1

Citation: Fong, C. F. (2010). In search of excellence: SAHK’s evolution to a

conductive education organisation. Abstracts of the 7th

World Congress on

Conductive Education (pp. 27 – 28). Hong Kong.

SAHK started implementing Conductive Education principles in its service centres in 1981. In the

past thirty years, we have experienced three different stages in the implementation of Conductive

Education principles in its various service centres, namely: the Adoption Stage, the Adaptation

Stage and the development Stage.

The Adoption Stage (Early 1980s to early 1990s): The Adoption of Conductive Education in

SAHK was a top-down approach under the direct leadership of the Council Chairman and General

Secretary at the time, supported by a Conductive Education Program Coordinator. The main

emphasis was on the work of pre-school children (at that time were mostly cerebral palsies). A lot

of in-service training activities, numerous intra-centre and inter-centre discussion forums as well

as work sessions were organized for the frontline therapists with the discussion focuses mainly on

practical and hand-on experimentation issues. Adaptation process started at the same time but

mainly at program level and in a localized manner. We consider “top level commitment” and

“staff empowerment” were the two utmost important critical success factors of the Adoption Stage.

The Adaptation Stage (The 1990s): In this stage, the main target wad to achieve an integrative

merge of the Conductive Education principles into a specific service setting. It stemmed from the

idea of having a “whole centre/school approach”. This involved a systematic review of the mode

of operation of the whole service centre and re-engineering at process and organizational level.

There were also financial and establishment constrains being set by the Government. SAHK had

successfully set up respective unique systems of application for its three major service settings viz.

pre-school centres, schools and adult service units. With a general observation of Conductive

Education being “strong in practice but weak in theory”, attempts in understanding and

articulating the Conductive Education theories emerged. A commitment to change among the key

staff, together with strong leadership and uncompromising execution of the administrators were

the critical success factors of the Adaptation Stage.

The Development Stage (Late 90s onward): The Development Stage started in the late 90s when

there was a mark decrease in children suffering from cerebral palsy and increase in children with

other developmental disabilities. We faced a dilemma of choosing between continuing Conductive

Education as the guiding approach of our service delivery in the various setting or restricted it

back to the program level only for the motor disordered.

A business model has been formulated which allows SAHK to employ Conductive Education as

philosophies and operational framework at the corporate level and to transform its service delivery

at the frontline level into an dynamic open system which provides mechanism for procurement

and incorporation of different intervention strategies gearing to specific needs of the specific

clienteles.

SAHK

2

The driving force behind SAHK from adopting Conductive Education adapting Conductive

Education and now developing Conductive Education is the quest for quality service and search

for excellence under the changing service environments.

3

Citation: Su, Y. W. (2010). Conductive Education in the 21st century. Abstracts of the

7th

World Congress on Conductive Education (pp. 59 – 60). Hong Kong.

Introduction: In HK (as in most developed countries/regions), there is a sharp divide among

rehabilitation, education and welfare providers. A comprehensive and coherent approach in

upbringing of people with developmental disabilities is lacking. Contemporary trend of person-

centred, holistic and life-span approaches has brought about growing concern of service

fragmentation as a result of the professional-driven, division-of-labour and snapshot mode of

training and practice.

History: Enshrined by CE, SAHK’s enduring appeal is built on a transdisciplinary model of

delivery and a corporate culture and operation that are deeply ingrained in the DNA of the

organisation. With our ‘through-train’ services from early childhood to late adulthood, SAHK has

been sitting along the old fault lines that demarcate rehabilitation, education and welfare. In the

past 30 years, we straddled the divide by marring CE’s know-how together with an affinity for

contemporary trends in rehabilitation and education. CE provides us more dimensions to reinvent

the conception of “development”, not as something purely biological but something more

psychosocial and contextual.

Description: By incorporating CE as a guiding philosophy shared by ALL staff disciplines and as

a foundation for laying out an infrastructure for life-wide and life-long learning, the HK model of

CE has demonstrated to be a promising alternative for promoting CE in places with established

service provision by allied health professionals, special education teachers and social workers.

“Conductor” is kind of new and it takes a long road to introduce a new profession within an

established staff structure, particularly in government-run and subvented settings. So hopefully, in

time, with more non-conductor practitioners coming to learn and implement CE in their own

settings and their transdisciplinary delivery of CE is also doing well, regional practice of CE

outside Hungary can be sustained.

Moreover, a sustainable practicing model in a region ought to have local scholars behind it. The

alignment of CE with current knowledge and findings in translational neuroscience,

developmental psychology and others will pave the road to articulate CE with other practitioners

in the field. By establishing and promoting a universally adopted research agenda within the CE

world, we are more able to stay connected with the mainstream.

Discussion: In fact, formally-trained conductors have a crucial role in our transdicsiplinary model

of CE delivery. What is apparent is that, here in HK, conductor is moving up the value chain in

jobs that are considered the prerogative of post-graduate education. This is the real challenge. But

it also leverages opportunities. The best response to it is a structural reform in CE training that

should not be limited to the 3- or 4-years’ formal training in Hungary or the UK. But instead, it

can be re-organised into multi-level certificate courses in form of distance-learning or transformed

into teaching modules that can be incorporated into undergraduate and postgraduate curricula of

rehabilitation, education and social sciences of local academic institutes of the countries and

regions.

Conclusion: CE should be made more accessible to other practitioners in rehabilitation, education

and welfare sectors. It should be something that can be appreciated not only by conductors, but

also by allied health, nursing, education and welfare professionals. By empowering and fostering

4

minds through open-mind collaborations and by leveraging the expertise to provide unrivalled

habilitation and upbringing, it will bring about a global impact to the lives of people with special

needs and their families. It is important for thousands of CE followers to see that CE at its

philosophical level has a much wider applications that need not be restricted to the motor

disordered. At the end of the day, we are advocating high-value opportunity for conductors to

further strengthen and sustain the reach of CE outside Hungary and the UK.

5

Citation: Yeung, Y. S. and Yuen, Y. M. (2010). Psycho-social and communication

development at Jockey Club Marion Fang Conductive Learning Centre.

Abstracts of the 7th

World Congress on Conductive Education (pp. 157 –

158). Hong Kong.

Introduction: Conductive Education emphasizes early intervention that captures the prime period

for development in young children. This early experience is expected to contribute to the overall

development in children including positive personality traits and can prepare them to become

active social beings that interact and communicate fruitfully with others in the society.

The Jockey Club Marion Fang Conductive Learning Centre (JCMFCLC) is one of the special

child care center under SAHK for 30 preschool children, aged from one to six, with cerebral palsy

and spina bifida. The children’s cognitive abilities range from normal to being severe mentally

challenged. Children admitted to the center may go through Mother and Baby, Pre-nursery,

Nursery to Kindergarten Group in Day Service and some receive Boarding Service too.

Case/Programme History and Description: JCMFCLC attempts to study the development of

one of the preschool boy with spastic quadriplegia who has been studying under the holistic model

of Conductive Education at JCMFCLC from the age of one for 5 years. This study aims to analyze

how the implementation of augmentative and alternative communication (AAC) and High Scope

approach in play under the Conductive Education system can enhance the development of this

child. Development in psychosocial and communication perspectives is focused. The study is

conducted by a longitudinal review on the assessment records, video recordings and the collection

of feedback from the parents and teachers.

Case/Programme Review: Over the period of review, the child showed positive outcome in his

motor and self care aspects. He also demonstrated improvement in initiating interaction and

sharing own thoughts and feelings though the use of AAC. The implementation of High Scope

facilitated his goal setting and heightened his awareness to own accomplishments. The progress of

this child in different aspects and feedback from his parents and teachers has been promising too.

6

Citation: Chi, W. H. and Yuen, T. Y. (2010). A pilot trial of quality of life enhancing

programme for people with severe PH. Abstracts of the 7th

World Congress

on Conductive Education (pp. 158). Hong Kong.

Background: In ‘07, SAHK attempted to evaluate the long term outcome of CE for adults with

severe PH and conducted an investigation on the QOL of day and residential clients. The

evaluation tool was Personal Wellbeing. A total of 512 valid answers were analysed and found

that “Future Security” was one of the domains with significantly lower satisfaction score.

Afterwards, our clinical psychologist developed a series of QOL intervention programs to address

the problem. This paper described the trial of these programs and reported the preliminary

outcomes.

Methods: 3 male and 3 female clients with CP and polymyositis working in sheltered workshop

participated in the programs focusing on enhancing one’s sense of security towards their own

future. Training contents based on the principles of Cognitive Behaviour Therapy and were

divided into 10 sessions. Participants were required to complete a questionnaire with 11 items

before and after the training.

Results: All clients completed the training and evaluation. 6 out of 11 items were found

significantly improved by Wilcoxon Signed-Rank Test. They: (1) managed to see my live from

different perspective (p=0.05); (2) understood the negative effect of irrational belief (p=0.05); (3)

knew the way of relieve anxious through relaxation exercise (p<0.025); (4) knew the way of

relieve anxious through joining leisure activities (p=0.05); (5) knew the way of relieve anxious

through problem solving (p=0.05); and (6) understood negative automatic thoughts (p<0.025).

Discussion: 6 out of 11 items in the questionnaire was significantly improved after the program.

Two items were found improved but not statistically significant, 2 items remained unchange while

1 item regressed. Some positive effect was observed in the program, especially in grasping the

techniques on relieving anxiety and understanding their causes. It was understood that correcting

one’s belief was not easy in only ten session time, so items related to their own anxiety was found

less improved in the group. Intelligent was another factor which might affect the effectiveness, it

was observed that clients with mild mental handicap was comparatively difficult in understanding

the discussion concerned abstract concept.

Conclusion: Positive effects have been demonstrated in the program. Further studies on the

training deliver technique and content revision would help to polish the training and improve our

client’s QOL.

7

Citation: Chun, M. C., Yung, M. Y., Ng, L. Y. and Dai, O. S. (2010). Improvement of

children with constipation following acupressure programme integrated into

the conductive education system. Abstracts of the 7th

World Congress on

Conductive Education (pp. 159). Hong Kong.

This article reveals a project on establishing the effectiveness of an acupressure programme

designed and carried out for our clients with constipation, and how this programme was integrated

into the conductive education system in which the clients were under. The protocol of this

acupressure programme was based on the theories of Traditional Chinese Medicine for treating

constipation in the paediatric population. Various selection criteria were set up, and alternate

experimental and control periods were arranged. Several indicators were chosen to examine the

changes of the bowel habits or other health-related issues in the clients. The satisfaction level of

the parents was also evaluated after the programme. According to the results obtained, positive

trends were noted in the bowel habits of the clients and the satisfaction level of the clients. Owing

to the limited number of clients participating in this study and relatively short research period, this

study can be viewed as preliminary to larger scale research later.

The project also gives an insight on how the acupressure programme can be implemented into the

clients’ daily living under the Conductive Education System. This programme is integrated into

the tasks and daily routine of the clients regarding the application of acupressure skills and the

coordination of building up clients’ bowel habit. Team approach was also employed with liaison

between different professionals in order to maximize the effects of the programme. Through this

seamless cooperation, it is hoped that the problem of constipation in our clients can be eased and

their health and development can be enhanced.

8

Citation: Wong, Y. C., Ip, W. K., and Wong, F. K. (2010). A mother’s experience

sharing on an effective Conductive Education (CE) programme enhancing

child development through intensive training at home and in the community.

Abstracts of the 7th

World Congress on Conductive Education (pp. 189 –

190). Hong Kong.

Introduction: Conductive education (CE) is a holistic and trans-disciplinary approach which

focuses on the all round development such as self-care, motor, cognitive, communication; and the

nurturing of one’s personality in an integrated manner for people with neurological motor

disorders. Hui Chak Lam, an 8-year-old mentally-challenged boy studying at the SAHK Ko Fook

Iu Memorial School (KFI), received intensive training consisting of both educational and

rehabilitation elements at home and at school through the close collaboration of his mother, the

school therapists and teachers. Training and activities focus on his daily functional training like

getting out of bed, washing hands, getting dressed, walking, bathing, self-feeding and drinking.

Various strategies are designated to enhance his learning motivation. The environment is

structured to provide continuous and consistent practice which is needed to help him meet the

challenges of everyday life. In the learning process, Chak Lam is an active participant; instead of a

recipient. Chak Lam’s mother reads many relevant books and adopts useful ideas and experiences

from different sources to create toys, interesting games and a motivating environment at home to

help him develop his cognitive, motor, language and self-care abilities. Through her ingenuity and

resourcefulness, innovative games and interesting activities are developed at home and in the

community to help him learn and grow. Chak Lam’s mother is invited to share her successful

experiences and meaningful games with her son at home in parallel with the trainings at school.

Objectives: To extend CE programme to home environment and in the community through the

creative use of materials, activities and facilities.

Methodology: An integrated curriculum was developed and implemented by the school teachers,

therapists, Chak Lam’s mother and his maid. A qualitative study through observations and

interviews was planned and conducted. Video-taped interviews, photos and video-clips were

collected and used to examine the pre-training and post-training ability of Chak Lam. Various

innovative activities were designed to enhance Chak Lam’s overall ability and also to facilitate the

development in various settings (home, shopping mall, playground, restaurant, classroom and

therapy room). Diversified strategies were adopted and on-going modifications were made to cater

for Chak Lam’s needs.

Discussion and conclusions: Qualitative method (observations and interviews) was used to

evaluate the progress of Hui Chak Lam. With the collaboration and effort of his mother and the

trans-disciplinary team of the school, Chak Lam has made marked improvement in cognitive

development, motor development, social skills and picture-exchange communication skills. His

independency is also remarkable. It is also observed that CE embraces the learning of movement,

communication and cognitive ability simultaneously, but not separately or consecutively. Chak

Lam’s mother has also proved the use of simple handy equipment and flexible modifications are

effective in motivating her son to work towards the goals.

9

Citation: Tsui, K. H. (2010). Realize the potentials, a poet's world - Conductive

Education. Abstracts of the 7th

World Congress on Conductive Education

(pp. 193 – 194). Hong Kong.

I am Tsui Kam Hing, a trainee of SAHK Bradbury Tak Tin Workshop. I am pleased to share my

story which is full of adversities, yet filled with joy and hope.

Suffering from cerebral palsy, I cannot walk on both legs but rely on wheelchairs. My hands

cannot be well controlled either. So I need help with everything in daily life. Since I cannot speak

clearly, I can only control my head.

I am used to wearing head-pointer with a penholder to work on my computer, including surfing

the internet, writing, reading the Bible or books, and listening to music, etc.

I remembered I was quite self-abased. I preferred not to walk in the street. However, I gradually

realized I was the only one who cared. My family who took care of me didn’t mind people’s

attention at all. They have always been there caring for and loving me. I am becoming stronger

and never give up easily with my family support as well as the trainings received at school and

workshop.

I studied at Ko Fook Iu Memorial School, SAHK in 1986, a special school practicing Conductive

Education. The therapists introduced appropriate equipment (head-pointer) to me after their

professional evaluation on me. I am pleased that I can now communicate with people by computer

whenever I put on my head-pointer.

Besides, I develop an interest in poetry writing. I started to appreciate my strengths, to treasure

what I have and not to grumble under the patient guidance of the instructors. This is the turning

point I have gone through during the implementation of Conductive Education.

SAHK encourages the trainees to realize their potentials, so a literature instructor was employed to

deliver "Poet World", a series of poetry writing classes. I was lucky to participate in the course

and polished my writing skills. I once participated in a local election for outstanding people with

disabilities organized by the Social Welfare Department and it is amazing that I won "The Most

Creative Award".

The award was not only an encouragement to myself, but also a driving force for my future

creation.

I hope the workshop will organize more poetry classes in future to further promote literature.

I love to be inspired by any trivial thing in my daily routines as the source of my creation. I hope I

will have an opportunity to publish my poetry album to share my poems and positive values of life

with the readers

Depite my physical limitations, I promise to keep going for my dreams!

10

Citation: Wong, Y. T. and Lam, N. S. (2010). Effect of participating in regular leisure

activities - the reflection of 5 boccia players. Abstracts of the 7th

World

Congress on Conductive Education (pp. 195 – 196). Hong Kong.

Introduction: Leisure activities have long been underrated its value in Chinese culture. “Hard

working is much beneficial than play (勤有功, 戏无益)” is an old Chinese proverb which reflects

the traditional attitudes towards leisure activities. However, more and more literatures believed on

the other way round. Positive health can be achieved when one has the choice to engage in leisure

besides self-care and work (AOTA, 1995; CAOT, 1996). Leisure participation provides the

opportunities for enjoyment, skills development, personal growth, social relationship formation,

life-purpose determination and achieving mental and physical health in adults with physical

disabilities (Specht, King, Brown & Foris, 2002). In addition, recreation or leisure is recognized as

one of the major routes for people with disability to integrate into community under the system of

Conductive Education in adult services of Hong Kong (Fung & Su, 1995). This paper is trying to

look into the effect of regular leisure activities on persons with disability in adult services of

SAHK from their own perspective.

Methods: Boccia, which first became a Paralympics sport in 1984, is one of the most commonly

participated leisure activities in our sheltered workshop. Questionnaires and interviews were

conducted with clients in order to understand their life experience of being an amateur boccia

player. Five Hong Kong Boccia Team members (present or former) who have joined the team

ranged from 7-17 years were selected. 7-question questionnaires were distributed to the

participants. Structured interviews were held for further data collection.

Results: The most common reflection was that boccia has broadened their horizons and social

network, providing participants chances to visit various countries such as Brazil, Korea, China and

Australia. Award attainment from international boccia competitions was considered as a life

achievement and facilitation of personal growth. Repetitive, intensive (3 days weekly) and goal-

oriented practice had challenged their concentration and endurance. Some participants reported

that boccia practising and skills training has even assisted their emotion management.

Conclusion: Engagement in the Hong Kong Boccia Team has positive influences to the lives of

clients with physical disabilities and in turn assists their integration into community. It is

worthwhile for service providers to consider setting up similar leisure projects and skills training

programs. Barriers and enablers of leisure implementation for adults with physical disabilities

could be further investigated, so as to promote leisure participation in an appropriate and effective

manner.

11

References

American Occupational Therapy Association. (1995): ‘Position paper: The psychosocial

core of occupational therapy’, American Journal of Occupational Therapy, 47, pp. 1021-1022.

Canadian Association of Occupational Therapists. (1996): ‘Profile of occupational

therapy practice in Canada’, Canadian Journal of Occupational Therapy, 63, pp. 79-95.

Fung, J. and Su, I. (1995): ‘The system of CE in adult services of Hong Kong’. Proc. 1st

International Conference of National Association for Conductive Education (NACE), Australia,

1995, pp.35.

Specht, J., King, G., Brown, E., and Foris, C. (2002): ‘The Importance of leisure in lives

of persons with congenital physical disabilities’, American Journal of Occupational Therapy, 56,

pp. 436-445.

12

Citation: Yuen, M. L. and Wong, Y. M. (2010). Pilot study of modified constraint

induced movement therapy in Hong Kong special schools under the

Conductive Education system. Abstracts of the 7th

World Congress on

Conductive Education (pp. 211 – 212). Hong Kong.

Introduction: Modified constraint-induced movement therapy (mCIMT) is proved an effective

approach that encourage active and goal directed learning targeting for children with hemiplegic

cerebral palsy. It aim to overcome “developmental disregard” of affected upper limb and to

improve its function through active participation and facilitating motivation. Previous studies

mainly focused on pre-school children. They were conducted in non authentic laboratory or

clinical setting, which were resource-intensive and both treatment and the school routine of

children involved were often disturbed. This study was the first on school based mCIMT and

which mCIMT were integrated into the school CE system. It was a qualitative study and was a

part of collaboration research. In this study, a protocol of mCIMT were developed which fit for

routine of school, furthermore a set of activities for structured training was developed which was

age-appropriate for school children. Finally, survey and questionnaire for students involved, as

well as interview with parent and staff were conducted to study their subjective perspectives on

mCIMT.

Materials and Methods: A three-week mCIMT program was carried out in two schools for

children with physical handicapped. During the period, affected upper limb of ten students with

hemiplegic cerebral palsy was restrained by a sling for six hours per day. And an one-hour

structure training was conducted each day. The activities of structure training were selected by

school children, which covered five major domains of their life. Weekly survey and questionnaire

at the end of program were conducted to monitor students’ perspective toward program. Parent

interview was used to collect parents’ comment on students’ performance at home. Staff interview

was conducted to collect teachers’ comment on student’s performance in school and feasibility of

conducting school based mCIMT.

Results and Discussion: After treatment, all student perceived improvement of affected upper

limb in functional tasks and they (85.1%) believed they would increase the amount of use of

affected upper limb in future. The mCIMT program was well accepted, which included length of

program (100%), duration of structured training (100%), as well as format and regime of restraint

(71.43%). Most of students (85.71%) preferred more mCIMT program in future. Parents reported

increased autonomy and frequency of using affect upper limb of their children at home. Teacher

commented treatment was effective but lasting effect was short. They believed mCIMT was

feasible to carry out in school without huge extra resources.

Conclusion: School based mCIMT was perceived effective and was accepted by students, parents

and school staff. It was cost effective and feasible to be conducted in school setting without

causing much disturbance to children’s regular study.

13

Citation: Wong, Y. M. and Yuen, M. L. (2010). Study on the effectiveness of modified

constraint-induced movement therapy and self-regulation learning for

children with hemiplegic cerebral palsy in school-based setting under the

conductive education system. Abstracts of the 7th

World Congress on

Conductive Education (pp. 213 – 214). Hong Kong.

Introduction: Constraint induced movement therapy (CIMT) is well- documented and researched

strategy and has demonstrated positive effect on children with hemiplegic cerebral palsy (CP).

Children have shown increased active use of their affected upper limb and functional performance

with long lasting effect. Moreover, self regulation (SR) is a strategy to help individuals to identify

problems and derive solutions which is widely applied in improving performance on motor tasks as

well as promoting relearning of functional tasks. Both CIMT and SR adopted same philosophy as

conductive education, that is "unity of mind and body". The active learning brought about by SR

combines with the active movement imposed by CIMT might help children with hemiplegic CP to

improve functions of their affected limb. However, there is no study for applying CIMT and SR in

school setting as CIMT traditionally engaged children’s affected limb on intensive structured

practice in laboratory, therapy room or campsite for three to six hours daily which involved intensive

therapist-guided training. In addition, there are limited studies for children aged above eight-year-old

and no published CIMT report in Hong Kong. Therefore, the effectiveness of a protocol combining

modified CIMT (mCIMT) and SR, which incorporated daily routine practice with less intensity of

structured practice, to children with hemiplegic CP studying at special school was studied.

Materials and Methods: Ten children diagnosed with hemiplegic CP with a mean age of 13.6

years (age 9 to 18 years) were involved. A within-subjects design was used with children acting as

their own controls. All children underwent a three-week modified constraint-induced movement

therapy plus self regulation (mCIMT + SR) program. A three-week no-treatment period was

followed to measure carry-over effect. The mCIMT + SR program involved restraint of the

unaffected upper limb of children using a cotton sling for 6 hours per day for 15 days. A one-

hour structured taskpractice with the use of SR was provided during each 6-hour restraint. Subtest 5

and subtest 8 of the Bruininks–Oseretsky Test of Motor Proficiency, the Jebsen-Taylor Test of Hand

Function, the Caregiver Functional Use Survey, a hand dynamometer, pinch gauge, and modified

Ashworth scale were used for evaluation. Children were assessed once before and twice after the

mCIMT + SR at 1 week and at 3 weeks. Repeated-measures ANOVA and paired t tests were used

to analyze the data.

Results: Children showed significant improvements in upper limb coordination (p=0.028), speed

and dexterty (p=0.003), quality use of upper limb (p=0.005) and hand strength (p=0.032), after

receiving the mCIMT + SR program and these gains sustained for at least 3 weeks post treatment.

Discussion: The findings suggest that the mCIMT + SR program demonstrated effective outcomes

in enhancing the upper limb function for school children with hemiplegic CP. The increased time

of practice during lessons and routine and use of SR during the structured practice were regarded

as cost-effective. In order to benefit more children with hemiplegic CP, feasibility of using this

protocol on children of different age, and/or mentality levels can be explored further.

14

Conclusion: Upper limb function of children with hemiplegic CP could be significantly improved

by applying mCIMT and SR in school setting. The program, therefore, appeared to be a practical

and cost-effective protocol for children studying in school-based setting.

15

Citation: Chan, H. Y. and So, K. W. (2010). Implementation of augmentative and

alternative communication (AAC) for adults with developmental disabilities

under Conductive Education (CE) – the setting up of communication station

at vocational and residential settings. Abstracts of the 7th

World Congress

on Conductive Education (pp. 240 – 241). Hong Kong.

Introduction: Numerous number of people with developmental disabilities failed to use speech to

communicate. The inability to communicate effectively would lead them to social isolation and

failure to sustain interpersonal relationship [1]

. Therefore, using different methods to replace or

complement the ineffective verbal means (i.e. the use of AAC) is of great importance. Clients

using AAC have to acquire a range of linguistics, operational and social skills in order to

communicate functionally in the natural environment [2]

. However, they are usually lacking of

motivation to communicate and lacking of the ability to generalize the skills into different

communication contexts [3]

that lead to a negative ramification particularly in the adulthood. As a

result, a majority of the adult clients (with or without AAC prescription during childhood) only

used their AAC during training sessions organized by speech therapist (ST) (if any), but not

during daily life context. This study aims at applying the holistic CE model during AAC

implementation for adults with developmental disabilities. By viewing the clients as active

learners and by providing them with learning opportunities during daily routines, we tried to

alleviate these two obstacles.

Method: A communication station, including communication software, adapted switches and

voice output communication devices, was set up in a sheltered workshop and a hostel for a total of

twenty adults with developmental disabilities. The clients were actively involved in selecting

vocabularies and designing the templates of the communication board. Trainings were

incorporated into clients’ daily routine via a transdisciplinary team. It involved cross-disciplinary

in-service trainings with all staff members (both professional and non-professional), so that they

shared the same repertoire of skills and knowledge about AAC.

Results and Discussion: Clients showed an increase in spontaneity and communicative functions

during daily conversation with frequent self-initiated use of the communication station. Non-ST

staff members were able to update the contents and carry out AAC training in real-life situations

with regular monitoring of ST. By treating clients as active learners, incorporating AAC training

into daily routine activities with consistency across the entire staff team, the clients’ motivation

and generalization across contexts in AAC usage were improved.

Conclusion: Through the application of CE principles, we provided our adult clients with active

and consistent learning opportunities throughout their daily life [4]

. This facilitated the successful

implementation of AAC. Extending this program to other adult units of SAHK and incorporating

other ST trainings under the CE system would be our future goals.

16

References

Jordan, F.M., Worrall, L.E., Hickson, L.M.H. and Dodd, B.J. (1993): ‘The evaluation of

intervention programs for communicatively impaired elderly people’, European Journal of

Disorders of Communication, 28, pp. 63-85.

Light, J.C. & Binger, C. (1998): ‘Building communicative competence with individuals

who use augmentative and alternative communication’, (Paul H. Brookes Publishing Co.,

Baltimore)

Glennen, S.L. & DeCoste, D.C. (1997): ‘Handbook of Augmentative and Alternative

Communication’, Chapter 1, (Singular Publishing Group Inc., California)

Su, I.Y.W. (1995): 'Habilitation of the Cerebral Palsies – A Holistic Model', the 5th

Conference of the Western Pacific Cerebral Palsy Association, 1995, Korea, pp. 106-108

17

Citation: Ho, S. M. (2010). The use of cooperative learning in the teaching of social

skills for successful inclusive education for children with physical

impairment. Abstracts of the 7th

World Congress on Conductive Education

(pp. 259 – 260). Hong Kong.

A child with physical impairment (PI) who integrates into a mainstream school is bound to face

multi-faceted challenges arisen from physical and social barriers. How well the school helps the

child manage the social barriers is a particularly major determinant of the real success of inclusive

education. In accordance with the principle of Conductive Education, the success of inclusive

education is not only measured by a child’s academic or functional achievement, but also reflected

in the formation of a positive personality which enables the child to lead a fully adaptive life in his

or her living and learning environment. Working towards these easier-said-than-done goals, the

integrator with PI face social-emotional challenges that are unfortunately not well-recognized and

therefore not dealt with in a proactive manner by the school. This is in stark contrast to how

similar challenges faced by children with emotional or behavioral impairment are dealt with by the

school, most probably since the former is not as apparent as the latter.

In response to a request made by a mainstream school to help some of their children with PI

improve their social-emotional development, the staff from the Conductive Learning Centre had

the opportunity to explore the effectiveness of the Cooperative Learning approach (CL) on these

children. CL and Conductive Education (CE) have several similarities. First, both believe that a

facilitative social environment with positive group dynamics is the key to successfully building up

a positive personality of an under-privileged child. Second, both develop a systematic method of

instruction or facilitation to achieve the aforementioned goal of personality development. CL is a

pedagogical practice that involves students’ working together in small groups to accomplish

shared goals. It is this sense of interdependence that motivates group members to help and support

each other’s endeavors [1]

. Five key components are essential for structuring cooperative learning

groups: positive interdependence, primitive interaction, individual accountability, interpersonal

and small-group skills, and group review processing. The teacher plays a very significant role in

giving explicit explanations of the social skills that need to be used in the group, and carefully

designing and monitoring the cooperative learning tasks. Extensive research on CL over the past

thirty years has unequivocally demonstrated the success of this approach to learning. CL has been

used successfully to promote learning achievement across diverse curriculum areas, from

kindergarten to college. In the presentation, the running of the experimental group in the

mainstream school and the effect of CL on the group were shown. Most importantly, the reasons

for the limited use of this highly regarded teaching-learning approach in mainstream and in special

schools in Hong Kong were investigated. Finally, common drawbacks observed in teachers using

CL were discussed.

18

References

Gilles, R., & Ashman, A. (2003): ‘Cooperative learning: The social and intellectual

outcomes of learning in groups’, (RoutledgeFalmer, London), pp.33

19

Citation: Lo, L. P., Lai, K. Y., Au, Y. C., Jim, S. W., Cheung, S. L., Ho, K. F. and

Chow, N. Y. (2010). A case study: a structured integrated programme using

the trans-disciplinary team approach on persons with special needs in a

special school for physically disabled students in Hong Kong. Abstracts of

the 7th

World Congress on Conductive Education (pp. 355 – 356). Hong

Kong.

Introduction: Equipping students with skills for lifelong learning and living in society inclusively

are the most important educational goals for all students with special needs. Conductive Education

(CE) is one of the philosophies for special schools to facilitate the learning of students with special

educational needs in Hong Kong. Based on the individual special needs of students, we purposely

arrange and design structured integrated programme that are important to enhance their learning

outcomes, especially in helping them to apply and generalize the acquired knowledge and skills in

daily life. Establishment and operation of a school system by CE principles via the trans-

disciplinary team are indispensable.

Objectives: The structured integrated programme, which was established by the trans-disciplinary

team under CE system, was selected to study its effects in facilitating the learning of students with

special needs. In addition, the effect of trans-disciplinary team approach in facilitating the learning

of students will be explored.

Method: Case study method was selected. A newly admitted athetoid student with multiple

disabilities studying in a primary class of the special school was chosen as the subject. A whole

day structured programme with different tasks were designed and implemented. The programme

comprised of individual treatment sessions, school subject lessons and leisure time activities,

which were documented in an individualized education plan (IEP) as well. Strategies such as

backward chaining basing on the expected outcomes were adopted. Regular meetings were

scheduled to allow different professional staff to work together cohesively and holistically. Social

communication, self-management and learning aspects of the student’s performance were

recorded and reported by observations, interviews, tests and records.

Result and discussion: Referred to the collected information, all the aspects including social

communication, self-management and learning aspects were making progress. The target student

acquired how to manage his school belongings effectively and independently, equipped with

social communication skill to interact with peers in leisure time, and acquired some skills to

express in written mode with assistive technology. More integrated and comprehensive task

analysis was designed by the trans-disciplinary teamwork. Tactics of transferring facilitation skills

among different staff to ensure consistency and continuity in handling persons with special needs

will be discussed in the study.

20

Citation: Ngai, L. C. (2010). Community Education programme --- SAHK

ambassador. Abstracts of the 7th

World Congress on Conductive Education

(pp. 373 – 374). Hong Kong.

Introduction: One of the major focuses of Conductive Education is to cultivate one’s self-efficacy

and self-worth for self-actualization and lead to active participation in community eventually. In

December 2008, SAHK started a community education programme to promote public’s

understanding on people with disability and bring out the positive view of life. 7 clients and 1 project

team from sheltered workshops were appointed as SAHK Ambassador. They visited school, youth

centre and disable people self-help group to share their past experience, successful story and

achievement. The feedback and response from the participants were very encouraging and positive

which in turn became the driving force for the Ambassadors to develop a more positive and

energetic personality. Both general public and the clients can ultimately benefit through this win-win

programme.

Programme Description: 7 clients and 1 project team with outstanding achievements were

appointed as SAHK Ambassador. Majority of them suffered from cerebral palsy, while there were

two clients suffered from spinal muscular atrophy and cerebral vascular accident. These

ambassadors included 2008 Beijing Paralympics boccia gold medalist, Awardee of Ten

Outstanding Young Persons of Hong Kong and winners of various arts, sports and social activities.

They were organised to visit schools, youth centres and self-help group with the objectives: 1.

Assist the youth and people with disability to develop a positive view of life and enhance their

adversity quotient through life education; 2. Provide opportunity for the public to increase

understanding on talent and potential of people with disability; 3. Promote the self-image,

confidence and self-efficacy of SAHK Ambassadors and cultivate their perseverance and positive

personality development.

During the visits, Ambassadors introduced themselves as well as their assistive device, shared

their own story, played role-exchange games and all participants were required to write down their

self-reflection at the end of programme.

Programme Review: In the period between December 2008 and April 2010, 62 visits have been

organized for 15 primary schools, 26 secondary schools, 1 tertiary education institute, 1 special

school and 19 welfare organisations. The total attendance was 15,153 and there were 244

participants in each visit averagely. A unit based program evaluation and opinion collection were

done after each visit. During the period, 62 questionnaires were distributed to the organisers and 58

valid responses were received. The average score of overall rating was 2.64 out of 3. In other part of

questionnaire, like extent of achieving objectives, program design and speaker performance, the

average score was 2.64, 2.57 and 2.60 respectively.

Discussion: Actually, it was really not an easy task for the clients to face such a big crowd of

participants (244 in average) in each visit. The impressive ratings from participants’ evaluation

further confirmed their hard working and excellent performance on the stage have won the

recognition from public. Conductive Education emphasis on developing one’s own attitudes or

personality to solve their problems encountered, SAHK Ambassador is a good arena for this

purpose.

21

Conclusions: In conclusion, the SAHK Ambassador is an effective programme. The clients can be

empowered through this community education in one hand, the general public, especially the

youth and disabled person, can be cultivated a more positive view of life and acquired deeper

understanding about people with disability on the other hand. The programme provides an

excellent education opportunity for our clients, even in the adult stage, to temper their personality

and equip them necessary quality to conquer future challenges.

22

Citation: Cheung, P. W., Ching, H. Y. and Ng, L. Y. (2010). The impact of

Conductive Education on upbringing the child with mental handicap.

Abstracts of the 7th

World Congress on Conductive Education (pp. 377 –

378). Hong Kong.

The system of conductive education has been using in the SAHK preschool centers years ago for

training children with special needs, including those with mental handicap. It provides a favorable

learning environment to enhance children holistic development, active learning and to maximize

their potential to achieve functional independence. Parents are working partners with professionals

to facilitate children development. This paper presents the progress of a client with mental

handicap, illustrating how the implementation of conductive education especially the home school

collaboration, impacting her upbringing.

TY was diagnosed as developmental delay with the 9th

chromosome deletion. She has multiple

congenital abnormalities especially on her intestine which affected her feeding and health

condition occasionally. After one and a half years training, there was an encouraging improvement

in her cognitive, physical and social development. The results on GMFM and Peabody

Developmental Motor Scales showed steady progress. As a sitter during admission, she is now

able to walk with ladder back chair under supervision and free hands for few steps. She is more

active in interacting with peers and willing to learn.

The close home school collaboration is found to be a key to her improvement. Mother actively

joined in our training programs such as task series programs and parent training courses. Parents

are empowered with support by our trans-disciplinary team including physiotherapist,

occupational therapist, speech therapist, teachers and social worker. All of us have positive

attitude towards the child’s growth. Besides, her home environment is equipped with suitable

furniture and training tools which also enhance the continuity of her learning from center to home

situation.

23

Citation: Chong, W. F., Wong, S. C., Lee, Y. C. and Lo, S. P. (2010). An exploration

of the alignment of social work and conductive education in pre-school

services for children with disabilities. Abstracts of the 7th

World Congress on

Conductive Education (pp. 381). Hong Kong.

The importance of Transdisciplinary in Conductive Education used in the local context is

unquestionable. A huge number of local studies stressed the key role playing by rehabilitation

practitioners under the framework of Transdisciplinary Teamwork Approach. However, the role

specifically playing by social workers in Transdisciplinary is in absence both in local and western

literatures.

In the pre-school centers running by SAHK, social workers are playing the “dual- role” in the

system. Apart from rendering social work services in addressing the welfare interests of disabled

children and their families, social workers are also playing the roles of administrators and

coordinators in drawing the consensus from different views of multiple disciplines in order to

uphold the integrity of service provision. Thus, an understanding of the alignment of social work

and Conductive Education is of crucial importance for social work practitioners to identify their

roles playing in the system. This paper is the first attempt to explore the similarities between social

work and Conductive Education based on their rationale orientations from five dimensions,

namely: (i) humanistic belief; (ii) “personality” growth; (iii) the psycho-social view of problem;

(iv) social justice; and (v) professional integrity. The paper also attempts to identify the different

roles playing social workers in six positions: (i) enabler; (ii) educator; (iii) facilitator; (iv)

mediator; (v) planner and (vi) advocator by examining their existing practices involved with the

system. It is hoped that rehabilitation social work practitioners can be more aware of their role-

identification under the framework of Transdisciplinary Teamwork Approach in viewing both the

learning and welfare interests of children with disabilities and their families.

24

Citation: Tong, W. K., Kwong, W. Y., Chan, C. M., Tai, C. M. and Fung, C. M.

(2010). Inseparability of body and mind: CE in community rehabilitation.

Abstracts of the 7th

World Congress on Conductive Education (pp. 387 - 388).

Hong Kong.

People with neurological impairments face the aftermath of life-long challenges which has

lingering effects on their self-image that may result in isolation from the community. An

integrated community rehabilitation programme founded on the principles of CE was being

implemented in a community-based day rehabilitation centre with the inclusion of caregiver(s) or

family members in the rehabilitation team together with allied health, nursing and welfare

professionals.

A pilot self-support group (SSG) emphasizing self-reliance and eradication of learned helplessness

was organised for 10 clients who suffered from Cerebrovascular Accident (CVA) for 6 – 18

months. The comprehensive programme targeted at cultivating physical exercising habit,

facilitating emotional control, experiencing peers support, promoting community participation as

well as establishing healthy life style for prevention of recurrent stroke. Group interviews were

conducted to collect feedback from clients and their caregivers after 4 month’s SSG.

During the programme, clients claimed that they were more engaged to physical activities with

verbalised movement and were more capable of experiencing fun and success in a group format.

Their compliance of elf-administered exercises at home was good. Increased confidence in taking

care of themselves and in leaving their own home was reported. Most clients perceived themselves

positively and accepted their own post-morbid limitations. Caregivers commented that more stable

emotion was found that had greatly reduced their caring burden. Both the clients and their caregivers

had acquired the basic skills for community participation with better understanding of available

community resources that are relevant to them. The philosophy of CE helps to align a

multidisciplinary staff team with a holistic mindset for establishing a structured programme that

facilitates clients to gradually process internal changes with continuing reinforcement from peers,

staff and family members. It was a crucial stepping stone for people with neurological impairments

to develop a sustainable coping will to combat the aftermath of their life-long challenges. Last but

not least, client’s and their caregivers’ active involvement together with mutual support from peers

and staff are the key to a successful outcome.

25

Citation: Liu, C. H. (2010). Constraint-induced movement therapy (cimt) for clients

with chronic stroke: how to collabrate with Conductive Education in

community rehabilitation (case study). Abstracts of the 7th

World Congress

on Conductive Education (pp. 393 - 394). Hong Kong.

Introduction: Constraint-induced Movement Therapy (CIMT) is an evidence-based and

promising rehabilitation strategy for overcoming the ‘learned non-use’ phenomenon [1-3]

. In last

decade, CIMT became popular in local rehabilitation field mostly for acute and subacute stages of

cardiovascular disease (CVA) in hospital settings [4-5]

. For community-based out-patient

rehabilitation settings, there are limitations for CIMT applications, such as patient compliance in

restraining the less affected limb, sustainability of intensive supervised training, etc. Modification

and structured protocol must be established for the community settings to ensure the effect of

CIMT.

Methodology: Case study was conducted to illustrate the limitations of CIMT application in a

community-based rehabilitation centre and measures were suggested to overcome these limitations.

A subject suffered from chronic stroke for 15 months, with Mini Mental State Examination

(MMSE) score = 23, Modified Functional Ambulatory category (MFAC) = 7 and meet the motor

criterion (45˚ of wrist extension, full thumb abduction and resting four fingers extend in almost

full range) participated in the study. Motor Activity Log (MAL), Functional Test for Hemiparetic

Upper Extremity (a 7-level test), Functional Independence measure (FIM), grasp and grip

strengths were used as outcome measures. The subject received a structured modified CIMT

protocol by incorporating the principles of Conductive Education (CE) with 2-hour’s individual

task series session followed by 6-hour constraint time daily with pre-determined activities in real-

life situations for 15 days.

Results: With the structured protocol, improvement was obtained in 2 MAL sub-scores, namely:

‘Amount of Use’ subscore (pre-test score: 2.05; post-test score: 3.57) and ‘How Well’ subscore

(pre-test score: 2.15; post-test score: 3.67) indicating that the phenomenon of learned non-use was

improved. The grasp and pincer grip powers were improved (pre-test power:6 kg; post-test power:

26 kg). The subject showed good compliance during the restraint period (mean restraint period =

5.35 hours daily) and satisfaction in the outcome with positive feedback were obtained.

Conclusion: The proposed protocol employed both CIMT and CE with a common cause of

maximizing the use of more-affected upper limb in both personal and instrumental self-care

activities for patients with chronic stroke, it serves well as one of the promising intervention

strategies to be implemented in community-based out-patient rehabilitation settings.

26

References

Taub, E., Useatte, G., King, D.K., Morris, D., Crago, J.E. and Chatterjee, A. (2008): ‘A

Placebo-Controlled Trial of Constraint-Induced Movement Therapy for Upper Extremity After

Stroke’, Stroke, 37, pp. 1045-1049.

Taub, E. and Uswatte, G. (1999): ‘Constraint-induced movement therapy: new approaches

to outcome measurement in rehabilitation’, In: Cognitive Neurorehabilitaion. Ed: Struss, D.T.,

Winocur, G., and Robertson, E.H., (Cambridge University Press), pp. 215-227.

Taub, E., Uswatte, G., Mark, V.W. and Morris, D.M. (2006): ‘The learned nonuse

phenomenon: implication for rehabilitation’, Eura Medicophys, 42, pp. 241-255.

Myint, M.W.W., Fung, C.Y., Yu, K.K., Kung, P.L., Wong, M.Y., Chow, K.C., Li, C.K.

and Wong, C.P. (2008): ‘A study of constraint-induced movement therapy in subacute stroke

patients in Hong Kong’, Clinical Rehabilitation, 22, pp. 112-124.

Myint, M.W.W., Fung, C.Y., Yu, K.K., Kung, P.L., Wong, M.Y., Chow, K.C., Li, C.K.

and Wong, C.P. (2008): ‘Use of constraint-induced movement therapy in Chinese stroke patients

during the sub-acute period’, Hong Kong Med J, 14:Suppl. 5, pp. S40-42.

27

Citation: Yu, Y. W. and Lam. M. H. (2010). Integrating the princples of Conductive

Education with transdisciplinary collaboration in a care home for the

severely physically handicapped. Abstracts of the 7th

World Congress on

Conductive Education (pp. 405 - 406). Hong Kong.

背景: 引導式教育理念強調中心不同崗位的職員都能緊密合作，以全人意念，透過細心安排

的生活程式，使服務使用者體驗生活中成功的喜悅。

華心謢康中心照顧 50 位肢體嚴重殘障的弱能人士，當中不少舍友均有吞咽困難，很容易造

成哽塞或吸入性肺炎，嚴重影響身體健康。自 2006 年中開始，華心護康中心逐步開展，至

今已全面推行的“餵食在華心，齊來攞滿 fun”計畫。目的乃配合引導式教育理念，推動跨

團隊合作，加強員工餵食知識及技巧，使嚴重弱能的服務使用者能在安全及輕鬆愉快的情

況下進食。

計畫內容:

項目 跨團隊成員之參與

Fun 1:餵食提示咭 -主任及治療師策劃，前線同事實踐

Fun 2: 餵食工作坊 -專業同事策劃，所有餵食職員參與

Fun 3: 開飯 7 件事廣播 -各職級同事輪流擔任廣播員

Fun 4: 餐前試食 -各職級均輪流參與

Fun 5: 餵食工作小組 -中心核心小組引領各職級均輪流參

與

Fun 6: 餐類製作及標準訂立 -主任、護士、治療師、廚師及文員

Fun 7: 職員餵食獎勵 -所有參與餵食的各職級同事均獲評

分

Fun 8: 舍友/家長意見收集 -專業同工及前線同事

結果:

舍友得益 員工得益

- 進食安全被高度重視 - 餵食流程較前暢順

28

- 接受一致性的餵食方法 - 安全餵食知識及技巧得以鞏固

- 對食/藥物的吞咽,進食能

力坐姿及儀容,被各職級

同事充分掌握

- 更清楚明白服務使用者的能力及整

體需要

- 膳食質素,包括色, 香,味,

得不斷提升

- 跨團隊工作目標更一致.

總結: 一向以來，吞咽問題主要是由言語治療師處理。但是單靠治療師的工作並不能滿足大

量的需要，而且最好的訓練時段其實往往就是服務物件用餐的時間。這些問題往往需要其

他職級職員配合才可有望解決。中心運用引導式教育的理念，推動及組織不同崗位的職員

緊密合作，以全人意念, 透過細心安排的進食程式, 使服務物件在生活中體驗成功的喜悅---

安全地享受餐膳及獲取均衡營養，達至身心健康。

17/F, 21 Pak Fuk Road North Point, HK 香港北角百福道

21 號 17 樓

PHONE 電話 (852) 2527 8978 FAX 傳真 (852) 2866 3727 EMAIL 電郵 ho@sahk1963.org.hk WEB SITE 網此 www.sahk1963.org.hk