Monday, 21 June 2010

ICF and CE

An a priori developmental position

Two-and-a-half years ago I contributed to Tsad Kadima's twentieth-anniversary conference in Tel Aviv, as part of which I contributed to a plenary Round Table, being quizzed along with Sarah Capelovitch by paediatrician Peter Rosebaum. Peter is an international Big Wheel in the paediatrics of cerebral palsy – and a major ICF-buff. Inter alia Peter posed the following question –

Today, the ICF is a central framework, which should guide our work and thinking, both for clinical and research activities in childhood disability.  Please try to ‘place’ the ideas of the approach you represent into the ‘modern’ conceptual framework of the ICF. 

Ex tempore, I began my reply by stating the following psition–

Conductive Education has remained largely untouched by the International Classification of Functioning, Heath and Disability. Internally at least, Conductive Education has not needed this, as it has already implicitly moved on to the next stage, which involves mechanisms for change not just classification.

I treasure a vivid mental image of the visible shock that passed across Peter's face at this opening gambit. This made it all the more interesting to read what Zsuzsanna Olexa Józsefné has written, as reported earlier today –

Conductive Education has remained largely untouched by the International Classification of Functioning, concerning the adult population. Internally at least, Conductive Education has not needed this, as it has already implicitly moved on to the next stage, which involves mechanisms for change not just classification. But International Classification of Functioning Children and Youth Version changes in the developing child’s functioning and performance and the role of enviromental factors are taken into account; applicable in varying health conditions.

My response on that platform in Tel Aviv was developed on a priori grounds. Looking back and rereading my own words, I consider them rather weak. In mitigation I might claim that I left out a phrase at a critical point of the transcription (Sod's Law!).

More substantively, pace Zsuzsanna Olexa, I was responding to a question posed by a paediatrician and was doing so with the childhood stages of life very much in mind. I was not arguing about adults (though stating this is not to suggest that those arguments might not necessaily apply here too).

Why did I say this?

The wheels of God grind slow in academic publishing and the edited report of that Round Table back in December 2007 have only just been published earlier this month, in the Israeli Journal of Occupational Therapy. I have had my copy of the print version for some three weeks now but last week, when Gill Maguire checked, the online version had yet to be published. In the online version, quite rightly my undisciplined oral extemporisation has been vigorously pruned back for the purposes of formal written publication.

I would personally see no harm in my publishing this original version but the editor of the journal might think otherwise and, anyway, I should not wish to pre-empt online publication of the formal version within its full, wider context (the context, that is of the whole Round Table).

I shall write to the Editor and, granting her permission, I shall restate my original, more elaborated reasons for this position on ICF and Conductive Education, here on Conductive World, for critical comment.

References

Sutton, A. (2010) András Pető and the Bobaths: new comparative analysis, Conductive World, 6 June

Sutton, A. (2010) It's that ICF again: big advance or fundamental disagreement, Conductive World, 21 June

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