Monday, 12 December 2011

A holistic view of Mano's needs

Dominique Fagnart's testimony

From Belgium, Dominique Fagnart writes –

Conductive Education (or conductive pedagogy) is a method of special education for cerebral palsy, created in the 1940s by the Hungarian paediatrician András Pető.

It is a comprehensive approach, from a positive wager on the abilities of those with cerebral palsy, in which through a series of games and exercise, disabled people are led to develop their achievements in the company of a conductor, the defining characteristic of whom is to be a versatile educator, trained for four years in psychology, physiotherapy, speech therapy, public education, to think up global exercises as opposed to usual care that is more fragmented.

Developed in Budapest in what is now the world's largest centre for children with cerebral palsy, it has spread around the world with the opening up of Eastern Europe. Since then it has been widely established in Germany, the United Kingdom and the United States. It is now practised in 170 facilities around the world. In the French-speaking world pilot centres exist in Belgium and Paris.

I have long been convinced that Conductive Education provides children with disabilities the keys to self and to self-esteem. Originally founded and described for children with motor disabilities, the philosophy of this approach can to my mind be extended and used in many other situations of disability.

When Mano joined Centre la Famille two and a half years ago, I knew that he would find a nurturing environment, taking into account all his capabilities as well as his difficulties, and be respectful of those around him and their and expectations.

Whatever their disability, children must be educated to interact with their peers, communicate with them, find their place in society, learn to see, confront and solve everyday problems – and they are legion – in the best way.

That is the price of finding their find their place in society and being as independent as possible.

When Mano says to me ‘I want to do it on my own’, be this wanting to climb into his car seat, or into his new bed – then let him proceed by trial and error, telling me what he does and seeking the help of the environment, and I tell myself that he has integrated the principles of Conductive Education to arrive at making a further step towards independence by seeking to adapt to new situations.

How does he get there? He mobilises all its resources; he uses his motor capacities by seeking the necessary points of support , by availing himself of his environment (stool, walker), by verbalising what he does. Speaking ‘out loud’ to help anticipate and plan his actions. Language helps connect him (what he thinks, what he will have to do) and his body. He likes to try to solve problems and I know that this always encouraged at school and in the family. The programme offered him at school is structured and makes connections between learning movement, language and cognition. He learns in situ, which gives his learning meaning.

Conductive Education mobilises many brain networks: not only the motor circuits but equally circuits of attention, emotion, communication, memory, learning, vision – it aims to make connections between them. It is a holistic approach.

Mano is an adorable little fellow, determined, joyful, generous and tender. He amazes us every day, and not just when he improvises at the piano and plays four-handed with his grandfather.

But his current difficulties do not just affect motor aspects. Other functions, are also very often affected as a result of brain damage: fine-motor skills and organization of movement (dyspraxia), difficulty to analyse and understand what he sees (central visual disturbances), difficulties in speak ‘on demand’ (for example, to answer a question: he expresses himself best spontaneously), concentration and memory.

The children's learning should always start from the concrete (if not, he does not see the sense in it), to be repeated, transposed and integrated into every moment of daily life. Conductive Education offers him this framework and allows it to grow. Learning is slower but once it is acquired, it is well established.

Any other type of education, taking account only only one of his difficulties on its own (as unfortunately our special education does, all too frequently), or even more commonly does not try to make connections between the motor aspects, learning and communication, is doomed to fail.

It is a holistic view that he needs. It is thanks to this that he has been able to progress so well and will continue to do so.

Dominique Fagnart, neuropaediatrician and Mano's grandmother

With apologies for lack of time and therefore quick-and-dirty translation. I shall try to comment on Dr Fagnart 's posting tomorrow.

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