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Should teaching pupils with medical diagnoses be built on similarity or difference?

Should teaching pupils with medical diagnoses be built on similarity or difference?

An old dispute issue in the field of special needs education is whether there are teaching methods that are specific to different target groups such as e.g. students with ADHD, students with intellectual disabilities and autism.

You can distinguish two extremes in this discussion. On the one hand, some advocate teaching built upon similarity, which means that pupils' group belongings are considered to have few or no educational implications. On the other hand, we have those who mean that the deficiencies of the target groups need to be mapped out in detail so that we can tailor teaching approaches to suit their needs.

For the sake of simplicity, I will refer to the two approaches as S (Similarity) and D (Difference) in the reminder of this blog.

 

Similarity as the point of departure

The S-teacher says something like this: "What's good for all students is good for students in need of special support/with medical diagnoses and vice versa." It was this conclusion that I believe John Hattie reached in his overview of educational research. Working methods such as direct teaching and peer learning appeared to be good for all students. In a similar vein, the S-teacher would argue that structure and order in schools, classrooms and lessons, which are usually emphasized as important to students with ADHD and Autism spectrum disorder, is beneficial to all students.


Insightful S-teachers are of course not ignorant of the fact that students are different. However, diversity is seen as a characteristic of individuals rather than as a variety of different kinds. In this way, the S-teacher has to attend to individual difference rather than group differences. Consequently, it is important to have knowledge of each student's specificity.


If a pupil encounters difficulties in school work, the S-teacher advocates a proper educational inquiry where the individual's situation is mapped. The occurrence of a diagnosis is of course not insignificant for such an investigation, but it provides limited information from an educational perspective. It is the individual and his/her teaching environment, including factors such as the teaching and the social climate, that becomes important in such an investigation.

An S-perspective can have very radical implications. If we consider that students are basically the same, it is difficult to argue that some students should be taught in specific groups. Thus, a central question then is how teachers can teach students with different conditions in the same classroom given a certain teaching content.

In other words, how should teachers teach e.g. math / English / gymnastics for students with different prerequisites? Framed differently, how can teachers teach different content in order to create inclusive classrooms? In order to be able to answer such questions in the best way, educational research has to be developed which addresses these types of questions. Unfortunately, such research is too rare.

 

Difference as the point of departure

The deviation is the starting point for the D-teacher. The question is not "What education is good for the heterogeneous student group?" but instead "How do we teach students with developmental disorder / learning disorder / dyslexia / behavioral disorder / Tourette's syndrome / obsessive-compulsive disorder"? The focus is on tailoring the education to these groups based on their specific characteristics.

It thus becomes important to investigate the deviation itself. Here a lot of research is taking place about, for example, executive functions, working memory and "theory of mind", which strives for a greater understanding of the specific deviations. Knowledge about such deviations, it is argued, will in the long run provide better education for these groups. This research is rarely didactic in the sense of being concerned with a specific knowledge content, but it is of course possible to ask, for example, "Which mathematics education is best for students with ADHD?"


The search for specific problems does not necessarily mean that segregated educational practices are strived for. Some suggest that we need to find out more about how these groups of students process information, etc. in order for them to be taught in the ordinary class.

 

An empirical question?

In part, the question about similarity or difference is an empirical issue. In order for us to methodologically determine the need for teaching strategies based on difference, we should be able to show that a teaching method X works for the Y group (for example, students with ADHD) in a different way than for "ordinary" students. This is actually quite rare. On the other hand, students in difficulties may often need more education to achieve the same goal, "more of the same."

An example from reading research can highlight this. A special teaching method for pupils with dyslexia would build on the assumption that students with dyslexia learn to decode text in other ways than the other students and thus need to be taught in a qualitatively different way. However, this assumption can hardly be said to be supported by research. On the other hand, students with dyslexia need longer time to learn to read. The difference sees thus to a large extent to be quantitative, more of a similar teaching, than qualitative, the need for another kind of teaching.

There are of course instances where teaching built on difference is necessary. For example, students who are blind need such special education. Seeing students orient themselves naturally easier in the room while pupils who are blind need to train orientation in space in qualitatively different ways, e.g. by learning to use a stick, be more vigilant on sounds and other non-visual perceptual information that seeing students do not need to focus to the same extent.


My own view is that teaching based on similarity takes us quite far but we need more didactic research on how heterogeneous groups can best be taught. Unfortunately several teachers feel more or less helpless when it comes to the task of teaching students whose behavior is considered to interfere with the order in the classroom. In such a situation, it is not uncommon for teachers to ask questions about "how shall I teach students with ADHD". Although research built on difference does not seem to have very many other answers than that it is good with order , structure and consistency and to be encouraging, which is probably good for all students, at least the teachers' concerns are taken seriously.


As long as we to a large extent lack the didactic research that I discussed above, ie didactic research that tries to solve the problem with how heterogeneous student groups are best taught in different subjects, then the demand for teaching methods built on difference will probably increase. One risk of this is that teaching built on difference easily translates into demands for special solutions and sometimes also to working methods that are not the most functional ones.

Moreover, if some students are seen as qualitatively different from other students in their learning, the step is not far to advocate teaching in special groups with educators who have a special knowledge of the group. Education built on difference provides an attractive frame for professional specialization, among other things because some of the high status of medicine comes with the special thinking. Another risk with a starting point in difference is that it conceals the enormous variety that exists within the groups. The pupil with a medical diagnosis then risks being treated based on a stereotype rather than on her/his own individuality.



 
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