The "bloody furniture"*

Nothing better then having a long weekend to finish some projects. I have been working on one piece of CE furniture for some time and really happy that it’s nearly finished. In the process, I had a quick learning curve about sanding the chair, prime it and even paint a quite cute picture - despite my lacking drawing talent. I found that particular chair in the basement of my boyfriends grandma and she was so kind to give it to me. She was really happy that it will have some good use as it otherwise would have landed in the trash.

My partner also build me an adjustable floor ladder, which I have used with some of my clients and which has contributed to their learning process.

I would like to stress here, that in order to live a conductive lifestyle you do NOT need the CE furniture and I have made so far do with little of it. But in some instances it can serve as a great learning tool during the conductive program, to teach certain skills or break-downs off, I chose not to completely go without. On the other hand I do sometimes purposefully spend time with the client, thinking or assisting the thought process of what to use, in order to learn, apply or practice a certain skill. But as a teacher you some times just need to have your tools handy that you know will work, so you can spend time teaching what you intended.

Making this equipment actually has made me problem-solve and enter unknown territory. I learned overcoming some difficulties along the way, which made the process for me, challenging, at time quite meditative and very conductive.

*that's what Andrew Sutton used to call it. Not sure where to find the original quote.
PS. hope i can upload the pictures soon.

Learning the art of the CE

Before I start, let me assure you writing this blog wasn’t an easy task. I must have re-writing and corrected it a dozen times and, as I always, I recognize that I do not hold the ultimate truth to everything and especially to everything that involves CE. But this is my story to how I got to my understanding and how I have communicated it in the past.

Back at University in the UK during our second year, we were asked to prepare a 20 min presentation about what CE is. We were supposed to explain it to our fellow students and teachers CE as they never heard about it. Sounds easy??? Surely, by the second year we should know what the heck we were studying?? Well, looking back it was one of the toughest tasks we had to master and I still draw from what I learned on my way to give this presentation.

By the way, we had to give quite a few presentations as our tutors and creator of this course thought we should be able to talk publicly about CE – annoying at the time, but I am now quite thankful for it. My presentation skills have improved a lot: Some of you will be pleased to know that I stopped rocking forward and back, hardly use my notes and even try to make eye contact. But mostly that depends on the audience and yes I am still learning.

Anyway, to prepare for the presentation I read through most of the published books about CE in English and German. Especially in German I read quite frequently about the principles of Conductive Education, which referred to:

• the conductor,
• the task series,
• rhythmical intention,
• the program(also daily routine),
• the group

and sometimes even the furniture.

According to Sutton the concept of CE principles orientated in Ester Cottons book (Funny, that I know exactly what book he is talking about but unfortunately its not in my small CE home library).

Even though we had all access to Cotton's CE principles, as far as I remember no one of us used it to describe it. I guess, it is because we didn't get CE taught in a black in white perspective; and because we wanted to look like we knew what we are talking about in front of our classmates and tutors. However, every now and then (actually more frequently lately) those principles pop back up to describe CE. In my eyes, the principles of CE according to Cotton are failing to describe the pure essence of CE. Further, the task series, the rhythmical intention, the program (or daily routine) are merrily facilitation tools available to teach certain skills. The description of the conductor read to me always like a job description – a very ambitious one for that matter. It always encouraged me to try to be a bit harder and be a bit better.

The question comes up and has come up in the past: if you do not have all of those teaching tools, resources and techniques available – even through they are pretty powerful- would you still do CE? I would like to argue that yes you do. We know that you do not necessary need a conductor to teach a conductive lifestyle, the parents with the right guidance can take over this role for their own child. If we as conductors did not believe this, why would we have parents and child groups and seek constant conversation with the parents and caregivers? Breaking down skills to make them learnable is a handy skill to have and give opportunities to practice those during the day is also important. But one can do that during their daily routine without actually following a task series or a program. At the end of the day that’s why we as conductors use task series during our program to encourage the use and application of different skills during the individuals daily life. I do not think that giving parents task series to practice with their kid is a way to encourage a conductive lifestyle. It actually estranges the individual and their family from living. To encourage the kid to hold on when riding their bike and swinging on a swing, keep their sitting balance when going sledging, moving their legs when playing soccer with their siblings and much more is living- that is conductive living. What we can do, is to show them how to break down certain skills or during which situations they can be practiced. By the way, I know when a family lives a conductive lifestyle, when they come back to me and found different way to apply those skills.

As my teacher from University used to say we do not want our clients to go through live counting. What we want them to take away is the things rhythmical intention (RI) teaches the way to organize our thoughts through speech, to slow our movement down or speed them up accordingly, to plan ahead, to learn how to use our breath effectively to move and much, much more. RI is a powerful and complex tool and helps to teach a lot of skills, but during my individual session I find myself using it less and as always only for certain purposes.

Coming back to the presentation I had to do for school. What did I do? How did I describe CE. To be honest looking back it was rather a process then a solid idea, that with the more I read and understood, changed the shape of project- quite literally. I am a quite visual person so I wanted to present CE in a kind of diagram, simple and clear. So I kept researching for the essence of CE. I read your typical CE books, at what we been taught in practice and what was taught to use during our conductive pedagogy lectures. In books I found Hari talking about techniques that unfold linear, longitudinal, spiral we used to teach. I guess that means techniques we use all the time like our observation skills; techniques that slowly increase determined of the circumstances, like techniques that build up on each other or slowly become less in use, like the use of manual, verbal and psychological facilitation. Looking at our practice I learned a lot of differentiation to suit each individual as well as the group needs, which we learn to use according to our observation skills. In our pedagogy lectures we learned the concept of how and when to use different techniques, being aware of different challenges and mostly encouraged to “think outside the box”.

First, I wanted to use my brothers magnets and sticks to build something, but due to shipping problems that idea failed. I tried to draw something but unfortunately I am not the artist of the family. So, my friend and me looked for something with linear, longitudinal, spiral structure on “google” and we came across the structure of an DNA. So that’s what I ended up using as my diagram to present CE. And it worked quite well to bring across my point, how each thing we do interlinks with another and depends on the individual we work with. Sometimes what we choose to do looks a little a bit different as the facilitation techniques vary in order to serve the individual as well as the group better or sometimes- as we do not live in perfect world - adapt to the resources we have available.

So what did I really learn about CE? That CE is complicated and simplifying it mostly denies its complexity. CE’s essence is its pedagogy– the way and the art of how we teach.

When I introduce CE to new crowds nowadays I start by explaining that it is foremost an educational approach focusing on teaching children and adults with movement disorders, skills that are relevant in each individuals life. That it looks at all aspects of the individual personality. That it recognizes that some skills like confidence, motivation and attention have to be addresses first in order to teach new physical skills. I talk about CE fundamentals, which consist in my eyes of the conviction in life-long learning and that with each new skill acquired new potential to learning is born. That in that quest of learning the dynamic of the relationship between the teacher and the learner is important, which builds up on trust that needs to be continuously nurtured. That we realize, that the role of the teacher and learner needs to be flexible. The reason for choosing what we teach, how to teach it and when, depends on techniques we learned during our training as well as our past experience, interests and additional training and how we have seen it work, or not work, to teach certain skills. As Susie Mallett in one of her latest blog said, there is no cook book for our work. Which allows us to try and be flexible in our teaching and change with our clients, but it is that fact that makes describing CE sometimes quite challenging.

The best way to make people understand what we do is choosing examples of our practice that might be relevant to their own learning and that very much depends on the crowd or person I talk to. Strangely or maybe not, that is exactly what we learned during our training to be able to give specific example to show what CE can do and has done in the past. And luckily that makes blogging about our practice even more important.

Notes:

http://www.susie-mallett.org/2011/04/let-us-be-careful-about-aphorisms.html

http://www.facebook.com/#!/profile.php?id=1540593482

The girl with the soft voice

Today, after my second stroke group session, the group coordinator and me had a little talk. We were both excited what we just witnessed. One of the ladies recently attending the stroke support group and my stroke trial just had a major break-through. She was able to move her arm for the first time by herself since she had the stroke but more importantly was the confidence she gained from it. She was literally glowing at the end of the session, enjoying the praise and attention that 60 minutes earlier would have made her blush and run out of the room.

She wasn’t the only one who gained from this session. A lot of people attended and gained from it in different ways. I don’t think it’s your typical CE session. For most attendees there has been no initial consultation, even though some of the basic forms have been filled out. If I could describe it, its like a drop-in CE session like the yoga/pottery/wood-work classes in the other rooms of community centre. Yes, its not ideal but when the stroke group coordinator and me first got together, we wanted to make it accessible for everyone in the group. We had a group that met every week to socialize, exercise, play cognitive games, switch information and learn from each other. Not unlike any other conductive group. So to utilize this in way to make it a conductive group, was the challenge we set ourselves. I put together a program that differentiates a lot to be useful as an introductory course for all levels and abilities and I think everyone took away at least one new thing from the session. This was the second week of our eight-week trial and so far so good.

I don’t think it will stay as useful for all over a long term, unless we are able to split up in smaller learning groups. But it’s great for an introduction and accessible for people, who otherwise do not attend for various reasons.

Anyhow, in our discussion about the session, the coordinator said she knew from the beginning that this is something great, something big and she is very passionate about it. However-and she told me to not take it the wrong way (oh dear, here it comes) – the members of the group were surprise to hear that the “girl with the soft voice” will be back, to teach the group. Ummphh, “the girl with the soft voice” is definitely not the greatest compliment I ever had. But I understood what she meant, because yes I do have a softer voice and as my boyfriend puts it a slight “British” politeness in my voice that makes it softer. I also know that I am very passive when it comes to sell CE. I do want people to know about it without pressurizing them. I wish sometimes I would be a bit more aggressive in my approach to promote CE and I will try to work on it. I also wish I would be better with words. In my head I thought I actually did quite a good job going out there and talk about CE, but I also know where my talents lie. I convince people by showing them what I do and explaining while doing it. During group sessions I feel at home, in fact quite safe. That’s where my passion and knowledge glows (or at least I hope so).

Funnily, I know a lot of conductor colleagues, who are like me: Shine in their practice and not so much in their public speaking. But I also know, met, read from conductors who are naturals in public speaking and feel at home doing that. I hope that some more of those will step it up and talk/write more about CE. Also, the ones who are less natural at this, try anyway. Isn’t that what we teach our clients- trying is more important then achieving. At the end of day, without me “trying” I would have had the opportunity I had today, to teach some amazing individuals some new skills and help them glow.

Linked-in. Are you??? Should you???

A couple of weeks ago one of my clients suggested to me to join Linked-in. She explained to me that the is a professional network and unlike Facebook connects people professional without viewing pictures of their last camping trip.

I know this is old news to some but I so far I found it most fascinating. Not really for the fact that I made a lot of contacts (which I haven’t) but more for the discussions that are going on. I joined a couple of groups like “Neurorehabilitation” and Cerebral Palsy groups and been getting email updates about different discussions on a daily basis. Something tells me that those are the discussions we (as in the conductive community) should take part in. Getting out there and let everyone know that we have a voice and a view. And we can get out of our professional hiding-place. There is right now a discussion about Neuroplasticity, rehabilitation and Stroke. We should be in there, shouldn’t we?

Funny that those discussion look a lot like some that have been going on in the boundaries of the CE world. But maybe we still have to decide what our view is. A few of us came to the conclusion not too long ago on Andrew Sutton's facebook wall. Is that true? Quite possible, but who know without real widespread discussion.

Through Linked-in I have made a quite interesting acquaintance with a professional working in Toronto. His name is Nathan Gendelman. I commented on one of his blogs and pointed out some similarities in our thinking about learning and functional application of daily life skills. He replied to me (and allowed me kindly to quote him) “The LIFE concept does have certain common points with Peto, but it does have a lot of differences, which does not mean we can work together under one roof. [Literally as conductors do work for his company] I think if we can benefit to kids and adults with disorders - this is the greatest thing we can do. All the rest can and have to be worked out, so there is one path and all in one treatment.” After some negative experience in the past I have made with different professional, I am very excited to come across some who are looking for the exchange of views. I always knew that they are out there (as I met a couple in the past) and lately I am happy to report there have been more positive experience then negative ones. After a couple of email exchanges with Natan Gendelman, I have been asked to write about CE on the enablekids blog. That is the first time I have been asked such a thing and feel quite honored, who wouldn’t? I said I will give it a go and hope I will be able to come up with something useful.

Anyway, I am in the middle of spring camp and therefore pretty busy just being a conductor working with children and their parents - full time. I think it created a lot of learning for all (of course it includes my learning, too) and that right now reserves most of my attention.

I do hope in the future to be more out there. Discussing, writing and learning.

Notes:

http://www.linkedin.com

http://www.facebook.com/#!/permalink.php?story_fbid=152911594770591&id=1540593482

http://www.enabledkids.ca/

PROPOSED CONDUCTIVE EDUCATION SUMMER CAMPS IN BC

We are slowly or should I say quickly approaching the first Purpose Society/Moving Ahead intensive Conductive Education spring camp. It looks like we are going to be filled up close to capacity. This is very exciting indeed. There are a couple of newbie’s to CE group sessions and a couple of returnees. We only going to have a week with everybody and I hope some old skills can be refreshed as well as new things can be learned. It will be exciting to see how everything comes together and I will do my best to write about it.

We have started to look towards the summer and it already feels like it is just around the corner. Because this is the first summer camp I am going to run out here, I wanted to give people the opportunity to have their say on what we put on. Please visit my website (thanks Ben) to download the dates and details of the proposed summer camps. http://www.movingaheadcc.com/index.html (scroll down to access the form) and let me know what you think!!!

By April we should know more what is going to be feasible to run and what not. In the meantime I will be looking in different themes, activities and games to ensure that those camps are going to be full of learning opportunities combined with lots of fun.

Realistic feedback aids intelligent love!!

During my previous job as a conductor, one of my duties was to help to train the new summer camp staff (we were lucky to have a lot of returning as well as regular staff members which made things a lot easier). Usually we only had 1 to 2 days training allocated for that. During which we were trying to cover a whole lot of topics: safety of clients, centres policies, basic facilitation, awareness of movements, expectation of conductive assistants and conductors, daily routines, details of children, set-up, being motivating and more.

One point of the training was how to fast track building a relationship with the child. This is a pretty hard skill to learn but makes all the difference in a CE summer camp setting, which relies on the good help of home trained CE assistance.

We discussed that having the right kind of expectations on the kids is important to get the kids to work for them. We told them that looking at their current and former aims as well as watching the conductor and senior assistants would give them a pretty good idea on what to expect of the child. We told them that its important to keep the children safe and that we would show them how to do that without over-helping them. We told them to have fun with them especially in the in-between times of the program. We told them how important realistic feedback is to those children and their self-awareness. We also told them that those kids are great kids, but that they get a lot of praise for things they have little control over like their smile, their cuteness, their eyes and their pure existence. And they had to be really careful with that, as we did not want them to cuddle the children all day long. It was their job to teach the child, to be fair and realistic with their feedback. We wanted them to look deeper to see the child’s personality in all its facets and talk with them and to them age-appropriately. We tried to teach them about Hari's intelligent love.

One of my favourite quotes about intelligent love is the one by Chas McGuigan : “You think you are giving a child love by cuddling it all the time, but are you creating more dependence? If you just push it away a bit, encourage it, teach it to do things, you are loving it with a capital L.'”

That’s why I disagree with the statement on feedback of one of my fellow conductors. (I disagreed with some more points in her blog, which I would like to discuss some other time):

Personally I like to give positive feedback to the kids all the time, even if they couldn’t do their best. To give an example, when a child cannot perform a task perfectly, I try to encourage him by saying next time; if you try to do your best a bit more, it will work. And I also tell him he did another task well.

What she says in her blogs comes from a good place and it made me think about it all day, which is definitely a positive thing. But it seems to be very controversial to what I tried and still trying to teach my conductive assistance and parents alike over the years.

I too, would rather give positive feedback to my kids and adult client all the time, but this is not always possible or even desirable. Being positive is great but feedback is all about reflecting reality. Do not get me wrong, I do always look for something positive to point - how small that might be. But that is just it, the task don’t have to be carried out perfectly, however they needs to show that they are intentional trying to accomplish the task at hand.

Most of the time my children and adult clients do try their best, in fact they try so hard that they forget to breath and/or they trigger unwanted movements (e.g. spasticity, tremors, over movements) and more. Telling them to just try a bit harder next time and it will work is not just unhelpful but leads to a continuing the circle of failure. If we let this happen, we are failing as teachers, because we simply don’t teach. A better way is to acknowledge that they are trying hard but although give suggestions how to change what they are doing e.g. breath, relax, fix other body parts etc. . We have been taught that letting our clients fail is not an option, that if we plan for something and we ask our clients to do it, we better make sure that it is completed successful, which by the way does not mean it has to be completed perfectly.

If you are not realistic, how can you teach appropriate behavioral responses? Some children and adults with movement disorders have behavior problems partly due to inappropriate feedback in their upbringing and daily life. You have to understand that this inappropriate feedback is because they love them and want to protect them from failing.

One of the moms I worked with told me the other week that she used to praise her 17-year-old daughter for anything she does, even if she didn’t really do what she was asked to do.

That meant she had a hard time following instructions correctly as well as showing some inappropriate behavior as everything she did was “right”. She said she changed this when she saw me working with her daughter. Every time she didn’t get I would tell her nice try, but try again until she got it and then gave her lots of praise. Sometimes I gave her some hand over hand help if she didn’t get it after a couple of tries (still making her initiate it), so I would not frustrate her. But she still had to be active during the process and initiate the right movement. This way she understood what was expected of her and was even more excited when she finished it. We also worked on reinforcing good behavior when she waited for her turn, used her voice instead of pushing people to get attention. My client is very different now, she learned a lot of different skills during a very short span of time and mostly has to do that the feedback has become more appropriate. Appropriate feedback has become a vital teaching tool to boost my clients learning and is part of her conductive upbringing at home.

The children and adults I worked with, always appreciated receiving realistic feedback. This way they know they can trust you, no matter what happens. This trust is the magic ingredient that builds the interpersonal relationship between the conductor (conductive assistant) and the client. The client can trust the feedback of the conductor because they know its real and not blinded by kindness. This is how we can expect our clients to try new and sometimes rather scary tasks because they can trust us. It’s a successful way of short-cutting building a good working relationship with my clients as well as their families.

Notes:

Chas McGuigan note on intelligent love:

http://www.nurseryworld.co.uk/news/727355/Conductive-education-Flexible-friends/

conductors blog

http://playingwithangels.wordpress.com/2011/02/21/elements-of-conductive-education-part-i-the-conductor/#respond

Walking – more then just a physical skill…

About two weeks ago I started working with a new client. This young man underwent a SDR (selective dorsal rhizotomy) about three month ago. Before the operation he was able to walk with a rolator under supervision but he scissored his legs a lot and his parents felt that he would never be independent. That’s why they opted for the operation.

When I meet him two weeks ago he had a hard time sitting up straight as his core was very weak. This is why his parents decided to hire me in the first place. They explained to me that he had extensive physiotherapy since the operation and that the therapist was working on walking. In fact she tried to have him walking with his legs in perfect alignment with the help of equipment and facilitation. The parents were told that they should avoid walking until he mastered this skill. In order to support his progress, they carried him. His way of moving around was someone carrying him, which meant he had no idea how to problem solve involving his body. Further this meant he had little opportunity to get to know his new body, as it now reacts in very different way then before the operation.
Consequently he had little confidence using his body and was very scared standing on his legs. We tried a couple of steps and he looked and felt more stronger then I expected. However he needed a lot of physical support because he tended to collapsed ( a common side effect of SDR) and felt very insecure about it. He also crossed his feet a lot, which made him collapse even more.

I talked with the parents about that the skills of sitting and walking as well as problem-solving, self-esteem and confidence are very much interlink and that to get the one stronger the other need to be worked on. We also talked about that its important for their and their childs physical and emotional health to stop carrying him. And that walking in perfect alignment is also my goal but that I think he needs the chance to learn to fix his feet so he does not panic in case they do cross.

I explained to them that all rehabilitation processes I have been involved in with children who had the SDR done, it was vital that they stood on their legs as often as they could to build up strength and stamina. They told me they would like to do more with him but its hard with four other children in the house, they simply have no time.. I discussed that it is important for him to be able to move more as part of his daily routine as this is more important then exercising. So instead of carrying they should walk with him, for the short distances in the house.When he has to sit himself up on the sofa I showed him how to help him, so he can get stronger and eventually do it himself. Instead of lifting him up they should help to stand up so he has an active part in it. The family has been involved with CE before my time and it made straight away sense to them.

I suggested to get their physiotherapist to contact me so we could discuss if keeping him of his feet was really necessary for his rehabilitation. A couple of days later I had a very nice email exchange with that Physiotherapist and she was very open to my suggestions. In fact she thought they were are good ideas and she agreed with everything I said (that was definitely very refreshing to the usual professional encounters I had). So, the family stopped carrying him and felt less torn between two professional opinions. I worked with him for a bit to build up his confidence as well as getting to know his body. We explored what he could do and how to move his legs in different positions. While we were playing games he was building up his strength. We practiced to reach in and out of his gravity point. He was scared to try and I ensured him he could do it and I would be there if something goes wrong, so he was safe to try. That helped him to get over his fear. Within a short time he was able to do more and more. And with everything new he could do, his confidence level rose.

During our last session he was able to take 44 steps with his rolator with me having my hands on his hips in case he collapsed. We learned that the only times he did collapse was when his feet weren’t in alignment or he stepped on his toes. With me giving him some small verbal guidance from time to time he could fix his feet position by himself. I shared this with his parents and recommended that they start using his rolator to walk short distances.

I think the important changes that happened were that he and his family had more confidence to try and stopped being scared of moving around. It’s going to be very exciting to watch where he goes from here.