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Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities, 2008, 43(3), 334–341<br />
© <str<strong>on</strong>g>Divisi<strong>on</strong></str<strong>on</strong>g> <strong>on</strong> Developmental Disabilities<br />
Therapeutic Interventi<strong>on</strong>s in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Belgium in<br />
Support of People with Profound Intellectual <strong>and</strong><br />
Multiple Disabilities<br />
Carla Vlaskamp <strong>and</strong> Han Nakken<br />
University of Gr<strong>on</strong>ingen<br />
Abstract: For several reas<strong>on</strong>s, people with profound <strong>and</strong> multiple disabilities may be offered a variety of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s. Thus far, researchers have shown a limited interest in providing an empirical base<br />
for <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s. Research is needed <strong>on</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>oretical rati<strong>on</strong>ale (if any), <str<strong>on</strong>g>the</str<strong>on</strong>g> supposed ‘modus oper<strong>and</strong>i’<br />
<strong>and</strong> <str<strong>on</strong>g>the</str<strong>on</strong>g> claimed benefits of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s. As a first step, this paper offers an overview of <str<strong>on</strong>g>the</str<strong>on</strong>g> use of<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s. A total of 48 settings in <str<strong>on</strong>g>the</str<strong>on</strong>g> Ne<str<strong>on</strong>g>the</str<strong>on</strong>g>rl<strong>and</strong>s <strong>and</strong> Belgium were included in this study. Results<br />
show that some interventi<strong>on</strong>s are very frequently used, with Snoezelen, Sensory Integrative Therapy, Equine<br />
Therapy, Basic Stimulati<strong>on</strong> <strong>and</strong> Aroma<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy being <str<strong>on</strong>g>the</str<strong>on</strong>g> most comm<strong>on</strong>. Only <strong>on</strong>e of <str<strong>on</strong>g>the</str<strong>on</strong>g>se five has been subjected<br />
to a number of carefully designed studies. Nearly a third of all <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s currently in use are not<br />
clinically evaluated. Of those that are evaluated, more than half are <strong>on</strong>ly evaluated m<strong>on</strong>thly or even less<br />
frequently. The article ends with a call for an effective research strategy to separate interventi<strong>on</strong>s that are<br />
beneficial to people with PIMD from those that are unsubstantiated.<br />
In <str<strong>on</strong>g>the</str<strong>on</strong>g> support of people with profound intellectual<br />
<strong>and</strong> multiple disabilities (PIMD), practiti<strong>on</strong>ers<br />
in centers for special educati<strong>on</strong>, day<br />
services centers <strong>and</strong> residential facilities use a<br />
series of <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic interventi<strong>on</strong>s that aim to<br />
achieve a broad spectrum of claimed effects,<br />
ranging from ‘feeling good’ <strong>and</strong> ‘restoring a<br />
natural balance’ to developmental effects <strong>and</strong><br />
regaining functi<strong>on</strong>s. These interventi<strong>on</strong>s or<br />
procedures are generally not carried out by<br />
medical staff but by direct support staff members<br />
or <str<strong>on</strong>g>the</str<strong>on</strong>g>rapists (such as physio<str<strong>on</strong>g>the</str<strong>on</strong>g>rapists or<br />
speech <str<strong>on</strong>g>the</str<strong>on</strong>g>rapists). In practice-oriented journals,<br />
popular magazines <strong>and</strong> <strong>on</strong> televisi<strong>on</strong> <strong>and</strong><br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> internet, a large range of <str<strong>on</strong>g>the</str<strong>on</strong>g>se interventi<strong>on</strong>s<br />
or <str<strong>on</strong>g>the</str<strong>on</strong>g>rapies are documented. They may<br />
claim ‘to cure’, such as Gentle Teaching, for<br />
example, which promises to cure self-injurious<br />
behavior by using unc<strong>on</strong>diti<strong>on</strong>al acceptance<br />
<strong>and</strong> a gentle touch. They may promise impor-<br />
The authors would like to thank prof. dr J.H.<br />
Hogg for his comments <strong>on</strong> a previous versi<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g><br />
manuscript. Corresp<strong>on</strong>dence c<strong>on</strong>cerning this article<br />
should be addressed to Carla Vlaskamp, Department<br />
of Health Care Psychology, University of Gr<strong>on</strong>ingen,<br />
Grote Rozenstraat 38, 9712 TJ Gr<strong>on</strong>ingen,<br />
The NETHERLANDS. Email: c.vlaskamp@rug.nl<br />
334 / Educati<strong>on</strong> <strong>and</strong> Training in Developmental Disabilities-September 2008<br />
tant sounding but vague benefits, such as<br />
Therapeutic Touch, which states that <str<strong>on</strong>g>the</str<strong>on</strong>g>re is<br />
‘a natural human potential which can be actualized<br />
through <str<strong>on</strong>g>the</str<strong>on</strong>g> intent to help or enhance<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g> recipients’ own ability to support<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>mselves towards wholeness,’ or ‘Dolphin<br />
<str<strong>on</strong>g>the</str<strong>on</strong>g>rapy’ which states that ‘swimming with dolphins<br />
makes children with special needs learn<br />
up to four times faster <strong>and</strong> more intensively.’<br />
These kinds of interventi<strong>on</strong>s are used<br />
throughout <str<strong>on</strong>g>the</str<strong>on</strong>g> human services area, <strong>and</strong><br />
while no area or enterprise has been immune<br />
to <str<strong>on</strong>g>the</str<strong>on</strong>g> phenomen<strong>on</strong> of unsubstantiated <str<strong>on</strong>g>the</str<strong>on</strong>g>rapeutic<br />
interventi<strong>on</strong>s, <str<strong>on</strong>g>the</str<strong>on</strong>g> field of profound<br />
<strong>and</strong> multiple disabilities appears to be particularly<br />
vulnerable. This may be due to several<br />
reas<strong>on</strong>s. Firstly, <str<strong>on</strong>g>the</str<strong>on</strong>g>re is <str<strong>on</strong>g>the</str<strong>on</strong>g> size <strong>and</strong> complexity<br />
of <str<strong>on</strong>g>the</str<strong>on</strong>g> disabilities of those with PIMD. In<br />
additi<strong>on</strong> to <str<strong>on</strong>g>the</str<strong>on</strong>g>ir profound intellectual <strong>and</strong><br />
severe or profound motor disabilities, individuals<br />
with PIMD also have a high prevalence of<br />
sensory disability (Nakken & Vlaskamp, 2006;<br />
Schrojenstein, Lantman-de Valk et al., 1997;<br />
Van Splunder, Stilma, Bernsen, Arentz, &<br />
Evenhuis, 2003). Fur<str<strong>on</strong>g>the</str<strong>on</strong>g>rmore, as well as <str<strong>on</strong>g>the</str<strong>on</strong>g>se<br />
impairments, people with PIMD have an overall<br />
risk of developing medical complicati<strong>on</strong>s<br />
<strong>and</strong> almost all require regularly administered