Monday, January 21, 2013

Don't just assist (and/or medicate); instruct, II

Every time I look through a new special education catalog or teach another round of my autism class, I encounter descriptions and discussions of the latest round of assistive technologies and medications. And my reaction is always the same. However helpful they may prove to be overall, might some of these technological and pharmaceutical innovations--as well as other sorts of acommodations--end up detracting from, rather than enhancing, the education of special needs children?

My personal area of expertise is autism, and as I noted earlier in reference to Assistive and Augmentative Communication devices (AACs):

In autism, the most commonly used AACs [are used] for language--devices like the DynaVox, which gives users a menu of common vocabulary and phrases to select in order to communicate basic needs. The devices can revolutionize a child's basic functioning and psychological well-being, improving substantially his or her classroom behavior and teachability.

But no one should see AACs as a panacea for language instruction. However much they assist children in deploying their current language skills, it's far from clear that they actually teach them new ones.
Furthermore, the Dynavox and the like may inflate teachers' impressions of student achievement. For example:
When a child pushes "JUICE" on his or her DynaVox, many may see this as the child's intended shorthand for a full-fledged grammatical sentence--"I want juice"--or question--"Can I have juice?"--when he or she hasn't actually acquired general subject-verb-object order or the syntax of question inversion. Clicking on preset key words and phrases rather than constructing one's own phrases and sentences from scratch may mean that one has learned simple associations between stimuli and sounds, but not the linguistic skills prerequisite for intentional linguistic communication and thinking in full-fledged propositions.
Worse yet:
The ease of AACs, and how much they help teachers manage a classroom full of AS students, may sometimes breed complacency about the students' continuing needs for direct instruction in language. Managing AS kids is one thing, but, when it comes to meeting their legally-mandated educational needs, it is only the first step.
Other strategies for other types of academic challenges are similarly concerning. Consider, for example, what an October, 2012 New York Times article says about what's happening to low-income children who struggle in school:
When Dr. Michael Anderson hears about his low-income patients struggling in elementary school, he usually gives them a taste of some powerful medicine: Adderall.

The pills boost focus and impulse control in children with attention deficit hyperactivity disorder. Although A.D.H.D is the diagnosis Dr. Anderson makes, he calls the disorder “made up” and “an excuse” to prescribe the pills to treat what he considers the children’s true ill — poor academic performance in inadequate schools.

“I don’t have a whole lot of choice,” said Dr. Anderson, a pediatrician for many poor families in Cherokee County, north of Atlanta. “We’ve decided as a society that it’s too expensive to modify the kid’s environment. So we have to modify the kid.”

Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.
A somewhat different problem emerges in a profile in last week's Philadelphia Inquirer of a school for children with dyslexia and other "language-based differences." This private, college-prep school, AIM Academy, uses an "arts-based approach that includes costumes, games, activities, and classrooms decorated as medieval castles and prehistoric caves":
With a password and secret hand signal, all who enter Tom Waitzman's classroom gain passage to the Middle Ages.

Once inside, Max Lentz, dressed in a white cloak, no longer is a fourth grader at the AIM Academy in Whitemarsh Township, Montgomery County, but "William, duke of Normandy." Sitting nearby are classmates "Charlemagne, king of the Franks," and "Eric the Red."

"Why are the Vikings leaving Scandinavia?" asked Waitzman, whose classroom incarnation is "Merlin the wise."

"Overpopulation," Max, 10, said. "Good word," Waitzman told him.
Again we see key words (is "overpopulation" really the answer here?). But what about complete thoughts?
"I'm not just going to give a quiz or a work sheet or have them remember a lecture," Waitzman said. "It doesn't work with students with language-based differences."

What works at the 217-student academy is the philosophy "live it and learn it," said Patricia Roberts, the executive director, CEO, and cofounder of the K-12 school.
The technique is partly designed to keep students curious and engaged at a time when frustration with their reading skills has the potential to overwhelm.

Sophomore Insaf Sydnor of University City knows that feeling well. "You see the word the, I see go," Sydnor, 15, said of the years before she enrolled in AIM. "You see bat, I see hit."

The experience left her feeling lost and frustrated.
And if the school's arts and experience-based classrooms never instruct this 15-year-old how to read "bat," vs. "hit," she will continue to feel lost and frustrated, not only in college, but also in life.


Anonymous said...

Many years ago, I remember reading an article which said that spec ed was initially intended for those kids with permanent disabilities (blindness, deafness, loss of digits or limbs, paralysis etc) which could not be lessened but which required accommodation. Such accommodation often included mechanical or human assistance like verbal instruction for the blind, visual/sign language etc. for the deaf, artificial limbs etc. The article continued by saying that spec ed's expansion into learning disabilities of all kinds (and I think specifically mentioned ASD kids entering schools),had simply continued the accommodation model, as if such disabilities could not be ameliorated by specific coping and compensation strategies. I've always found that idea, that spec ed for SLDs and ASDs should have different goals and methods, to be very interesting. I know that this coping/compensating stratefy worked very well with a young dyslexic relative, to the point that she needed no IEP support by MS entry. Is this related to your point?

Katharine Beals said...

"I know that this coping/compensating stratefy worked very well with a young dyslexic relative, to the point that she needed no IEP support by MS entry. Is this related to your point?" Yes, that is partly it. Direct instruction can be highly effective vis a vis so-called "learning disabilites," esp those that may be partly the result of earlier "dysteachia" (e.g. failure to teach phonics).

Anonymous said...

When my now 5.5yo was almost 3yo, his speech therapist recommended PECS (some picture communication thing). I refused, because I'd found a (then recent) study that found that kids using PECS do better with their communication skills than kids without, but do worse with speech than the kids without. I figured that eventually the communication would catch up with the speech, and doubted that the speech would catch up with the communication if using PECS. While he used only about 20 words at almost 3yo, he's now 5.5yo and his speech therapist says he has a good vocabulary. He's made a lot of progress, and after two years of mixed SpEd pre-K he is in regular K now, and will continue on to regular 1st grade next year. His main problem is that he rarely asks questions, but he's beginning to tell me about his day at school, and understands all sorts of instructions. I don't regret saying 'no' to PECS at all.