Sunday, December 29, 2013

What's so good about "early," anyway?





















  1. This is an important message that applies in spades to early intervention for developmental disorders. I discuss it further here,, but in brief, everyone assumes that it is good to diagnose conditions such as dyslexia, autism, language impairment, etc, as soon as you can, because it is better to intervene before all the adverse secondary consequences kick in. With kids there's the additional notion of brain plasticity which is coupled with the idea that if you don't get in early, things may become entrenched. All seems sensible, except that we've got ample evidence that early screening picks up a lot of false positives: kids who are going to do fine anyhow without intervention. So what happens is that a lot of concern is generated, and resources are diverted to very young children who are thought to be 'at risk', so those who have more long-term persistent problems get less. Worse still, those doing the early intervention are encouraged by the large number of children who improve – unless, that is, they include an untreated control group, which shows the same proportion improve under their own steam.
    If we could achieve more accurate prediction of which children have a high probability of ending up with long-term problems, then I'd be all in favour of early screening so we could start intervention as soon as possible. But we're not there yet, and, as Jon Brock has noted ( some of those pushing for early intervention show a worrying lack of understanding of these issues.

    1. Extremely important points and extra reading - thanks!

  2. Why do I love your hand-drawn blue and green graphs so much more than the usual ones? Also love your summary: "Early detection means many people are fighting heroic battles that were never necessary." Thanks so much for all of this.

    1. That's so nice to hear - thanks! If you mean more than my usual ones, it could be because this looks more like paint. For this one, I used a different brand - they're gorgeous, but I don't have many colors in it.

  3. Nice work you did i am highly recommended here keep it continue.