Occasionally, people ask me whether I recommend certain treatments. A new franchise opened up near my office, called “Brain Balance Achievement Centers.” This franchise says that it treats such problems as Asperger’s, ADHD and PDD, NOS (Pervasive Developmental Disorder, Not Otherwise Specified). As both a child psychiatrist and a parent of someone with Autism, I am always looking for treatments that work. Unfortunately, after looking into this, Brain Balance does not meet my test.
Whenever I look at potential treatments, I ask:
- What are the Assessments?
- What are the treatments?
- Do they do any harm?
- Are they worth the money?
Their website says they first do an evaluation, based on 120 tests. Who performs these tests and what these tests are is not clear. This is not like going to a doctor, a psychologist, or an occupational therapist, who is licensed by the state and trained to perform tests and treatments. According to their website, the people who administer these tests are “Program and Center Directors.” The only qualifications for them, and the people who administer the programs, is 20 hours of training from Brain Balance. There is no requirement for being a licensed professional, such as a doctor, psychologist, therapist or even teacher.
So what do these tests do? Brain Balance claims that the tests figure out which side of the brain is delayed. Curious. As I will explain below, the supposed scientific basis for their program is that the right side of the brain has problems. So now they are saying it could be either side? This is a big contradiction.
After testing, which apparently can show anything, each child is prescribed sensory motor training, a neuro-academic coach who provides some type of tutoring, and a special diet.
Sensory Motor “Training”
First, the sensory motor training. Sensory motor exercises are not new. They have been done for years by occupational and physical therapists under the name of sensory integration therapy, something that can help a child calm down. Sensory integration therapy is usually done by a licensed professional, such as an Occupational Therapist. In schools, Sensory Integration Therapy usually is available for free to children in schools whom the school has identified as having the types of disorders that respond to it, such as Autism. It may be covered by insurance.
The sensory motor training through Brain Balance is done by a “sensory-motor coach” with at least “20 hours of training” through Brain Balance. This is not the equivalent of a licensed professional with years of training and experience.
When people come to see me, for example, they know that I am a board certified child and adolescent psychiatrist with a Ph.D. in nutrition. That training is four years of college, four years of medical school, three years in a Ph.D. program, and an additional eight years of training. In addition, I am certified through a national agency and must maintain certification through a series of annual rigorous continuing education programs that are highly regimented. My training means something, both to the patient and to the insurance companies.
In contrast, when people go to Brain Balance, all they are guaranteed is that the person helping them has 20 hours of training. This difference in training and experience should mean something to the patient, especially as the Brain Balance program costs much more than medical treatment.
Second, the academic training. What are the qualifications of the “trainers”? According to Brain Balance’s website, these trainers are not even necessarily teachers. They are described as “typically educators,” but of course they don’t need to be educators. Are they college students? Are they high school grads? The only requirement for being a “neuro-academic teacher” is to attend 20 hours of Brain Balance training. So you really have no idea who will be training your child. Is this a teacher with a Master’s Degree in Special Education with 20 additional hours of training? Is this a high school student with 20 hours of training period? Would this make a difference to you? It would to me.
Third, the diet. The “special diet” is “only available” with a special password that you of course need to pay for. They say that the diet leads to balance in the brain. In reality, the diet that they describe appears to be a mixture of commonly used diets for Autism and other special needs. Their approach is nothing new or different and certainly nothing that you would need a special password to unlock. The diet is based on some books on food allergy by “clinical ecologists” written in the late 1970’s and early 1980’s, combined with more recent gluten free, casein free approaches and of course they exclude sugar.
The Brain Balance diet is said to eliminate food sensitivities and “brain inflammation.” This is a very strong statement that has no proof. There is no proof that eating offending foods causes brain inflammation, nor that eliminating these foods eliminates brain inflammation. I wish there were some proof for how a change of diet will reduce brain inflammation but there is none.
The Biggest Harm is the Extremely High Cost
Given that none of the treatments are new or different, the question is, will they harm your child? Probably not. Nothing is harmful about changing diet, as I discuss throughout my website. The benefits of changing diet far outweigh the risks and harms if you don’t pay $6000 to find out about the diet. I cannot comment on whether subjecting your child to Sensory Motor training by an unlicensed professional, or tutoring by a person with 20 hours of training, is harmful.
The major harm is the cost. Brain Balance charges thousands of dollars upfront (that is, payable in advance) for this supposed treatment. Right now the cost is $6000. Just to compare, $6000 is roughly more than the cost of tuition for a semester at UW Madison. To put this in perspective, many people complain about not being able to bill insurance for a single doctor’s visit due to “out of network” problems and other problems. The cost of an initial consultation with me, for example, averages about $325 (I have different fees for telemedicine consults, and in-person consults). Follow-ups are cheaper. Even my initial consult is only 6% of the cost of Brain Balance. For the same price as Brain Balance, you could see me or another doctor like me every week for almost a year at my standard price, even if you had no insurance. So you need to think carefully about this.
If you are seeking therapy, not medical care, you can use an evidence-based treatment like ABA Therapy (Applied Behavioral Analysis). Even paying out of pocket, you can get a board certified behavior analyst to see your child each week for more than a year for the same price as Brain Balance. In addition, because ABA Therapy is evidence-based, many insurance companies and Wisconsin Title XIX cover it.
So you need to ask what the costs and benefits are. Brain Balance treatment is not covered by insurance, because the people prescribing and administering the treatments are not licensed professionals, because dietary change is not covered by insurance, and because tutoring is not covered by insurance.
Is the Cost Justified by Science? No
Brain Balance can get away with charging people lots of money upfront by claiming that their treatments are based on science. So let’s look at the “science” underlying their treatment.
Brain Balance says that it is based on a theory called the “Functional Disconnection Syndrome” applied to Autism. The person who started Brain Balance wrote an article called Autism Spectrum Disorders as Functional Disconnection Syndrome, which is cited on their website. I also included the link here, so you can read this yourself.
I read through their material carefully.
I will quote from what they say:
One of the most interesting features of children with neurocognitive disorders is the “unevenness” of cognitive skills. For example it is not unusual to observe high verbal scores combined with low performance scores on intelligence tests. One must explain the basis of why unusually high skills are combined with unusually low skills in the same child.
The pattern of strengths and weaknesses in these children seems to appear as a fairly reproducible pattern of strengths and weaknesses. In addition the degree of strengths in some skills is matched by the weakness of others. This leads us to conjecture a relationship between strengths and weaknesses.
So what does this mean? I have no idea. The authors theorize that this is the basis of all Autism Spectrum Disorders and other learning disorders. What struck me is that they seem to be dealing with a totally different group of people with Autism than I have treated in the past 20 plus years.
I have been a practicing board certified Child and Adolescent Psychiatrist for many years. I have treated scores of patients with Autism. It is extremely uncommon to see “high verbal scores” combined with low performance scores on intelligence tests. Perhaps they are referring to learning disabilities, in which these types of scattered scores are more common. However, in children and adults with Autism, I have observed most to have so little control over their verbal ability that one cannot say this at all. For example, the last patient I saw (last week) was so aggressive during the exam that her mother had to restrain her constantly. During the interview, this pre-teen child kicked her two year old sister in the face besides kicking the mother continually. How could I possibly see in this child that some skills were higher than others and that the high skills “consistently match the weaknesses in the low skills?” The authors may be cherry-picking their patients for a handful of very high functioning people who may have a few symptoms of Autism They are not referring to the vast majority of people with Autism.
The second problem is that even the people who started Brain Balance know that they have no real evidence supporting their theory. To tie their thoughts and observations together, they use words like “conjecture”, and “seem to be associated,” “could result,” etc.
What does “conjecture” mean? The word “conjecture” is defined by Merriam-Webster Dictionary as an “an opinion or idea formed without proof or sufficient evidence.” So they base their entire theory on their own opinion, which even as they say, has no proof or sufficient evidence.
What is this theory without proof or evidence? They say that some imbalance between the right and left sides of the brain exists, and that somehow this is the explanation for Autism and other disorders, and for a fee of many thousands of dollars, they can treat it. However, even in their academic paper, they say this is just a “hypothesis,” meaning they recognize once again that they have no proof. I will point out again that their testing is designed to determine “which” side of the brain is weaker, causing the imbalance. This is a direct contradiction between their theory, that is it the right side, and their practice. In reality, they can test for everything and find whatever will justify their charging you, their patient, for therapy.
The authors continue to “conjecture” a relationship between strengths and weaknesses. Again, they realize that they have no evidence or proof. Does that mean there is such a relationship or just something they imagine?
After several more “conjectures,” the paper then discusses how the right side of the brain is the real problem. They say, “This also seems to be consistent with the reduced cognitive, motor and sensory functions that are primarily controlled by the right hemisphere (of the brain).”
The authors string together all of these conjectures—ideas without proof or evidence—and other loose connections, to explain Autism. In their Brain Balance centers, they then expand their conjectures, theories, and thoughts to all learning problems.
Certainly, they are allowed to publish this information and somehow these authors convinced a medical journal to publish their thoughts and conjectures. However, now, they are using this publication to take advantage of parents who are desperate for help. Brain Balance charges a huge amount of money up front for each child, in the several thousands of dollars. If I were taking my child to a doctor for treatment, I would want more proof than Brain Balance gives before I would spent thousands of dollars upfront for a bunch of therapy that is not even unique or new. Have they ever turned away a parent with an open checkbook? Or is every child whose parents are willing to pay upfront a good candidate for treatment? I don’t know. It’s worth asking.
I am not opposed to people using any of these discrete types of therapy, provided the person administering the therapy is qualified to do so, that the patient has the right to do the therapy a little at a time to see if it works, and assess the success or failure.
For dietary change, you can buy Feast Without Yeast for less than $30, try the diet, and see if it works. For sensory motor therapy, you can go to a licensed professional like an Occupational Therapist. Even if you pay out of pocket, the entire course of treatment probably will be less than $6000. You also can assess whether the therapy is working and decide whether to continue it. For tutoring, you can go to a licensed teacher, or other educator. You can see if the tutoring is helpful before paying for months of sessions in advance. For medical care, go to a licensed health professional.
I just cannot find anything here that justifies paying thousands of dollars in advance for these therapies, especially since Brain Balance is based on a series of conjectures and hypotheses with no basis in evidence.
I suggest you ask yourself, if someone told you that they had a great idea that had no evidence supporting it, but they wanted to try on your child, and that it would cost you $6000, without any guarantees, and you had to pay upfront, would you do it? I wouldn’t. So I give it a “thumbs down” for treatments.