If you read about the state of education in America, you might conclude that students are sick and are in need of medical interventions. That’s because the language used to characterize kids who depart from established norms is often borrowed from doctors’ diagnoses and treatments.
The field of special education — while including many devoted, skillful and caring teachers — has often employed the language of medicine to refer to developmental challenges facing the students in their charge. In this view, there is a normal pattern of human development based on biological maturation, a schedule derived from Jean Piaget’s attention to his own children in Switzerland a century ago.
Some students develop on a slower timetable. Others develop in a different direction altogether, based on how they have been raised. These kids are often considered to require a special education to make them, in the behavioristic phrasing of autistic evaluations, indistinguishable from their peers.
At least on the surface.
Credit: Con
Credit: Con
When I’m sick, I go to the doctor. In school, kids who are not developing on other students’ schedules are often considered to be in need of something akin to a doctor’s diagnosis and treatment.
Disability rights advocates have long critiqued the “medical model” of intervention. This term was introduced in the 1950s to contest the negative ways in which mental health departures are understood and pathologized as diseases, rather than as atypical ways of navigating the world.
The biological approach of the medical model “focuses on a person’s genetics, neurotransmitters, neurophysiology, neuroanatomy and other aspects of their physical makeup. It uses the same type of framework used to diagnose and treat physical illnesses such as the common cold to also diagnose and treat psychological conditions.”
It’s all about biology, with no social dimensions of the sort that surround us all, some more debilitatingly than others. Meanwhile, the critical shortage of school nurses allows real illnesses to fester, in turn slowing sickly students’ developmental progress.
The language of medicine has since been applied to other areas of schooling. Students who struggle with reading, no matter what the cause, are often labeled dyslexic.
According to my computer’s “co-pilot”: “Dyslexia is a learning disorder characterized by difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words (decoding). It is a language-based learning disability that affects reading and language skills, and it is widespread and treatable. Symptoms may include difficulties with spelling, writing, and pronouncing words, and it can occur on a continuum from mild to severe.
“While there is no cure for dyslexia, appropriate instruction tailored to individual learning needs can help individuals overcome their literacy challenges and lead productive lives. Dyslexia is diagnosed through a series of tests assessing memory, vision, spelling, and reading skills. Treatment often involves adjusting teaching methods to meet the person’s needs.”
Symptoms, diagnosis, treatment (but no “cure”), disorder, disability. That sounds like a serious illness to me, even as the term dyslexia has been applied to just about any behind-schedule reading development, no matter what the cause.
Furthermore, among reading educators there is disagreement over how much phonics to teach. To some, hours of phonics a day works best; to others, no phonics at all.
The amount of time devoted to teaching phonics is known as the “dosage” of instruction. As phrased by Science of Reading authority Timothy Shanahan, “Time should be seen as dosage. Too often we’re satisfied that teachers are teaching writing or teaching phonics. But we should be asking, ‘Are they teaching enough of those things?’”
I agree that it matters how much time teachers spend on different parts of the curriculum. We used to call this dedication “time on task.”
In medical language, it becomes a treatment for an illness. And in whole-class phonics instruction, it treats the most advanced readers the same as the least developed, providing them all with a dose of phonics as a curative.
I recently came across a reference to differentiated “text diets” that support students’ various reading profiles. Many of us at one time or another have gone on diets to lose weight, often prescribed by a doctor.
I think it’s a great idea to individualize students’ reading selections. What I don’t like is the language of the obesity epidemic.
What is sick here: the kids or the language used to describe them? To me the problem is the presence of a rhetoric grounded in sickness and treatment, and confined to individual biology.
It’s an old problem in education: Students come to school and are measured according to their deficiencies and not their assets.
Of course, kids go to school to learn new ideas and skills. But there’s quite a difference between administering doses of instruction and providing appropriate time on task for learning, even as they refer to the same thing.
How we phrase an intervention matters in how teachers and students understand its intent. Let’s leave medicine to the doctors and use a language of schooling that builds on kids’ strengths in their learning rather than pathologizing them for what they cannot yet do.
Peter Smagorinsky is a retired University of Georgia professor whose high-functioning autism does not make him sick, but rather opens new areas of potential.
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