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Montreal ABR Training in April

I’d like to clarify the goals and the procedure of the forthcoming ABR training session in Montreal in April.

I think that there are some major misunderstandings that create negative emotions. Shall I start complaining that my best intentions always end up misinterpreted? :-)

 First and foremost, we never divide children and families into ‘favorites’ and ‘also-runs’. Your decision of choosing ABR as physical rehabilitation platform for your child is an honor for all of us and for me personally as its founder. I said this before and I really mean it.

At the same time whether the case is severe or milder – doesn’t make any difference for us neither. We want to help your kids to reach the maximum of their potential and live through the best case scenario of their motor and sensory development. Both severe and milder children have lots of room for further progress that we try to get untapped through ABR

 The April training session in Montreal is not the gathering of ‘privileged’ families. Neither is it a return to the old model.

The main idea of this project is to build a knowledge base – film and document a variety of ABR exercises done in real settings with real cases in such a way that all of you today and in the future will get the access to it via a designated website or DVDs.

Where does s the pressing need for such a knowledge base come from?

The satellite visits are forced into being a compromise.

I want to remind that on our side we always pushed for making them longer – keeping them what they were several years ago – 4-5 training days. We were forced to cut them into shorter ones under immense pressure from the families, who pointed out, quite reasonably, that a North American vacation/work leave is most often just 2 weeks a year, hence attending weeklong sessions was unrealistic for most of families.

I also mentioned before that for ABR trainers shorter visits are more difficult – since these visits are a lot more packed and the value of productive time increases tremendously.

So a ‘bad day’ when a child doesn’t cooperate is not a big deal when you have another 3-4 days to find ways of teaching home exercises; however, a ‘bad day’ within a visit that lasts only 3 or even 2 days (double sessions) – creates a very stressful situation.

On the one hand, as a caring parent you “protect” your child and align with one: “He doesn’t feel well today…” or “She is not in the mood this morning…”, on the other hand, as a customer, you feel that you are not getting enough value and attention (especially several weeks later when that ‘bad day’ is well forgotten).

Trainers have to do a lot more homework to prepare for the short and intensive satellite session and at the same time they need to deliver in a very stressful situation.

On top of that, add the introduction of the new techniques (Super-Soft Ball Rolling) plus the need to check the machine setups – all of that teaching bulk indeed leaves very little breathing room.

What do our trainers get for their hard work? – Mostly the blame.

What happens if a child does not cooperate? – A trainer is in Catch 22 – “damned if he does and damned if he doesn’t...” If a trainer tries to push through ,regardless of child’s cooperation, trying to give you – the customer –as much value as possible: he gets the blame for not being sensitive enough – by you wearing your ‘parent’s’ hat.  If a trainer does the opposite and draws back waiting until child’s cooperation improves, what is the response? – “He didn’t spend enough time with us; we didn’t learn this and that…”… Well, that’s you wearing your paying ‘customer’s’ hat.

What do I end up with? – Unhappy trainer and unhappy parent. Paradoxically both act with best intentions, but the end result is often frustrating.

On top of that I get frustrated with trainers as well – asking them: “Why haven’t you explained this important nuance and why this essential technical element was not emphasized enough?…” – Their response is most often the same: “We want to… but between feeding, changing, resting etc. – we are out of time. So we cut down to the minimum making sure that at least some basics get done… ”

So we are really locked – we can’t make the satellite sessions longer  for objective economical reasons but we still want to give you as much teaching value as possible and at the same time not to end up in a stone-hearted ‘drill sergeant’ role.

That’s why the only working solution that I see, given all of those constraints, – is the development of ABR skills knowledge base recorded on video and later transcribed.  

The idea is to make into a website with secure access specifically for the families doing ABR.

In that respect the Montreal training in April 2010 is the one of our first attempts of starting to build such a knowledge base – key technical elements; collection of practical tips; positional management advice etc.

For this idea to work – we needed some ‘model selection and recruitment process’.

·        That’s why it is quite natural that the kids and parents that I thought would be ‘best models’ are the ones with the greatest ABR experience and respectively hands-on skills.

·        This choice also makes sense since the ‘veteran’ families are most likely to ask more advanced questions thus giving this knowledge base a further reach.

·        At the same time – considering these ‘model’ cases I also wanted to ensure a relatively high probability of child’s emotional cooperation because the  training sessions will be only 2 days long and my goal is to pack as much of material as possible.

·        On top of these factors I have asked the trainers to contribute their opinions – which cases do they feel they need maximum help with.

So when all of these factors were put together we made an ‘Invitation list’.

The idea of this “Invitation list” was to present it as an option, where in case a family preferred more convenient satellite training we’d be happy to oblige.

So once again, by no means the April training in Montreal is meant to be the ‘gathering of the Montreal center favorites’ – that’s really a very twisted way of looking at it.

April session is going to be a period of intense work aimed at the creation of a knowledge base, from which we expect all of the present and future ABR families to benefit from.

Another important benefit of this session in Montreal is for me to upgrade the skills of our trainers. The designed format of the visit is 1+2+1: Where the first day is the assessments with the explanation of the intended strategy and exercises goals; days 2 and 3 – actual teaching and filming; day 4 – analysis with the trainers of the previous 3 days.

The idea of such a format came to me last November during the ‘Training the Trainers’ visit to Montreal. It was very productive – however, without the opportunity of doing demonstrations and corresponding filming – we were limited in our training scope.

 So I hope that I’ve managed to communicate the idea of the April session better and I would like to emphasize once again: I am working for ‘collective you’; even though I do get certain emotional attachments to the ABR families I met many times – such emotions are not the basis of my decision-making.

My only goal is to deliver the maximum benefit for all of the current and future ABR families without any exceptions or privileges. 


I would also like to address briefly another important issue that popped up through the ABR grapevine recently.

The issues of: ‘How long shall we do ABR?’; ‘How good a child’s body structure should be before we graduate?’; ‘Have ABR people told anyone to stop because it wasn’t working well enough or because finally the child has got “enough” of ABR?’

 I addressed these matters a number of times before but they tend to surface up every now and then.

First, I definitely spend some time covering these grounds in last year’s Lunar New Year Message (especially parts 1-3, I think) but I admit that being a 2.5 h video – it’s not the most user-friendly. However, I suggest that you’d go to the Vimeo website directly – and download those videos straight into your computer.

 So I’ll give some brief account.

 Question: “For how long will ABR continue to benefit my child?…

ABR is based on the idea of conditioning – improvement of fundamentals of musculoskeletal system; more specifically – strengthening of the weakest links with the goal of Strategic Developmental Enhancement of your child .

After all what is the ABR package of exercises that you bring as a home program? – It is a collection of application addressing the Top 3 to Top 7 weakest links chosen according to the matrix of factors:

·        long-term strategic importance;

·        immediate tactical value;

·        current level of parent’s skill;

·        child’s most comfortable position etc.

Sometimes we go as far as taking into account the position of a TV in a living room…

Your next visit – things have evolved.

Some of the weakest links got stronger; your skill level improved; but it is also possible that new tactical challenges emerged suddenly; and so on.

Again, at the next training visit, – we give you a package that covers the Top 3 to Top 7 weakest links of the current moment – based on all of those factors and more.

Does such a change mean that the previous weakest link became so strong that it doesn’t need any application in the future or that your child wouldn’t benefit from continued application? – Not at all.

I mentioned many-many times – even if you have just learned nothing else but the classic 3Q ABR chest exercise and will be doing it for years to come – your child’s condition will be improving in the related regions.

It is as simple as that.

What our supervision is for then? – We assume that you trust our experience and integrity to define those Top 3 to Top 7 weakest links that are the most important for your child at this present moment given all of the variables of his structural development, cooperation, tactical challenges, general health, favorite positions, your backaches etc.—your ABR home program is then a package that we judge as the best possible for your child.

 Taken from this angle – ABR is on the same platform as wellness and conditioning, i.e. ongoing support and way of life, rather than the treatment/ rehabilitation mindset – that are supposed to end at some point, expecting ‘a patient’ to leave the stage of “being treated” and then continue ‘naturally’ and unaided into ‘regular life’.

 If we drive this argument further – no matter who is in front of me: severely disabled child or professional athlete – I can always point out the weakest links that could be addressed in order to improve performance.

So from this perspective there is no such thing as “ideal body structure”.

 On the other hand, I believe that questions like this might stem from insufficient understanding of the stages of transition from spasticity to controlled movement.

Since in ABR analysis we define at least 10 of those stages, where only the last 3 belong to “positive”, i.e. having direct functional value (voluntary movement), the first 7 are all ‘below zero’, being the phases of ‘reduction of negatives’.

 In the near future I’ll do an extra designated screencast on this topic – since it really deserves an emphasis.

 B. Graduation from ABR coaching.

That’s a completely different story.

Yes, we do want you to graduate. Plain and simple.

We want you to obtain the ABR skill set and toolset based on a conditioning mindset and then move on to the next phase of our relationship – towards the distant supervision, where we’d be giving you the workouts/ home program prescriptions based on the ABR skills and applications that you know – following the same Top 5 Weakest Links principle.

That’s the intention that has always been there. Actually it has been my ‘guiding light’ ever since I started on my own nearly 10 years ago.

No one wants to drag that live coaching umbilical cord for years and years.

So the problem is not in the lack of the intention.

The problem, as I’ve just mentioned in the ‘Painful Lessons’ post few days ago, stems from the fact of fast evolution and ongoing improvements of the ABR tools.

For a while, back at the end of 2008 and beginning of 2009, I felt extremely happy, thinking that after several years of innovation rush we finally came to a point of the “end of new exercises”.

In such a case we finally looked at the realistic opportunity of developing a fixed curriculum of Comprehensive ABR Skillset, sufficient to cover any area of a child’s body and also being specifically optimized for a difference between milder and more severe children.

Ideally, we’d want to have at least 3 of those Comprehensive Skillsets for GMFCS Levels V-IV; Levels III and Levels II –I.

That’s the intention and the plan.

The challenge stems from the radical new developments. That’s what I mentioned in the ‘Painful Lessons’ post: ABR being at its’ infancy and the ongoing improvement of the curriculum.

Those plans for fixed curriculum introduction were interfered with by the Super-Soft Ball Rolling developments during 2009.

However, I still hope that within 2010 the skillset and the curriculum for the Super-Soft Ball Rolling technique will stabilize and we will be able to get back to the implementation of graduation-based format.

 I am going to talk about this more in the near future – describing the ‘new’ hierarchy of ABR training stratified according to a spectrum of time budgets both in respect to hands-on ABR homework and to available learning hours.

However, such a transition to graduation-based format of ABR – regardless of the final specifics – should be standing upon the must-have cornerstone – we need to be able to introduce user-friendly remote knowledge base through videos and Web access. Well established distant communication is the only way we can develop further.

 I can only say that this profound mismatch between the image of what ABR format and structure should ideally be to provide the best value for the families, and what we have now is the source of my ever-present, gnawing frustration. Closing this gap between desired and actual is the pre-dominant and pre-occupying thing both for me and for all the ABR centers.

We all very much appreciate your feedback and the exposure of our shortcomings and articulating your wishes and wants, but at the same time, even though such expression often comes in rather harsh words – I do hope for having some benefit of the doubt.

All of the members of ABR team try hard and try their best, but at the same time we operate within a number of tough constraints so oftentimes things do not work out as smoothly or as quickly as we would like them to be….

Thanks for your understanding…