Monday, 5 March 2012

'CUT SPASTIC LEGS OFF'


Suggestion not specific to one country
Exemplifies wider point

On his blog this morning Ralph Strzałkowski recalled an incident in Poland when an eminent professor of orthopaedics made a surprising suggestion about one way to deal with Ralph's spastic legs –

From the first minutes it was becoming obvious that his experience with spastic limbs was limited at best and he didn't really know what to do with me. He wanted to say something just so it wouldn't seem like he was wasting our time and his, which he was. As we were talking, he said, 'You're so highly functional and your upper body is strong, your legs seem to be holding you back. It is just an idea, but perhaps you could walk with prosthetic legs.'

Such an unthinking and ill-informed response is not of course specifically Polish. It reminded me immediately of a daft conversation that I had years ago in the British Houses of Parliament –

In the mid-eighties, shortly after the screening of Standing up for Joe, at the hight of the national CE-fever, I was at some CE-related event at the Houses of Parliament. I was approached by some beamish Sir Bufton-Tufton MP, exuding the desire to say something to indicate his positive, beefy good will.

'What I can't understand though is why, if their legs don't work, they can't just have them amputated and artificial ones fitted...'

Knowledge management

On might understand bumbling lay naivety like Sir Bufton's, and it is relatively easy to deal with. The doctor's is another matter. Ralph comments:

It seems to me that some medical practitioners are hostages to their limited perspective and they are not open enough to try other ideas. The 'I know better' (even if I don't know anything about it) attitude is not only a product of a particular time or location. I also think that resistance to the Peto method is rooted in the same type of sentiment that prevents some to even entertain it as a possible approach. And just by watching my mother interact with the man I realized another deeply rooted thing. Utmost respect for the profession, no matter what. Even if you're dealing with an closed minded  person. We are ready to dismiss things, even if we don't know. Some people will just say silly things. I almost had my legs amputated! On the other end you have parents, who would try anything if it can possibly help. But they don't often have the full information. To my doctor his suggestion made more sense than alternatives that he didn't consider and didn't  know existed. Obviously we didn't go through it, but it opened a Pandora's box of questions I'm too afraid to ask.

A specific, fearful question that immediately occurs is to wonder whether some doctors and lay people have actually gone forward and made such a radical surgical response, somewhere, some time...

But the less acute problem, the chronic but more pervasive one of self-confident, often unquestioned (but all the same limited) professional understandings should be of wider concern. These are not restricted to one country or to any one profession. As Conductive World reported earlier this week, there is expressed concerned about this tendency amongst doctors. Ralph's eminent Polish specialist seems an excellent candidate for knowledge-management. Let us hope that Conductive Education crates effective measures of its own.

References

Strzałkowski, R. (2012), "Let's amputate your legs", Lawyer on Wheels, 5 March

Sutton, A. (2011) An anecdote from olden time, Conductive World, 15 September

Sutton, A. (2012) A doctors' dilemma, Conductive World, 27 February

Sunday, 4 March 2012

HUSH, HUSH, WHISPER WHO DARES

Debate in and around Conductive Education

Later this week I am off to Rosenheim in Bavaria, to the two-day biennial national bash of what in German they call Konduktive Förderung – or just plain 'Petö' – i.e. what, just as confusingly, English-speakers usually refer to as Conductive Education. The conference is provocatively titled 'Petö and Inclusion'. Both halves of this coupling are enough to create excitement and disagreement in themselves: bringing the two together even more so. I do hope that this will prove a lively and stimulating occasion.

Oh, I do hope so. Despite the considerable unresolved conflicts in and around Conductive Education (or Konduktive Förderung, or 'Petö' or whatever it is called in umpteen different languages nowadays), there are few if any public debates about anything in or around the field.

I was reminded about this today, by an email received from Rony Schenker –

The only published comment on my recent post'(Middle) East meets (Far) East', was that of Norman Perrin, who asked me "What does 'rehabilitation' mean for you?'

My answer was the following: 'For me rehabilitation is a mode of segregated ‘fixing’ service-delivery, derived from the medical model, and based on outcomes in which the child is perceived as a puzzle, whose different parts are divided between different professionals, where at best, the pieces may perfectly fit but the whole picture does not make any sense.'

This reply, however, did not evoke any other comments. But... I'm still curious to hear others' opinions on what rehabilitation meana.

Maybe if published on your Blog, Andrew it will. Maybe not.

Well, Rony, here it is as requested. There can hardly be bigger questions in the world today than those posed by China – and lil' ole CE is not to be spared in this respect. As for your second point, there are those who advocate the term 'conductive rehabilitation'. You hardly make this sound an attractive proposition.

I do wonder, however, whether my requested intervention will prompt the debates around either issue that you would like to see.

Still, we live in hope.

Respond to...

Rony's report on China, along with her challenge over 'rehabilitation', can be read and replied to at:

Thursday, 1 March 2012

FUTUROLOGY

A cheerful exercise

If you are in part of the world where the popular-science weekly New Scientist is sold, look out on the news stands for the bright orange dayglow cover of this week's special issue: 'The deep future: a guide to humanity's next 100,000 years'.

Its sixteen pages of short feature articles around this ambitious time scale certainly help put today's questions of into perspective– not just today's but those of our whole generation and well beyond.

And, such a refreshing change, this is a futurology that may be generally be described as upbeat. Reading it left me feeling just a tiny little bit wiser, a tiny little bit more optimistic for the long term, even though there will most certainly be some very hard times for an awful lot of people in the meantime!

Our own short term

100,000 years may not be a long time sub specie aeternitatis, but it is quite a long one for the species homo sapiens. As for the shorter term, however, well, that is a matter quite outside this special issue's brief. As the Editor remarks –

It is easier to think about very long timescales than how technology will evolve in the near future.

From the sublime to the ridiculous. Just over year ago, at the 7th International CE Congress in Hong Kong, I was asked to contribute a few minutes to the concluding Round Table plenary session on 'CE in the Twenty-First Century'. Even with only ninety years of the century to run, I found such prediction beyond my powers of foresight.

I have published what I did come up with as part of my recent collection Last Year in Hong Kong.

What's your guess?

References

(2012) Special Report: The deep future, New Scientist, vol. 213, no 2854, 3 March, pp. 36-49
Brief previews of the Editorial and the various articles are available on line:

Sutton, A. (2011) in Last Year in Hong Kong, Birmingham, Conductive Education Press, pp. 45-48
Preview and purchase on line:




DOCTORS AND CONDUCTORS

Each with their own contradictions

The previous posting here has provoked a critical Comment from Sue Reilly, who had sent me a copy of the article that prompted it–

Hi Andrew,

I think you are being a little harsh on CE in suggesting there are any substantive parallels between its practitioners and the overwheening arrogance of the medical profession over many, many decades in its negative, pessimistic, indeed some would say nihilistic attitude towards people with severe brain damage and brain injuries - basically just writing them off. An attitude which surely helps explain much of the medical profession's historical hostility to optimistic, positive approaches such as CE – surely?

My reason for sending you this article is that I reckon all those of us who believe in the capacity of individuals to learn, and to develop,should celebrate any sign that there are medical professionals out there willing to concede that medical dogma - dogma such as the belief, for instance, that severe brain damage automatically prevents individuals from learning or developing - can be, and often is, a VERY dangerous and destructive thing.
Sue xxx


Sorry, Sue, I suspect that I may have not expressed myself too well, and so clouded my intention.

Doctors

At the level of objective social practice I acknowledge the contradictory nature of all professional groups ('There's good and bad in all sorts). As far as the medical profession is concerned, this includes a hefty contribution to the sad biologisation of so much human personal and social activity. Perhaps this is inevitable. I suppose that this could be chuckled off as just pain daft. Read any history of medicine for examples galore, amusing enough now perhaps but truly awful at the time for victims> Things were possible 'then' because society, also contradictory, has apparently been so eager to host such notions and welcomed medicine into pivotal decision-making roles. As it is now.

At the same time we are all endebted to the ranks of the medical profession for incalculable contributions to progressive causes and understandings, to which the history of special education over a couple of centuries testifies. It is hard to conceive how special education would have developed had things been left just to the educators, without the leading roles played by so many physicians-turned-educators in its fundamental development. I need look no further for examples of this than Drs Pető and Hári.

Conductors

And at the same level I have to admit that conductors, whatever their manifest virtues, are not without their contradictory contributions within the subsequent development of Conductive Education. Quite a lot of people around the world know that.###

Managing knowledge

What I really wished to emphasised, however, in writing what I did, was at the level of knowledge management, the problems of which – for any profession – do appear to extend to conductors, in spades. Their virtues in terms or personal practice and philosophical understandings do not deny real prblems at this level, real enough even to constitute a threat in the long-term to their being able to maintain, defend and develop well-being of these most considerable virtues.

It is this dimension that I wish to emphasise. That belief 'in the capacity of individuals to learn, and to develop' is such a precious treasure .

This belief is a powerful force – but beliefs can be so fragile.

'Knowledge-management', 'belief-management', whatever. The words sound so dry. What they represent, as generation succeeds generation, with little conscious attention to keeping the fire alive, may prove critical.

Reference

Sutton, A. (2012) A doctors' dilemma: a dilemma for others too – conductors for example, Conductive World, 27 February

Monday, 27 February 2012

A DOCTORS' DILEMMA

A dilemma for others too – conductors for example

Sue O'Reilly has written to tell me of an Editorial from last October's Medical Journal of Australia, a challenging item by Professor Rinaldo Bellomo on a major question facing modern medicine, knowledge-management.

This problem may loom particularly large in medicine but it cannot be ignored is less developed fields like, for example the provision of services for those with motor disorders – and conductors.

To illustrate this, I have taken the liberty of extracting a little of this Editorial, but in doing so have replaced the words 'medicine' with 'Conductive Education,' and 'doctors' with 'conductors', and I have changed a couple of associated words to fit in with this. I find that Prof. Bellomo's analysis transfers rather well –

In a world populated by rapid-diffusion media, varied cultures, widespread literacy, extraordinary means of communication and media veneration of the might of the scientific method, one might expect that the “marketplace of ideas” would be extraordinarily open, lively and free from censorship or restrictions. In such a world, one might expect that Conductive Education shine like a beacon of open-mindedness and acceptance of new ideas and that it would foster the development of challenges to operative paradigms. In such a world, dogma would fail to develop roots and could not survive. Evidence would triumph and, in its absence, both experts and the broader citizenry would hold on to healthy doubt. In such a world, one might expect that Conductive Education would shine like a beacon of open-mindedness and acceptance of new ideas and that it would foster the development of challenges to operative paradigms.

There are several potential explanations for Conductive Education's persistent love affair with dogma ... The cognitive “illusion of knowledge” also plays a role. We have to believe we know the answer and that there is only one answer, the one we have. To accept that we do not know the answer, or that other people might know the answer while we do not, is emotionally challenging and calls into question our very professional essence. Best to believe that what we think we know is actually true. As Thomas Kuhn would have it, at any time in history we operate within 'paradigms', the 'soft'(but often strongly enforced) dogmas ... We use such paradigms as totems and make challenging them a professional taboo.

Dogma probably protects patients from rogue behaviour. We need to make sure that not all treatments are allowed. Rules (dogmas) do exist for a reason ... The difficulty, however, occurs in situations where the evidence that a particular action is needed is not so clear, or, just as frequently, when the practitioner is not aware that such evidence even exists ... In such a state of permanent flux, it is a lot easier to 'stick to what you know'(received dogma) and never change until retirement. This is a problem, because while such a stance might have been justified in 1911, it seems spectacularly out of touch in 2011. Indeed, together with the obstinate adherence to such 'training school' dogma, knowledge management (knowing what one does not know and knowing what one should know) may now be one of the major challenges of Conductive Education.

Finally, in a world full of “experts”, controversy and opinion, holding on to dogma is reassuring and may well have vital functions. Yet, dogma has a dark side and its dangers may be as great as its benefits. Conductors would do well to maintain a degree of cautious skepticism for both bold new fashions and received wisdom, whether generated by the world or by the self. They would do even better to question what they do and see such questioning as an asset. It is everyone’s responsibility to find out how to ask questions systematically, find answers from searching the literature, critically appraise the literature and apply the results to practice ... Resources need to be allocated ... to make this process of questioning dogma and obtaining up-to-date high-quality evidence a ... priority. Unless this is done, dogma will continue to rule conductive hearts and minds.

I have omitted Profe. Bellomo's well-referenced, medicine-specific examples (indicated above by ellipsis … ). Readers will presumably be able to find their own though, such is the present state of knowledge-management in Conductive Eduction, they may find it harder to ensure that these are as well-referenced.

Epigraph

The epigraph to this Editorial is a quotation from Harriet Beecher Stowe's Little Foxes – 


Physicians are quite as intolerant as theologians. They never had the power of burning at the stake for medical opinions, but they certainly have shown the will.

Does that transfer too?

Reference

Bellomo, R, (2011) The dangers of dogma in medicine. Is the dogma of today the footnote of tomorrow? The Medical Journal of Australia, vol. 195, no 7, pp. 372-373.

Sunday, 26 February 2012


ROMANTIC SCIENCE
A suitable methodology for CE research

In what A. R. Luriya regarded as his third and final major individual case study, on his own professional life, his concluding summing up of his long career leads off as follows –

At the beginning of the twentieth century the German scholar Max Verworn suggested that scientists can be divided into two distinct groups according to their basic orientation toward science: classical and romantic. These two basic orientations, he noted, reflect not only the scholar's general attitude towards science but his personal characteristics as well.

Classical scholars are those who look upon events in terms of their constituent parts. Step by step they single out important units and elements until they can formulate abstract, general laws. These laws are then seen as the governing agents of the phenomena in the field under study. One outcome of this approach is the reduction of living reality with all its richness of detail to abstract schemas. The properties of the living whole are lost, which provoked Goethe to pen
Grey is every theory, but ever green is the tree of life.
Romantic scholars' traits, attitudes and strategies are just the opposite. They do not follow the path of reductionism, which is the leading philosophy of the classical group. Romantics in science want neither to split living reality into its elementary components nor to represent the wealth of life's concrete events in abstract models that lose the properties of the phenomena themselves. It is of the utmost importance to romantics to preserve the wealth of living reality, and they aspire to a science that retains this richness.

Of course, romantic scholars and romantic science have their shortcomings. Romantic science typically lacks the logic and does not follow the careful, consecutive, step-by-step reasoning that is characteristic of classical science, nor does it easily reach firm formulations and universally applicable laws. Sometimes logical step-by-step analysis escapes romantic scholars, and on occasion, they let artistic preferences and intuitions take over. Frequently their descriptions not only precede explanation but replace it. I have long puzzled which of the two approaches in principle, leads to a better understanding of living reality.

The dilemma is a reformulation of the conflict between nomothetic and idiographic approaches to psychology...

(pp. 174-174)

Simple observations and description have their shortcomings too. They can lead to a description of immediately perceived events that seduces observers into pseudoexplanations based on their own phenomenological understanding. This kind of error jeopardises the essential role of scientific analysis. But it is a danger only when phenomenological description is superficial and incomplete. Truly scientific observation avoids such dangers. Scientific observation is not merely pure description of separate facts. Its main goal is to view an event from as many perspectives as possible. The eye of science does not probe 'a thing', and event, isolated from other things or events. Its real object is to see and understand the way a thing or event relates to other things or events.

I have always admired Lenin's observation that a glass, as an object of science, can only be understood when it is viewed from many perspectives. With respect to the material of which it is made, it becomes an object of physics; with respect to its value, an object of economics; and with respect to its form, an object of aesthetics. The more we single out important relations during our descriptions, the closer we come to the essence of the object, to an understanding of its qualities and the rules of its existence. And the more we preserve the whole wealth of its qualities, the closer we come to the inner laws that determine its existence. It was this perspective that led Karl Marx to describe the process of scientific description with the strange-sounding expression,'ascending to the concrete'...

My efforts to revive the traditions of romantic science resulted in two books, The Mind of a Mnemonist (1968) The man with a Shattered World (1972)...

(pp. 177-8)

Brief commentary

In the passages quoted above Luriya offers a rather more elegant and relevant methodological distinction than the much-parroted 'quantitative' vs 'qualitative'.

This book's editors faced an unenviable task, and came up with a less than satisfactory solution to the English-language problem of science/scientists as apparently different from scholarship/scholars. This passage would read much better in Luriya's main languages of Russian and German, as readers of those language would make no such distinction. (Nor incidentally would Hungarian readers if there were a Hungarian edition.) I can think of no way of solving this translation problem for English-speakers (or should that be English-thinkers?) other than through a cumbersome footnote. This matter has already been addressed more than once in Conductive World.

Goethean science has also been addressed on these pages.

The Mind of a Mnemonist and The Man with a Shattered World were on my reading lists when I used to teach psycho-pedagogy to student-conductors. I think that some students might have read them. I do hope that some remember, especially when the talk turns to 'research'.

These two books might reasonably be described as major 'qualitative' studies, not merely in their scope and depth but also their contribution to knowledge. Those looking for an appropriate methodological model for 'Conductive Education research' would do worse than adopt this model to their purposes – indeed many have done worse, much worse. Oliver Sacks has won enormous respect for his own line of romantic science. *

The wholly legitimate calls for 'CE-research' are all to easily drowned out by loud assertions that there is only one possible way to respond, of the kind that Luriya refers to here as classical, reductionist. There is another way, and one could not wish for more authoritative support in arguing it...

Reference

Luria, A. R. The Making of a Mind: a personal account of Soviet psychology, Cambridge, Mass, Harvard University Press


* Sacks on Luriya and romantic science: http://www.youtube.com/watch?v=eGqLfP-LtgE

Friday, 24 February 2012

RUSSIAN CONDUCTOR AND MASSEUR

In a country of which one knows so very little

One of the Russians who trained in at the PAI in Budapest in the mid-nineties, thanks to the Yeltsin Foundation – just spotted in a Moscow masseurs' catalogue:

МОСТОВОЙ ДЕНИС ЮРЬЕВИЧ


Образование: Высшее (Педагогическое)
Возраст: 35 лет
Пол: мужской
Стаж: 12 лет
Типы массажа: Реабилитолог, педагог-кондуктор, детский массаж, инструктор Лфк, Лфк для детей

Образование:
  • 1993-1998 гг. Будапештский Институт Кондуктивной педагогики и восстановительной двигательной терапии им. Андраша Пето (Венгрия), специальность- специалист восстановительной двигательной терапии у детей с ДЦП.
  • 1998-2000 г.г. Российский Государственный Социальный Университет, факультет социальной педагогики
  • специальность-социальный педагог квалификация – педагог-психолог
  • 0ктябрь 2005 г. Защита кандидатской диссертации
Реабилитолог, Педагог-кондуктор, Детский массаж, ЛФК. Реабилитация детей с ДЦП и нарушениями опорно-двигательного аппарата. Инсульты мозговые и спинальные.  Провожу групповые и индивидуальные занятия.


Which being translated...

DENIS JUR'EVICH MOSTOVOI

Education: Higher (Pedagogic)
Age: 35 years
Sex:  Male
Experience: 12 years
Types of massage: rehabilitation, teacher-conductor, baby massage, LFK instructor, children's LFK [LFK may be conveniently though not precisely understood as 'physio']

Education:
  • 1998. The András Pető Institute of Conductive Pedagogy and Developmental Movement Therapy.Budapest (Hungary), as a specialist in bringing up children with cerebral palsy.
  • 1998-2000 Russian State Social University, Social Pedagogy Faculty
  • Specialist social pedagogue qualification – pedagogue=psychologist
  • October 2005.  Defense of candidate's dissertation [may be read as a PhD equivalent]
Rehabilitationist, Teacher-conductor, Baby massage, LFK. Rehabilitation of children with cerebral palsy and disorders of the apparatus for support and movement [established Russian term for physical disabilities]. Brain and spinal damage. I lead group and individual lessons.

Video


Mr Mostovoi explains, but my Russian is too slow and rickety to catch what precisely he is saying. There is, however, a brief written summary beneath the video, that translates –

At the present day there exists and is being successfully developed in our country a system of social-pedagogical rehabilitation for people with disabilities of the apparatus for support and movement, in which the priority is use if a pedagogical approach.

A different world

Whatever is happening in the former Soviet Union is right off the cognitive map for most of those living and working in CE in the rest of the world today. The travails and destiny of CE over there may be much he same as elsewhere, tor surprisingly different to many outside that country.

By nowadays' standards, though, European Russia is feographically not that far away, from Europe. So here is another 'East meets West' divide for a World Congress to consider, should the organisers of next year's Eighth think of taking it up.

Meanwhile Conductive World will keep an eye out...