Hey Fatheads!

I know I usually do the right thing and disappear for a few months after commandeering The Big Chair, but this was too good not to share.

I was perusing the local paper of record Monday and there was a story headlined “BEHAVIOR ANALYSIS: Free services offered to children with skill deficits.” It was about a”new intensive feeding clinic” developed by the Southern Illinois University’s Child Behavior Research and Training Lab. Its mission is to help parents use “Applied Behavior Analysis” (ABA) to overcome the dread “picky eater” crisis that’s sweeping the nation.

I’m assuming it must be a crisis, anyway, since one of our main public universities — in a state that is hundreds of billions behind on pension funding, hasn’t passed a budget in over two years, and has put half of the NFP social service agencies out of business — is devoting resources to it and running the program at no charge.

They’re applying some of their expertise from other areas of child behavior. One example, for instance, was how to avoid your kid having a tantrum in the store because you won’t buy them Skittles. So the solution offered by the expert is to give them one Skittle per minute while shopping.

Seriously. These are experts.

I’m accustomed to such credentialed idiocy (as are most Fat Heads, I believe), but another line regarding a predecessor program being used as a template for the picky eater solution had me howling out loud:

“Earlier this spring, Hirst rolled out an intensive, one-day potty training program that incorporates a mix of evidence-based procedures. “

Yep, there it is kids. Pre-adolescent turd disposal has joined the elite ranks of all things evidence-based. So if any of you still thought “evidence-based” had any real meaning, that swishing sound you hear is the last shred of any of the term’s rhetorical value swirling around the bowl.


Don’t worry, Mom — it’s evidence-based!

We now return to our regular programming…

Cheers!

The Older Brother

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19 Responses to “The Older Brother Does an Evidence-Based Spit Take”
  1. Dianne says:

    Oh. Good. Grief. As for tantrums while shopping, my mother had a solution — my sister and I each threw one tantrum in public, got paddled instantly (not enough to damage our behinds but enough to wound our pride), and never threw another. As for being picky eaters, we got two choices — take it or leave it. And I do assure you that we both reached adulthood with our psyches, if that is the right word, and our love and respect for our parents intact. So did my sister’s kids, raised he same way. As for the skittles solution, it sounds like a good way to teach a kid he can get what he wants by threatening to start trouble if he doesn’t. And there’s probably plenty of evidence for that. Anyway, we need to send these experts back under the rocks they crawled out from under in the first place, and replace them with some old-fashioned grandmas.

    • The Older Brother says:

      Yeah, but it’s not evidence-based!

      I think the whole country would be better off if we could agree to adopt “grandma-based” as an approach to evaluating the merits of various ideas outside of the hard science disciplines. With the caveat that it would have to be, as you say, old-fashioned grandmas. I’m thinking they’d have to be born before 1940 to be considered experts, and then ranked by age. Like tenure.

      The Older Brother

      • Kathy in OK says:

        yes, Yes, YES!!!!

        • Kathy in OK says:

          Oh, and I still think you need to reawaken your old blog.

          • The Older Brother says:

            Just switched to a Linux based server so I can upgrade WordPress. It will take another week to get things ported over, then all I have to do is wait for a politician to do something stupid. Keep your fingers crossed.

            Cheers!

      • Dianne says:

        I love this idea! I wish I’d followed the grandma-based dietary advice I got way back when, instead of the government/WW-based advice I did follow when I started putting on weight. Grandma was born in 1883, referred to avoiding sugar and starch for weight loss/control as “banting,” and said that things like coconut cake and mashed potatoes with gravy would make us fat so we should eat steak and salad. Her only evidence was that it worked for her. Once again, experience loses out to an attractive theory

        • The Older Brother says:

          Banting was a layperson in the (I believe) 1800’s who figured out that they way to cure his obesity, gout, etc was to avoid breads and sweets and load up on fatty meats. Taubs gives him a lot of coverage early in “Good Calories, Bad Calories” as one of the first to take the LCHF idea and push it as a diet program. Of course, he was poor-poohed by the experts of the day since he wasn’t a doctor.

          The Older Brother

          • Bob Niland says:

            There were two Bantings:
            Frederick Banting (1891–1941), Canadian medical scientist
            William Banting (1797–1878), English undertaker and dietician

            That grandma was likely referring to William. This Banting Diet was at issue in the recent Noakes kangaroo court.

            Because Bill was ignored, Fred had an opening to become famous for discovering insulin, which is useful in T1D, but also shows up later in the optional T2D, where it partially mitigates the ultimate consequences of consensus diets, for a while.

          • Walter Bushell says:

            Via Wikiperdia

            “William Banting (c. December 1796 – 16 March 1878) was a notable English undertaker”. He Undertook royalty and the upper crust in general.

            One of the people anyone who is interested in nutrition should know.

          • Bill says:

            You can find Banting’s’ Letter on Corpulence’ on Amazon for next to no$$. Tim Noakes in SA has adopted Banting as a headline for his diet courses. What it shows that our mainstream ‘accredited’ so-called professional dieticians et al have learnt nothing, nyet, nada zero about how to help people lose weight and improve their health. The numerous ‘peer’ reviewed papers that are supposed to support the current dietary fad (aka food pyramid) are surely the product of overtrained, industry influenced industry in and of itself. I’m sure there is some great science out there, I worked in electronic for 40 years- if it didn’t work or it didn’t work well you had to rethink it, not coat it in BS and hope no one noticed.

    • Samuel Justus (Heero Yuy Parallax) says:

      Dear Mrs. Dianne,

      This response seems very similar to those who say, “I eat a high carbohydrate diet and I am perfectly fine, I take statins and I am OK, I was circumcised and Im OK. On meme even jokingly followed this up with, “Now excuse me while I take these five medications I need to function during the day.” Or as one Anti-Vaxxer put it, “My kids are vaccinated and they are perfectly healthy, now excuse me, because my child has to take their medication for ADHD and his allergy pills.”

      Maybe you dont take any medications but I would beg you, plead with you to read the following information:

      Google: James Prescott Body pleasures and the origins of violence whale . to

      I am glad for every thing that has happened to me, including abuse (not just spankings but severe mental, emotional, chemical, and religious abuse) but I want people to know the risk and have a choice, because despite that these things are often considered socially acceptable, they can lead to horrific ohtcomes, even if they are considered normal.

      It isn’t suporising at all that a kid would want Skittles. A lot of them are vaccine and diet damaged, and are lacking essential nutrients, and they may have a lot of frustrations because as educator (and one who actually observed children I will add, this was not some ivory tower intellectual) John Holt (See: Escape From Childhood and other works freely available online) and (like wise extremely observent) independent researcher L. Ron Hubbard pointed out (See: Scientology, A New Slant on Life as well as The Cause of Suppression and other works) life can be very frustrating for a child due to environmental and other factors.

      One of the beings I was, when I was in College, the Psychology teacher gave an example of a time he had made a deal that if one of his children stopped a certain behavior he would give him an ice cream cone at the end of their time at the mall. The son complied and the father kept his end of the bargain. The son immediately started his behavior again on receiving the cone.

      The Professor asked before hand what we (one of the beings I eas and the other stufents) Thought would happen when the child received the cone. Even back then, the being I was had the knowledge to tell him what would happen next, because it had already happened to a different being I was.

      The Father didnt actually fix the problem of what was causing the sons frustration. He nearly suppressed the symptom. When the suppression was lifted the behavior returned. Of course it did, the problem had not been solved, simply repressed.

      Which is what so inspires me when people talk in terms of punishment as a solution. It isn’t. It doesn’t take away the pain, it only creates resentment. Its like giving someone a drug for a problem. Great. But does it solve the problem? No.

      The easiest response to statements such as those I’ve made would be to callously dismiss them. Such are the effects of physical punishment, poor nutrition, and suppression. Its hard to feel through calluses. And its hard to think when authority has been substituted for truth. Its especially hard if someone you love is being accused of doing or teaching things that bring harm to others, things which you yourself may have adopted as the proper standard. But I would ask you, as someone who has memories of beings I have been being on the other side of the punishments you describe and likely deal out, to please, please open your mind and consider that there might be a better way.

      I apologize, Ma’am, if I have been condescending. but I know your likely response, and it was well summarized in the title.of a book by Dr. Andrew Wakefield, “Callous Disregard.”

      Parallax) – Samuel Justus (Heero Yuy Parallax)

  2. KidPsych says:

    I love this site and have greatly appreciated your take on health and diet. While I understand the skepticism in regard to ABA (and in many cases it’s warranted), I think pulling a single (poorly trained) practitioner’s advice as proof that it’s not effective is below your standards. As someone who works almost exclusively with kids with Autism and other developmental disabilities, I rely on ABA therapists to keep families from bursting apart from the multitude of challenges inevitably encountered by them. As a matter of fact, one of the better psychologists (and ABA therapists) I work with is a feeding expert, who does wonderful work helping kids (who sometimes won’t eat anything) eating somewhat typically. It’s hard, often exasperating work, but it feels right to help families in crisis. No capable ABA therapist would use the advice you listed. I’d be happy to talk to you about this at length if you like. You have my email.

    • The Older Brother says:

      Well, that “poorly trained practitioner” is an assistant professor in SIU’s Behavior Analysis and Therapy program and oversees the lab, so I really don’t think it’s my standards that are the problem. The problem is, how does a lay person distinguish between capable and credentialed?

      I also get the challenges families of Autistic kids and the professionals who work with them have to deal with. I’ve seen it. Not close enough to be personally affected, but I think close enough to get it. The article, and I guess I didn’t clarify this well, indicates that although the BAT program usually works with kids with Autism and other specific challenges, this one was aimed “to make mealtimes easier for parents of picky eaters.” In the business world, this is called scope- or mission creep. I believe for most picky eating kids, some “old-fashioned grandma” therapy (see Diane’s comment) would be miles ahead of a new “program,” although it would be completely inappropriate for a child whose refusal to eat is part of a mental impairment.

      The actual object of my derision wasn’t ABA. ABA is probably about as good as one can hope for in this field, but it’s not (as I’m sure you know better than I) “rocket science.” It has to be subjective because you’re dealing with individual human beings. [If you follow this blog, I hope you’ll agree that ABA aside, if a child’s gut biome is in a constant state of uproar there’s not much that counseling, behavior modifications, medication, coping strategies, etc. can offer for long-term progress?]

      My main reference was to my previous post regarding how many previously discredited or questionable arguments are now wrapping themselves in an “evidence-based” mantle as a way of implying some higher level of scientific rigor. I found it hilarious that getting a baby to poop in a toilet can be labelled with the same level of veracity as those using the term to argue for government policies, budget allocations, climate regulations, diet and exercise programs and more. Hilarious and true.

      My irritation and amusement aren’t a charge of fraud. They’re a plea for humility.

      Anyone who works with kids with Autism and other challenges is doing God’s work. Thank you. Thank you. Thank you.

      The Older Brother

      • KidPsych says:

        Thanks for the thoughtful reply, Older Brother. I think you and I would have a lot to talk about in regard to problem behaviors. I just wince a bit when I think people might be judging others when we don’t know all the facts. I know when I’ve worked with kids in the field I’ve gotten hairy eyeballs from others who must think I’m a terrible parent. (And in fact, without knowing about the specifics of what the practitioner was faced with – feeding skittles might have been the only way for a parent to get through a grocery store without an hour-long meltdown.)

        I really do appreciate your thoughtful take. As someone who holds a psych and ABA license (in other words, I was dim enough to go through an endless series of hoops), I often find myself wedged between ABA folk (who can be, let’s say, a little bit narrow in their thinking) and psychology, which hopefully can be a little more accommodating to the realities of home life (but obviously possesses a limitless range of pitfalls). In fact, my complaint about ABA is often that it presents itself as rocket science, but truthfully is generally not that technical (or as you state, scientifically rigorous). (And yes, the same critique could be lodged at psychology.) I roll my eyes often enough that I worry they might get lodged in my forehead.

        I like to think about all of these challenges we face as humans in neurological terms: left hemispheric function is largely about categorization, data, logical links, while the right is focused on holistically bringing everything together (this is all stated with the understanding that there is much shared function between the two). I think we get into trouble when fine-grained data become divorced from the whole (i.e., when left and right are not in harmony). As Einstein (maybe) said, just because you can measure something doesn’t mean it’s worth measuring, and you might not be able to measure what you’d really like to measure (like happiness).

        Anyhoo, thanks for being a part of this terrific community. (And thanks for letting me blither).

        • The Older Brother says:

          I’d be curious to know how much the mainstream in the psych professions has recognized the role of the “second brain.” The gut biome, as Dr. David Perlmutter argues in “Brain Maker,” is a major driver in our mental development and health. It seems not factoring this in, especially for kids with Autism and other mental issues, would be akin to the common advice of “eat less, exercise more” in the health/fitness.nutrition arena.

          The Older Brother

          • KidPsych says:

            Honestly, I’m seeing more and more patients whose parents see the links. Fortunately there are medical providers who know enough to guide them appropriately. I have to be careful with what I say because dietary advice falls outside my scope of practice, but I do talk about what I do, and I do tell them where they can read studies that might be helpful. The tide is shifting here (or maybe I’m just a blithering optimist!).

  3. Elenor says:

    Hail Older Brother!

    “make mealtimes easier for parents of picky eaters.”

    Let me throw in a word for the OTHER side! I was (and still am, alas!) that picky eater! OMG! Hours and hours sitting alone at the table facing a plate of hated hated horrible literally-made-me-gag (and STILL make me gag: I’m 61!!) veggies! Doesn’t matter how much sympathy I feel for my parents dealing with a horribly picky eater — it was hell for me (too)! (Couldn’t get the damned dog to eat the stupid veg either — SHE was no fool!)

    I can look back now and notice that I was a dreadfully colicky baby — (my mother every couple of years will apologize for shaking the hell out of me when I was an agonized screaming infant; if only she/they/we had known the gut pain was food-caused. Thankfully (?), I have no conscious memory of that: just of the yelling, the hours a the table after everyone had left, the force… my uncle actually scratched the back of my throat once trying to force-feed me a veg — they had no kids so had no practice in ‘dealing-with-kids reality… {shrug} No one knew better what to do. And a skittle an hour sounds like more torture!!)

    The Monel Chemical Lab in Philly would describe me as a ‘super-taster’ — and yes, it does involve more and different proportions of taste buds than “normal” tasters and non-tasters. (Bell Curve, you know? I’m at the tippy-top “reactive” side of the curve!) It is ACTUALLY legit that some kids DO have seemingly insane (both bad and good!) reactions to flavors. Most folks have never “gone to heaven’ over a vanilla wafer. Most people have never actually gagged in a public restaurant when trying (“it’s sweet, you’ll like it!”) a lychee nut.

    Just a … slightly defensive … note about being the target of the slurs and outrageous fortune — NOT a consummation devoutly to be desired!

    • The Older Brother says:

      Wow. I never got the whole “you’re going to sit there until your plate is clean!” bit.

      Mom never did it to us, and The Wife and I always just told the kids they needed to try a bite of something new before declining to eat it. In that case, they could make themselves a peanut butter sandwich. We do the same thing with The Granddaughters now. We’re about 50/50 on them deciding maybe whatever we’re offering isn’t so bad after all.

      Of course, some people are just terrible cooks. I’ve got a brother-in-law with a list of several things he won’t eat — meatloaf, casseroles, several vegetables, and others — because his mom cooked everything beyond recognition!

      Colic is hell on the baby and parents, but sure isn’t an excuse for child abuse. It would be nice if knowledge of the gut biome and the damage most baby cereals can do became more common.

      Here’s the thing, though. I’m skeptical that these experts will first take a look at the picky-eating kids’ diets to see if they may have some gut disbiosis. It may be whoever wrote the story missed a major point, but if you were adapting an eating program for/based on working with a lot of kids with Autism, why wouldn’t that be the first thing you’d look at, given the high rates of IBS and other gut maladies among the Autistic? The fact that it’s not mentioned makes me think it’s not checked.

      The Older Brother

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