Readiness

What Is Readiness?

Dictionary.com defines readiness as: a developmental stage at which a child has the capacity to receive instruction at a given level of difficulty or to engage in a particular activity.

Vygotsky (1935, 1978) referenced this idea as the zone of proximal development.

It’s the idea that individuals are ‘ready’ to learn particular concepts, information, or skills.

Notice there are no ages associated with the actual definition of ‘readiness’, only stages.

We use ‘readiness’ socially to justify restricting driving to individuals who are 16 or older or voting until the age of 18 or starting kindergarten at age 5 (science has shown us we were right about this one in terms of brain development!) But, how and why did we decide that 18 was the age of majority for most things and for other things the age of majority is 21?

I argue that our individual concept of ‘readiness’ has morphed into a culturally-dependent sense of when things are supposed to happen. That can be a problem when it comes to the therapeutic process.

Who Decides When Families Are Ready for What?

I have no memories of my parents reading to me as a young child – at least as far back as I can remember. I remember my parents reading to my brother who is 15 months younger than me. I asked my mom about this a few years ago. And this was her answer — That’s because I taught you how to read right when you turned 3 and you’ve been reading yourself to sleep ever since.

I’m forever grateful that my mother recognized that I was ready to learn to read when I was 3. But, my brother wasn’t at the same age. And, she recognized that, too.

I think more adults who interact with children and their families need to take a more individualized approach like the one my mother took when introducing learning to read to my brother and me. We need to look past the child’s chronological age and see what the child and the family are really ready for.

We need to look at the child as part of the family structure as a whole. Maybe the child is ready to move forward, but the adults aren’t. In that case, we need to consider the adult’s degree of readiness. It’s taken a young, first-time mother of a toddler born at 23 weeks four months to get used to the idea that her child is ready to try to eat orally. (The toddler has been ready!) This mom has had to learn to see her child differently now that many of the life-threatening medical crises are behind them. She’s had to reach this stage of readiness herself. It’s taken pointing out that the toddler was beginning to mouth objects independently, not struggling while chewing on a variety of objects (including not drooling or gagging), pointing out all of the positive things going on while the toddler was actively chewing on things (e.g., good lip seal with zero spillage, good munching/chewing pattern, using the tongue to help move the teether from side to side, no change in heart rate or O2, etc.) to help this mom see that her child was ready to start trying at least pureed baby foods. It took a few sessions to help the mom see that the toddler’s refusal to put any food in their mouth was purely behavioral. We set up a behavioral contingency for that (first taste, then bubbles) and worked past it. And, the result is that just this week, the toddler sat in the high chair, opened their mouth when mom presented the spoon, and actually ate bites of pureed carrots willingly!

I also think cultural responsiveness comes into play here. By and large, the field is comprised of mainstream culture, middle class women. I think we need to step out of our comfortable, culturally bound shoes to look at situations from the families’ points of view. A family from a cultural and linguistic background with no history of using child directed speech isn’t going to be receptive to suggestions that they ‘baby talk’ to their child with a communication disorder. Before recommending that families read to their children, double check that the adults are literate in the primary language of the home. Be open to considering that families may view the roles of parent and teacher to be two separate things. In situations like these, ask questions. What is challenging for the family? Where would they like your help? Maybe it’s bedtime/nap routines. Maybe it’s brushing teeth. Maybe it’s they want the child to be able to play with other family members the same age. Maybe it’s something you didn’t think about. Start there. Work on those routines. Show the family you are sensitive to their needs and their readiness and willingness to address what you see as the child’s biggest concerns will come more naturally next.

Who Decides When Kids Are Ready For What?

I’ve written about this before in the context of phonology.

I’ll say it again. If you’re using Sander’s (1972) chart to justify waiting to intervene, then you’re doing speech sound intervention wrong. Sander’s whole point was that we should be intervening earlier.

Vygotsky’s zone of proximal development comes into play here. A short history lesson first: Vygotsky wrote the last chapter of his book on child development in 1934 as he was dying from tuberculosis. If you read his actual text (as I have), it’s very stream of consciousness and the concept of the zone of proximal development is not very well-fleshed out. However, I do think there’s a lot of value in what he was able to put on paper. The zone of proximal development includes those skills which may be too difficult for a person to acquire on their own, but which they can acquire when provided with the appropriate guidance from someone more knowledgeable, social interactions with peers, and/or scaffolding support from others.

Let’s go back to phonology for a moment. If a child is stimulable for (i.e., able to imitate) sounds they don’t produce spontaneously, then those sounds are on their way into the system and should be considered second tier intervention targets. The child can produce them with minimal support from others; consequently, these sounds fall much closer to the range of things they can do on their own. Non-stimulable sounds, however, fall firmly in the zone of proximal development. These sounds won’t be acquired without guidance from others. These are your first tier treatment targets.

Let’s go back to providing simplified input to non-verbal or minimally verbal children. I wrote about this just recently. Intentionally providing ungrammatical input to any client is definitely not part of providing support in the zone of proximal development. Nor is it culturally responsive. This is a practice I think we really need to re-examine. The input we provide can be simplified without making it ungrammatical.

Who decided that receptive language develops ahead of expressive language anyway? That’s conventional wisdom. It may very well be true for many individuals with communication disorders, but we know from the adult literature it’s entirely possible to have a disorder that affects comprehension but verbal output is relatively unaffected. (I’m looking at you fluent aphasias.) Why don’t we consider this possibility for children?

My own research with children at the 2-4 word stage suggests they are ready for much more of a challenge than we give them. Yes, you can expand children’s language at this stage by making them say, “please” or by trying to get them to use “describing” or “hot & spicy” words to expand the noun phrase. As an example, you can develop a goal where children will expand the noun phrase “the ball” to “the big ball” or “the red ball” or “the soccer ball.” It will encourage children to use more adjectives and it will make it look like they’ve increased their MLU. But, these types of goals won’t help them learn to use the appropriate pronouns or make their productive grammar more flexible. Why? Click here to read more on the research behind this. The next time you work with a child at the 2-4 word linguistic stage, consider the possibility they are ready for more than you think. The zone of proximal development is a range. What if you worked at the upper limits of a child’s ‘readiness’?

In other words, what if you reconsidered the ripple effect on your client’s lives and used a stone with more mass to set those ripples into motion? Because here’s a dirty little secret — if you find you’ve bitten off more than the child can chew, you can always revisit your goals. You can always back up a bit if you really, really need to.

Thank you for reading and I look forward to your comments!