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Differentiated Teaching is the Norm. Why Not Medicine?

One%20Size%20does%20not%20fit%20all By Julie Obradovic
Not that anyone has noticed, but I've been underground for a little while over the last 10 months. In my life outside of advocacy I embarked on a professional growth project that required almost all of my little free time. Thankfully it is almost complete, as it has been one of the most intense endeavors I have ever undertaken. I'm anxious to be able to dedicate more time to Autism.
For those who don't know, I am a teacher. The process I underwent was to enhance my expertise, and I am confident is has. Centered on the framework of reflection, I spent literally months analyzing what I'm doing, why I'm doing it, and how I know if it is working or not. I was forced to analyze the effectiveness of everything from my materials to the physical setting of my room to the rate of my speech and so much more.
Perhaps the most frequent question I had to respond to was how I knew or not that my teaching was having a significant impact on student learning and finding the evidence to support that. That's a lot harder than it sounds, and like I said, the process forced me to dig deep. Likewise, I had to explain in great detail what I was doing to address the various learning styles and academic needs of my students. In the educational world, we call this "differentiated instruction".
Which really got me thinking.
I have an average of almost 25 students in all of my classes. Although I teach an elective that often does not see many children with special needs passing through (something I'm working to change), I do see a wide variety of learning styles, abilities, and needs on a daily basis. And although I use the same syllabus to guide me through the school year and approach the content I need to cover, my biggest goal is always ensuring the success of as many of my students as possible. The speed of covering the content never takes precedent over the process in which we do.
In one class, for example, I may have to address 15 different things in just one aspect of one lesson. Suzie can't hear well out of her right ear so I have to make sure to stand where she can. Johnny doesn't do well without paper and pencil tasks, so I have to make sure to modify whatever we're doing to meet his needs. Peter is visually sensitive to print on stark white paper so I have to make sure I used colored paper when making copies.

I could go on with one hundred more modifications. Some of them are mandated by a 504 plan or IEP, yes, but the vast majority of these interventions are not. They are simply what I know I need to do to get the very best out of my students. As a parent, I strive every day to treat my student's academic needs as I would want my children's to be treated. And I know that the overwhelming majority of my colleagues do the same. We don't necessarily have to differentiate our students instruction. We do it because it's best for them, in spite of the fact that it is time consuming and inconvenient to do so.
Same content. Same outcome. Different methods of getting there.
What if medicine did the same for our children? When we advocate for safer vaccines and safer vaccine schedules, isn't all we are asking of our physicians is to have our children be treated as individuals? Isn't all we want for them is to be treated based on their unique needs to ensure the best outcome for them?
I can't imagine in this day and age presenting my student's parents with a syllabus and saying this is what we cover, this is the only way I do it, and there will be absolutely no exceptions to this regardless of how your child is doing. Alternative help is a waste of money. We test on these days and these days only. And if you don't like it, or God forbid, bring me in some research to question my methods, you and your child will be dismissed from my class.
It sounds funny when put in an educational context, but that's precisely what is happening in the pediatric one.
It is my JOB to differentiate my instruction to meet the needs of my students. No one feels sorry for me if it takes too much time, or if it's inconvenient, which frankly, more often than not it is. It's a pain in the butt sometimes. Honestly. But it's what my students need. It's not about me. And if I don't like dealing with it, I should find a different profession.
Well guess what? That's their job too; to meet the needs of their patients. It's their JOB to figure out if there are individual medical differences that warrant an alternative vaccine schedule. It's their JOB to identify susceptibilities to heavy metals and other vaccine ingredients. It's their JOB to know whether or not the current vaccine schedule is safe in the real-world setting in which it is administered.
 It's their job to work with you and listen to you. It's their job to make sure your child is healthy and thriving and meeting their milestones, and it's their job to figure out why they aren't...with REAL, CONCRETE, MEASURABLE EVIDENCE from which to draw their conclusion.
Why can't Johnny read, you ask me, Mrs. Smith?
It's genetic. Just happens sometimes, I say.
What evidence do I have of that, you ask?
Oh, none, actually, I continue.
Why are so many of Johnny's friends also illiterate?
Oh, we just didn't notice how many kids couldn't read before.
Even if those answers were true, their isn't a school in the country that would accept that as the final response. There isn't a parent I know who would either. Heck, even our government doesn't allow us to accept that. Ever heard of No Child Left Behind? Like it or not, it's based in the philosophy that all children can learn, all teachers need to make that happen to the very best of their ability, and if not, all schools need to be held accountable for those teachers.
I offer up the same standards be asked of our physicians.
Prove Autism is genetic before you go around using that as an excuse for doing nothing. Explain why even if it is that trumps treatment. Reflect on your current practices for treating Autism. What's working? What's not? What do you still need to learn? How healthy is your patient population? What do you need to change? How do you know this? How are you addressing their individual needs?
Is it time consuming and inconvenient to do this? You betcha. I've heard this exact reason even offered up most recently by Dr. Oz for why physicians won't submit to alternative, spread out vaccine schedules.
But you know what? Too bad. THAT'S THEIR JOB.
It's time they started being held accountable for the quality in which they are doing it.
Julie Obradovic is a Contributing Editor of Age of Autism.



Angela Warner

As usual Julie, terrific article and excellent analogy.

We must remember tho' that unfortunately it is not just the pediatricians who are at fault when it comes to our kids. Practitioners aross the board are failing our kids. I think of the neurosurgeon at OHSU who, without waiting for the testing he ordered to come back, stated boldly that my son did not have a tethered cord and he would be happy to refer him to a neuro-psychiatrist. Three months or so later my son was diagnosed with tethered cord by a much more knowledgable neurosurgeon (I know - more knowledgable than OHSU?) and had surgery and after two years has recovered most of his bladder and bowel functioning.

I think of how the medical community and Tricare failed me this entire weekend causing me an infection, which had they listened to me and looked at me as an individual instead of a member of "the herd", I wouldn't have endured. Not to mention the severe pain this has caused, so much so that percocet at times barely touched the pain. It's all getting better thanks to me advocating for myself just as I did my kids, although it's not over yet.

It's not just the pediatricians, it's the entire medical community, and I believe as one commenter suggested it's because everyone is afraid to speak up for fear of the backlash (paraphrased). It's more than that I think. I think the majority of the population is so drugged that they don't even realize what has happened, and what continues to happen.

Cynthia Cournoyer

If people were treated as individuals when it comes to vaccines, they would vaccinate fewer people. Then, just as the flu vaccine, with only 30% compliance, they would see that there is no emergency. Then fewer would vaccinate and then eventually there would be no vaccines! Celebrate!

BEGIN to treat the individual, and you will start to lose vaccines altogether;it is a slippery slope and a threat to those who profit. It is not likely they will even begin to go down that slope. Look at all the other drugs pulled off the market. They took a look at how a certain drug was harmful to a few. Pretty soon it was gone. They know that's how it works. La-la-la-la, vaccines are always good for everyone, la-la-la-la.

One vaccine was all it took to kill some children. It's not IF vaccines are bad, it's how many does it take to damage or kill you? Some people need more vaccines to finally damage them than others. But the standard way of thinking is it's better to sacrifice a few along the way, rather than find out what a person's limit is.

Bob Moffitt

Dr. Sherri Tenpenny recent Huffington Post:

Offers numerous examples how veterinarians strive to treat animals "individually" while pediatricians treat individual children as members of the "herd".

Something is drastically wrong when veterinarians make the effort to do THEIR JOB .. while pediatricians appear to have neither the time nor inclination to do the same when treating their patients.


As the husband of a teacher, I also want to point out how little they are paid for doing everything that differentiated instruction requires--long hours preparing, grading, tutoring, doing paperwork.
I find that most doctors are not only well paid, they have staffs to help with what they have to do, and get to choose their hours for what is convenient for THEM.

michael framson

Julie, it boils down to an individualized approach whether teaching, medicine, athletics, health. Homeopathic philosophy appreciates those differences. Its the individual differences that matter, not what may be common.

I don't think getting this logic/philosophy into the hands of pediatricians will matter. Pediatricians have too many years of expensive hard wiring education to toss that into the toilet to begin to unlearn most of their training. I'm appreciative of the ones that do break free. It took energy to overcome the centripetal force that keeps pediatricians in their "unenlightened" orbits.


Great analogy, Julie. Most pediatricians triple book kids and barely give you the time of day, except to prescribe antibiotics or have the nurse give a couple vaccines. Maybe if my son's pediatricians had paid as much attention to him as his teachers do we wouldn't be in this mess... I'm still looking for someone to print the "Genes don't cause autism - careless Pediatricians do" bumper sticker.


Your comparison well illustrates the double standard regarding job performance. Do health care professionals get less grilling because society is afraid of their collective power if consumers talk back?


Yes, it is their job, but just like their are less than stellar teachers, their are less than stellar physicians. As the parent of a child with moderate to severe SPD and Asperger's tendencies, I have become the expert. I have asked the questions and done the research. I can't count on anyone but me. While I have not encountered physicians who look at these aspects of health and wellness as their job, I have been fortunate enough to encounter awesome teachers who do see this as part of their job. Hopefully physicians will get on board, too. In the mean time, I'm investigating a non-medical approach to balancing the de-synchronization of the brain that happens with neuro-behavioral disorders called the Brain Balance Program - - and weighing it against Berard AIT Therapy and conventional OT. Still looking for answers...

Nicole Beurkens

This is a fabulous article! As a former teacher turned clinical psychologist, I understand the concept of differentiated instruction well. I had never connected this to the field of medicine, and what it might look like if physicians practiced differentiated medicine. Thanks for drawing the parallel and sharing it with us!
Nicole Beurkens


I've never thought of it this way but you've absolutely hit the nail on the head. Anyone in the service industry (I'm an attorney, my husband a teacher) knows that your clients are all different. In my profession, some need hand holding, some need swift efficiency. If I treated them all the same way, I would no longer have a business. Why does the medical community get to put on their blinders to the fact that they are dealing with individuals?

Harry H.

Great one, Julie. I love the idea that the medical community needs to prove that autism is genetic instead of doing nothing. That's been the get out of jail free card they keep using to deny doing any actual research. Any doctor worth their license knows some bodies can't take being injected with one or a hundred thousand vaccines, yet they won't investigate which bodies are susceptable.

Thanks for the great work.


Brilliant analogy, Julie, and you are dead-on: IT'S THEIR JOB. And with our kids' well-being at stake, it's absurd that convenience and profit margins win out in healthcare priorities...

Thank you for this---So glad you're back!


If doctors had to futz with justifying their treatments (or lack of) then how would they ever have time for those pharma rep funded free lunches or expense paid lectures?

K Fuller Yuba City

How do we get this into the hands of every Doctor in America?
Thank you Julie. Really,really well done.


Thank you, Julie, excellent points!

A bit off the primary topic, but this article also shows how hard special ed teachers work to do their jobs, and how much of their work we as parents may not be aware of -- the continuing education, the work with all the students in the class with varied needs. I'm sure not every special ed teacher cares as much or works as hard (an with as much intelligence) as Julie, but still -- it's just a reminder to appreciate what teachers do!

Leslie Phillips

Excellent analogy, Julie. And teachers don't take a Hippocratic oath, for that matter neither do Pharma execs. I place the majority of the blame for the autism epidemic squarely on the shoulders of the AAP, who should've known better from the beginning, and yet decades into this tragedy, still don't bother to even read the research.


Yes, yes, yes, yes, yes Judith - you are 100% right! Did you know that parents of Autistic child are held with contempt by many pediatricians because they blame us for the fact that they now have to spend 3 times as long with patients parents convincing them that vaccines are safe for all kids? Too bad. We are not the problem, as Jim Carrey says, "the problem is the problem".

Pediatricians allowed for the trippling of the childhood vaccines schedule without demanding studies into, much less even a conversation considering what impact such an increase might have on children genetically predisposed to autoimmunity - our children! Just because medicine is a top down profession does not exonerate pediatricians. They didn't ask questions and as a result have let our children down.

It is time for us as a community to hold pediatricians accountable and quit cowering and avoiding speaking our minds for fear that they will kick our child out of their practices. Who friggin' cares. Who wants to be part of their medical mafia dictatorship anymore. I have an urgent treatment center right across the street and a family doctor who would love to treat my child....not to mention a Naturopathy system that actually knows how to promote health!


As always when it comes to Julie's writing pieces, I LOVE THIS ARTICLE!!!!

Not an MD

Fabulous article, Julie. Thank you for the plain and obvious logic. We are all unique individuals, yet conventional pediatric medicine does not take this into consideration when it comes to vaccines. All logic and individuality goes out the window. The same overcrowded schedule applies to all whether a child is mildly ill, or on antibiotics, at the time of an office visit. This is not acceptable. As more and more children are damaged, the parents' outcry will intensify, and pediatricians will have no choice but to listen as the cacophony will be deafening.

thanks a lot, Doc

What a terrific parallel. I find it fascinating to learn how teachers strive to individualize their curricula for students, and yet, what a stark contrast with physicians at vaccination time. Our doctors are lazy, ignorant or both. It's obvious that "no child left behind" is being implemented in the wrong place - it should be at the doctors' offices. Teachers now must compensate for the horrendous mistakes of the medical profession.

Speaking of mistakes, please sign the petition to oppose Ari Ne'eman if you haven't already - and tell friends and family too.

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