Needing Explicit Teaching Doesn’t Mean Inability to Think Critically or Generalize, and it Doesn’t Mean You Want to Follow a Recipe

This post about one of my pet peeves was inspired by a Specialisterne article Jaime A. Heidel shared on Linked-In. The title was,

“Your autistic employees may need explicit, step-based instructions to learn effectively.”

The topic brought up painful memories from a clinical program I attended. I started commenting on Jaime’s post, ran out of character space, and realized I wanted to tell a larger story.

This list of elements of explicit teaching comes from Comprehensible Classroom.

In most academic areas, and when reading self help books, I can teach myself. When teaching myself, I generally don’t learn step by step (unless A to Q to B to Z counts), and much of my learning is implicit. However, in areas of weakness, which usually involve performing actions in the physical world, I can’t teach myself. Then, I need a specific sort of explicit teaching.

Like autistic people, I rarely get the sort of instruction I need. After years of this frustration, I’ve come to believe I learn best by teaching myself.

Ironically, the situation where I was most frustrated and stymied was in a clinical program learning to be a speech/language therapist.

Clinical programs work like apprenticeships. You provide therapy while a clinical supervisor observes, and occasionally intervenes or demonstrates a teaching technique. The clinical supervisor also helps you plan what you’ll do with your clients at each meeting, and gives you feedback on your teaching. Virtually all your instruction in “clinical judgment” comes from your clinical supervisor.

I asked my clinical supervisors many detailed questions, and often asked for explicit teaching. They often gave a reply like, “I don’t want to tell you everything, because you need to learn how to think for yourself,” or “the situation is complex and it’s not like a recipe or an experiment you do the same way every time.” Like autistic people, I was confronted with a myth many people believe:

If you have to learn something explicitly and need things verbalized that most people would “just see,” then you want a “recipe” where you can always do the same thing in every situation and don’t have to engage in critical thinking. You also want the teacher to be working hard, not you. In other words, you don’t want to learn clinical judgment.

This assumption is ableist. It’s also incorrect.

In fact, everyone learns better with explicit teaching, and when people understand something thoroughly, that makes it easier to think critically about it and use it appropriately! (Also, I don’t want to do things the same way every time. That’s boring).

If I just wanted to mechanically apply a set of steps, I wouldn’t need to ask when to use a new skill, when to do something else, and how to tell.

My clinical supervisors seemed to assume I didn’t understand what I already knew: interactions with clients are complex, and clinical judgment is a nuanced way of thinking and deciding, at any moment, what to say and do. I wanted to learn clinical judgment. I wanted to be taught how my teacher made decisions, so I could go through a similar flexible thought process myself.

I knew every client and every session is different — but which differences matter? I kept asking, what cues from the client do you use to decide how to respond? I re-watched my therapy sessions each week searching for the variables my clinical supervisor would be semi-consciously using to decide.

When my supervisors refused to answer my questions, it amounted to choosing not to teach, and pushing that responsibility off onto the student.

To be fair, “clinical judgment” is a set of skills that most people learn mostly unconsciously. Teachers aren’t used to examining how they do it and explaining their thought process in words. And that seems to work well for a lot of people. But for people like me who don’t think that way:

• We need to be told things more explicitly.
• We need to be able to ask questions and talk through different situations where a clinical skill could come up, to learn when or when not to use it.
• We need frequent feedback. Are we doing the right thing for the specific situation? What can we do better?

Unfortunately, the program denied me opportunities to learn this way at every turn.

First — due to the faculty’s busy schedules and the way SLP masters programs try to cram in a PhD’s worth of learning — students barely got any time to talk with their clinical supervisors. It was a struggle to get time to talk through anything with my supervisor.

Then, when we did meet, my supervisors and other important people in the program:

1. Refused to teach me in a way I could absorb, arguing that it would prevent me from developing clinical judgment.
2. Denigrated, inaccurately, the way I learned.
3. Assumed that if I learned clinical judgment more explicitly than others, I wouldn’t be good at it once I learned it.
4. Complained I wasn’t learning fast enough, when I was denied the sort of teaching I needed and forced to use learning methods that didn’t work well for me.

Maddeningly, SLP’s know better. They constantly told us that explicit teaching is necessary with our clients — whether teaching dyslexic students phonics, lisping kids speech sounds, or autistic children how to tell a story. The research we read made the same point. Yet, those responsible for my education in the program — who knew I was neurodivergent — did not offer me the effective teaching we provided our clients.

Worst of all, these people all were friendly, expressed interest in helping me, offered a few accommodations, and seemed to genuinely want me to succeed.

I say “worst of all” because it’s hard to come to grips with a program effectively designed to push me out of the field, when the people delivering it don’t actually want that outcome, and are nice.

Perhaps that’s why I’m still hurt and angry about the whole experience.

TL;DR

I want people to understand:

• What matters is not how we learn skills.
• What matters is whether we learn them, and how well we use them.

Disclaimer

In expressing my frustration with the SLP program I attended, I do not intend to insult or discredit it. It has a good reputation and has turned out many excellent SLP’s. Most of my classmates seemed happy. I doubt my experience was typical for their students. I was also treated much better than many neurodivergent people who struggle with their higher education programs.