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  <channel>
    <title>heterogeneity &amp;mdash; Language &amp; Literacy</title>
    <link>https://languageandliteracy.blog/tag:heterogeneity</link>
    <description>Musings about language and literacy and learning</description>
    <pubDate>Sun, 19 Apr 2026 11:03:58 +0000</pubDate>
    <image>
      <url>https://i.snap.as/LIFR67Bi.png</url>
      <title>heterogeneity &amp;mdash; Language &amp; Literacy</title>
      <link>https://languageandliteracy.blog/tag:heterogeneity</link>
    </image>
    <item>
      <title>A Finale: Learning to Read and Write is a Remarkable Human Feat</title>
      <link>https://languageandliteracy.blog/a-finale-learning-to-read-and-write-is-a-remarkable-human-feat?pk_campaign=rss-feed</link>
      <description>&lt;![CDATA[  The first thing that happened to reading is writing. For most of our history, humans have been able to speak but not read. Writing is a human creation, the first information technology, as much an invention as the telephone or computer.&#xA;&#xA;  —Mark Seidenberg, Language at the Speed of Sight&#xA;&#xA;What is (un)natural about learning to read and write? We began our quest with this question, prompted by two references in a line in a David Share paper.&#xA;&#xA;  Like learning to read (English) which Gough famously dubbed “unnatural” [43], see also [3], becoming aware of the constituent phonemes in spoken words does not come “naturally”.&#xA;&#xA;  —Share, D. L. (2021). Common Misconceptions about the Phonological Deficit Theory of Dyslexia. Brain Sciences, 11(11), 1510.&#xA;&#xA;This led us to unpack three foundational papers from 1976 to 1992 that have provided us with some surprising twists and turns and even moments, dare I say, of clarity.&#xA;&#xA;!--more--&#xA;&#xA;Rather than spend too much time re-hashing what we’ve already covered, I wanted to take an opportunity to further reflect on what I’ve learned and on where I currently stand after all these geeky deep dives (I took a brief interlude between the 1st two papers to ruminate as well).&#xA;&#xA;I believe that this debate about what is “natural” about teaching early reading is far more fundamental than it seems. For example, the “sage on the stage” vs. “guide on the side” divide surfaces in the Goodmans’ account of what effective teaching and learning should be for early reading, reflecting a deep-seated romantic tendency to elevate the status of children, wherein there is the belief that if we just allow children to learn “naturally,” they will somehow discover complex academic concepts.&#xA;&#xA;This is true of social language. The swiftness with which we acquire our native language(s) as children is remarkable. Yet even here we must be careful. There are some children that do not learn and develop language at the same rate that others do, perhaps due to differences in working memory and other neurobiological reasons. This tells me that Liberman’s conjecture that speech is pre-cognitive may have been too bold.&#xA;&#xA;Effortful, Rather Than Unnatural&#xA;&#xA;Tracing these arguments has helped me to see more clearly that language and literacy development are on a spectrum from effortless to effortful, with another axis around the individual profile of a child that requires either more explicit instruction and deliberate practice or greater opportunities for more independent implicit learning. There are certain abilities that are more commonly effortless for most children, such as learning a first language, and others that are more commonly effortful for many, such as learning to break the code. And some children find effortless ones more effortful, and other children find the effortful ones also quite effortless (lucky them).&#xA;&#xA;This applies to any skill: some kids can jump on a bike and start riding almost immediately, while others will need quite a lot of explicit modeling and practice with training wheels. Some kids can swim like a fish after a few lessons and practice, while other kids (like me) will only develop a half-sufficient dog paddle even after swim lessons, living near the ocean, and having a pool in their backyard.&#xA;&#xA;The analyses of G&amp;H and Liberman have helped me to identify more precisely where the greatest effort in learning to read in English lies: at the sublexical level—the level of phonemes and letters and letter sequences—a level that is, in their estimation, “unnatural,” because these sublexical units are “meaningless” and “artificial,” in the sense that they are “arbitrary.”&#xA;&#xA;We do need to acknowledge there is an “artificiality” to written language. This artifice allows us to map “arbitrary” symbols onto our spoken language and record them for all time.&#xA;&#xA;Yet I am concerned that framing learning sublexical units as completely unnatural may be a turn-off to those who would decide that teaching them is therefore antithetical to the goal of channeling the innate and “natural” curiosity and potential of children to read. I mean, there are still active and inflamed debates about phonics going on, and we’re trying to bring people on board here.&#xA;&#xA;Gough and Hillinger’s analogy of learning to read to cryptanalysis is a highly useful one, but I am not convinced that warrants calling the process unnatural. Ever heard of the genetic code? Nature has its own alphabetic cipher going on!&#xA;&#xA;Learning to Read is Learning to Control a Flame&#xA;&#xA;Instead, I think we should focus on the fact that written language is a remarkable feat of human development, as awe-inspiring as rocket ships, as innovative as smartphones, and as individually empowering as the automobile (though with far less toxicity).&#xA;&#xA;While I find Liberman’s distinction between oral language as biological in origin and written language as cultural useful, I also think it’s again more of a question of a spectrum, rather than a sharp divide. We have no biological, innate ability to create fire, for example. Our ability to create controlled flame is entirely driven by human culture. Yet fire is so deeply interwoven into the propagation of our species that it is intimately tied to our biological evolution and survival. Would we say that learning to make fire is “unnatural”?&#xA;&#xA;This is mostly a matter of rhetoric, of course. The reason for G&amp;H and Liberman’s branding of “unnatural” was to highlight the fact that learning to decode written language can be challenging, and to try and unpack exactly why that is.&#xA;&#xA;So let’s instead focus on the fact that learning to break apart spoken words into little pieces of phonemes to attach them to letter sequences (and vice versa) is both abstract and effortful for many children, and also an absolutely amazing collective and individual achievement. This allows us to see that it therefore will most likely require explicit support and deliberate practice, and that furthermore it is well worth getting kids pumped up about gaining it.&#xA;&#xA;This is where we also need to bear in mind the spectrum in what students bring to their first encounters with formal instruction with written language. Nancy Young’s updated Ladder of Reading and Writing is a great depiction of this spectrum, which acknowledges that there are indeed a small percentage of children for whom acquiring literacy will be mostly effortless, while for the majority of kids, a structured literacy approach is needed, with more intensity required for some.&#xA;&#xA;We also know that students bring different spoken dialects and languages to the classroom, and the nature of those dialects and languages may influence the form of code-based instruction that could be highest leverage.&#xA;&#xA;Let’s also remember a caution that both Gough and Goodman made in their respective papers: we can’t just hand over a codebook of rules to our kids. They must ultimately internalize the cipher themselves. What is the right balance of explicit and implicit learning, of difficulty and ease, of guided and independent practice? What are the profiles of student that we have in our classroom, and how can that guide us in determining the level of structure that we need to provide?&#xA;&#xA;Well, clearly, there’s more to explore here, with plenty of controversy remaining. If you’ve stuck with me this far, I salute you! Thanks for reading.&#xA;&#xA;#natural #unnatural #innate #language #literacy #reading #writing #heterogeneity #implicit #explicit&#xA;&#xA;a href=&#34;https://remark.as/p/languageandliteracy.blog/a-finale-learning-to-read-and-write-is-a-remarkable-human-feat&#34;Discuss.../a]]&gt;</description>
      <content:encoded><![CDATA[<blockquote><p>The first thing that happened to reading is writing. For most of our history, humans have been able to speak but not read. Writing is a human creation, the first information technology, as much an invention as the telephone or computer.</p>

<p>—Mark Seidenberg, Language at the Speed of Sight</p></blockquote>

<p><strong>What is (un)natural about learning to read and write?</strong> We <a href="https://write.as/manderson/what-is-un-natural-about-learning-to-read-and-write">began our quest</a> with this question, prompted by two references in a line in a David Share paper.</p>

<blockquote><p>Like learning to read (English) which Gough famously dubbed “unnatural” [43], see also [3], becoming aware of the constituent phonemes in spoken words does not come “naturally”.</p>

<p>—Share, D. L. (2021). Common Misconceptions about the Phonological Deficit Theory of Dyslexia. Brain Sciences, 11(11), 1510.</p></blockquote>

<p>This led us to unpack three foundational papers from 1976 to 1992 that have provided us with some surprising twists and turns and even moments, dare I say, of clarity.</p>



<p>Rather than spend too much time re-hashing what we’ve already covered, I wanted to take an opportunity to further reflect on what I’ve learned and on where I currently stand after all these geeky deep dives (I took a brief interlude between the 1st two papers to ruminate as well).</p>

<p>I believe that this debate about what is “natural” about teaching early reading is far more fundamental than it seems. For example, the “sage on the stage” vs. “guide on the side” divide surfaces in the Goodmans’ account of what effective teaching and learning should be for early reading, reflecting a deep-seated romantic tendency to elevate the status of children, wherein there is the belief that if we just allow children to learn “naturally,” they will somehow discover complex academic concepts.</p>

<p>This is true of social language. The swiftness with which we acquire our native language(s) as children is remarkable. Yet even here we must be careful. There are some children that do not learn and develop language at the same rate that others do, perhaps due to differences in working memory and other neurobiological reasons. This tells me that Liberman’s conjecture that speech is pre-cognitive may have been too bold.</p>

<h1 id="effortful-rather-than-unnatural" id="effortful-rather-than-unnatural">Effortful, Rather Than Unnatural</h1>

<p>Tracing these arguments has helped me to see more clearly that language and literacy development are on a spectrum from effortless to effortful, with another axis around the individual profile of a child that requires either more explicit instruction and deliberate practice or greater opportunities for more independent implicit learning. There are certain abilities that are more commonly effortless for most children, such as learning a first language, and others that are more commonly effortful for many, such as learning to break the code. And some children find effortless ones more effortful, and other children find the effortful ones also quite effortless (lucky them).</p>

<p>This applies to any skill: some kids can jump on a bike and start riding almost immediately, while others will need quite a lot of explicit modeling and practice with training wheels. Some kids can swim like a fish after a few lessons and practice, while other kids (like me) will only develop a half-sufficient dog paddle even after swim lessons, living near the ocean, and having a pool in their backyard.</p>

<p>The analyses of G&amp;H and Liberman have helped me to identify more precisely where the greatest effort in learning to read in English lies: at the sublexical level—the level of phonemes and letters and letter sequences—a level that is, in their estimation, “unnatural,” because these sublexical units are “meaningless” and “artificial,” in the sense that they are “arbitrary.”</p>

<p>We do need to acknowledge there is an “artificiality” to written language. This artifice allows us to map “arbitrary” symbols onto our spoken language and record them for all time.</p>

<p>Yet I am concerned that framing learning sublexical units as completely <em>unnatural</em> may be a turn-off to those who would decide that teaching them is therefore antithetical to the goal of channeling the innate and “natural” curiosity and potential of children to read. I mean, there are still active and inflamed debates about phonics going on, and we’re trying to bring people on board here.</p>

<p>Gough and Hillinger’s analogy of learning to read to <em>cryptanalysis</em> is a highly useful one, but I am not convinced that warrants calling the process <em>unnatural</em>. Ever heard of the genetic code? Nature has its own alphabetic cipher going on!</p>

<h1 id="learning-to-read-is-learning-to-control-a-flame" id="learning-to-read-is-learning-to-control-a-flame">Learning to Read is Learning to Control a Flame</h1>

<p>Instead, I think we should focus on the fact that written language is a remarkable feat of human development, as awe-inspiring as rocket ships, as innovative as smartphones, and as individually empowering as the automobile (though with far less toxicity).</p>

<p>While I find Liberman’s distinction between oral language as biological in origin and written language as cultural useful, I also think it’s again more of a question of a spectrum, rather than a sharp divide. We have no biological, innate ability to create fire, for example. Our ability to create controlled flame is entirely driven by human culture. Yet fire is so deeply interwoven into the propagation of our species that it is intimately tied to our biological evolution and survival. Would we say that learning to make fire is “unnatural”?</p>

<p>This is mostly a matter of rhetoric, of course. The reason for G&amp;H and Liberman’s branding of “unnatural” was to highlight the fact that learning to decode written language can be challenging, and to try and unpack exactly why that is.</p>

<p>So let’s instead focus on the fact that learning to break apart spoken words into little pieces of phonemes to attach them to letter sequences (and vice versa) is both abstract and effortful for many children, and also an absolutely amazing collective and individual achievement. This allows us to see that it therefore will most likely require explicit support and deliberate practice, and that furthermore it is well worth getting kids pumped up about gaining it.</p>

<p>This is where we also need to bear in mind the spectrum in what students bring to their first encounters with formal instruction with written language. Nancy Young’s updated <a href="https://www.nancyyoung.ca/blog">Ladder of Reading and Writing</a> is a great depiction of this spectrum, which acknowledges that there are indeed a small percentage of children for whom acquiring literacy will be mostly effortless, while for the majority of kids, a structured literacy approach is needed, with more intensity required for some.</p>

<p>We also know that students bring different spoken dialects and languages to the classroom, and the nature of those dialects and languages may influence the form of code-based instruction that could be highest leverage.</p>

<p>Let’s also remember a caution that both Gough and Goodman made in their respective papers: we can’t just hand over a codebook of rules to our kids. They must ultimately <em>internalize</em> the cipher themselves. What is the right balance of explicit and implicit learning, of difficulty and ease, of guided and independent practice? What are the profiles of student that we have in our classroom, and how can that guide us in determining the level of structure that we need to provide?</p>

<p>Well, clearly, there’s more to explore here, with plenty of controversy remaining. If you’ve stuck with me this far, I salute you! Thanks for reading.</p>

<p><a href="https://languageandliteracy.blog/tag:natural" class="hashtag"><span>#</span><span class="p-category">natural</span></a> <a href="https://languageandliteracy.blog/tag:unnatural" class="hashtag"><span>#</span><span class="p-category">unnatural</span></a> <a href="https://languageandliteracy.blog/tag:innate" class="hashtag"><span>#</span><span class="p-category">innate</span></a> <a href="https://languageandliteracy.blog/tag:language" class="hashtag"><span>#</span><span class="p-category">language</span></a> <a href="https://languageandliteracy.blog/tag:literacy" class="hashtag"><span>#</span><span class="p-category">literacy</span></a> <a href="https://languageandliteracy.blog/tag:reading" class="hashtag"><span>#</span><span class="p-category">reading</span></a> <a href="https://languageandliteracy.blog/tag:writing" class="hashtag"><span>#</span><span class="p-category">writing</span></a> <a href="https://languageandliteracy.blog/tag:heterogeneity" class="hashtag"><span>#</span><span class="p-category">heterogeneity</span></a> <a href="https://languageandliteracy.blog/tag:implicit" class="hashtag"><span>#</span><span class="p-category">implicit</span></a> <a href="https://languageandliteracy.blog/tag:explicit" class="hashtag"><span>#</span><span class="p-category">explicit</span></a></p>

<p><a href="https://remark.as/p/languageandliteracy.blog/a-finale-learning-to-read-and-write-is-a-remarkable-human-feat">Discuss...</a></p>
]]></content:encoded>
      <guid>https://languageandliteracy.blog/a-finale-learning-to-read-and-write-is-a-remarkable-human-feat</guid>
      <pubDate>Fri, 28 Jan 2022 06:36:23 +0000</pubDate>
    </item>
    <item>
      <title>The Science of Reading and Cancer</title>
      <link>https://languageandliteracy.blog/the-science-of-reading-and-cancer?pk_campaign=rss-feed</link>
      <description>&lt;![CDATA[I have somewhat eclectic book reading habits, and I take pleasure in reading haphazardly (i.e. whatever I happen to come across). After growing bored with Moby Dick recently, I happened across a copy of Siddhartha Mukerjee’s The Emperor of All Maladies: A Biography of Cancer.&#xA;&#xA;The book is compellingly written, narrating an expansive overview of the history of the treatment of cancer, while at the same time painting portraits of individual researchers, clinicians, and patients that draws the reader in. It makes oncology research and clinical practice sound exciting, which is no small feat.&#xA;&#xA;!--more--&#xA;&#xA;As I read Mukerjee’s book, I began drawing parallels between the slow but accumulating body of knowledge on cancers to research on literacy development.&#xA;&#xA;Cancer, just like reading, has seen massive investments and nationwide commitments to improve outcomes, yet with seemingly little to show for all the rhetoric, money, and effort. And just as with reading, in the absence of clear evidence and knowledge, there have been ego-driven and problematic practices and treatments, and many strong assertions with little data.&#xA;&#xA;Yet through Mukerjee’s telling, it becomes clear that however zigzagging and plodding and subject to the whims of character and fortune, science and knowledge has slowly advanced and that we now have an understanding of various forms of cancer that–while no silver bullets exist for all cancers–we do have an arsenal of screening and specific treatments for specific forms of cancer that we can wield, and that however incremental, the field is advancing.&#xA;&#xA;In reading and literacy and language research, it can feel at times like the “science” is a matter of opinion, and that we know not much at all. There are many who discount the value of empirical research in the field of education completely. And yet, I think we would do well to heed the history of cancer to see not only the progress we have made and can make, but to at the same time bear greater cautiousness against overzealous claims by silver bullet enthusiasts.&#xA;&#xA;One passage in particular, describing the endeavors of Henry Kaplan, a radiologist in the 1960s, got me started in thinking along these lines:&#xA;&#xA;  This simple principle—the meticulous matching of a particular therapy to a particular form and stage of cancer—would eventually be given its due merit in cancer therapy. Early-stage, local cancers, Kaplan realized, were often inherently different from widely spread, metastatic cancers—even within the same form of cancer. A hundred instances of Hodgkin’s disease, even though pathologically classified as the same entity, were a hundred variants around a common theme. Cancers possessed temperaments, personalities—behaviors. And biological heterogeneity demanded therapeutic heterogeneity; the same treatment could not indiscriminately be applied to all.&#xA;&#xA;The insight described here is that while we use one term to describe the phenomena of “cancer,” researchers began to increasingly realize that different cancers manifested in incredibly diverse ways, and thus required similarly diverse approaches in treatment.&#xA;&#xA;Prior to this insight, a silver bullet was sought against all forms of cancer, and all kind of ego-driven practices and over extrapolations of unclear research led to, for example, mastectomies that tore out nearly everything from the shoulder to the ribs, in the zealous belief that cancer would be rooted out.&#xA;&#xA;How often do we hear “dyslexia” described as a general construct that requires a silver bullet solution? Yet increasing research demonstrates the genetic and biological variation in individual brain development that can manifest in difficulty with literacy or language — and may thus require differing forms of instruction and supports.&#xA;&#xA;What are the implications for assessment? Here’s another passage that stood out on this idea of heterogeneity:&#xA;&#xA;  But although these alternatives did not offer definitive cures, several important principles of cancer biology and cancer therapy were firmly cemented in these powerful trials. First, as Kaplan had found with Hodgkin’s disease, these trials again clearly etched the message that cancer was enormously heterogeneous. Breast or prostate cancers came in an array of forms, each with unique biological behaviors. The heterogeneity was genetic: in breast cancer, for instance, some variants responded to hormonal treatment, while others were hormone-unresponsive. And the heterogeneity was anatomic: some cancers were localized to the breast when detected, while others had a propensity to spread to distant organs.&#xA;&#xA;  Second, understanding that heterogeneity was of deep consequence. “Know thine enemy” runs the adage, and Fisher’s and Bonadonna’s trials had shown that it was essential to “know” the cancer as intimately as possible before rushing to treat it.&#xA;&#xA;I want to be careful about drawing too closely on an extended analogy between cancer and reading — but there is a similar need in schools to build more precise and accurate profiles of students to ensure the right form of instruction and intervention. We often land on the simple distinction of “students not meeting standards,” then rely on item analysis of standards (which are at a composite level of performance), rather than identifying the underlying literacy and language skills that could be targeted for further support.&#xA;&#xA;Here’s another passage on cancer screening, which certainly has some similarities to screening for reading and language difficulty in schools:&#xA;&#xA;  In cancer, where both overdiagnosis and underdiagnosis come at high costs, finding that exquisite balance is often impossible. We want every cancer test to operate with perfect specificity and sensitivity. But the technologies for screening are not perfect. . . .&#xA;&#xA;  No; merely detecting a small tumor is not sufficient. Cancer demonstrates a spectrum of behavior. . . To address the inherent behavioral heterogeneity of cancer, the screening test must go further. It must increase survival.&#xA;&#xA;For screening in schools, it must increase literacy attainment. And this is where the rubber hits the road. Even when a school is drowning in data, it does not mean the needed action will be undertaken, either to improve core instruction across classrooms, or for putting in place the right interventions for the right groups of students at the right time.&#xA;&#xA;The academic specializations that result in terminology so precise it is opaque to those outside of that domain may seem extremely distant from classroom practice, but I don’t see how we can make headway until we more fully unpack how, when, and where learning happens in the brain in relation to its body and its environment, while at the same time identifying the forms and use of language and literacy that are most fundamental.&#xA;&#xA;Despite the great heterogeneity of cancer, scientists have begun to recognize some universal understandings that is leading to more effective treatments:&#xA;&#xA;  Biologists looking directly into cancer’s maw now recognized that roiling beneath the incredible heterogeneity of cancer were behaviors, genes, and pathways. . . . Notably, Weinberg and Hanahan wrote, these six rules were not abstract descriptions of cancer’s behavior. Many of the genes and pathways that enabled each of these six behaviors had concretely been identified—ras, myc, Rb, to name just a few. The task now was to connect this causal understanding of cancer’s deep biology to the quest for its cure . . . The mechanistic maturity of cancer science would create a new kind of cancer medicine, Weinberg and Hanahan posited: “With holistic clarity of mechanism, cancer prognosis and treatment will become a rational science, unrecognizable by current practitioners.” Having wandered in the darkness for decades, scientists had finally reached a clearing in their understanding of cancer. Medicine’s task was to continue that journey toward a new therapeutic attack.&#xA;&#xA;We are beginning to recognize some universals and particulars of language and literacy, as well. We can improve literacy outcomes for our society. It just may be much more complex and progress much slower than we’d like to think.&#xA;&#xA;I’m not being a Pollyanna here on either front, by the way. My father died of lymphoma last December after being diagnosed in October, and his doctors seemed just as surprised as us when his artery ruptured suddenly just as his 3rd round of chemo treatment began. Some forms of cancer will continue to kill us prematurely, despite our best efforts based on our current understanding of the research and the technological tools in our arsenal. And some children will continue to struggle to read and write fluently, despite the concerted efforts of many committed educators.&#xA;&#xA;My sincere hope is that every casualty along the way provides new learning that can inform improvement. If we learn from every failure, than each failure will not be in vain.&#xA;&#xA;#cancer #language #literacy #reading #dyslexia #screening #SiddharthaMukerjee #research #knowledge #heterogeneity&#xA;&#xA;a href=&#34;https://remark.as/p/languageandliteracy.blog/the-science-of-reading-and-cancer&#34;Discuss.../a]]&gt;</description>
      <content:encoded><![CDATA[<p>I have somewhat eclectic book reading habits, and I take pleasure in reading haphazardly (i.e. whatever I happen to come across). After <a href="https://twitter.com/mandercorn/status/1434297825999921152?s=20">growing bored with Moby Dick</a> recently, I happened across a copy of Siddhartha Mukerjee’s <em>The Emperor of All Maladies: A Biography of Cancer</em>.</p>

<p>The book is compellingly written, narrating an expansive overview of the history of the treatment of cancer, while at the same time painting portraits of individual researchers, clinicians, and patients that draws the reader in. It makes oncology research and clinical practice sound exciting, which is no small feat.</p>



<p>As I read Mukerjee’s book, I began drawing parallels between the slow but accumulating body of knowledge on cancers to research on literacy development.</p>

<p>Cancer, just like reading, has seen massive investments and nationwide commitments to improve outcomes, yet with seemingly little to show for all the rhetoric, money, and effort. And just as with reading, in the absence of clear evidence and knowledge, there have been ego-driven and problematic practices and treatments, and many strong assertions with little data.</p>

<p>Yet through Mukerjee’s telling, it becomes clear that however zigzagging and plodding and subject to the whims of character and fortune, science and knowledge has slowly advanced and that we now have an understanding of various forms of cancer that–while no silver bullets exist for all cancers–we do have an arsenal of screening and specific treatments for specific forms of cancer that we can wield, and that however incremental, the field is advancing.</p>

<p>In reading and literacy and language research, it can feel at times like the “science” is a matter of opinion, and that we know not much at all. There are many who discount the value of empirical research in the field of education completely. And yet, I think we would do well to heed the history of cancer to see not only the progress we have made and can make, but to at the same time bear greater cautiousness against overzealous claims by silver bullet enthusiasts.</p>

<p>One passage in particular, describing the endeavors of Henry Kaplan, a radiologist in the 1960s, got me started in thinking along these lines:</p>

<blockquote><p>This simple principle—the meticulous matching of a particular therapy to a particular form and stage of cancer—would eventually be given its due merit in cancer therapy. Early-stage, local cancers, Kaplan realized, were often inherently different from widely spread, metastatic cancers—even within the same form of cancer. A hundred instances of Hodgkin’s disease, even though pathologically classified as the same entity, were a hundred variants around a common theme. Cancers possessed temperaments, personalities—behaviors. And biological heterogeneity demanded therapeutic heterogeneity; the same treatment could not indiscriminately be applied to all.</p></blockquote>

<p>The insight described here is that while we use one term to describe the phenomena of “cancer,” researchers began to increasingly realize that different cancers manifested in incredibly diverse ways, and thus required similarly diverse approaches in treatment.</p>

<p>Prior to this insight, a silver bullet was sought against all forms of cancer, and all kind of ego-driven practices and over extrapolations of unclear research led to, for example, mastectomies that tore out nearly everything from the shoulder to the ribs, in the zealous belief that cancer would be rooted out.</p>

<p>How often do we hear “dyslexia” described as a general construct that requires a silver bullet solution? Yet increasing research demonstrates the genetic and biological variation in individual brain development that can manifest in difficulty with literacy or language — and may thus require differing forms of instruction and supports.</p>

<p>What are the implications for assessment? Here’s another passage that stood out on this idea of heterogeneity:</p>

<blockquote><p>But although these alternatives did not offer definitive cures, several important principles of cancer biology and cancer therapy were firmly cemented in these powerful trials. First, as Kaplan had found with Hodgkin’s disease, these trials again clearly etched the message that cancer was enormously heterogeneous. Breast or prostate cancers came in an array of forms, each with unique biological behaviors. The heterogeneity was genetic: in breast cancer, for instance, some variants responded to hormonal treatment, while others were hormone-unresponsive. And the heterogeneity was anatomic: some cancers were localized to the breast when detected, while others had a propensity to spread to distant organs.</p>

<p>Second, understanding that heterogeneity was of deep consequence. “Know thine enemy” runs the adage, and Fisher’s and Bonadonna’s trials had shown that it was essential to “know” the cancer as intimately as possible before rushing to treat it.</p></blockquote>

<p>I want to be careful about drawing too closely on an extended analogy between cancer and reading — but there is a similar need in schools to build more precise and accurate profiles of students to ensure the right form of instruction and intervention. We often land on the simple distinction of “students not meeting standards,” then rely on item analysis of standards (which are at a composite level of performance), rather than identifying the underlying literacy and language skills that could be targeted for further support.</p>

<p>Here’s another passage on cancer screening, which certainly has some similarities to screening for reading and language difficulty in schools:</p>

<blockquote><p>In cancer, where both overdiagnosis and underdiagnosis come at high costs, finding that exquisite balance is often impossible. We want every cancer test to operate with perfect specificity and sensitivity. But the technologies for screening are not perfect. . . .</p>

<p>No; merely detecting a small tumor is not sufficient. Cancer demonstrates a spectrum of behavior. . . To address the inherent behavioral heterogeneity of cancer, the screening test must go further. It must increase survival.</p></blockquote>

<p>For screening in schools, it must increase literacy attainment. And this is where the rubber hits the road. Even when a school is drowning in data, it does not mean the needed action will be undertaken, either to improve core instruction across classrooms, or for putting in place the right interventions for the right groups of students at the right time.</p>

<p>The academic specializations that result in terminology so precise it is opaque to those outside of that domain may seem extremely distant from classroom practice, but I don’t see how we can make headway until we more fully unpack how, when, and where learning happens in the brain in relation to its body and its environment, while at the same time identifying the forms and use of language and literacy that are most fundamental.</p>

<p>Despite the great heterogeneity of cancer, scientists have begun to recognize some universal understandings that is leading to more effective treatments:</p>

<blockquote><p>Biologists looking directly into cancer’s maw now recognized that roiling beneath the incredible heterogeneity of cancer were behaviors, genes, and pathways. . . . Notably, Weinberg and Hanahan wrote, these six rules were not abstract descriptions of cancer’s behavior. Many of the genes and pathways that enabled each of these six behaviors had concretely been identified—ras, myc, Rb, to name just a few. The task now was to connect this causal understanding of cancer’s deep biology to the quest for its cure . . . The mechanistic maturity of cancer science would create a new kind of cancer medicine, Weinberg and Hanahan posited: “With holistic clarity of mechanism, cancer prognosis and treatment will become a rational science, unrecognizable by current practitioners.” Having wandered in the darkness for decades, scientists had finally reached a clearing in their understanding of cancer. Medicine’s task was to continue that journey toward a new therapeutic attack.</p></blockquote>

<p>We are <a href="https://languageandliteracy.blog/universals-of-language">beginning to recognize</a> some universals and particulars of language and literacy, as well. We can improve literacy outcomes for our society. It just may be much more complex and progress much slower than we’d like to think.</p>

<p>I’m not being a Pollyanna here on either front, by the way. My father died of lymphoma last December after being diagnosed in October, and his doctors seemed just as surprised as us when his artery ruptured suddenly just as his 3rd round of chemo treatment began. Some forms of cancer will continue to kill us prematurely, despite our best efforts based on our current understanding of the research and the technological tools in our arsenal. And some children will continue to struggle to read and write fluently, despite the concerted efforts of many committed educators.</p>

<p>My sincere hope is that every casualty along the way provides new learning that can inform improvement. If we <a href="https://schoolecosystem.org/2015/12/08/failure-uncertainty-risk/">learn from every failure</a>, than each failure will not be in vain.</p>

<p><a href="https://languageandliteracy.blog/tag:cancer" class="hashtag"><span>#</span><span class="p-category">cancer</span></a> <a href="https://languageandliteracy.blog/tag:language" class="hashtag"><span>#</span><span class="p-category">language</span></a> <a href="https://languageandliteracy.blog/tag:literacy" class="hashtag"><span>#</span><span class="p-category">literacy</span></a> <a href="https://languageandliteracy.blog/tag:reading" class="hashtag"><span>#</span><span class="p-category">reading</span></a> <a href="https://languageandliteracy.blog/tag:dyslexia" class="hashtag"><span>#</span><span class="p-category">dyslexia</span></a> <a href="https://languageandliteracy.blog/tag:screening" class="hashtag"><span>#</span><span class="p-category">screening</span></a> <a href="https://languageandliteracy.blog/tag:SiddharthaMukerjee" class="hashtag"><span>#</span><span class="p-category">SiddharthaMukerjee</span></a> <a href="https://languageandliteracy.blog/tag:research" class="hashtag"><span>#</span><span class="p-category">research</span></a> <a href="https://languageandliteracy.blog/tag:knowledge" class="hashtag"><span>#</span><span class="p-category">knowledge</span></a> <a href="https://languageandliteracy.blog/tag:heterogeneity" class="hashtag"><span>#</span><span class="p-category">heterogeneity</span></a></p>

<p><a href="https://remark.as/p/languageandliteracy.blog/the-science-of-reading-and-cancer">Discuss...</a></p>
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      <guid>https://languageandliteracy.blog/the-science-of-reading-and-cancer</guid>
      <pubDate>Sun, 26 Sep 2021 00:44:33 +0000</pubDate>
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