DDAT: Bunk or Not?

Update June 1 2008: Dore seems to be out of business, world-wide.  See this summary post.  My sympathies to those families who prepaid and have no economic recourse.

Update: The Dore method, or DDAT, keeps getting positive reports in the credulous press.   The more rigorous scientific community is not impressed.

The original article:
Reynolds, D., Nicolson, R. I. and Hambly, H. (2003). Evaluation of an exercise-based treatment for children with reading difficulties.
Dyslexia. 2003 Aug;9(3):164-6; discussion 167-76. No abstract available.
PMID: 12940300 [PubMed - indexed for MEDLINE]

Commentary was published here:
    * Dyslexia. 2003 Aug;9(3):137-9; discussion 167-76.
    * Dyslexia. 2003 Aug;9(3):140-5; discussion 167-76.
    * Dyslexia. 2003 Aug;9(3):146-50; discussion 167-76.
    * Dyslexia. 2003 Aug;9(3):151-60; discussion 167-76.
    * Dyslexia. 2003 Aug;9(3):161-3; discussion 167-76.
    * Dyslexia. 2003 Aug;9(3):164-6; discussion 167-76.
    * Dyslexia. 2003 May;9(2):122-4.
    * Dyslexia. 2003 May;9(2):124-6.
    * Dyslexia. 2003 May;9(2):127-33; discussion 134-5.

Appraisal of DDAT controlled trial: Dyslexia   1 May 2003, vol. 9, no. 2,   pp. 127-133(7)

Commentary by M. J. Snowling and C Hulme,   Department of Psychology, University of York, York, United Kingdom: A critique of claims from Reynolds, Nicolson & Hambly (2003) that DDAT is an effective treatment for reading problems: �Lies, damned lies and (inappropriate) statistics�. Dyslexia: An International Journal of Research & Practice, 9, 1-7.

Abstract:
Reynolds, Nicolson and Hambly (Dyslexia 2003; 9: 48) report a study to evaluate the effectiveness of dyslexia dyspraxia attention deficit treatment (DDAT)—an exercise-based treatment for children with reading difficulties. They claim that DDAT is an effective treatment with positive effects on the cognitive skills underlying literacy and the reading process. We outline the numerous methodological and statistical problems with this study and conclude that it provides no evidence that DDAT is an effective form of treatment for children with reading difficulties. Copyright © 2003 John Wiley & Sons, Ltd.

http://www.ets.org/disability/ldpolicy.html

Personally, I would not invest my child's time or my money in the DDAT or Dore treatment.
Original follows:

In the latest issue of Dyslexia OnLine Journal, a British dyslexia educator warns us not to reject all of the widely-publicized movement therapy to treat dyslexia.

Sally Goddard Blythe writes: Some of us have been working for over 30 years with various types of developmental

movement programmes to improve the functioning of the vestibular-cerebellar circuit, coordination and postural control. It would be a great pity if the aggressive marketing strategies of the Dore organisation threatened to discredit the detailed and long-term work of so many people. [snip]

[T]hose of us who have worked with movement based regimes for many years would acknowledge that movement programmes are only a solution to specific types of dyslexia. There are at least 4 different categories of dyslexia, 3 of which require additional or alternative intervention:

1. Problems with accurate decoding and processing of visual information.
2. Phonological processing problems
3. Families in which there is a strong genetic tendency
4. Motor-perceptual and vestibular related functions.

It is children in category 4 who are most responsive to an exercise-based regime. Certain children in category 1 also frequently benefit from an exercise programme if their visual processing problems are connected to dysfunction in the vestibular-cerebellar loop. In other words, it is the aetiology not an individual method that is the key to success. This is where detailed assessment of the individual child is crucial to the implementation of an effective method of remediation and analysis of the efficacy of various types of remediation.

Sally Goddard Blythe is the Director of  The Institute for Neuro-Physiological Psychology (INPP) 4, Stanley Place Chester CH1 2LU UK  Email: mail@inpp.org.uk

I wold be more impressed if she had provided some references for the reason she thinks there are four types, and some numbers.

What the controversy is about: A British entreprenuer,  Wynford Dore, became enamored of a theory that says that the cause of dyslexia lies in the impaired workings of the cerebellum, the part of the brain that controls co-ordination.  He established Dyslexia, Dyspraxia and Attention Disorder Treatment Centre (DDAT) in England. Press releases publicizing the centre's work said the techniques were designed by NASA to aid astronauts who suffered from temporary dyslexia.

The DDAT treatment has been widely publicized in the UK and in the United  States, particularly the claims of a  "cure" for dyslexia that costs more than a thousand pounds.

NASA was sufficiently vexed to issue a statement:

Q. I heard that NASA has a treatment for dyslexia, how can I get more information?
A.Due to recent articles in the British press, namely "The Independent", that describe a new treatment for dyslexia that utilizes "Space research, in the form of computerised balance tests given to returning astronauts and corrective exercises that reintroduce stability after weightlessness", we have received numerous requests for information concerning this research.

In response, the Acting NASA Chief Health and Medical Officer, Richard S. Williams MD, has issued the following statement:

"In our experience, the prolonged exposure of Astronauts to the microgravity environment of space flight does not give rise to any physical symptoms or signs that would suggest dyslexia. To the best of our knowledge, NASA is not funding or engaging in research concerning dyslexia. Similarly, we do not have (or are unaware of) evidence that any of our medical or rehabilitative interventions for the Astronauts might be effective in treating dyslexia."

More information here

Sixty Minutes, an American television program, aired a segment on the "DDAT" treatment. 

Today, Dore sells his exercise regime for around $3,000 dollars per patient. He calls the treatment revolutionary, but exercises to treat dyslexia are not new. In fact, one American researcher introduced similar balance training exercises more than 30 years ago.

What is discouraging is how credulous 60 Minutes was.  They could have administered standard assessment  tests to the two people they profiled, and then re-tested them at the end.  But they didn't.

IDA (the international dyslexia association) has repudiated DDAT and rebuked 60 Minutes for being so credulous.  (It is a PDF, so may load slowly).

Comments

[Taylor]

Yo i goto d dd d d ddd dat and me knwo ti gdoo . learn me alot d dat at. I learnded alfalabet
nd to how spell dat d . Feel free to contacts me on sulphie@hotmail.com

[ADBatstone]

Wynford Dore = quack.

There is absolutely no evidence that mere exercises can stimulate the growth of connections in the cerebellum.

[John Bedson]

Free Exercises for Dyslexic Children
(It's An Open Dore!)

http://www.australianinvestmentguide.com/free_exercises_for_dyslexic_chil.htm

[Terry Casey]

Hi

I am determined to stop this man Wynford Dore, who I believe is not telling the truth.

My son and I have followd the DDAT program. We paid over £2000 each for the treatment.

I have completed the progam and a almost a year on I have noticed no change, i am still dyslexic.

My son followed the program for 2 years and eventually we felt it kinder to stop. After almost three years my son still reverses his numbers & letters.

I have asked for a refund, but keep on getting brushed off.

If you have a similar complaint and want to get your money back contact me tm.casey@ntlworld.com

Thanks for listening.

Terry

[Patti Burns]

My son has been on the dore program in Australia(we took a loan out)and my son hated it. Also his behaviour become worse. I think i will stop and think alot HARDER next time. It was a waste of time for me and my son, the tears from my son broke my heart. My son asked am i smart yet mum(what do you say). I would do anything for my son and they know that. I am going to ask for my $$$$$ back. I have only spoken to two people and now am waiting on some man to ring back.

[Liz]

Dear Ms. Burns, I am so sorry for your monetary loss and your son's unhappiness.

If you were addressing your son's dyslexia, you may wish to visit Barton Reading, and the related one,

Bright Solutions for Dyslexia.

Ms. Barton's reputation is excellent, and many parents have reported great success:

IDA's">http://interdys.org/forum/topic.asp?TOPIC_ID=876">IDA's Discussion Board

A Happy Barton User

[Liz]

You may also want to look around the SchwabLearning site

SchwabLeaning Home

and the discussion board

Discussion Board Index

There are several Australians participating in the discussion board.

[P Buddery]

I was sniffing at the Dore method for info concerning autism, and I was run through a rather too-simple quiz which concluded that I had ADHD. I probably do, if my inability to tolerate boredom is any indication.

My point is this: the quiz was far too simple and lacking in rigour, and any information gleaned therefrom could not possibly be complete enough for any useful purpose. Further, the website was rather keen to enrol me in the exercise course.

Interestingly, it was concluded (or assumed) that I was a child with ADHD and a range of reading and writing difficulties, rather than a middle-aged engineer who has always been a keen reader and an effortless prose writer.

P Buddery

[A Ashton]

Hi

Tried to look up that australianinvestmentguide.com site. It doesn't exist anymore. Any updates on this address?

thanks

[ellen hickey]

am 14 and I have completed ddat. I started when I was 12 and finished at 13. It changed my life; I had been bullied through all my school life and had no confidence what so ever. I believed that I was an idiot because I suffered from dyslexia and dyspraxia. By the age of 12 I still could not recite my times tables, I believed I had no hope in ever achieving anything in life. After doing some research my family came across ddat and we signed up. At first I thought there was no way it work. It seemed ridiculous that jumping about with bean bags and falling all over the place would do any good. Eventually I saw some difference and gradually cached up on my class mates until I was considered one of the most intelligent people in my class because I had the confidence to show my creativity and debating skills. I am now considered average at maths and spelling and excellent at literacy. My sports skills have also improved immensely and my art is some of the best in my year.

[Sean]

ADBatstone above said:
"Wynford Dore = quack.

There is absolutely no evidence that mere exercises can stimulate the growth of connections in the cerebellum."

From "A User's Guide to the Brain" by Harvard associate clinical professor of psychiatry:
(p369) "...it has been shown that it [simple exercise] can increase the number and density of blood vessels in areas that need them most: the motor cortex and cerebellum."

This is presumably due to the increased energy demands placed on these brain areas by the challenge of exercise.

Do a search on cerebellar plasticity and you'll find research that shows that the dendrites and synapses in the cerebellum are very plastic and are capable of being educated and even repaired/regenerated after being damaged or destroyed (although when Purkinje neurons are lost, they cannot be regrown. The number of dendrites they connect with, however, and the number of synapses can increase for a given purkinje neuron enabling it to pass more signals, and pass them more clearly):

"Every change we saw [in rats exposed to alcohol for a long period of time] was a reversible phenomenon. The brain [cerebellum] was repairing itself after alcohol damage." (from http://www.newswise.com/articles/view/?id=alcohol.ubu)

Cerebellar plasticity, per se, is not new or controversial. According to the literature, Physical Therapists can rehabilitate the balance of geriatric patients a great deal (i.e. improve the performance of their cerebellums) with just 3 months on balance boards. Wynfred Dore is not a quack for telling people their balance and coordination can improve or even that their cerebellums can "mature."

What I would recommend, if you are interested for your child, is to simply observe how coordinated they are and how well they can balance. If they lag behind their peers in balance, coordination or reaction time, The Learning Breakthrough program can be bought for $325 and can greatly improve these aspects of the child's abilities. There is mounting circumstantial evidence that this might help improve at least some of the higher cognitive functions in a person who has gross motor deficiencies.

I am doing this program myself. After 5 weeks, I cannot believe how much it has improved my balance. I am optimistic that it has improved my focus and reading speed somewhat too (I am not dyslexic, btw, just a very slow reader for my IQ). But 5 weeks is too early to tell for certain.

My immature gait and balance have been problems for me my whole life. These minor improvements alone are worth $325 to me, and I still have a long way to go. By the end, I believe at least these aspects of my cerebellum will have been fully matured.

I wish someone would have done that for me when I was 7 years old.