The American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) periodically prepares reports that summarize and evaluate the information that has been published about a clinical intervention used for the management of a developmental disorder. It has recently done such for “Conductive Education” (CE).(1)
The report describes the history of the development of CE (developed in Hungary in the 1940s); the role of conductors (supervisors serving both as teachers & therapists); the use of group motivation, rhyme and song; and the CE goal of improvement in activities of daily living. Children are encouraged to work independently with support from their peers and the conductor.
In summary, the AACPDM analysis reports:
There are published reports of the effects of CE on 966 individuals; however, only 231 individuals meet criteria useful for analysis. The moderate number and a lack of a meaningful description of the children included make it difficult to evaluate if a specific treatment plan works for a child with a specific disability.
The usual results of the strongest studies reveal no difference between the CE group and groups receiving other interventions.
The “classical” CE treatment program developed in Hungary needs to be compared to changes made in other cultures where assistive technology is incorporated into treatment programs; assistive technology is not usually used in the Hungarian CE programs.
Research evaluating CE needs to incorporate the means of identifying the best fit between a child and a specific CE type of intervention. CE studies to date have not done that.
The present literature does not provide conclusive evidence either in support of or against CE. Because of this, parents must consider items such as cost, time, accessibility and the impact on the family when considering CE.
As indicated in the Research Fact Sheet of 1997, Conductive Education (CE) is characterized by the therapeutic use of very positive support from peers, the encouragement of the parent and the therapist-educator (the conductor) and immersion for an extended period of time in the program. It raises the question of the comparative efficacy of other programs (techniques) where similar motivation and prolonged intense periods of therapeutic immersion are used. Is it the technology or the immersion that are the background for the reports of improved function? Unfortunately, CE is a 1940 intervention that has been and continues to be reported using 1940 s criteria of evaluation. Thus, individual reports of usefulness are undermined by poor methods of evaluation. A controlled clinical trial using specific entry and exclusion criteria, established endpoints, a reasonable period of follow-up and a comparative population (“controls”) are required to understand the role of CE in the treatment of specific types of cerebral palsy. Until then, CE will continue to be considered an interesting but “alternative therapy” and not meet the standards necessary for incorporation into modern clinical care.
1 – Darrah, J. et al (2004) Conductive Education Intervention for Children with Cerebral Palsy: An AACPDM evidence report. Developmental Medicine & Child Neurology 46: 187-203.