Recently I came across the website for an earth based facility, one of many unfortunately, that employs a potentially dangerous approach to the treatment of disabled and behavior challenged human children. This treatment is based on a theorized etiology of such problems that is unfounded. Nehemiah's Ranch describes itself as a "faith-based, non-denominational organization that is supported both by contributions and fees for services...". They claim, "After many years of personally working with youth in various capacities and settings, the staff at Nehemiah’s Ranch For Youth believe that every youth is "reachable". Our goal is to reach the ones labeled "UN-reachable" and help them rebuild their lives.". Admirable to be certain. And perhaps they are a legitimate organization. I doubt it though because most humans are liars to some degree.
Reading their provided info is likely very reassuring to parents who have had difficulty caring for problem children or kids with issues ranging from cerebral palsy to autism. For instance, they state that, "Our staff build the young people up with positive reinforcement, yet challenge the thinking patterns which promote their destructive behaviors. The trust issues, defense mechanisms, social interaction problems and control issues that children and youth have are all addressed in the "safe place" which we offer, where they are accepted, encouraged, and valued." They also reveal, "We utilize collective resources from the community, businesses, sponsors, churches, county and state juvenile agencies, and philanthropic organizations to enable high-risk young people, especially those from disadvantaged circumstances, to realize their full potential as productive, responsible, and caring citizens." Sounds good so far. Just wait.
Anything more than a cursory glance reveals that there is something deeply disturbing about this facility. The first clue that something wicked this way comes is on the home page where, under the "Who We Are" section, they explain that, "Many of these children have had interrupted neuro-development...". The second clue, and one even more revealing, is their claim that "Some of these children have Reactive Attachment Disorder and are hurting because of adoption, developmental issues, abuse, rejection, traumas, or indifference at some point in their lives." Besides the mention of Reactive Attachment Disorder, a legitimate diagnosis often twisted into an almost urecognizable bogus one by pseudotherapists, there is the mention again of development gone awry. Finally, Co-founder Troy Skeen is quoted, "Through the neuro-developmental work and mentoring in our Future Hope program we help children and youth learn empathy and responsibility, unstick their ‘emotional age,’ develop reasonable cause and effect thinking, address anger and violence issues, and learn to make good choices." Curious? The plot thickens.
Further investigation reveals that the foundation of this organization's treatment philosophy is something known as Neurological Reorganization. They employ their very own Neurological Reorganization Practitioner by the name of Susan Scott. Not suprisingly, it does not appear that this is a legitimate certification as the only info I was able to find was a single link, to Susan Scott and this very website, by plugging "neurological reorganization practitioner" into google. Not proof of illegitimacy by any means but suspicious. I was however able to find some coursework in this subject available at the Wu Hsing Tao School in Seattle. Their website reveals,
"Neurological Reorganization Work: allows the therapist to diagnose any incomplete stages in a person's neurological development. The progression of these patterns is a natural phenomenon occurring from before birth to walking. Incomplete stages in the natural progression of development can impair true learning later in life even though intellectual compensation is made. Such learning impairments may consist of learning disabilities such as dyslexia and attention deficit disorder. Moreover, this type of therapy also benefits people who feel stuck, procrastinate, have difficulty with right/left discrimination, retention, comprehension, or eye fatigue. Through a skilled assessment of certain neurological motor and sensory functions, the therapist prescribes a series of re-patterning exercises to be practiced at home. The result is in a better utilization of brain function, reduction of subconscious stress from compensation mechanisms, and improvement of learning capability."
The Nehemiah's Ranch website discusses neurological reorganization in a similar fashion but in much greater detail. It sounds very scientific and makes use of a number of legitimate scientific terms such as pons and vestibulo-ocular reflex, but is grounded in anything but actual scientific discovery of the nature of the human brain. They explain,
"The program we use is based on the normal phases of neurological development that all healthy infants in the world go through if they are given the opportunity to do so. Those stages of neurological development are encoded into our central nervous system, which can be described as an instruction booklet for us. In this analogy, when a child has missed out on reading some of the pages in the instruction booklet, meaning that the child has skipped important developmental work that he or she needs to do, that can lead to gaps in his or her neurological function."
They look for this "skipped developmental work" with the use of "Functional Neurological Evaluations". "We begin by doing a functional neurological evaluation, which is a non-invasive test that allows us to isolate and highlight particular neurological functions that we want to evaluate. By observing how the client is able to accomplish each task, we can observe a particular brain function. We compile an inventory of what is working and what is not working in the brain at an age-appropriate level."
They then get to work fixing what isn't working. "After we have that knowledge, we go back to the earliest developmental stage where there is evidence of a gap. In daily exercises we ask the client to repeat the normal developmental activities that a child would have been doing at that developmental stage. These activities are intended to trigger whole body reflex responses from the brain that exercise the connections that are necessary to do the functions in each respective part of the brain."
This sounds complicated so the men and women who are providing this therapy, under the guidance of an actual Neurological Reorganization Practitioner, must be highly qualified right? According to the website, "Founders Troy and Charity Skeen held significant leadership positions at a key branch of a large international mission organization that worked primarily with youth, being involved with the organization for a total of 9 years each. Executive Director Marlin Brownell has a Masters degree and 26 years of experience in leadership, working with youth, and counseling. Jeanene Brownell has a degree in Therapeutic Recreation. A majority of the staff at Nehemiah's has at least a Bachelor's degree, plus other training and various types of experience in working with youth." This is the only information provided.
Is having worked with an international mission a qualification for work with autistic children or children with behavior problems? A masters degree in what? 26 years experience working with youth in what capacity? Therapeutic Recreation degree? Bachelors degrees in what? Other training and various experience with youth is a tad vague don't you think? So where did Neurological Reorganization come from?
Neurological Reorganization, the primary component of the Doman-Delacato Method, originated in the 1960's, was evaluated and debated by experts, and was determined to be worthless. A number of studies looked into it and found no benefit. It has been soundly thrashed by legitimate medical authorities ever since.
A 1970 AAP statement included the following, "It has been concluded that the data thus far advanced are insufficient to justify affirmative conclusions about the system of treatment. Consideration of the statistics of individual case reports suggest that the changes obtained may reflect normal growth and development occurring independently of the method applied, or the inadvertent consequence of social stimulation and environmental change inherent in, or resulting from, the application of almost any method. We have also noted evidence that is available that justifies questioning the theoretical premises of the method." Almost 40 years later, despite a number of advances in our understanding of neurodevelopment, nothing has been discovered that supports this method.
An excellent discussion of this method was written in 1996 by Dr. Steven Novella, a Yale neurologist and author of the blog NeuroLogica.
The most concerning aspect of the care provided at this facility is their use Masking. The website includes the following explanation of the treatment:
"Masking is the process of breathing into a bag-like container for a minute, taking a short break, and repeating this cycle several times causing a person to capture and re-breath his or her own exhalations. This causes the person to breathe more carbon dioxide than is present in normal air. While a common paper bag can be used, we use a commercially manufactured oxygen rebreather mask. The presence of more carbon dioxide triggers two reflex responses in our brain:1) respiratory stimulation (it makes us breathe more deeply).2) vaso-dilation (it opens up our blood vessels so that more blood is delivered to the lungs, where it picks up more oxygen, therefore causing more oxygen to be delivered to the body).
"Masking is the process of breathing into a bag-like container for a minute, taking a short break, and repeating this cycle several times causing a person to capture and re-breath his or her own exhalations. This causes the person to breathe more carbon dioxide than is present in normal air. While a common paper bag can be used, we use a commercially manufactured oxygen rebreather mask. The presence of more carbon dioxide triggers two reflex responses in our brain:1) respiratory stimulation (it makes us breathe more deeply).2) vaso-dilation (it opens up our blood vessels so that more blood is delivered to the lungs, where it picks up more oxygen, therefore causing more oxygen to be delivered to the body).
Masking raises carbon dioxide levels in the bloodstream which triggers breathing. In other words, masking stimulates the breathing reflex. The net result is that when a person concludes breathing into a bag or bag-like container, the brain receives about 70% more oxygen than in normal circumstances. The effect of receiving more oxygen to the brain lasts several minutes. This process has a cumulative benefit, and when done over time, more oxygen is received by the brain for longer periods of time. The use of this technique is important for our program because this aids neurological reorganization, clarity and memory.
The benefits of masking are:1) increased memory capabilities2) the availability of oxygen is globally increased (it’s been compared to filling up a gas tank with high octane gas)3) nerve cells are fed as they grow new dendrites4) it allows for optimum function of a person’s current brain capacity5) it increases our attention, focus, and the speed at which our brain processes (it makes our brain work better) We use masking as part of our work in neurological reorganization and find that it is beneficial for our clients."
The only problem is that a basic knowledge of human physiology is enough to figure out that all of this is bogus. Increasing the amount of CO2 in the blood will cause dilation of the cerebral blood vessels. Vasodilation also occurs in other tissues but the brain is especially sensitive. As CO2 builds up in the rebreather system, oxygen levels decline pretty much in equal amounts, the precise rates being dependent somewhat on the carbohydrate/protein/fat ratio of the diet. Increasing the inspired CO2 will simply overcome the normal blood flow regulation that happens in the brain which ensures that the brain gets the blood flow it needs in order to achieve adequate oxygen delivery. This is a very finely tuned system.
The most likely outcome from rebreathing is an increase in CO2 to an amount not quite high enough to cause confusion, incoordination and unconsciousness but merely headache (likely because of increased blood flow in the meninges, anxiety and elevated adrenaline( perhaps the cause of increased "... attention, focus, and the speed at which our brain processes."). Increasing blood flow will not increase oxygen delivery to the brain in a healthy person. The vasodilation caused by increased CO2 could in fact lead to worse blood flow to areas with vascular problems because of decreased systemic blood pressure.
The red blood cells will unload oxygen in proportion to the acidity, CO2 content and 2,3 DPG levels of the tissues they are passing through. If the blood has a higher CO2 level (and resultant higher acidity - lower pH) coming from the lungs, they will be less efficient at carrying oxygen and the oxygen capacity of the blood will drop. Increasing the CO2 level in the blood by rebreathing will cause an increased blood flow with an offsetting DECREASE in oxygen carrying capacity that might cancel each other out. There is probably no appreciable increase in oxygen delivery. Any subjective feeling of increased "...attention, focus, and the speed at which our brain processes" is probably due to increased epinephrine levels as a response to partial suffocation.
This type of program tends to have little no oversight and no evidence of benefit aside from testimonials. This facility may not be as bad as I think they are but there is the unfortunate fact that children all over the world are abused both physically and psychologically, some murdered, while being subjected to some "tough love" and "Christian discipline" formatted treatment programs. There is an attitude of contempt for children, the stressing of conformity, and an underlying philosophy that can lead to torture. There is "treatment" of these children that would not be acceptable to use on prisoners of war and sometimes the parents aren't even aware. It is unclear if the people who run this particular program have any idea what they are doing. Perhaps enthusiasm and religious faith are not always good bedfellows. But man is there a lot of money to be made.
