The title of this post is taken from a Times article published on Thursday 1st October 1987. The original was found browning in a box as we sorted papers after redecorating a bedroom. With it was a Sunday Times Magazine from the same time (of which more in another post).
Here is the article and, at the end, an inset panel. In so many ways, reading it brings back a different world. (In passing, I note - with no surprise - that the author is a doctor, not an educator, the Times medical correspondent Dr Thomas Stuttaford.)
Standing on their own feet
In Budapest conductive education is successfully training handicapped children.
Now its ideas are coming here
Three weeks ago, everyone other than her parents and Dr Maria Hari of Budapest thought eight-year-old Dawn Rogers was helpless. She had suffered irreversible damage to her nervous system at birth, and was incapable of walking or standing. When I saw her last week at the Peto Institute for Conductive Education in Budapest, where Dr Hari is the director, she was triumphant and her mother jubilant: after 10 days' training. Dawn was standing unaided.
In a different classroom in the five-storey institute, another British child, four-year- old Sebastian Clarke, had a broad grin on his face as he staggered towards me. He was under 21b at birth and suffered four cerebral haemorrhages while in a premature baby unit, which left him with cerebral palsy (a spastic). After assessment at the age of two by local paediatricians in Birmingham, his parents were told that he would never walk or have a socially acceptable intellect. They refused to accept this verdict, and four months later arranged for him to go to the Peto institute.
Initially Sebastian's training at the institute, and the living expenses of the parent who accompanied him, were paid for by local benefactors; now Birmingham council has supplied the £13,000 needed to fund Sebastian's one-year stay in Budapest, which is considerably less than it would cost to care for him at home in Birmingham.
Dawn and Sebastian are only two of the thousands of children suffering from cerebral palsy or spina bifida who have been helped by conductive education at the institute, where training combines aspects of physiotherapy, teaching, medicine and what used to be known in paediatric wards as TLC (tender loving care). Of the 4,948 children who have passed through the institute since the sixties, 3,657 have graduated to an ordinary school or to a job.
In Britain, assessment of such children is commonly performed by local paediatricians in conjunction with physiotherapists, social workers and the local department of education, who then decide what treatment and care may be applicable. The result, as in Sebastian Clarke's case, may be the recommendation of specialist physiotherapy for only an hour or two a week.
Training at the Peto institute is incorporated into everyday life, so that the children become immersed in it. Many are boarders. Their dormitories are attached to classrooms and living areas, so that learning never stops. The atmosphere is one of cheerfulness, humour and hope.
The institute was started by Dr Andreas Peto, who taught that children with motor difficulties who were suffering from some types of spina bifida would achieve totally unexpected goals if they could have their self-esteem boosted by being encouraged to help themselves to pass apparently unattainable milestones.
He was certain that one of the problems was the separation of education and physiotherapy into two distinct disciplines, and that a holistic approach was needed. He taught the children to carry out the complex actions which are of everyday use and which require the interplay of many muscle groups — standing, walking, putting on shoes or getting dressed. He found that as the children succeeded, their successes stimulated them to even greater endeavour.
When he died Dr Hari, his pupil and confidante, took over. Now in her fifties, she was a dancer and PT instructor before qualifying as a doctor and undergoing three years' specialist training in rheumatology.
When asked to analyse the reasons for the institute's success she suggests that assessment of the children and of the conductors is all-important. The child is now seen by a panel of experts including paediatricians, neurologists and a neurosurgeon. After the initial examination, the patient is repeatedly re-assessed during the next three months.
The Institute hates to reject a child and accepts between 50 and 60 per cent of those sent to it. However, if assessment reveals uncontrolled epilepsy or diabetes, severe or increasing hydrocephalis, or an IQ which is so low that the child is unable to respond to commands or react to parents, it is felt unlikely that the child will benefit from the course.
Selecting conductors for the four-year training course is equally important. Dr Hari says that they should have warm personalities and an agreeable appearance, so that children can easily relate to them; they should move easily and gracefully, as much of the child's training is about movement; they must be capable of developing an ear for music, also important for the training, and they must have a natural aptitude for teaching.
It is very different from the British situation, where the sight of a converted minibus collecting spastic children from their homes and delivering them to special schools for the day is a depressing feature of early morning life.
But Dr Hari has recently started co-operating with the Institute of Conductive Education in Birmingham, which embraces her views. They will select 10 potential conductors to go to Budapest to start training. Over the next four years, this group will divide its time between the two cities and some of Dr Hari's conductors. In the future it seems that the Budapest institute will become an international training centre, but, for the moment Britain enjoys a privileged position; over the past year 120 British children have visited the institute, and at least 35 are being taught there now.
Doctors realize that the pattern of neurological disease in small children varies from country to country, and depends perhaps as much as anything on the care which the premature infant receives; in some countries with highly sophisticated neonatal units, grossly damaged children survive, whereas elsewhere they would have died. But if I was a parent of a child with cerebral palsy, I would want Dr Hari's opinion before I assigned my child to the minibus run.
Dr Thomas Stuttaford
THE BRITISH CONNECTION
This month the Birmingham Institute for Conductive Education will be sending the first British trainees to the Peto Institute, for the four-year conductor's course.
After a visit to the Peto Institute in 1984, Mr Kenneth Clarke, then at the DHSS, asked for information on similar schemes in Britain. Civil servants were told by the Spastics Society that conductive education was proceeding apace at its own residential schools.
But on its own admission, the society has only "adapted" conductive education to a British, multi-disciplinary context — it uses teams of physiotherapists, teachers and other experts instead of individual staff trained in all these disciplines.
Critics say that the "adapted" approach misses the point. "By using large teams of people, the child's education becomes disjointed," says Alison Salt, a 25- year-old teacher and one of the trainees. "The Spastics Society is not, whatever it says, providing conductive education in the true sense."
But there are strict rules of admission for the Birmingham Institute — pupils must not be "suffering from profound mental handicap, blindness, autism, continuous ill-health, continuous fits or medication that affect the ability to participate". The Spastics Society and many health service professionals believe that their duty lies with children who have these handicaps.
Sarah Thompson
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