Cack-handed
Our bungled attempts to make sense of human difference
My older brother is left handed. He is a one in ten. According to what I was told as a child (probably by him), left-handed people are more intelligent. It made sense because he did much better than me at school. That explains it, I thought, and carried on neglecting my homework and messing about in class while he studied hard.
When he received his excellent exam results, we all went out to celebrate my sinistral sibling. Imagine what he could have achieved if only he were ambidextrous!
And yet, look up synonyms for left-handed and you will be offered cack-handed, clumsy, awkward, butterfingered, maladroit, graceless, and unskilled.
Born in a different time, my brother may have been thought unlucky, even evil. He may have had his left hand tied behind his back to force him to use his right hand in class. He may have been beaten for doing otherwise. Throughout history, leftness has been associated with wrongness. The word sinister derives from the Latin for left, as does sinistral, the technical term for left-handedness.
Fortunately, we live in enlightened times. For around five decades, according to the academic Chris MacManus in his excellent article on the subject, researchers have set about understanding the causes and correlations of this human trait.
What has been established in half a century of research? Surprisingly, not much. Left handedness is not new; there is evidence of left-handedness in Neanderthals over 500,000 years ago. Rates of left-handedness are stable between populations and over time. It is tied in some way to brain asymmetry and which hemisphere specialises in language, but not strongly. There is a genetic origin, but no single gene that determines preference. Intriguingly, males are slightly more likely to be left handed than females, and homosexuals more likely than heterosexuals. No-one knows why.
We do not know, despite trying really hard to find out, how left-handedness develops, the interplay between genetic and environmental factors, and how it is linked to other traits.
Various sinistral neuromyths have arisen, been pursued by academics, then eventually put to bed. These include claims that left handed people die younger, had traumatic births, have higher IQs, are more creative, or have a more dominant hemisphere of the brain than right handed people do.
In roughly the period of time since my brother was born left-handedly into the world, little research has been done as to the lived experience of left handed people. We know that society has evolved to favour the majority right-handed population (quelle surprise!), from the design of equipment to the custom of writing from left to right. However, left handed people can also gain advantages, such as in sport. We no longer associate left-handedness with evil, bad luck, or defect, nor with natural advantage or ability. It is simply a part of human difference and any disability that results from being left handed is the fault of the way we have designed our world, not a dysfunction of the individual.
Engines of discovery
The story of left-handedness follows a familiar path for how we make sense of human difference. The philosopher of science, Ian Hacking, identified 10 mechanisms which describe society’s response to human variation.1 Applied to left-handedness, they are as follows:
First, we noticed those with a difference (we could count them), then quantified this (one in ten). This created a norm, in this case, right handedness. Left handedness was correlated with dysfunction (or evil, or bad luck) and treated through cure or correction (medicalised). Next, we looked for biological and genetic causes, all the time finding ways to normalise left-handedness by providing adapted equipment and dispelling neuromyths. Identification of difference was bureaucratised in schools so that barriers could be removed (like different pens for left handed children). Finally, left handed people reclaimed their identity, insisting that society accept their difference as a normal part of human diversity.
Left handed people have always existed, but Hacking argues that the above process creates a group and an identity that ‘in a sense did not exist before’. Society has found the means, through scientific method, to categorise and create meanings which then become identities, ideologies, and movements.
To frame this in another way, this process progresses from how people are, to what people have, to who people are. What we choose to measure, categorise, and label is a choice - one which defines identities.
Of course, left handedness manifests in a way that is easy to identify, count, quantify and define. There is no sense in which left-handedness was ‘discovered’. However, as our measuring tools become more sophisticated we are able to count, quantify and categorise more shades of human difference.
One example he gives is the ‘discovery’ of Multiple Personality Disorder (MPD) in the 1970s.2 MPD became quite a thing during that era, both in the media and in the real world. There was a rapid increase in the number of people not only being diagnosed but also in the number of people presenting with symptoms. The number of personalities possessed by one person also proliferated from 2/3 to an average of 17! A new person came into being: the multiple. There were even (allegedly) special bars where multiples could socialise (in America, I’m guessing).
Multiple Personality Disorder became Dissociative Identity Disorder, a classification which defined suffering in a different way, without distinct personalities. Consequently, fewer people presented claiming to have multiple personalities. It is important to note that Hacking is not claiming that the people who sought help ‘made up’ their condition or that any suffering or coping difficulties were not real. His point is that the way they made sense of themselves was influenced by societal constructs.
The multiple personality era influenced one of my all-time favourite films, Quadrophenia. In it, Jimmy, a troubled young man struggling with mental illness, existential despair, and the violence that rages between the mod’s and rockers in 1960s Brighton, is challenged by his (rocker) friend who tells him his behaviour is not normal. “What’s normal, then?” Jimmy replies, “What’s that?”
Good question, Jimmy. I’ll come back to you on that.
The hidden q factor
If the multiple personality example is a little out-there, let’s apply Hacking’s mechanisms to something more mainstream: intelligence.
In Testing Times, Gordon Stobart examines how the act of assessing and measuring has the ability to create types of people. He argues that our conception of intelligence has come into existence as a result of what we choose to measure and subsequently reify (think into existence). Stobart is not arguing that intelligence isn’t a thing, but that it has transformed from being a way of describing human behaviour (an outcome of who we are and what we have experienced) to a way of explaining it - a biological cause. But intelligence cannot, he argues, be the cause of our intelligence any more than success can be the cause of our success.
The reification of intelligence follows Hacking’s mechanisms, beginning with inventing tools with which to measure human difference, classifying people accordingly (spawning a lexicon of distasteful language to describe those at the lower end of the bell-curve), normalising and sub-normalising, searching for biological and genetic causes, and innovating and institutionalising accommodations and corrections. Throughout, a mysterious correlate known as ‘g’3 has been assumed to be a causal constant, as yet undiscovered or unexplained, but ‘revealed’ through our measures. Stobart quotes John Stuart Mill to highlight the absurdity of this logic:
The tendency has always been strong to believe that whatever received a name must be an entity or being, having an independent existence of its own. And if no real entity answering to the name could be found, men did not for that reason suppose that none existed, but imagined that it was something particularly abstruse and mysterious.4
Stobart highlights the ways in which the methods of testing have shaped the concept of intelligence. Intelligence tests often use a single scale, therefore promoting the idea that it is a single thing being measured. The reporting of results on a numerical scale creates the belief that some people can hold more intelligence than others - it is quantifiable. The development of techniques for mass testing, such as multiple choice questions, allowed classification and the ranking of social groups. Coupled with the view that what is being measured is an underlying, fixed, capacity rather than the accumulation of ability, it becomes possible to make claims about the ‘natural’ intelligence of various groups.
Today, despite the dispelling of many neuromyths and the rejection of distasteful notions of biological superiority, we hear people refer to themselves using the language of ability, natural gifts, and inherited intelligence. Hacking’s claim comes to mind: ‘sometimes our sciences create kinds of people that in a sense did not exist before’.
Taking stock of where we are so far, we should reflect that left-handedness, personality disorders, and intelligence are all real things in that they describe the ways we interact with the world. In each case, to varying degrees, we have socially constructed meaning which affects the identity, even the behaviour, of those whom we describe and this meaning has real-world consequences in how institutions are structured and function. We should be cautious in how we drive our engines of discovery.
We also have failed to identify a simple causal mechanism in each case. However, our lack of insight should not stop us from acting to reduce the barriers those affected have to living fulfilling lives.
Complex etiologies
In a recent paper titled ‘A network approach to developmental differences and disorders’, Deniz et al5 take to task the ‘single deficit approaches’ which assume named disorders have simple causes, arguing that things are, well… a little more complicated than that.
Diagnostic nosology, the naming of clusters of traits or symptoms on the assumption that their co-concurrence reflects an underlying pathology, is a top-down approach which has resulted in diagnoses such as depression, ADHD, autism and dyslexia. One attempt to overcome the limitations of a single deficit approach is to posit latent vulnerabilities which drive symptoms and characteristics: the p- and g- factors, p being a vulnerability to psychopathology and g being cognitive development vulnerability. Sound familiar? We’re not a million miles away from the search for the source of general intelligence again.
Deniz et al advocate for an alternative approach which posits that ‘characteristics or symptoms arise together because they are causally related’. This bottom-up perspective casts diagnostic categories as social constructs - the outward signs of complex developmental processes. Network approaches seek to model how differences and disorders arise from interactions between characteristics and symptoms, such as memory, attention, non-verbal ability, reading, language, motor skills, social functioning and wellbeing. This theory may explain why diagnostic categories often overlap and share symptoms and also why two people with the same diagnosis can be so different in their profile.
Their conclusion is that what appear to be neurodevelopmental and psychiatric conditions may in fact ‘be underpinned by diverse etiologies’ in children. They advocate for an approach in schools which targets ‘specific characteristics and symptoms with the aim of deactivating clusters’, rather than focussing on diagnostic categories.
None of this is to say that so-called ‘neurodivergent’ and psychological conditions don’t exist. But perhaps these labels are descriptive, not explanatory: as people can be intelligent, they can equally be autistic, dyslexic, or depressed. However, it may be that there is no common, underlying cause at work and that outcomes that cluster together reflect very different profiles and histories.
The thing is that we don’t really know anything for certain. If it took fifty years to get this far in understanding left-handedness, I suspect we have a long way to go to get a grip on the remainder of human difference. However, as an educator in a mainstream setting, a network approach is appealing because whilst scientists are creating types of people through their diagnostic categories, I would prefer to be supporting children with specific difficulties. I am interested in a child’s interaction with lessons and school, in how this plays out, in what barriers there are to their successful engagement, and not in the label they have been given.
For the most part, descriptions trump explanations for teachers, particularly when the explanations create circular arguments. For example, a student may become overwhelmed in class when the environment becomes unpredictable and chaotic (a description which contains the conditions and response). You may say that the student becomes overwhelmed because she is autistic. I ask how do you know she is autistic? You reply, because she gets overwhelmed (amongst other things). The diagnostic label is really just getting in the way, whereas the description enables me to predict the student’s behaviour and do something to help. You may argue that ‘autistic’ conveys the information that this is a student who may become overwhelmed, but it really just tells me something about the distribution of characteristics within the diagnostic group, not information about this child. And if the network theory is correct, the diagnostic label may be naming something that looks similar between people on the surface but is vastly more complex in its emergence.
Does this apply to left-handedness? You may argue that saying ‘this student is left handed’ is no different to saying ‘this student writes with their left hand’. But I disagree. The latter is more specific and contextual. Some people who write with their left hand may favour their right hand for other tasks. Context matters but is often forgotten about when we leap to label children.
How schools reify dysfunction
Once we move away from abstract nouns and move towards descriptions of behaviours, we start to appreciate the contextual nature of many ‘characteristics’ which have been attributed to the person.
For the following section of this post, I am going to draw upon two pieces by Bernard Andrews, here and here. Andrews’ writing can be rather esoteric due to the forensic way he dissects meaning but I find his words worth studying. In the first of these posts, he argues that most psychological terms are adverbial because they have meaning in relation to ‘the manner in which the action was done’. To illustrate, Andrews takes the definition of ADHD from WHO’s International Classification of Diseases, which is ‘A persistent pattern (e.g., at least 6 months) of inattention symptoms and/or a combination of hyperactivity and impulsivity symptoms’. He asks:
How do we define any of the key terms here? Inattention, hyperactivity, and impulsivity are what philosophers call ‘polymorphous’ concepts —they take on different forms in different contexts. So what might be hyperactive in a classroom isn’t on a football field. Attention doesn’t look the same in every context. Compare what it means to pay attention in a classroom, with paying attention during a fitness class. There is no action or set of actions that necessarily occurs in all examples of attentive behaviour — we have to investigate the adverbial content to establish what counts as paying attention: where are we? From whose point of view? Paying attention to whom or what? And so on.
Many times in my career I have heard teachers comment that a particular child is ‘a completely different person’ when observed in a different context from the classroom. Perhaps the teacher has taken the student on a school trip, visited them on their work experience placement, or knows the child in a social context due to having children of the same age.
We also know, anecdotally, people who really did not get on well at school but who have been successful in their chosen occupation because they have found their niche, found ways to cope with the world, or just because they have grown up!
Schools are weird. Outside of education, where else would we require people to do the sort of things we require them to do at school? At what point in your adult life have you been made to sit in a room for hours at a time listening to someone talk and doing directed tasks with pen and paper? I ask this not to suggest some radical reformation of the system is needed; the mass schooling system remains the most efficient and effective way of educating the nation’s children, as flawed as it is. I am simply observing the weirdness of this arrangement.
I have heard it said many times recently that the higher education system is far more inclusive than school - that young people who struggled to attend school go on to be successful in universities. It is no surprise to me, particularly since the pandemic. Lectures can now be attended in person, online, watched later, or skipped entirely. Even when attended in person, it is often possible to hide at the back and avoid any interaction. I know of one young person who achieved a first-class degree without hardly ever attending a lecture or even knowing that degrees have classes!
The workplace is increasingly offering these flexibilities too. And so, it is becoming ever more the case that schools are requiring things of children that in adulthood are largely avoidable.
When Andrews says that attention is adverbial, I am reminded that finding it difficult to maintain attention in classes throughout the school day says as much about the system as it does about the child. We must be cautious in explaining this by attributing a label of attentional disorder to the child, which we then go looking for. Andrews invokes John Stuart Mill’s case (quoted above) when he says:
The danger of construing attention as substantival [pointing to a particular object] rather than adverbial is that we then need to find the substance to which it refers — and since no substance can be found, we assume that it must be hidden.
Logical leaps that problematise children
The tendency to observe a behaviour and reason towards a dysfunction when no dysfunction exists is a form of attribution error. What we are observing is the way an individual and a circumstance interact. What we attribute this to is a characteristic of the child.
It is this attributional error that undermines the concept of additional learning needs. The SEND Code of Practice identifies categories of need such as cognitive, speech and language, and social and emotional needs. If you ask a teacher what they understand by these needs they will likely imply that they are situated with the child rather than describing a need which arises due to the interaction of the child with their environment. This is a subtle but important distinction.
To illustrate, let’s return to left handedness. A left handed child may have a need for left handed equipment, like scissors. The need arises due to their left handedness. Or does it? In a world where the majority of people were left handed, it would be the right handed person in need of special provision. This is an example of the social model of disability.
Now let’s consider colour blindness in the form of a child who cannot distinguish between red and green due to a condition called deuteranomaly, a dysfunction in the green cone cells in the eye. There is a known biological cause for this, therefore attributing the need as arising from the child is more justifiable. However, we should accept that this difference would not cause disability if our society did not rely so much upon being able to distinguish red from green (in traffic lights, for example). So in some sense, although the impairment is arguably a dysfunction (because human eyes should be able to distinguish red from green), the need arises when this impairment meets context. This view combines biological and social perspectives to understand how a need manifests.
The situation is even less clear when we consider the adverbial characteristics identified by Andrews. For example, hyperactivity in a classroom may be an outcome of complex origins and in part context dependent, but we readily look to cast it is substantive and indicative of an underlying cause (a pathological vulnerability). There is indeed a need to do something, but this need does not require us to diagnose. Indeed, diagnostic labels promote an attribution error and draw attention away from other factors. For example, has a dyslexic child been taught to read well in the first place? Is an attentional deficit in part due to excessive screen-time in early childhood? Is the hyperactive child just bored?
It is for these reasons that I advocate for the language of barriers before needs. Barriers to learning may arise due to impairment (like colour blindness) or due to circumstance (like being in the left-handed minority), but almost always due to the confluence of both individual difference and context. Identifying barriers reduces the risk that we attribute dysfunction solely to child - ‘this child has needs’ - rather we should say ‘there is a need to’.
There is a further logical leap that Andrews identifies that is relevant to our argument here and that is a confusion about what we mean by ‘typical’. Listen up, Jimmy. I’m about to answer your question.
What’s normal then?
Andrews argues that we confuse two different meanings of the word typical in education, as follows:
Normatively typical - what is constitutive of a kind of thing
Statistically typical - what is true of most instances of that kind
He illustrates this difference by asking what is typical of a heart? It is both true to say that a heart typically pumps blood around the body (normative - that’s what hearts do) and that a heart is typically less than two metres above the ground (statistically correct, but it tells us nothing about what hearts should do).
This confusion leads us to conflate things that are statistically atypical with things that indicate abnormal function. For example, there is a continuum of ability in recognising human emotions from facial expressions - some people are better at it than others. Inevitably, therefore, some of us will be at the lower end of the distribution and this may cause us difficulty. This creates a ‘need’ for support in social environments such as schools where there are repercussions for not being able to read emotions easily. Our SEN system places a (fairly arbitrary) cut-off along this continuum, creating a sense of abnormality. However, this is a statistical atypicality, not a normative one.
Andrews’ concern is that this confusion creates an error of reasoning whereby we slide from saying ‘most children do X’ to claiming ‘children ought to do X’.
This is the logical fallacy: we can’t say things like ‘most students do X’ therefore ‘students ought to do X’. We can, however, describe the normative functions of particular organs etc. and point out when they are not working as they should, or when someone has a particular disability.
As our meritocratic education system has increasingly found ways of measuring ‘ability’ along single scales, what is revealed to us is that most children ‘keep up’ whilst some ‘fall behind’. The ought-from-a-most fallacy sets alarm bells ringing with parents who want an explanation for this difference, which the SEN system and diagnostic industry is happy to provide. Statistical atypicality becomes (alleged) normative atypicality, with all the connotations of dysfunction that these ‘explanations’ provide.
And this fence is where neurodiversity has also fallen, a term coined to capture the glorious diversity of human kind, now re-coined to describe a type of person who finds themselves caught up in this mish-mash of constructs, myths, conceptual confusion, and identity politics. Celebrating the diversity of humans is a good thing; labelling some as categorically different just because they are statistically atypical in some regard feels like a retrograde step.
There are children with normatively atypical disabilities. Many of these children are educated in specialist settings. I visited a number of special schools recently to understand better the challenges facing this sector. What is palpable is the difference between normative atypicality - inability to speak, to move, to connect - and the statistical atypicality we manage in mainstream settings. Understanding where human functioning moves from being somewhere on a continuum to being a categorical difference where things are not as they ought to be feels important. It is a threshold which might inform decisions about where legal protection and a fundamentally different form of provision is needed.
The right to an education
The Human Rights Act (1988) states that ‘No person shall be denied the right to an education’. This right is a good place to start if we want to make our schools more inclusive because it begs the question, ‘What would prevent this right from being fulfilled?’, which in turn leads us to consider barriers, which in turn points to need.
These barriers may be financial, logistical, cultural, discriminatory, circumstantial, biological, psychological or historical. It is important that we consider this range of barriers and do not inadvertently preference a limited number, such as financial disadvantage and special educational needs (which the new Ofsted framework appears to do). It is important for two reasons. First, there is no moral hierarchy whereby one type of barrier trumps another. A child prevented from accessing education due to a medical condition, due to financial disadvantage, due to family circumstance, or due to language barriers, all place an equal moral responsibility on us to act (although the legal duties differ). Second, barriers hunt in packs. It is likely that there are multiple, interrelating factors that create barriers for children.
To be an inclusive school means to enforce the right to an education for every child by taking reasonable steps to reduce barriers and/or adjust provision to meet need.
However, there is another duty on schools which is to achieve the above without harm. We do not have a good track record in this regard.
We do harm when we are more certain than we have a right to be. We do harm when we move from description to prescription, both in terms of telling people how they should be and medicating them accordingly. We do harm when we count, quantify and classify human difference without fully understanding what it is we are measuring or stopping to think about how this might affect those being labelled.
As educationalists, we should concern ourselves with how people are in the here and now, not who they are according to some taxonomy; with specific needs, not generic descriptors; with pragmatic accommodations, not murky etiologies. To do otherwise is cack-handed.
I have drawn this example and the summary of Hacking’s theory from Testing Times by Gordan Stobart rather than the source material. See here for more.
A measure of general intelligence developed by Charles Spearman in 1904.