Ever since we got our first Macintosh computer in 1989 our family has been quite devoted to Apple products (currently our household boasts four Macs, an iPhone, five or six iPods, and an Apple TV). Peter and I even regularly read blogs devoted to Apple news and commentary. One of things these sorts of blogs do occasionally is report news stories about companies or school boards ordering huge quantities of Mac computers. (This is a holdover from the grim years in the 90s when Apple was tanking and Mac devotees desperately grabbed at any indication that someone—anyone!—thought the products were worth getting.)

Thus the “Apple press” noted a recent article in the New York Times by Alan Schwarz, which described a program in an elementary school district in Mooresville, North Carolina, that basically replaced most classroom learning materials by laptop computers. The board issued MacBooks to 4,400 4th to 12th graders in five schools. The results were stunning: (all quotes from the NY Times article)

The district’s graduation rate was 91 percent in 2011, up from 80 percent in 2008. On state tests in reading, math and science, an average of 88 percent of students across grades and subjects met proficiency standards, compared with 73 percent three years ago.…Mooresville ranks 100th out of 115 districts in North Carolina in terms of dollars spent per student … but it is now third in test scores and second in graduation rates.

The learning process was also changed considerably, with the students using individualized software modules and learning at their own pace. Teachers taught students on a more individualized basis, with more of their time spent on weaker students. This had good results in surprising areas:

…[weaker students don’t have to] struggle at the blackboard in front of the class; this dynamic has helped children with learning disabilities to participate and succeed in mainstream classes.

The tech press and computer geek takeaway from this seems to be that computers in classrooms = good. But these admittedly stellar results aren’t just the result of computers per se; they also required a complete overhaul of the educational method, which necessitated some sacrifices (often unpleasant ones) to fund the program:

Sixty-five jobs were eliminated, including 37 teachers, which resulted in larger class sizes — in middle schools, it is 30 instead of 18 — but district officials say they can be more efficiently managed because of the technology. Some costly items had become obsolete (like computer labs), though getting rid of others tested the willingness of teachers to embrace the new day: who needs globes in the age of Google Earth? …

Many students adapted to the overhaul more easily than their teachers, some of whom resented having beloved tools — scripted lectures, printed textbooks and a predictable flow through the curriculum — vanish. The layoffs in 2009 and 2010, of about 10 percent of the district’s teachers, helped weed out the most reluctant… others [had to be convinced] that the technology would actually allow for more personal and enjoyable interaction with students.

“You have to trust kids more than you’ve ever trusted them … Your teachers have to be willing to give up control.”

And that, not the laptops, is the crux of the argument. To implement a sea change like this you have to make sure enough people are onboard with it, teachers, parents, students and board alike. Assuming there wasn’t a huge kerfuffle regarding the mass layoffs (and with 10% getting canned how could there not be), the remaining staff (no doubt suffering drooping morale due to the firings and imposed changes) would be required to completely reinvent their teaching techniques, which is hard for employees in any field. Creating such a huge reliance on computers could be tough for many staffers—especially for ones unadept with technology—without a lot of support and encouragement from appropriate quarters. Administrators have to be forward-thinking and inclusive: The Mooreville board negotiated a deal so that poor families could buy broadband internet access at home for $10 a month.

The story about Mooreville’s schools is interesting, but it’s more than just a story about a school board giving Mac computers to all the kids. It’s about a school program that underwent an all-encompassing change in educational strategy and managed to make it work. And that is the great achievement.

A couple of years ago we posted (here and here) about Globe and Mail writer Ian Brown’s heartbreaking series of articles about his severely disabled son, Walker. Although most of Walker’s disabilities are much more profound than anything we’ve encountered, Brown wrote about issues, feelings, and thoughts that had an eerie resonance with us.

Brown has now expanded the articles into a book, The Boy in the Moon: A Father’s Search for His Disabled Son. An excerpt was recently posted on the Globe‘s site. Again we saw a disquieting parallel with our own life, when Brown writes about his home’s storage of huge amounts of old supplies and equipment, kept just in case they might be needed again. Also, rooms filled with unused clothing and toys (given to Walker by well-meaning relatives) that the family can’t bear to get rid of.

We have shelves and toyboxes filled with wonderful toys given to us by friends and relatives over the years—stuffed animals, puzzle games, Lego sets, trucks—that we hoped would get lovingly used and destroyed by Jon. Unfortunately he never had much interest in plush toys, trucks or games; and lacked the manual and visual dexterity for Lego and puzzles. But we couldn’t bring ourselves to get rid of them, rationalizing that maybe, one day he’d want to play with them….

One of several old toy depositories littered throughout our house

A month or two ago in his column in the Guardian, noted science-writer Simon Singh (who wrote a favourite of mine, The Code Book) laid a broadside against the chiropractic industry in Britain, as well as chiropractic in general. Based on the dubious history of chiropractic and the damning evidence of recent studies and key peer-review research, he criticized the industry’s claims of being able to treat many diseases. Furious, the British Chiropractic Association sued him for libel. Later the Association released their “evidence” list to shore up their case, none of which actually dealt with the issue at hand. In actual fact there is a great deal of evidence against specific claims (claiming chiropractic can treat children for ear infections, colic, asthma, feeding issues, etc.)

The libel trial held a preliminary hearing to determine the meaning of the BCA article. In a perplexing decision he judge decided that because Singh had used the adjective “bogus” to describe the treatments and had said that chiropractors had “happily promoted them”, he was accusing them of being deliberately dishonest. Singh argued otherwise. The judge indicated that he feels that is Singh guilty of libel, and the actual science has no part in this. Therefore, Singh was found guilty. That’s the antiquated world of British libel courts.

Singh has decided to fight. (He, not the Guardian, is paying for his own defence.) In response, the chiropractic organizations are in full retreat, one of the associations asking all of its members to take down their websites to avoid posting overreaching claims. One of the ways is that Singh is fighting is asking bloggers and websites to post the original article—now reviewed and edited slightly by lawyers.

So here it is.

Beware the Spinal Trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results — and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying — even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

There is a good follow-up article in today’s Guardian.