In this issue there is an excellent update of a medical perspective of presumed controversial therapies in the management of attention deficit disorders and learning disabilities. Dr Silver briefly reviews generally "acceptable" therapies, including special education, medication (ie, psychostimulants), and psychological therapies. I am uncertain what criteria differentiate these approaches to a difficult, complicated problem. Supporters of controversial therapies point to the success of their approaches with the same conviction with which that physicians perceive benefit from medication or changes in diet, educators believe in an individualized education plan, or psychologists rely on their therapeutic modalities.
In his review of controversial therapies, Dr Golden2 offers six characteristics of these modalities. They are novel and not completely consistent with modern scientific knowledge. Treatments are suggested for a broad range of vaguely defined problems. These "natural" substances or approaches are without apparent adverse effects. Media other than