The Institutes for The Achievement of Human Potential
Encyclopedia
The Institutes for The Achievement of Human Potential is a non-profit organization
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

 providing teaching programs and literature which it promotes as improving the health and neurological development of normal children and of children who have sustained a brain injury.

Although the institute's programs were supported by some notable individuals such as Linus Pauling
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...

 (1901–1994) and Raymond Dart
Raymond Dart
Raymond Arthur Dart was an Australian anatomist and anthropologist, best known for his involvement in the 1924 discovery of the first fossil ever found of Australopithecus africanus, an extinct hominid closely related to humans, at Taung in the North of South Africa in the province...

 (1893–1988), their programs for brain injured children have been widely criticized. According to the American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...

, the institute's patterning treatment is based on an outmoded and oversimplified theory of brain development, its effectiveness is not supported by evidence-based medicine
Evidence-based medicine
Evidence-based medicine or evidence-based practice aims to apply the best available evidence gained from the scientific method to clinical decision making. It seeks to assess the strength of evidence of the risks and benefits of treatments and diagnostic tests...

, and its use is unwarranted.

IAHP has its own journal titled In-Report, which publishes results that are to be shared among fellow professionals.

History

Founded in 1955, the Institutes for The Achievement of Human Potential (IAHP, also known as "The Institutes") is located in Wyndmoor, Pa.
Wyndmoor, Pennsylvania
Wyndmoor is a census-designated place in Springfield Township, Montgomery County, Pennsylvania, USA. The population was 5,498 at the 2010 census.-Geography:...

, a suburb of Philadelphia, Pennsylvania
Philadelphia, Pennsylvania
Philadelphia is the largest city in the Commonwealth of Pennsylvania and the county seat of Philadelphia County, with which it is coterminous. The city is located in the Northeastern United States along the Delaware and Schuylkill rivers. It is the fifth-most-populous city in the United States,...

. The founder, Glenn Doman (a physical therapist), together with Carl Delacato (an educational psychologist
Psychologist
Psychologist is a professional or academic title used by individuals who are either:* Clinical professionals who work with patients in a variety of therapeutic contexts .* Scientists conducting psychological research or teaching psychology in a college...

), developed an approach to treating children with brain injury, published in 1960 in the Journal of the American Medical Association
Journal of the American Medical Association
The Journal of the American Medical Association is a weekly, peer-reviewed, medical journal, published by the American Medical Association. Beginning in July 2011, the editor in chief will be Howard C. Bauchner, vice chairman of pediatrics at Boston University’s School of Medicine, replacing ...

 (JAMA). Glenn Doman received his degree in Physical Therapy from the University of Pennsylvania in 1940. Their work drew heavily on the ideas of Temple Fay (a neurophysiologist), who was head of the Department of Neurosurgery
Neurosurgery
Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment, and rehabilitation of disorders which affect any portion of the nervous system including the brain, spine, spinal cord, peripheral nerves, and extra-cranial cerebrovascular system.-In the United States:In...

 at Temple University Medical School and president of the Philadelphia Neurological Society. Fay 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
Ontogeny
Ontogeny is the origin and the development of an organism – for example: from the fertilized egg to mature form. It covers in essence, the study of an organism's lifespan...

 recapitulates phylogeny", also known as the recapitulation theory
Recapitulation theory
The theory of recapitulation, also called the biogenetic law or embryological parallelism—and often expressed as "ontogeny recapitulates phylogeny"—is a disproven hypothesis that in developing from embryo to adult, animals go through stages resembling or representing successive stages...

, is considered obsolete by modern mainstream biologists. The IAHP claim that brain injury at a given level of neurological development prevents further progress. The IAHP states that its therapies are based on the theory of neuroplasticity
Neuroplasticity
Neuroplasticity is a non-specific neuroscience term referring to the ability of the brain and nervous system in all species to change structurally and functionally as a result of input from the environment. Plasticity occurs on a variety of levels, ranging from cellular changes involved in...

, or the brain’s inherent ability to grow both functionally and anatomically. It claims that traditional medicine has attempted to treat brain injured children by medicating them, and that such medications can have negative side effects. The IAHP claims that due to neuroplasticity, their programs of increased sensory stimulation can actually physically grow the brain and produce improved neurological function in their patients. Another aspect of the IAHP's theories is that a lack of oxygen to the brain is a key cause of many problems in brain-injured children. The IAHP asserts that their program includes techniques that improve this oxygen supply, and that increased oxygen to the brain will help their patients recover.

Glenn Doman published the book What To Do About Your Brain-Injured
Brain damage
"Brain damage" or "brain injury" is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors...

 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. Since 1964, Glen Doman (later also Janet and Douglas Doman) has published a number of books in the "Gentle Revolution Series", a line of books for parents of normal children, covering topics such as reading, math, intelligence, and swimming. Programs for "well children" are a significant aspect of the IAHP's promotional material, literature and web site.

Programs for brain-injured children

Before initiation of an IAHP program with their "brain-injured" children, parents attend a five day seminar that the IAHP presents called the "What To Do About Your Brain-Injured Child Course". The IAHP states that this course gives a good basis of understanding of their programs to parents. This course is presented in Philadelphia, Italy
Italy
Italy , officially the Italian Republic languages]] under the European Charter for Regional or Minority Languages. In each of these, Italy's official name is as follows:;;;;;;;;), is a unitary parliamentary republic in South-Central Europe. To the north it borders France, Switzerland, Austria and...

, Japan
Japan
Japan is an island nation in East Asia. Located in the Pacific Ocean, it lies to the east of the Sea of Japan, China, North Korea, South Korea and Russia, stretching from the Sea of Okhotsk in the north to the East China Sea and Taiwan in the south...

, Mexico
Mexico
The United Mexican States , commonly known as Mexico , is a federal constitutional republic in North America. It is bordered on the north by the United States; on the south and west by the Pacific Ocean; on the southeast by Guatemala, Belize, and the Caribbean Sea; and on the east by the Gulf of...

, and Singapore
Singapore
Singapore , officially the Republic of Singapore, is a Southeast Asian city-state off the southern tip of the Malay Peninsula, north of the equator. An island country made up of 63 islands, it is separated from Malaysia by the Straits of Johor to its north and from Indonesia's Riau Islands by the...

.

The program for "brain-injured" children includes:
  • Patterning – manipulation of limbs and head in a rhythmic fashion
  • Creeping – forward bodily movement with the abdomen in contact with the floor
  • Crawling – 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 a rebreathing 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 designed to be used by a parent 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." They believe the order of brain development occurs as higher brain stages are successively brought into play.

Programs for well children

The IAHP also provides programs and literature to the parents of well children. Glenn Doman believes that because the neurological development of brain injured children could be speeded, that the same should be true of well children. The IAHP provides a series of books and early education kits called the "Gentle Revolution Series", which state that their use will accelerate development of well children. For example, one program is "How to teach your baby to read"http://www.gentlerevolution.com.

The IAHP teaches a week-long seminar called the "How To Multiply Your Baby's Intelligence Course", which provides demonstrations of children taught with the IAHP's methods. The IAHP claims that at the course, "parents learn how to teach their children to read, how to learn a foreign language...mathematics, and music appreciation. Parents learn about sensory and motor development and the fundamentals of a good nutritional program for the family."

Epilepsy treatment

The IAHP requires that all brain-injured children be gradually weaned off anticonvulsant
Anticonvulsant
The anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers, and in the treatment of neuropathic pain. The goal of an...

s. They claim that seizures are a "natural reflex defense response to a lethal threat to the brain", but that the seizures themselves are not directly harmful to the brain. Instead of placing children on anticonvulsant
Anticonvulsant
The anticonvulsants are a diverse group of pharmaceuticals used in the treatment of epileptic seizures. Anticonvulsants are also increasingly being used in the treatment of bipolar disorder, since many seem to act as mood stabilizers, and in the treatment of neuropathic pain. The goal of an...

 medications, the IAHP claims that resources should be directed at "developing methods and bioactive agents that promote neuroplasticity
Neuroplasticity
Neuroplasticity is a non-specific neuroscience term referring to the ability of the brain and nervous system in all species to change structurally and functionally as a result of input from the environment. Plasticity occurs on a variety of levels, ranging from cellular changes involved in...

", the brain's ability to grow and change. The IAHP asserts that status epilepticus
Status epilepticus
Status epilepticus is a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 5 minutes, or recurrent seizures without regaining consciousness between seizures...

 can be caused by anticonvulsants and may be best left untreated by them. Instead, they believe that seizures can be reduced or eliminated by a "masking" program, which they claim periodically reduces oxygen intake and increases carbon dioxide
Carbon dioxide
Carbon dioxide is a naturally occurring chemical compound composed of two oxygen atoms covalently bonded to a single carbon atom...

 intake. The IAHP also claims that seizures can be reduced by decreasing intake of salt and fluids, supplements of magnesium
Magnesium
Magnesium is a chemical element with the symbol Mg, atomic number 12, and common oxidation number +2. It is an alkaline earth metal and the eighth most abundant element in the Earth's crust and ninth in the known universe as a whole...

 calcium
Calcium
Calcium is the chemical element with the symbol Ca and atomic number 20. It has an atomic mass of 40.078 amu. Calcium is a soft gray alkaline earth metal, and is the fifth-most-abundant element by mass in the Earth's crust...

 and pyridoxine
Pyridoxine
Pyridoxine is one of the compounds that can be called vitamin B6, along with pyridoxal and pyridoxamine. It differs from pyridoxamine by the substituent at the '4' position. It is often used as 'pyridoxine hydrochloride'.-Chemistry:...

, and a healthy diet and environment.

Scientific criticism

The American Academy of Pediatrics
American Academy of Pediatrics
The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...

 Committee on Children With Disabilities issued warnings regarding patterning, one of the IAHP's therapies for brain injured children, as early as 1968 and repeated in 1982. Their latest cautionary policy statement was in 1999, which was reaffirmed in 2002 and 2005. It stated:


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.... [T]he 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.


Since 1960 the IAHP has published multiple studies professing to show the effectiveness of the program. These studies, upon review, have not stood up to scientific scrutiny and have not been reproduced by other sources. In 1978, Sara Sparrow (professor emerita and senior research scientist at Yale Child Study Center) and Edward Zigler (professor emeritus at the Department of Psychology at Yale University, one of the principle architects of the US federal Head Start program and recipient of the 2008 APA Award For Outstanding Lifetime Contribution To Psychology) evaluated patterning as a treatment for retarded children. They concluded that no evidence was found for an improvement over that which would be expected of children given attention or that expected of any child as they mature; the patterning method cannot be recommended for seriously retarded children. Zigler wrote a 1981 editorial entitled "A plea to end the use of the patterning treatment for retarded children", which emphasized the harmful effect the treatment has by raising false hopes and increasing parental guilt. According to Edward Zigler and Robert Hodapp, in their book Understanding Mental Retardation, the Doman-Delacato method has major flaws:
  • The recapitulation theory it is built upon has been discarded by the natural sciences.
  • The suggestion that motor development has stages, which depend on earlier developments, is not supported by evidence.
  • There is no evidence that passive movements by a child, forced to engage in crawling movements, affects neurological organization.
  • Children who voluntarily perform an activity (such as sitting or walking) before mastering preceding stages, are prevented from doing so by the IAHP—possibly harming the child.
  • The only scientific paper published by Doman on patterning (in 1960) contains many methodological errors and overstatements of findings. The study had no control group so was unable to compare with children who would naturally show some developmental progress over time. When independent scientists compared the results with the progress made by untreated children, the "results of patterning appear singularly unimpressive".
  • The patterning procedure may be harmful to its participants (the parents experience guilt at being unable to achieve the intensive program required) and other family members through neglect.
  • It is cruel to offer hope through a program that is impossible to fully carry out.


In addition to the American Academy of Pediatrics, a number of other organizations have issued cautionary statements about claims for efficacy of this therapy. These include the executive committee of the American Academy for Cerebral Palsy, the United Cerebral Palsy Association of Texas, the Canadian Association for Retarded Children the executive board of the American Academy of Neurology
American Academy of Neurology
The American Academy of Neurology is a professional society for neurologists and neuroscientists. As a medical specialty society it was established in 1949 by A.B. Baker of the University of Minnesota to advance the art and science of neurology, and thereby promote the best possible care for...

, and the American Academy of Physical Medicine and Rehabilitation.

A 2006 retrospective study of 21 children by the IAHP and others of children with cortical visual impairment
Cortical visual impairment
Cortical visual impairment is a form of visual impairment that is caused by a brain problem rather than an eye problem. Some people have both CVI and a form of ocular visual impairment.CVI is also sometimes known as cortical blindness, although most people with CVI...

 found significant improvement after use of the program; the study had no control group and has not been replicated.

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 pseudoscientific 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 widespread criticism in his book Running a Team for Disabled Children and Their Families but concedes that Doman and Delacato caused paediatricians and therapists to recognize that early intervention programs are needed.

Steven Novella
Steven Novella
Steven P. Novella is an American clinical neurologist, assistant professor and Director of General Neurology at Yale University School of Medicine...

, assistant professor of Neurology at Yale University School of Medicine, criticized the technique as follows:

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 instill 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.

Notable supporters

A few notable individuals have expressed support for the IAHP.

Physicist Linus Pauling
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...

 presented a talk on the "Orthomolecular
Orthomolecular medicine
Orthomolecular medicine is a form of complementary and alternative medicine that seeks to maintain health and prevent or treat diseases by optimizing nutritional intake and/or prescribing supplements...

 enhancement of human development" in 1978 at a conference on human neurological development co-sponsored by the IAHP. In his opening remarks, he praised his hosts: "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."

Anthropologist Raymond Dart
Raymond Dart
Raymond Arthur Dart was an Australian anatomist and anthropologist, best known for his involvement in the 1924 discovery of the first fossil ever found of Australopithecus africanus, an extinct hominid closely related to humans, at Taung in the North of South Africa in the province...

 spent the last 20 years of his life dividing his time between South Africa and the IAHP. Dart supported the "ontogeny
Ontogeny
Ontogeny is the origin and the development of an organism – for example: from the fertilized egg to mature form. It covers in essence, the study of an organism's lifespan...

 recapitulates phylogeny" premise behind the IAHP's work. Dart stated that "the development of the individual does, indeed, recapitulate the evolution of the species."

Actress Liza Minnelli
Liza Minnelli
Liza May Minnelli is an American actress and singer. She is the daughter of singer and actress Judy Garland and film director Vincente Minnelli....

served on their board of directors for some time and appeared in their commercials.

External links

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