Monday, 27 July 2009

So you want Conductive Education to be a therapy

VELLEM VAGY ELLENEM *

A 'said therapy' is a sad therapy

So you want Conductive Education to be a 'therapy'. You want to talk about it and think about it, and act, as if it were?

If that is your judgement then that is your choice. Go ahead and do so. It's free world.
  • You can talk about Conductive Education as a therapy or a treatment
  • You can think about is in the same way
  • You can advance brain-based explanations of the processes involved in Conducive Education
  • You can take part in practical activities (as service-users, conductors or providers/funders) that as it were dispense 'doses' of conductive programs
  • You can bury or dissolve conductive practice in, or under, 'multidisciplinary teams
  • You can even place it under 'medical direction'
  • You can struggle to get Conductive Education funded through heath insurance schemes or by state health-care systems
  • You can implement further medical-style comparative outcome evaluations to answer the question of whether Conductive Education 'works'
Just don't be too disappointed if you do not achieve every thing that you would like to from all this. Don't even be surprised if the cause of Conductive Education makes little or no advance at all. You are not the first to try this road. Large numbers of people have been doing these things for years.

If these are the rules that you wish to play by, however, do also recognise that if you are ever to have the slendrest chance of winning according to the rules of the therapy game you must meet the criteria and requirements that you will meet there, and accept the consequences of failing to do so.

If you really want Conductive Education to be a 'therapy' or a 'treatment', here is a just-published example of what awaits you.

The US National Center for Complementary and Alternative Medicine (CAM) defines CAM as "a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." The problem with said therapies is that, for the most part, their effectiveness is questionable and their side effect profile is essentially unknown. Furthermore, as stated by Rosenbaum, many CAM treatments are based on "at best, anecdotal evidence and at times rather unusual ideas about the biology of the conditions to which they are being applied." In spite of the data shortage, Americans are forecasted to spend more than $42 billion on CAM during 2009. Using a patient for illustration purposes, the author presents 3 CAM treatments that have been advocated for children with cerebral palsy. The current scientific literature on these remedies and their purported benefit is reviewed. The article ends with a discussion on the reasons why prescribing said therapies is contrary to the concept of evidence-based medicine and the tenets of medical ethics.

This is the formal published abstract of an article by Pedro Weisleder in this month's Clinical Pediatrics. This is not an open-source journal and Conductive World has no resources to access the original article. Can anyone oblige? It would be very interesting to know whether Conductive Education has landed itself in the basket of three 'said therapies' that the reviewer has examined in his single-case study.

No matter either way, look at the two concluding sentences:

The current scientific literature on these remedies and their purported benefit is reviewed. The article ends with a discussion on the reasons why prescribing said therapies is contrary to the concept of evidence-based medicine and the tenets of medical ethics.

Think what you like about the current concept of 'evidence-based medicine' there are plenty of people in and out of medicine who have no doubts about it whatsoever, and may be equally at ease with conflating 'evidence-based' and 'medical ethics'. Maybe it is right and reasonable to do so; maybe not. If you want to Conductive Education to be a therapy, then good luck in that discussion too. You will find it a tough one.

Feel free

Yes, it is a free world, one in which I defend your right to hold and express your own opinion, even though that opinion has done such harm to the cause of Conductive Education (and quite possibly may do so to your own personal cause too). It has set back a cause that should be benefiting uncountable numbers of disabled children and adults, their families and carers around the world, now and in the future.

Sets it back? It potentially wrecks it!

And at the individual level, so much wasted money, so much misguided hope and energy, so much disappointment, so much self-inflicted burden when there is already difficulty enough in life.

So I also reserve my own right to combat such erroneous thinking, wherever I find it conflicting with my own interests as an advocate of the cause of Conductive Education.
Wise up

Please count me out of discussing Conductive Education as as therapy, as a matter for medical evaluation, or as a topic for medical ethics (other than over the wider question of medicine's trespassing outside its field of competence).

Count me amongst those whose interest is in conductive pedagogy/conductive upbringing, what has been recently discussed on the Conductive Education blogosphere as 'Conductive EDUCATION'.
  • You can talk about Conductive Education as a pedagogy or an upbringing
  • You can think about it in the same way
  • You can advance social-psychological explanations of the processes involved in Conducive Education
  • You can take part in practical activities (as service-users, conductors or providers/funders) that are part of wider educational processes
  • You can integrate conductive practice into the life of families and the life of school
  • You can place it under 'education' where it belongs
  • You can struggle to get Conductive Education funded as part of the universal entitlement to proper education
  • You can implement appropriate educational research to answer proper educational questions, about how it works, what it does, how this might be improved etc...

You can also have ethical discussions, at an appropriate level.

Synthesis

And with these ways of thinking and acting are firmly in place, then we can look again at questions of 'therapy', in an altogether new light.

Reference

Weisleder, P., (2009) Unethical prescriptions: alternative therapies for children with cerebral palsy. Clinical Pediatrics (e-publication ahead of print)
http://www.unboundmedicine.com/medline/ebm/journal/Clinical_pediatrics


* With me or against me?

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