So, what should chiropractors do regarding vaccinations? Obviously, we believe that it is unethical to recommend avoiding vaccinations while also recommending adjusting, because of the comparable level of risk. Likewise, we would agree that for a chiropractor who strongly believes that vaccinations are bad, and believes that adjusting is good, telling patients who ask about vaccinations that they should have them is also a significant ethical problem. While doctors need to respect their patients' autonomy rights, they also need to respect their own. The great problems in ethics occur when two rights or duties are in conflict. Thus, for the anti-vax chiropractor, we see a significant ethical distress. The solution, we believe, was developed by the College of Chiropractors of Ontario. Its Standard of Practice S-015 states: "Chiropractors may not, in their professional capacity, express views about immunization/vaccination as it is outside their scope of practice." It seems best, since there are questions as to the ethics of recommending avoidance of immunizations, to not say anything at all.
In 1983 a woman named Helen Irlen hypothesized that there might be an underlying neurological problem in encoding and decoding visual information for some people who have trouble learning to read, or for people who have trouble with sustained reading. She futher hypothesized that this problem can be alleviated by adjustments to the appearance of the printed page: that is, special colored lenses in glasses, or colored overlays on the page, and so forth.
Here's an important point: some people do seem to have perceptual distortions especially when doing close work requiring the rapid discrimination of similar stimuli, such as comparing and comprehending the following sentences:
Helen Irlen, a licensed Marriage, Family
and Child Counselor from Long Beach, California, theorizes a condition
she calls "Scoptic Sensitivity Syndrome" (SSS). She
claims that 15% of the general population, and more than 50% of
the reading disabled, suffers from SSS as diagnosed with the Irlen
Differential Perceptual Schedule (IDPS). Irlen was twice featured
on 60 Minutes demonstrating a dramatic improvement in oral
reading fluency in children and adults by wearing tinted eyeglass
lenses. A brochure published by an Irlen Clinic also claims "great
relief," in some cases, for amblyopia, nystagmus and cataracts.
Irlen Clinics are opening throughout the USA. A cadre of local
screeners is being trained to feed the clinics with patients.
Screeners are using direct mailings to schools and professionals
claiming a "remarkably simple" cure for reading disability.
Screeners charge up to $60 for their services. The total cost
of diagnosis and treatment is approximately $565. Yearly follow
up visits will add to this cost.
Although the proponents may be sincere in
their beliefs, it is my opinion that the aggressive promotion
of the Irlen approach is unwarranted based upon current evidence.
Computerized searches of the scientific literature have failed
to produce studies supporting SSS, although several critical reviews
have been published. The psychological literature supports the
effects of colors on some aspects of behavior. Flyers, shooters
and skiers use yellow lenses to increase contrast, optometrists
prescribe pink lenses to control reading glare, and spectrally
modified lenses are prescribed to enhance visual performance in
selected patients. On the other hand, it has been shown that the
eye's autofocus system (accommodation) is blind to color, so tinted
glasses should not help a focusing problem.
Testimonials, a clinical study, and several
unpublished studies dispensed by the Irlen Institute note some
positive effects, but to date, studies have NOT shown that:
SSS diagnosed with the IDPS exists as
a unique condition different from those already known.
The use of colored lenses is more effective
than a placebo or other interventions for reading disabled individuals.
That any beneficial effects persist over
SSS seems to be very similar to minimal
binocular dysfunction diagnosed by behavioral optometrists. The
term scotopic is a misnomer. Scotopic refers to dark adapted vision
in which only the rods, which are insensitive to color, are active.
Since decoding is a complex cognitive task which transcends vision
and involves both auditory skills and higher level functions,
it is hard to propose a mechanism for improved oral fluency based
on the simple application of colored lenses.
In summary, it is my view that the claims
of the Irlen Institute are extraordinary within the historical
context of research of learning disabilities and dyslexia. Although
their theory is interesting, SSS advocates should develop a broad
base of clinical and experimental evidence before commercial promotion
can be justified. I believe that parents should evaluate all of
the alternatives available to them, including private tutoring,
standard assessment and remedial procedures before allocating
money, time and energy on any reading enhancement program.
Dr. Worrall is Assistant Clinical Professor,
School of Optometry, UC Berkeley; Coordinator, NCAHF Task Force
on Vision-Related Misinformation. (References available upon request.)
Scholar Man & Scholar Woman are the only adult members of our family who haven't seen the Birth of Impressionism exhibit, because of babysitting complications. I'm hoping they will be able to take in, maybe at one of these evenings.
June 17 through September 2, the de Young presents Impressionism at
Twilight every Thursday evening, featuring reduced admission fees and
extended viewing hours for Birth of Impressionism until 8:45
pm, a special French-inspired menu in the de Young Café, and
magnificent sunset views of the city and the Pacific from the de Young
Tower’s ninth-floor observation deck. Adult/senior/student admission
for Impressionism at Twilight is $16 and youth admission is $10.
Tickets for members are free.
Item #1 -- As expected, Andrew Wakefield is no longer registered as a physician in the United Kingdom. I gather the old locution, "struck off" is no longer accurate. Wakefield lost his license for because of his unethical and dishonest behavior in conducting his research.
Item #2 -- A study published May 24 2010 online in Pediatrics compared neurological outcomes at age 7 and 10 in 1047 children based upon their vaccine schedule. The study's title says it all: On-time Vaccine Receipt in the First Year Does Not Adversely Affect Neuropsychological Outcomes.
On Wakefield's disgrace (a sample of the coverage)
The other day I carpooled to and from an event with a married couple who are 30 years younger than I am. I was looking forward to the drive because I'm quite fond of both the husband and the wife, and I don't get to visit with them often.
The husband drove. On the way up, the wife sat in the back and spent most of the trip on her cell phone, arranging a weekend event for their family. Because she was in the back, I could kind of shut out her end of the cell phone conversation. I didn't feel like it would be intrusive to chat with the husband so I was able to have a long conversation with him.
On the way back, the wife sat in the front seat and spent most of the trip on her cell phone with a friend she sees several times a week, talking about several issues the friend was having. I didn't feel like I should carry on a conversation with the husband, because it would intrude on the wife's cell phone conversation.
I realized the next day that I was a bit put out with the wife, who (in my view) found it more important to talk with friends she sees every week than to talk with me.
I expressed this feeling to my daughter (who also knows and likes the couple) and her view was that it was a generational difference. The wife wasn't being rude at all.
Then I ran across this article at Discover Magazine:
I was fortunate enough to see an advance viewing of the exhibit of works from the Musée d'Orsay, Birth of Impressionism at the de Young Museum in San Francisco last week. This is a magnificent exhibit.
On May 19, Dear Abby published a letter from a mother upset over a friend's comment about the mother's adult son, "Jasper". Jasper has autism and a girlfriend, and the mother's friend suggested that the mother should consider getting Jasper "fixed." The mother was writing for advice on what to say to this "friend".
Establishes 2-tier voluntary licensing system, requiring specific
training and examination in multi-sensory structured language education. Requires Department of Health to issue regulations and enforce licensing scheme, with potential civil penalties for violation. Public schools are not required to hire
licensed practitioners, but “practitioners” are allowed to practice only in a school or clinic setting; only “therapists” may offers services in a private setting.
Part III--IACC: Coverage elsewhere on the web of IACC meetings, announcements, plans, and issues
Part IV--2010 IACC members
In part I, I took "the daily web newspaper of the autism epidemic" to task for their paltry and biased coverage of IACC meetings, decisions, and reports. I thought it only fair to look to see if the IACC was getting better coverage elsewhere.
Method: First, I searched individual blogs known to cover autism issues. Second, I used a general search to find other posts. Note #1: I am sure I missed many relevant posts -- please leave a note in the comments and I will add to the list. Note #2: Just as I did in part II, I excluded posts that were merely announcing meetings or giving instructions on how to comment, etc.