Since 1979, the IAHP has targeted these "well babies" with their Better Baby Institute. This consumes 10% of The Institutes yearly program of courses, but is a significant aspect of their promotional material, literature and web site.

Doman published the book What To Do About Your Brain-Injured Child in 1974, which describes the ideas and techniques used by IAHP. The subtitle of the book "or your Brain-damaged. Mentally Retarded, Mentally Deficient, Cerebral-Palsied, Epileptic, Autistic, Athetoid, Hyperactive, Attention Deficit Disordered, Developmentally Delayed, Down’s Child" lists the many conditions the author regards as being encompassed by "brain injured" – the term favoured by IAHP.

Program
The program for "brain injured" children includes:


 * Patterning – manipulation of limbs and head in a rhythmic fashion
 * Crawling – forward bodily movement with the abdomen in contact with the floor
 * Creeping – forward bodily movement with the abdomen raised from the floor
 * Receptive stimulation – visual, tactile and auditory stimulation
 * Expressive activities – e.g. picking up objects
 * Masking – breathing into an oxygen mask to increase the amount of carbon dioxide inhaled, which is believed to increase cerebral blood flow
 * Brachiation – swinging from a bar or vertical ladder
 * Gravity/Antigravity activities – rolling, somersaulting and hanging upside down.

(The above is taken from Understanding Mental Retardation, page 185-186.)

The program is highly intensive and designed to be used by a parent full-time at home. Patterning is perhaps the key technique. IAHP state "if we have to put everything we do on one hook, patterning is really not a bad place to hang our hat" and "that if these patterns were applied rigorously, on a specific schedule, and done with a religious zeal, brain-injured kids improved."

Epilepsy Treatment
A highly controversial aspect of the IAHP is their approach to treating epilepsy. Their program requires that all children be slowly weaned off anticonvulsants. They claim that often seizures cause no harm and that status epilepticus can be caused by anticonvulsants and may be best left untreated by them. Instead, they believe epilepsy can be cured by enhanced oxygen intake, respiration, and diet. This has not been studied or confirmed using scientific research methods and so there is no reliable evidence that this approach is either safe or effective. It has not found favour with neurologists or epilepsy support organisations. Anticonvulsant medication, as with any therapy, is a compromise between the side effects of the drugs and the problems caused by seizures.

Criticism
Criticism of the Doman-Delacato method is widespread in the medical establishment, many of whom regard it as quackery. One of the most vocal is the American Academy of Pediatrics (AAP). Their Committee on Children With Disabilities has issued warnings regarding patterning as early as 1968. They updated and repeated their warnings in 1982. The latest cautionary "policy statement" from them was in 1999, which was reaffirmed in 2002 and 2005:


 * "This statement reviews patterning as a treatment for children with neurologic impairments. This treatment is based on an outmoded and oversimplified theory of brain development. Current information does not support the claims of proponents that this treatment is efficacious, and its use continues to be unwarranted."


 * "the demands and expectations placed on families are so great that in some cases their financial resources may be depleted substantially and parental and sibling relationships could be stressed."

Kathleen Ann Quill, in her book "Teaching children with autism: What parents want", says "thousands of families have wasted time and money to follow Doman's methods." She goes on to say "Professionals have nothing to learn from Doman's pesudoscientific treatments, but they have plenty to learn from his marketing strategy", which is aimed at parent's "hopes and fantasies".

Martha Farrell Erickson and Karen Marie Kurz-Riemer discuss Early Intervention with "Normal Infants and Toddlers" in their book "Infants Toddlers and Families". They claim Doman "capitalized on the desires of members of the "baby boom" generation to maximise their children's intellectual potential" and "encouraged parents to push their infants to develop maximum brain power". However his programs were "based on shaky or nonexistent research evidence" and "most child development experts at the time described many aspects of the program as useless and perhaps even harmful."

Martin Robards also cites criticism in his book "Running a Team for Disabled Children and Their Families" but concedes that Doman and Delacato caused paediatricians and therapists to recognise that early intervention programs are needed.

Steven Novella, MD is a neurolgist who has criticized the technique in an article called Psychomotor Patterning: An Expose of a Cruel Pseudoscience. The conclusion is reproduced here:

"The Doman-Delacato patterning technique is premised on a bankrupt and discarded theory and has failed when tested under controlled conditions. Its promotion with unsubstantiated claims can cause significant financial and emotional damage. Such claims can instil false hope in many people who are already plagued by guilt and depression, setting them up for a further disappointment, guilt, and feelings of inadequacy. The process can also waste their time, energy, emotion, and money. These resources may be taken away from their children. Parents can also be distracted from dealing with the situation in other practical ways and coping psychologically as a family with the reality of having a brain-injured or mentally retarded child. Parents are encouraged, in fact, to remain in a state of denial while they are pursuing a false cure."

Support
Linus Pauling, winner of two Nobel Prizes, praises the Institutes in his paper "Orthomolecular enhancement of human development", which was presented in 1978 at the symposium Human Neurological Development: Past, Present, and Future, jointly sponsored by NASA Ames Research Center and IAHP:
 * "I believe that there are great possibilities for improving the lot of human beings, the health of human beings, including the work fo the Institutes for Achievement of Human Potential and I admire the work that has been done in these Institutes very much. I know that considerable emphasis is placed on good nutrition for the people who come to the Institutes and that large doses of vitamin C are given to them."

In his book "A Life with Purpose", Kevin Berg (who was born with cerebral palsy) devotes a chapter to "Patterning" and his parent's involvement with IAHP. He states "I have a very different opinion than the mainstream scientific community based on my experience."

David Mills is also a fan. In his book "Science Shams & Bible Bloopers: How You're Being Hoodwinked by Know-Nothing "Experts" and gassy "Authorities"", he describes Glenn Doman as "a remarkable and selfless gentleman" and a "pioneer". He "had succeeded, where others had failed, in developing an effective, systematic approach to educating mentally handicapped children." Of his work on "well children", Mills goes on to say "Toddlers, barely old enough to stand, were being taught by Doman to read with good comprehension years before "experts" said it was possible".

Naturally, the IAHP web site contains a significant amount of promotional material for their programs and techniques. There are numerous case histories and testimonials. Their results are, however, not presented in the detail required for a scientific paper. In addition there is no independent review of their work, nor are controls used.

Many parents who have had their children treated by IAHP are also enthusiastically supportive. These parents claim they have seen remarkable progress in their children while on the program. Medical professionals counter that this is mostly wishful thinking on the parent’s part and that any gain would have occurred without the IAHP’s program since children with developmental disorders do improve with age, just at a much slower pace than a regular child.