Locations of Site Visitors László Szögeczki's CE blog: CE use of ICF (?)

Saturday 19 June 2010

CE use of ICF (?)

The use of ICF is getting more common in the 'medical world' all over the world by now. Strangely, the Britons are not very much keen using it anywhere. ICF can be a useful measurement basis system since it views human in its complexity (just like CE) the person as a whole (just like Peto).

The possibility of reasonable use of ICF for the documentation of CE has been considered for a while by different CE service providers mostly in Europe and has been discussed at a research seminar in UK too.

Zsuzsanna Olexa one of the Hungarian trained conductors who has been working at the Peto Institute, Budapest and currently is a PhD student has chosen ICF as thesis subject:

Development of a common language to serve as a scientific basis in conductive education, with the help of the International Classification of Functioning (ICF)
and its Children and Youth Version (ICF-CY)

I am glad to announce that I have the permission from Zsuzsa to publish her work for the very first time here on my blog.

You will be able to read the whole work here in parts.

Development of a common language to serve as a scientific basis in conductive education, with the help of the International Classification of Functioning (ICF)
and its Children and Youth Version (ICF-CY)

by Zsuzsanna Olexa Józsefné



(The Andras Pető Institute of Conductive Education and Conductor Training College; Doctoral School of Educational Sciences, Faculty of Education and Sciences, Eötvös Loránd University, Budapest, Hungary)

The mission of the Pető Institute is to show individuals suffering from injuries to the central nervous system and their families the way to a full life and to make society aware of the opportunities to help.
Physician and educator Andras Pető developed his conductive education system in the 1940s. His method opened up a new path for the rehabilitation of children and adults whose motor impairments originate from damage to the central nervous system. His approach was first taught and practised in the predecessor of the institute now named after him. Conductive education (CE) is based on the idea that despite the damage, the nervous system still possesses the capacity to form new neural connections and this ability can be mobilised with the help of a properly guided teaching and learning process. That is the reason why Professor Peto called his education system „conductive”.
Conductive education (CE), a suitable method for habilitating/rehabilitating individuals in any age-group with motor disorders due to central nervous system damage has by now become known all over the world. Practice has proved its effectiveness and thus it has been established outside Hungary as well.
The conductive educators are trained multidisciplinary and therefore they are able to deal with all damaged functions of brain damaged persons. The work in group with group of clients and educate or conduct them how to perform everyday activities.
Several international studies have examined the effectiveness of CE (Rochel and Weber, 1992.; Bairstow, 1993; Reddihough, 1998; Blank and von Voss, 1996-2001). According to these international studies, to our comparative study and to our practical experiences it may be stated that CE is at least as effective as the traditional rehabilitation team (using the Bobath or Vojta method), or in some aspect more effective, achieving higher satisfaction of clients and their carers.
Research into the matter has made it clear that for measuring accurately the performance of individuals with central nervous disorders a very complex, comprehensive measurement tool is essential.

Studying the various methods of measuring and comparing them with the ICF-CY (International Classification of Functioning Children and Youth Version) prepared by the WHO in 2006 I have come to the idea that I should consider adapting a unified international measurement method.


Conductive Education has remained largely untouched by the International Classification of Functioning, concerning the adult population. Internally at least, Conductive Education has not needed this, as it has already implicitly moved on to the next stage, which involves mechanisms for change not just classification. But International Classification of Functioning Children and Youth Version changes in the developing child’ s functioning and performance and the role of enviromental factors are taken into account; applicable in varying health conditions.

The topic of my PhD research on the application of the ICF-CY in Hungary can be regarded as a pioneering effort for to the best of my knowledge the subject is not dealt with on academic level in this country.
The relevance of the International Classification of Functioning Children and Youth Version to conductive education is that the method developed by the WHO makes an all-round assessment of the disabled individual and the supportive or impediment factors of the environment possible. The classification aims to meet the demands of medical, pedagogical and social-occupational rehabilitation and to provide the different rehabilitation professionals with a common language.
Creating an internationally accepted measurement instrument like the ICF-CY, suitable for the objective measuring of the efficiency of conductive education would be of great importance to both the Pető Institute and conductive pedagogy.

7 comments:

Rony Schenker, OTR, PhD, Tsad Kadima, Israel said...

I would be grateful to receive Zsuzsanna work for reading.
I deal with the ICF since it was first published back in 2001, and it served as a frame of reference of my PhD work as an OT.
Yet, I am skeptic regarding its compatibility to CE. It is a health model and not a pedagogical one.
I always tell my students when introducing the ICF model, that if this model existed back in the late 80"s, the world would understand more easily what CE has to offer. YET, it does not mean that it is the right choice to refer to it as a scientific basis for measuring outcomes in CE. It is, however, useful for conductivists because of it complexity.
I'm open and ready to change my mind if convinced otherwise

Rony Schenker, OTR, PhD, Tsad Kadima, Israel said...

I would be grateful to receive Zsuzsanna work for reading.
I deal with the ICF since it was first published back in 2001, and it served as a frame of reference of my PhD work as an OT.
Yet, I am skeptic regarding its compatibility to CE. It is a health model and not a pedagogical one.
I always tell my students when introducing the ICF model, that if this model existed back in the late 80"s, the world would understand more easily what CE has to offer. YET, it does not mean that it is the right choice to refer to it as a scientific basis for measuring outcomes in CE. It is, however, useful for conductivists because of it complexity.
I'm open and ready to change my mind if convinced otherwise

Andrew Sutton said...

Thank you for this, Laci, it will be very interesting indeed to read the rest of this document.

Could you please clear up a couple of questions on the present status of the work work that you have begun reporting here.

I do not understand the structure of Hungarian higher degrees. Could you please explain how far this study has proceeded? You write that Mrs József 'currently is a PhD student has chosen ICF as thesis subject'. So what is it exactly that you are quoting here.? Is it some sort of intermediate report?

You are quoting her in English. Is Hungary now doing what several European counties do – does it permit students the option of submitting their theses in English? If not – how come an English version – who translated it?

You use the English expression 'PhD'. Has Hungary now ceased the former structure of kis doktor and nagy doktor – what award exactly is this dissertation submitted towards?

Sorry to be a pest and a nit-picker but what she and you are doing is very important. Mrs József is offering a formal, academic examination of something that is very much flavour of the month – the ICF. This could not be more timely. And you, a private blogger, are cutting a path by providing both her and the rest of us with the sort of service that Conductive Education's institutions just do not do.

My respect to the two of you.

I want to deal with the substance of what she says. First, however, could you help clarify the status of this study.

Andrew.

Laszlo said...

Dear Rony,
Zsuzsa will read (or already read)your comment here and it is very likely that she will find her way to contact you.
Laszlo

Laszlo said...

Dear Andrew,
you have several questions here.
For start, I can suggest - because you have specific questions on Zsuzsanna's PhD work and the present status of it - to contact her; she is the one who can answer those correctly. What I am doing here, as a private blogger, is nothing else but "publishing" an article from her which happens to gain interest. Who translated it? Does this matter at all?
The hungarian academic system, as far as I know, just like the Uk or European academic system. Referring to a PhD is pretty normal in Hungary nowadays.
Laszlo

Anonymous said...

László, thanks for bringing Zsuzsanna's work to our attention and for thereby generating important discussion.

Will you allow me to pick up on one small but important point in Zsuzsanna's work?

She writes "Several international studies have examined the effectiveness of CE (Rochel and Weber, 1992.; Bairstow, 1993;...)"

I am really rather surprised that anyone, for any useful reason (other than than to evidence how not to do research) would refer to Bairstow et al 1993.

In 1996, only three years after the "research" was published, ARIF (a specialist unit based at the University of Birmingham, set up to review research with the aim of helping health care workers access and interpret research evidence, particularly systematic reviews of research, in response to particular problems they are experiencing), reviewed Bairstow et al and concluded: "This prospective trial with matched controls purported to show no effect of conductive education, but our appraisal of the method is in accord with other critics of this piece of research, suggesting that failure to demonstrate an effect was as likely to arise from the way the study was performed as conductive education truly being ineffective." (Source: www.arif.bham.ac.uk - I have a copy on my laptop).

In short, a poorly conducted piece of work that reaches a conclusion that cannot be relied upon. In plain English: nonsense.

I remember vividly, the unfortunate Sunday Times report of Bairstow et all; a report that rubbished conductive education and did our cause in the UK untold damage. For instance, years later, here in Sheffield we struggled to advance CE with an education officer who had worked at the Bairstow control school. As far as she was concerned it was proven that CE was no better than anything else.

As I say, simply, I'm surprised anyone would refer to this nonsense at all, without a health warning.

Laszlo said...

Hi Norman,

Yes, I totally agree Bairstov et al is not the best to refer. To be honest the Von Voss and R. Blank's German research (2002) was also not that positive what I would warmly refer to but of course, as I wrote Andrew too, this is Zsuzsa's work. I liberally respect anybody's oppinion here on my blog, so thank you for putting yours.