What you Call Something Matters

I have some significant concerns about quackery in the therapeutic products that are developed by some practitioners who serve the special education community.

While there is identifiable value to be found in some of the therapeutic components associated with “gestalt language processing” [GLP], the foundation itself is nonsense (including the fiction called “delayed echolalia”), and the consequently harmful parts should be repaired. I will offer a taxonomy to help clarify such notions as imitation, repetition (scripting and automatizing), and the various echophenomena… mahna mahna… ^⇲

Furthermore, in special education (particularly as student needs become increasingly intense), substantial competence around interoception (and its related concepts) is vital to the design and implementation of therapy; unfortunately, the term “interoception” has come to be used as little more than a marketing buzzword in some therapy products (some of which make an appeal to GLP). I will offer some clarity around that set of concepts as well.

We can and should care for people better than this.

A Plea for Open-mindedness in the Beforemath ^⇲

After focusing so intently on the rank prevalence of quackery in our shared culture (especially on this side of COVID), I find that cynicism is plaguing me; consequently, I am not feeling very confident that this discussion will make enough of a difference, given that:

• those whose skills provide them with sufficient immunity to quackery probably already know all of this stuff; while in contrast,

• those who sacrifice the data to save their speculations will likely reject everything that is written here and wander away unscathed.

Given the conservative environment, it can be difficult not to wallow in such absolutes. But I have friends for whom this material might be helpful, and they represent a world of difference.

I have put out some feelers over the years, so I know that some among you are already feeling the rumblings of a compulsion to excuse these misleading labels (or to defend them outright); however, please first consider the following:

• I agree with you about the aspects that have value, such as supporting a person’s use of unconventional language (whether as their volitional selection among accessible alternatives, or as a compensatory strategy); and

• I agree that imitation occurs within GLP (albeit no such repetition can be functionally attributed to “delayed echolalia”); however,

• I disagree with the description of “gestalt language processors” as cognizing actual gestalts (given that they are using unconventionally long phrases precisely because they have not yet accessed the ability to segment that time-series into the parts from which a gestalt emerges); and, finally,

• I take exception to the commercial blood-letting of “interception” for selfish consumerization (which is contemptible in a therapeutic community).

Having said all of that, I’d like to feel that I didn’t still have to make the following request, but:

Please remain open minded (for a while at least).

In other words, if you do decide to tear into me (which is fine for you to do^⇲), I won’t engage with your critique unless you have at least read the material first (which is just as fine of me^⇲).

Now that the stage is set, we can proceed with (a variable reverence for) caution.

Recipe for Snake Oil

Some people are exceeding their competence by wandering outside of their scope of practice, well beyond the range of their education and experience, into areas for which no research exists. ^⇲

The “wandering outside” part is not the problem; in fact, transdisciplinarity is best served when people make broad forays into the wide world. We want people to scale their fences to travel yonder realms. We want people to explore where dragons be.

It’s the “exceeding their competence” bit that puts others at risk.

Their expertise in one field leads them to express their speculations about another as if they were an informed authority there as well. They assume pathology in observed behavior, then try to analyze those dysfunctions by spinning imaginative stories about underlying functions. Because they have only fractured ideas about how the targeted system works, their guesses end up being wrong, no matter how much it feels like the truth to them. ^⇲

Then they stuff it all in a container, slap a clever name on the label (making sure to buy the domain name), and sell the artfully boxed sets (in association with paid training, of course).

The Slick Pitch

The lack of evidence to support their speculation is written off with various types of cavalier comments, such as these real-life examples:

• “The research is still in progress.”

• “All we need now is the research.”

That research will never be forthcoming when the speculation driving the hypothesis is a fantasy. Then there’s this sort of thing (which I have encountered in the likes of therapy product trainings):

• “Evidence-Based Practice denies an individual’s lived experience.”

• “I’ve been doing this for years. That’s all the evidence I need.”

Lived-Experience Informed Practice and Evidence-Based Practice are not at odds with one another (neither do they deny appeals to responsible Practice-Based Evidence). Which leads us to:

• “I just couldn’t make my students wait that long to get (my) help.”

What the developer really couldn’t wait for was their profit.

That’s what quacks do.

It’s Still a Duck

That assessment might sound harsh, and it’s also true that some quacks are well intentioned in their determined ignorance. So here’s one of my hopes for this tutorial, namely: that some self awareness might allow such vulnerable people to climb out of this pitfall.

No matter their intent, my concern is that this belief-based therapy is being dressed up in an authoritative costume and marketed as science.

Don’t get me wrong: I am not criticizing belief-based approaches.⇲ But if a client is being led to partake in a kind of faith-based healing – or any other kind of therapy, for that matter – then that participation should be grounded in their informed choice.

Therefore, what I object to is Feckless Reckless Bamboozlement (FRB).^⇲

Respecting What you Don’t Know

In large (but not entire) part, this behavior is captured by the Dunning-Kruger Effect, in which insufficient knowledge can lead people to overestimate their competence. ^⇲

There.

Done.

You now have knowledge insufficient for competence about the Dunning-Kruger Effect.

You can start to address this very insufficiency by reading the article referenced in the popup.

You can continue by reading Adam Grant’s Think Again, in which he refers to the DKE as an example of “failing to realize that we’ve climbed to the top of Mount Stupid without making it over to the other side.” ^⇲

You could also read more of this article.^⇲

Guideline #1: Consort with Wizards

Having consulted with some people who know even more about this topic than I do (despite it being well within my own domains of expertise), I am feeling competent enough to put forward the following advice with some confidence:

Consult with the people whose domains you have visited in your speculations.

That doesn’t seem too outlandish, does it?

In other words, before you go creating a product about which you know too little, collaborate with some people who know much more about what’s really going on than you do. Not such anecdotal archetypes as:

• “My friend said…”

• “I have a client who…”

• “I have a colleague who expressed an (equally uninformed) opinion…”

I mean something much more along the lines of:

• “I don’t have a license in this area, or anything remotely close to the equivalent real-life experience enjoyed by a bona fide practitioner in this field, so I shall meaningfully involve someone who does have stuff like that.”

Yes, I do understand that some people (a) exchange prescribed medicines, (b) engage in surgical procedures, and (c) jump off of cliffs, all on the basis of stories related by casual acquaintances; nonetheless, our reality imperative should be much more exacting for our therapeutic practice because our decisions affect other people. ^⇲

Guideline #1 should now be clear without any further rambling on my part.

Guideline #2: Invite Criticism

Having established that preliminary foundation, I now feel confident in suggesting further advice (drawing upon my own significant experience in the field of argumentation and rhetorical analysis, and having nonetheless consulted with other practitioners):

Elicit feedback from people who tell you how very wrong you are.

It’s not enough to talk with the people who praise the precocious children of your grand imagination and ambition. It is crucial to collaborate with some knowledgeable people who can identify the places where you might have gotten lost, dazed, and confused.

Yes, I’ve done that very thing in writing up this discussion. I checked in with folks.

“Why?”

Good question. I’m glad you asked.

Because one of the best ways to navigate beyond the DKE is to have other people evaluate your competence, rather than just listening to yourself saying how great your own ideas are, and telling yourself how right you are about everything.

Look, here’s the thing about research: it handily embodies masses of those “other people” whose collaboration you should meaningfully involve, some of whom will support your ideas (to one degree or another), and some of whom will not (likewise).

But if you aren’t willing to wait for the research, then at least don’t tell yourself that reading one article on a topic (or working with other specialists for years, or whatever) is the equivalent of an actual program of education and lived experience.

And that should be enough maundering to make Guideline #2 eminently clear.

Cautious Reiteration

As stated earlier, accomplishing the first thing on my list should have been easy, and I should be able to relax, but a desire to address irony drives me to reiterate:

Please do not overestimate your competence in your ability to avoid the DKE.

So far, all I’ve done is to (a) tell you a little bit about that dynamic, and (b) point you at a couple of books. Alone, that is insufficient for competence.

The next step is to take a look at a few examples where practitioners have built themselves grim fortresses to jealously guard the summit of Mount Stupid. I’d like you to see the kinds of things that I am trying to help people to avoid, where I am eventually going to address particularly insidious products in the CDS field.