Concepts of access for people with learning difficulties: towards a shared understanding

This article explores both the process and outcomes of a seminar series on the concept of access for people with learning difficulties. The seminar topics chosen to foster dialogue across professional and disciplinary boundaries included access to information, education, employment, the law, health, leisure, community, past histories and future plans. The seminars brought together people with learning difficulties and their support workers, researchers and professionals, to examine the expert knowledge of people with learning difficulties in negotiating access, the role of practitioners in mediating access and the contribution of research to understanding access. The aim was to develop a rich, shared understanding of the concept of access for people with learning difficulties. However, a huge amount of ‘access work’ had to be done to achieve this. The article discusses that access work and proposes a multidimensional model of access and ways of promoting it.     

The role of self-advocacy in work for people with learning difficulties

This paper explores the relationship between self-advocacy and work for people with learning difficulties [1]. Explorations are based mainly on a participant observation study in which members of a self-advocacy group for people with learning difficulties included the researcher in their regular meetings. Discussions about work, most broadly defined as meaningful activity which makes a contribution to society, emerged as a critical preoccupation. We examine the importance of self-advocacy as a vehicle for people with learning difficulties who want to remove or circumvent barriers which surround their employment. Our research shows that understanding the role of self-advocacy in relation to work creates many development opportunities for both disabled employees and their prospective, or actual, employers. It is suggested that self-advocates can themselves achieve change in employers' attitudes by challenging oppressive images of people with learning difficulties in the workplace. It is hoped the paper will advance recognition of the importance of self-advocacy for maximising the participation of people with learning difficulties in work, and for acceptance of their status as workers.     

Beyond normalization and impairment: theorizing subjectivity in learning difficulties – theory and practice

Normalization and social role valorization continue to play a central role in shaping debates and practice relating to learning difficulties. In the context of recent arguments this paper draws on the work of Foucault to deconstruct these theories. Foucault’s work alerts us to a conceptual confusion at their heart which reproduces a common but problematic individual–society dualism. There is an implicit, and problematic, presence in the theories of a pre‐social individual conceived as having essential impairments and who is passive in the face of negative socialization. We propose that Foucault’s ‘ethical’ domain of inquiry, with its concern for how people actively understand themselves and govern their conduct in relation to specific values and a ‘truth’ that they are obliged to recognize in themselves, provides the basis for returning the individual‐as‐subject to theories in an active, critical manner.     

Men with learning difficulties doing research: challenging views of learning difficulties

This paper explores the views of men with learning difficulties living in a secure environment. Reflecting findings from a doctoral thesis based upon a research project where the participants looked at the processes and concepts of research, the dialogues within the study were analysed using critical discourse analysis. Thesis aims relevant here include investigating given ‘truths’ about the positives of having a learning disability. The men are not only categorised as having a learning difficulty, but also have the added stigma of being offenders, and commonly having mental health issues which expose them to the worst of myths surrounding learning difficulty. Despite this, the findings suggest that the men are very positive about their lives – reporting that they have many attributes and talents – and view having a learning difficulty as an advantage at times. This affirms Foucauldian ideas on the way that dominant knowledge may be challenged.     

Children with profound and multiple learning difficulties: laughter,capability and relating to others

There are numerous ways in which human beings respond to humour: they smile, grin, laugh, giggle or guffaw, and their behaviour might include anything from a glint in the eye to an uncontrollable heaving of the whole body. We consider how laughter is displayed in the lives of four children with profound and multiple learning difficulties and disabilities (PMLD), and reflect on what this reveals about their capabilities and relationships. We look at examples of absurdity and incongruity as elements of humour, and we explore how these create a space for ‘relational commonality’ between people whose differences are many and profound. We suggest that laughter, and involvement in humorous interaction, enables children with PMLD to express themselves, to develop relations with others and to be seen as fully our fellow human beings.     

Impact of a multidimensional intervention programme applied to families at risk for child neglect

The purpose of this study is to evaluate the effects of an intervention programme applied to families at risk for child neglect. Twenty‐nine families were recruited through a Local Community Services Centre (LCSC) and were assigned to two groups: (1) the first group participated in a multidimensional eco‐systemic intervention programme called the Personal, Family and Community Help Program (PFCHP); and (2) the second group underwent psychosocial intervention that was provided as part of regular LCSC services and focused mainly on the social worker–family relationship. Pre‐test measures were obtained at the beginning of intervention for both groups and a follow‐up was held 24 months later. Quantitative and qualitative analyses indicated that both forms of intervention were associated with improved parent–child relationship and the reduction of parental stress, depression and the potential for child abuse and neglect. However, PFCHP participants showed multiple indications of improvement in their social and marital relationships, which was not the case for LCSC participants. The conclusion outlines the need for a long‐term intervention process for families at high risk for child neglect and the necessity of addressing multiple dimensions of family life if lasting changes are to be expected. Copyright 2000 John Wiley & Sons, Ltd.     

Report on the implementation and evaluation of an interprofessional learning programme for inter‐agency child protection teams

Effective collaborative working between the different professions and agencies working to safeguard children is essential. Lack of knowledge of others' roles, perceived differences in status and expertise, and negative stereotypes are examples of why this can be difficult to achieve. A facilitated interprofessional learning (IPL) programme was implemented to assess if such an intervention could overcome some of the barriers to effective interprofessional and inter‐agency team working. Six teams based in primary and secondary care trusts took part with participants from health, education, police and social services. Quantitative and qualitative data were collected from individual participants using a pre‐validated team climate inventory and reflective statements. Findings from this study demonstrate statistically significant changes in five out of six categories in the inventory. Reflective statements suggested that overall the programme offered a positive learning experience at both an individual and team level. The importance of outside facilitation to maintain the team's momentum was acknowledged, as was the difficulty of maintaining a good level of activity once the programme had ended. Nevertheless, the IPL programme provided a timely opportunity to reflect upon the interprofessional and inter‐agency team working needed within Children's Trusts and the implications for staff involved with regard to skills development. Copyright © 2009 John Wiley & Sons, Ltd.     

Begging as work: a study of people with mobility difficulties in Accra, Ghana

Even though begging is illegal in Ghana, an increasing number of disabled people engage in it. Begging is not only abhorred by the law, but also regarded by many Ghanaians as stigmatizing and devaluing. Successive governments of the country and some non-governmental organizations (NGOs) have made efforts either to reduce or eliminate begging. The attempts made have, however, been unsuccessful and the disabled beggars involved have returned to the streets of Accra. The question is why is it difficult to reduce begging in the research area. While poverty, mobility needs, lack of education and employable skills and employment avenues are factors that explain the decision to start begging, it also seems that the ways in which beggars justify their activities contribute to its perseverance. The study aims at sensitizing policy-makers and other stakeholders in attempts to find empowering alternatives to begging.     

Listening to children: Evaluation of a positive parenting programme through art-based research

This paper presents data from a unique programme evaluation of the parenting programme titled ‘Learning together, growing as a family’ applied in 14 cities in Spain and targeting families at risk of neglectful behaviour. The programme evaluation is based on the voices of children using the qualitative methodology of art-based research. Eighty-six children 6–12 years of age were interviewed in groups. The outcomes of the evaluation reveal that children perceive improvements in the parental competencies of their parents and in themselves and that these changes serve as a catalyst for positive family change.     

Issues of autonomy in the psychotherapy of children with learning problems

For certain children, learning and performance represent a major battleground in their struggles for autonomy. In treatment these children try to get the therapist to do something to them. This poses serious clinical problems since interpretations may be perceived as an attempt at control by the therapist. Such children can use interpretations only after treatment has proceeded in such a way that they have come to feel more autonomous. The psychotherapy of a latency-aged girl with severe learning problems is described and discussed. The authors' approach suggests implications for educational practice.     

Examining the effect of the computer-based educational package on quality of life and severity of hypogonadism symptoms in males

Objective: The objective of this study was to determine the effect of the computer-based educational package on men’s QoL and the severity of their hypogonadism symptoms.

Methods: A quasi-experimental study was conducted on 80 male employees. The data collection tool included the ‘Aging Male Symptoms’ (AMS) and ‘Short Form-36’ (SF36) questionnaires. Four sessions were held for the intervention group over a period of 4 weeks. Two months after training, QoL and the severity of hypogonadism symptoms were measured in both the intervention and control groups. The data were analyzed with SPSS 22 software and statistical tests, such as χ², independent t-test, Fisher’s exact test, and paired t-tests.

Results: Significant statistical changes were observed in the intervention group before and 2 months after the training in the QoL score in the overall dimensions of physical–psychological health and all its domains except for three domains of emotional role, social function, and pain. Furthermore, the paired t-tests showed significant differences between 2 months before and after the training in all the domains and the overall hypogonadism score in the intervention group.

Conclusions: Based on our findings, the computer-based educational package has a positive effect on QoL and reduction of hypogonadism symptoms.     

Ethical challenges in researching in group homes for people with severe learning difficulties: shifting the balance of power

Our aim in this paper is to open up debate about informed consent. We do this by presenting stories from group homes where staff have frustrated our research efforts and marginalised the interests of people with severe learning difficulties. We problematise normative ethics and argue that in some circumstances the basic principle of informed consent should be waived for employees of human service organisations. We maintain that, in such circumstances, researchers and an organisation’s senior managers can still act in a manner that is consistent with the broad aims of ethical regulation. We consider the role of Research Ethics Committees and suggest that in order to fully consider the conflicting interests of multiple stakeholders, the application of different ethical theories is required. A requirement for making balanced ethical judgements is to see outside the extant dominant view of ethical research standards and behaviour.     

Dealing with context in logic model development: Reflections from a realist evaluation of a community health worker programme in Nigeria

Logic models (LMs) have been used in programme evaluation for over four decades. Current debate questions the ability of logic modelling techniques to incorporate contextual factors into logic models. We share experience of developing a logic model within an ongoing realist evaluation which assesses the extent to which, and under what circumstances a community health workers (CHW) programme promotes access to maternity services in Nigeria. The article contributes to logic modelling debate by: i) reflecting on how other scholars captured context during LM development in theory-driven evaluations; and ii) explaining how we explored context during logic model development for realist evaluation of the CHW programme in Nigeria. Data collection methods that informed our logic model development included documents review, email discussions and teleconferences with programme stakeholders and a technical workshop with researchers to clarify programme goals and untangle relationships among programme elements. One of the most important findings is that, rather than being an end in itself, logic model development is an essential step for identifying initial hypotheses for tentative relevant contexts, mechanisms and outcomes (CMOs) and CMO configurations of how programmes produce change. The logic model also informed development of a methodology handbook that is guiding verification and consolidation of underlying programme theories.     

A report of an intervention with staff in a hostel for people with learning difficulties

Abstract

This article is a report of a group designed to help staff in a hostel for people with learning difficulties. The group was led by the writer, who at that time was a clinical psychologist based at a local hospital and provided a service to clients and staff in a variety of situations. The group sessions are described, and the implications for leadership and contracting with the group briefly discussed     

Social work education crossing the borders: a field education programme for international internship

The demand for setting international social work education standards are on the rise. The increased prospects of global exchange in teaching learning process initiated by different international universities, as a part of their agenda for international collaboration and cross cultural immersion in the profession are major impetuses for the same. Social work interns who participated in international exchanges appreciated the need for knowledge of global priorities and strategies to advance social work education, research and skill development for practice which also has lead to future collaboration between the institutions in these areas. But there are many challenges for the intern as well as the institutions involved, which should be integrated during different phases of the exchange process. This requires meticulous planning from the part of host institution. This paper focus on the need for international social work, the challenges involved in international internship and the process and content of field education provided to the international students based on experience of the author. The intention of the paper is to propose a general model of international field education, which may be mutually shared and agreed by the home institution as well as the host institution.     

Strategies for supporting the online publishing activities of adults with learning difficulties

This paper reports on a study that explored the online publishing activities of adults with learning difficulties, the strategies that carers and professionals have used to support these activities and the implications these strategies may have for empowerment and self-advocacy. Content analysis of 15 home pages revealed that despite having a certain degree of information and communication technology literacy, many of the authors were being supported in their online publishing activities. For, the majority, their family provided this support. The supportive strategies that were used involved including the home page as part of a bigger family web site and taking sole or joint responsibility for writing the narrative of the home page. These strategies raise interesting questions about the validity of online publishing activities as vehicles for self-advocacy and the power relationships that such activities expose.     

Parental perceptions of risks with older teenagers who have severe learning difficulties contrasted with the young people's views and experiences

The majority of school leavers over two years from two special schools for pupils with severe learning disabilities were individually interviewed (N = 34), as were their parents (N = 38). Parental reports stressed the amount of care and supervision required by these young people. They viewed them as vulnerable to various different hazards such as crossing roads and only a minority were prepared to take the risk of teaching them. However more of the young people felt they were capable of certain tasks. Parents had a particular fear that their son or daughter may be taken advantage of sexually even though the bigger risk—going by the young people's reports—is verbal abuse and bullying from peers. A model is proposed of the influences on parental assessments of risks. This might be used in arriving at ‘shared risk‐taking’ strategies with professionals and the young people during the later years of schooling.     

Pseudo-science and Dividing Practices: a genealogy of the first educational provision for pupils with learning difficulties

Two of Michel Foucault's concepts are used to frame the analysis of the impact of the first dominant form of educational provision for pupils with learning difficulties. The historical background is that of elementary education a century ago and the conjuncture of two Royal Commissions whose deliberations effectively divided the school population into the normal and the exceptional. The definition which identified the exceptional pupil was faulty from the outset, but prevailed over several decades in legislation and secured the dominance of the medical profession in the field. At first, the recommendation for the location of educational provision was ambiguous. The London School Board employed the definition in a particular manner to establish a network of segregated special schools. That became the dominant model, but there was simultaneously available a successful example in another Board of inclusive education for the exceptional children which rejected both the definition and segregation.