Wednesday, 31 March 2010

Cerebral palsies: a limited understanding

A very widespread one

Middle England sinks back into winter, so today I took refuge in the warmth of W. H. Smiths newsagents and sought out this week's issue of the British Journal of Nursing. I was looking for the full text of the review article on cerebral palsy mentioned here on Conductive World on Monday. This earlier mention had relied of the article's formal abstract and now I wanted to see the complete review. There was the BJN in paper form, bright an glossy, thick and perfect-bound, and at under a fiver less than half the cost of just buying the complete review article on line.

A tempting purchase but, while much of the rest of the issue is probably fascinating for nurses, it bore no direct interest for me. A fiver is a fiver, and the curiosity value of this review article was insufficient incentive for me to shell out (though, were I still teaching, it would have make a great now-not-to teaching aid).

So I took the third option, lined up unashamedly with the other old pykers, and skim-read it on the spot.

A fair abstract

And oh, ugh, the on-line abstract was certainly a fair one of the complete article: a quick line up of some physical aspects of cerebral palsy, a confused diversion into diagnosis (medical) and labelling (sociological), a mention of a couple of 'therapies' and – presszto! – time for an unjustified-by-the evidence leap into multi-disciplinary practice, unargued, undefined and undescribed). Oh, yes, and another non sequitur along the way, the the central role of the nurse in all this, again unargued undefined and undescribed.

But the essential psycho-social mechanisms linking all this together, the effects upon lives, both upon individual development and family life, the means to combat the effects – and the things not to do if one is not to make things worse – sorry, these were not there. Presumably the readership constitutes primarily fellow nurses. What might their roles be, in what circumstances, what understandings of development might they respond to and impart? Again, sorry...

Of small matter perhaps in the great scheme of things, but the great scheme is made up of many small matters, and so many of them at this level of professional discourse (and let no one think that I am singling out nurses over this) can so easily represent unthinking restatement, uncritical assembly of facts, without a theoretical position to link them together to old them up to the light..

Instead one may have, as here, implicit and unrecognised reinforcement of the understanding that a developmental disability such stems from as cerebral palsy is sufficiently and best accounted for in terms of its underlying 'physical' basis, making it (again implicitly) unlike any other developmental disorder, I can hardly imagine a article dealing with, say, children with hearing impairments, slipping through into the pages of BNJ, that could be analogous is any way in in its overall structure. There would be universal outrage!

Why do motor disorders have to put up with second best?

Persising hegemony – what a pity

This is not the fault of the editors or even the author of this particular article. Go to the bookshelves, look at the paediatric and habilitational literature (tellingly, there is no special-educational literature) on children with cerebral palsies). Look at what the voluntary (charitable) organisations say and write. Look at such official documents in which you can discern a gleam of concrete meaning beneath all the obfuscating verbiage.

Of course there are skilled, experienced and insightful people working in all disciplines, who fully understand and operate within understandings that are psycho-social, transactional, systemic, dynamic etc. When things are written down, however, for some reason these aspects tend to be pushed aside while the same old stuff is stated and restated, in the same old terms – i.e. in the current hegemonic professional discourse (apologies, that does sound dreadfully post-modern!). The present public discourse deserves a piori examination and challenging debate – not uncritical review

Perhaps I am being too harsh and review articles of the kind mentioned here would not be doing heir job were they not to reflect this dominant orientation within the public record. But in the meantime, pity the nurses and student-nurses whose attitudes and practices may be informed with knowledge that is partial and insufficient. Pity the families who, although they cannot know what is going on, most certainly 'know' that something is falling terribly short in how 'the professionals' (and, again, not just nursed professionals by a long chalk) understand and deal with them and their children. And pity the kids.

Don't take my word for it

If you are in the British Isles this Easter weekend you may be in for a chill old time, with snow, sleet, wind and rain. Duck into your local branch of W. H. Smiths, browse the magazine racks and seek out the current issue of the generally excellent British Journal of Nursing.

Find the article on cerebral palsy and judge for yourself. Am I right or am I wrong?

Previous item on this topic

Review article in question

Tuesday, 30 March 2010

Pető Institute training 'conductive aides'

Belated information, in Hungarian

The following information has been available on the Pető Institute's website since early December last year – and presumably through other Hungarian outlets too.

If this were simply a domestic Hungarian matter, offering Hungarian people training places and a Hungarian qualification, leading to Hungarian jobs, then no matter. But this is not. In two years time people with this new qualification will be ready to decant on to the international conductive job market. This makes the new qualification of 'conductive aide'. An imminent concern of everybody in the present conductive world.

Konduktorsegítő szakirányú továbbképzés

The public announcement of this course, in Hungarian –

English translation

In English, this means something like –

Vocational training for conductive aides

Posted on 7 December 2009 by Dr Adrienn Deák

The Pető Institute launches its four-semester vocational training for conductive aides in February.. Deadline for applying: 18 January 2010: [Link to application form no longer available].

Application fee: 5000 Hungarian Forints. Successful applicants will require a university or college degree and to have passed an aptitude test The course fee is 190,000 Hungarian Forints a semester. Further information from Dr Adrienn Deák or Indri Józsefné:

Tel: Budapest 224-1556 or 224-1592

The vocational training in detail

This specialized training course has the title CONDUCTIVE AIDE and bears a qualification certificate in that name. Its educational level is college-level vocational training within the teacher-training sector, and carries 120 credits

Vocational training education does not provide the level of training of basic and masters' level that university-degree or college-level education certification do, and the four semesters of the diploma rest upon existing, underlying expertise to provide specialist professional qualification.

The training aims for pedagogical training of specialists who are presumed to possess sound knowledge and skills suitable for disabled people with special educational needs (central nervous system damage) of any age, provided under the direction of a conductor or (conductor-teacher, conductor-kindergarten teacher).

The deadline for application is 21 December 2009. Apply electronically by downloading the application form from the college's website, or by mail or in person. Application form: [link no longer available].

Application fee: 5000 Forints, by bank transfer, check or cash. Application must be accompanied by a certified copy of a university or college-level qualification. Further conditions include passing music, speech and physical-aptitude examinations.

The aptitude test requirements can be found on the College's website and the Higher Education Admission Information for the Teachers and Teacher-Training. Aptitude Test will be held at 8 p.m. on 30 January 2010. The test fee is: 4,000 Forints. Place: 6 Kútvölgyi út, 1125 Budapest

A couple of translation problems

This announcement is fairly simply stated, being mainly administrative facts and therefore relatively easy to translate with some certainty. Some comment or guidance is required here from others, however, over two particular passages.
  1. Educational levels and qualifications are notoriously difficult to translate. This is not simply a linguistic problem: they are a conceptual and cross-cultural nightmare and have already created confusions aplenty in Conductive Education with respect to conductors. I have translated szakirányú továbbképzés into English as 'vocational but am very aware that this may is less than adequate. I think the problem is less apparent for German-speakers, whothink in terms of Fachschüle, but there is no direct equivalent in English (certainly not in British English). 'Trade school' sounds too artisan, 'further education' is too general and 'continuing education' may be misleading. 'Technical college' may hit the right spot for older readers, but possibly not for younger ones. I have no ideas of relevant usages in other lands. Perhaps someone with an understanding of European 'levels' can state it better in this new super-national educational currency
  2. The two most important paragraphs to uinderstand, certainly for people outside Hungary, are those starting Szakirányú továbbképzés and Szakirányú továbbképzés ('This specialized training course has the title...' and 'The training aims for...'). Sod's law says that the most unfamiliar sense is always harder to translate but is the most essential to know! Please, somebody who really understands what this course is about and what it aims to do, offer a translation or explanation that makes better sense of this than I can.
'Conductive aides'

konduktor – 'conductor'

segítő – literally 'helper', but 'aide' seems a more acceptable term in this context, or you might say 'assistant'

So far so good. A problem arises, however, when the two words are combined as konduktorsegítő, I do not know the subtle shades of meaning involved in Hungarian but how best to render this new compound term into English?

Maybe I am being picky but to me anyway, the term 'conductor-aid' (or 'conductor-assistant') implies a conductor who is also an aide or assistant (compare 'conductor-teacher, for example). I have therefore rendered konduktorsegítő here as 'conductive aid' to emphasis that this is primarily an assistant.

No doubt in years to come the 'conductor assistant' term will attain primacy, a cumbersome compound noun all too easily confused with 'conductor'.

In two years' time, if the world remains much as it is, conductor-aids may be looking for employment with cash-strapped private families and in all sorts of cash-strapped institutions around the world. One wonderswhat sorts of remuneration they might achieve.

It has been hard enough till now for non-Hungarians to understand the training, competencies, qualifications etc. of conductors. The World Congress in Hong Kong will offer timely opportunity to clarify the role and purpose of this new grade of conductive practitioner

By the way, earlier this week two items on Conductive World, on the unmeetable shortage of conductors and the international roles of conductor assistants, have raised considerable comment:

The information above on the new course in Budapest is important background information for considering these problems. It offers solution to neither.

* 'Some one, or nobody, knows I wot. / Who or which or why or what...'  (Edward Lear)

Monday, 29 March 2010

Research can raise a smile...

But you never know...

Less than a week ago an item on Conductive World reported how I the miserable, depressing English March weather, the spirits can often be raised by a little chortle at how research folks are putting on the style.

Really dismal weather again today but on cue along comes the weekly tragi-comic research round-up from Australia. What jokers some of those researchers are.

Have you heard the one about the multidisciplinary approach?

Hayes, C. (2010) Cerebral palsy: classification, diagnosis and challenges of care, British Journal of Nursing, vol. 19, no 6, pp. 368-73

Abstract. This article aims to build capacity between nursing and allied healthcare practitioner staff in highlighting the unique challenges that caring for people with cerebral palsy (CP) brings. It gives an insight into how CP is classified and diagnosed, and briefly outlines issues of political correctness in labelling people with this condition. It covers the complexities of brain development in people with CP, with consideration of the key aetiological contributors to the incidence of the condition. A straightforward approach to unravelling the classification of movement disorders in CP is adopted. It concludes that a multidisciplinary approach to the management of CP, with the nurse at the centre of this holistic approach to patient care, is pivotal to future healthcare provision.

The joke here is, like last week, the extraordinary feat of non sequitur between what may have been found and the deus ex machina conclusion deriving from this.

Same caveat as last week. Amusement may be a totally unfair response to Catherine Hayes' hard work, on the basis of my having read a mere abstract (though a proper abstract is meant to convey a study's absolute essence). It will cost me a tenner (£10.00) to read this article on line. It will cost less to buy the whole issue in the local newsagent. It was cost less still to read the article standing there! I shall try to remember to call into W. H. Smiths and see what action this matter merits.

More seriously, what are the unstated hegemonic assumptions that set up such a review in the first place?. Indeed,what assumptions  in the first placeshaped the evidence-gathering in that form?

A positive stroke?

Still quite amusing, if you are a connoisseur of Pseuds' Corner, is the strangulated English prose in the Results and the Conclusions sections of the following Abstract (it hails from France and Switzerland).

In this case, however, you can access the whole article, free of charge on line. Thank you Wiley Inter-Science. Respect..

Walusinski, O., Neau, J. P., Bogousslavsky, J. (2010) Hand up! Yawn and raise your arm, International Journal of Stroke, vol.5, ni1, pp.:21-27

BACKGROUND: In some cases of hemiplegia, the initiation of yawning is associated with involuntary raising of theparalysed arm. Reports are scarce in the literature, probably because the phenomenon has largely been overlooked.

METHODS: We studied six patients from two neurologic units, and compared them with published cases from the last 200 years. Brain imaging typically shows a small vascular lesion most often located in the internal capsule.

RESULTS: After comparison with experimental models in cats, we suggest that damage to the corticoneocerebellar tract of the extrapyramidal system disinhibits the spino-archeocerebellar tract, enabling a motor stimulation of the arm by the lateral reticular nucleus, which harmonises both central respiratory and locomotor rhythms.

CONCLUSIONS: When phylogenetically primitive structures are disinhibited, they regain autonomy in the homeostatic process associating the massive inspiration of yawning--a form of behaviour that stimulates vigilance – with a motor control mechanism that is active during locomotion. For this phenomenon, we coined the term 'parakinesia brachialis oscitans'.

There is something substantively very serious here, midst all the serious verbiage, the sort of neurological phenomenon that András Pető would seize upon as what I would call a potential pedagogic tool. Perhaps he did with this one, there is no convenient way of checking up on this. Perhaps conductors who work with adults all know about this one anyway, and utilise it. Ditto.

Either way, this article demonstrates something that everyone seems to know in real medicine, that well described and pertinent case studies, even only half a dozen of them, can indeed provide the basis for a certain essential stage in the research process.

So many conductors have such a rich experience of the strange phenomena, mental and physical, that the damaged brain can manifest. There is a legitimate contribution to be made to research by sharing these in the public domain, even if they are 'only anecdotes'!

Just take it easy with the verbiage.

Aides, assistants and students

What do you think

'V' writes –

I read on that the Pető Institute is starting a 2-year "conductor aid" course in September. I think it's high time. However I have to admit I can't clearly see the complex reasons behind this training right there, maybe someone could help out with this? The Pető Institute always used its own trainee conductors as aids; maybe these new aids are for export? :-) Would be great!

29 March 2010 02:35

'Anna' responds –

Obviously there is a misunderstanding about the role of the conductor trainees in the practice of CE.They are not used as aids but they always have a special task in the program according to their actual theoretical and practical knowledges
  • First years: able to conduct self-care activities
  • Second years: able to lead different task series and facilitate the task-solving
  • Third years: able to set goals and build different task series,learn to teach academic subjects in the classrooms
  • Fourth years: able to create and conduct the whole program of different group of children.
Of course this is a simplified description of the requirements,but shows that they are learners and their improvement is an integrated part of the program in the group they are practising in. This is the way of getting ready for all the roles of the conductor. Many times the conductor is the 'aid' of them while practising their different skills. The aids are going to be the helpers of the conductors providing the conditions of accomplishing a conductive program.

Hope I could add some aspects to clarify this problem.

29 March 2010 05:45

And 'V' comes back –.

The above is obviously the truth and who wouldn't know this who went through the conductor training at Pető . The trainee conductors are obviously getting ready for all the roles of the conductor, and they are learners, and all that, and in the meantime they do most of the jobs that the conductor aids do at every other establishment, where there are no trainee conductors; which also prepares them for their roles of the conductor. There's nothing wrong with that, nor there is disrespect in it. At the end of the day, nobody wants conductors who don't know how to fold and put away towels, clean and disinfect potties or keep an eye on the children. Sure trainee conductors do these, so do aids, so do conductors when there are neither aids nor trainees.

29 March 2010 06:36

The above three contributions were posted as Comments on yesterday's Conductive World posting, 'Feldshers, barefoot conductors and super-conductors':

They raise interesting and important topics, though they do represent a diversion from the central point of that posting. They have therefore been moved here, as a posting in their own right, as they are treating points of considerable interest within conductive practice.

– What do you think about the training and use of aides and assistants in Conductive Education?

– And what do you think of the employment of students during their vacation? There are ads enough for this on CONDUCTIVE WORLD JOBS to suggest that this is now wdespread practice?

If anyone has anything to say, on such matters, please add it as a Comment below. 'V' and 'Anna' too, please, if you have more to say.

What other people have experience of training assistants? What sot of things do you train them in, as well as folding and putting away towels, cleaning and disinfecting potties or keeping an eye on the children, to justify their assistance being considered 'conductive'?

Sunday, 28 March 2010

Feldshers, barefoot conductors, super-conductors... or what?

Any other solutions to a very big problem?


The question of 'feldsherism' has been intermittently one of the hottest questions in medical professionalism for well over a hundred years.

It refers to the independent medical practice of people with training that is different to or less than (the two are not necessarily interchangeable) fully trained medical;l practitioners ('doctors'). The term 'feldsher' is originally Russian (фельдшер, from the German Feldscher) but the question has arisen in different guises in different countries.

In the United Kingdom the recent discussion has been around 'nurse practitioners'. In Hungary midwives are presently a hot issue (one long resolved in the UK).

And the really big social-policy manifestation in my lifetime has been the Chinese 'barefoot doctor'.

To my lay understanding certain features are common (though not universal) in situations where a feldsherist solutionor something like it  is advocated or adopted. I know that feldsherism has been subject to considerable scholarly enquiry over the years but I have no time to dig into this. The following summary points will have to suffice, however, for present purposes.
  • A situation where there is widespread medical need and a massive shortage of doctors (the original term comes from the German word for for 'field surgeon'). This is fundamental to feldsherism in the modern world. Somebody has to help, or nobody will. There are few or no doctors.. There would be no possibility of fancy medicine even if there were. All the same, rough-and-ready, applicable to particular situations, may still prove a life-saver or a major ameliorator of human suffering.
  • There are major non-military applications of this too, of course. At then present day he developing nations spring at once to mind. The nineteenth and twentieth centuries presented examples aplenty in places that are now economically well developed.
  • If you wait till there are 'enough doctors' trained (whatever 'enough doctors' means) you will wait too long for the next generation or two to benefit, and perhaps you will wait for ever. Where that is recognised as politically, humanly or morally unacceptable, then something has to be done.
  • 'Modern, scientific medicine' might be wonderful but there are other, traditional approached to care and healing, indigenous to the place and perhaps ready and waiting for fast uptake. And cheap. So, incorporate them.
  • Provide a stripped-down, shorter professional training, with lower educational requirements for entrants to training, a a focus upon treatment for a range of circumscribed but very common conditions, and then a below-degree-level qualification. This does not necessarily mean  abandonment of the concept of standards. Just different ones. Horses for courses.
  • Expect many or most of the practitioners for this new (lower-paid, lower-status) profession to be women.
  • Watch out for a major reaction from some (though not all) established medical practitioners.
Perhaps I am presenting a caricature here, based upon ignorance. If you are reading these words, check on this. Form your own undersatanding

Conductive felsherism?

I do so because the present situation in Conductive Education is rather like that of the first couple of points proposed above. For 'doctors' read 'conductors:
  • A situation where there is widespread habilitational, rehabilitational and special-educational need and a massive shortage of conductors This situation is fundamental to feldsherism in the modern conductive world. Somebody has to help, or nobody will. There are few or no conductors. There would be no possibility of fancy Conductive Education even if there were. All the same, rough-and-ready, applicable to particular situations, may still prove a major ameliorator of human suffering.
  • At the present day the developing nations spring first to mind. But even in places that are now economically well developed is the situation for most people who could potentially benefit so much better? Be honest. The availability of Conductive Education for all is about as socially devisive in the wealthy nations as just about anything that you could think of.
As for training, it should be clear to everyone that potential demand is so vastly ahead of potential production that Conductive Education faces a problem here that is, simply speaking, insoluble. :Let us have no comforting, namby-pamby talk about 'challenges;' On present analyses, we face an task that is impossible. This leads to the next two features of feldsherism as outlined above. Again, there is quite a good fit with CE today and in the foreseeable future:
  • If you wait till there are 'enough conductors' trained (whatever 'enough conductors' means) you will wait too long for the next generation or two to benefit, and perhaps you will wait for ever. Where that is recognised as politically, humanly or morally unacceptable, then something has to be done. Here the analogy of course breaks down. There is no political, human or moral force in society for a way to rescue disabled children and adults, and their families, from a culture that implicitly accepts pedagogic neglect (however well meaning and benign) as being somehow in accord with the laws of nature pedagogic Without that force for change then you will be waiting for ever.
  • 'Modern, scientific medicine' might be wonderful but there are other, traditional approached to care and healing, indigenous to the place and perhaps ready and waiting for fast uptake. So, incorporate them. Perhaps a little more serious attention to the historical and philosophical roots of conductive pedagogy might be instructive. Just what sort of doctor was András Pető anyway, and what did he bring to the party to ameliorate the lot of the disabled (and. let us not forget, people with all sorts of other conditions) in the desperate days of post-War, early-Communist Hungary? Think on't. If you want a steer on this, I would advocate (yet again) looking at András Pető's two published works on the nature of healing. And what about traditional approaches as candidates for incorporation today? Look no further than the burgeoning CE research literature, from China.
And what sort of professionalism might this imply for what is presently called Conductive Education? . The last two points on medical feldsherism proposed above night be indicative:
  • Expect many or most of the practitioners for this new (lower-paid, lower-status) profession to be women. To report that this is already the case amongst existing conductors is not to condone the situation, merely to acknowledge it. Depending upon the society that one is considering. this situation may be or may not be open to change.
  • Watch out for a major reaction from some (though not all) established conductors. You might think that doctors might consider themselves professionally secure. Medical reaction to felsherism could suggest otherwise. Conductors are nothing like as securely established as are doctors, just about hanging on in fact, and may find the very thought of conductive feldsherism threatening not just to their status but to their very livelihoods
But is 'a conductor' as presently construed and defined (and I should love to see that in black and white from some brave soul or institution) really an a priori solution to the tasks that the even the present generation of relatively well healed and fortunate first-world users of Conductive Education would like to see solved? And how useful is this model of professional training and delivery to everybody else?

Other ways?

Feldsherism is but one alternative approach:
  • Most obvious is recourse to training existing professionals, in something (usually the so-called and diversionary 'principles of Conductive Education'). This has still to be properly argued out and even, where it has been tried, it has still yet to be properly described . (As ever, for those who favour the concept of a 'challenge', please prove me wrong by directing us to the literature that does just that). The actual problems here would seen immense, not least the oil-and-water problems at both the philosophical and the practical levels, and the sheer logistical issue that the existing professionals may be as hard to come by as conductors, and cost even more!. Minute advantages, maybe, in some yet to be described circumstances, but no solution at a molar level.
  • Less obvious – and far more radical – is Karóly Ákos's proposal to deinstitutionalise Conductive Education and go instead direct to the basic cell of human society, the family. As he put it in the epigraph to the book Dina, quoting Goethe's Faust: 'There is a way… the mothers!' Of course this has been tried. In the late nineteen sixties, when Karóly Ákos was actively involved with the then State Institute in Budapest, parent-and-child work appeared as the a fundamentally new way of working. Ad hoc variations of this have appeared since, in different parts of the world, but no formulated extension or elaboration into, say, other age groups. And certainly, despite the ever-extending possibilities that arise from the Internet, no attempt to update the epistolary practice recorded in Dina itself into the world of the Internet.
  • Less obvious and as yet to be explicitly mapped out, never mind tried out in practice is some sort of 'super-conductor', with a vastly extended and more broadly applicable knowledge base – and with a social role much different from the conductor of today. This could of course be developed out of the existing workforce, a situation that would doubtless be welcomed by many conductors. Or it could by-pass it altogether, which might be rather less acceptable! The important first step in elaborating such a possibility, though, is not surely neither acceptability nor job-enhancement, but an a priori examination of the world might require. More radical proposals such as adumbrated in the previous point, may have to await the arrival of superconductors.
There is something else, another way to extend a limited trained :workforce with something cheaper and quicker to bring into production. This is common already in teaching, nursing and the therapies: 'assistants'. But the very term gives the game away. Autonomous practice is not implied. Nor is a discernible knowledge base in its own right. This is not what is being implied here by 'conductive feldshers'.

So what might a conductive feldsher be?

Who knows? I have been carrying this notion about for years and years, and talking with people about it, but I think that this is the first time, that I have committed it, however informally, to paper. It is easier to do so now than it was even just a few years ago, as the degree of the crisis ahead of Conductive Education begins to sink in.

There is no empirical answer yet to this question – not yet at least in the public domain. But there are certainly potentially communicable experiences that might contribute to understanding the possibilities. The work at Sizanani Village in South Africa is an obvious example.

And of all places, China seems an obvious place to start thinking of 'barefoot conductors'.

Perhaps they already exist.

Saturday, 27 March 2010


A social transaction

Could you wish for a better concrete example of the fundamental fact that Conductive Education is systemic, developmental, and a social transaction, than yesterday's blog posting from James Forliti in British Columbia –

Forliti, J. (2010) Pigs, CE in BC, 26 March

And en passent, could you wish for a better example of the immensity of the challenge facing those who would evaluate the outcomes of conductive upbringing? No wonder nobody dares confront this!

Up a gum tree

Not an Australian one

For  something a little different, hop across to Norman Perrin's blog.

Norman is a father and a CE service-provider in Sheffield, England. His blog embeds consideration of Conductive Education in some of the serious social, moral and political issues that impinge upon both these bedrock areas of social practice.

You do not get to see much of that in the public domain. Pity.

Tree boy

On the blog-boil over at Norman's at the moment is the peculiar tale (sign of the times, urban legend?) currently going the rounds in the UK press – and to some degree in the world press too – the story of the boy rescued from up a tree by passer-by Kim Barrett (or not, as the case might be) in the playground of Manor School in Melksham in Wiltshire:

I have no idea what has been happening in Melksham, a faraway country town populated by people of whom I know very little. All I can see is that a few of these people seem up a serious public gumtree over the sort of childhood scrape that I used to enjoy reading about when I took the Beano*.

Nothing to do with us in Conductive Education?

Don't you believe it
More important that the specifics, what does this fuss say about the sort of societies that we live in (not just the UK) and into which we are trying to introduce Conductive Education?

Particularly, what does this funny business say to somebody in Norman's position(s):
  • to a parent of a disabled young adult
  • to somebody responsible for a school and other services for disabled children
  • to anyone who is a critical advocate of the potential benefits to society of the fundamental messages of Conductive Education?
That covers a lot of the readership of the CE-blogosphere – and a lot of those in Conductive Education who are not, but ought to be

* The Beano: archetypal British chidren's comic

I'm not going to take this any more

Australian disability campaign on the road

The expected article by Mike Steketee, in The Australian, has now appeared:

Also in The Australian

There will doubtless be others but it is not within the province of Conductive World to report these specifics. The public campaign is successfully off the starting blocks and no doubt particular highlights will be passed on here.

I'm mad as Hell and I'm not going to take this any more

The iconic 'I'm as mad as hell' speech from the film Network (1976), spoken by Peter Finch –

First Conductive Education support...

Will others in Conductive Education around the world be folllowing Judit Szatmáry's lead, throwing open their windows, sticking their heads out, and shouting...?

Not necessarily windows in 21C, of course, more likely social-networking sites like Facebook.

More information

Friday, 26 March 2010

Mad as Hell

Good on you, Diggers *

One often (too often?) meets the word 'mad'  in conversations about Conductive Education. In English, of course, the word bears two major meanings:
  • deranged, insane, bonkers
  • exceedingly angry, furious
Within Conductive Education it is the first of these meanings that is usually needed and intended. Here, though, we shall be invoking the second meaning, furious, in which sense Australian parents and carers, disabled people themselves, and service-providers too, are as mad as cut snakes, and that in a context wider than Conductive Education.

They are mad for the wholly rational reason of the deplorable failure of the state in that their rich country of theirs to ensure a civilised welfare system for those affected by disability. And with a General Election coming up soon, some of them are responding in a thoroughly rational way. They are forcing their case vigorously into the political arena.

Mad as Hell

Sue O'Reily writes –

Launched today: a journo mate of mine in Brisbane, Fiona Porter, has been working with me on a national, grass-roots, web-based political campaign in the lead-up to the next federal election due around October, to mobilise the votes of around two million Australians, some fifteen per cent of the national electorate who are fed up to the back teeth with Australia's cruel, dysfunctional, shambolic, wasteful and crisis-driven disability support system.

Attached is the media release we're issuing tomorrow, plus the national email alert we're sending out tomorrow directly to all our networks, and following is the website link.

Mad as Hell's media release is appended to this posting, below. So is a copy of the email that is being circulated, and repcirculated, through individuals' personal networks (do pass it on yourself).

That's the way to do it

Fiona Peter writes –

This website took us just under four weeks – from 'having an idea' to completion. Fingers xx, it becomes the central rallying point to get sufficient numbers of voters to demand politicians fix disability services in this country.

Early days yet, the media release has only just gone out. How things will develop and the matters arising will unfold over the coming months. Here, though, are some immediate questions.
  • What about the big, established organisations and professional bodies and individuals with established positions and reputations in the field? What about their colossal resources of money, staff, establishment links, supposed influaence etc? Simply, Mad as Hell is by-passing them. because they are too deeply involved in the status quo. This is a matter for individual citizens, the new politics of 21C.
  • What about the media? In the new politics of the twenty-first century the media of course have a role – but the very meaning of the word 'media' is evolving fast. Mike Steketee is writing a column in the Weekend Australian, and that's the sort of contribution that we valued so much when Conductive Education in the UK was run as a political campaign. There will be news stories too and, properly managed, these are invaluable too. But, Sue writes, 'This is individuals, and thank God for email and internet because that what makes it all possible. The beauty of this campaign too is that it completely bypasses the traditional media. Again because of email and internet, we get the message DIRECT - to millions.'
  • What has any of this to do with the rest of us, outside Australia? Well, in response, here are two more question: Which of you reading this lives in a country, rich or poor, where services are adequate? What are YOU going to do to achieve meaningful change in your own country?. This Australian campaign looks like being grown-up politics, and Australian politics can be very outspoken and very rough and tumble.(and great fun to watch!). It will be instructive to see what this political action takes down there, what the campaigners will have to do, and what they get out of it. Not least, some other people have General Elections in the offing, the United Kingdom for example. Of course, the UK voters have not been told yet when this will be, but very soon now. No time probably for getting a similar act together in the UK – but this Australians' grown-up, individual politics should not be just for General Elections, but for life.
  • Will Conductive Education be featuring in any way in these Australian shenanigans – either as something to be mentioned or participating actively in the campaign? As far as Mad as Hell is concerned, Conductive Education is far down the track yet – part of the longer-term strategy for the future. Sue writes  'Once Australia gets its NDIS [National Disability Insurance Scheme], then those Aussies who want CE will have much more chance of success, because funding will be much more individualised, 'person-centred' as they say these days and under our own direct control.'
Meanwhile it will be up to everyone involved with Conductive Education in Australia, individuals and organisations, to decide whether they wish to take part in this campaign, and judge for themselves what along the way it might contribute to their concerns.

And act. 

* Pedantic footnote

Strictly speaking and historically, the word 'Digger' refers to both Australians and New Zealanders. My impression is that in recent years anyway, outside the Antipodes the word is understood mainly in respect to Australians. If I am wrong in using bit here in this way, then do please suggest an alternative word to imply the same rugged, respect.


Enough’s Enough 
We’re Mad as Hell about Australia’s disability support system
We’re not going to take it anymore 
And there are millions of us 
A national, grassroots, web-based political campaign is today being launched to harness the voting power of millions of people with disabilities, carers and family members infuriated by Australia’s broken, dysfunctional disability support system.

With a federal election due later this year, the Mad as Hell Campaign features as its centrepiece a Pledge of Voting Intent, stating that signatories will only vote for a party or parties that unreservedly commit to introducing, or supporting the introduction of, a National Disability Insurance Scheme immediately following the completion of a Productivity Commission feasibility study in July next year. 

Joint national convenors of the Mad as Hell Campaign, Brisbane-based communications consultant Fiona Porter and Sydney-based journalist Sue O’Reilly – both mothers of sons with disabilities - say that in every State and Territory, disability support services are now so dire that many people are being driven to vote solely on the basis of each party’s disability reform promises.

“The strategy for the Mad as Hell campaign is based around the fact that there are between two and three million Australians of voting age whose lives are directly and grievously affected by this country’s disgraceful, Third World disability support system,” Ms Porter said.

“This includes more than one million Australians who were born with or have acquired disabilities as the result of catastrophic accidents or chronic illnesses, more than half a million family members who are full-time, primary carers of people with severe to profound disabilities, and numerous other family members such as sons, daughters, brothers, sisters and grandparents.

“There are also tens of thousands of health professionals, teachers, therapists, disability support workers and close family friends who witness every day the suffering caused by grossly inadequate funding for basic equipment such as wheelchairs and hoists, essential therapy services,  targeted educational support services, choice in accommodation, relevant in-home support services, respite, and genuine employment and other post-school opportunities.”

Sue O’Reilly, who lived with her family in “disability exile” in the UK for 12 years and last year, after  returning to Australia, founded a charity called Fighting Chance to help fund essential therapy services for children with disabilities, says: “It’s hard to describe how galling it is for people with disabilities, families and professionals to be forced to watch as vast sums of taxpayer funding - supposedly allocated for disability services - are squandered, year in year out, on mountains of red tape, bureaucracy and an entirely crisis-driven approach that withholds cost-effective support or intervention until the last possible moment, not infrequently when people are beyond desperate and in complete crisis.

“The current system utterly demeans people with disabilities and their families and carers by making us apply, cap in hand, for services or equipment that usually aren’t available anyway. Without the legislated rights to basic, essential services that exist in the UK and other countries, Australians with disabilities and their family carers have to put up with being told, over and over and over again: ‘Good news, you qualify for this or that service – but bad luck, the funds ran out two months ago’, or: ‘Sorry, but you are at the bottom of a three- year wait list, so if you really need a new wheelchair, you’re just going to have to go out and buy it yourself’. But many carers and severely disabled people live in poverty, because of the impact of disability, and can’t afford to buy even basic equipment.  So they just have to go without.”

The Mad as Hell convenors say there are now thousands of elderly Australian parents aged in their 70s, 80s, even 90s, still expected to struggle on as sole carers for sons and daughters with severe disabilities aged in their 40s and 50s.  Porter and O’Reilly say that everyone who has witnessed or experienced the extreme inefficiency and cruelty of Australia’s current disability support system, either at first hand or through media reports, is shocked.

“That even includes the federal parliamentary secretary for disabilities, Bill Shorten, who has had the courage to say publicly that Australia’s treatment of people with disabilities is a ‘disgrace’, and who has been a strong advocate within government of the proposed National Disability Insurance Scheme,” says Mrs O’Reilly.

However, while the Mad as Hell Campaign acknowledges the efforts of the Rudd Labor Government to date to improve disability services, including asking the Productivity Commission to report on the feasibility of a long-term disability care and support scheme, all Campaign supporters will reserve judgement on which party to vote for in the forthcoming federal election until all parties’ election manifestos are unveiled.    

“Because there are so many Australian voters directly affected, and because the current system is so dire, the national, grassroots coalition of people with disabilities, parents and other family members who have come together to launch Mad as Hell firmly believe this campaign could become one of the most powerful single issue electoral forces in Australian political history,” both mothers said.


  Are you mad as hell about Australia’s dreadful disability support system? Yes? Then -
Time to make YOUR vote count
We are writing to inform you of the launch of a national, grassroots, web-based electoral lobbying campaign in support of a National Disability Insurance Scheme (NDIS) – a Scheme which, if designed and implemented properly, will transform Australia’s broken disability support system and finally give real hope, support and essential services to millions of Australians affected by disability.

The goal of this website-based electoral lobbying campaign, called Mad as Hell, is nothing less than to harness the voting power of all Australians who grasp the need for fundamental disability reform, so as to make political parties commit to full implementation of an NDIS – regardless of which party is in power.

 Millions of people = Voting Power

All Australians would benefit from the introduction of a national, no-fault disability insurance scheme, funded by a Medicare-style levy, because disability can strike any individual, any family, at any time.

But all around Australia, there are people – voters – whose lives have already been touched by disability, and who are as mad as hell about the state of this country’s grossly dysfunctional disability support and service system.  And there are millions of us.  If we join together, we could become one of the most powerful single issue lobby groups in Australian political history. Ordinary citizens like us have just one moment of power in a democracy, and that is when we go to a polling station on a Federal or State election day and cast our vote. Proposals for a transformative National Disability Insurance Scheme are now on the table, and a federal election is due later this year. So now is the time for all NDIS supporters to unite and harness our combined voting power to ensure fundamental reform of Australia’s disability support system.

The Mad as Hell Campaign, launched today via the website fratures a Pledge of Voting Intent at the next federal and State elections. The Mad as Hell Pledge states:

I pledge that in the next federal and State elections, I will only vote for a political party which publicly promises to transform Australia’s broken, inefficient, crisis-driven disability support system by:
  • Introducing and supporting a national, entitlement-based disability insurance scheme immediately after the study by the Productivity Commission, due in July 2011
  • Ensuring  people with disabilities, and if applicable their
  • Families or  nominated  representative, have control over how funding allocated in their name and for their benefit is spent

The Mad as Hell campaign is of direct relevance to
  •  more than one million Australians with permanent disabilities, and the vast numbers of their family members who are either primary carers or close relatives, including mothers, fathers, sons, daughters, brothers, sisters, aunts, uncles and grandparents
  • thousands of health professionals, teachers, therapists and disability workers who witness each day the devastating impact of Australia’s dysfunctional, broken, crisis-driven support system on people with disabilities and their families   
  • thousands of Australians working for the disability service organisations that now overwhelmingly support the introduction of an NDIS.

To join in and support the Mad As Hell Campaign, you don’t have to give any money to anyone; you don’t have to write to your federal or state MP or local newspaper; you don’t have to become a member of any organisation or political party; you don’t have to march in the streets.

All you have to do is go to, click on the Pledge and type in your name, email address and postcode.

All postcodes submitted will be matched to federal and state electorates, and all candidates standing for election in these seats kept notified of the number of Pledges made by electors in these seats – with particular attention paid to marginal electorates.

The campaign will be backed by an intensive publicity drive throughout Australia, with early, pre-launch expressions of interest in covering this campaign already received from The Australian, the ABC and local radio stations around Australia.

All those millions of us directly affected by the dire state of Australia’s current disability support system need to remember this:
  • We are not just socially isolated, poverty-stricken, desperate, individual victims of the cruel, inequitable, severely underfunded and crisis-driven disability support system now in force in Australia. We are also members of one of the most numerically powerful groupings in Australian society, united by the anger and outrage we feel at the grave injustices we see all around us, every day, and united by our wholehearted desire for sweeping, transformational change, justice and equity, in the shape of a national, no-fault, entitlement-based Disability Insurance Scheme.
We urge you to circulate this email to every single person in your email address book today, and ask them to circulate it to every single person in their email address book immediately, so that information about the launch of blankets Australia within a matter of days.

We will keep all supporters informed with regular updates about the number of pledges made, media coverage and the response of political parties.

It’s way past time for those of us who are mad as hell to get mobilise, unite and make our millions of votes count.

The national Mad as Hell Campaign Committee has representatives in each State/Territory:

 For further information, including contact details, go to

26 March 2010

Thursday, 25 March 2010

Brussels sprouts

More green shoots?

Do you recall the correspondence with Professor Bernard Dan a couple of months back, about the now immanent annual conference of the EACD (the European Academy of Childhood Disability), in Brussels?

The final programme for the conference has now been published. Here is a page from the site –

Parents welcome

Yes, parents will be welcome at the meeting, as we feel that they constitute an important expert component of the multidisciplinary setting involved in the care of children with disabilities.

The programme of the meeting includes a workshop ‘by parents for parents’ (which will, like the other sessions, be open to any interested participant) on the theme of “parenting the child with disabilities”.

Although the programme is otherwise mostly scientific, there will be a one-minute presentation prepared by a parent in each themed session, illustrating the theme of the session by presenting a subjective perspective.

In addition, the programme is organised in such a way that parents can chose to follow a suggested “parents’ track” of parallel sessions dealing with issues
that might be more relevant to them (e.g. 'inclusive education' or 'transition to adulthood').

There is a reduced fee of 100 euros for parents for the whole meeting.

Possibly things would have been much the same without the intervention of Conductive World but on the face of it this does look rather better than mere rhetoric or tokenism. A lot will depend now of course on whether parents are able to attend, what they say, and whether anyone listens.

Still, as they say, 'It's a start'. Congratulations to the European Academy for going an extra mile (I.. km as they put it in Europe) beyond what many organisations and their conferences do not yet even aspire to. Let us hope that the Academy's example in Brussels will be reflected in local, everyday paediatric and habilitative practice across Europe. Where it is not, then there is at least the Academy's example to point to in admonition, as something to aim for..

Good luck with the conference. Let us also hope that some account of will be published somewhere accessible.

Final conference programme

Earlier correspondence

Sutton, A. (2010) Des grandes fromages aux Bruxelles: big cheeses in Europe Conductive World, 2 January

Sutton, A. (2010) A nice letter: it pays to say your piece, Conductive World, 12 February

Wednesday, 24 March 2010

Seeing is believing

So what does one show?

Still photos are by definition a very poor way of capturing movement. They can totally miss its essence – or out of a single frozen instant, they can create a wholly misleading impression. When one uses still images to help communicate about communicate about Conductive Education, for technical or propagandising purposes these problems come swiftly to the fore, and can be used for good or for ill. I recall from twenty-plus years ago the agonising that we used to go through over whether we should use particular photographs – 'Yes, this one is a brilliant image but No, look at that position' etc., and of course, 'That's not a laugh, that's a spasm'. One can often tell today when looking at collections of photos, particularly now of course on websites, when there has been just such agonising – and when there has not.

I remember too when the first clunking video cameras became available. As far as movement per se is concerned, moving pictures go quite some way towards telling how it is though they can still misportray the whole picture as far as human movement is concerned. The basic problem still remains, however: what is good to show, illuminating and explanatory and what is thoroughly bad practice with with the added advantage (or further cause for confusion) of sound?

Now video cameras are no longer clunking great things and they come cheaper and cheaper and cheaper. Alongside this, it has become easier and easier and easier to upload a video sequence on to one's website, or on to YouTube etc, even if you have no site of your own. It will become cheaper and easier still, with as yet unforeseeable effects.

And the technological has advanced at such a rate! Only a couple of years ago, videos of Conductive Education on line were so rare that Conductive World used to list them the DIRECTORY on the left of this page. There came a point last year by which videos posted on line (and this includes of course professionally made stuff, usually from local TV newscasts) had become so two-a-penny that it was longer possible or even functional to list things in this way. If you want to find an online video of something that somebody calls “Conductive Education”, go to YouTube and take your chances. This morning, such a search came up with 156 hits:

And that is before you look elsewhere. Go to Google Videos and you will find 172. Search elsewhere, and on blogs and websites, and you will find yet more...

The good, the bad and the indifferent

Make no mistake about what is being said here, video is a brilliant medium for conveying Conductive Education, and free video on line for all is a most remarjable boon. Some of the stuff available on like is wonderful, especially sequences that link moving imaged integrally to informed and sensitive commentary. When such materials come to light, then Conductive World does its best to draw them to wider attention.

And there are some truly awful examples of practice up there waiting to be downloaded, to mislead parents and others with personal interest and to lend weight to the criticisms of those who oppose Conductive Education.

A general Internet problem then rears its head, one that is specific neither to Conductive Education nor to videos. We have a situation in which the indifferent and the outrightly bad are two a penny, the good are as rare as hen's teeth. The former just bury then latter and, when people who want to see and understand Conductive Education do shop around, the two-a-penny bad or indifferent coin can drive out the good.

What to do?

Who knows? Certainly not the gurus of the wider Internet. The little world of Conductive Education is stuck with the same emerging contradictions over Internet access and what it is going to do to our lives as is everyone else on the planet.Wthin the tiny world of Conductive Education, problems over duff videos on line probably pale into insignificance alongside some of the other potential effects of the Internet.

One ought, however, to be aware of some of the issues around online CE videos. Conductive Education may not have much 'literature', nor much research and academic enquiry relevant to the realities of users and providers, but there are occasional conferences, there are initial conductor-education courses, centres and programs surely have in-service training activities, and there are all sorts or channels to express things on the Internet itself. I have had conductors personally expressing very grave concern about some of the practice that they see portrayed in online videos, on the verge of tears even at what has been shown. Why is this not a topic for more public, explicit consideration?

Probably because there are so many other important matters about which one could ask the same question. How to prioritise? And anyway, this particular problem has come upon us so quickly that it may be particularly hard for institutions and the people who run them to recognise what is going on, never mind to adapt.

Again, nothing unique about the particular issue raised here!

North American conference comes round again

A very full two days

Call for Abstracts
Thursday-Friday, 26-27 August 2010
Toronto, Ontario, Canada
The Association for Conductive Education in North America (ACENA) presents the 6th Annual North American Conductive Education Conference August 26 and 27, 2010 in Toronto, Ontario, Canada. This year’s conference is hosted by March of Dimes Canada.
Submissions and enquiries to conductor Mhairi Watson:
Deadline: 31 May 2010

Practices, benefits, education/medicine

ACENA's call for abstracts announces that the conference will have two 'streams'
  • applications in the Conductive Education classroom
  • best practices in Conductive Education administration
Further ...

We are looking for individuals who have benefited from Conductive Education, or their family members/caregivers, to share their successes and successful strategies, as well as service providers/professionals to present their successes and best practices to a diverse group of delegates, including: program administrators, conductor/teachers, and program participants and their caregivers.

The theme for this year’s Conference is 'Conductive Education: Building an Educational and Medical Partnership'

It is not yet clear how these three dimensions will fit together. Doubtless further, specific details will emerge. Altogether a very busy couple of days, taking on some very big questions. See more at:


I recall the last big CE conference in Toronto that was organised by March of Dimes. This was held on 28-29 May 1993 and called 'Discover Conductive Education'. It drew upon the considerable resources of a big and multi-faceted organisation to produce bound and informative conference proceedings.

I do hope, and I will not be the only one, that the conference in August will come up with the same sort of thing.

Tuesday, 23 March 2010

It has been a poor old day...

I could do with a laugh

Conductive World should not have tempted Providence this morning by invoking Chaucer's 'droghte of March'. Here in Mercia the weather today has turned out truly vile. It doesn't need to rain: the very air is wet. Hence today's disproportionate number of postings from my dank cave.

Nothing cheers like a heavy statement of the obvious and a call for more of the same from that veritable tribe of jokers, 'the researchers'. Here is this afternoon's beaut, distributed from Sunny Sydney, an unending source of merriment for the desperate, for as long as you keep your sense of humour. The place in Sydney that sends them out does not actually do research itself (correct me if I am wrong) but it does like ensuring that we all have a chance to share what's going round. Actually, this one comes from French Canada –

Majnemer A, Shevell M, Hall N, Poulin C, Law M. ( 2010) Developmental and functional abilities in children with cerebral palsy as related to pattern and level of motor function, Journal of Child Neurology, in press

Abilities among school-aged children with cerebral palsy with different patterns and levels of motor function were evaluated. Children within spasticity patterns (33 with quadriplegia, 25 with hemiplegia, 19 with diplegia) and Gross Motor Function Classification System levels were compared (level I, walking = 47%; level II-III, restricted ambulation = 18%; level IV-V, wheelchair needs = 34%,). Outcomes included measures of intelligence, behavior, motor, and functional limitations (communication, daily living, socialization). Motor performance and prosocial behaviors were lower for children with quadriplegia (F = 16.13, 12.71; P < .0001), with no differences for behavioral difficulties between spasticity groups. Prosocial behaviors were different between level IV-V and other groups (F = 16.25, P < .0001). Functional limitations were more likely for children with quadriplegia (P < .0001), but not diplegia or hemiplegia, and for children in level IV-V, but similar for level I and level II-III. Children with quadriplegia, or level IV-V, are more likely to exhibit limitations, whereas children with better motor function (I-III), hemiplegia, or diplegia, exhibit diverse capabilities. A holistic assessment approach is essential to ensure that limitations are addressed comprehensively.

No joking, this is a serious matter. It has helped keep at the very least the four named authors in employment during these very hard time and, though the final sentence (the conclusion/recommendation of their work) is surely a non sequitur from what follows before, the published article helps them and their colleagues everywhere by restating and reinforcing society's apparently unquestioning need to keep on funding endeavour of this kind in the name of 'research'.

Sorry, this is a totally unfair response to all their hard work on the basis of having read a mere abstract though  aproper abstract is meant to convey a study's absolute essence).. All that '< .0001'... Wow! But you have to laugh, surely, for to start thinking seriously about such matters and what they are all about, especially on a day like today, is surely the fast track to seasonal affective disorder. I am sad enough already about how the world of 'rehab' is like going to the races: everybody seems to win, bar the punters..