When my brother Alan, who has autism, was in his twenties, my late mother (an inveterate matchmaker) told me that she was working on a marriage between him and a young woman with a similar disability. Her inspiration came from the movie David and Lisa, which told the fictional story of two young people with serious psychiatric difficulties who were "cured" through their mutual love for each other. I managed to talk my mother out of this idea, which I thought was based on her desperate wish for my brother to be normal. Like many parents of disabled children, my mom never stopped hoping for a miracle. Perhaps she thought that marriage, a role indicating achievement of adulthood, might overcome Alan’s very significant limitations. (She had similar fantasies about me).

Obviously, one’s reaction to any parent having difficulty accepting her/his child’s disability is, or should be, one of sympathy.

One should also remember that in the 1960’s parents received more blame than supports or services. But what is one to feel today, when a professional, however well-meaning, fosters such fantasizing and magical thinking? I saw this for my own eyes recently, when famed Israeli psychologist Reuven Feuerstein spoke proudly at a forum in New York of how he had arranged a marriage for his niece who has Down Syndrome, and urged (or more accurately, ordered) parents in the audience to marry off their developmentally disabled sons and daughters.

Personally, I have no problem with developmentally disabled adults getting married, when it is their own idea. In fact, much of my professional writing in recent years has been about a logical extension of such marriages, namely parenting. But I do have a problem with anyone promoting the notion that marriage, or any other simple intervention, can bring about miraculous increases in competence or social success. For Feuerstein, marrying clients off is but the latest of several magical solutions that he has aggressively promoted to parents. He is primarily known for a cognitive intervention, Feuerstein Instrumental Enrichment (FIE), which he claims (with little empirical support) will bring about dramatic increases in intelligence in persons with mental retardation. And he has been quite successful in persuading parents in Israel to subject their children with Down Syndrome to an even more radical intervention (again, for which there is little empirical support), namely to alter their facial appearance through plastic surgery.

There are three things that bother me about Feuerstein, and other professionals, who promote what I feel are magical ideas to parents of children with disabilities. First, I believe (and so do ethical codes for psychology and most other disciplines) that one must temper one’s enthusiasm for an intervention with concern about evidence of its efficacy. All too often, proponents for magical interventions go about their business with a quasi-religious fervor, rely heavily (as do revivalist preachers) on first-person testimonials, and tend to dismiss objective scientific studies, when they are non-supportive, as unnecessary and irrelevant.

My second objection is based on the principle (again, one reflected in ethical codes) that professionals should respect the autonomy, values, and most importantly, vulnerabilities of clients, and resist imposing treatments on them. Many professionals promoting magical solutions cross way over the line, in my opinion, and promote much too vigorously their own views regarding treatment options.

Third, speaking from painful personal experience, I believe that healthy family adaptation to a disabled member requires a balancing act between hope and realism. While skilled and supportive programming can help persons with developmental disabilities to achieve undreamed-of successes and satisfactions, it is foolish to assume that limitations imposed by biological anomalies do not exist or can be easily overcome. What is worse, advocating such an idea can make family adaptation (i.e., realistic acceptance) more difficult, and can divert resources and attention away from other, less messianic, interventions that could be of real benefit. In short, those espousing magical cures raise, or reactivate, false hopes among family members and interfere with the healing process which is essential to family harmony and to the happiness of individual family members.

Complicating the picture is the rise of the phenomenon of "political correctness," and the extent to which certain therapies are evaluated more on the basis of their value orientation than on the basis of factual merit. This is most clearly seen with respect to the phenomenon of Facilitated Communication (FC), in which supporters of the practice have managed to turn the debate over FC into a litmus test for how one feels about integrated services and the value of persons with disabilities.

It is not an accident that autism is the branch of developmental disabilities where magical cures seem to be most widely espoused and where parents seem to be especially receptive. Among the many bandwagons which professionals and parents interested in autism have jumped on over the past couple of decades are: Sunrise, the Bettelheim Method, Doman-Delacato (patterning), the Lovaas Method, Holding Therapy, Auditory-Integration Therapy, Mega-Vitamin Therapy, Cranial Massage, Animal Therapy, and (most spectacularly of all) Facilitated Communication. Factors contributing to autism’s status as a breeding ground for faddism will be discussed below.

Perhaps the biggest reason why faddism is so prevalent in autism is that the condition is such a mystery. Many theories about autism abound, and researchers have yet to agree on the causes, or even the essential features, of autism. The failure of legitimate scientists to provide adequate answers opens the door for fads and fakers.

Another reason why autism is fertile ground for faddism is that there is such variability both within and among persons with the disorder. Thus, even when possessing IQ in the range of mental retardation, persons with autism typically have areas of average or even genius functioning, which causes us to overestimate their overall ability and potential. Furthermore, autism provides a broad umbrella under which can be found persons with very different levels of impairment (the recent invention of the sub-type of "Asperger’s disorder" is a recognition that some persons with autism are quite high functioning). Thus, claims for "cures" may reflect the fact that some individuals are less impaired to begin with, and are likely to make a relatively good adaptation regardless of the intervention used.

Because the biological causes of autism are so poorly understood, because of the variability in competencies both within and among persons with autism, and because the diagnostic process for children with autism is typically protracted and unsettling, parents of children with autism often have a very difficult time (compared even to parents with other developmental disabilities) in coming to terms with the reality and finality of their son’s or daughter’s condition. Thus, parents of autistic children are especially vulnerable to claims and entreaties made by proponents of magical cures and treatments.

Contributing to the problem of faddism in disability services is the fact that disability professionals from certain disciplines, even those possessing doctorates, receive remark-ably little exposure to the literature on low- incidence disorders and possess little ability to evaluate the claims made by proponents of human service fads. This "dumbing down" in professional training results in large numbers of persons in helping roles who possess little true knowledge or expertise and (what is even worse) little insight into the extent of their own ignorance.

A related problem is that many persons in the disability field have received no training in professional ethics, and may even lack familiarity with their own discipline’s code of conduct. A result of this state of affairs is a lack of sensitivity to the ethical problems posed by over-zealous promotion of questionable therapies by practitioners with dubious qualifications. Thus, while some of the shaky practice (as in any field) may be traceable to people of unscrupulous morality seeking to enrich themselves by consciously peddling what they know to be snake oil, the bulk of the problem is traceable to well-intentioned but gullible professionals who lack sufficient understanding of their ethical obligations to clients and families.

Contributing to the phenomenon of quackism is the fact that the field of chronic disabilities lacks clear guidelines for evaluating the effectiveness of standard, let alone experimental, procedures. Too often, practitioners who are considered in the vanguard of their profession engage in practices which later come to be seen as ineffective or even, in some cases, downright harmful. This is certainly the case with pre-frontal lobotomy, which was once quite widespread (it was performed, for example, on the sisters of two of the most famous Americans of the Twentieth century: John F. Kennedy and Tennessee Williams). Yet, this practice, now universally condemned as grievously harmful, was performed by prominent neurosurgeons in some of our most prestigious medical schools, and sold to unsuspecting and anguished parents as a plausible answer to their desperate prayers.

My basic message in this article is, therefore, that family members need to exercise caution when receiving advice from professionals (or laypersons, for that matter) promising to bring about dramatic changes in their son or daughter with developmental disabilities. Not everyone posing as an expert, even those with advanced degrees and fancy reputations, knows what he or she is doing. It is an unfortunate fact of life, as we approach the end of this century, that wariness must be the order of the day, even towards professionals and agencies whom we rely upon to help us deal with one of life’s greatest heartaches.