Is This A Money-Making Opportunity for Franchisees, or A Legitimate Therapy?

(a  version of this post is cross-posted at Academic Remediation)

See updated discussion at the bottom of the post

Years ago, Daniel Dage published The Fleecing of the Autism Community, on all the ways people sell "cures" and "treatments" to parents of children with autism.

From a commenter on a forum discussing Brain Balance:

There's also a burden-of-proof issue here. Proposed therapies basically need to be assumed ineffective until proven otherwise. The fact that this therapy has not managed to generate a shred of research in its favor is a very bad sign.

There's a new wrinkle: a chiropractor is marketing franchises to sell his "treatment", called "Brain Balance".   It isn't cheap (this is from an Atlanta, Georgia-area seminar, and was posted September 21st, 2010)

• $450 for your child's Brain Balance assessment (Brain Balances's confusing way to say your child needs help and to justify their specific program/vitamins for your child)
• For $7,000:
  • 24 1-hour sessions over 6 weeks, at 3 sessions per week.  
  • Blood/Urine analysis that will determine which franchise vitamin supplements your child will need to "succeed".
• Additional supplements as indicated by the tests above. These supplements can only be purchased while enrolled in this franchise.

As more than one commenter said in the forum linked above, if it works, $7,000 is cheap. However: The Brain Balance scheme has no research base, is founded on misunderstandings about brain development, is extremely expensive, and is unlikely to help your child..

The Brain Balance Program® is an individualized and comprehensive approach to helping children with neurobehavioral and learning difficulties surmount their unique challenges. This proprietary, non-medical program has been successful in helping hundreds of children reach their physical, social/behavioral health and academic potential. We work with children who suffer with ADD/ADHD, Dyslexia, Tourette’s, Asperger’s and Autism Spectrum Disorders.

First point: despite claims and testamonials on the Brain Balance website, there is no published evidence that the Brain Balance program does anything other than lighten your wallet.  There have been no peer-reviewed, randomized controlled trials (RCTs)  for the Brain Balance program.   In this article  Dorothy Bishop explains why RCTs are necessary to evaluate psychological and/or  educational interventions.

Second point:  while the explanations from Brain Balance sound "sciencey",  they are almost entirely psuedoscience:

Harriet Hall MD wrote:

[The Brain Balance website claims]  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.

Emily Willingham wrote:

One of the cardinal signs of a pseudoscience is the promise to ameliorate unrelated problems with a single, curative method...that is proprietary.

Steven Novella MD wrote

the brain balance paradigm wants to roll back the clock of our understanding about half a century....  To argue that a broad range of neurological disorders all come down to one narrow subtype of one type of brain dysfunction is pseudoscience – it is good for marketing your one therapy, but not for actually helping people or understanding neuroscience.

Mina Dulcan MD on the foundational idea behind Brain Balance:

"The notion that one half of the brain developed faster than the other just doesn't fit with anything we know about the brain"

Third point: it's a turn-key franchise business. 

click on image for full size

That's right, the owner of the Brain Balance enterprise in your town may have no expertise in education, or treatment of ADHD, learning disabilities such as dyslexia, or neurological conditions such as Tourette's or autism. 

Here's a portion of the sales pitch for prospective Brain Balance franchisees:

Description: Brain Balance™ Achievement Centers. Where every kid connects with success. Some people say that parents of children with developmental and learning disorders can only expect so much from their child. We disagree.
Opportunities: Franchises available throughout the US.

Business Type: Franchise.
Minimum Investment: $188,900.
Training Provided: Yes.
SBA-Approved: Yes.


At each Brain Balance™ Achievement Center, you will be trained to employ our exclusive Brain Balance Program®. The Brain Balance Program® is an individualized, comprehensive program that integrates physical and cognitive exercises, with easy-to-follow dietary changes. The Brain Balance Program® integrates physical activities (sensory-based stimulation and motor exercises) with effective educational and behavioral methods, as well as supportive nutritional initiatives, in order to promote optimum brain and body function.

The Brain Balance Program® does not rely on pharmaceutical drugs, medical procedures, or psychotherapy. Our program is an integrated approach – one that is designed to help children who suffer from a range of neurobehavioral disorders.
What Brain Balance™ Achievement Centers offer

•  Use of our proprietary software that will allow you, as a franchisee, to oversee and manage your center from anywhere in the world, at any time. It also allows you to handle all the daily center student program activities and provide frequent reports to parents in real time.
• Training and consulting by Dr. Robert Melillo and his staff. Dr. Robert Melillo is the founder of the Brain Balance Program® and is an internationally known brain researcher, professor, author and functional neurologist.  Note that "Dr" Melillo is actually a chiropractor, not a physician.
  
• High level of training and use of our effective, innovative training platform
• Support from our corporate staff, which has many years experience in franchise development, center business applications and school education.

Do you really want a cookie-cutter, ineffective, expensive "treatment" for your child, administered by persons of unknown (if any) training,paid $12-18 per hour?  The image below is an ad for a "Sensory Motor Coach" for the Denver Brain Balance, retrieved 12/4/2010 from http://denver.craigslist.org/edu/2049522111.html

Further Reading:

• Emily Willingham, PhD at a Life Less Ordinary Brain Balance: A Critique
• Steven Novella, MD at Neurologica Brain Balance
• Harriet Hall, MD at Science-Based Medicine Brain Balance
• Jim Roche, PhD at AutismBC Brain Balance not so Balanced
• Margaret V. Bishop PhD at BishopBlog Three Ways to Improve Cognitive Test Scores Without Intervention
• Franchise Direct Start a Brain Balance Franchise Business
• Guy Bolton, Milwaukee Sentinel Bulletin Doctors Skeptical of Center's Claims

Actual parents' responses:

http://www.city-data.com/forum/atlanta/408686-brain-balance-my-add-child-4.html

Mxyzpltk 04-10-2009, 12:38 PM

We too experienced the great Dr. Pete at an Open House. He was fantastic and had answers to everything. But in the end what we took away from Brain Balance was a sense of disappointment at what could have been. If the program had been regulated and monitored in a professional manner, we might have seen some success without medication for ADHD.

I have heard many different opinions about Brain Balance. We attended the one in Peachtree Center. One of our acquaintances has a child with HFA and the elimination diet alone has helped them tremendously. Although we tried this, it did not help our situation. Our child is now seen a reputable trained psychiatrist and is prescribed medication.

At the end of our 12 weeks, BB said 'oh, we've made progress but not enough...but if you give us another 3K (on top of the 5K we paid for 12 weeks) we will be excited to work with your child for another 12 weeks.

Even after explaining how outrageous their request was, no one ever contacted us from BB to discuss nor empathize with our disappointment.

About a year after (this January), we did receive a letter. It was to tell us there were new vitamin/amino acids we could purchase...as if the $500 for that wasn't enough.

I wouldn't have cared on the amount of money we spent on trying to find a non-medication based therapy for our child. I do care that they only saw our family, our child, as a profit margin.

http://www.city-data.com/forum/atlanta/408686-brain-balance-my-add-child-5.html

10-19-2009; boys007

Brain Balance did not help our child!!!!! Save your $6000 and go to a good psychologist! They often stimulate the wrong side of the brain and really only help a handful of kids.

Ask them what happens if you aren't satisfied? They only offered us more sessions for another $6000!!

http://www.city-data.com/forum/atlanta/408686-brain-balance-my-add-child-6.html

  05-17-2010,E&NM

There is no evidence of long term gains from such a program. Brain Balance has employed an amazing NY PR firm to sell their product. This program promises to cure disorders that have no known cure by packaging bits and pieces of interventions as a cure. Use the $6,000 and hire a great tutor to incrementally help a child with skill development OR put it towards a private school that can support your child's needs. Most of the CAMs fall in this category.

http://www.city-data.com/forum/atlanta/408686-brain-balance-my-add-child-6.html

08-04-2010 hrkheather

I would also like to mention that Brain Balance hires people to scour the internet for forums, like this. They are hired to write numerous posts, in several aliases, as satisfied customers.

---

http://www.city-data.com/forum/atlanta/408686-brain-balance-my-add-child-6.html

08-29-2010 tamadhur

Brain Balance is about profit, pure and simple. Why on earth does someone need $7,000 to throw together a program that dedicated parents, with the support of qualified therapists and educators, could establish at home? What Brain Balance is doing is ripping off various approaches (biomedical, Defeat Autism Now!, Floortime), combining them with OT and ABA lite, and repackaging them as some innovative cure for autism. This is bunk.

I spoke with an actual board-certified behavior analyst, with a PhD in psychology, and he referred to Brain Balance as "snake oil."

The guy who runs Brain Balance's franchise in Suwanee is not a neurologist; he is a chiropractor. Since Brain Balance claims their approach is rooted in neuroscience, shouldn't the people who run the place actually have backgrounds in neuroscience?

I attended one of their free information sessions and found the presentation to be a little too slick and glib. I was also completely turned off by the guy's attitude. When I expressed my skepticism about this "miraculous" approach that no one else had discovered, and learned that the people working with my child were not actual psychologists or therapists, but just coaches with special training, the center director became very dismissive. Instead of making himself available to answer my questions, he sequestered himself in his office, leaving me wondering what kind of reception my child would receive if I decided to enroll him in the program.

I am so grateful I decided not to give Brain Balance my money.

My child was diagnosed with autism nearly four years ago. I have attended workshops, conferences, seminars, and classes, and have amassed a lot of information on potential treatments for autism.

I know when an approach is rooted in science and when something is cleverly marketed to play on parents' emotions. Brain Balance is a marketing strategy to lure in gullible parents who are willing to plunk down thousands of dollars for a 3-month program they could easily implement at home for a fraction of the cost.

I know when someone wants to genuinely help my child and when they are in it for the money.

Autism parents be warned! There a whole lot of people out there who don't give a damn about your child but who are very interested in your money.

Bottom line: I am sure that the franchisees mean well and may "believe" in the efficacy of the "treatment" they offer, but I wouldn't waste my money or my child's time.  

Update I found another forum discussing the Brain Balance program. I found another discussion of Brain Balance at the forum listed below:

http://giftedissues.davidsongifted.org/BB/ubbthreads.php/topics/74063/menu_control_74075

From MegMeg 4/15/10 re a previous poster asking about Brain Balance:

This is a load of snake-oil. If they have one jot of peer-reviewed, methodologically-sound evidence that these therapies work, I will eat my hat.

(My field is cognitive neuroscience, so I'm allowed to be snarky about it. wink )

Seriously though, everything in this article sets off all the standard alarm bells. The blithe over-simplification of the science, the claims of outlandishly large results, the childishly simple theraputic techniques (a buzzer in the left ear will help autism? Really?) -- all of these are hallmarks of the pseudo-therapy industry. Don't even get me started on EMDR (Eye Movement Desensitization and Reprocessing), or Facilitated Communication.

From  MegMeg on  5/1/10

More digging turns up further oddities: the PsycInfo database shows he [Melillo] has only three publications, just one of which is peer-reviewed (the one discussed above), and it is in a journal so obscure that I cannot access it through the University of California.

From MegMeg 6/11/10, responding to a question about Brain Balance

Maybe you should turn your question around and ask yourself, why are you taking anecdotal evidence as your gold standard? Personal stories 1) don't tell you what the overall success rates are (an individual anecdote may be wildly unrepresentative), and 2) they rely on subjective impressions of success rather than measured improvements.

There's also a burden-of-proof issue here. Proposed therapies basically need to be assumed ineffective until proven otherwise. The fact that this therapy has not managed to generate a shred of research in its favor is a very bad sign.

From MegMeg on 6/11/10

 

(previous commenter) We've become intrigued by the whole Right Brain/Left Brain disconnect approach, As it is accepted science which i can GENERALLY understand.

I also want to address this specifically. It is simply not true that any "right brain/left brain disconnect approach" to autism is accepted by serious researchers. Details upon request.

From  MegMeg on 6/12/10

(previous commenter) You don't believe in the science behind delineating right brain/left brain processing? Thats well beyond being generally scientifically accepted. Even from a laymans persepective.

I'm a neuroscientist by profession. Most of what laypeople know about left-brain/right-brain is wrong. I would be happy to give you a quick tutorial about what we do know about the specializations of the left and right hemispheres.....

From MegMeg on 6/12/10

responding to the request about specialization of the left and right hemispheres

The quick version is:

Both hemispheres have areas for - visual processing - auditory processing - identifying familiar objects - processing spatial locations and spatial relationships - processing information coming in from the body - planning body movements - reasoning and decision-making - and much more

The left hemisphere - has a few areas that are specialized for language (but may be more generally for fast temporal changes)

The right hemisphere - is more strongly involved in spatial processing - is specialized for some "large scale" language stuff (e.g. discourse processing)

All this is just for right-handers. Left handers may be the same, reversed, or mixed.

The popular media have drastically over-exaggerated and over-simplified these issues. The whole "right brain equals logical, sequential, detail-oriented, mathematical; left brain equals intuitive, wholistic, artistic" mythology is just simply made up.

The two hemispheres are connected by a thick band of communicative fibers called the corpus callosum. The two hemispheres function together as a single system. Everyone uses both. There is no such thing as a "left-brained person" or a "right-brained person."

As for citations, well, the literature is vast. Your best bet is a good undergraduate text in cognitive psychology or cognitive neuroscience. My personal choice is Reisberg's text, but it's quite pricey (they all are).

 

Discussion betweetn Kriston & MegMeg on  6/14/10

Kriston I am COMPLETELY on-board the peer-reviewed, scientific evidence train. The plural of anecdote is not data. I can't even begin to tell you how strongly I agree!

However...

I think it's important to add that I'm similarly skeptical of the notion that because we don't know about something right now, it doesn't exist. I think we have to be very wary of accepting the current thinking as the ONLY POSSIBLE thinking, especially when it comes to the brain.

The fact is that we don't know it all, and if past history is any indication of the future of science, some of what we think we know isn't 100% correct yet. Science is always evolving, happily.

Lack of peer-reviewed evidence is not evidence that something doesn't exist or isn't happening. It may just mean that it hasn't yet been studied. Lack of peer-reviewed evidence isn't the same as a debunking.

With that said, I completely agree that lack of evidence of effectiveness is a *very* good reason to think twice--or 3 or 4 or 5 times!--before handing someone your money for an unproven treatment for a disorder that may not even exist.

Basically I dislike blind faith in anything, even science!

From MegMeg responding to Kriston:

You raise an important issue. It's one that I think is very much misunderstood by the non-scientist public. First, scientists would be the first to say that we don't have all the answers yet! Especially when it comes to understanding the brain, everybody in the biz knows that we have barely scratched the surface.

But that is a separate issue from, second, whether a particular proposal has any truth to it. This is where scientists start to get impatient and sound like know-it-alls. Because, really, we've been around that block SO many times, it's like playing whack-a-mole.

This is where the burden-of-proof issue comes in. It is incumbent upon the person proposing a theory to provide SOME reason, ANY reason, why it should be taken seriously, before asking people to waste their time and scarce research funds looking into it. Our culture has this myth of the persecuted genius (think Galileo) who is eventually vindicated by history. But that kind of thing is rare. Vanishingly rare. Meanwhile, there is a river of crackpot ideas that will never be anything but crackpot.

It's like being asked, "You don't believe in the Easter Bunny? Why not? Give me all your reasons and arguments, in explicit detail. Oh, okay, I guess that sounds kinda convincing, but what about Santa Claus? Why don't you believe in him? Don't you think you're being a little closed-minded? What about Ganesh? Leprechauns? Aliens who built the pyramids? Absence of evidence isn't evidence of absence, ya know."

This analogy might sound rather snarky and unfair, but it's really pretty accurate. Because another feature of these kinds of theories is their sheer implausibility. Their quality of pulled-out-of-nowhere-ness. Their complete lack of fit with everything else we already know.

This leads to my next point, which is the myth that scientists are dismissive of any idea that hasn't already been proven. In fact, scientists LOVE new and promising ideas. Think of the history of AIDS treatment research. There were numerous ideas and approaches that seemed promising and raised scientists' hopes, that turned out to be dead ends, before real progress finally started happening. Those early treatments were taken seriously because there was some reason to think they could pan out. For example, maybe a certain effect worked in the petri dish, but just didn't scale up (or whatever). This is one of the important features that distinguishes viable theories from theories that make scientists roll their eyeballs.

Thanks for raising this important issue, and giving me a chance to do another Public Service Announcement!

So: Burden of proof is on the Brain Balance corporation to prove that it is efficacious for the conditions it claims to help.  I'm not holding my breath.

Comments

[Tammy Swarek]

My post is only to the statement that a single issue can not be responsible for a host of neurological problems as you call it. I beg to differ. Have you ever read the sheets that are issued with your medications? Each "symptom" that it may cause is very different from one to the next. All stemming from the same cause. People react differently. That is just common sense.

[selch2]

I find it interesting that people are willing to take medicine for a problem like ADHD. How many dual drug studies have been done with any of the ADHD medications? I ask this since many of these children take more than one.
Answer: None. There is not one study on not only the cross effects that a 2nd medication will do to the results of the 1st medicine, but what side effects result from it. Yet when you go the person prescribing the medicine, they will say it's safe. There's no way for them to even know that.

[selch2]

Dr. Dulcan is used as an "expert". She is the furthest thing from. She was at the center of the biggest ADHD drug scandal in US History. It's easy to find this information as they had congressional hearings over it. Her group falsified findings on an ADHD drug from Eli Lilly. The findings showed that the drug caused an increased rate of suicides, stunted children's growth, and worked worse than the placebo. They stated none of these facts in their findings and said the drug worked. Their findings indicated results that were in direct opposition to the data. They openly lied. She also receives several hundred thousand dollars a year from Eli Lilly. Again, this is public information and easy to get.

She is hardly the person that should be billed as an expert. In fact, she used to be editor of a psychology magazine, but that was taken away from her because of her falsifying of study results. Just last year the BBC asked her whether she was sorry that she participated in the release of that study. She said no because it increased discussion around the topic. In other words, she didn't care that kids were trying to kill themselves at a higher rate because it created a discussion.

I find that vile. I would never want my child around her or anything associated with her.

[selch2]

Let me look at Boulton's 2nd "expert". Maybe she's better.....NOPE.

Your so-called experts are awful. The more I look into them, the more I wonder where did you scrape these people up from. Expert #2 is Harriet Hall. She touts an award from CFI, Los Angeles in 8/2010. This group is a consolidation of various atheist groups throughout California. Nice.

If you look more into her history, it's no shock that she would question Brain Balance and their studies. The studies were conducted through the F. R. Carrick Institute for Clinical Ergonomics, Rehabilitation, and Applied Neuroscience (C.E.R.A.N.). Dr. Carrick was on a special on PBS about a chiropractic procedure that was helping people and giving great results. Harriet Hall wrote a critical piece about this. Dr. Carrick then wrote a response to this critique by going point by point and shutting down her reasons against this program. In fact, he showed how little she actually knew about working with patients through a testing protocol. You can read it here: http://www.blindspotmapping.com/page/page/3823275.htm.

Ever since this back and forth between the two, she has tried to discredit anything even slightly associated with Dr. Carrick because he embarrassed her.

Not exactly an impartial point of view and a spokesperson for atheists. That isn't someone I want speaking for me either. Pathetic.

[selch2]

Here's some commentary on the article:
http://newsprintwatch.com/about/brain-balance-gets-it-right-journal-sentinel-gets-it-wrong/

[JoyMama]

Hmm - Dr. Jim Roche's post on Brain Balance -- which I'd chosen to link to in an online discussion recently -- has gone "poof". Have you come in for any cease-and-desist pressure to take this one down (as if you'd cave to that sort of thing!)? I'm wondering whether there's a web-scrubbing arm of the Brain Balance online marketing strategy...