Children’s rights and Cochlear Implants

cochlear-implant-girl-medical-diagram-superimposed

The United Nations says all people have the right to a language. But some people in the Cochlear Implant industry are prepared to gamble with that right. The gamble is that a Cochlear Implant (CI) will be successful for the child. It’s a gamble because if the part of the brain that deals with language is not developed, then the child may never acquire a language, whether it be sign language or spoken language. There is only one way to develop the language part of the brain – via exposure to a proper language at a young age. Deaf people say Many audiologists have a medical view. They try to fix the ears and neglect sign language.

A Cochlear Implant (CI) is a surgically implanted electronic device PLUS intensive speech therapy, which is why the videos of a child being “switched on” are misleading. The implant is connected to the auditory nerve then the skin is sewn up and usually heals fine. An external wire goes from a hearing aid behind the ear to the head and attaches magnetically through the skull to the implant – so CAT scans are very dangerous. A CI kid needs continuous audiology appointments and ongoing intensive Auditory-Verbal Therapy. A CI needs enormous dedication and commitment from the family. It’s not a magic bullet. The CI industry also acknowledges that CI does not work in many cases.

The CI industry often says that sign language for CI kids is not needed and may even stop them learning a spoken language. Research shows this is not true. Figures are hard to get, but an estimated 10% of CI kids cannot speak as well as their peers by age 5 and many have no language at all. The results are better if a kid has a CI for both ears which are implanted at the same time. The CI industry often says if the CI doesn’t work THEN the kids can learn sign language. This is an irresponsible gamble.

So I was very interested to go to audiologist Julia Sarant’s talk (pdf) on Tuesday 9 August 2016 at the Hearing House in Auckland, New Zealand about these issues. The Hearing House paid for her meta study and the task was “to compare Oral Communication with Oral Communication plus Sign”. In her meta study, Oral Communication (OC) means teaching a CI kid a spoken language. As we will see below, it’s not clear from her meta study if “Sign” means a natural sign language or some other form of manual communication such as Signed English. I met Julia over a cup of tea afterwards. She said she couldn’t tell me who wrote the poor studies which she included in her meta study because it was important to maintain good relations in the industry. She really feels for the grief that some hearing parents never recover from when a Deaf child is born to them. Often that grief harms the child as in this sad subtitled documentary where a 4 years old doesn’t know their name.

Many worried mums were at the talk and a few dads and some hearing and education professionals. The questions after the talk showed many parents were confused and worried about the choices they had made or would soon have to make for their kids. They looked to Julia and her meta study for reassurance. It was also clear that one or two of the professionals did not know how to evaluate a meta study.

A meta study is not new research. It evaluates previous studies to try to find the truth (despite what postmodernists believe, truth exists). The conclusion of a meta study depends on what studies are included. A good meta study will try to cover the field. My preference is to avoid including poor studies in a meta study. However, it might report them in an introductory literature review or use them as examples of a failure.

Julia concluded, perhaps wrongly as we will see, that for Deaf kids “There is no evidence that bilingual education [OC plus sign language] improves educational outcomes over oral education.” Her meta study (pdf) looked at 39 other studies, but only 32 are listed in her bibliography (and one of these is an outdated 2001 paper by Harris et. al. about how to rank studies when she should have used the current USPSTF Quality of Evidence guidelines). So we do not even know what the 39 studies were. She said they covered six areas:

  1. speech perception
  2. speech production
  3. vocabulary
  4. language development
  5. reading/literacy
  6. social development.

Julia rated one study as “good” for one of these six areas. All the rest were fair or poor for all categories. That result calls into question why other studies were not chosen by Julia to be part of her meta study. It is worth quoting in full from the Gallaudet University Linguistics Department which lists some of those studies:

To properly evaluate the effect of ASL [American Sign Language] on early English development, the appropriate comparison to make is between children raised with oral communication only and children raised with spoken English plus a full, natural sign language. Studies making this comparison have been appearing at an increasing rate, focusing on deaf cochlear implant users raised by deaf, signing parents. This population is relatively small but internationally studied. Recent research from Belgium (Mouvet 2013), Brazil (Quadros, Cruz, & Pizzio 2012), Iran (Hassanzadeh 2012), Italy (Rinaldi & Caselli 2009, 2014), the Netherlands (Giezen 2011, Giezen, Baker, & Escudero 2014), and the United States (Davidson et al. 2014) all report successful spoken language development for deaf cochlear implant users who are raised with natural sign language input. All of these studies have come to the same conclusion: There is no evidence that early exposure to a full, natural sign language obstructs spoken language development. In fact, Marcel Giezen (2011) concludes in his dissertation by saying that the evidence points to bimodal bilingual training as the optimal choice for cochlear implanted children, giving them the best chances for language success. (Source: Gallaudet University Linguistics Department)

Why did Julia not mention a single one of these studies? When I asked her later via email which was the “good” study which she included in her meta study she said it was Teresa Ching: Ching, T. Y. C. (2015). Is Early Intervention Effective in Improving Spoken Language Outcomes of Children With Congenital Hearing Loss? American Journal of Audiology, 24(3), 345–348. http://doi.org/10.1044/2015_AJA-15-0007. Again, Teresa’s study is not in the bibliography of Julia’s paper. This is another oversight. I eventually got a copy of Teresa’s short paper, but have been unable to get a copy of the data on which it relies. It’s unclear from Teresa’s study how many CI kids also learnt sign language. When I emailed Teresa’s office and left two messages to clarify this, I got no response, though they had earlier emailed me the information which helped me track down Teresa’s study. Elizabeth Levesque presented a slide (below) about Teresa’s study which is known as the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI). Elizabeth discussed the LOCHI data during her 2016 presentation to the Australian and New Zealand Conference for Educators of the Deaf (ANZCED). The slide also shows that the reported data from Terera’s study is unclear. Why? Because we don’t know how many of the 22% of LOCHI kids were taught natural sign language rather than some form of Signed English.

ching-2013-bimodal-bilingual-unlcear

So I am not convinced by the reliance Julia makes on Teresa’s paper to conclude that oral communication is better than oral communication plus sign language for language development.

Besides the studies above which Gallaudet reports, the Oxford Handbook of Deaf Studies, Language and Education also contains a chapter by Rachel Mayberry reporting the opposite of what Julia claims. Mayberry showed that Deaf children who learn to sign before they learn English can later learn to read and write English with native proficiency. But if Deaf children are taught spoken English as a first language but fail to learn it properly, then their chance of ever learning any language properly, whether sign language, oral language, or written language is zero. Mayberry also discussed two related and critically important points. First, language structures in the anterior left hemisphere of the brains of Deaf and hearing people are the same. Second, if these structures are not activated properly (in the early critical period for acquiring languages) then the child can never learn any language properly.

So in Julia’s meta study she asks us to believe in one study, and one study only, which she rated good and says supports her case. She does not give enough information for us to judge the worth of this study and she does not mention the other studies I have referred to here. This is not the way science proceeds. Science progresses by the whole scientific community reaching a consensus on all of the best available data as Naomi Oreskes shows in this entertaining and informative video. We need to share data, we need to know the details and we need to be able to test the claims for ourselves. Unfortunately I would rate Julia’s paper poor. It does not give any evidence, other than her rating of Teresa’s study.

A parent said to Julia during question time after the talk, “Your message is a great relief to me”. I am almost in tears as I write this because Julia said “There is no evidence at all that bilingualism helps.” I wrote down these words in my notebook as she said them. The words actually contradict her paper which said “There is limited evidence that early use of sign language may assist with the development of spoken language.” I’m not sure whether by ‘limited’ Julia means  ‘some’ (in a positive sense) or ‘very little’ (in a negative sense’). In either sense, Gallaudet and Oxford Handbook contradicts this. There is lots of evidence that bilingualism (having both sign language and spoken language) can benefit both languages. When asked by someone else in the audience about the evidence from Colorado which also contradicts it, Julia she said “I think it was one study.”

If parents were properly informed I don’t think they would take the risk of not teaching their CI kids sign language. It is against the human rights of their child to gamble with language acquisition. Unfortunately by the time you discover your CI kid is behind in spoken language, it is likely to be too late. There are also heaps of stories on the internet from CI people who speak well but also wish they were taught sign language. My call to action is to encourage parents to form strong bonds with the Deaf community and to have a fluent signer interact regularly with their child. One of the big myths is that sign language is hard to learn. I’m hoping to blog about that myth soon.

This all fills me with sadness for the kids who are missing out.

(I’d like to thank the friends and members of the Deaf community who made very useful comments on earlier drafts of this blog.)

Ngapipi lights – waste of money

separated-bike-lane

This is my submission to Auckland Council about the proposed traffic lights on the corner of Ngapipi Road and Tamaki Drive in Auckland, New Zealand:

1. This submission from a bicycle rider opposes the proposed upgrade of the intersection of Tamaki Drive and Ngapipi Road (Application numbers R/LUC/2016/3297, R/REG/2016/3298, R/REG/2016/3299, R/REG/2016/3307 & R/REG/2016/3493) and suggests a more simple and cost effective solution to the problem the proposal seeks to solve. Millions of dollars could be spent much better elsewhere to improve bicycle saftety in Auckland. Images below are from the notified documents.

2. Before giving my reasons for opposing the proposal I’d like to say I am unhappy with having to download a slew of 27 separate PDF documents in order to assess the proposal. This level of inefficiency is unacceptable. The documents should have been consolidated into one. I am also unhappy that Auckland Council refuses to accept the industry standard .odt format for submissions and instead forces the use of Microsoft or another standard just to upload a submission.

3. I note that a major rationale for the proposal is cyclist safety. Unfortunately the most simple, the cheapest and the most obvious solution has not been considered. The documents show 9 crashes involving cyclists were reported at the intersection from 2011-2015 (one of these was between 2 cyclists on the shared path). All remaining crashes with cyclists were vehicles turning right into Ngapipi Road failing to give way to oncoming cyclists. There were no other cycle crashes reported. I suggest the obvious solution is to install a sign on the cycleway heading west that requires cyclists to Give Way. The fact that more crashes were not reported suggests that most cyclists are already giving way and cycling defensively. Further analysis of the cycle crashes may be buried somewhere in the 27 documents but I am unable to determine the times of day or whether the cyclists were wearing reflective safety vests or had adequate lights.

ngapipi-crash-stats

4. I note that the proposal will increase traffic delays for very little gain. That is unacceptable.

ngapipi-travel-times-up

5. I am also concerned that the likely impact of sea-level rise has not been properly assessed. The word “normal” in the following quote is unacceptable when we are facing abnormal changes. I would prefer to see a fuller discussion of the estimates and likely impacts using the NIWA definition of red alert tides.

ngapipi-lights-sea-level

The Gallaudet Linguistics Department response to the AG Bell Association April 2016 statement

Gallaudet University Linguistics Department

April 15, 2016
Meredith Sugar, President
Alexander Graham Bell Association for the Deaf and Hard of Hearing


To Ms. Sugar:
Your April 1, 2016 online statement, “Dispelling myths about deafness,” has already elicited a tidal wave of responses from across the United States and international Deaf communities, including various statements from researchers specializing in deafness and language development. Those responses have highlighted numerous inaccuracies in your portrayal of current research.

We, the Linguistics Department of Gallaudet University, support those responses and have added a few words of our own. We would like to call to your attention the following evidence-based considerations that refute the framework of your arguments. While we share your concern for deaf and hard-of-hearing people to reach their highest potential, we do not believe that your current prescriptive policies are likely to lead to that outcome.


ASL is a LANGUAGE, not a tool.
Myth: ASL is not…

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Eight rules for using an interpreter

communication

Using an interpreter effectively is a high level skill that requires time and practice to develop. Ideally both sides, or more for multiparty discussions, will have their own interpreter.

An interpreter is YOUR tool but is also a person who may have their own personal insecurities and performance anxiety. You may need to encourage and congratulate them to make them feel relaxed and happy. People perform better this way.

Make sure you have established some ground rules with your interpreter and of course with the person you are talking to. It might be useful to go over these rules explicitly between you all at the beginning of the session.

1. YOU are in charge. The interpreter is not in charge and will know that.

2. The person you are talking to must look at you and talk to you. They shouldn’t talk to the interpreter; they are talking to you. You may need to remind them of this so don’t be afraid to do so.

3. Make sure the person you are talking to knows that the session is likely to take twice as long, at least, as without an interpreter. Why? Because the messages have to be repeated and sometimes clarified. Everyone has to give the interpreter time to finish interpreting before starting again. People using an interpreter should understand that short sentences are better. Metaphors should be used with care or perhaps not used at all. Sometimes metaphors are difficult to interpret and they also put an extra cognitive load on the interpreter, particularly in simultaneous interpreting. If you feel a metaphor is needed, perhaps draw special attention to it, but be aware that it might not “translate” very well and might need dedicated time to discuss its meaning. Having the time can be fun and create shared bonds, but it depends on the circumstance. In simultaneous interpreting I have seen interpreters simply ignore metaphors.

4. EVERYTHING that’s said must be interpreted. All sides should know this. Some interpreting guides say listen to the advice of the interpreter in culturally tricky or sensitive situations. That’s fine, but it’s your decision if you want to override the interpreter’s advice. The interpreter should be totally happy with this.

5. The interpreter must promise everyone that if they are not 100% sure of something, they will clarify. That works both ways ie they must clarify with you and with the person you are talking when needed. All sides should understand this.

6. Use one simple sentence at a time until you are confident of the interpreter’s abilities. If you are not sure the message is getting across, say it again or rephrase it.

7. If you are unsure that the interpreter is interpreting well, ask the person you are talking to to paraphrase what you have said. For example, “You know a minute or two ago I spoke of A? Would you mind repeating back to me what I said about A.” If the message doesn’t come back to you more or less intact, then there’s a problem somewhere. The problem may be with the interpreter or it may be with the person you’re talking to. And hey, it might be a problem with you too. Communication is a two way street which is hard enough; but here it’s a three way street. Communication is understanding the other person in order to understand them, not merely to make a quick riposte.

8. If you discover a problem in the communication you should say so. “I think we might have a communication problem here. Let’s try to sort it out.” It’s better to be honest about it straight away. The interpreter should be totally comfortable with this too.

Finally a note for interpreters. A good interpreting session is one where the people talking to each other forget that the interpreter is there. Interpreters will know the feeling and love it.

The Murray Gell-Mann Amnesia effect

SeekerBlog

Jack Kelly has a nice piece on media (in)credibility, where he quotes from Michael Crichton’s 2002 “Why Speculate?”:

Media carries with it a credibility that is totally undeserved. You have all experienced this, in what I call the Murray Gell-Mann Amnesia effect. (I call it by this name because I once discussed it with Murray Gell-Mann, and by dropping a famous name I imply greater importance to myself, and to the effect, than it would otherwise have.)

Briefly stated, the Gell-Mann Amnesia effect works as follows. You open the newspaper to an article on some subject you know well. In Murray’s case, physics. In mine, show business. You read the article and see the journalist has absolutely no understanding of either the facts or the issues. Often, the article is so wrong it actually presents the story backward-reversing cause and effect. I call these the “wet streets cause rain”…

View original post 165 more words

Vitamin industry in our universities

vitamins-cancer-q

I’m placing these emails here for public interest. I haven’t had time to sort them into sequence. I’m happy to discuss them. My point is that Professor Julia Rucklidge of University of Canterbury’s Department of Psychology has no expertise in biology, yet makes outlandish claims for multivitamins. When challenged she says the media misrepresents her. Judge for yourself. She is funded by the multivitamin industry.

21 April 2016 1.12 pm
from Julia Rucklidge
I think we need to agree to disagree. Just as you feel I am not hearing you, the feeling is mutual J Julia

——–
My response
Unbelievable! You clearly have not even had time to read my email properly! Oh well, horses and water.

Conversation opened. 10 messages. All messages read.

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Kevin

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ADHD Study
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Kevin McCready
Kia Ora Kathryn Re: http://www.psyc.canterbury.ac.nz/research/Mental_Health_a…
Apr 11 (3 days ago)
7 older messages
Julia Rucklidge

11:30 AM (44 minutes ago)

to me, Kathryn

Dear Kevin,

It appears that you don’t have a problem with my research, but with how it has been portrayed in the media.

I am not here to sway your opinion as I don’t believe you are trying to understand this area of work based on your comments. I provided you with the articles you asked for. There are many more studies out there using broad spectrum micronutrients to treat various psychological symptoms if you choose to look. You will note that when I speak to the media I don’t promote one product, I discuss the idea that some people may need more nutrients than what they can get out of their food for optimal brain functioning. My work is completed without funding from any of the companies that provide the nutrients (and I have studied a number of different products). They have no influence on our publications, positive or negative.

Rather than attack me and this work, you could support the need for more research in this area. I am sure you would agree that those desperate parents need more data points in order to make good informed decisions for their children.

Unless you are able to engage in an open-minded, thoughtful and considered discussion of this research and the significant challenges our society currently faces in being able to effectively treat people with mental illness, I will not be replying to any further emails.

———–
And BTW Julia

Something constructive for you, lest you accuse me of not being interested in mental health research (a rather galling accusation to make to a man whose younger brother has recently died after a long battle with schizophrenia and who has spend much of his professional life researching these issues).

In my suggestion that you consult with the scientific community, you would be well served by getting some good statisticians on board.

Your hypothesis is that multi micronutrients affect mood. Unfortunately your experimental designs are inadequate to test the hypothesis. You need to say which combination of nutrients and in what doses. Then to test the hypothesis you need to vary these in a controlled manner under a Multivariate analysis of variance (MANOVA) designed work. Your big gun approach with various commercial products and their large numbers of nutrients is not going to cut the mustard as any statistician will be able to tell you.

Kind regards Julia

From: Kevin McCready [mailto:kevin1mccready@gmail.com]
Sent: Wednesday, 13 April 2016 3:15 p.m.
Kevin McCready <kevin1mccready@gmail.com>

12:05 PM (10 minutes ago)

to Julia, Kathryn
Dear Julia

Thank you for your email.

Your own public comments exceed by far the published findings of your own research. You have not explained to me why this is so. To blame the media is disingenuous.

To accuse me of being close minded when it is you who make public statements which cannot yet be supported by science, particularly when those statements are also contradicted by the words of your own published work is actually very revealing.

It is common for adherents of any hypothesis to call for more research in the hope of finding support for their beliefs. Generally their emotional/intellectual attachment makes them unsuitable to judge when enough research is enough. I use the dyad term ’emotional/intellectual attachment’ carefully in terms of what we know about brain function as rather nicely revealed by the Capgras Delusion to which we are all, myself included, subject.

You clearly have an emotional investment (in terms of your beliefs and your reputation) and a financial investment (in terms of your salary) in this hypothesis. It is very unfortunate that your public statements are being seized on by naturopaths and other quacks who seek to gain financially. I know you have no control over that, but I have not heard you caution that the science is not yet strong enough to support the extreme claims being associated with your name (a simple internet search reveals these).

Finally, I urge you to take a look at yourself in consultation with the community of scientists (not just those academics supporting your own hypothesis) and be much more careful in expressing yourself in future.
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———-
April 21 8.31 am
Kevin, I am sorry to hear about your brother, I am assuming that perhaps your disdain for my work stems from experiences you may have had in the health sector. However, I meant a lack of interest in understanding why it is worth considering the impact that NHPs might have on the treatment of mental illness, not a lack of interest in mental illness.

Regardless, I do take science communication very seriously (hence why despite my inclination to not reply further to your rather hostile emails, I have decided to craft a response), I do stick to the data, I am always careful to tell reporters about the limitations, that is doesn’t work for everyone, I give stats of recovery etc – if they choose not to use the full interview, that is something that is very hard to control. We will have to agree to disagree on my enthusiasm for my collective work over a decade with hundreds of people and multiple designs (depending on results from RCTs only is a huge error) as well as the work of others. Nevertheless, I do take on board your comments. Thank you.

On the note of a statistician – I indeed do have a statistician – but I respectfully think that your comment stems from a single ingredient fallacy and that no one ingredient is important on its own. Others can spend their careers finding out the mechanism of action of specific nutrients, I chose to dedicate my research time to determining if claims made by companies hold up in scientific research (which afterall is a role of scientists) and then if they do, trying to figure out the mechanism of action collectively.

Indeed, such magic bullet thinking is at odds with human physiology (which requires the ingestion of many nutrients in balance) and largely explains why the single nutrient strategy has yielded only modest benefits. Supplementing with broad spectrum formulations ensures the patient’s safety as the combination prevents imbalances, such as one nutrient causing a deficiency in another (e.g., taking zinc alone may cause copper deficiency). Recommending that researchers first understand how one nutrient functions on its own, in isolation, ignores the inevitable changes and potential for harm occurring in other nutrient levels.

The concept underlying the use of micronutrients for the amelioration of mental health symptoms is that mental illness may be a manifestation of suboptimal nutrition, relative to genetically-determined needs for optimal brain metabolic activity.

Neurotransmitters go through many metabolic steps to ensure synthesis, uptake, and breakdown. Each step requires enzymes, and every enzyme is dependent upon multiple co-enzymes (cofactors). A variety of vitamins and minerals are required as cofactors in most, if not all, of those steps. Some people may inherit an in-born error of metabolism that results in less than optimal use of nutrients that are present. Flooding the system with many nutrients ensures the body receives what it requires for optimal brain functioning.

The one-disease, one-nutrient solution to mental disorders is outdated, and needs to be replaced by a model that is responsive to the broad spectrum of human nutritional needs. Perhaps the perpetuation of single-nutrient studies continues because this methodology fits comfortably within the pharmaceutical paradigm and traditional scientific methodology where drugs are typically single ingredient and independent variables are manipulated one at a time. However, shifting psychiatric research towards a consideration of multi-ingredient formulations requires rethinking the scientific paradigm that has thus far shaped this field.

Kind regards

Julia

———–
April 21 2016 1.06 pm
Thanks Julia

Thanks for your comments about my brother Gerard.

No I have not misunderstood your hypothesis and have never believed in single magic bullets. Thus most of your email is not relevant to what I said. The whole point of a multivariate analysis is to vary the ratios of nutrients and be able to study the various combinations. I thought this was clearly stated. I’d be curious to know if you showed my email to your statistician before replying and if so, did that person also misunderstand me?

I am familiar with metabolic pathways, networks, feedback loops and hysteresis. My own hypothesis is that because of the NP-Hard problem these will never be fully explicated. Nonetheless we should continue with the endeavour with the tools we have while being as aware as possible of their limitations. I’m not meaning to be rude, but your call for paradigm shift is in my view based on a misunderstanding of how science proceeds and is almost ‘undergraduate’ in its framing. Have you seen Naomi Oreskes speak to this? Even while I acknowledge the ills of much of big pharma, to characterise all pharma research with the accusation you make is insupportable.

Again I make the indisputable observation that It is your own words that hype your hypothesis beyond what the data supports, not only the actions of media reporting you. You seem unable to understand this. Perhaps your belief in your hypothesis sometimes overrides your scientific training when you speak to the media.

Even in the email you have just sent me you say  “Flooding the system with many nutrients ensures the body receives what it requires for optimal brain functioning.” This is a gross and dangerous error. For many physiological processes the same substance can be wonderful or very dangerous, depending on the dose. Particularly in your field of nutrients you ought to be acutely aware of recent research on hormesis (Vitamin E springs to mind). I’m hugely disappointed again that someone in your position can write such a statement in what is clearly a carefully considered email.

Can I urge you again to conduct your scientific life in careful consultation with experts and with an attitude of strong scepticism towards your own hypothesis? Your email to me with your “flooding the system” comment indicates it is unlikely you checked it with an expert. I’m sorry if this sounds rude – that is far from my intention.

I have lived and worked with scientists all my life and one of the most distressing episodes related to a dear friend and has occurred only recently. He has now realised that an important piece of work he had high hopes for and worked on day and night for the last twenty years is coming to nothing. It is a very difficult time for him. I am not saying your work will result in the same experience, but all good scientists need to face this possibility, joyfully if possible.

———

my email to her 13Apr2016

Julia

I’m sorry to say so, but your adherence to this stuff borders on the religious.

None of the 6 pieces you have emailed me contain substantial evidence for the public claims you make. My mind is open but you have failed to demonstrate your case.

The single randomised control study you constantly tout is the one with 80 ADHD adults and even then you could only say there was “preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults … The findings reported here need to be interpreted cautiously given the inconsistencies noted across raters; larger trials are required to determine how robust these preliminary findings are. … The field is plagued with poorly designed and controlled studies, often leading to erroneous conclusions.”
This conclusion is at huge variance with your public statements of your belief system.

How then can you stand my your public statements which inevitably lead desperate parents to shell out big dollars?

Here are some more quotes from your own material.

‘Journal of Attention Disorders-2014-Rucklidge-one year follow up RCT.pdf’
“For the small number of participants who stayed on micronutrients, the benefits conferred through the controlled trial were maintained. The results are limited by small sample, lack of blinding, expectation, and reliance on self-report of symptoms.”

Finally in ‘2015 Kaplan et al Nutritional mental health CPS.pdf’ which is a rather silly mishmash puff piece we get this breathless prose based on your belief system: “A bright new future of understanding, preventing, and treating mental disorders awaits us”

Kia ora
kevin1mccready@gmail.com
@kmccready
32 Hawera Rd
Kohimarama 1071
Auckland, New Zealand
+64 (0)9 528 1174 home
+64 (0)226 710 335 cell
https://kmccready.wordpress.com/about/

On Wed, Apr 13, 2016 at 12:17 PM, Julia Rucklidge <julia.rucklidge@canterbury.ac.nz> wrote:

Attached a few studies on ADHD. These are not for circulation. Only for personal use. I am not sure what claims you are referring to. If you want to better understand why one would need nutrients above a healthy diet, please read the Kaplan article or watch my TEDx talk: https://www.youtube.com/watch?v=3dqXHHCc5lA to start thinking differently about the role additional nutrients might play for some people.

Kind regards Julia

From: Kevin McCready [mailto:kevin1mccready@gmail.com]
Sent: Tuesday, 12 April 2016 5:18 p.m.
To: Julia Rucklidge
Cc: Kathryn Darling
Subject: Re: FW: ADHD Study

Thanks Julia

When I tried to download full study, it was paywalled. Could you please email me the full study or studies which supports your claims.

Kia ora
kevin1mccready@gmail.com

@kmccready

32 Hawera Rd
Kohimarama 1071
Auckland, New Zealand
+64 (0)9 528 1174 home
+64 (0)226 710 335 cell
https://kmccready.wordpress.com/about/

On Tue, Apr 12, 2016 at 12:04 PM, Julia Rucklidge <julia.rucklidge@canterbury.ac.nz> wrote:

Dear Kevin,

Kathryn forward your email to me as the Director of the Mental Health and Nutrition Research Group.

We share your concerns about there not being enough research on alternative therapies and therefore our lab is set up independent of the companies that sell the products in order to study the efficacy and safety of micronutrients for mental illness. If you go to our website, you will see that we have published a range of trials from open label to the gold standard double blind RCT, with more under review, and 3 further RCTs underway in our lab.

Kind regards,

Julia

Julia Rucklidge, PhD, CPsych, FNZPsS
Professor of Clinical Psychology

Director of the Mental Health and Nutrition Research Group
Clinical Psychologist
Department of Psychology
University of Canterbury
Private Bag 4800
Christchurch 8140
New Zealand
Phone: 64-3-364-2987-7959
Fax: 64-3-364-2181
Email: julia.rucklidge@canterbury.ac.nz

Follow me on twitter: @JuliaRucklidge

https://www.researchgate.net/profile/Julia_Rucklidge/publications

web: http://www.psyc.canterbury.ac.nz/people/rucklidge.shtml

From: Kevin McCready [mailto:kevin1mccready@gmail.com]
Sent: Monday, 11 April 2016 4:16 p.m.
To: Kathryn Darling
Subject: Re: ADHD Study

Opps. here’s what I posted:

As I suspected an “open label trial”. If you follow the links on this bullshit naturopath boost, it’s very sad how desperate, uneducated parents are conned into forking over good money for bottled vitamins you get from a healthy diet. Pyramid selling schemes and all. And it’s pathetic that certain universities are willing to prostitute themselves to the altmed industry. http://blog.healthy.co.nz/22267-2/ Here’s the registration info. Judge for yourself. Australian New Zealand Clinical Trials Registry, ID number ACTRN12613000896774 And the final sad is a media untrained to ask basic questions as to why an open label trial with 14 kids is worthy of report.

Kia ora
kevin1mccready@gmail.com

@kmccready

32 Hawera Rd
Kohimarama 1071
Auckland, New Zealand
+64 (0)9 528 1174 home
+64 (0)226 710 335 cell
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On Mon, Apr 11, 2016 at 4:14 PM, Kevin McCready <kevin1mccready@gmail.com> wrote:

Thanks Kathryn

I’ve had a look and in the interests of full disclosure I should let you and the team know what I think. Here’s what I posted on Facebook to someone who was promoting it:

Kia ora
kevin1mccready@gmail.com

@kmccready

32 Hawera Rd
Kohimarama 1071
Auckland, New Zealand
+64 (0)9 528 1174 home
+64 (0)226 710 335 cell
https://kmccready.wordpress.com/about/

On Mon, Apr 11, 2016 at 3:43 PM, Kathryn Darling <kathryn.darling@pg.canterbury.ac.nz> wrote:

Hi Kevin,

If you go to http://www.bit.ly/childadhd you will find a link to register interest, and another link to an information sheet.

The trial is registered on the Australian New Zealand Clinical Trials Registry, ID number ACTRN12613000896774.

If you have any specific questions, I’m happy to answer them or forward you to someone who can.

Kind regards,

Kathryn Darling

Research Coordinator

Mental Health and Nutrition Research Group
Psychology Department

University of Canterbury

Private Bag 4800

Christchurch 8140

Phone: (03) 364 2987 ext. 7705

From: Kevin McCready [mailto:kevin1mccready@gmail.com]
Sent: Monday, 11 April 2016 3:23 p.m.
To: Kathryn Darling
Subject: ADHD Study

Kia Ora Kathryn

Re:
http://www.psyc.canterbury.ac.nz/research/Mental_Health_and_Nutrition/Child%20ADHD%20Study.shtml

Hoping you might have a link to where the study is described and registered?

Kia ora
kevin1mccready@gmail.com

@kmccready

32 Hawera Rd
Kohimarama 1071
Auckland, New Zealand
+64 (0)9 528 1174 home
+64 (0)226 710 335 cell
https://kmccready.wordpress.com/about/

my email 14Apr2016
Dear Julia

Thank you for your email.

Your own public comments exceed by far the published findings of your own research. You have not explained to me why this is so. To blame the media is disingenuous.

To accuse me of being close minded when it is you who make public statements which cannot yet be supported by science, particularly when those statements are also contradicted by the words of your own published work is actually very revealing.

It is common for adherents of any hypothesis to call for more research in the hope of finding support for their beliefs. Generally their emotional/intellectual attachment makes them unsuitable to judge when enough research is enough. I use the dyad term ’emotional/intellectual attachment’ carefully in terms of what we know about brain function as rather nicely revealed by the Capgras Delusion [link to my blog] to which we are all, myself included, subject.

You clearly have an emotional investment (in terms of your beliefs and your reputation) and a financial investment (in terms of your salary) in this hypothesis. It is very unfortunate that your public statements are being seized on by naturopaths and other quacks who seek to gain financially. I know you have no control over that, but I have not heard you caution that the science is not yet strong enough to support the extreme claims being associated with your name (a simple internet search reveals these).

Finally, I urge you to take a look at yourself in consultation with the community of scientists [link to Orsekes youtube vid] (not just those academics supporting your own hypothesis) and be much more careful in expressing yourself in future.

———-

Lipreading is not about ‘reading’ the shape of the lips

My wife Joanna wears hearing aids and lip reads more than she knew. Now I know why she often nodded in agreement when she hadn’t really heard me. We cut a deal a long time ago that she asks me to repeat if she’s not sure.

Asphyxia

Lipreading

There’s a misconception that lipreading is just like reading a book. You look at the mouth and read, right?

But no, it’s far, far more complicated than that. I have to queue up words in my mind, invent possibilities that fit the facial expression, body language, approximate number of syllables etc etc. Sometimes there are a couple of possibilities, and I hold both in my mind simultaneously, waiting for it to become clear. While I’m doing this, collecting possibilities and sifting through them all, I need to keep the conversation going. So I smile and nod and say ‘mmm,’ and ‘yep…’ as appropriate. If I don’t do that, the speaker stops, and we haven’t gotten anywhere.

Sometimes though, I get right to the end, and I realise that none of the possibilities work. The whole thing just doesn’t make sense. And then I have to say, ‘Sorry, can you go…

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