Wednesday, September 21, 2005

Response to Trish's message

Trish has posted a message, and I would like to comment. If you want to know more about her ideas, check her website.

I take issue with the way she is presenting her arguments.

I take issue with no 2:
"The people who do Lidcombe therapy have no precise understanding why it should work, apart from some general intuition that targeted practice and "pressure" will change the children's behaviour."

Rather insulting to some of us who actually work or have worked in the field.
Fallacy No. 1: It is completely irrelevant to the strength of an argument whether someone feels insulted by an argument or not. If someone tells me that I am ugly, it is surely insulting but that doesnt make me beautiful (if I am ugly)! There is nothing more harming to an open scientific debate that loading upon the proposer of an argument social guilt/pressure e.g.: It is insulting for you to say that, You are questioning my professional conduct by saying that, How would you feel if I said to you that.

Lidcombe works because it removes tension and repetitions which result from the tension.
Fallacy No. 2: Using vague terminology and making unfalsifiable statements. What exactly is tension? How do you measure it? Why do repetitions result from tension? How can you test that repetitions result from tension? Where is the literature that supports it? Which experiments can be made to prove it?

The excess tension begins because there have been sudden changes or difficulties in the child's life - a new sibling has arrived, a parent has disappeared from the scene...
Fallacy No. 3: Confusing correlation with causation. If two events are correlated, it does not mean that there is a causal link between them. If I meet you in the centre of London, it is mostly likely by chance (and it is not a proof of the theory that I am following you on purpose). Sudden changes in a child's life always happen, and onset of stuttering at around 3 also happens. And they might by chance happen at the same time. A counterexample: There are millions of kids who had sudden changes in their early life, and they did not start to stutter. Why not? Or they did stutter but it went away for 80%. Why only for these 80%? And it not good to say that these kids handle tension in other ways, because then you have not explained the mechanism how in some kids tensions lead to stuttering.

A three year old came to me with his mother and baby sister. We discussed, in front of him, changes to his life. His mother had been aware that he was upset that his father was working away - so upset that he would not even talk to his dad on the phone. He was upset too that his father gave more attention to the baby because she did not reject him. We were sympathetic and, quite frankly, I told him not to stammer. He never stammered again.

His mother said he stopped stammering in the car on his way home. The family gave him and his problems proper attention. It's not that he was attention seeking - rather, the discussion reassured him that all was well and that he was well-loved
Fallacy No.4: Anecdotes never make good science. This could have just happened by chance at the same time. So you need to have many observations to exclude the chance factor. Moreover, anecdotes are never reproducable by other researchers. Trish herself relies on testimony by the mother. The observations might give an indication of a relationship but certainly not a proof.

1 comment:

Patricia Sims said...

1.Well it worked - I got a reaction!

2.Thank you Tom for asking these important questions!
"What exactly is tension? How do you measure it? Why do repetitions result from tension? How can you test that repetitions result from tension? Where is the literature that supports it? Which experiments can be made to prove it?"
Regarding the "Where is the literature that supports it?" So far there is only mine, it would seem - and mine comes from a longterm broad investigation into children's personality traits rather than a formal study. Nevertheless, I have seen and heard enough to be convinced. But for others to be convinced? - they could perhaps observe in the same sort of way because it is by looking broadly at stammering, and seeing it in the context of the other main childhood difficulties that things become clearer and pennies drop.
The fact that research in this "tension" area could be difficult should not stop folk considering ways to do it.
Of course anecdotal information has an important place - it suggests areas for research; I'm not calling it "proof".
I have explained elsewhere why I have come to my conclusions and theory but I am not a researcher and it is too late for me to become one - and so I have been trying very hard to interest others in what I have found to be true.

"...you have not explained the mechanism how in some kids tensions lead to stuttering."
Our genes will surely have a say in the way we express our tension - just as they interact to influence other behaviour and development. I have tried to illustrate the great diversity of tension-related traits in "Reasons and Remedies". And I have been at pains to say that tension is a necessary and often useful attribute of us all. Yet while some children might, let us say, begin to wet the bed at difficult times for them, and others perhaps suck their thumbs more vigorously, some become more repetitive in their behaviour - and sometimes the repetitive behaviour comes out in their speech.
I won't duplicate here what I've written elsewhere and on my websites.
Perhaps we need speech and language therapists/pathologists to collect data re. their patients/clients in order to look at children's developmental difficulties eg. stammering, other speech and language problems, dyslexia, ADHD, dyspraxia, tourettes, etc in the light of behavioural traits related to tension and anxiety.

We should beware of verbalising too many obstacles to broad research - I can't see how progress is to be made without it.
Won't somebody do some??
Tish