Monday, July 19, 2010

Why we are awesome

Skepticism and critical thought is important.  It saves people money, protects them from making bad decisions, stops them wallowing in wishful thinking and it saves lives.

I have another - less happy - anecdote on a similar topic.  I know a couple who have a child with Asperger’s Syndrome, a distressing condition on the autism spectrum.  At times, the child’s behaviour has been troublesome, which has been difficult for everyone: the child himself, his parents, his teachers, his siblings…

In some desperation, his parents tried remedies that were not skeptically informed.  They tried magic fish oil, enthusing in raptures over its supposed effects and claiming improvements in behaviour which, if they were there, nobody else could see.  They tried cranial osteopathy, which is stone-cold bullshit (I seem to be mixing metaphors a lot lately). 

These are for the most part, rational, intelligent, web-savvy people.  Rather than look up information about cranial osteopathy, they believed what the osteopath said.  They were very impressed indeed with her, and were again highly enthusiastic.  They seemed to look on her unquestioningly as an authority because she said what they wanted to hear: they wanted a silver bullet.  Before the kid’s asperger’s was diagnosed, they’d noticed he was slow to start talking and had quite a bit of difficulty while learning.  They arranged some speech therapy for him….but didn’t keep it up because the visits were inconvenient.  I’m not meaning to sound harsh here – I’m not judging them – it’s just the kind of thing that points to their wanting a silver bullet.  Rather than working hard, it looks from outside as though they wanted the problem to go away.  There were other examples.  They kept saying that things would get better when he went to school… then when he got a teaching aid… then when he got to the next school… then when he was formally diagnosed….

There’s a excellent happy ending part and a more unfortunate part. 

The good is that the kid’s parents got him a scholarship at a school that specialises in disorders of his type.  He loves the school, he fits in well, has friends, and is having none of the quite severe behavioural problems that characterised his early life.

The bad part is that there’s no evidence the parents learned anything.  When they started with the fish oil, I explained that the evidence wasn’t really there (this was back when omega 3 was relatively new on the scene, so it was hard to point to debunkings).  They listened politely, but resolved to try it anyway.  Fair enough, no immediate harm done (although wishful thinking can itself be harmful).  When they went to the cranial osteopath, I was more forceful about the fact that it wouldn’t work.  I don’t think I was a dick about it.  I was trying to help and did so by pointing to resources that were sympathetic but honest.  They didn’t react well.  They shut off the lines of communication on that subject.  They didn’t want to hear it.  They only wanted to hear positive things, as though trying something was the same as doing good.

The school seems to be working.  It works because the staff are experienced and know what they are doing.  They’ve observed the behaviour of children with such conditions, they’ve theorised about how to treat them for maximum benefit and they’ve tested it out.  They’ve presumably measured the results (formally or informally) and modified them until they work best.  Hopefully they are still modifying their approach on a daily basis. 

The lesson the parents could have taken home from what happened is that there are good and bad reasons for believing something works.  Wishful thinking is a bad reason.  Track record is a good one. Their track record of believing in things with a bad track record is bad.  Or good. I’ve confused myself.  Instead, they feel vindicated.  They tried a bunch of stuff and eventually one worked.  This is not a vindication of their strategy, it’s serendipity.  If they hadn’t been looking for a silver bullet and they’d put more effort into researching potential treatments, they might have arrived at a good one sooner and the kid might have avoided a lot of anguish.

I know I’m being harsh. I’m not judging the parents and I’m not claiming I’d have done better.  I understand the impulse to try things that are not supported by evidence when nothing so far has seemed to help.  But there’s no excuse for not recognising and learning from one’s mistakes. 

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