The discussion continues...
Over the last two weeks readers of have been raising important questions in the Comments pages of Conductive World:
Events march on, new items appear and it is easy for discussion like this to be 'buried'. I am therefore taking the most recent posting from these two threads and republishing it here with greater prominence: so that more readers may see it.
Jo Lebeer MD PhD, University of Antwerp, BE said...
Interesting discussion. I am particularly concerned that CE has been classified by the AACP (American Academy of Cerebral Palsy) as "insufficiently evidence based" and therefore not recommendable treatment, which puts CE along the same (poor evidence based) line as NDT such as Bobath and Vojta.
Gone are the 20th century paradigms (in the eyes of the academics). On the EACD (European Academy of Childhood Disability) conference in Monaco, then AACP president Charlotte Butler placed CE amongst the list of quackeries. In the EACD Barcelona conference, I had a talk on "the dilemma between inclusive education and activation", where I presented, as an example, the inspiring results obtained in a small CE+inclusion project in Hengelo, NL, as well as referring to Rony Schenker's and Roby O'Shea's positive results in this respect. After the talk, I received a comment: "It's a pity that you mentioned CE examples, because CE is not an evidence-based therapy".
However, listening afterward to Elisabeth Bower's talk on Collaborative Goal Setting, I had a feeling of "old wine in new barrels"; the idea of functional and goal-oriented treatment seems to be the 21st century approach; the underlying philosophy has been advocated long ago by... Andras Petö, who, however, is not cited by E. Bower.
Strikingly, Maria Hari's chapter in the "academic bible" on CP therapy, Management of motor disorders of children with cerebral palsy, London: McKeithPress, has been replaced by Elisabeth Bower's chapter on collaborative goal-setting. Equally, when you carefully read Diane Damiano's article on Activity, Activity, Activity, this is precisely what CE also advocates, right from the beginning. It has been the cornerstone of CE.
So, don't throw away this cornerstone, but Damiano (and Rony Shenker) are right that we need more research to measure the effect of activity. Why is it that CE people never present research results in the EACD or AACP conferences? It is difficult to prove any effect of any therapy in the field of pediatric rehabilitation systems. I tried to explain this in my article "Towards an ecology of rehabilitation: Methodology issues in evaluating intervention, in Conductive Education Occasional Papers, N° 9".
Nice to see you here Jo. I have a couple of things that I woud like to say about what you have written, but perhaps other people might like to get in first!




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