On the PMLD Network Forum, Peter Limbrick from Interconnections posted a most interesting question. He wrote:
"A young child with visual disability will be helped by a visual impairment teacher. If there are hearing problems, there will be a hearing impairment teacher. For a child who needs help with movement and posture there will be a physiotherapist. For speech, language and communication support there will be a speech and language therapist. Some children require all of these as early intervention.
My question is: Why is helping a child learn to visually track a toy, or to match sounds to objects considered to be 'teaching', while helping a child learn to sit or roll or use a sign to ask for a drink considered to be 'therapy'? In this context, what is 'teaching' and what is 'therapy'? Does the distinction have any meaning or value, or is it just another way to confuse parents - and the rest of us?"
Peter’s question about the distinction between therapy and teaching has intrigued me. It is an important question. I cannot say I have an answer for Peter. However, the following are some of my reflections.
1. “Therapy” is what therapists do; “teaching” is what teachers do. A simple – even silly - statement but pointing to a larger fact that the practitioners and the practice exist in separate professional worlds. These sometimes overlap and, in the experience of parents and service users, seem at times to do similar things when it comes to service delivery. The separation of these two worlds might be evidenced in the current fashion for and difficulties in achieving “joined up” services at strategic, resource and management levels.
2. Meanings of words exist as much in “lexical sets” as in individual ‘dictionary definitions’. We can test the different lexical sets of these words by asking ourselves what first comes to mind when we hear the words “therapy” and “teaching”. ‘Therapy’ would seem to be a word firmly from a medical or health lexical set whilst ‘teaching’ belongs in an educational set.
3. Does the observation that therapists are ‘professions ancillary to medicine’ whereas teachers are not ancillary to education’ tell us anything about the difference between ‘therapy’ and ‘teaching’?
4. Is there a relevant difference of time-frame? Although some people can receive ‘therapy’ for years, ‘therapy’ is mostly associated with the comparatively short-term whereas teaching, especially as far as children are concerned, can now extend from early years to the end of further or higher education.
5. Might there be a difference in purpose? Could the purpose of ‘therapy’ be summarised as individual ‘wellbeing’ or ‘health’ whereas that of ‘teaching’ is ‘up-bringing’ (or, in a perhaps old-fashioned academic term, ‘socialisation’)? It comes to mind that the lexical sets around therapy might include words like ‘intervention’ and ‘rehabilitation’, words not usually found with ‘teaching’ – pointing to different purposes.
Peter’s choice of examples is interesting and points to further speculation about differences.
6. Could the difference between ‘therapists’ and ‘teachers’ be mainly one of western culture, history and society (1)? The current fashion for multi-disciplinary service teams simply underscores the fact that there are ‘multi-professions’. Is it possible to imagine a uni-discipinary professional? Over 35 years ago, the Younghusband Report (Living with Handicap: the report of a working party on children with special needs. 1970) seemed to envisage as much in its proposal for ‘hybrid’ training courses. Conductive Education offers such a single-profession model in the profession of the ‘Conductor’. As an aside, for parents of disabled children, dealing with a single professional instead of the very many professionals that some parents now manage, the advantages should be self-evident.
7. Could the difference between ‘therapists’ and ‘teachers’ be mainly one of western culture, history and society (2)? Peter rightly points out that in the case of the young child with a visual disability or hearing problem there will be a teacher, whereas for “a child who needs help with movement and posture there will be a physiotherapist.” Is it not the case that whereas we provide specialist initial teacher training for those who would teach children with sensory impairments, we do not do so for those who would teach children motor disabilities nor even other disabilities? In other words, the physiotherapist is the first trained option our society offers, even in the classroom? Why did we decide to abandon specialist training for most teachers of children with disabilities and is it still right that we do not do so? This question was approached but not fully addressed in the House of Commons Education and Skills Committee on special education needs, Chaired by Barry Shearman which reported in 2006.
I am indebted to Dr Andrew Sutton for the origin of thoughts 7 and 8 - though Andrew cannot be blamed for the wording here, which is down to me.
8. I will add one further thought with something of a wry smile. As an example, Peter’s chooses “the child who needs help with movement and posture” for whom “there will be a physiotherapist”. If the child’s movement and posture problems derive from a neuromotor disorder such as cerebral palsy, Conductive Education asserts that there is a problem of teaching.
Finally: “After two decades of pioneering work in brain research, the education community has started to realise that ‘understanding the brain’ can help to open new pathways to improve educational research, policies and practice. … This calls for holistic approaches which recognise the close interdependence of physical and intellectual well-being and the close interplay of the emotional and cognitive.” (Understanding the Brain: The Birth of a Learning Science. Organisation for Economic Co-operation and Development. Centre for Educational Research and Innovation. July 2007.)