Kids With Cerebral Palsy May Benefit From Intense Therapy
WebMD News Archive
One example of Olivia's progress: Today, at age 5, she can sit by herself on the couch. "She gets down off it, turns around, can walk along the edge. It may not seem like much, it's as much as a normal 1-year-old can do, but she didn't have any sense of walking before, even the concept of movement," Krindl says.
Conductive education is a "total immersion" philosophy that seems to work largely because it envelops the child's daily existence, Murray Goldstein, MD, medical director of United Cerebral Palsy's Research and Educational Foundation, tells WebMD. However, the results are temporary, and children require constant retraining, he says.
Outside of one small study, scientific research is not available on conductive education, says Goldstein. "Even though we have pushed these organizations very hard to conduct research, they have not. ... We have asked, do they have any specific information about special characteristics of children who can be helped, how long the effect will last. I suspect it doesn't last long because children keep going back for classes. It's a very, very, very intense program."
The one study, which took place last year in the Australian school system, separated children with cerebral palsy into two groups, one receiving conductive education, the other receiving standard physiotherapy. Both groups had therapy the same number of hours a week: five to six hours a day, five days a week.
"So the only thing different was the actual therapy. And they found no difference [in the children's progress]," Goldstein tells WebMD. "It wasn't the most complete experiment in the world, but it reinforces the hypothesis that the biggest benefit is the immersion technique and the strong motivational reward system."
"I've seen good things with conductive education," says Donna Nimec, MD, MS, director of pediatric physical medicine and rehabilitation at Boston Children's Hospital and Spaulding Rehabilitation Hospital. "It's a very therapeutic environment. Children do make really nice gains, but I think it's important to understand the ultimate goals."
"I believe that conductive education combined with other therapies may be most beneficial," she says. "Conductive educators get their training in all the therapies -- speech therapy, occupational therapy, physical therapy -- but those are each specialty areas. One person can't learn all those therapies in just a few year's training."
As in building a bridge, traditional physical therapy seeks to build "supports before you build the actual roadway," Nimec tells WebMD. And that may frustrate some parents.
"If I can't control my head," Nimec explains, "if I can't control my trunk, therapists may start out working to strengthen muscles. If I can't sit on the floor, how will I be able to stand, when gravity has so much greater effect on me when I'm up higher? In a parent's perception, this may seem like the therapists are just not moving fast enough."