Sunday, 28 September 2008

I am voting for optimism!




"Art" by Susie Mallett aged 5, 7 and 10 years


Bayern wählt” - Bavaria votes

Today the streets are full of people taking a walk in the sun and ending up in the local school to cast their votes in the regional elections. Many are probably wondering if their voices will be strong enough to bring about any changes they are hoping for.

I didn’t go to vote today, I only get a chance in the local elections, so I didn’t go out for a stroll to the polling station, but even so I am still wondering about the strength of my voice. I am asking myself can conductors and the rest of the conductive world collectively have a voice strong enough to bring about the changes that we hope for.

Instead of wandering down the road to vote, as I took a break from doing my paperwork, I took a walk around the internet and I discovered this website which brought a smile to my face on this sunny autumn Sunday, http://theteyafund.org/ . It fits well to my last posting “From the very start of life: pessimism or optimism”, September 26th 2008, and brings me to think that maybe it is not unrealistic to imagine that the start of each new life will be greeted with optimism and hope and not with pessimism and despair. It doesn’t have to be Conductive Education, there are other people out there who are also offering parents hope and maybe all the voices together can bring about change.


Notes

I thank my lovely mum for treasuring, for 47 years, the books from my first years at school. On my visit home just weeks before she died I found these books awaiting me on my bed. The pictures which head this posting come from the books dating from 1962, 1964 and 1967. My Mum always hoped for the best for her family and I thank her for the encouragement she gave me which was obviously enough to make an artist out of the child who did these first funny drawings.

Landtagswahl: German regional election http://www.welt.de/muenchen/article2497494/Was-mit-Bayern-bei-50-Prozent-minus-X-passiert.html

http://theteyafund.org/
http://www.cuevasmedek.com/ : this is the therapy programme which Teya followed.

Susie Mallett: http://konduktorin.blogspot.com/2008/09/from-very-start-of-life-pessimism-or.html

Friday, 26 September 2008

From the very start of life: pessimism or optimism?

"The very start of life" by Susie Mallett, 1979


I was reading Gill Maguire's latest blog and linked from there to a newspaper article from Wales that spoke about the death of Naomi.

In the article were comments on the subject by other parents of children with cerebral palsy, and in the section “Call for register of children with disorder” there were quotes from a Mr Richard Parnell. Mr Parnell is research and evidence manager for Scope, which is all that's left of the former Spastics Society.

Speaking about cerebral palsy, Mr Parnell said: "It is around six to eight months when children are rolling over when you may have cause for concern. It is maybe at that time that you notice. But it is something you don’t find out typically until the child is at 18 months.”

I don't understand how things like this get published or even said!!!

I went as a third-year student alone to a hospital in Budapest with a conductor from the Mother and Child Department at the Petö Institute.


I saw the conductor who took me there again last Easter when I was at the Petö Institute and I told her how I had never forgotten what I had learned on that visit. This conductor was Homoródi Zsuzsa, head of Gyerek Ambulancia, the children's outpatient department.

We visited the premature baby unit. The conductor had a regular clinic there, where she talked to mothers who brought their babies back each week and gave them advice, checked whether the development of the babies was age appropriate and made any necessary referrals to the Petö Institute.


Then we went to the ward where the babies were who had yet to go home. We handled one very tiny baby, eight-weeks old, who had not yet reached her full-term birth date. The conductor showed me and the mother how to position this baby symmetrically and to do so every time the mother made contact with the baby during the day... at least 20 times. This tiny baby had asymmetrical reflexes and the conductor told the mother that if she positioned the child in the correct (foetal) position and turned the head to middle to gain eye contact, then she could prevent some very serious problems and symptoms developing. The baby was so small that I could positions all the limbs and head correctly just by using the tips of all my fingers! It took the skill of this conductor to show me and the mother how to do this.

Why am I telling you this?

Because it infuriates me whenever I read something like the above statement from Mr Parnell, or hear from parents that they have not been given the diagnosis cerebral palsy until their child is 18 months old. If a conductor can see that a new-born premature baby has problems then why can’t a doctor?

My guess is that many hospitals don't tell the parents because they don't know what to say directly after.

They don't know what to advise parents to do.

They do not know how to give parents hope.


I saw one thing to do in that premature baby clinic in Budapest and it was so easy and could prevent so much. The conductor told me that this could mean the difference between a very severe athetoid child and very mild symptoms.

I know that one of my thoughts at the time was that even showing the mother to turn the head in the middle to gain eye contact would make the life of that baby and its view on the world very different.

Why oh why do the Mr Parnells of this world not think like this? What is Scope for?


Notes

Gill Maguire

Wednesday, 24 September 2008

Fresh off the press

"Making changes" 1993


Are more voices to be heard?

Since yesterday the new website for the Bundesverband der in Deutschland tätigen KonduktorInnen is online and just in time for the 10th Anniversary Congress which takes place in Munich, 24-26th October.

http://www.konduktorenverband.de/


Notes

The young boy being creative with me in the title photograph also created the new website.

Bundesverband der in Deutschland tätigen KonduktorInnen: this is an association for conductors who are working in Germany.

Saturday, 20 September 2008

Schau mir in die Augen, Kleines

The all seeing eyes, 15th September 2007, by Susie Mallett



Can I show you my pain?


Today I was working with a client who looked deeply into my eyes and asked “ Would you like to see my pain?”

What could I say?

I could have answered that I had been looking at him since the session started and seen the pain in his eyes all the time, and not just the physical pain, the emotional pain too. I didn’t say this but we did talk about his pain and what we could do to relieve it and to work with it.

This client had been in a lot of pain for a long time and the cause had been overlooked. He had conceived the pain from a broken hip that happened in a fall as knee pain and therefore the knee had been x-rayed several times but not the hip.

A dreadful mistake and a common experience. I have worked with many teenagers and young adults with cerebral palsy who have had hip operations and they have all told me that the pain often appears to be more severe in the knee than in the affected hip.

Now the physiotherapists and I are trying to get today’s client back on his feet and to do this we have to overcome the real and the imagined, the physical and the emotional pains.

When my client asked me if I would like to see his pain I told him that I knew he had pain and, above all, I knew the difficulties that he must be experiencing from such an extreme change occurring in his life. Having been an independent person, walking without aids and needing little help to lead an active life, he now needs to use a wheelchair and depends on others to help meet many of his needs.

We talked more and I told him that there was no need to show me his scars, his “pain”. We discussed how much pain he could bear and when should we stop. He became calm and responsive and appeared almost a different person – he had started to communicate with me at last.

As a conductor I am confronted by pain every day but when I was a student this subject was never discussed in detail, it was not the subject of any lectures, it was not something talked about during practical training.

I have had to learn about this on the job, through my contact with clients and through discussion with another conductor...

Tarczay Klára had taught me at the Petö Institute, I still pick her brains when we meet and collect her wonderful tips, and it was she who told me as I finished my training - “ Keep an eye on your clients, look them in the eye, for there you will see almost everything you need to know”. How right she was, I have practised what she told me for many years and today as I worked I realised it is time to write about it.

The pain threshold

I can see when the pain threshold has been reached by looking in the eyes of my clients. These clients often wonder why I ask them to work on certain tasks with their eyes open, I explain and some smile knowingly at me while others immediately shut their eyes again, not wanting to reveal anything!

Stroke clients


In my stroke group it is so important that I see when this threshold has been reached. The clients will often push themselves too far and it is my job to put on the brakes. It makes the difference between achieving that which we are aiming at, gradually increasing the range of movement or having a painful inflammation in a joint. Here is an actual example, from practice in the stroke group.


The clients are on the plinths, on their backs, aiming to lift their clasped hands above their heads, bringing them down on to their foreheads and finally sliding them down behind their heads into their necks. This very complicated movement can be the cause of pain in many places: in the fingers, in the back of the unaffected hand (spastic fingers digging in), in wrist or elbow and in the most likely place the shoulder. Usually no one complains, no one refuses to do it, all those who can attempt it do and the others wait for assistance.

I need to be in control here, I move up and down the row peering into each person’s eyes, from where I receive the information that I need so I know when to say stop or when to begin a different task.

Try it out, it works nearly every time, you can have even the toughest, most highly motivated person in the group who never gives up and never complains, but you will see his pain in his eyes. Such high motivation is good but experiencing unnecessary pain is not the aim of Conductive Education, experiencing improved movement is, and we have to find the balance together.

Some stroke clients experience a different kind of pain. A pain which is very difficult to describe so I will use the words of a client I have known for ten years and who, over the years, has explained to me in great detail many aspects of her disability and her rehabilitation.

She tells me about what happens as feeling begins to return to her fingers and how everything she touches she experiences as pain – it is the hypersensitive peripheral nerves she tells herself over and over again, until her brain has understood the difference between a gentle touch on the skin and a painful prod. Each time that she feels pain in another part of her body paralysed by the stroke she repeats the same process. It may take days or weeks before she perceives the “pain” as a feeling of touch similar to what she experiences over the rest of her body, but however long it takes eventually the pain is replaced by normal feelings.

Now she tells me that each time she experiences such pain she can smile because she recognises it as the beginning of yet another step in her healing process.

We can assist this path to normal feeling by alternating warm and cold, rough and smooth applications to her hand.

Pain and spasticity


Spasticity shoots into a muscle, or more than one muscle, it is visible as arms fly up, a head jerks backwards, legs stretch out or the whole body folds up in a ball. But less visible is what is felt, as this process is more often than not accompanied by pain.

Not just pain caused by a resulting fall or from knocking a bony elbow on the plinth, there is pain in the contracting muscle, something similar I imagine to the pain that we all have experienced when getting cramp in a leg during the night or when playing sport.

It hurts, but our clients rarely tell us this.

I try to teach my clients how to anticipate this contraction and stop it before it begins. They practise breathing, they count, they learn how to move their bodies to minimise the pain.
They learn to react to their bodies and relax the muscles before the spasticity shoots in.
It is a long learning process, especially with adults. As conductors maybe we should also be considering how conscious we are of this problem when we work with children with cerebral palsy, are we doing enough to teach them how to achieve a life with less pain? Even to let them know that we recognise that they have pain is a step in the right direction, as I experienced with my client today.

Pain and multiple sclerosis

Again I write from the mouth of a client who describes the twitches and jerks, accompanied by pain that prevent the body coming to rest and prevent sleeping. He also describes having a pain in his body as being like a wide metal belt tightened around his waist as the spasticity in his muscles increases. He talks about the pain as he slowly stretches his legs in order to stand up and then the increased pain as they suddenly jack-knife back to the bent starting position.

He learns in the conductive group through breathing exercises to relax the muscles around his waist and therefore reduce the pain, he learns actively to stretch his legs only to the point just before spasticity shoots in, he learns to actively bend and stretch his legs to reduce the jerks and twitches, and the pain, and therefore allow his body to rest.

This client has also learnt to talk about his pain, to describe it and to work out how to minimise it, but many clients do not say a word and this is when I need to recognise it and be prepared to discuss it with them.

People with multiple sclerosis are liable to push themselves too far, they find it hard to recognise their own limits. It is very important for these clients to learn that even though today they may feel fit to conquer the world, tomorrow is another day and they then may regret having exerted themselves too much.

Through Conductive Education they can learn where their limits are, they can get to know their bodies well enough to say "If I do this today I will feel like this tomorrow”. They learn to decide for themselves how much exhaustion and how much pain they are willing to have tomorrow in order to do something today. They learn how much exhaustion or pain their body can endure without making their symptoms worse.

As a conductor I must know my clients and their symptoms and through our programme show them how they can learn this too. I need to know whether we should work with weights on the plinth today and be able to move our arms tomorrow. Tomorrow’s pain I can’t see in the eyes of my clients, it isn’t there yet, but maybe I can see the tiredness or the exhaustion.

My clients learn their own methods to solve their problems and reduce the pain. One client strokes her upper arm and talks quietly to it, another stares at his hand and talks sternly to it. They all learn which tasks to do and which not to do and I learn when to put the brakes on and I continue to look into their eyes while they learn to look back into mine.

Dealing with pain and stretching its boundaries is a very difficult aspect of my work and it is one which rarely gets discussed. How much pain can I expect a client to experience how much is an individual willing to experience. Each client is different, each client’s body reacts differently on reaching and crossing the pain threshold. Conductive Education is not just about exercising but the tasks are part of it and sometimes they hurt, just as walking or putting on a jacket or holding something in a paralysed hand can also hurt. As a conductor I must recognise when enough is enough or when to push on just a bit further. I must know when pushing on will do good and when it will do harm. Not only must I know these things I must know how to teach my client to recognise them too.

Yes, we should reach that border and go slightly beyond it to stretch a muscle a little, to achieve a bit more movement, but for them to have so much pain that I can see it in their eyes, no that isn’t what my work is about.

Through Conductive Education clients can learn how to build up their stamina and strength, they learn to become more active or to increase their range of movements, all without experiencing unnecessary pain. We can use the rhythm of the movement, the direction of the movement and the speed of the movement all in controlling pain. We can speak and count and improve breathing techniques, we can learn about all aspects of the body and the influences that the whole of the daily routine has on it, including the influence of the weather!

The "pain of tomorrow" I can anticipate only through experience and in the group we can build up stamina and strength and learn the movements needed to prevent it being there at all.


No pain, no gain!

My german clients often say to me while we are working that nothing can be achieved without some measure of pain, the slang phrase they use "Ka Schmerz, bringt nichts" translates well into English as "no pain, no gain!"

Together we learn to discover the limits and achieve the balance between the two, between the pain and the gain.


Notes

Tarczay Istvánné: Vezetö : Felnött Nevelési Egység , Head Conductor, Adults Department, Petö Institute.

Casablanca. Dirk Bogart and Ingrid Bergmann
In the German version the last sentence Rick says to Ilsa, “Here’s looking at you, kid”, is translated as “Schau mir in die Augen, Kleines” , (“Look me in the eyes, little one”).

Thursday, 18 September 2008

Something to ponder over

Rastafarian, by Susie Mallett 1981


Do we need conductors to carry out conductive upbringing?

If I say you don’t need a conductor to carry out conductive upbringing then I would soon be out of a job, I also don’t think it is true, but what I can say is you don’t always need a conductor to carry out conductive upbringing.

This is how I work when I work with people in their homes, it is my aim that conductive upbringing can take place without a conductor. Surely this is the aim of all conductors, to motivate activity in not just the child but the whole family so conductive upbringing continues when conductors are not present.

I think what you do need are conductors to bring about an understanding of conductive pedagogy and when an understanding has been reached then it may be possible for conductive upbringing to take place without the conductor.
This harks back to the correspondence of a week or so back beginning with Szogeczki Laci’s posting, about conductors finding a voice.

Conductors need to find their voice to educate, to change the way of thinking, to influence and activate all of the people dealing in all aspects of a child’s life and then, maybe then, can conductive upbringing take place without a conductor.

And what about the “bloody” furniture?
I can practise conductive upbringing without a single piece of furniture. I can take a child on the bus, to the shops, out in the garden or into the swimming pool without taking along a plinth or a ladderback chair! If they are there and help then I use them but if not I find alternatives, that’s what being a creative conductor is all about, isn’t it?

I still believe the less of it the better especially when I work at home with the child.
By observing us at work parents can learn how to use what is there on hand and learn how to adapt what is in the home and then see what they may need to provide at a later date.
I believe that the less furniture there is the more creative the conductor, the more creative the client and the more creative the parents.
And with less furniture the more normal is the environment in which they all live.

Notes


Szogeczki Laci
http://www.szogeczki.blogspot.com/
Voice of conductors, 6th September 2008


And what about the “bloody” furniture?
This refers to a comment from Norman Perrin on "No need for a spectacle" 14th september 2008

Norman Perrin
http://paces.typepad.com/

Sunday, 14 September 2008

No need for a spectacle!

The Traveller, 2003 by Susie Mallett


I have been away again.

Two weeks with one family and one week with another, and as usual the work was great. Of course there are ups and downs, and the children decide enough is enough and go on strike, but its all part of life and therefore conductive upbringing.

On my return to my computer I have just read on, Conductive Education World, Andrew Sutton’s “Relevant thought? A discussion point at least…?"

And it got me thinking.

I go to work in many places being a self-employed, peripatetic conductor and through this I have discovered that there are places where Conductive Education/upbringing takes place, with or without conductors, with or without the furniture, with or without a big institute and there are also places where it isn’t taking place.

It is of course possible to build your “arena” for conductive upbringing with bricks and mortar, you can fill it with the best equipment, plus ladderback chairs, plinths, wall bars and boxes, you can import some conductors or send some students off to be trained, but does this mean that there will be Conductive Education/upbringing?

Not necessarily.

I visit families for whom Conductive Education is completely new and they are working with their disabled child more “conductively” than some families who have been sending their child to a “ conductive” group for many years.

I have worked in some places where the “conductive group” is just that , a group which works conductively for a few hours a day or a week but the work does not extend outside the group into the daily life, to home to school etc. sometimes it doesn't even extend as far as the car (as I mentioned in "Time for finding your feet ", August 30th).

I have worked in family situations where every one from little sister to great grandfather are involved in the “upbringing” of the whole family and where the concept of conductive upbringing filters into every minute of daily life, and not only for the disabled child, everyone is influenced by it.

Even in the newest initiative with lots of funding behind it conductive upbringing can only take place when understanding is there and the will to make change is there, when the wish to “nurture and to educate and socialise children in their entirety” is there.

This quote comes from Andrew Sutton’s description of conductive upbringing at the beginning of Mária Hári on Conductive Pedagogy. He goes on to define it as implying more than just academic education but also as “ the creation, direction and correction of personal traits, behaviour, values and morals”.

I believe that the term conductive upbringing as Mária Hári described it and used it, has still not been fully understood everywhere where “conductive education” is being practised, the term Conductive Education having replaced it in general use and the concept then becoming one of academic education and not of upbringing.


Conductive upbringing is more than teaching, it is more than an education at “school”, it is something much wider involving many people and all aspects of a child’s life and personality.

Successful conductive upbringing does not depend on how big and polished and grand the arena is, on how many conductors are on hand, on how many hours a day a child spends in a conductive group, it depends on the willingness to transform, to bring about changes and to develop a system.

I believe that conductive upbringing can take place anywhere, not only in the arena, if given the creative atmosphere and interest, and of course the Seele!

Notes

Spectacle: something exhibited to view as unusual, notable, or entertaining ; especially : an eye-catching or dramatic public display
http://www.merriam-webster.com/dictionary/spectacle

Andrew Sutton, Conductive Education World, “Relevant thought? A discussion point at least…?" September 8th, 2008.

Mária Hári on Conductive Pedagogy, Translations, terminology and statistics.
Edited by Gillian Macguire and Andrew Sutton
ISBN 1-897588-24-0

Sunday, 7 September 2008

Are the voices getting louder?

A walk by the old canal by Susie Mallett, 2008

Have people seen the discussion developing on the Net about conductor's "Voice”, or rather lack of it. I've just addressed my bit to Andrew Sutton's and Laszlo Szogeczki's blogs. This is what I wrote:


I am experiencing some of these problems you mention myself here in Germany at the moment and because of my lack of "voice" I am dangling on a string waiting to see if I have any work when term starts again later this month. As you say conductors move from place to place and are either dependent on charitable organisations or parent initiatives to give them work and often choose to keep a low profile.

Time is also a governing factor and in the small groups of conductors working all over Europe there is rarely one where a conductor is responsible for organisation, thus having a "voice", this is left to a non-conductor. Conductors are needed for the hands-on work.

Also because of language barriers conductors do not have the contact with all the different authorities and departments which are involved in the financing and organisation of CE groups, so once again no voice. It is almost as if CE takes place with a hidden, invisible presence, the mysterious conductor, in the background.

This lack of a "voice" has a detrimental effect on developing Conductive Education as a profession outside of Hungary.

Tuesday, 2 September 2008

Mária Hári on Conductive Pedagogy

Study in blue, 2002 by Susie Mallett


"Love is not enough. It must be intelligent love"

I used to think that Dina (Ákos, K. and Àkos, M. 1991) was the most useful book I could recommend to parents of a disabled child so they could get a good understanding of conductive upbringing and conductive pedagogy, but now I have begun to recommend a second one.

The more often I read my Little White Book Mária Hári on Conductive Pedagogy, with her smiling face radiating from the cover, the more I learn and the more convinced I am that everyone should read it!

At first I thought that Dr Hári’s book would probably only be useful to conductors, or maybe to other professionals, who already had some idea of the subjects covered here, but now I believe that it could be also useful to parents, especially those who do not have access to Conductive Education in a group setting, or whose children attend schools or groups where only "elements of conductive education" are on offer. Through reading this book they can learn about conductors and their training, the formation and dynamics of groups, daily routines and all aspects essential to a conductive upbringing.

Each time that I delve into these collected papers of Dr Hári many familiar phrases leap out from the pages and make me consider that maybe, if parents knew this or that, they would then be able to visualise the system that they wish to use to bring up their child.

While reading further I wonder whether this book is not also full of information for non-conductors working in the field, which would perhaps lead to an improved understanding between colleagues.

Dr Hári always did have a way of saying things which made me exclaim during my student days "Oh, yes it is actually so simple, really it is common sense".

Of course it was never that easy, but she did have a way of bringing ideas together so that conductive pedagogy was understandable to us at last, and she does the same in many of the papers in this collection.

There are many points in the different papers which would help parents to understand that Conductive Education is not a therapy to which a child is sent, but it is a life style that they can choose to follow for many years to come, that they too must learn. By reading on past the facts and figures, andould exclaim" Oh! Yes now I understand ", just as I did in the early 1990s in Budapest.

It is also possible to use this little book as a dictionary. as the index is full of words that one comes across in almost everything that there is to read about Conductive Education, and for which a definition in context would often be welcome. Words such as "spontaneity", "orthofunction", "tasks", "observation", "facilitation", "attention" and "activity". These are words and phrases commonly used only in the "conductive language" and therefore sometimes difficult to define. Look them up in the index and there will be several references to them in the book. and explanations to be found.

This is not just a compilation of papers on conductive pedagogy. There a long introduction by the editors where you can learn some of the history of Conductive Education and something about the life of Dr Hári, you can read of how she proceeded to share her knowledge and how Conductive Education began to spread to all corners of the world.

There are a couple of sentences in the introductory pages that always make me smile when I read them as they describe Mária Hári well and tell of how she presented Conductive Education to her audience with all her heart and soul.

"She would lace her account with anecdotes and asides, and could let these lead her argument into new and unexpected turns."

This was exactly how she was and as a student it was very beneficial if you knew about it as you could use it to your advantage. You could so easily lead her on to subjects where you had a greater knowledge and steer her away from a subject in which you were faltering.

"She liked to interact with her visual materials, film, sequences of still photos and overhead projections and in the privacy of the student lecture room she would readily leap on to the table, 'making the gymnastic' and using her own body to illustrate the point"

Yes, she really did do this I have seen her in action! She made conductive pedagogy come alive as indeed she does in this collection of her papers and texts.

It is well worth a read!

Notes

"Love is not enough. It must be intelligent love"

Mária Hári , Standing up for Joe, BBC1 1 April 1986.

Dina by Ákos, K. and Àkos, M. 1991, Birmingham and Ulm: Foundation for Conductive Education and Alabanda–Verlag.

Mária Hári on Conductive Pedagogy, edited by Gillian Maguire and Andrew Sutton., 2004 Foundation of Conductive Education
ISBN 1-897588-24-0
available from Gill Maguire at http://ce-library.blogspot.com/