Saturday, February 5, 2011

Conductive Education, the Brain, and Dr. House

If you watch TV, you may have seen this scene from episode 15, season 6 of Dr. House:

Wow, how interesting! Sadly, the brain imaging procedure shown in the clip, called “cognitive pattern recognition” doesn’t exist. House says “it’s not magical, it’s experimental”, but exactly magical it is! There is no brain imaging device today with the help of which we could see pictures and thoughts in someone’s brain. It is entirely fascinating though…just like time travel, or traveling with light speed (just press the light speed button, whoooosh!). It’s so much fun to watch movies. This is for now—as it’s supposed to be, and as you’d expect from a TV show—entertainment.

Entertainment it is, but don’t we all just love this stuff? I went to college in the 1990s, in the “decade of the brain”. The entire topic—brains, neurons, new neural connections, “brain plasticity”, etc. –just blew my mind. I was sitting through the Neuroanatomy lectures with my ears wide open, eager to discover the secrets of this mystical, magnificent organ, learn the names of the parts in Latin, their locations, their functions. I soon had to discover though that I’m not going to get the answers I was looking for, which left me somewhat disappointed. The profession I was studying—I was training to be a conductor-teacher—was not based on any sort of fancy brain science. We did have to study Anatomy and Neuroanatomy since we were teaching disabled children and such knowledge of the human body was deemed necessary to be able to do this job well, but this didn’t mean that any one of the teaching methods or techniques that we were also learning about during lectures and in practice, in the classrooms, had any more backing in neuroscience than any of the same teaching methods and techniques used by any teacher in any school around the corner. Teaching just turned out to be teaching, and it worked if the children ended up learning. We were taught, in theory and practice, the how-to of working out new teaching methods if the teaching methods we tried so far didn’t work. We were taught not to give up on the children, we were taught that it is in all cases the teacher’s fault if the children don’t learn, it is because we didn’t choose the correct methods or didn’t allow enough time and opportunity, and not because the child is too disabled to learn, as there is no such thing. The proof was right there: children with various levels of disabilities were learning all sorts of “impossible” things seemingly against the odds, through processes that us trainee conductors had to observe, understand, and then do ourselves. In the meantime, we were taught exactly this much about what’s happening in the brain while the children go through the learning process:

“Despite the injury, the central nervous system always has reserves that aren’t injured. These parts may take over the functions of the parts that are injured.”

Anyway, it was something like this. We were taught this much mostly because this is how much just about anybody can guess. If you look at the “Good reads” links on the right side, you’ll see a link called “Neuroscience for Kids”. The site may be intended for kids, but it does actually establish as much as it is known about the brain today, minus the details. The wording of the articles, for example this one about learning and brain plasticity correctly includes “some evidence supports” and “according to XY” which are the appropriate terms to describe something we have good guesses about, but we aren’t sure.

Fascinating brain science here or there, science is just science, not to be confused with science fiction, or science of the future. We do know a lot more about the brain than we did 50 years ago and we now have incredible imaging devices like MRIs but we still know almost nothing compared to what there is to know. Nobody to this day can look at an MRI of someone’s brain and tell what the person is thinking, or knows, or can do. Great professors and 21st century technologies here or there, nobody on earth would be able to tell you by looking at two random brains which person can play the guitar.

It is because of the extremely interesting and mystical nature of brains, and brain injuries, and because of the fact that the topic is very widely present in pop culture and entertainment that I can’t blame anybody, especially not parents of disabled children for falling into the trap and trying to find solutions for brain injury by trying to reverse the brain injury itself. I do understand that it sounds logical: the brain is injured—this causes disability—let’s fix the brain injury—the disability will go away. It would be great if we could do this. I’m not sure how many people realize that if we could, it would be absolutely the greatest scientific discovery of all times, probably more important than any Nobel prize winning discoveries to date; this would give humanity such a power that is currently hard even to imagine: besides being able to cure a plethora of conditions, we could also transplant a brain from one person’s head to an other’s, we could transplant a head to a whole new body and the person would be able to walk away, we could destroy a person’s brain and grow them a new one (talk about starting afresh!), and…you use your imagination.

I hope it is clear by now that it is very unfortunate to associate conductive education, or pedagogy in general with brain science as this doesn’t lead anywhere, it just leads to science fiction and attracts ridicule. I can’t tell how many times I’ve been asked mostly by parents but sometimes by journalists and also by other professionals about the neurological background behind conductive education, but I failed, and I’m afraid I will always fail to give a satisfactory answer. I did try to satisfy the curiosity of these people, mostly by translating to English from Hungarian the one sentence I was taught at college (which gave me an awful lot of trouble, especially at the beginning, and I can tell it troubles some of my colleagues, too), but I gave up on that long ago as I found it counterproductive. All in all, when our children learn, something does indeed change in their brain—it must!—but we don’t know exactly what that is, and we have a very vague knowledge of how it happens. If you decide to ask me about what has happened to your child’s brain who has athetoid cerebral palsy and has learnt to produce readable handwriting in a conductive education classroom, please ask me at the same time when you’re asking your typical child’s Math teacher what kind of recovery his brain went through when he learnt to multiply numbers.

Therefore, we have no reason to try and analyze these changes in the brain since doing so won’t change one bit how we’re going to teach our children. There are much more useful things for us to do: we can learn more about teaching for example. We don’t have any reason to think that learning takes place in any different way in disabled children than it does in any other human, all we know is what we can observe: that it is more difficult and takes more time to learn with an injured brain. We can, however, also easily observe that learning isn’t impossible (why would it be, brain injury doesn’t equal total brain death) because our children constantly learn, don’t they? The disabled child learns the alphabet for exactly the same reason the typical child learns the alphabet: because they’re taught. Now, there is no doubt that it might be lot more difficult for the disabled child than for the typical child to learn the same thing, but difficult doesn’t equal impossible.

The main problem is that it is difficult, and sometimes incredibly difficult to teach a disabled person. Those who lack the necessary training, knowledge and experience to understand that difficult doesn’t equal impossible will not be willing to realize that it is their insufficient teaching methods, and not the disabled person’s inability to learn the culprit. Whoever teaches the disabled person—parent, teacher, any professional—has often to be very imaginative in their ways to work out new and new and cunning methods to teach. They also have to quickly realize when certain methods don’t work (whether they worked before or no, or if they work brilliantly with other children), and then they have to try something else, and then something else, until they succeed. This, as you have probably guessed, is the ideal situation and is rarely happening. Such approach is time-consuming and laboursome, and someone has to pay for it, so instead, today’s society is ready to accept “oh well, he’s disabled and he’ll never learn to hold his spoon”. You bet he’ll never learn to hold his spoon, especially if he never tried, or if he tried, he never got the chance to follow through the learning process—which can easily be long, very long and very difficult.

I have no doubts that this is the main reason why conductive education, despite having been around for about 70 years in its birthplace in Hungary and having been available for the West and the rest for about 30 years, is still not around in every household raising disabled children and is still not around in every school, rehabilitation center, playground and mind. Neuroscience, brain fixes and quick-fixes sound so much better than “hey, you have to put in a lot of time and effort and learn the hard way”, right until we understand that the first is not possible but the latter very much is. Parents who did understand this have been fighting and fighting for conductive education for decades now, and it will make another post to try and figure out the reasons why on earth this has been taking so long.

My respectful message to Ontario March of Dimes, and everyone else who participates in constructing web pages that give out information about conductive education, or anyone who advises parents or professionals about conductive education: Pie-in-the sky explanations and representations are okay in the Dr. House TV show, but they are sketchy in the fields of our profession. Don’t do it. Such talk may indeed attract more people first which may help your business, but in the long run, you’re only helping to spread ignorance and misinformation about conductive education, and I believe that is not your goal.


  1. LOVING IT. Especially the last part, where you point out it might help in the beginning but not in the long run. In my experience the people who look for a quick fix of CE usually don't stick around after intensive camps. Sometimes they come back after a couple of years when they realize that sadly there is no quick fix.

  2. You tell 'em, Viktoria!

    Spot on for identifying magical concepts.


  3. Thanks Norman, Anne, and Barbara.

    Anne, I just realized how much more there is to do--I just had to delete the comment of a poor lad who brought up the "peer reviewed scientific studies" about conductive education--we just talked about those briefly on your blog. I'd hate to pretend to be able to discuss such a huge issue here in the comment section after this post which is about something else, but I realize I have to address this some time soon...What a trip! :-)

  4. I must have been composing the following further thoughts on Brain ≠ mind at about the same time as you were doing yours!

    Your unpublished correspondent would be most welcome to comment on peer-reviewed scientific studies there.

  5. Thank you Andrew, I'll let him know.

  6. Actually, it's not entirely magic. The House episode does contain a lot of science fiction (no such technology exists today), but we are starting to get results towards that: this section of the Wikipedia article on "brain-computer interfaces" (BCI) demonstrates reconstruction of "what the brain sees" in cats (using invasive implants), and this one has some results in humans (using noninvasive fMRI).

  7. Thank you for the update and information.