Challenging the Tyrannous Practice of ‘age-appropriateness’ for People with Severe and Profound and Multiple Learning Difficulties by Julia Barnes

This article will describe and support the contention that ‘age-appropriateness’ can be a potentially tyrannous practice which may deny a voiceless minority experiences, activities and resources that can support learning and enhance lives.

When practitioners in services for children and adults with severe or profound and multiple learning difficulties (SLD or PMLD) discuss a new intervention, a criterion which may be applied to evaluate the approach is ‘age-appropriateness’.  As Forster (2010) suggests, the term implies a focus through which the worth of the intervention is assessed: are the materials, methodology or spirit of the intervention commensurate with an individual’s chronological age?  Initially this might seem a reasonable consideration, however, taken to an extreme, it becomes:

“[P]eople who have severe learning difficulties should only have experiences in-line with their chronological ages” (Nind and Hewett, 2006, p.161)

This is a doctrine demonstrating the power relationship between the dominant group who can decide and authorise what is chronologically ‘age-appropriate’ for people with learning difficulties.  This article will describe and support the contention that this can be a potentially tyrannous practice which may deny this voiceless minority experiences, activities and resources that can support their learning and enhance their lives.  

Having worked within the field of special needs since 2003, I have assimilated a cultural understanding of ‘age-appropriateness’ as it has been discussed and applied within special needs schools by practitioners I have met and worked alongside. I have encountered variations on the justifications for applying the doctrine of ‘age-appropriateness’:

1. Educationally: people with learning difficulties will progress and develop if offered opportunities ‘dictated’ to their chronological age rather than their developmental age.  

2. Sociologically: being chronologically ‘age-appropriate’ enhances a sense of respect and status for the person with learning difficulties.  

However, the research into any benefits of deployment of the doctrine of ‘age-appropriateness’ is nearly non-existent.  The majority of authors who decry the doctrine are educators who describe experiences of its limitations on pedagogy and curriculum offered to people with SLD and PMLD (Nind and Hewett, 1994, 1996; Smith, 1998; Peters, 1998; Samuel and Maggs, 1998; Stothard, 1998; Forster, 2010).  The next section of this paper will explore the merit of these justifications:

1. Educationally:

As an educationalist, it is challenging to understand the logic that students will learn effectively if presented with opportunities approximate to their chronological age regardless of their developmental age.  An established pedagogical theory is that of Vygotsky’s ‘zone of proximal development’ (ZPD) –  the difference between the most difficult task a child can do independently and the most difficult task they can do with support (Mooney, 2000). Experiences below a child’s ZPD are likely to be found boring and above, impossible (Lacey, 2009).  Due to the severity of their intellectual impairments (Male, 2015), learners with SLD and PMLD have an inconsistency between their cognitive and chronological ages – a gap that increases with age. The severity of the intellectual impairment of a teenager with SLD or PMLD means it would be inappropriate to expect them to attend a GCSE maths lesson and learn the discreet subject of mathematics.  However, expectations that educators adhere to ‘age-appropriateness’ can lead to special needs teachers adopting teaching methods that more closely resemble mainstream classrooms e.g. ensuring the class is sitting and working around a table to learn maths.  Or using and differentiating mainstream materials such as Shakespeare’s Romeo and Juliet text (Grove and Park, 1999).  Differentiation in this context means adapting materials to make them appropriate to specific learner(s) or group(s) of learners.  Done well it can provide a tangible experience that relates well to the original text.  Done badly it can resemble a disjointed set of experiences that have little resemblance of the original.  Imray and Colley decry this practice:

“[T]he philosophy and practice of teaching those on the SLD and PMLD spectrums is not just a matter of differentiation, it is fundamentally different. This leads to the inevitable conclusion we ought to be teaching them differently and indeed different things.” (Imray and Colley, 2017, p.3)

The argument isn’t the appropriateness of the differentiated text, Romeo and Juliet in my example, which I have enjoyed delivering to learners with SLD and PMLD complete with a recreated Elizabethan market and sword fighting!  But the choice of delivering this over more developmentally appropriate experiences such as engaging in Intensive Interaction which supports learners to develop the fundamentals of communication (Nind and Hewett, 2006).  Some of the earliest proponents of ‘age-appropriateness’ would appear to agree with the teaching of a different curriculum to students with SLD:

“[T]here are a substantial number of skills that students with significant disabilities will never acquire. Translating from Spanish to English, selling life insurance and driving a bus are but a few. Nevertheless, there are many chronological age appropriate skills that students with significant disabilities can indeed acquire. Eating, communicating and turning on a television are but a few.” (Brown et al., 1980, p.204)

Whilst the chronologically ‘age-appropriate’ examples provided by Brown et al. are likely to be achievable for someone with SLD, they are limiting and uninspiring. Today, educators are more likely to recognise the developmental need for play for students with SLD and PMLD (Orr, 2003; Corke, 2012), but considerable effort may be involved to try and give play opportunities a veneer of ‘age-appropriateness’. There is a need to search for theoretical underpinnings or guidelines which may support such educational practices. 

Guidelines, or academic and theoretical verification of the doctrine of ‘age-appropriateness’ to provision:

The most recent statutory guidance for special needs in England (Department of Education and Department of Health, 2015) has no mention of ‘age-appropriate’ within the 292 page document.  The most recent government guidance for teaching students with learning difficulties (Qualifications and Curriculum Authority, 2009) does not specifically mention ‘age-appropriateness’ but makes a couple of ambiguous statements:

“[T]he school curriculum might aim to… provide a wide range of learning experiences for pupils in each key stage suitable for their age (my emphasis) p.6”.

“[C]ontexts for learning…pupils are offered a variety of activities, resources and environments appropriate to their age (my emphasis) p.18”.

There is no definition of whether this is a reference to developmental or chronological age, leaving interpretation to individual schools.  

With the omission of ‘age-appropriateness’ from statutory documentation in England, I then continued the literature search by perusing authoritative texts on SLD and PMLD teaching, learning and curriculum between 1978 and 2015 and the publication of the comprehensive Lacey et al tome in that year:

I can find no rationale for ‘age-appropriateness’ as a teaching and learning or sociological conceptualisation. Moreover, only three of the texts have any entries whatsoever in the indexes. The texts make brief mention of ‘age-appropriateness’ without elaborating a rationale or defining the concept. Writing in ‘The Routledge Companion to Severe, Profound and Multiple Learning Difficulties’ (Lacey et al., (eds) 2015) have been the most established and authoritative UK practitioner-thinkers, lecturers and writers on issues of SLD and PMLD education.  The index shows one entry for ‘age-appropriateness’ and it may be illuminating to quote:

“Placing play as a central point in any curriculum for learners with SLD/PMLD, irrespective of the age of the individual involved… releases us all from the prison of ‘age appropriateness’ which rather strangely assumes that people no longer play once they have reached secondary age and certainly not once they are adults!” (Imray and Orr, 2015, p.357)

Describing ‘age-appropriateness’ as a ‘prison’ clearly illustrates the authors’ opinions of an oppressive construct from which people with SLD or PMLD should be freed.  

Surprisingly, there are few journal articles discussing ‘age-appropriateness’ (Brown et al., 1980; Calhoun and Calhoun, 1993; Matson et al., 1993; Messent et al., 2000; Forster, 2010).  The two most recent papers discuss the restrictive nature of applying notions of ‘age-appropriateness’. This view is supported by the authors of the seminal book chapter concerned with ‘age-appropriateness’ in special education (Nind and Hewett, 1996). The major texts on Intensive Interaction (Nind and Hewett, 2001, 2006; Hewett et al., 2012) include sections that reject ‘age-appropriateness’ dogma and provide a clear rationale for applying approaches that are developmentally and ‘person-appropriate’ (p.160). Smith eloquently sums this up:

“In order to treat people with learning difficulties with respect, our behaviour in relation to them must surely have to take into account their level of language development, their level of understanding of their social world and their emotional maturity.” (Smith, 1998, p.51)

Interestingly, Nind & Hewett also state that in all their interactions with schools and social care providers, they have never seen a written policy to support ‘age-appropriateness’ (2006, p.162; Hewett et al., 2012, p.135).  This concurs with my experience; I have never seen such a policy and when I discuss ‘age-appropriateness’ with other professionals, it seems their practice in this regard is not informed from written documentation but by cultural habits and workplace practices.

The lack of any theorising to support the educational justification of ‘age-appropriateness’ may indicate that practices in schools have been influenced by sociological theorising of ‘age-appropriateness’ without a sound understanding of these theories.  Differentiation, by its nature, requires the educator to consider the developmental age of a learner and present opportunities appropriate to that age. Therefore, prioritising ‘age-appropriateness’ for people with SLD and PMLD requires considerable effort to adapt the learning experiences of mainstream learners rather than utilising pedagogical approaches pertinent to this group of students.  

2. Sociologically:

To understand the sociological justification for ‘age-appropriateness’ it is important to consider the history of the conceptualization of normalization principles (Nirje, 1969). At the beginning of the past century, people with SLD and PMLD were likely to be institutionalised and deemed ‘ineducable’. The term was abolished as recently as 1972, for the first time entitling people with SLD and PMLD to an education (Department of Education and Science and Science, 1970).  Scandals and inquiries over the conditions and “care” of people in institutions (ELY HOSPITAL, CARDIFF: INQUIRY FINDINGS (Hansard, 27 March 1969), n.d.) resulted in targets for the closure of long-stay hospitals (Department of Health and Social Services, 1971).  In the subsequent search for a better model of provision, normalization principles were influential (Culham and Nind, 2003).  

The normalisation movement had its foundations in Scandinavia to cultivate opportunities for people with disabilities:

“Making available to the mentally retarded patterns and conditions of everyday life which are as close as possible to the norms and patterns of the mainstream society.” (Nirje, 1969, p.181)

As normalisation was adopted in the USA, UK and Australia, it was further transformed to emphasise ‘social role valorisation’ (SRV), which took the principle of normalization in a radically different direction.  SRV theorises that for people with disabilities to be valued by society, they need to adopt an image of and the roles of those valued by others in wider society (Forster, 2010, p.129).

“People who fill roles that are positively valued by others will generally be afforded by the latter the good things in life, but people who fill roles that are devalued by others will typically get badly treated by them (Wolfensberger, 2000, p.105).”

Wolfenberger’s concept of SRV focused on the image of people with learning disabilities rather than their needs or desires (Nind and Hewett, 1996, p.52).  Regardless of the gradually evolving conflicting opinions of the founders of normalization, severe notions of ‘age-appropriateness’ derived from the application of aspects of the theories, particularly with adults with SLD and PMLD.  In many areas it became an expectation in residential and day care provision, and almost a ‘standard’ to which the quality of provision could be inspected against (Reid et al., 2001). 

At the same time there was an intellectual and political movement headed by disabled people which led to the conceptualization of ‘The Social Model of Disability’(UPIAS, 1976, p.14).  A combination of normalization principles and the social model of disability led to greater expectations that ‘ordinary schools’ would adapt to accommodate all children (Norwich, 2010, p.91). Schools were expected to modify their environment and teaching to accommodate children with disabilities but they were in turn expected to change and ‘normalise’ themselves to gain acceptance (Culham and Nind, 2003, p.68).  

In their 2003 article, Culham and Nind describe the concept of normalization as a dominant force in social and educational policy in the UK across three decades. In 2005, when I started my teacher training, there seemed to have been a shift towards individualised learning perhaps due to the interest in learning styles at that time (Desmedt and Valcke, 2004).  A similar shift towards personalisation has occurred in social care (MENCAP, 2012) with a current focus on person-centred planning towards ‘A Good life’ (Johnson and Walmsley, 2010; Parry Hughes et al., 2018).

Due to the shift of towards person-centred approaches and lessening influences of ‘age-appropriateness’ (Nind and Hewett, 2006, p.158), it may seem trivial to question a practice that appears to be declining in special needs education and wider society.  However, any practice that oppresses a minority group because of their deviance from a perceived norm deserves questioning.  

Although it is difficult to find documented evidence on the harm caused by notions of ‘age-appropriateness’, there are examples.  For instance adults denied toy trains or dolls (Lovett, 1996, p.12), prevented from indulging in personal interests such as cartoons or playing on swings, having their personal possessions taken away, (Nind and Hewett, 2006), or having preferences for music in an exercise session being disregarded (Messent et al., 2000, p.261). These may seem minor infringements to lifestyle choices but removing choices from the lives of others is clearly a dominant group exerting power over a minority group.  What is most concerning are examples of notions of ‘age-appropriateness’ preventing the developmentally pertinent strategies to enable people with SLD or PMLD to develop through play (Stothard, 1998) or learning to communicate through the intervention of Intensive Interaction (Hewett and Nind, 1998).  

It is clear that in the examples within literature it is the professionals who have control over the environments.  As Ferri and Gregg point out, applying notions of ‘age-appropriateness’ to people with complex needs requires them to change so that they may be able to be included in society rather than ‘question their exclusion’ (1998, p.243). Which, critically, because of the severity and complexity of their learning difficulties, this heterogeneous group is unable to do (Garland-Thomson, 2001, p.2), resulting in dependence on their families, advocates and professionals to do so on their behalf. Segal extends the responsibility to question exclusion onto society:

“[I]t is imperative that we as a society, adapt environments to them, rather than pressure them to ‘adapt’ to the wider society (Segal, 2009, p.111).”

The reality is surely that in our society there is a minority group of people who, due to naturally occurring incidents or accidents of nature, have a tendency to behave in ways younger than their chronological age – what is the problem with that?  

Law professor and feminist philosopher Martha Nussbaum has attempted to objectively define an approach to a quality of life whilst attempting to make her definitions common to all and cross cultural (Nussbaum, 2000, p.231).  She challenges the male hegemony of reason by stressing the importance of emotion and passion in life (Johnson and Walmsley, 2010, p.37).  Nussbaum lists ten ‘Central Human Functional Capabilities’ (2000, p. 231-233) which have been adopted to help define wellbeing for people with PMLD (Colley and Tilbury, 2021).   But, for the purpose of troubling these notions of ‘age-appropriateness’, I shall consider three:

“4) Being able to use the senses to imagine, think and reason – and to do these things in a “truly human” way. A way cultivated by an adequate education… Being able to have pleasurable experiences (Nussbaum, 2000, p.232)”

As previously discussed, play is fundamentally important to the development of typically developing infants. It takes many forms, often appealing to all the senses (Grace, 2017).  People with complex needs require this accessible and developmentally pertinent way to learn (Imray and Orr, 2015), one that Stothard (1998) described as being frequently denied to learners under the doctrine of ‘age-appropriateness’. Similarly, denying people an established, widely researched and developmentally appropriate intervention such as Intensive Interaction because of notions of ‘age-appropriateness’ – perhaps over concerns over the public image of a communication partner conversing with someone with SLD through vocalisations (Samuel and Maggs, 1998, p.127) – is clearly a denial of Nussbaum’s ‘adequate education’.  

The young adults with SLD refused their preferred music in an exercise session described by Messent et al. are clearly being denied what Nussbaum describes as ‘pleasurable experiences’. This situation seems ludicrous as the session was intended to be ‘participant centred’ and therefore specifically designed to meet their needs. Evidently, notions of ‘age-appropriateness’ took precedence over enjoyment and participation (Messent et al., 2000, p.258). In turn, this creates a paradox: where attempts to accord people with SLD and PMLD adult status and dignity the effects of ‘age-appropriateness’ diminish personal power and ability to choose something as simple as to which music they would like to exercise.  

Although it seems ridiculous to need to justify an individual’s right to their own possessions, the capabilities approach clearly states this:

 “10.b) Being able to own property on an equal basis with others (Nussbaum, 2000, p.234).”

In wider society people may only be denied their personal property by legal confiscation of items bought illegally or used to threaten or harm others such as knives (Criminal Justice Act 1988).  Clearly items such as dolls and trains are not harmful and personal property cannot be confiscated from people with complex needs in the name of ‘age-appropriateness’.  

People with SLD and PMLD are so diverse it is very difficult to have public recognition of them and their needs.  However, Nussbaum’s Capability Approach requires precisely that:

“7)b …being able to be treated as a dignified being whose worth is equal to that of others (Nussbaum, 2000, p.232).”  

It seems we have become more accepting of adults in western society having needs to play, provided, for example, by video games and Lego kits with an 18+ label and price tag to match, favourite cuddly toys and comics. We need to extend this acceptance within education and all services as it is imperative that the needs and choices of people with SLD and PMLD are respected on an equal footing with others within their communities, including those that may attract comments from some who are ill-informed that they are not ‘age-appropriate’.

Julia Barnes, Special Needs Teacher and Post Graduate Researcher at The University of Birmingham

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