LydiaPinkham2This is Your Brain on Placebos

It seems the Brits are way ahead of us. At least there’s an effort in the U.K. to disabuse educators of what are now called “Neuromyths.”


As I’ve mentioned, some citizens across the pond were aghast not only at BrainGym itself, but also at the amount of taxpayer money the government spent on it. By 2009, Education Secretary Ed Balls issued a statement admitting the program has no scientific basis. It was too late – BrainGym had caught on.

There’s no question that Neuroscience and Education are aligned. The question is whether teachers have accurate information. An Education and Neuroscience project was introduced earlier this month in England. A £6 million fund, established by the Wellcome Trust and the Education Endowment Foundation, supports the project in an effort to bridge an “evidence gap.” The Education Endowment Foundation’s chief executive, Kevan Collins, noted that the use of neuroscience in education was “often haphazard and not well informed.” Sir Peter Lampl, chair of the foundation, is quoted as saying, “Knowing the impact of neuroscience in the classroom will also make it easier to spot the plausible sounding fakes and fads, which don’t improve standards.”

Ah, British understatement.

Forbes’ headline is more direct: “Multimillion-Pound Brain Fund Set Up To Stop Teachers Buying Into Neuroscience Myths.”

The Education Endowment Foundation also offers an online Toolkit reviewing topics and techniques for cost and effectiveness. A related PDF document, “Neuroscience and Education: A Review of Educational Interventions and Approaches Informed by Neuroscience,” provides a lot of useful information and makes a handy guide. Similarly, the London-based Teaching and Learning Programme, with funding from the Economic and Social Research Council, published a PDF commentary, “Neuroscience and Education: Issues and Opportunities.” This handbook connects neuroscience, psychology and education with a clear, concise overview of current research.

Teachers aren’t to blame for “buying into” neuromyths. The ideas are often presented in professional development workshops sanctioned (or even required) by administrators. The products come loaded with glowing success stories from around the world, boasting the credibility of research and impressive results, all packaged in glossy wrappings. Plus, science can be downright intimidating. Just the jargon can be complicated enough to cause a depolarization of postsynaptic membrane potential. (No, I don’t really know what that means.) Why would a teacher question the product’s validity?

“There’s research!” is a label of credibility, the way “All natural!” on a cereal box marks it as health food. Looking at the studies behind the claims can be kind of fun, actually. (More fun than finding out your “all natural” cereal is loaded with sugar.)

Teachers want what is best for their students, and professional educators’ organizations frequently focus on research. This would have been a shorter post, but some research results made big headlines a few weeks ago. It’s a good example of how hype can overrun facts, especially when money is involved.

Case in point: Posit Science

Websites offering “brain games” have cropped up in recent years, selling subscriptions with claims of improving memory, concentration, reasoning, and other cognitive skills. I stumbled across one such site recently: Posit Science. It boasts “World Class Science” with “Peer-reviewed Research.”

The site doesn’t link to the actual studies, instead highlighting positive outcomes in marketing descriptions, but Google came through. The first study mentioned, IMPACT, claims to have improved memory skills as measured by the activity – in other words, if you practice something, you’ll get better at it. But it goes further in claiming that these skills transfer to other tasks involving memory. This was measured with “standardized neuropsychological assessments of memory and attention,” and without knowing what those are, it’s hard to say how similar the tasks are to the training method.

In any case, the gains didn’t last. Within three months, they were gone. “Previously significant improvements became nonsignificant at the 3-month follow-up for the primary outcome” and for other outcomes, a conclusion stated as “Training effects were maintained but waned over the 3-month no-contact period.” (Maybe there’s another definition for “nonsignificant.”)

Let’s look at the next one: The ACTIVE study — Advanced Cognitive Training for Independent and Vital Elderly. The Posit Science page trumpets amazing findings: “Large improvements in cognitive abilities; 35.6% reduction in risk of serious health-related quality of life decline; Effects that last 10+ years without further training.”

With NIH funding, the ACTIVE study took four groups of people over 65, and introduced a specific “training” to three of the groups: one designed to improve memory, one for reasoning ability, and one for speed of processing. A control group had no contact. Some were given “booster” training at intervals, and all were tested again after 5 years and after 10 years. However, the training taught specific strategies, so people learned new ways of doing things. (The memory group was taught mnemonic devices for remembering words; the reasoning group learned methods for decoding logical sequences of numbers.) Learning a new skill is different from maintaining existing abilities in memory and reasoning, but oh well. I’m just a teacher.

The “speed of processing” element used an earlier version of Posit Science’s “Double Decision” exercise. It requires fast perception of two images, and recalling one’s identity and the other’s position. It’s much like a Dalcrozian “quick-reaction” exercise, and the signal-response time progressively narrows. (It’s fun – try it!) According to Posit Science, the study “proves that healthy older adults can make significant cognitive improvements with appropriate cognitive training and practice. It also demonstrates that the Posit Science training in BrainHQ drives improvements that are significantly better than other types of cognitive exercise.”

Well, the results of all three kinds of training were reported, but the study wasn’t designed to compare them. The abstract first published in JAMA, 2002, states that the objective was “to evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older, independent-living adults.” That’s different than what Posit says: “The ACTIVE study was designed to compare three different types of cognitive training: one that focused on memory, one that targeted reasoning, and BrainHQ training that exercised speed of processing.” But oh well. I’m not a scientist.

The participants showed improvement, or lesser decline, on the specific skills in which they’d been trained, but the training didn’t improve performance of “everyday” tasks related to the memory, reasoning or processing (Instrumental Activities of Daily Living or IADL). The researchers note that this isn’t surprising, partly because “most of our subjects were not yet impaired in the domains of training.” (Well right, because people who were impaired were eliminated from the start.)

The 2006 follow-up didn’t show a transfer either, but for the BrainHQ exercise, results showed that “booster” practice helped more than practice helped in the other areas. So the NIH boasted, “Mental Exercise Helps Maintain Some Seniors’ Thinking Skills.” In JAMA, there’s a noncommittal incomplete sentence: “Long-term effects of cognitive training on everyday functional outcomes in older adults.”

The 10-year follow-up has just occurred. The NIH’s National Institute on Aging has the headline, Cognitive Training Shows Staying Power.” The results?

“At the end of the trial, all groups showed declines from their baseline tests in memory, reasoning and speed of processing. However, the participants who had training in reasoning and speed of processing experienced less decline than those in the memory and control groups.”

(So IF the study were about comparing the three kinds of training, that would be a big deal for Posit Science. I’m just sayin’.)

As for the effects on daily function:

“The current study showed weak to absent effects of cognitive training on performance-based measures of daily function.”

You wouldn’t know that from the headlines:

  • Health Day, 1/13/14. Gains of ‘Brain Training’ for Elderly Seen 10 Years Later: Problem-solving ability surpassed memory, study finds
  • Senior Journal, 1/16/14. Cognitive Training for Senior Citizens Shows 10-Year Benefit in Reasoning, Speed
  • Washington Post, 1/13/14. First large-scale study finds cognitive training aids in long-term function in older people
  • Washington Post, 1/20/14. Clinical trial funded by National Institute on Aging aimed at enabling seniors to maintain cognitive abilities as they age: Just a few brain workouts can have long-lasting benefits in seniors, study says
  • Reuters, 1/13/14. Brain training helped older adults stay sharp for years
  • Dallas News, 1/20/14. Health Alerts: The key to boosting brain function
  • Vancouver Sun, 1/15/14. Daily puzzle keeps the brain sharp
  • Business Wire, 1/13/14. Landmark Study Shows Benefits of BrainHQ Training Last 10 Years

Wait… Business Wire? Oh, yes. Brain-training is big business. In fact, this study’s Conflict of Interest statement shows that several of the scientists in this study are also involved in the commercial products used, including Posit Science.

“Drs. Unverzagt and Marsiske have received research support from Posit Science, Inc., in the form of site licenses for cognitive training programs for investigator-initiated research projects. Dr. Marsiske has received research support from Robert Wood Johnson Foundation and McKnight Brain Research Foundation and payment for development of education presentations from the National Academy of Neuropsychology and the International Neuropsychological Society for workshops on cognitive interventions and from the National Institute on Aging and American Society on Aging for overview presentation on cognitive interventions. Dr. Ball is a consultant and owns stock in the Visual Awareness Research Group and Posit Science, Inc., the companies that market the UFOV Test and speed-of-processing training software, now called Insight (the Visual Awareness Research Group invented Insight and the UFOV). Dr. Ball serves as a member of the Posit Science Scientific Advisory Board. Posit Science paid royalties to the Visual Awareness Research Group (unrelated to the study described). The Visual Awareness Research Group is an S Corp; all profits and losses flow to stockholders.” (Visual Awareness Research Group is run by Roenker, Ball, and one other colleague.)

One more time: Bal-A-Vis-X

Bal-A-Vis-X is yet another commercial enterprise of the BrainGym variety. The name stands for “rhythmic Balance, Auditory, Vision, eXercises for brain and brain/body integration.”

Here we go again.

The brainchild of Bill Hubert, a former teacher, Bal-A-Vis-X is:

“… a series of some 300 exercises, most of which are done with sand-filled bags and/or racquetballs, often while standing on a Bal-A-Vis-X balance board. Requiring multiple thousands of mid-line crossings in three dimensions, these exercises are steadily rhythmic, with a pronounced auditory foundation, executed at a pace that naturally results from proper physical techniques. Bal-A-Vis-X enables the whole mind-body system to experience the symmetrical flow of a pendulum.”

Apparently, Hubert was teaching first graders and “noticed, as we all worked on balance and rhythm, that now and then when a struggling student’s balance and rhythm improved, his/her academic performance also improved. 
Connecting these dots, then, posed this question: might fine tuning a child’s balance and rhythm simultaneously address his/her academic difficulties? What followed were more than 20 years of trial and error to find out.”

So did he find out?

As you’d expect from a commercial product like this, there are lots of anecdotes. It would seem tossing beanbags helps speech impairments, cognitive impairments, handwriting, sign language, occupational therapy, physical therapy, dyslexia, spelling, and rheumatism. (Okay, I made up the rheumatism part.)

From the videos on the website, the exercises look remarkably like old-fashioned Dalcroze exercises, minus the music. I emailed Hubert last year to ask whether he was influenced by Eurhythmics, and he replied that he was aware of it. The difference, he explained, is that his work is not about the sounds, but just the visual element.

He tells us more about how it’s different from other movement “programs” on the website.

“First, rhythm. And I mean natural rhythm. Not matching a tone or a metronome or a musical beat or any other outside source. The rhythms of Bal-A-Vis-X are the natural outcome of proper physical techniques–which techniques one learns and commits to muscle memory during our trainings.”

(But wouldn’t that also apply to typing, basketball, or shoveling snow?)

“Second, visual tracking. In a typical 30-minute Bal-A-Vis-X session one tracks across three “midlines” (side-side, up-down, near-far) probably 1,000 times.”

(I’m not convinced this matters, but in any case, I imagine badminton, four-square, or shopping at the mall would do the same.)

“Third, entrainment. The majority of our exercises are done with a partner and/or in concert with others. Synchronicity is always the goal. In a Bal-A-Vis-X setting no one is allowed to be a Lone Ranger, free to follow his own plan.”

(Is there any shortage of this in children’s lives?)

“Fourth, responsibility. As soon as you are fully competent with even a few exercises, you are immediately set the task of teaching those exercises to a new or less competent student–always, of course, under the trained eye of your instructor. You, still a student, are responsible for the new student while the instructor is responsible for you both. In time, as your competence grows, and you become less a student and more an instructor yourself, your responsibilities and confidence grow exponentially. Earned self-esteem naturally follows.”

(That’s fine, but it’s a fairly common teaching technique, and a frequent feature of children’s independent play.)

But what’s this? Research!

There are three research studies linked on the site. They are all designed and conducted by, no doubt, sincere and well-meaning teachers. But you don’t have to be a scientist to recognize that the studies aren’t scientifically valid.

  • As in many such studies, Bal-a-Vis-X process and effects aren’t distinguished from any other movement – jogging, dancing, sports, etc. We don’t know what, if anything, the control group did with their time, so it’s unclear whether any exercise, or other exercises with particular features, would have shown the same result.
  • All three studies begin with presuppositions about Bal-a-Vis-X. There’s nothing wrong with having biases or expecting particular results, but the studies were not double- blind or even single-blind, opening up huge possibilities for the testers’ own biases, behaviors, and expectations to influence results.
  • Much of the hypotheses rest on the same debunked theories aligned with BrainGym. One study quotes “research” to assert that children experience acute stress responses in school, which “tear at the foundational structure of the brain” and cause children to “freeze.” (Frequent acute stress responses might indicate a severe anxiety disorder.) It’s also claimed that stress moves blood flow away from one area of the brain. (I think blood flows through all parts of the brain, unless one is having a stroke. But I’m not a doctor.)
  • None of the studies describe random groupings. One grouped the students by classrooms, introducing different peer dynamics, classroom environments, teachers, etc.  Sample groups were small, and got smaller, and whether differences were statistically significant isn’t addressed. It’s also unknown whether pre- and post- tests were administered under the same conditions.

Like BrainGym, Bal-a-Vis-X is selling around the world.

It works!

Here are a few more things that work. (You can thank me later.)

  • How to feel good: Lydia Pinkham’s Vegetable Compound, a patent medicine first marketed in 1875, was said to ease all sorts of “female complaints.” Its remarkable ability to make women feel better came from a special blend of medicinal herbs… oh, and up to 20% alcohol.
  • How to lose weight: Wear this magic bracelet, or take this magic pill, or apply this magic skin cream… Also, follow the instructions enclosed for a 900-calorie/day diet and an hour of daily exercise.
  • How to make Stone Soup: You know this one, right? Start with a stone, and add olive oil, onions, garlic, carrots, celery, green beans, tomatoes, then stock… Stones are the secret to fantastic soup.

Yes, it works; but “it” isn’t always what we think it is.

Surely there’s no question that children are wired to move, play, and interact with each other. Their school days are so counter to their natural impulses, introducing small opportunities to move is like watering a thirsty plant. Add to that the excitement of special new activity (let alone an experiment!), the teachers’ expectations, and the predictions of a particular effect. There will probably be a result, but there isn’t any reliable evidence that specific beanbag exercises or “brain buttons” caused it. The commercial brain-training products are the stone in the soup.

There are many reasons people become convinced of things that aren’t true. It’s just human nature. I like the explanation at a blog called The Soap Box: “11 Reasons why people believe in Pseudoscience.” The #1 Reason: “It goes along with something they are trying to sell.”

“Sometimes belief in a pseudoscience doesn’t just make logical sense to some people, it can also make finical sense as well, especially if they are selling some product or service based on pseudoscience (like alternative medicine). This can be due to the combination of wanting something you’re selling to work, and customers telling you that it works.”

Indeed, there’s money to be made.

  • A press release from a company called “Sharp Brains” carries the headline, Brain Training and Cognitive Assessment Market Surpassed $1.3 Billion In 2013, Led by US and Asia Consumer Demand
  • Even back in 2010, the trend was clear. Here’s a fun headline: The Brain-Training Industry: A New Precious Gem to Mine? Forget Diamonds, the Internet and iPads – There’s gold in them synapses!”
  • Last August, the The Economist ran: Commercialising neuroscience — Brain sells: Cognitive training may be a moneyspinner despite scientists’ doubts
  • In December, the Wall Street Journal announced: Rosetta Stone to Acquire Fit Brains Creator Vivity Labs, Will Enter Fast-Growing Brain-Training Market

Again, there is nothing implicitly harmful or dangerous about Bal-a-Vis-X, BrainGym, or BrainHQ, but they teach children (and teachers) ideas that simply aren’t backed by facts. Whether or not the purveyors of these products intend to deceive, pseudoscience is their stock in trade. The money spent on these programs could be put to better use in schools; and taxpayer dollars are supporting NIH studies of commercial products when many communities have pressing needs for Health and Human Services.

Kids can do a lot with a jumprope, or a ball, or chalk and stones. It’s nothing new. For hundreds of years, children have taught each other street games in their own self-directed play. Naturally, these involved coordination, rhythm, socialization, quick reactions, sensory integration, mind/body connections and brain activity (which occurs 24/7, unless you’re dead). But nobody packaged and sold this, or claimed it cured dyslexia or helped kids spell better.

Now, activities that offer less than these old street games are packaged and sold as brain-training, backed by flawed research and debunked theories. They claim incredible benefits, and rely largely on anecdotal evidence. It’s big business. “It works” commercially. For that reason alone, it’s not going away any time soon.

And that’s unfortunate.