Scientific criticism about IAHP

The American Academy of Pediatrics Committee on Children With Disabilities issued warnings regarding patterning, one of the IAHP's therapies for brain injured children, as early as 1968^[24] and repeated in 1982.^[25] Their latest cautionary policy statement was in 1999, which was reaffirmed in 2002 and 2005. It stated:^[2]

This statement reviews patterning as a treatment for children with neurologic impairments. This treatment is based on an outmoded and oversimplified theory of brain development. Current information does not support the claims of proponents that this treatment is efficacious, and its use continues to be unwarranted.... [T]he demands and expectations placed on families are so great that in some cases their financial resources may be depleted substantially and parental and sibling relationships could be stressed.

Since 1960 the IAHP has published multiple studies professing to show the effectiveness of the program. These studies, upon review, have not stood up to scientific scrutiny and have not been reproduced by other sources.^[26] In 1978, Sara Sparrow (professor emerita and senior research scientist at Yale Child Study Center)^[27] and Edward Zigler (professor emeritus at the Department of Psychology at Yale University,^[28] one of the principle architects of the US federal Head Start program and recipient of the 2008 APA Award For Outstanding Lifetime Contribution To Psychology)^[29] evaluated patterning as a treatment for retarded children. They concluded that no evidence was found for an improvement over that which would be expected of children given attention or that expected of any child as they mature; the patterning method cannot be recommended for seriously retarded children.^[30] Zigler wrote a 1981 editorial entitled "A plea to end the use of the patterning treatment for retarded children", which emphasized the harmful effect the treatment has by raising false hopes and increasing parental guilt.^[26][31] According to Edward Zigler and Robert Hodapp, in their book Understanding Mental Retardation, the Doman-Delacato method has major flaws:^[17]

• The recapitulation theory it is built upon has been discarded by the natural sciences.
• The suggestion that motor development has stages, which depend on earlier developments, is not supported by evidence.
• There is no evidence that passive movements by a child, forced to engage in crawling movements, affects neurological organization.
• Children who voluntarily perform an activity (such as sitting or walking) before mastering preceding stages, are prevented from doing so by the IAHP—possibly harming the child.
• The only scientific paper published by Doman on patterning (in 1960) contains many methodological errors and overstatements of findings. The study had no control group so was unable to compare with children who would naturally show some developmental progress over time. When independent scientists compared the results with the progress made by untreated children, the "results of patterning appear singularly unimpressive".
• The patterning procedure may be harmful to its participants (the parents experience guilt at being unable to achieve the intensive program required) and other family members through neglect.
• It is cruel to offer hope through a program that is impossible to fully carry out.

In addition to the American Academy of Pediatrics, a number of other organizations have issued cautionary statements about claims for efficacy of this therapy.^[2] These include the executive committee of the American Academy for Cerebral Palsy,^[32] the United Cerebral Palsy Association of Texas,^[33] the Canadian Association for Retarded Children^[34] the executive board of the American Academy of Neurology,^[35] and the American Academy of Physical Medicine and Rehabilitation.^[36]

A 2006 retrospective study of 21 children by the IAHP and others of children with cortical visual impairment found significant improvement after use of the program; the study had no control group and has not been replicated.^[37]

Kathleen Ann Quill, in her book Teaching children with autism: What parents want,^[38] says "thousands of families have wasted time and money to follow Doman's methods." She goes on to say "Professionals have nothing to learn from Doman's pseudoscientific treatments, but they have plenty to learn from his marketing strategy", which is aimed at parent's "hopes and fantasies".

Martha Farrell Erickson and Karen Marie Kurz-Riemer discuss Early Intervention with "Normal Infants and Toddlers" in their book "Infants Toddlers and Families".^[39] They claim Doman "capitalized on the desires of members of the "baby boom" generation to maximise their children's intellectual potential" and "encouraged parents to push their infants to develop maximum brain power". However his programs were "based on shaky or nonexistent research evidence" and "most child development experts at the time described many aspects of the program as useless and perhaps even harmful."

Martin Robards also cites widespread criticism in his book Running a Team for Disabled Children and Their Families^[1] but concedes that Doman and Delacato caused paediatricians and therapists to recognize that early intervention programs are needed.

Steven Novella, assistant professor of Neurology at Yale University School of Medicine, criticized the technique as follows:^[40]

The Doman-Delacato patterning technique is premised on a bankrupt and discarded theory and has failed when tested under controlled conditions. Its promotion with unsubstantiated claims can cause significant financial and emotional damage. Such claims can instill false hope in many people who are already plagued by guilt and depression, setting them up for a further disappointment, guilt, and feelings of inadequacy. The process can also waste their time, energy, emotion, and money. These resources may be taken away from their children. Parents can also be distracted from dealing with the situation in other practical ways and coping psychologically as a family with the reality of having a brain-injured or mentally retarded child. Parents are encouraged, in fact, to remain in a state of denial while they are pursuing a false cure.^[40]