Conductive education – an educational program for children with cerebral palsy

Findings by SBU Alert

This is a translation of version 1, published on June 16, 2000. The latest version of this report is not available in English.

Conductive education (CE) is an educational treatment program used mainly in children with motor disorders caused by Cerebral Palsy (CP). Conductive education is usually used as a complement to other treatment methods. The method was developed by Dr. András Petö in Budapest and is sometimes referred to as the Petö Method. In English, the method is referred to as conductive education, and in Sweden it is found in various forms, eg, Move and Walk and the Moira School. A feature common to the various types of conductive education is the inclusion of educational training programs aimed at stimulating the development of the child. A primary treatment goal is to teach the child to control his/her motor skills. Treatment usually is carried out in groups and by a so-called conductor.

Conductive education has been assessed in only a few controlled studies in England and Australia. These studies have focused mainly on the childs progress in motor skills, and the method has been compared to traditional physiotherapy i.e. NDT or Bobath Therapy. No studies have shown differences among the children who received training through conductive education and those who received traditional treatment. It should be pointed out that the studies include only a limited number of children, which means it is difficult to draw reliable conclusions on the effects.

Alert finds there is poor* scientific documentation on conductive education as regards patient benefits and risks in the short term. There is no* scientific documentation concerning its long-term effects or cost effectiveness.

The lack of comparative scientific followup concerns not only conductive education in its various forms, but also many other treatment methods used in the treatment of Cerebral Palsy patients. To acquire an understanding of the overall effects of different rehabilitation programs, it is necessary to compare them with control groups that receive no treatment. It can be difficult to motivate such assessments of already established methods. However, before new methods are introduced it is important to demonstrate their advantages and disadvantages in relationship to, or as a complement to, established methods.

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Prof. Hans Forssberg, Karolinska Hospital, Stockholm and Birgit Rösblad, Dr Med Sci, Kolbäckens Habilitering, Umeå. It has been reviewed by Assoc. Prof. Gunnar Sanner, Centralsjukhuset, Karlstad.

The complete report is available in Swedish only.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

1. Bairstow P, Cochrane R, Hur JJ. Evaluation of Conductive Education for children with cerebral palsy. Final report (Part I and II). London:HMSO, 1993.
2. Catanese AA, Coleman GJ, King JA, Reddinhough DS. Journal of Paediatrics and Child Health 1995;31:418-422.
3. Coleman GJ, King JA, Reddihough DS. A pilot evaluation of Conductive Education-based intervention for children with cerebral palsy: The Tongala project. Journal of Paediatrics and Child Health 1995;31:412-417.
4. Hur JJ. Skills for independence for children with cerebral palsy: A comparative longitudinal study. International Journal Of Disability, Development and education 1997;44:263-274.
5. Hur J, Cochrane R. Academic performance of children with cerebral palsy: A comparative study of Conductive Education and British special education programmes. The British Journal of Developmental Disabilities 1995;Vol XLI(Part 1):33-41.
6. Lind.L. Konduktiv pedagogik. Ett alternativ för barn med rörelsehinder. Forskningsrapport nr 23 1999, Teknik Kommunikation, Samhälle. ISSN 1102-7967.
7. Reddihough DS, King J, Coleman G, Catanse T. Efficacy of programmes based on Conductive Education for young children with cerebral palsy. Devlopmental Medicine and Child neurology 1998;40:763-770.