An Archi-texture of Learning Disability Services: the use of Michel Foucault

The work of Michel Foucault has been widely used in the social sciences to explore relationships of power and knowledge. This paper utilises Foucault's methods in an initial formation of discourse in the problem of care of people with learning disabilities in the twentieth century, and focuses on the problematisation of people with learning disabilities and their care needs. Little has been published regarding the contingencies of past and current practices in any form of systematic way within learning disability services. Neither has literature on disablism been utilised to support these contingencies. In order to establish a basis for the establishment of this discussion, the work and methodologies of Foucault have been utilised to develop ideas and a textual framework, and links are made with disablist literature. This paper is split into two halves; first classification and support structures, and secondly an architexture of learning disability services.     

The Social Care Work Portfolio: An Aid to Integrated Learning and Reflection in Social Care Training

The focus of the paper is on the use of a specifically designed portfolio in social care training as an aid to both integrated learning and reflection. Integrated learning is achieved through the use of discrete sections in the portfolio which require students to discuss their practice placement agencies from perspectives that demonstrate their understanding of subjects such as theories and practices of social care, psychology, social policy, legal studies. Reflection, which is considered a core element of social care training, is examined as a learning tool. A model for the promotion of reflection is presented to help students gain new perspectives on their learning experiences. Criteria for the assessment of both integrated learning and use of reflection are discussed. Some comments of students, recorded during the evaluation process, are presented as evidence of their learning through the use of the portfolio model.     

Using a logic model to evaluate the Kids Together early education inclusion program for children with disabilities and additional needs

Despite clear evidence that learning and social opportunities for children with disabilities and special needs are more effective in inclusive not segregated settings, there are few known effective inclusion programs available to children with disabilities, their families or teachers in the early years within Australia. The Kids Together program was developed to support children with disabilities/additional needs aged 0–8 years attending mainstream early learning environments. Using a key worker transdisciplinary team model, the program aligns with the individualised package approach of the National Disability Insurance Scheme (NDIS).AimThis paper reports on the use of a logic model to underpin the process, outcomes and impact evaluation of the Kids Together program.MethodsThe research team worked across 15 Early Childhood Education and Care (ECEC) centres and in home and community settings. A realist evaluation using mixed methods was undertaken to understand what works, for whom and in what contexts. The development of a logic model provided a structured way to explore how the program was implemented and achieved short, medium and long term outcomes within a complex community setting.Discussion and conclusionKids Together was shown to be a highly effective and innovative model for supporting the inclusion of children with disabilities/additional needs in a range of environments central for early childhood learning and development. The use of a logic model provided a visual representation of the Kids Together model and its component parts and enabled a theory of change to be inferred, showing how a coordinated and collaborative approached can work across multiple environments.     

Reviewing Respite Services: some lessons from the literature

Although the community care reforms raised the profile of respite services for adults with learning disabilities, little is known about the character of respite provision in Britain. This lack of information is compounded by the way the literature about respite is dispersed across user groups and is often restricted to particular types of services or to specific localities. In order to highlight some of the key issues associated with respite, this paper draws on a wide range of literature. Regardless of differences in terms of the service user groups, common themes are identified which are relevant to service planning and provision for adults with learning disabilities. The paper discusses these themes and argues that a break with the traditional notion of respite as primarily a way to relieve carer burden is long overdue. Adopting the perspective of the primary service users affords the opportunity to re-think respite services.     

Youth with disabilities in the United States Child Welfare System

Existing literature suggests that youth with disabilities are known to be at increased risk of maltreatment in the form of abuse and/or neglect. Little is known, however, about the experiences of youth with disabilities who are living in foster care or who are supervised by child protection authorities. This study establishes a baseline estimate of the prevalence of youth with disabilities living in foster care, documents reasons for child protection system involvement, identifies placement types while youth are in care and explores case outcomes. This cross-sectional, exploratory study draws on data from the 2012 Adoption and Foster Care Reporting System (AFCARS) for foster youth in 50 states, the District of Columbia and Puerto Rico. A sample of youth with disabilities (N = 36.492) and a comparison group without disabilities (N = 601.539) were identified. Findings about demographics, reasons for child removal, foster care placements, permanency planning goals and case outcomes are presented. Findings have implications for the prevention the removal of youth from caregivers, the need for family supports to prevent foster care involvement, the promotion of community inclusion of foster youth while in foster care and the need for inter-system collaboration at the transitional age stage.     

Consulting the Children: Interviews with Children Using Residential Respite Care Services

The Children Act, 1989, requires that services for children are provided in partnership with parents and that the wishes and feelings of the child and his/her parents are ascertained and given due consideration (sect. 22). As part of a research project assessing the quality of services to children with disabilities under the Children Act, the authors carried out evaluations of six residential respite care services. The services were used mainly by children with learning difficulties, some of whom had little or no speech. Staff at the schools attended by the children were asked to interview them, so that their views could be included in the evaluation reports. Interview schedules and aids to communication were devised to try and enable all the children to express their views. This article describes the initial schedules and the changes made in the light of experience during the research. The authors then summarise the children's responses and consider how the process of consultation could be improved in future.     

A Survey of Wellness/Healthy Lifestyling on College and University Campuses

Abstract

Mental health providers at university counseling and health centers should be alert to the possibility that college students with previously unrecognized attention deficit hyperactivity disorder (ADHD) may present for initial evaluation at their centers. This study was a systematic chart review of 42 students at an Upper Midwest university who were diagnosed with ADHD during calendar year 1993. Diagnoses were made by the treating psychiatrist, who reviewed records for presenting problems; recent associated problems; previous evaluations as a child, adolescent, or adult; and associated problems in childhood. Presenting problems included ADHD symptoms, mood symptoms, nonspecific learning disability, and academic underachievement. Associated problems were depressive disorders, anxiety disorders, drug and alcohol abuse or both, dependency, legal problems, learning disabilities, and eating disorders. Thirty-three percent had been evaluated for academic or behavior problems as children, and 36% had sought previous psychological care for non-ADHD symptoms as adults. Thirty-one percent were presenting at the university health center for their first evaluation. Childhood histories showed educational underachievement, learning disabilities, and behavior problems.     

Reconstructing the Sexuality of Men with Learning Disabilities: empirical evidence and theoretical interpretations of need

Research and practice in sexuality and learning disability has directly and indirectly highlighted the pathological sexual behaviour of men with learning disabilities, particularly their abuse and exploitation of women with learning disabilities, and relatively high HIV risk sexual behaviour with men without learning disabilities. It is consequently argued that there has been a relative neglect of their wider sexuality and sexual needs. This paper reconstructs this wider agenda, drawing on empirical evidence and theoretical interpretations of need from research and sex education in support of the observations made. In identifying a range of key issues for sexuality work with men with learning disabilities and arguing that they require greater recognition and attention, the paper also provides directional pointers for informing such work and for responding more widely.     

Teenage dyslexia: stürm und drang

Adolescence, a time of emotional risk for all children, is especially difficult for children with learning disabilities. Academic, social and psychological problems frequently result in extended dependency and derivitive complications. Helping adolescents with learning disabilities achieve social and academic success and psychological well being are important goals of treatment. This paper addresses the special problems youngsters with learning disabilities face during adolescence. Professional interventions are suggested.     

Using discourse analysis to study the experiences of women with learning disabilities

There has been a steady rise in interest in qualitative research methods in the area of learning disability over recent years. Discourse analysis has found relatively little use though, particularly in studying the experiences of people with learning disabilities directly, rather than the accounts of non-disabled informants. The present study used a discourse analytic approach in examining the accounts of women with learning disabilities, in order to arrive at an understanding how they position themselves in relation to gender and disability. The results indicate that, while the learning disability literature and services are largely ‘gender blind’, for women with learning disabilities gender and disability cannot be separated. Instead, they may be faced with marked contradictions and dilemmas when they position themselves within dominant discourses of gender, while also subject to powerful discourses of disability.     

Challenges in Identifying Factors Which Determine the Placement of Children in Care? An International Review

Placing a child in out-of-home care is one of the most important decisions made by professionals in the child care system, with substantial social, psychological, educational, medical and economic consequences. This paper considers the challenges and difficulties of building statistical models of this decision by reviewing the available international evidence. Despite the large number of empirical investigations over a 50 year period, a consensus on the variables associated with this decision is hard to identify. In addition, the individual models have low explanatory and predictive power and should not be relied on to make placement decisions. A number of reasons for this poor performance are offered, and some ways forwards suggested. This paper also aims to facilitate the emergence of a coherent and integrated international literature from the disconnected and fragmented empirical studies. Rather than one placement problem, there are many slightly different problems, and therefore it is expected that a number of related sub-literatures will emerge, each concentrating on a particular definition of the placement problem.     

How Far to Gay? The Politics of HIV in Learning Disability

This paper examines work in sexual health and HIV prevention in services for people with learning disabilities from a political stance associated with the rehomosexualisation of AIDS in Britain. Arguments are made for the re-homosexualisation of AIDS in services for people with learning disabilities, based on evidence of where HIV risk lies in relation to men with learning disabilities who have sex with men. This provides an opportunity to critically review approaches and responses to HIV risk assessment and risk management in services for people with learning disabilities, with reference to the assumptions which underpin practice and issues of sexual identity. The case is made for a more radical sexual politics in learning disability to help combat HIV and to provide more realistic approaches to service commissioning and safer sex education. Pointers for service development and key areas where the re-homosexualisation of AIDS can inform practice and resource development are also provided.     

Problems experienced by students on field placement: using research findings to inform curriculum design and content

Recent recognition of workplace learning from within the University sector has resulted in more emphasis being placed on including field experiences in course curriculum across a range of disciplines. This article begins with a short review of the literature relating to the current context in which work-based learning occurs. Next, selected findings from a survey of 39 Victorian social work students on their experiences of placement learning are reported. The survey focused on problems encountered by students on placement. A number of the problems students faced suggested the need for additional opportunities both before and during the placements to engage with material on safety in the field, and ways to deal with workplace stress and conflict. In response to these issues the article summarises some pedagogical strategies that may be used to enhance student learning in these areas both leading up to and during their field placements. In addition to matters relating to safety and stress, financial pressures were evident for students endeavouring to complete field placements. The recent moves from universities to embrace industry based learning, clearly has implications for funding support made available to students undertaking this type of education.     

The family caregiving context among adults with disabilities: A review of the research on developmental disabilities,serious mental illness,and traumatic brain injury

ABSTRACT

A majority of adults with serious disabilities are cared for in the home by family members. Guided by an ecological framework, this article presents the findings of a literature review of research on family caregiving and family support for adults with disabilities. This review included 33 research studies published between 2000 and 2015 focused on three disabilities: Developmental disabilities, serious mental illnesses, and traumatic brain injury. A synthesis of the findings underscores the critical role that family caregivers occupy in addressing the needs of their loved one with a disability; however, the needs of the caregiver are insufficiently met by existing service approaches. A better understanding of the unique needs and strengths of the family support context of caregivers and care recipients is needed, giving greater attention to ethnic, racial, and cultural considerations in future research.     

Whose Body Is It Anyway? Pressures and Control for Women with Learning Disabilities

What women with learning disabilities think and feel about their bodies should be of interest to those concerned with women's rights and disability rights. Yet scant attention appears to have paid to these issues. It has been suggested in the past that one of the 'blessings' of having a learning disability is that one is free from many of the pressures society places on individuals to conform. However, the research presented here suggests that far from being immune to these pressures to conform, women with learning disabilities are, indeed, subject to strong influences, and overt and covert control mechanisms shape their bodies and minds towards achieving certain norms of femininity.     

Learning for the Twenty-First Century: Maximising Learning Transfer from Learning and Development Activity

This article builds on the learning gathered from the evaluation of a Scotland-wide child protection training programme. Based on Kirkpatrick's four-level framework, the study aimed to evaluate the impact of the learning programme on the practice of participants in the workplace. The study prompted the authors to examine the literature on maximising learning transfer across a range of occupations. This literature is discussed in the light of the findings from the evaluation and the experience of the authors in designing and implementing continuous professional development programmes in social services.

The practice of inspection, monitoring and audit seems to have impacted negatively on staff's willingness to participate in data collection, and coupled with what appeared to be confusion about data protection legislation, the perceived burden of audit and inspection has significant implications for research and evaluation activity.

Suggestions are made for the future design, delivery and evaluation of learning and development activity, and the role of managers is explored in relation to their responsibility for preparation, support and follow-up of workplace learning.     

Emancipation and Self-determination of People with Learning Disabilities and Down-sizing Institutional Care

In Arduin, an organisation for services to people with learning disabilities in the Netherlands, the emancipation and self-determination of people with learning disabilities has been positively adopted as fundamental in order to secure the best possible quality of life of the clients. The client is being encouraged in several ways in a development from a position of dependence towards self-determination. The services provided by the organisation had to be adjusted accordingly and are also going through a transition from 'providing a total care service' towards 'offering the support that the client desires'. In this article the background and developments in perception are being outlined, and those dimensions in quality of life are elaborated that are seen as most essential in the innovation: inclusion, self-determination and personal development. The choices that were made as a consequence in Arduin and most fundamental the choice to dismantle the institution are described.     

Supporting families: Outcomes of placement in voluntary out-of-home care for children and young people with disabilities and their families

Parents caring for children and young people with disabilities typically have extensive additional demands on their time and resources. This added pressure can significantly impact well-being and mental health. In extreme circumstances, parents may seek an out-of-home placement for their child. Previous research has looked into factors that influence decisions for families to place their child into out-of-home care but little is known about outcomes for these young people and their families. The Supporting Families study aimed to explore the impact of a voluntary out-of-home placement on young people with disabilities, and consequences for their families. Fourteen parents/carers, twenty six case managers, six accommodation services' managers, and four young people with disabilities participated in face-to-face and telephone interviews and focus groups. Participants reported a range of outcomes for young people in care. Positive outcomes included increased levels of respect for themselves and others, an improvement in independent living skills, and reductions in challenging behaviours. Negative outcomes centred on their experiences of grief, loss and rejection, as well as behavioural problems. Positive and negative outcomes were also found for families. For many parents/carers there was a reduction in perceived stress and caring load, as well as improved mental health and wellbeing for them and the child's siblings. However, parents/carers often experienced ongoing feelings of guilt, grief and loss. The study adds to knowledge about outcomes of being in voluntary out-of-home care for this small but vulnerable group of young people in care and their families.