A member of Quackwatch’s Healthfraud discussion list recently reported from a health fair:
One booth was a bit of a mystery for me: Brain Balance. “Is your child struggling with ADHD, dyslexia, autism, Asperger’s, Tourette’s, or other related disorders?” A quick glance at their website makes it seem that they may be legitimate.
No, a quick glance at their website makes it seem that they are not legitimate, and a more detailed examination confirms that initial impression.
The Claims
It’s easy to see the attraction of the program. They offer hope: the brain can be changed. They can figure out exactly what is wrong and how to fix it. They offer a package of interventions to improve academic performance, social abilities, cognitive function, sensory and motor skills, visual-spatial organizational skills, improved immunity and nutritional health. Miraculous results are reported (“He spoke for the first time!”), and there are impressive testimonials. But there are a number of red flags indicating that this website might not be a reliable source of health information. They use the word “balance,” a vague term often used in pseudoscience and seldom based on clearly defined scientific realities; they use other buzz words like “holistic,” “without drugs,” and “improves immunity”; they are aggressively selling something (a service, through their own clinics) and you can buy a franchise and they will train you; “Dr. Robert Melillo” is not identified as a chiropractor; and the biggest red flag of all is that a headline on the front page says their program is “clinically proven,” yet they provide only testimonials and one published study (which turns out not to support their claims).
Their website’s list of possible environmental factors which can affect brain development and/or gene expression is decidedly unconventional and highly questionable:
- sedentary behavior of child or mother (prenatal or postnatal)
- abnormal sensory motor development caused by birth injury or from lack of sufficient stimuli early on
- poor diet and nutritional deficiencies and sensitivities prenatal or postnatal
- exposure to toxins pre or postnatal
- chronic infection / yeast / bacterial / parasite of mother or child
- psychological stress prenatal or postnatal
- sleep deprivation of mother prenatal and of child
- hypoxia (perinatal, postnatal)
This list is fanciful, even bizarre (“sedentary behavior of child”??!). I suppose anything is “possible,” but most of these are not recognized by mainstream science as probable or as worthy of further investigation, and some of them are ruled out by the known facts.
They claim that ADHD, autism, Tourette’s syndrome, pervasive developmental disorder and dyslexia are no longer considered separate entities but are now considered points on a spectrum of neurobehavioral/developmental disorders. This is their own idiosyncratic interpretation and it directly contradicts the understanding of mainstream science.
The Evidence
Do their treatments work?
To give you a better sense of the outstanding results our clients continue to realize, we have included success stories and findings from a formalized research study initiated by the F.R. Carrick Research Institute.
One formalized research study. Only one. One might be persuasive if it were scientifically rigorous and convincing, but this one certainly isn’t.
The complete study is available online. It was published in the International Journal of Adolescent Medicine and Health. This is an obscure peer-reviewed journal published by the Freund Publishing House in Tel Aviv, Israel; I could find no listing for its impact factor. Only one of the study’s authors is an MD; the rest are chiropractors and MScs. All of them are affiliated with two “Carrick Institutes” named for the last author, Frederick Carrick. Carrick is a chiropractor who teaches chiropractic neurology to post-graduate chiropractic students. He has a PhD, but in education, not science.
I had encountered Dr. Carrick before. A few years ago I wrote about a study he did on blind spot mapping. It found that everyone has an enlarged blind spot in one eye (averaging 50% larger than in the other eye!?) and that this constitutes a “map” of brain function showing abnormalities in the corresponding cortical hemisphere, and that normal hemispheric brain function can be restored by chiropractic manipulation of the proper side of the neck. “Normal function” was essentially defined as a shrinking of the previously enlarged blind spot. If this sounds like nonsense, it is. In an article in The Scientific Review of Alternative Medicine (not available online) I wrote a more complete analysis showing that the study demonstrated logical fallacies, faulty syllogisms, careless writing, poor citations, poor methodology, unwarranted conclusions, and a poor understanding of science, and that its results were not credible. Carrick responded with a diatribe in which he accused me of deception, fraud, and lying and called me delusional and “perhaps psychotic” and much else.
The Brain Balance Study
This new study on brain balance is a pilot study, the kind of study whose results are not intended to guide clinical decisions but only to direct future research. They didn’t even bother to use a control group. They took 122 children with diagnosed ADHD and submitted them to what they call “a hemisphere specific remediation program.” The rationale for the study was flimsy. They speculate that ADHD is related to a “functional dysconnectivity,” hemispheric imbalance, subcortical dysfunction, a lack of temporal coherence, and a difference in arousal level between the hemispheres. They provide no evidence that these are characteristic of ADHD or were present in their subjects, or that their treatments specifically changed any of them. They assumed an underactive right hemisphere (it was not clear why) and they provided interventions that they assumed (without any supporting evidence) ought to remedy the alleged imbalance. They tested for the child’s specific deficits and provided tailored interventions: these included sensory stimulation, motor training, aerobic strength and conditioning, primitive reflex inhibition exercises and academic training. None of these interventions seem to me to be directed at a specific hemisphere, despite their unsupported statement that the treatment “was aimed nominally at exercises thought to principally stimulate the less efficiently performing hemisphere.” (Emphasis added.) Synchronized Metronome Treatment was given, where subjects listened to a metronome beat and matched physical movements to it. This was intended to “improve participants’ timing/rhythmicity by reducing the latency between the onset of the metronome beat and the participant’s expectancy response to the beat.” It is not clear how any of the tested interventions constituted “hemisphere specific training.”
The subjects improved significantly on several measures: parental reports, achievement tests, grade level performance, objective improvement in coordination with the interactive metronome. But what do these results mean? Without a control group, it is impossible to know whether the interventions were responsible for the improvement. In the “Hawthorne effect,” simply being enrolled in a study tends to improve performance. People frequently improve their performance when any test is repeated. In this case, all children were also taking stimulant medication throughout the study: how do we know that alone didn’t account for the improvements?
At any rate, the interventions in this study were not comparable to the Brain Balance program: the program includes dietary manipulations and is “drug-free.” The study participants were all on drugs and their diets were not manipulated.
In the discussion section, the authors themselves admit that this was only a pilot study and that a large scale clinical trial will be needed. So how can Brain Balance justify citing this one uncontrolled pilot study as evidence of the “outstanding results” their clients realize? The authors comment that trials will need to examine the differential effects of medication and hemisphere specific treatment. They also comment out of the blue that they will need to examine the effects of nutritional interventions: where did that come from?!
Conclusion
The one study presented as evidence for the Brain Balance program does not constitute evidence. While some aspects of the program’s interventions are already used in more conventional programs and might prove helpful to individual children, there is no indication that the theoretical concepts of “functional dysconnectivity,” “brain balance,” or “hemisphere specific training” are clinically useful. The Brain Balance program is based on speculation, not on credible evidence.
This article was originally published in the Science-Based Medicine Blog
