Wednesday, 4 January 2012

ADULT LITERATURE

Don't hold your breath...

The British Medical Journal has published an Editorial attacking the pharmaceutical and science community for the long-existing habit of only selectively publishing the results of clinical trials. Its Editor-in-Chief Fiona Godlee was on the radio this morning, along with neuro-scientist Colin Blakemore, complaining that a false picture is being put forward by medical science, and other forms of science, by restricting publication to 'successful' and 'interesting' studies (1).

Of course, they had to admit, researchers are not likely to press for publication of studies that show no effect, and journal-editors do not want to publish stuff that is boring.

It could just be that a solution is at last in sight to this long-standing and pervasive problem, as data storage is become ever-easier – and cheaper. So all findings could soon be potentially stashed away, to be examined, re-combined, re-analysed by others, now or in the future, permitting a potentially more complete and rounded understanding of reality than possible with the current cherry-picking of results for public presentation.

And Conductive Education?

All the above is just another outing for one of those hoary old mega-problems within the scientific endeavor, like fraud, that is taken out now and again, dusted off, tutted over, then shoved back discretely under the carpet, while scientists get on with the pressing practicalities of their lives (like finding where further fundable research might be needed). Given the nature of most research around Conductive Education, comparative-outcome evaluations research, and its general finding, then the problem as stated this morning hardly applies! So we are alright, then?

No, despite its almost total lack of formal methods of investigation and communication, the world is Conduction is every bit as bad. I personally am happy to stand up to be counted as supporting – indeed advocating – wider and wider informal communication of what CE is experienced as doing and achieving (2). But the same qualification has to apply: whatever the short-term personal and/or institutional advantages to those who do this, in the longer term Conductive Education surely suffers from being recorded and disseminated wholly in terms of good-news stories.

I do not need telling that everything that happens in the name of Conductive Education (and in the names of conductive pedagogy and conductive upbringing too) might not result all the time and everywhere in hoped-for outcomes. Some interventions will be wholly for the good. Some may be, well, neutral in what they achieve, and some may prove downright harmful.

If we do not record and report and discuss the whole range of outcomes, then (a) we are dishonest and (b) we severely limit – perhaps altogether curtail – our ability to come to judgments, hypotheses etc about what might be going wrong, and how better to do things in the future.

What interesting proposals for conferences and congress, what fascinating press reports: 'Emotion distress and financial hardship associated with attendance at CE summer school', 'Lack of persisting benefits following 'interval Conductive Education', 'Local mother thinks benefits of CE over-hyped and overpriced', 'School staff find training course unconvincing', 'Major practical problems of incorporating basic conductive concepts into a 'multidisciplinary team', 'Conductive Education: if it wasn't so sad it would be funny'...

What lively discussions and perhaps even some heart-searching might ensue. Maybe even some action and progress.

Towards an adult literature

Would that CE were mature enough to generate a truly adult literature. On can see immediate pressures against this, including reluctance to attract unpleasantness both from within and without the movement, and particularly ways that any such 'bad news' might be seen as impacting upon income, personal and institutional.

So I expect that things in Conductive Education will continue much as the same. After all, in the big, ugly world of medical-science research the bold hopes for information reform through publication of boring or even negative trial-outcomes have yet to get round Big Pharma, until when they will largely remain at the level of pipe dreams.

Notes

(1)   Broadcast available on line for a few days:
http://news.bbc.co.uk/today/hi/today/newsid_9671000/9671074.stm

(2)   Most recently: A. Sutton, Researching Conductive Education, past, present and future, in Last Year in Hong Kong,  Birmingham Conductive Education Press, December 2011, pp. 7-
http://www.blurb.com/bookstore/detail/2826466

6 comments:

  1. As a student that has had (albeit extremely limited) experience with science and research, it's sadly understandable why "selective reporting" is so prominent: funding. It's always a concern where the next big check comes from and when, and it's always a competition with other labs to get the funding. Your statement of the hopes of full disclosure remaining a "pipe dream" is entirely true, as sad as that maybe, but to hear it from the BMJ, one of the more prominent journals in the world, it maybe a small drop today but hopefully it's the start of something bigger in the future.

    With regards of this to CE, I remember reading one of Maria Hari's papers in the collection that was published a few years back. It was concerned with the initial hype of CE, how a small team of researchers went to the Peto institute and gave a...discouraging report in the BMJ. One of the concerns in the preface to that paper or the one following it, was that the visiting researchers only saw the "successful" areas of the institute. Potentially this caused more harm than good in the long run (who can say what would be different otherwise?).

    My point (finally, I know) is: you're right. CE would be (and potentially is) suffering from only having "good news". We'd be repeating the same mistakes from decades ago, and in this day and age, with medical science having increasing "hard evidence" of the active learning on diseases like Parkinson's (read an article two months ago about a study linking active learning and neuroplasticity in people with Parkinson's, study took place at a respectable university), where will CE be?

    Having an "adult literature" (not sure why you chose the word adult, to be honest) would "stir the pot" so to speak, but if supporters of CE play the cards right then CE could potentially be catapulted to the world stage in a big way.

    Don't get me wrong, CE is changing right now, what with new students every year bringing in new ideas and their own styles to the practice, but it's slow and in this day and age, slow and steady does not win the race.

    ReplyDelete
  2. Thank you Steven for this. Here are some immediate, curmudgeonly responses.

    The BMJ's chipping in its fourpence-worth may be a harbinger of better things to come, but authoritative sources have been pointing out major flaws in the myth of institutional science for a very long time and the forces that shape the workplace (even supposedly august workplaces) are simply stronger that the power of good, rightness, justice etc. Tis ever thus, in every field! Humanum errare est...

    If I remember correctly, they were not 'researchers, but paediatricians who attended a sort introductory course at the PAI. I do not think that they were a 'team' either. I cannot of course say whether their intervention had any effect one way or the other to the great flow of history. I suspect that it was just another drop in the great flow of reaction (word used in both senses) generated by the enormous public and popular enthusiasm for CE at the time in the UK. I am afraid that over the years he PAI made a stick t0 beat its own back in that it took considerable effort to fake good in the face of foreign visitors, and the brighter visitors soon saw through this.

    I am not as convinced as you are about the 'hard evidence' (you really ought to give references!).

    I used the word 'adult' to imply a mature field of study. Its opposite in such a context might be 'juvenile'.

    I would be very interested to hear which cards and how they might be played to create that catapult effect. My own view that we are talking less of a race (with rules) and more of a jungle. Good luck to CE out there.
    And yes, it will be your (CE) world, to make better that the one handed on to you.

    Andrew.

    ReplyDelete
    Replies
    1. Dr. Sutton,

      I apologize if my initial comments elicited a negative response from you, I didn't mean to have any sort of negative connotation to the post (at least, that's what I'm gathering from the word "curmudgeonly").

      Apologies if I was in error regarding the paediatricians visit, and not researchers. It is a shame that the PAI did what it did to appear as a solution to motor disability, I still wonder how things would change if the BMJ article from years past was more positive...

      But the more I think about it, as you suggested, if that visit really was just a drop in the pond, then things may just remain the same.

      Regarding to the "hard evidence" I was talking about, here's the link of the article I had read.

      http://www.bbc.co.uk/news/uk-wales-15644449

      It's not as "hard" as I remembered it, but I think this is definitely a potential step in the right direction for research in CE (or at least CE's future). Neuroplasticity, I believe, has become increasingly accepted in the scientific community, and the more research done on it, in relation to diseases CE works with, the better.

      About the cards comment: I remember Mel saying that, when Michael J. Fox revealed he had Parkinson's, the disease became huge. Celebrities do have power over the public, after all. While the fervor surrounding Parkinson's has slowed down (which things do with the public eye, of course), PD has become ingrained in the public mind.

      My statements forthwith will undoubtedly be read as crude, I know they are. I don't like it myself, but...

      If CE had its own "celebrity" of some sort, then I think CE could also become ingrained with the public consciousness as PT and OT are for rehabilitation (I know we're not quite rehab, but what other example can I use?). I do not wish anyone to have to suffer any sort of debilitating disease of any kind, much less take on the public stage as a patron of CE, but this sort of action might be what is needed. Word of mouth can be strong and has been of huge benefit, but I think CE must pursue all avenues to grow.

      Steven

      Delete
  3. Google Alerts has sent out a worldwide notification, as it does, that a new reader's Comment has been published on Conductive World.

    Unfortunately, this Comment does not show on Conductive World itself! It beats me what has gone wrong and I can find no way to fix it.

    So here is Google's Alert anyway –


    Steven has left a new comment on your post "ADULT LITERATURE":
    Dr. Sutton,
    I apologize if my initial comments elicited a negative response from you, I didn't mean to have any sort of negative connotation to the post (at least, that's what I'm gathering from the word "curmudgeonly").
    Apologies if I was in error regarding the paediatricians visit, and not researchers. It is a shame that the PAI did what it did to appear as a solution to motor disability, I still wonder how things would change if the BMJ article from years past was more positive...
    But the more I think about it, as you suggested, if that visit really was just a drop in the pond, then things may just remain the same.
    Regarding to the "hard evidence" I was talking about, here's the link of the article I had read.
    http://www.bbc.co.uk/news/uk-wales-15644449
    It's not as "hard" as I remembered it, but I think this is definitely a potential step in the right direction for research in CE (or at least CE's future). Neuroplasticity, I believe, has become increasingly accepted in the scientific community, and the more research done on it, in relation to diseases CE works with, the better.
    About the cards comment: I remember Mel saying that, when Michael J. Fox revealed he had Parkinson's, the disease became huge. Celebrities do have power over the public, after all. While the fervor surrounding Parkinson's has slowed down (which things do with the public eye, of course), PD has become ingrained in the public mind.
    My statements forthwith will undoubtedly be read as crude, I know they are. I don't like it myself, but...
    If CE had its own "celebrity" of some sort, then I think CE could also become ingrained with the public consciousness as PT and OT are for rehabilitation (I know we're not quite rehab, but what other example can I use?). I do not wish anyone to have to suffer any sort of debilitating disease of any kind, much less take on the public stage as a patron of CE, but this sort of action might be what is needed. Word of mouth can be strong and has been of huge benefit, but I think CE must pursue all avenues to grow.
    Steven
    Posted by Steven to CONDUCTIVE WORLD at Sunday, 15 January 2012 15:29:00 GMT




    I can but hope that there are not other Comments 'lost' in this ways. Please let me know if there are.

    Apologies to Steven for the delay in posting his thoughtful response, and to anyone else inconvenienced. I shall respond to this one as soon as I can.

    And please don't call me 'Dr.' I get curmudgeonly about that too!

    A.

    ReplyDelete
  4. Fret not about 'curmudgeonly'. I don't need the help of others to be that way...

    As for those paediatricians all those years ago, one of the great contrasts of life is between how important things appear at the time (especially things that personally concern us and, above all, those that we are actively involved in) and how they appear in retrospect and/or from outside. What seems a big deal this week will soon be lost in the mists of time! On the other hand, things do change, and there may be human agency in this, even the working out of human purpose. The trick is to sort the wheat from the chaff – and to burn off as little energy as possible in chaff-chasing! What a trick to be able to pull off consistently, in CE as in anything!

    Sorry, 'hard evidence' of what? You offer an effect demonstrated, justifying at least a replication. Maybe a bit of a hypothesis-raiser, perhaps a little heuristic, especially if demonstrated consistently. But as far as pedagogy/upbringing are concerned, so what? What possible effect might this have for the future or even present of psycho-social processes? I am not denying that there may conceivably be such an effect, just asking what it might possibly be in respect either of normal human functioning or in the preence of disease or damage.

    'Neuroplasticity' has been known of for yonks and I doubt has ever had any problem being 'accepted'. So, for much, much longer have teaching and learning, upbringing and education. The Nobels will be handed out if/when anyone manages clearly to demonstrate practical links between the two. I doubt that you or I will live to see this and there is no a priori reason to expect that anyone ever will. Meanwhile, CE has enough on its hands if it sensibly joins the struggle for creation and acceptance of a proper pedagogical science.

    'Scientific community'? Who they?

    Celebrities... Rosemary Clooney and Vera Lynne have done a lot for their specific CE centres in the UK and maybe there are other, less documented examples. In other countries no doubt too. And yes, M. J. Fox did a lot for PD, and Superman (sorry, cannot recall actor's name) did a lot for high spinal-cord injury – both dead now, I think, and what they did has passed. I doubt that awareness of PD really owes that much to one foreign actor, rather than to all the other human experience and propagandising, and PR, that has been going on over the years.

    But CE is a cause, and idea, a philosophy. I cannot recall successful celebrity involvement in such. I may be wrong and would be pleased to hear of exceptions. And does the persisting existence of physio or OT to reflect the effects of celebrity sparkle, or what?

    Of course let CE (what that?) take on all avenues (remembering that celebrity endorsement may be a two-way process, with two-way benefits, not necessarily all flowing to the 'beneficiary'). As you say, somebody has to live to experience CE, and it may as well be somebody public and adulated as all the rest of us. Dream Ticket? A Royal One. Or does such a thought fall under the category of what you consider as 'crude'. I do not.

    A.

    ReplyDelete
  5. On being a curmudgeon...

    I have just remembered this:

    http://zsippzsupp.blogspot.com/2011/07/wheres-pudding.html

    A.

    ReplyDelete