Wednesday, 15 April 2015

A CRITICAL FRIEND

Some positive suggestions

The Cerebral Palsy International Research Foundation started as a substantial offshoot of United Cerebral Palsy, and is based in New York. Some years ago CPI made some most intelligent comments upon researching Conductive Education, but it has gone quiet on the topic in recent years (even though over this time a growing variety of CE services and practices have been established in the United States and internationally).

September 1995

The Cerebral Palsy International Research Foundation published its first factsheet on Conductive Education. Unfortunately there has been a mix-up on CPI's website and this factsheet is not available.

September 1997

CPI's next Fact Sheet on this topic, however, summarised the previous one 
In a previous Research Fact Sheet (September 1995), comments were made on a series of articles on Conductive Education published in the journal Infants and Young Children. In essence, the comments were aimed at the need for more valid information; information that was specific, reliable and reproducible. This need is still unmet.
https://cpirf.org/update-conductive-education/

Rather than rely upon published academic research CPI went out and looked for itself (it did not disclose where, an important omission) –
During the past several weeks, the Foundation has had an opportunity to observe Conductive Education classes, speak to Conductors (education-therapists), and to parents of children enrolled. A number of thoughtful questions on the program were asked by well motivated, friendly participants. The following is a summary of those discussions.
Does Conductive Education work? Quite obviously it does work, as do a number of other interventions. However, that isn’t the meaningful question. The meaningful questions are: For whom? As compared to what? What are the long term effects?
When one incorporates total immersion for extended periods of time, heightened motivation, positive encouragement and reward, peer support and active participation, it should be expected to work. Conductors are professionals, skilled in utilizing their approach to the child both as an individual and as part of a group...

CPI then asked some important, trenchant questions, and followed these with a concrete suggestion –
We suspect that there is now enough of a body of experience internationally for the leadership of Conductive Education to arrive at consensus in reply to these questions. If so, the answers to these and other questions need to be written down so they can be examined and evaluated by others! Without this, the efficacy of Conductive Education will remain in the realm of “fringe therapy”, receiving enthusiastic support by a limited number of involved parents and professionals and looked upon with suspicion by a large number of others who have seen “remarkable therapies” come and go...
...Is the leadership of Conductive Education prepared to undertake this task? I hope so.

That was eighteen years ago.

2004

On the basis of the research review by Darrah et al., CPI published a Research Status Report. This briefly summarised that review's findings of the numerous Western research endeavours (or, if you prefer, its non-findings) –

The present literature does not provide conclusive evidence either in support of or against CE. Because of this, parents must consider items such as cost, time, accessibility and the impact on the family when considering CE.
https://cpirf.org/conductive-education-2004-research-status-report/
And as before, raised some trenchant questions –
As indicated in the Research Fact Sheet of 1997, Conductive Education (CE) is characterized by the therapeutic use of very positive support from peers, the encouragement of the parent and the therapist-educator (the conductor) and immersion for an extended period of time in the program. It raises the question of the comparative efficacy of other programs (techniques) where similar motivation and prolonged intense periods of therapeutic immersion are used. Is it the technology or the immersion that are the background for the reports of improved function? Unfortunately, CE is a 1940 intervention that has been and continues to be reported using 1940 s criteria of evaluation. Thus, individual reports of usefulness are undermined by poor methods of evaluation. A controlled clinical trial using specific entry and exclusion criteria, established endpoints, a reasonable period of follow-up and a comparative population (“controls”) are required to understand the role of CE in the treatment of specific types of cerebral palsy. Until then, CE will continue to be considered an interesting but “alternative therapy” and not meet the standards necessary for incorporation into modern clinical care.
That was eleven years ago.

Self-evident!

I cannot resist repeating the following (from 1997)
When one incorporates total immersion for extended periods of time, heightened motivation, positive encouragement and reward, peer support and active participation, it should be expected to work.
Yes indeedy, a good a short statement of processes of critical  importance in much CE prsctice as you may find anyway. CPI did not indicate who wrote these published comments. Someone who seems to understand in the same way in which anyone with sense and sensibility understands. What is Conductive Education? Such a question... 


2 comments:

  1. ".... to work"? What does that mean in the context of education?

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  2. Your question, Norman is perhaps easiest addressed if one starts with the simultaneous question 'What does NOT work?'

    To my mind this leads straight on to appreciation that WHATEVER one does in terms of education, whether this be through family, school of social life in general, always teaches SOMETHING, and therefore conributes to the process of development in some direction or other, with outcomes that are intended or othwerwise, for good or for ill in one's own mind or that of others...

    And from that I derive that the question 'What works in education' is not primarily one to be answered EMPIRICALLY. Primarily the question has to be addressed FORMALLY, in terms of values, goals etc, i.e. what does one regard as good or bad outcomes?

    There can therefore surely be no single, absolute answer to the question that you pose here. Perhaps the world of CE should be more up front about this, both internally and externally.

    Then perhaps one could ask people 'outside CE', such as respective state sectors, professionals, researchers, above all those who use Conductive Education, another question – what are THEIRS?

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