One morning last week I went to the orthopaedic clinic in Worcester. By the door, in large letters, was a sign. It told patients not to go straight to the desk, but to collect a number from a box below the sign, and sit in the waiting room for their number to be called. This message was repeated on another large sign above the reception desk, which also told patients not to stand near the desk in order to maintain the privacy of individual patients speaking to the receptionist. I collected my number (21) and waited. After five minutes, my number was called. Another man (number 22) hovered round the desk and tried to barge in front of me, but I held my ground. I was registered by the receptionist and waited to see the physiotherapist and consultant.
While I did so, I noticed that half the people entering the clinic failed to pick up a number from the box and had to be told to do so by the receptionist. Some could not even find the box, and had to be guided by other patients. Why this manifest failure to follow a simple instruction? The reason did not seem to be age or infirmity. The great majority of patients in the clinic were young or middle-aged, and this group included almost all those who failed to read the signs. I suspect the main reason was simply functional illiteracy.
By ‘functional illiteracy’, I mean not just the inability to read, but also the unwillingness to do so. Many people are able to read, but find that it requires an unwelcome effort of concentration. When faced by a sign with words (even large ones like those in the clinic), they look the other way. There are many other examples of this. When I go to Foregate Street Railway Station in Worcester, I note the screens that indicate for each train the time, destination and platform (there are only two at this station). Around the window where you buy tickets, there are lists of the next trains to the main destinations. Yet sreveral customers do not read any of this written information and ask at the ticket office.
Many people therefore live in a world where they depend entirely on the spoken word, whether face-to-face, on a mobile phone, or on television. There may be few if any books in their homes, and parents do not try and help their children learn to read. People can lead a satisfactory life with functional illiteracy until they encounter the world of formal bureaucracy, whether public or private. In such cases, there is a wall of mutual incomprehension between an organisation dominated by written rules, job descriptions and standardised forms, and an individual whose understanding of the world is based on the spoken word. People with functional illiteracy faced by an official-looking letter must either show it to someone with greater expertise, or just ignore it. The latter course of action can be catastrophic. When I was a social worker in West Lothian in the 1970s, we were routinely told by the Housing Department of impending evictions (usually for non-payment of rent). This information was usually received on the day of the eviction. We would visit the tenant to see if there were implications for childcare, or if a disabled person was involved. I visited the S Family, and found they were utterly unaware of what was due to happen at 11am that day. I found a series of letters from the Housing Department, unopened and unread, behind the clock on the mantelpiece. Later, Mrs S told me in distress of her life with an abusive husband, a son in prison and an estranged daughter. “Mr Cumella”, she said with feeling, “I feel so thingy”. So functional illiteracy was coupled in her case with a lack of vocabulary to express emotions.
Much of the debate in education about how to improve literacy seems to be about teaching techniques. English spelling does make learning to read a bit more difficult than would be the case in a language like Spanish, in which spelling is phonetic. But literacy levels are high in Japan, where the written language uses three different orthographies. I think the main problem is not teaching technique or the quality of primary school teachers, but the lack of commitment among some parents to education itself and the low expectations they have of their children.
It is not easy to see how we can deal with this problem, but in the meantime we need to help people with functional illiteracy cope better with formal organisations. This means using symbols and colour schemes to supplement written signs. At the Orthopaedic Clinic, this would mean using a sign of a large arrow (in a contrasting colour to the wall) pointing to the box, with a picture of a hand picking a card. The use of symbols of this kind is widely-accepted in services for people with a learning (intellectual) disability: we just need to recognise that there are very many more people who have problems in reading and learning than we have previously estimated.
While I did so, I noticed that half the people entering the clinic failed to pick up a number from the box and had to be told to do so by the receptionist. Some could not even find the box, and had to be guided by other patients. Why this manifest failure to follow a simple instruction? The reason did not seem to be age or infirmity. The great majority of patients in the clinic were young or middle-aged, and this group included almost all those who failed to read the signs. I suspect the main reason was simply functional illiteracy.
By ‘functional illiteracy’, I mean not just the inability to read, but also the unwillingness to do so. Many people are able to read, but find that it requires an unwelcome effort of concentration. When faced by a sign with words (even large ones like those in the clinic), they look the other way. There are many other examples of this. When I go to Foregate Street Railway Station in Worcester, I note the screens that indicate for each train the time, destination and platform (there are only two at this station). Around the window where you buy tickets, there are lists of the next trains to the main destinations. Yet sreveral customers do not read any of this written information and ask at the ticket office.
Many people therefore live in a world where they depend entirely on the spoken word, whether face-to-face, on a mobile phone, or on television. There may be few if any books in their homes, and parents do not try and help their children learn to read. People can lead a satisfactory life with functional illiteracy until they encounter the world of formal bureaucracy, whether public or private. In such cases, there is a wall of mutual incomprehension between an organisation dominated by written rules, job descriptions and standardised forms, and an individual whose understanding of the world is based on the spoken word. People with functional illiteracy faced by an official-looking letter must either show it to someone with greater expertise, or just ignore it. The latter course of action can be catastrophic. When I was a social worker in West Lothian in the 1970s, we were routinely told by the Housing Department of impending evictions (usually for non-payment of rent). This information was usually received on the day of the eviction. We would visit the tenant to see if there were implications for childcare, or if a disabled person was involved. I visited the S Family, and found they were utterly unaware of what was due to happen at 11am that day. I found a series of letters from the Housing Department, unopened and unread, behind the clock on the mantelpiece. Later, Mrs S told me in distress of her life with an abusive husband, a son in prison and an estranged daughter. “Mr Cumella”, she said with feeling, “I feel so thingy”. So functional illiteracy was coupled in her case with a lack of vocabulary to express emotions.
Much of the debate in education about how to improve literacy seems to be about teaching techniques. English spelling does make learning to read a bit more difficult than would be the case in a language like Spanish, in which spelling is phonetic. But literacy levels are high in Japan, where the written language uses three different orthographies. I think the main problem is not teaching technique or the quality of primary school teachers, but the lack of commitment among some parents to education itself and the low expectations they have of their children.
It is not easy to see how we can deal with this problem, but in the meantime we need to help people with functional illiteracy cope better with formal organisations. This means using symbols and colour schemes to supplement written signs. At the Orthopaedic Clinic, this would mean using a sign of a large arrow (in a contrasting colour to the wall) pointing to the box, with a picture of a hand picking a card. The use of symbols of this kind is widely-accepted in services for people with a learning (intellectual) disability: we just need to recognise that there are very many more people who have problems in reading and learning than we have previously estimated.
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