This essay will start ofby giving a definition on normality, and then explore the concepts of learning disabilities, along withthe arguments onlearning disabilities people moving out of long-stay hospitals and into the community.The essay will explore examples and studies of disability groups attaining to what society class as ‘normal’ living within the community. The essay will then explain what the medical model and social model declare about learning disability, along with challenges of both models and what Foucault and Goffman say in relation to the models. The essay will draw on labelling those with learning disabilities, and the positive and negative factors to having a label.
The essay will outline the concept of the discrimination law in association to normality and disability and what the arguments are. The essay will move on to discuss the association with those with learning disabilities and social justice in regards to their class and rights, additionally what Marx and Webber arguments are on this matter. The essay will discuss the media views are on learning disability;and discuss the balance between social workers and those with a learning disability, and how they work together successfully.
There is not one specific definition for normality. According to dictionary.com normality is defined as “the state or fact of being normal…” (2007). It goes on to say that normality is “being within certain limits that define the range of normal functioning…” (2007)
Learning Difficulties is a term used indicating intellectual impairment. The name ‘learning difficulty’ replaced the term mental handicap; this was a way of referring to individuals with intellectual impairments (Pierson & Thomas, 2002). The name ‘learning difficulties’ signify that individuals would like to and are able to learn, even though it indicate there are those that excel more than others (Chappell A.L, et al 2001).
In the UK People with Learning Difficulties are being moved out of long-stay hospitals as a result of targets both the 1990 NHS and Community Care Act and the 2001 white paper Valuing People. The government pushed back the target date to 2006 having failed to meet its’ initial target to move all people with Learning Difficulty out of such long-stay hospitals by 2004. Currently, just over two hundred people with Learning Difficulty remain in 10 NHS long-stay hospitals (Community Care 1990).
A number of learning disability adults are users of day centres, which are poorly represented within society, additionally access by peoplewith a learning disabilityto mainstream education, and leisure are limited (Pierson & Thomas, 2002). Therefore, the approach of ‘Normalisation’ and ‘Social Role Valorisation (SRV),’ had an impact on professionals which made a transfer for deinstitutionalisation for individuals with learning disability, which influenced several factors. This highlighted that learning disability adults should be able to live in the community as ‘normal’ individuals do and enjoy the styles of living that are valued in society(Pierson & Thomas, 2002).
A response to this move was that this notion failed to take into account the attitude and practices of others towards those with learning disabilities. It is perceived uncritically that service users should adopt customary norms of behaviour so they could be recognised (Pierson & Thomas, 2002). Normalisation refers to a set of objectives and techniques adopted by provisions for people with learning disabilities. Normalisation objective is to ensure that those with learning disabilities have shared choices, and lifestyle as those who is not disabled (Brown and Smith 1992).However, there have been challenges which entail social acceptability or making sure that the services are meeting the needs of their sexual orientation, gender and ethnicity.
Rather than struggling for normalisation by service users, it was introduced by service providers. Nevertheless, “the principles on community presence, community participation, choice competence and respect”(Pierson & Thomas, 2002 pg 253), that associates with normalisation, has shaped a progressive service settings which support individuals to gain skills, take part in community life and make choices (Pierson & Thomas, 2002).
One have gained personal experience working with learning disability adults in a statutory organisation providing a service for those with, complex needs, and individuals with Autism Spectrum Disorders in the borough of Enfield. One supports service users to lead an ordinary independent life by aiding them to leave the institutions whereby they lived, and then support them to live in their own flat within their community. Additionally one supports the users to be integrated in their community, and support them to carry out every day activities. By doing this, one is enabling and aiding the service users to have a ‘normal’ life so they can value.
At times some of the project neighbours of the service users have been discriminative by being oppressive towards the users by making complaints to staff saying, that the users are mad and should not be living in the community, and should be locked up in institutions. This is because the users may at times become frustrated with certain circumstances and then take their frustrations out in the flat, by banging and screaming. When the neighbours hear this and see this through the user’s window they believe that the users are a danger to the community. They have also threatened to speak to the media to ‘expose’ this perceived threat and danger.
There are several studies which have looked at different community feelings and thoughts to people with learning disabilities, such as Mc-Conkey et al (1993);andSinson (1993). Out of their studies, there have been various patterns of reaction that have surface. A few responses were: hostility towards the thought of individuals with learning disabilities living in the community; additionally a lack of knowledge that there are people with learning disabilities in the community (Myers F, et al 1998).
However, previous studies suggest some community have an eagerness to engage with those with learning disabilities as a value. Studies have showed that theses communities are in Edgerton’s (1967 inMyers F, et al 1998) words as `benefactors’, and in Atkinson’s (1986in Myers F, et al 1998) view as ‘competent others’. However, the community could incorporate the people whom, in Taylor and Bogdan’s (1989,in Myers F, et al 1998) phrase, engage in `accepting relationships’ and Lutfiyya (1991 inMyers F, et al 19981) notion was that of making friends. These positive thoughts are the aims and objectives of the theory of person centred approach which was developed by Karl Rogers.Person Centred is aboutfinding ways of listening to service users to find out what is most important to them and what they want from their lives. The next step is to enable and empower the users to achieve this, which is apart of social work values.
There are a number of significant factors above which are associated with the medical and social model in relation to the social care of people with particular support needs. The social model and medical was introduced to explain and comprehend disability and its functioning. Both models underline issues of power, exclusion and oppression. The point of the medical model is anti-diversity and essentialised as it considers disabled people to be abnormal. Additionally, the medical model only affords expertise to the medical professionals(Williams V, & Heslop P. 2005).
“According to the medical model of disability, disability is a ‘natural’ problem of the person, directly caused by the person’s mental or physical impairments” (Ho 2004 pg 88). The management of the disability is designed to change and adjust the individual’s behaviour. Medical care is deemed as the primary concern. Challengers dispute that the medical model perceives that those diagnosed with learning disabilities are abnormal and naturally inferior to those that do not have such diagnosis. In the case of a child who is at school, the medical model of disability is incompetent when attempting to “explain the experience of children with learning difficulties or promoting equal educational opportunities for all children” (Ho 2004 pg 88). The medical model focuses on the biophysical abnormality and does take into consideration the experience that those with impairments may differ depending on their culture and social structure.
Although diagnosis for those with learning disability can offer a range of benefits and legal protections, there are particular reasons why those with a disability can defy the label ‘learning disabilities’. One reason being that “not everyone appreciates learning disabilities or takes these diagnoses as morally neutral. Given the historical oppression on disabled people, some may not want to think of or label their child or themselves as being disabled”(Ho 2004 pg 87)
Michel Foucault a seminal social constructionist writer, notion on the medical model was that medicine as a practice and profession constructs its own objects of inquiry and looks for ways for people to fit the expected norms. However, the application of medicine to disability and normal/abnormal labels that occur in society are mutually constitutive. Therefore, the medical model is complicit with society definitions of normality. And this complicity has little ethical concern with the quality and value of disabled people’s lives given that they are pre-judged as abnormal (Foucault, 1973).
Goffman (1963) developed what is known as Goffman’s Stigma Theory. In this society’s attention are focussed on the attribute of a disabled individual that is seen to be inferior. This particular attribute is assigned a ‘master status’ and the resulting label (disabled) dominates all other possible characteristics. The need of society for people to have an acceptable image creates problems for the disabled as in many cases the disability ‘leaks out’. For example, one of the autistic service users within the project (which was mentioned above) shouts and bangs at times, and makes unfamiliar funny noises, or another service user who have an unusual walk. Goffman argued that medicine is interested in controlling or covering up the abnormal, i.e. the project neighbours appears to want to have a perfect neighbourhood, in their perceptions is ‘normal’, without engaging in abnormality, within their community.
A challenge to the medical model has always been the public’s increasing lay knowledge of science and health and the increasing popularity of complementary and alternative medicines. The new community-based approach to working with people with learning disabilities shows signs of this widened scope of understanding in that it takes a more holistic view of the lives of learning disabilities people. Indeed in the grey area of Autism (which in itself is not a LD) there are many families who have sought treatments and forms of care and support that are not wholly supported by medicine at all i.e. The Lovas approach – Son Rise, or that disregard the focus on the body in order to focus on the individual cognitive functioning for example the TEACCH and ABA programme. Is there a reference for this please?
However, the social model surfaced because the cause of those with physical and sensory impairments. The model differentiates between impairment and disability.The social model can compare with usual customs of comprehending disability which find the problem of disability in an impaired person. It perceives problems as inevitable consequences of impairment. Therefore, those who are disabled are perceived to need:
“a multitude of professionals and services to enable them to come to terms with their impairments, rehabilitate them into non-disabled society or remove them from it (if they cannot be ‘cured’)” (Chappell A.L, et al 2001 pg 46).
Those without the label will not get the service which is required, this is associated with what Webber say to social processes………………………………Unsure how to explain further.
The social model stresses the importance of collective action. There are emphases made for individuals and societal members to disintegrate disablement, and advocate for an active and inclusive culture.
“The social model should promise much for people with learningdifficulties in terms of its analysis of their experience and its strategies for change. However, this promise has not been realized” (Chappell A.L, et al 2001 pg 46).
The challenge to the model is to ensure that supporters, professionals, and those with and without learning difficulties, identify the significance of the social model to disabled people, additionally, the factors which should articulated.
Those who have a label are officially protected by various disability mandates; however, there are still various negative social and political connotations that connect to the label. This is due to society creating a ‘normal’ group and then labelling those who are ‘deviant’ (Ho 2004). Although the disability term approved individuals to arrange together with others through the self-advocacy movement and bureaucracy, the conception of ‘learning difficulties’ and ‘learning disabilities’ are diverse (Goodley, 2001). Certain individuals may at times feel that by having a disability label they are different and can be frequently “understood to be inferior and not fit to be part of the ‘normal’ population (Ho 2004 pg 87). This can be seen as a social problem which can be linked to social justice or social order.How? Make it clear.
WithinBritain the Disability Discrimination Act(1995)identifies disability utilising the medical model. However, it the responsibility of managers as well as service providers to ensure that there are equitable adjustments to their policies, practices, and physical aspects of their premises, which pursue the social model. As a result of adjustments being made, employers and service providers are ensuring that barriers are eliminated, which according to the social model, are effectively eradicate, an individual disability (Chappell A.L, et al).
Consequently, although particular mandates are complied with by various organisations in making employment decisions, the legislations around disabilities within certain countries that have been developed to protect those who are disabled from discrimination, have not tackled certain discriminatory attitude and responses universally (Ho 2004).Such as what? Make it clear.
“Until about a century and a half ago, justice was standardly understood as a virtue not of societies but of individuals” (Barry 2005, pg4). In the 1940s, the contemporary perception of social justice surface out from the throes of early industrialisation in the UK and France. The radical notion of the idea of social justice was that the justice of the core of society establishments may be challenged.
When linking a social justice theory to the remit of normalisation it is important there is a right theory of social justice. The phrase ‘the machinery of social justice’ came from a Commission on a Social Justice paper by David Donnison. Donninson claimed that “the working parts of the injustice machine are different patterns or dimensions of injustice, each of which has many causes” (Barry 2005 pg 14). Thus the effect of the interdependence amid the impact of social injustice is “none of [these patterns or dimensions of injustice] can be reversed if it is tackled in isolation from the others” (Barry 2005 pg 14).
If the question was asked, what is the subject of social justice? There would be influential answers, found in studies by John Rawls who described it in ‘A Theory of Justice’, as a basic structure of society. The basic structure can be represented by the major institutions which allocate rights, opportunities and resources (Barry 2005).
Institutions which play an important part in providing individuals with different life chances are significant to understanding what social justice is. To an extent, they have vital factors that can transform passing laws. Institutions are not an end in themselves; they are a way of getting things done. In order to know how far a society’s institutions collaborate in unity to generate social justice, there must be considerations on “the distribution of individual rights, opportunities and resources” (Barry 2005 pg 17) that the institutions bring.
There are requirements for social justice to be ‘just’, but this can be resulted to incompetence of liberal justice. “…The foundation of the liberal conception of justice is that all citizens should be treated equally” (Barry 2005 pg 23). However, a number of learning difficulties adults who live within communities are treated as second class citizens because of their label, and impairment of understanding additionally; they are not seen as ‘normal’. Furthermore, because of oppression on those with learning disabilities, at times individuals are unable to access their rights in particular circumstances, i.e. obtaining a job. Karl Marx was one of many who saw the importance of individuals having opportunities and individual rights…….Marx discussed class and capitalist………….Webber rejected Marx perception on capitalist…..Webber ideologies was on class structure. There were internal contradictions on a class structure…through having social ranking and social class, there are inequality of justice and order…….Unsure how to further explainI don’t think you should get lost in this one, maybe just a simple nod to Weber will do it. You don’t need to get into major explanations of Marx/Weberian differences economic-political structures.
Within the media, those with a learning disability are scarcely featured on television, radio or in newspapers. There are several companies investigating how those with a learning disability are seen in the media. Recently various papers such as the London EveningStandard and the Guardian all displayed people with learning disabilities positively. Films such as Afterlife and Fleshand Blood, and Radio 4’s live programme, ‘Does He Take Sugar?’ Have featured actors with a learning disabilityHowever,Media groups recognise that they need to do more for people with a learning disability, nevertheless changes have been slow.(http://www.imagesofdisability.gov.uk/docs/viewpoint.pdf)
Since learning disabilities people were brought out of long-stay hospitals and into the community and particular things have changed and person-centred planning has been adopted as a tool of practice, there is a more mutual relationship between a learning disability person and the professional where both are afforded some expertise. Social workers now act as their care managers rather than psychiatrists and nurses. There is a different balance of power as social workers don’t have the all-controlling power of doctors. Some have regarded this as a ‘therapeutic alliance’ between the social worker and service user. They have to collaborate together to be successful. Additionally, it is important that social workers enable that there is equality and justice when working with learning disability people.
In conclusion, theMedia can be a powerful tool in breaking down stereotypes and oppression faced by those with learning difficulties,as the media voice can inform society of the social problemshelping to change people’s ideas via using pictures of people with learning disabilities which show what they can do, such as having a job or volunteering.
It is important for all social workers to be careful in what they may identify as what is normal. What one may think is normal; another person may perceive as abnormal, therefore, it is vital that social workers work fairly enabling people to have respect for whoever the service users are.
In order for the social justice and social order inequalities not to exist, it is important for people with learning disabilities to have entitlement, first class citizenship, autonomy, and have rights. The political forces need to require and bring about changes which would be needed to carry over to advance justice in other ways.
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