The following is a copyright transcript of the UK Federation for Conductive Education's publication. It is also available with their permission and can be supplied in the printed form from G & S Smirthwaite, geof.smirthwaite@virgin.net
We have known cerebral palsy right through the history of mankind. Authors and poets have described the condition; most familiar to us is Shakespeare's "Richard III":
"I that am curtailed in this fair proportion
Cheated of feature by dissembling nature,
Deformed, unfinished, sent before my time
Into this breathing world, scarce half made up
And that so lamely and unfashionable
That dogs bark at me as I halt by them. "
In this century an ever increasing interest in the possibility of integrating children and adults with motor disorders, such as cerebral palsy, into society has been witnessed amongst doctors, teachers and therapists.\
Methods, systems and approaches have appeared based on normal development, phylogenetic development, orthopaedic procedures or a mixture of these.
The originator of conductive education, Andras Pėto, was born in Hungary. Later he moved to Austria to practise as a doctor of medicine. This was between the two world wars, when Vienna was the European centre for intellectuals. It was in this artistic atmosphere that Pėto was stimulated to formulate a new holistic system of learning.
When returning to Budapest during the war, Pėto was hidden in a basement of a house owned by a gentile friend. Here he spent most of his time working and playing with the daughter of his hostess who had cerebral palsy. He was very successful with the child and immediately after the war he concentrated on training staff to work with children with cerebral palsy in his new institute which he called "The Institute for the Motor Impaired". This was in 1951. In 1984 the new Institute, now very famous in Budapest, was opened in the Buda Hills.
Pėto died in 1967 and the important work was continued by his students and colleagues. Most well known is Maria Hari, whose inspired work saw the Institute through the exciting, but often difficult, times in the 70s and 80s, when work expanded throughout the world at an amazing speed.
Pėto was not a fundamentalist. "Take it and use it", he told me in 1966. "The children will tell you how", he added, suggesting the solution lies in knowledge gained by thorough observation.
The UK Federation for Conductive Education was established to unite all those with interest in conductive education and seeks to promote conductive education as an integral part of services. The Federation acts as a link with colleagues on several continents and the world-wide distribution of "Understanding Conductive Education" will bring together those who seek to make conductive education accessible in today's and tomorrow's society.
Ester Cotton
February 1998
Understanding conductive education has been extremely difficult because of problems of language translation, differing interpretations of terminology and concepts and the fact that Pėto, its originator, bequeathed a living practice, not a well documented theory. Moreover, in the half century that conductive education has been practised at the International Pėto Institute it has developed. Half a century has led not only to a very sophisticated practice but also to a staff structure, training and network, a referral assessment and follow up system all of which support that practice and are almost inexorably fused with it.
The key principles in conductive education in so far as they can be separated from the cultural framework within which it operates in Budapest are described below. The key principles are those which might be replicable in a different building, a different cultural framework. In short, it is a process of experiences which lead the person to work with their disabilities and move towards independence. Conductive education consists of many interrelated facets which when combined make it a powerful force and requires a great determination to understand let alone put into practice.
To understand conductive education it is necessary to understand neurological motor disorders and their effects upon the person's whole being. Conductive education as a system is suitable for people with neurological disorders such as cerebral palsy, Parkinson's disease, multiple sclerosis and those who have suffered strokes or head injuries. It is a learning process and not, as has been variously described as treatment, therapy and/or exercises. The individual is learning components of skills which are needed to meet the challenges of everyday life. The individual is not a recipient of treatment, s/he is an active participant in the learning process. Conductive education is a partnership between educator and learners to create circumstances for learning - it is an all day learning process.
Conductive education is a system in its own right. It is not a composite or an amalgamation, it is a system of learning which has been developed for groups of individuals with motor disorders.
As a result of motor disorder most people have a wide range of developmental difficulties which can include those of gross and fine motor perceptual, intellectual, social, emotional, speech and language. The results of such difficulties can also have significant effects upon motivation and personality. Moreover whilst, in some cases, the original brain damage may be non-progressive its effect upon all these areas of development may be constantly changing. As individuals we face greater and greater challenges and require more and more skills. Motor disorder can have a devastating effect upon the ability to meet these challenges and learn the necessary skills.
" One point in the basic philosophy of Pėto was that one has to complete what one has begun. This principle means that any function or action, even any thought, cannot be broken off, it must be carried out: one has to complete what one begins.....This also applies to people with disabilities caused by structural alterations, who begin an action and seem not to be capable of finishing it. The way has to be found to do it." (Hari 1990)
The term education is used to indicate that the process is neither static nor localised. Through learning change is possible. People with disabilities are able to learn new ways of approaching and dealing with everyday activities through a greater knowledge of their own abilities.
The term orthofunction has been widely used as the aim of conductive education. There has been great confusion about what it means and most proposed definitions have been criticised. Orthofunction is not based on a set of specific criteria which the person needs to achieve. Orthofunction is a process of learning based on the concept of reaching one's potential. As human potential constantly changes based on previous experience, circumstances and learned skills, thus orthofunction is constantly changing. Conductive education uses orthofunction to describe the process of learning. The individual will be guided, by the conductor, to find a solution to the task at hand, this is then practised in the context of daily life and becomes a part of the individual. Orthofunction should be judged on it's qualities as a means of actively participating in daily events and not as a set of pre-determined criteria or as a comparison with the performance of others (Hari, 1984).
Conductive education teaches people with neurologically based movement problems to:
Conductive education works to teach each individual strategies for coping. Through meaningful activity the child or adult will begin to learn new ways of approaching the challenges they face in everyday life. They will find ways of achieving their highest level of potential and will learn the techniques which enable this. The conductor acts as a facilitator and a teacher but does not provide all solutions. S/he is a catalyst in the learning process.
There are five main areas used to facilitate this process. It cannot be over emphasized that the following are not a series of disconnected facilitations. Having some of them does not mean that conductive education is operating. Indeed having all of them does not necessarily lead to conductive education. They are interrelated, interdependent forms of facilitation which are a part of the whole process.
The focus for the conductor is on the positive. S/he guides children and adults towards realistic, meaningful goals which are negotiated in line with the needs of the individual. The relationship is clearly a very caring and intimate one. However the relationship is always being used to gain the greatest possible effort from the child/adult. The conductor's high but realistic expectations are constantly transmitted and there is praise in abundance for effort and success. The conductor promotes a feeling of success through facilitation which enables individuals to realise their own goals. Mutual trust has to exist between the conductor and the individual with whom s/he are working. There is no hierarchy of teacher and pupil as this would reduce active participation and stifle problem solving.
Conductors are not an amalgamation of present professionals in education, therapy and rehabilitation. They are new, distinct professionals whose training, experience and methods of working are unique to conductive education.
The programme for the day will depend on the age of the person and their individual requirements. For many it may include getting out of bed, going to the toilet, washing and having breakfast. All the activities are included within a daily routine. For a school age child the programme will need to include academic lessons, playing with peers, entertaining him/herself; for the adult it may include working, hobbies, or family duties; for the teenager it may include dancing, going to the pub, accessing a social life.
As the individual develops so his/her needs, responsibilities and priorities will change. The programme is an evolving dynamic process not a series of routines or exercises punctuated by breaks. Parts of the day can be broken down into challenges to be met and elements to be learned. They must remain, however, a whole programme. It is the functionality of the programme which makes it a motivation, a facilitator. It must remain a meaningful functional whole which is constantly evolving. Many people search for a conductive programme for the whole day and feel that this is something which should be prescribed. There is no conductive programme for the whole day - the whole day becomes conductive. For children in a residential setting to adults within their own home the programme will differ but they can all be conductive.
Each task provides an element of movement skill. Each individual learns how to produce this movement in relation to their own capabilities and expectations. The individual needs to learn how to intend the movement as well as how to perform this while reaching their highest level of potential. The task series provides the opportunity for each individual to learn how to regulate their intention and performance. There are only a certain number of movements the human body can make. The movements in the task series are built around these e.g. bending legs, lifting arms, moving head, moving feet and toes, moving fingers. These movements, however do not enable a person to perform everyday activities unless they are used in different combinations and connected with meaningful goals. This is where the connection between the programme and the task series lies. There is little point in sitting through a maths lesson if it has no meaning. However if during this learning process you have to work out how much can be bought with the money in your purse then the maths becomes meaningful to you. This completes the learning cycle. The same is true of movements. The tasks carried out in the task series act as the base for the daily programme. Each individual is taught how to connect these tasks and how to build them into the skills required to fulfil daily activities.
While participating in a task series individuals are learning how to control their movements and learning techniques which lead to success. Each task must be within the individuals grasp. To try and then fail is demotivating. For each person the task must be presented in a way which allows him/her to succeed, at the same time as s/he is learning a new skill or reinforcing a newly acquired one. If the conductor sets up the situation and guides the person through it, it can be described as active learning and thus can be applied in other situations. Success must lie with the individual. If the conductor performs the task for the individual then s/he will not experience success.
Initial assessment is the starting point for both the task series and the programme. This leads to an initial set of objectives and a structure within which to achieve them. These objectives are constantly monitored by the conductor using operant observation. Operant observation means not only observing the individual's progress but responding to it on the spot by changing or developing aspects of the work. Operant observation helps to keep the whole process a dynamic, motivating, learning one and is essential if success is to be achieved.
"When you are faced with a daunting physical task you pull from somewhere within yourself the intention to act.... the result does not so much depend on your own physical strength as on the power of that inner will, that 'energy' you feel within you" (Peat 1995)
In conductive education we see that many people with neurological conditions may lack this intention. It is often described as a 'will to act'. This does not mean that people with disabilities do not want to act but that they lack the neurological processes required to do this. What, for most people is automatic, has to be consciously learned.
Rhythmical intention is a term commonly used within conductive education. It is not only one of the most powerful tools of teaching but is also one of the tools that adds to the unique nature of the system.
When a conductor verbalises an intention like `I make a fist' a number of cognitive processes occur. The individual is hearing an intention which leads to an internalised language viz. `I make a fist'. This is preparing the central nervous system for action. The individual may also be constructing an internal picture of what s/he is about to do. The individual may be asked to verbalise, in some form, the intention. The physical sensation of this helps the person focus on what the intention is and acts as a stimulus to the physical actions needed to carry out the intention. This linkage of physical vocalisation to further action is an important element of the neurological processes which are going on in the development of motor memory. Thus vocalisation reinforces the intention and also acts as a stimulus to motor activity and a reinforcer of motor memory.
Vocalisation of a task is a common practice for all of us. When we are faced with a difficult or new task not only do we initiate the intention to act we often talk ourselves through the stages. In this way we monitor and control our own actions. The person with a neurological disorder needs to acquire this ability as a pre-requisite to performance and enhancement of skill.
Another key element is the role of rhythm in rhythmical intention. The conductor is using rhythm either delivered musically, by dynamic speech or by counting to reinforce the appropriate rhythm of the action being carried out.
A person with spasticity, whether this be due to cerebral palsy, stroke, multiple sclerosis or head injury, needs to perform movements in a way that does not increase spasticity. Movements which allow time for the person to intend and prepare are more successful. In this instance the conductor would use rhythm to allow the child to perform a movement with success, thus the person would repeat the intention and produce the movement in a steady rhythm. If this is too quick then the spasticity will increase and the person will not be successful, if too slow then the gap between intention and performance will affect motor learning. The conductor needs to find the appropriate use of rhythm to ensure success.
A person with Parkinson's disease is unable to initiate movements; there is a time lag between intention and performance. The conductor will verbalise the intention and teach the person to react immediately. In this instance the individual would not need to repeat the intention as this would increase the time lag already present and would not lead to success.
A person with involuntary movements, whether this be due to cerebral palsy or head injury would need to learn how to direct movement, thus reducing the time taken for performance of an action. If this is too long the over movements will affect success. In this case the person may be asked to repeat the intention to allow time to prepare for the movement and then execute the movement directly. Motor memory is being reinforced by intention, language, speech, rhythm and action. All of these play a vital role in the learning of skills.
Rhythm can also be seen as a motivation which reinforces the rhythm of the task, the group, the day. There are many examples of this outside the realms of conductive education. Rhythm helps the process remain dynamic and can help maintain the interest of the individual. Once learned the rhythm is internalised and the individual is able to utilise this in many forms. As the process of learning skills advances so the need to verbalise intention and rhythm is reduced and it is at this stage that we can say that learning has taken place. This learning can then be applied to the situation and task at hand throughout the day.
One striking element of conductive education is that most learning takes place in groups. This is common for children but it is not for adults. A number of people in a room together does not constitute a group.
The group in conductive education refers to a psychological entity which is used as a facilitator. Groups have been used in psychology and psychiatry as a therapeutic force and it is within this domain that the group in conductive education fits. Within a group there will be a range of levels of development in all areas and individuals in the group offer a series of models. Each individual can see how others solve similar problems and can learn from them. The conductors use group dynamics to motivate the group members. A group may wait for an individual to solve a problem, may urge him/her on, praise his/her success and delight in his/her achievement. That same individual, on another occasion, will be one of those who facilitates another member. In this way a psychodynamic group is built and consolidated. Such dynamics are an irresistible force for positive achievement.
The group includes both the children/adults and the team of conductors. The whole group experience pride in their achievements. It is an all encompassing and very powerful entity.
Learning takes place both in the structured teaching environment and the home.
The home environment is where the individual is able to consolidate his/her learning. The application of skills from the learning environment to the home environment is a key element in the development of skill.
The teaching environment within conductive education must offer the opportunity for the individual to use the skills s/he is learning. If the area is too large then independence is not achievable, if too small there is no opportunity for learning. The teaching environment must cater for all aspects of daily living in order to promote application of learned skills and as such lead towards independence. Equipment often used in the teaching environment includes plinths and ladder back chairs, both of which can be used as a teaching tool for children and adults.
These must provide facilitation to learning, they are key tools. They must not create a dependency as this prevents further learning. They can provide facilitation to enable the goal to be achieved. They do not facilitate the goal but the path towards achieving it. As skills develop they can be withdrawn or reduced.
All individuals who take part in the conductive system need advice and help about the application of their skills into both their home environment and their wider community This must remain an important aspect of conductive education if the process is to provide success.
The multi-professional team, including conductor, nursery nurse, occupational therapist, physiotherapist, speech & language therapist and teacher, have found a consensus view through discussion. This has been largely lacking within the world of conductive education and it is time for all those in the United Kingdom involved in conductive education or related practices to pool their knowledge, experience and resources for the benefit of all those for whom conductive education will be such a powerful and positive force. There are major implications for practice in the UK if the benefits of conductive education are to be enjoyed by all those for whom Pėto devoted his life's work.
Hari Maria (1984). Conductive Education. PIREMON Kisvallalata Nzomdauzemeben. Debrecen. Hungary
Hari Maria (1990) The History of Conductive Education and the Educational principles of the Peto System. Paper delivered at the World Congress on Conductive Education, Budapest.
Peat F David (1995) Blackfoot Physics. Fourth Estate Ltd. London.
If you would like further information about this publication or require additional copies please write to:
The Secretary,
The UK Federation for Conductive Education,
C/o Horton Lodge School, Horton, Near Leek,
Staffordshire STl3 8RB.
Telephone: 01538 306 214
Fax: 01538 306 006
Akos K. And Akos M. Dina - A mother practises conductive education. The Foundation for Conductive Education, 1991
Brown M. And Mikula-Toth A. Adult Conductive Education. Stanley Thornes, 1997
Cottam P And Sutton A. Conductive Education. A system for Overcoming Motor Disorder. London: Croom Helm, 1986
Cotton E. The Institute for movement therapy and school for 'conductors' Budapest, Hungary. Developmental Medicine & Child Neurology, August 1965, 4, 437-446
Cotton E. The Basic Motor Pattern. London: The Spastics Society, 1981
Cotton E. Integration of disciplines in the treatment and education of children with cerebral palsy. Levitt S (Ed) Paediatric Developmental Therapy. London: Blackwell Scientific Publications, 1984
Hari M. and Akos K. Conductive Education. Translated by Neville Horton Smith and Joy Stevens. London: Routledge, 1988
Hari M and Tilleman T. Conductive Education in Scrutton D. (Ed) Management of Motor Disorders of children with cerebral palsy. Clinics in Developmental Medicine, 1984, 90, 19-35
Jernqvist L. Conductive Education: an Educational System for Children with Neurological Disorders, European Journal of Special Needs Education, 1986 1,3-12
Jernqvist L. And Taylor M. (Eds) European Journal of Special Need; Education, special issue on conductive education, 1995, 10, 2
Russel A. and Cotton E. (Eds). The Pėto System and its evolution in Britain. Acorn Foundation Publications, 1994
Read J. A different outlook: service user's perspectives of conductive education. The Foundation for Conductive Education 1996
Towards a curriculum for life: conductive and mainstream education.
Craighalbert Centre, 1997
The Federation was founded
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