The Dore programme is an interesting ‘cure’ for all kinds of things: as Dorothy Bishop puts it, “Dore Achievement Centres are springing up world-wide with a mission to cure cerebellar developmental delay, thought to be the cause of dyslexia, attention-deficit hyperactivity disorder, dyspraxia and Asperger’s syndrome. Remarkable success is claimed for an exercise-based treatment that is designed to accelerate cerebellar development.” Sound great, doesn’t it. Except, as Bishop shows in a new journal article, this is not supported by good evidence and it is therefore the case that “the claims made for this expensive treatment are misleading”. While academic journals are normally pretty restrained, this is about as close as I’ve seen to a thoroughgoing fisking in a journal article: Dore, and their research, are really pwned here. Given that – according to Ben Goldacre in the Guardian – a course of Dore treatment costs around £1,700 (and takes a load of time) I’d want much better evidence of efficacy before splashing out.
Dore is certainly well-promoted. Google “Asperger’s Syndrome” and it brings up an advert for Dore’s “Proven Long Term Drug-Free Solution Relieving the Symptoms of Aspergers”. Google “dyspraxia” and an advert informs one about Dore offering a “Proven Long Term Drug-Free Solution Relieving the Symptoms of Dyspraxia”. Google “dyslexia” and an advert promotes Dore as a “Proven Drug-Free, Exercise Based Dyslexia Remedy”. As a slick Dore promotional DVD puts it: “Now Dore Centres are able to offer real hope to those in despair” due to suffering from ‘learning disorders’. This includes Asperger’s Syndrome, which Dore’s UK site describes as “a problem associated with poor social behaviour.” Dore is apparently “suitable for those with high functioning Asperger’s Syndrome and Autism” (are any alternative treatments nowadays not marketed as suitable for people on the autistic spectrum?).
This marketing might make Dore seem appealing. Bishop notes that, “Although most of the promotion of the treatment is based on personal testimonials, these are backed up by research. Dore pointed to a study showing that treatment led to a nearly fivefold improvement in comprehension, a threefold improvement in reading age, and a 17-fold improvement in writing.” Sounds good, right? But the quality of the research was pretty dismal. Among other problems, while the research did include a control group
there were no data corresponding to a time when the treatment group had had intervention and the control group had not – because the control group had embarked on treatment at the end of the first phase. Accordingly, the authors presented the data only from the treated group.
‘Oops’, is all I can say…Bishop puts it more eloquently, making clear that “The publication of two papers in peer-reviewed scientific journal (Dyslexia) has been presented as giving further credibility to the treatment. However, the research community in this area has been dismayed that work of such poor standard has been published.” I wonder how the researchers justified this poor control to Dyslexia – maybe the good old excuse that ‘the dog ate my control group’?
This might sound bad for Dore, but that’s not the half of it – Bishop also takes apart Dore’s posited mechanism of action:
The gaping hole in the rationale for the Dore Programme is a lack of evidence that training on motor-coordination can have any influence on higher-level skills mediated by the cerebellum. If training eye–hand co-ordination, motor skill and balance caused generalised cerebellar development, then one should find a low rate of dyslexia and ADHD in children who are good at skateboarding, gymnastics or juggling. Yet several of the celebrity endorsements of the Dore programme come from professional sports people.
So, aside from lacking a plausible mechanism of action, and lacking good evidence of efficacy, Dore seems like a great idea. If that leaves anyone rushing to get out their cheque book, Bishop kicks the dead horse a few more times. It’s therefore also worth quoting Bishop’s key points about the Dore treatment:
1 The treatment offered by Dore Achievement Centres is being promoted as a “drug free” alternative to conventional treatment for ADHD, and as a ‘miracle cure’ for dyslexia. It is presented as having a neurological rationale and gains credibility by appearing to be medical treatment.
2 The publication of two papers in peer-reviewed scientific journal (Dyslexia) has been presented as giving further credibility to the treatment. However, the research community in this area has been dismayed that work of such poor standard has been published.
3 The research purporting to show efficacy of the treatment does not show sustained gains in literacy scores in treated vs. control children. Furthermore, the intervention has not been evaluated on the clinical groups for which it is recommended.
Ouch. If only more articles in science journals were like this – clear, well-written, and brutal in a rather entertaining way – they’d make much better weekend reading…
17 Comments
October 16, 2007 at 12:30 am
[...] for dyslexia, ADHD and a load of other things. Dorothy Bishop recently published a paper showing that the evidence for Dore as a treatment for dyslexia and ADHD is woefully inadequate (it’s [...]
October 26, 2007 at 11:32 pm
Excellent post. I would really like to read Bishop’s paper. Can you offer a better deal than Blackwell’s 39USD for access?
November 1, 2007 at 9:41 am
[...] 1st, 2007 · No Comments You couldn’t make it up. Sue Foss – a Dore Sales Manager currently before an industrial tribunal – alleges that she was “ordered to go [...]
May 23, 2008 at 6:08 pm
[...] shame – I was pedantic enough to call and e-mail a number of media outlets to let them know about a new article trashing Dore’s research base, no-one chose to cover this story. There are definitely questions to be asked about the [...]
May 24, 2008 at 10:25 am
[...] as accepted as it was in mainstream teaching, and why such practice is not always evidence-based. HolfordWatch has also looked at how the research and the marketing claims do not always match up. LeftBrainRightBrain has gone [...]
May 25, 2008 at 4:37 pm
[...] The Dore Programme has enjoyed a lot of positive media coverage in the UK. Charismatic ambassadors told their stories of personal transformation. But the stories didn’t make clear that clients, many of them cash-strapped parents, needed to make up-front payments for their miracles. Eager parents were never told that there is no strong evidence that Dore could treat dyslexia, dyspraxia, ADHD or ASD. [...]
May 26, 2008 at 7:12 am
[...] Dore criticised in medical journal. [...]
May 26, 2008 at 8:16 am
[...] It is also surprising to see Wynford Dore claim that his treatment is scientifically proven, as Holfordwatch have reported, academics have cast serious doubt on Wynford’s logic and explanations and the little [...]
January 6, 2009 at 6:38 pm
[...] miracle for dyslexia (or any learning difficulty) – a fact that has been repeatedly, and forcibly, pointed out – but that did not stop Dore from extending the claims for his ‘miracle cure’ to [...]
February 27, 2009 at 8:44 am
[...] figure) has a misleading CV Jump to Comments Roy Rutherford – who was Medical Director of Dore, a company selling a ‘miracle cure‘ for various specific learning difficulties – is [...]
April 23, 2009 at 11:01 pm
[...] a post titled “why are Dore so bad at research”, and HolfordWatch have a post from October 2007 that is headlined “Dore pwned in medical journal: expensive and unproven ‘cure’”. [...]
May 23, 2009 at 4:47 pm
[...] to do certain things and one might argue, for example, that for example a tendency to carry out very bad research is a much more serious problem than poor [...]
July 20, 2009 at 7:51 pm
[...] issues that the segment fails to cover. Among other concerns: – There is no mention of the lack of good evidence that Dore is effective, or the high cost of the programme. – There is no mention that Dynevor, which now owns Dore, was [...]
August 4, 2009 at 12:25 pm
[...] The Times and Hopkins allow Quinnell to plug Dore Jump to Comments Sigh. John Hopkins in the Times has given Scott Quinnell substantial opportunity to plug the Dore treatment for specific learning difficulties (which Quinnell has now invested in). Quinnell is a former rugby international, and his current support of Dore does not change the fact that there is not good evidence that Dore works. [...]
September 28, 2009 at 10:08 pm
[...] news bulletin today to an uncritical plug for the Dore treatment for learning difficulties.* The lack of good evidence that the Dore programme works – and the fact that Dore UK went into administration last year – were not enough to [...]
November 9, 2009 at 10:00 pm
[...] There is no mention of the lack of good evidence that the Dore treatment is effective. [...]
August 3, 2010 at 10:43 am
[...] (here, here and here), have previously covered the collapse of Dore, a business promoting an unscientific and ineffective treatment for dyslexia and other specific learning disorders, into administration and their subsequent reincarnation, fronted by former rugby player, Scott [...]