Friday, 22 January 2010

Public row in Sweden

Look what the rest of us are missing

This morning, and without comment, Lars Mulback sent me the following press release:


This is in Swedish. By my own reckoning, this is what it says –

Do not miss: "'Health care is CP', to be shown in TV4 at 1600 hours on Saturday 23 January

In this new documentary Mullback sets the nation's leading CP-researchers, Hans Forsberg, Ann-Christin Eliasson and Eva Brogren-Carlberg, against Professor Arvid Carlsson joint winner of a Nobel Prize in 2000 for the discovery that the brain is plastic.

'Neglect!' screamed Lars Mullback in a debate in 1996, 'Cerebrally palsied children, so cherished by the Swedish health care system die prematurely as a result of the well-meaning help of incompetent therapists, instead of teaching their patients to move'. He followed up by setting up embarrassing documentary films in TV4 on health care that was awkward at helping those with cerebral palsy with their problems.

Doctors said that Mullback had told lies and exaggerated in the television and newspaper debate and the National Board found that the method that had taught Mullback to eat and to dress himself in three months, was quackery and should be banned in Sweden.

Despite the opposition and warnings of the establishment, five private schools have been established in Sweden and several thousand have been trained through Conductive Education, the method that has been so controversial. Many have to pay several hundred thousands themselves for their treatment if they live in the wrong county.

Lars Mullback, film-maker and himself disabled with cerebral palsy, has now made a new documentary about what has happened to children with cerebral palsy who chose the Hungarian treatment in the late 1990s. Now, they can tell us how even today training services are not offered as a treatment option.

This new film is called: 'Health care is CP!. which means that those with cerebral palsy have learning problems that are best remedied by education, not health care.

In this new documentary Mullback sets the nation's leading CP-researchers, Hans Forsberg, Ann-Christin Eliasson and Eva Brogren-Carlberg, against Professor Arvid Carlsson joint winner of a Nobel Prize in 2000 for discovering that the brain is plastic.

Contrary to the Nobel Laureate, this is the view of the three scientists,who govern how cerebral palsy should be treated in Sweden. These three do not believe that Conductive Education is somehow better than medical care. 'It is neither better nor worse' says Hans Forssberg.

Nobel Laureate Arvid Carlsson, however, says: ''The brain is plastic, meaning that it can rebuild itself and solearn new things. This also applies to a damaged brain. New synapses emerge and seek new contacts with other cells. With conductive pedagogical help children with cerebral palsy learn to move . Though I am not an authority on the CP area, I have seen this when I visited your school, said Arvid Carlsson in the film, stressing the importance of providing children with praise when they do things right: 'It is through the encouragement of a reward system as we learn new skills,' he explains.

The three scientists believe that they have evidence to the contrary, that it is not good to get children with cerebral palsy to move in a more correct manner. Eva Brogren-Carlberg says: 'The disabled themselves should have their own idea of how to move, that someone else should teach you a movement, I perceive as problematic.'

Maria Andersson is now 18 years and has cerebral palsy. Today she says: 'It has often been tough many times but I regret nothing.. Without this training, today I would have been a package.'

Due to lack of interest in this treatment option, only twenty percent of those with cerebral palsy in this country receive support for Conductive Education, the remainder are referred to the medical rehabilitation services, without any educational assistance to develop their ability.

Maria Andersson says: 'I have friends who have been packages. I am receiving the best training, I see the course. I am receiving the best training, I see how it goes. Those who do not get it, they only get worse. It is very hard to see.

I would not take my translation to court but I think that it conveys the drift. The word 'training' is frequently used in Norwegian and Swedish to cover both Conductive Education and therapy. I have never been able to discover whether it bears the same rather negative connotations in those languages as it can in English. I have translated sjukgymnasters as 'therapist'. I could have said 'remedial gymnast'. I am sure that neither English term will really be equivalent. The wor kolli can be translated as package, parcel – or vegetable.

This is a repeat of a programme first put out over Christmas. Draw your own conclusions.

Dramatis personae


Arvid Carlsson. Pharmacologist whose work had involved dopamine and synapses, rather than plasticity in damaged nervous systems, also well-known in Sweden for his opposition of fluridisation.

Hans Forssberg. Neuroscientist, Vice-President of the Karolinska Institute and Director of Stockholm Brain Institute. His view quoted above, that CE is neither better nor any worse that other approaches, is fair summary of the outcome of nearly twenty years medical and medical-style evaluation of Conductive Education.

Ann-Christine Eliasson. Occupational therapist, working at the Karolinska Institute, has been involved with 'intensive training' which was developed in part in reaction to parental enthusiasm for Conductive Education.

Eva Brogren-Carlberg. Physiotherapist, also at the Karolinska Institute.

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