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  • 1 Semmelweis University, Hungary

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Introduction

The study presents the opportunities of conductive education for children with cerebral palsy in early intervention. András Pető originated the developmental approach, which is increasingly known and adopted in the rehabilitation practice both in Hungary and internationally in the 1950s. The former András Pető College, currently the András Pető Faculty of Semmelweis University, is the centre of conductor training, offering high-standard conductive educational practice, and serving as a location where the practical requirements of undergraduate conductor training can be accomplished. The present article is aimed to introduce the organisational background of early conductive education provided by András Pető Faculty, Semmelweis University, to describe the concept briefly, and to present the possible results of early conductive education.

The Conductive Education System

Conductive education was developed by the physician and special educator András Pető. Irrespective of age, one of the most important aims of conductive pedagogy is teaching to learn, i.e., developing learning skills. Clients are motivated while being conducted, and their interest is stimulated during the development, which is always applied in a group at every age.

In most cases, the birth of a child with special educational needs induces a crisis situation, is unexpected, and thereby impossible to be prepared for. The arrival of a newborn by itself brings about changes in the family; in case the infant is affected by a health problem, the attention, time, energy, and financial burden required will multiply, imposing great difficulties on the family members. Psychologically, the whole family will experience increased pressure.

Conductive Education, Movement Therapy, and Pedagogical Rehabilitation

Pedagogical rehabilitation means special instruction, special education for the children, and social integration for adults. Characterised by a holistic and systemic approach, our child-centred pedagogy encourages individuals to learn and thereby mobilises their mental reserves. Focusing on the personality, learning, and education, our comprehensive development is an alternative method of rehabilitation: habilitation and restoration through education. Its characteristic elements include the group effect and rhythmical intending. On the conductive sessions speech, motor coordination, evaluation of perception, activities of daily living, and communication are simultaneously fostered in a comprehensive and integrated manner.

The Conductor

As a helping, caring, and rehabilitating pedagogue and therapist, the conductor promotes the learners’ development embedded in a broad repertoire of activities, i.e., treats cognitive and motor development as complex occurrences. In our comprehensive pedagogical system, the different areas in need of development are influenced simultaneously by one professional, the conductor, who organises a learning environment that is optimal for the children’s age and condition.

In the Pető Institute’s groups for children, conductors work in homogeneous teams; however, the plans and timing for development are regularly discussed with the representatives of sister professions. For children over 18 months of age, conductors may run habilitation/rehabilitation programmes with health and pedagogical objectives if deemed necessary according to the statement of the expert committee [1].

Current Interpretation of Cerebral Palsy

In cerebral palsy movement, posture, cognitive, and learning skills function in a different way. The insult affecting the brain is static, but as a result of development, environmental experiences, and new knowledge, the symptoms change. The residual symptoms are permanent, but the dysfunctions can be mitigated through development and education [2]. The positive interactions lead to a higher level of knowledge. Children actively participate in the controlled, consciously planned reprogramming.

Aim of Our Special Pedagogical/Rehabilitation Education System

Insufficient manual and visual experiences, non-standard quality of interpreting and processing information, and the changes in body scheme may cause secondary learning difficulties from birth. Our aims are to detect and relieve positive and negative symptoms, to prevent psychic consequences and to reduce learning disorders [3].

Symptoms include the following:

  1. Positive symptoms: increased muscle tone and reflexes and pathological posture.
  2. Negative symptoms: lack of motivation, fatigue, and slow procession of information.

Neuroplasticity on Which We Build

In order to build new neuronal connections and renewing existing ones, the brain needs continuous activity. Physical and mental practising brings about anatomical changes in the motor cortex. The conductor organises a learning environment that is optimal for the child’s age and condition. In the course of group work, appropriate emotional and social qualities are formed. Malleability, plasticity manifests itself through motivated, self-initiated the activity. Pető took advantage of the positive effect of the group.

These qualities can be actively changed through alteration of behaviour, through targeted, repetitive, multichannel practising of learning functions. Our education system treats brain damage as a learning disorder rather than a biological obstacle. Consequently, it is not a local problem we speak about, but a pedagogical approach, an active learning process based on the plasticity of the brain. In spite of the damage, the nervous system has reserved, i.e., an unexploited receptivity, a potential for building new connections.

Prevention and Conductive Counselling

Screening is a conductive assessment where, building on previous information, operative observation and manual examination are carried out in order to assess the infant’s motor patterns, level of perceptual and sensory development, crying, and direct responses. Through a further training programme organised for health visitors, it may be achieved that following their professional guidance early counselling and targeted development can be offered. Counselling is also a learning process, a practising; with this complexity, we strive to map the infant’s sensory operation, perception, and the maturity of the nervous system compared to the child’s age, in close cooperation with the neurology specialist. We provide off-site conductive pedagogical counselling for prevention in two clinics, as well as in paediatricians’ and health visitors’ offices in the districts of Budapest in cooperation with the professionals working in primary care.

Positive Effects of Conductive Education in Infancy

Early conductive education is recommended for children with central nervous disorders, babies born premature, and children with abnormal muscle tone and delayed motor development. Up to the age of 18 months, infants are accepted on the basis of diagnostic opinion and therapeutic proposal from the field of infant and paediatric medicine or from a specialist of child neurology.

According to our deed of foundation, we provide early conductive education and care as well as conductive pedagogical provision for infants and children with motor impairments originating from damage to the central nervous system until they enter kindergarten. Educational counselling is also offered to families where needed. This is the most sensitive phase during a child’s course of development. Within a consciously constructed daily routine, we offer multichannel modular experiences in order to deepen and preserve the learning process. Thus, we contribute to the efficient processing of information and the interaction of motor and cognitive functions. The maturation of highest level cognitive functions related to the frontal area is supported through the components of a previously planned development programme in the group.

The abilities required for learning are established before the children reach the age of 1 year. We ensure independently performed movements and the sense of achievement for the baby and thus mothers can also enjoy success. With the help of the conductor, infants experience the surroundings, human language, social relationships, and the impact they make on the outside world. This process leads to joint learning where all actors have defined roles mutually reinforcing each other.

Results of Conductive Education

Early intervention is provided in individual and group format. Taking advantage of the positive effects of the group, we strive to teach babies and mothers in small groups from the optimal earliest time and to raise awareness of the essence of our professional programme. Children construct their knowledge with respect to the environment, from their mother’s behaviour. On the basis of feedback and reflection, children’s behaviour is arranged in an integrated motor pattern [4].

Results of counselling discussions, psychoeducation for parents, and joint developmental programmes:

  1. decrease of stress in family members
  2. increased optimism in family members regarding the future
  3. improved quality of interaction within the family
  4. higher level of functioning in the family following consultation
  5. opportunity to share concerns with other families facing similar problems
  6. families stop feeling left alone with their problems

Modern Early Childhood Intervention

The common aim of professionals working in early intervention is to provide preventive education for vulnerable children in need of special treatment and their families from birth to 6–7 years of age, while considering the circumstances, the needs and opportunities of the child and the family. In addition to prevention and developmental education, reinforcing the family’s own competences and promoting optimal development of the child are also important. Following balanced intrauterine development, the most important circumstance influencing brain development is attachment to the parents and the quality of adjustment to each other. With our comprehensive programme, we support the formation of acceptive attitudes and improve the quantity and quality of parents’ efficient coping strategies.

Our goal is preventive support and psychoeducation for planning optimal child journeys. The aims of mother and baby groups and sessions for individuals and pairs include supporting familial upbringing and preparing children for kindergarten and school life. With the help of a wide repertoire of activities, the conductor promotes faith and parents reflect positive emotions to the infant. Self-initiated task performance is planned, prepared, and anticipated, with the conductor taking both the parent and the child by the hand, praising and encouraging them, talking and demonstrating, provoking, and acknowledging simultaneously. Parents can try themselves, gain experiences regarding themselves. The joy they share will reassure them and carry them forward. Even severely afflicted children are capable of directed attention and active participation in their own development. Communication as a tool is a crucial part of our work. Through explanation, interpretation, reassurance, and loving gestures towards the child, all actors get involved in the interaction processes.

Modern Approach of Conductive Provision in Early Education

From January 2017, short-term intensive groups are operated as part of public education, which is unparalleled in the country. In the mother and child group, development is based on our tradition. In interval, block conductive pedagogical provision, as a part of systemic cooperation with the families, parents are taught to handle their children and promote their development efficiently. We provide intensive, motivated, age-appropriate comprehensive development in a group as proposed by up-to-date brain sciences, while taking advantage of parents’ supportive attitudes and professionally controlling them, as well as teaching integrated upbringing in the family. In that developmental situation, the opportunity is there to establish social relationships, to form parents’ self-help groups, and to experience accepting, unconditional love.

All these are offered at the same place under appropriate objective and professional conditions. We have the opportunity to thoroughly observe children, to prepare individual developmental plans, to set long-term goals as appropriate for the child’s temperament, and own learning pattern, which can serve as a basis for local professionals to continue development until admission to kindergarten. During subsequent visits, individual aims may be modified and reevaluated, and the experiences gathered at home as well as doubts can be discussed.

References

  • 1.

    Medveczky E . A konduktív nevelés, mint a neurorehabilitáció pedagógiai módszere [Conductive pedagogy as a pedagogical means of neurorehabilitation]. Budapest: GraphiTech Nyomdai Előkészítő és Kivitelező Kft.; 2004.

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  • 2.

    Balla Gy , Vekerdy-Nagy ZS . A gyermekrehabilitáció sajátosságai [The characteristics of child rehabilitation]. In: Vekerdy-Nagy ZS, ed. Rehabilitációs orvoslás [Rehabilitation medicine]. Budapest: Medicina Könyvkiadó; 2010. p. 66976.

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    • Export Citation
  • 3.

    Balogh E , Kozma I , Hári M . The conductive education of cerebral palsy in early age. In: Fejerman N, Chamoles NA, eds. New trends in pediatric neurology. Proceedings of the 6th Congress of the International Child Neurology Association, Buenos Aires. Amsterdam: Excerpta Medica; 1993. p. 2414.

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    • Export Citation
  • 4.

    Feketéné SZÉ . A szakmai együttműködés lehetősége, felelőssége a központi idegrendszeri sérültek ellátásában a konduktív nevelés keretei között [The importance of professional cooperation in care for neurological patients within the frameworks of conductive education]. Budapesti Nevelő. 2011;47(3–4):7587.

    • Search Google Scholar
    • Export Citation

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1.

    Medveczky E . A konduktív nevelés, mint a neurorehabilitáció pedagógiai módszere [Conductive pedagogy as a pedagogical means of neurorehabilitation]. Budapest: GraphiTech Nyomdai Előkészítő és Kivitelező Kft.; 2004.

    • Search Google Scholar
    • Export Citation
  • 2.

    Balla Gy , Vekerdy-Nagy ZS . A gyermekrehabilitáció sajátosságai [The characteristics of child rehabilitation]. In: Vekerdy-Nagy ZS, ed. Rehabilitációs orvoslás [Rehabilitation medicine]. Budapest: Medicina Könyvkiadó; 2010. p. 66976.

    • Search Google Scholar
    • Export Citation
  • 3.

    Balogh E , Kozma I , Hári M . The conductive education of cerebral palsy in early age. In: Fejerman N, Chamoles NA, eds. New trends in pediatric neurology. Proceedings of the 6th Congress of the International Child Neurology Association, Buenos Aires. Amsterdam: Excerpta Medica; 1993. p. 2414.

    • Search Google Scholar
    • Export Citation
  • 4.

    Feketéné SZÉ . A szakmai együttműködés lehetősége, felelőssége a központi idegrendszeri sérültek ellátásában a konduktív nevelés keretei között [The importance of professional cooperation in care for neurological patients within the frameworks of conductive education]. Budapesti Nevelő. 2011;47(3–4):7587.

    • Search Google Scholar
    • Export Citation