Opinion: Private treatment for learning difficulties - what to consider.
Jan 2020: Dr Sue Fletcher-Watson, Director of the Salvesen Mindroom Research Centre, addresses what people should look out for when choosing treatments for adults or children with learning difficulties.
In these times of austerity and uncertainty, it is no surprise that parents turn to private clinics for support when their children are struggling to learn. One such parent is radio DJ Chris Evans, who recently spoke about the benefits he felt his son had received from private therapy.
That’s all well and good, and clearly it is always happy news to hear that a young person is thriving. However, as the director of a research centre focused on learning difficulties, I’ve looked into the therapies described in this case and I’m concerned they are not grounded in research evidence. What can we learn from this case, to help other parents make good choices when seeking extra support for their children?
When someone struggles at school or is diagnosed with a learning difficulty, I am always concerned that there are commercial ventures looking to take advantage of a family’s search for help. There are a few simple steps I recommend you consider before paying out for expensive diagnoses or a treatment.
Firstly, always be cautious when a clinic diagnoses an obscure problem for which they also, uniquely, provide an expensive solution. Is the diagnosis you have been given recognised by medical professionals or listed in major diagnostic manuals?
A general appraisal of the clinic website may also show a number of obvious red flags for bad science, including clear conflicts of interest, such as practitioners who are also the inventors of the therapies they recommend. Other concerns would be use of over-complicated jargon, and cherry-picked information with a lack of links to the original, peer-reviewed research studies. These red flags can be signs that the practises of the clinic are not founded on the best or latest scientific knowledge.
Deeper investigation of independent reviews of therapies and treatments can also be helpful when considering whether to invest in a practitioner or clinic. Google Scholar provides a great way to search for the latest academic evidence – often pdfs can be found free to download, and it’s also fine to email authors directly to ask for advice. But really, the clinic should be sharing the underlying evidence in a way that makes it easy for you to find the original source material.
When a clinic makes no attempt to show research evidence support – such as when the relevant journal articles are not properly cited, making them hard to find - the risk is that they are hiding poor quality evidence.
Now, this piece isn’t about one family, one therapy, or one clinic. What it is about, is making sure that parents and carers of children who experience difficulties in learning can get the right support. The danger of promoting practices that lack an evidence base should not be under-estimated. Without proper evidence, we cannot be sure that such approaches are not directly harmful to the child. And even if they have a neutral effect, there are certainly other sources of harm. What about the wasted time expended on these “therapies” that could be used for something else? What about the hundreds or thousands of pounds spent by parents who feel no other option? And worse of all, what about the young person at the centre of this – if they don’t “make gains” how will they feel, seeing all the effort that has gone into trying to “make them better”?
You may be asking, what can we do instead? Here at the Salvesen Mindroom Research Centre, based in the University of Edinburgh, we are committed to improving the quality of services for children and young people with learning difficulties, such as dyslexia, dyscalculia, dyspraxia, autism and ADHD. This important work provides the essential evidence needed to build high quality support systems for those who need them. We also work closely with our third sector partner and the community, to get our work into practice quickly and effectively. Even so, good quality research is slow and lots of people need support here and now.
Thankfully, there’s something we can all do to help children with problems learning – support and accept them, take the time to listen to them and believe their struggles. Our education system was not set up with their needs in mind and, while we work towards changing that, we can all be more patient, more flexible and more understanding.
For more information on the research work being pursued at the Salvesen Mindroom Research Centre, please follow the links below.
Dr Sue Fletcher-Watson