Normalization of Group Homes - Essay Example

Normalization of group homes entails more than the visual appearance. Non visual features such as poor acoustics can be just as important.There may be a relationship between poor acoustics and resident comfort and behavioral outbursts. Several group homes in Western New York were studied to determine the extent of poor acoustic conditions and their causes. Size and material choices, in conjunction with the use of space contributed to poor acoustic conditions. Definition Normalization involves the acceptance of people with disabilities, with their disabilities, offering them the same conditions as are offered to other citizens. It involves an awareness of the normal rhythm of life - including the normal rhythm of a day, a week, a year, and the life-cycle itself. It involves the normal conditions of life - housing, schooling, exercise, recreation and freedom of choice. This includes "the dignity of risk", rather than an emphasis on "protection". (Bank-Mikkelsen, 1976, Misconceptions on the principle of normalisation, Address to IASSMD Conference, Washington, D.c.) Introduction Understanding of people with significant learning disability (and work with them) has changed over the years. There has been an evolution from early notions that emphasized otherness, through theoretical and social administrative frameworks that legitimized segregation and under-resourcing through an emphasis on pathology and deficiency, to the present situation where there is widespread legitimation (if not consistent support) for notions of shared humanity, inclusion, civil rights and need for additional support History The principle of normalization was developed in Scandinavia during the sixties and was first developed and articulated by Bengt Nirjie (The normalisation principle and its human management implications, in R. Kugel & W. Wolfensberger (Eds.) Changing patterns in residential services for the mentally retarded, Washing, D.C. President's Committee on Mental Retardation.) The principle was developed during the seventies, especially by Wolfensberger in Canada through the National Institute on Mental Retardation (NIMR) (Normalization. The principle of normalisation in human services, Toronto, NIMR, 1972). Normalization has had a significant effect on the way services for people with disabilities have been structured throughout the UK, Europe, North America, Australasia and increasingly other parts of the world. It has led to a new conceptualisation of disability as not simply being a medical issue (the medical model which saw the person as indistinguishable from the disorder), but as a social situation. Government reports began from the 1970s to reflect this, e.g. the NSW Anti-Discrimination Board report of 1981 made recommendations on "the rights of people with intellectual handicaps to receive appropriate services, to assert their rights to independent living so far as this is possible, and to pursue the principle of normalization." Traditional conceptions of perception Traditional conceptions of perception acknowledge the five senses: taste, touch, smell, vision and hearing. Thus perceptual theory suggests that there are additional aspects to normalization beyond appearance. In particular, acoustics can have a strong impact on the character of a place. What acoustic issues in group homes affect normalization, health and well being of the residents There are a range of concerns, from the physical comfort of the residents, the safety and stability of the staff's working conditions, as well as questions about the relationship, if any, between acoustic problems and behavioral incidents among residents with autism and other disabilities Ordinary living, rights, needs-based, normalisation / role valorisation - based perspectives. Definitive statements about the normalisation principle include Nirje (1969, 1980, 1985), O'Brien and Tyne (1985), Wolfensberger (1972, 1980, 1983, 1992), Wolfensberger and Glenn (1975), Wolfensberger and Thomas (1983). A variety of guides and manuals for practice and service provision has been based on or drawn freely from this body of work (e.g. Brechin and Swain (1987); Firth and Rapley (1990); O'Brien (1987); Perske (1980); Richardson and Ritchie (1989), Sanderson (1995). Different exponents tend to have rather different emphases, but as a whole this tradition emphasises the following: social integration (with its corollaries of localisation and dispersal of provision), positive social roles and images, .the commitment and involvement of community members rather than service system employees, dignity, autonomy and growth. Ideology of normalization All social changes require an ideology to support the economic rationality underpinning them. So the ideology underpinning the rise of the institution was ultimately a medical and a therapeutic one; accordingly placing people in institutions was not only good for the health of individuals, it was also good for the health of society. Normalization, it could be argued, is the ideology (or one of the ideologies) that allowed people to be returned to the community in that they can be 'normalized' or in its later variant, be allocated normal (valued) social roles. After all, we don't want the different, the deviant or even the dangerous returned to our communities. Normalization and service sector To Wolfensberger, normalization can do as much for the mentally ill as for the retarded. It will integrate the patient into society, at least as far as his illness permits, and wipe out or minimize the "subcultures of deviancy" that develop in institutions. To achieve that goal, Wolfensberger advocates specific changes in treatment: > Patients should not be submitted to a "mortification" process-stripped of clothes and possessions and locked up. They should be free to turn lights off and on, open or close windows, welcome or reject a would-be visitor: "A nurse sweeping abruptly into a resident's room commits an act of denormalization." Patients should also get up, eat and retire at normal hours. > "Normalization means living in a bisexual world." There should be "at least as much mingling of sexes as in a hotel, a mixed boardinghouse, or a home in which there live adults other than a married couple." > Patients should not be forced, or even encouraged to take part in endless recreational therapy. "While American society approves of recreation after work, it does not approve of recreation instead of work; the latter is viewed as childlike play activity." Normalisation and Criticised Normalisation has been criticised (by Wolfensberger and others) as narrow in its approach and only prescribing action, rather than placing it in a social context with scientific explanation. It was also open to perverse use: for instance, assuming that if people were made to live in normal housing, they were seen as "normalised." It was easily assumed that Normalisation was obvious and simple, as it seemed such a simple concept. Normalisation theory was re-formulated to give it a base in social science theory. It stresses the importance of the position that a person holds in society, rather than the mere normalisation of work or home settings. The name was chosen to avoid an assumption that it was 'common sense'. Greater emphasis is placed on role rather than experiences. Valorisation means, "Giving a Value To." Social Roles are discussed in-depth later. Wolf Wolfensberger at Syracuse University, New York was the person who made this reformulation. The Principle of Normalisation The application of what science has to tell us about the defence or upgrading of the socially perceived value of people's roles. Wolf Wolfensberger 1998 Working Definition Used In This Text This is the current working definition that I use: SRV is a scientific explanation of why people are badly treated by society. It may also suggest ways that such people may be helped to avoid negative outcomes Normalistic Subjectivity and Self-normalization According to Link, normalistic subjectivity is based on the ability of self-normalization within a social organization. It is structured in a way that a high social inner stability is maintained despite different, constantly changing influences of the social environment. Normalization is, thus, to be seen as the process through which subjects tentatively approach, adapt to, and develop new and modern conceptions of normality The Role of Experience In explaining why the idea of normalization was so powerful for many people, Wolfensberger claims that it connected with their commonsense, it gave them a language or discourse in which to talk about the issues and it gave them a unified mental scheme (social theory)connecting a range of issues (p59). Of course, in talking about this he is talking about the connection of these ideas to the experience of academics, professionals and policy makers not to the experience of people with learning difficulties Benefits of Normalisation Normalization theory sees improving human services as a major platform for improving the quality of life for disabled people and indeed much time and energy is devoted to precisely this. As far as disabled people are concerned, we have seen over the past fifteen years disabled people coming together to organise themselves as a movement at local, national and international levels. In Britain, for example, in order to harness this growing consciousness of disabled people, to provide a platform to articulate the re-definition of the problem of disability and to give a focus to the campaigns for independent living and against discrimination, the British Council of Organisations of Disabled People (BCODP) was formed in 1981 and its success in the subsequent decade is entirely an achievement of disabled people themselves (Hasler 1993). Other benefits for the normalization as follows The role of (un)consciousness Individual, organisational, and societal unconsciousness sustains social devaluation. This is particularly the case when unconsciousness reduces the awareness of the extent, realities, and dynamics of social devaluation. SRV aims to raise consciousness about these issues, especially in human services and society. The dynamics and relevance of social imagery The symbols and images that are, and historically have been, attached to devalued people influence role expectancies about them and their social valuation. SRV incorporates an examination of these processes and the adoption of strategies that will convey positive messages. The power of mind-sets and expectancies Mind-sets and expectancies largely control the perceptions of, and behaviour towards, people. "[They] play an especially important part in the specific role expectancies that will be placed on, or structured for a person or group, and in the competency-enhancing measures and conditions that are afforded or made available to a person or group." 8 SRV develops many strategies about how to influence mind-sets and expectancies positively. The relevance of role expectancy and role circularity to deviancy making and deviancy unmaking. Role expectancies and role circularities, sometimes referred to as 'self-fulfilling prophecies', are "among the most powerful social influence and control methods known." 8 SRV identifies the means by which these influences operate (e.g. via physical environment, juxtapositions of people, language) and how they can be used to convey positive or negative role expectancies. The importance of interpersonal identification between valued and devalued people Access to "the good things in life" 8 is more likely to be afforded to devalued people if valued people see themselves as being like them and having things in common with them. The importance of personal social integration and valued social participation, especially for people at risk of social devaluation Segregation from valued society is a major wound experienced by devalued people and reinforces negative societal beliefs about those groups. SRV provides a set of rationales in support of the social integration of devalued people in valued participation, with valued people, in valued activities, which take place in valued settings. THE SOCIAL ROLES OF PERSONS WITH INTELLECTUAL HANDICAP The principle of normalization offers a clear direction for learning-through-action by specifying a common sense standard for judgment: services should use socially valued means to promote socially valued lives. Once they are awakened to this way of seeing, the pervasiveness of service practices that vary wildly from what is typical, much less what is socially valued,* convinces some people that they should do better. From discovering how little most residences are like real homes, how little most day activities are like real jobs, how little special education resembles ordinary schooling, and how well these differences are obscured by everyday beliefs about people with disabilities, people working to apply the principle of normalization often decide that exploration of one or another socially valued analogies to the form of service under consideration offers a way forward. They work to provide real homes, real jobs and real schooling. In doing so, they repeatedly confront the protean forms of social devaluation. Two of these viewpoints usually occur in the debate on the implications of the "normalization principle". The third aspect, which motivates this dramatic change in relations between society and persons with handicap, takes a stand on a very critical issue, namely the question of what social role is conferred on these persons. It was Wolfensberger (1969) who gave particular attention to the relation between the social role conferred on persons with handicap and the way in which society chooses to organize and provide measures for them. He points for example to the time when these persons were regarded as "Holy Innocents" and it was the task of the church to provide for them. When this handicap-group were considered to consist of "subhuman organisms" measures could be accepted which did not recognize the human needs of these persons. The large institutions, with an environment and routine which was impervious to the needs of those residing there illustrate his point well. When the person with handicap was perceived as a "sick person" it was natural that provision was made for them within the medical services, in hospital buildings and with medically trained staff. SOME SOCIAL ROLES FOUND IN SWEDISH SERVICES No proper analysis, comparable to that presented by Wolfensberger, has been made over the social roles conferred on persons with intellectual handicap in Sweden. There is however some manifestation of the use of social roles which makes it possible to characterize some such roles. It is not uncommon that one has more or less inexplicitly accepted a certain role. It has sometimes even been relatively well characterized. Qvarsell for example has pointed to a motive which influenced the content of institutions established during the 19th century. As a reaction to what was considered the "negligent" family, which no longer could care for its children, it was regarded as desirable that conditions within the institution as far as possible resembled the traditional family including the just father figure. The person with handicap became the "child" that would receive its upbringing with the "family" of the institution. "As Much as Possible" - The Motor for Learning The principle of normalization contains this indefiniteness with the conditional phrase, "as much as possible," which provides a motor for continuing learning through repeated cycles of action and reflection. This conditional phrase brings high aspiration firmly in contact with everyday life in a way that invites practitioners to acknowledge and actively engage multiple constraints in their pursuit of socially valued lives. "As much as possible" acknowledges limits arising from: the level of overall resources available in a society and in a community; a person's disability, given access to assistive and instructional technology; a person's choice, given opportunity and assistance; and the human condition. These limits are framed as constraints to be actively engaged in the process of learning rather than used as excuses for inaction or shoddy work. Active engagement will change the limits in uncertain and unpredictable ways: a disabled person who experiences the expectations and rewards of filling a valued job role will face new developmental challenges with different resources than a person left to languish as a client in an activity center. Some challenges may be daunting and the person's resources may be insufficient, but the set of constraints is changed by seeking as valued a way as possible to offer the person occupation. The Powers of Social Devaluation Those who apply the principle of normalization do not find a smooth road which we can traverse from darkness into light just by working smart and hard. Their work is not like sculpting hard stone or building a highway in difficult terrain. The situations they struggle to change don't passively assume the shape of their meticulously implemented designs as a simple function of craft and persistence. The situations they struggle to change fight back. There is even more to this intractability than the political difficulty of persuading or commanding people with diverse interests to cooperate, or the managerial problems of accounting for complex uncertainty. Much teaching about the principle of normalization descriptively labels this systemic capacity to fight back "social devaluation," and elucidates its dynamics: there are powerful and actively oppressive forces inherent in human social organization that assign disabled people to devalued roles and cast them out of ordinary society into settings that congregate, segregate, control, and further stigmatize them. Efforts to offer people valued social roles are themselves stamped by these forces, usually in ways that are not apparent to change agents until ironic or downright destructive consequences ensue. The Turning Point The decision to withdraw from activities and service forms unmasked as hurtful brings the learner to another decision: whether to withdraw completely from the work of reforming services and to pursue a more communitarian or personalistic commitment to devalued people, or to look for a path of creation. Identifying this decision is not to make a moral judgment in favor of the path of creation, however attractive the name may be. It is only to say that moving away from service reform leads a person away from one of the central challenges of the principle of normalization -which, as exhaustively defined by PASS and PASSING, is almost completely about reforming service practice. There can be great merit in deciding not to step back into the service world and embracing some other commitment. And, given the craziness of service systems, following the path of detachment right out of the service world may sometimes be the most prudent choice as well. Implementation of normalisation principles It is important to note here that by normalisation they did not mean making intellectually disabled people average or normal, but rather to provide them as much as possible with the opportunities and experiences that non-disabled people have access to. A major corollary of the implementation of normalisation principles has been a change in the accommodation options available to people with a disability. Congregate care in large, institutional, hospital-like settings, a legacy of the outmoded medical model, was replaced by a preference for smaller size options, such as shared flats or living in groups of four or five in houses in the community, called community residential units (CRUs). In the last half-decade the most innovative service providers are now providing individualised supports that enable people with a disability to live in their own homes with people they choose. It is important to note that relocation from large institutions to smaller scale options, often referred to as de-institutionalisation, does not mean less resources are required to provide the support services for the people involved. Unfortunately, some attempts at de-institutionalisation have not succeeded due to a failure to adequately provide necessary support services in the community. In contrast, there are many examples, both in Australia and overseas, in which people with intellectual disabilities have been successfully relocated into the community (for example, Radler, Laurie & Gavidia-Payne, 1999; Radler, 2004). The person-centred planning movement (Kincaid, 1996; O'Brien, Mount, & O'Brien, 1991) has articulated values and provided tools for planning with individuals with an intellectual disability so that they can be fully included in the life of the community. Many psychologists work with people who have an intellectual disability. For some psychologists it will be the prime focus of their job. This will apply to the psychologists who work for the various State government disability services. For other psychologists it will be an incidental part of their job. This would apply, for example, to psychologists who work for a State government department of education, in hospital out-patient clinics, or in private practice. It is not unreasonable to suggest that because of the use of generic services by people with intellectual disabilities, all psychologists need to be professionally prepared to provide them with appropriate support. The nature of psychological work in the field of intellectual disability will vary considerably, but three major areas are the assessment of individuals, the planning and provision of interventions to address challenging behaviour, and the evaluation of services provided to disabled people. Refinement of normalization As part of the refinement of normalization, Wolfensberger and his Training Institute associates developed a service evaluation instrument that came to be known as PASSING, which stands for "Program Analysis of Service Systems' Implementation of Normalization Goals" (Wolfensberger & Thomas, 1983, 1988). PASSING was designed to assess the quality of human services in relation to their adherence to SRV. The major action implications of SRV are spelled out in much more detail in PASSING than in any other publication to date. However, the term "Social Role Valorization" had not yet been coined when PASSING was printed. PASSING thus incorporates mostly SRV concepts while still using the earlier normalization language. The development of PASSING contributed much to the insight that actions to achieve the ultimate as well as intermediate goals and processes of SRV can all be classified as dealing with either image and/or competency enhancement. Misconceptions There are a few misconceptions about the principle of normalization: a) Normalization means making people "normal" - forcing them to conform to societal norms. Wolfensberger himself, in 1980, suggested "Normalizing measures can be offered in some circumstances, and imposed in others." (Wolfensberger, W. (1980) The definition of normalisation: update, problems, disagreements and misunderstandings. In R.J. Flynn & K.E. Nitsch (Eds). Normalization, social integration and human services. Baltimore: University Park Press) This view is not accepted by most people in the field, including Nirjie. b) Normalization supports "dumping" people into the community or into schools without support. Normalization has been blamed for the closure of services (such as institutions) leading to a lack of support for children and adults with disabilities. However support services which facilitate normal life opportunities for people with disabilities - such as special education services, advocacy and housing support - are not incompatible with normalization, although some particular services (such as special schools) may actually detract from rather than enhance normal living. Conclusion I have attempted to chart the development of social and educational practice in relation to persons with special needs due to disabilities and other backgrounds such as social, linguistic and economic experiences. The normalisation movement, which began in Scandinavian countries in the late 1950s, spawned many research activities since the 1960s in Europe and North America. The concept of normalisation was not relevant to Africa; we did not have institutions. However, it influenced the move towards integration, which was adopted in all regions of the world. I would like to argue that integration is also alien to Africa because it does not recognise diversity of human beings. It merely seeks to assimilate those who are different to learn and behave like everyone else. It also supports the continued existence of special education as a separate system In summary, debriefing is valued and may help some, but for most the appraoch should be normalisation, allowing them to express emotions and return to normal as quickly as possible. I think faith has a large role to play in helping people ask big questions, offering and facilitating prayer, tempering the anti-islamic hate and providing an external 'other' to blame, invoke or shelter in. Gender - Disability - Normality are directly interrelated. Gender and disability function as organizing societal categories, though the category of gender should be understood as a stable and fixed one (organized in modern society as binary oppositions), the category of disability, in comparison, is a softer and more flexible category. Normality, in contrast, has a different structure: it is mainly visible through risk and deviance, and it is also more readily definable through risk and deviance, rather than as an independent concept; it is debated in constant social discourse, is always mobile and finds its place, guided by everyday, growth-oriented societal requirements. Normalisation and SRV have contributed much to human service development, particularly for people with learning disabilities where the ideas first emerged. Although more than 3 decades old and following unprecedented reform and changes in services, the ideas remain challenging and provocative. For that reason, and because SRV theory in particular is comprehensive and complex, they are not well understood and often misunderstood References "Setting the record straight: a critique of some frequent misconceptions of the normalization principle", Perrin, B. & Nirjie, B, Australia and New Zealand Journal of Developmental Disabilities, 1985, Vol 11, No. 2, 69-72 Flynn, R.J. (In press). Evaluation of service quality with PASS and PASSING: A review of research, 1988-1995. In Flynn, R.J., & Lemay, R. (Eds.), A Quarter-Century of Normalization and Social Role Valorization. Ottawa: University of Ottawa Press. Nirje, B. (1982): The basis and logic of the normalization principle. From Kebbon, L. (Ed) Six papers. IASSMD Congress, Toronto 1982. Uppsala: Mental Retardation Project. SFS 1954:483 Lag om undervisning och vrd av vissa psykiskt efterblivna. (Law on education and care for certain mentally deficient persons). SFS 1967:940 Lag angende omsorger om vissa psykiskt utvecklingsstrda. (Law on services for certain mentally retarded persons). Wolfensberger, W. 1983: Social role valorization: A proposed new term for the principle of normalization. Mental Retardation, vol. 21(6), 234-239. Read More