Tuesday, December 17, 2019
Getting Emails From Forbrain(TM)?
In the last several months I’ve had several emails from an outfit called Forbrain™. These emails give purely anecdotal evidence for the use of some devices that are supposed to treat a variety of childhood problems such as motor and balance difficulties, autism, sensory processing disorders, and ADD/ADHD. As these problems probably have different causes and certainly have different trajectories, it seems unlikely that one form of treatment can help all of them, but who knows? I would not care to swear that it can’t, without further evidence.
However, neither would I swear that it can help without further evidence. One email I received stated that there were “scientific studies” supporting this view, but when I clicked on the link I got a warning so I didn’t go any further. The email described the case of a child named Josephine who was said to have had her speech and general conduct much improved by use of Forbrain™ technology and even stopped having frequent tantrums. This is very nice,(although obviously it can’t be checked, nor could we know whether Josephine would have started doing better even without this treatment. Nothing here seems to be providing the kind of information that consumers should demand before they commit to a treatment for children.
Forbrain™ apparently involves the wearing of a headset that provides conduction of sounds through bones into the inner ear, rather than stimulation of the inner ear in the usual way by the passage of sound waves through air in the auditory canal, followed by movement of the eardrum, etc. The Forbrain™ device also filters some sounds and is said to allow practice on the “audio-vocal loop". A second device advertised by the Forbrain™ advocates is called Soundsory ®; this one uses “specially designed music processed with neuro-acoustic modifications as well as a series of movement-based exercises” and is intended to “establish good foundations, from the fundamentals of sensory integration to more complex cognitive functions”.
Listening to special music? Being exposed to certain kinds of sound patterns? It’s all rather familiar—and the name Tomatis springs to mind. Yes, an Internet search shows Tomatis therapy , Forbrain ™ and Soundsory® on the same page. It would appear that there is no systematic evidence to support any of these practices.
What should consumers ask for before they commit to the trouble and expense of methods like these? Anecdotes are not good enough. It may be that Josephine’s condition did improve—but would this necessarily be true for any other child? Was Josephine’s improvement caused by Forbrain™? Might it have happened anyway? Or could it even have been that she would have improved more without Forbrain™? These questions can’t be answered by even the most touching story, but touching stories are likely to make us forget to ask the right questions.
For adequate demonstration that either Forbrain™ or Soundsory® technology are useful for any of the problems mentioned earlier, we need the following: A large group of children who share a problem that can be evaluated and quantified. These children are to be divided into two groups (treatment and comparison) with equivalent age ranges, gender proportions, and severity of problems. Assignment to groups is done by staff who do not have information that identifies individuals. Treatment is done by staff who do not know which group each child belongs to. One [treatment] group is given the treatment recommended by Forbrain™ advocates. The other [comparison] group receives a “sham” program—they wear headsets for the same amounts of time as the treatment group but hear different things. At the end of the treatment period, all children are re-evaluated by staff members who do not know which group a child was in. Finally, changes seen in the treatment children are compared to changes seen in the comparison children. If the changes seen in the treatment children are positive, and are statistically greater than those in the comparison group, then advocates of Forbrain™ and Soundsory® can say that they have evidence that their treatments are effective.
Until this happens, caveat emptor!