Friday, 18 July 2014


Something fresh in 'CE research'

No way to run a railroad

Local CE charity Stick 'n' Step has injected a much-needed new paradigm for consideration outcome-evaluation into the field of Conductive Education. But the field learns about it – if at all  almost by chance

On Monday of this week an English local newspaper published an interesting report by Craig Manning its Chief Reporter, concerning a university-based evaluation completed on the CE centre Stick 'n' Step:

The evaluation was made through investigation of Stick 'n' Step's 'SROI' (social return on investment). The study was conducted by Gayle Whelan and Gareth Roach of the Centre for Public Health at John Moores University.

I had picked this story up through Google Alerts. I emailed Kerry Schaffer Roe-Ely of Stick 'n' Step to ask about publication. I also Facebooked what I had found: 

The University had promised to publish but, as far as I could see, has yet to do so. This morning, Friday, Kerry told me that Stick'n'Step has now published the report on its own site:

This completed final report had been dated February of this year.

Is this some measure of just how urgent 'research' really is in the Conductive Education sector?

A quick look at the report

The report reminds that the topic of this report is of more than of just academic interest –
With the Public Value (Social Value) Act 2012 requiring public authorities to consider how services they procure might improve the economic, social and environmental wellbeing of communities, it is also timely to consider the wider impacts of community projects on the areas they thrive in. (p.8)

SLOI analysis uses a combination of qualitative, quantitative and financial information to estimate the amount of ‘value’ created or destroyed by the project, which is typically expressed thus –
For every £1 invested in the project, £x of social value is created(Nicholls et al., 2012)

Qualitative data were gained by various means from 13 'stakeholders'. The headline finding, taken up by local newspaper the Wirral Globe, was that for every £1 spent by Stick 'n' Step, £4.89 of social value was created. The improvements identified clustered into four groups:
  • improvements in health and wellbeing
  • increase in mobility
  • socialising
  • learning new skills
All children and adult stakeholders involved in this evaluation reported a number of outcomes from which three main themes of impacts emerged, based around social, mental health and wellbeing benefits and the learning of new skills. Social benefits included the meeting of new people, making of new friends and feeling more socially included in society.
As a result of engagement with Stick ’n’ Step, mental health and wellbeing had improved with many respondents stating they felt happy and relaxed after attending. Having learnt new skills which had enabled them to make improvements in their mobility, and the pain reduction that came with CE sessions, many young people reported feelings of pride brought on by how hard they had worked to achieve personal goals set out as part of their holistic programme of care when they first attended Stick ‘n’ Step.
(page 3)

Financial data were also collected or estimated by a number of means.

A few specifics
Attending Stick ‘n’ Step was reported as being life-changing for many as it resulted in usually being pain-free for the day that they had attended their CE session. (p. 3)
… many respondents stating they felt happy and relaxed after attending. (p.3)
...Having learnt new skills which had enabled them to make improvements in their mobility, and the pain reduction that came with CE sessions, many young people reported feelings of pride brought on by how hard they had worked to achieve personal goals set out as part of their holistic programme of care when they first attended Stick ‘n’ Step. (p.3)
Another factor linked to the social aspect was that of trust. Stakeholders described how friendships between adults (volunteers, Stick ‘n’ Step staff and conductors) and the child were forged through trust. This was trust that was built up over time and was related to the child trusting that the adult was working to help them, but also their parents trusted the charity overall to act in the best interests of their child. (p. 13)
For many young people they stated they were pain-free for the day that they had attended their CE session and had consequently experienced an increase in mobility. This had meant they were able to do more and were no longer as reliant on parents/carers tosupport them when doing everyday tasks. (p.14)
...children and parents reporting feeling happier. As the young person’s achievements were often noticeable, such as having greater mobility, they stated they felt happy and there was a sense that they felt ‘normalised’ and able to get on with their lives like their peers were able to. (p. 15)
Time and travel costs were the only negative issues reported by those involved in the evaluation... However, all reported that this journey was beneficial and something they wanted to do in order to achieve the gains that were felt by attending the CE sessions. (p. 18)

There are qualities mentioned here that are familiar enough and greatly valued among many of those those directly involved in Conductive Education, but not arising in evaluation of CE-outcomes – demonstrating yet again the need for a qualitative-quantitative cycle for CE-research.

Minor critical comments

The report is written in a generally clear, comfortable academic style, and provides a welcome outsiders' view of a modern Western CE practice. It largely escapes CE-jargon – but introduces some jarring, unspecific examples of its own, e.g. 'key stakeholders' 'engagement'

Though the report offers a detailed overview of the services that Stick 'n' Step provides, it does not say what the individuals investigated here actually received, e.g. what kind of 'Conductive Education', how often, over what period. It therefore falls short of the proposal for 'manualisation' (Ludwig et al., 2003) that is perhaps the most important practical proposal to have emerged from the earlier glut of 'CE-research'. This seems to be an essential prerequisite for all outcome studies in this sector if they are to have concrete value in contributing to a guide to future policy.

The report refers to a refreshingly new range of sources. This posting is meant to be no more that a quick look, and I have not ploughed through the referencing like an outside examiner! I was vain enough, however, to notice my own. 'Sutton (2002)' is duly listed in the back. 'Sutton (2006)' is not. I wonder what it was! I should not have to.


Fundamentally, SROI is about value rather than money, and the report's concluding remarks (p. 26) make this point well.

That said, this is an important document for advancing and extending consideration of outcome-evaluating in Conductive Education. It does rather change the game and any functioning field of study future researchers will be obliged to grant it careful and critical account.

Whatever the virtues or shortcomings of this specific study and its findings, those concerned for questions of outcome-evaluation in Conductive Education will have to get their heads around SROI, and at learn how to weigh and criticise studies of this kind.

Moreover, the notion of 'social return on investment' has received considerable official backing in the United Kingdom. To express Conductive Education in its terms would likely be more acceptable if official quarters than through the results of the sorts of measures used in the past (even were they favourable to Conductive Education!) Moreover, the approach fits well to the global, molar, 'holistic' stance that Conductive Education itself represents.

There is no mystery involved in SROI. There is a hefty guidelines document and a lively network available on line. Stick 'n' Step has taken a lead. It should not be too hard for others to follow.


Ludwig, S., Leggett, P., Hartsal, C, (2000) Conductive Education for children with cerebral palsy, Edmonton, Alberta Heritage Foundation for Medical Research

Manning, C, (2014) Report confirms 1.5m reasons why Wirral chariry is good value for money, Wirral Globe, 14 July

Nicholls et al., (2012) A Guide to Social Return on Investment, revised edition, SROI Network, January

Whelan, G., Roach, G. (2014) An evaluation of the Stick ‘n’ Step charity in Wirral, Merseyside, Final report, Liverpool, John Moores University, February

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