Controversial Therapies for Developmental Disabilities

One of the largest and most complex human services systems in Western nations has evolved to address the needs of people with developmental disabilities. In the U.S., for example, school budgets are stretched thin by legally mandated special education, and billions of Medicaid dollars annually are consumed by residential and professional services to this population. The temptation of a quick fix is strong. Many parents desperately seek the latest ideas and place pressure on program administrators, who often are not trained to think critically about the evidence base for intervention efforts. The problems of people with developmental disabilities have historically been targeted by a wide range of professionals who rely on clinical experience and intuition and do not submit their claims to the tests of scientific research. Professional entrepreneurs have energetically promoted their treatments to a public perhaps too trustful of those with credentials. Thus, families and their children are buffeted by reforms founded on belief and ideologically driven management. Services fluctuate with the currents of social movements and rapidly shifting philosophies of care as policymakers and providers strive for increased responsiveness and individualization. These forces affect not only where and how, but how well people are served. Too often, services are less effective than they could be, or worse, damaging to personal growth and quality of life. Many treatments are based on poorly understood or even disproven approaches. What approaches to early intervention, education, therapy, and remediation really help those with mental retardation and developmental disabilities improve their functioning and adaptation? And what approaches represent wastes of time, effort, and resources? This book brings together leading behavioral scientists and practitioners to focus light on the major controversies surrounding these questions. The authors review the origins, perpetuation, and resistance to scrutiny of questionable practices, and offer a clear rationale for appraising the quality of services. In an era of increasing accountability, no one with a professional stake in services to individuals with mental retardation and developmental disabilities can afford not to read this book.