Monday, August 11, 2008

Disingenuous and myopic

Responding to Ken DeRosa, who suggests that he has been 'waiting' for 17 days for "evidence on the effectiveness of Broader, Bolder." In response to Leo Casey, who says "Disingenuous calls for 'evidence' that community schools work require a willful myopia on the effect on life in poverty on education," DeRosa says,

> I'll take disingenuous and myopic...

Such is evident from his words. Consider his treatment of the 'evidence' surrounding a series of claims made by Casey, including one that teachers "have seen asthma reach epidemic proportions among students living in poverty, and they know that the lack of preventive and prophylactic medical care leads to more frequent attacks of a more severe nature, and more absences from school."

De Rosa cites some studies that appear to refute this conclusion. He comments, "Notice how the subjective measures (teachers' grades and parental reporting of grades) conflict with the objective measures (standardized test results and school-recorded absences)."

Let's examine them (the Clark et.al. study, at least - the Evans one doesn't show up on Google at all and as usual you provide neither links not dates).

It's clear DeRosa quotes Clark et.al. from their abstract. One wonders whether he read further. To find this, for example, summarized by Gale Jurasek:

"One disappointing result was the failure of the investigators to connect with the children’s primary care clinicians and obtain an asthma action plan. Baseline data indicated that only one quarter of the asthmatic children in the study were receiving adequate treatment..."

Gee, don't you think receiving treatment might be important?

In the study where adequate medical care *was* provided (Halterman JS, Szilagyi PG, Yoos HL, et al.) a positive result was obtained in many cases:

"The children in the intervention group missed a mean of 6.8 days of school, compared with 8.8 days missed in the usual care group...."

Wait. That is what Casey said.

Worth noting was that "the intervention was ineffective for children who were exposed to secondhand smoke at home, but it was highly effective for the other children."

Do you think controlling for tobacco smoke in the home might have been important?

It is also worth noting that all studies - including the ones DeRosa cites - conclude (to quote the Evans, et.al. study):

"Overall, the intervention provided significant benefits, particularly for children with persistent asthma."

So an examination of the research shows that it does not support the conclusion DeRosa says that it does, and indeed, explicitly states the opposite.

But, of course, DeRosa's demand for evidence was, as Casey stated, disingenuous. He isn't interested in the conclusions actual researchers in the field draw. Rather, he will map their results against his own idiosyncratic definitions (of, say, 'improvement') and declare, contrary to all the researchers, that the asthma programs are ineffective.

And what - that they should be scrapped?

As for the rest of Casey's argument, why, DeRosa leaves it untouched. As though there were somehow no evidence for the propositions that:

- eye problems impact the ability to learn how to read (tell me, how does DeRosa account for the programs set up for blind children?)

- lack of proper medical care heightens the severity of childhood illnesses and makes them last longer (guess DeRosa hasn't been following the deaths that result when parents withhold treatment, refuse inoculations, prohibit transfusions, and the like - or the evidence from epidemiology about the spread of untreated disease)

- untreated asthma leads to more absences from school - this was clearly stated in the studies cited above. And it's worth noting that Casey makes *no claim* about asthma and grades or testing - this is something DeRosa brings to the table, a straw man set up for the attack

- screening for lead poisoning happens least for children in poverty - why doesn't DeRosa read "The dimensions of poverty among children in the United States" - http://www.servingtheunderserved.org/epilogue.pdf it's the second freaking link in Google (right after the D-Ed post, bet DeRosa's proud)

... and the rest. The points cited by Casey are disputed only by the willfully ignorant, by people who - like the creationists and global warming sceptics - will not allow any body of evidence to change their beliefs.

Continued, responding to response... italic quotations are DeRosa's, the rest are m response.

> Unlike double-standard Downes, I cited these two research studies because they actually met some minimum standards of social-science research. See Coordinated school health programs and academic achievement...

Unlikely. You found one survey, and then began picking references out of the survey, without bothering to read beyond the abstract.

I can see why you didn't list it among your citations, even though it is your primary source. look what it says:

"The strongest evidence from scientifically rigorous evaluations exists for a positive effect on some academic outcomes from school health programs for asth­matic children that incorporate health education and parental involvement."

Oh, hey, that's the *opposite* of what you are claiming. You are saying there's no academic gain, and yet here is your own metastudy, not even mentioned in the original post, that concludes that there is a *positive* effect.

> These two studies were only two of about a half dozen studies related to school health programs that met generally accepted research standards.

18 studies in all were surveyed, but only two had to do with treatment of asthma (others dealt with nutrition programs, physical fitness, counseling, etc. and found positive benefits for those* interventions as well).

It would be more interesting to discuss what counts as a 'generally accepted research standard'.

> Thanks for unwittingly proving my point once again. I don't doubt that the school bungled the treatment...

I haven't proven your point at all. This study is evidence that *you* have found that you say supports *your* point. The fact that it contains a serious flaw undermines your position.

Indeed - what I would really like to know is how your citation such research can count as falling under 'generally accepted research standards'. It certainly doesn't evaluate the result of treatment of asthma, even though you cite it as though it does.

> that's what schools do -- they bungle.

There's a sweeping generalization for you, one more interesting for the bias it reveals than for any information it contains.

> Here's what the study tells us: even under experimental conditions, the school couldn't implement the treatment regime adequately such that it could improve student outcomes.

No, it says the school *did* not implement a program, not that it *could* not.

No citation?

Halterman JS, Szilagyi PG, Yoos HL, et al. Benefits of a school-based asthma treatment program in the absence of secondhand smoke exposure. Arch Pediatr Adolesc Med. 2004;158:460-467.

Foolishly I assumed that you had read the one-page summary in the link that I provided.

> No determination if it meets minimal standards.

Why should I do your work for you?

> It was excluded from the 2007 Murray et al. meta-anlysis cited above.

I have no idea why it was excluded. The article only provides a generalized list of criteria, not a specific criticism of individual papers. For all I know, their research assistants couldn't find it.

> Oh, that's right, it agrees with your world-view so it must be true. The Downes double-standard rears its ugly head again.

Actually, pretty much everything I read on the subject 'agrees with my world view'. That's how I form my 'world view' - I read the literature, and come to an unbiased conclusion based on that reading.

You are the only person in this conversation cherry-picking and misinterpreting the texts. Accusing me of this is a case of what Freud used to call 'projection' - a phenomenon very common among political commentators.

> Substantively, however, I fail to see how gaining two school days (a 1 % increase) has ever led to an increased student achievement. Maybe you can find a cite for that?

That's not relevant. You said there was no evidence that showed an increase in attendance. Yet here is clearly evince - in a source *you* cite and say shows otherwise - evidence for an increase in attendance.

Perhaps you can see how a series of measures, each adding 1 percent to attendance rates, might have an effect on outcome. It would be ridiculous to attempt to survey one of these measures in isolation, since the contribution of each is marginal.

> "Overall, the intervention provided significant benefits, particularly for children with persistent asthma." Benefits which apparently didn't include student achievement.

Benefits that - according to the metastudy you omitted to mention in your original post, *do* include increases in student achievement.

That you would claim the research says what it clearly doesn't is absolutely shameless.

> "So an examination of the research shows that it does[n't:sic??] support the conclusion you say that it does, and indeed, explicitly states the opposite." Only if we count outcomes not related to student achievement

And yet - I find explicit evidence in the survey paper you cite for gains in academic achievement.

> --the explicit reason given by Broader, Bolder. If we limit the outcomes to student achievement related measures the benefits, as usual, are elusive.

Actually, Broader, Bolder could cite the papers in this discussion as evidence for their position.

> I don't remember claiming that these studies didn't show any benefits, just none related to student achievement

Oh, let's quote that study again:

"evidence from scientifically rigorous evaluations exists for
a positive effect on some academic outcomes from school health programs for asth­matic children"

This would be exactly the result you say wasn't obtained.

Look at the Evans, et.al. study:

"Significant improvements noted among health education compared with controls: for academic grades (4% vs 0%; p = .05), mathematics
(8% vs 3%; p = .03), science (5% vs 4%; p = .005), and oral expression (6% vs 1%; p = .04)."

The 'academic grades' refer to the marks given by teachers, but 'mathematics ' and 'science', which are listed separately, refer to standardized tests.

Looks like this study says *exactly* what you say it doesn't. Got an explanation for that?

> a sine qua non for using limited educational resources which might be used more productively on other educational programs. (And let's not discount the infirmities of extrapolating generalized results from these small scale studies which in all likelihood have methodological infirmities)

The justification for re-allocating resources must be based, not merely on a narrow description of improvement as 'higher grades on standardized tests' (which would be ridiculous) but rather on a wide ranging assessment of *all* benefits realized from the spending, including (say) health and social benefits.

> Nice Downesian (i.e., dishonest) framing. The question is whether providing a school-based version of these kinds of intervention will show an improvement over what is already being done.

You are criticizing Casey. Casey does not make this assertion. All he says is that asthma treatments reduce absences.

The rest of it is you projecting your own agenda onto Casey.

For my own part - when I look at a study of some 835 Detroit students, and find that "one quarter of the asthmatic children in the study were receiving adequate treatment," then it seems to me that "what is already being done" is grossly inadequate.

> Surely you can cite specific school-based programs on each point which has been researched and has shown a positive impact on student achievement. Large scale, no doubt, and replicated.

For many of these, a large-scale study would be pointless and ridiculous. Why do we need more study to determine whether poor vision makes it harder to learn how to read? What genuine doubt is there about this proposition?

> Prove me wrong.

I think we're well beyond the point where we need to prove anything to you. As Casey says, your calls for evidence are disingenuous. You don't really care about what the researchers actually say, and you consistently misquote them to support your own conclusions (I've seen you do this on *numerous* occasions, not just here).

You may have a body of readers who support your position, but those readers should know that *real* researchers - people with some actual qualifications in the field, who have actually done some research themselves - disagree overwhelmingly with the sort of propositions being advanced in this blog.

> If you're going to carry Casey's water, at least do a competent job.

As compared to... you?

1 comment:

  1. Stephen, here are your citations:

    * Evans D, Clark NM, Feldman CH, et al. A school health education program for children with asthma aged 8-11 years. Health Educ Q. 1987;14(3):267-279

    * Clark NM, Brown R, Joseph CL, Anderson EW, Liu M, Valerio MA. Effects of a comprehensive school-based asthma program on symptoms, parent management, grades, and absenteeism. Chest. 2004; 125(5):1674-1679.

    Unlike double-standard Downes, I cited these two research studies because they actually met some minimum standards of social-science research. See Coordinated school health programs and academic achievement: a systematic review of the literature, Journal of School Health; Nov 1, 2007; Murray, Nancy G. Low, Barbara J. Hollis, Christine Cross, Alan W. Davis, Sally M.

    These two studies were only two of about a half dozen studies related to school health programs that met generally accepted research standards.

    "One disappointing result was the failure of the investigators to connect with the children’s primary care clinicians and obtain an asthma action plan. Baseline data indicated that only one quarter of the asthmatic children in the study were receiving adequate treatment..."

    Gee, don't you think receiving treatment might be important?


    Thanks for unwittingly proving my point once again.

    I don't doubt that the school bungled the treatment; that's what schools do -- they bungle. Here's what the study tells us: even under experimental conditions, the school couldn't implement the treatment regime adequately such that it could improve student outcomes.

    In the study where adequate medical care *was* provided (Halterman JS, Szilagyi PG, Yoos HL, et al.) a positive result was obtained in many cases

    No citation? No determination if it meets minimal standards. It was excluded from the 2007 Murray et al. meta-anlysis cited above. Oh, that's right, it agrees with your world-view so it must be true. The Downes double-standard rears its ugly head again.

    Substantively, however, I fail to see how gaining two school days (a 1 % increase) has ever led to an increased student achievement. Maybe you can find a cite for that?

    "Overall, the intervention provided significant benefits, particularly for children with persistent asthma."

    Benefits which apparently didn't include student achievement.

    So an examination of the research shows that it does[n't:sic??] support the conclusion you say that it does, and indeed, explicitly states the opposite.

    Only if we count outcomes not related to student achievement--the explicit reason given by Broader, Bolder. If we limit the outcomes to student achievement related measures the benefits, as usual, are elusive.

    Rather, you will map their results against your own idiosyncratic definitions (of, say, 'improvement') and declare, contrary to all the researchers, that the asthma programs are ineffective.

    I don't remember claiming that these studies didn't show any benefits, just none related to student achievement, a sine qua non for using limited educational resources which might be used more productively on other educational programs. (And let's not discount the infirmities of extrapolating generalized results from these small scale studies which in all likelihood have methodological infirmities)

    eye problems impact the ability to learn how to read

    lack of proper medical care heightens the severity of childhood illnesses and makes them last longer

    untreated asthma leads to more absences from school


    Nice Downesian (i.e., dishonest) framing. The question is whether providing a school-based version of these kinds of intervention will show an improvement over what is already being done.

    You seem very confident in your opinions here. Surely you can cite specific school-based programs on each point which has been researched and has shown a positive impact on student achievement. Large scale, no doubt, and replicated.

    screening for lead poisoning happens least for children in poverty

    Current lead exposure levels are soundly in the realm of junkscience. But maybe I'm wrong and really have a study that shows increased achievement due to better school-based screening. Prove me wrong.

    If you're going to carry Casey's water, at least do a competent job.

    ReplyDelete

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