'It's pretty hard with our ones, they can't talk, the more able bodied can participate': staff attitudes about the applicability of disability policies to people with severe and profound intellectual disabilities.
Train staff that partnership, not ability level, drives inclusion.
01Research in Context
What this study did
Bigby et al. (2009) asked residential staff if disability inclusion policies work for residents with severe or profound intellectual disability. They ran focus groups and coded the talk for themes.
Staff liked inclusion in theory. They said it breaks down when residents cannot speak or need total help.
What they found
Workers agreed inclusion is good. They also said, "Our people are too disabled to take part."
The gap between policy and practice was taken for granted. No one asked how to close it.
How this fits with other research
Cramm et al. (2009) talked to adults with mild ID. Those adults said supported jobs made them feel proud. The two 2009 studies seem to clash—staff doubt inclusion works while clients say it helps. The gap vanishes when you see the first group had mild ID and the second had severe ID.
Cudré-Mauroux et al. (2020) shows a fix. Staff who shift from "I decide" to "let’s decide together" boost self-determination even in people with limited speech. Their partnership style extends the target paper by giving a concrete tool.
Libero et al. (2016) scoping review agrees the field still has no shared definition of participation. They include the 2009 staff doubt as one piece in a bigger picture.
Why it matters
Your team may quietly think inclusion is pointless for the most disabled clients. That belief blocks progress. Use Annick’s partnership script: offer choices, wait for any response, and honor it. Model this in your next staff training so "too disabled" stops being a reason and starts being a design challenge.
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02At a glance
03Original abstract
BACKGROUND: The level of resident's adaptive behaviour and staff facilitative practices are key sources of variation in outcomes for residents in community-based residential services. The higher the resident support needs the poorer their outcome. Although substantial investment has been made in values-based training for staff, their attitudes and the impact of these on practice is largely unexplored. METHOD AND FINDINGS: The first study used ethnographic and action research methods to examine the daily lives of 25 residents with severe and profound intellectual disabilities (ID), who lived in five small group homes, and the attitudes of the staff supporting them. Thematic analysis of the data led to a proposition that although staff accept principles of inclusion, choice and participation for people with ID in general, they do not consider it feasible to apply these to the people with severe and profound ID to whom they provide support. The findings from a second study that used a group comparison design and administered a short questionnaire about staff attitudes to 144 direct-care staff and first-line managers working in disability services confirmed this hypothesis. CONCLUSIONS: The study suggests more focused attention is needed to staff understanding the values embedded in current policies and their application to people with more severe disabilities.
Journal of intellectual disability research : JIDR, 2009 · doi:10.1111/j.1365-2788.2009.01154.x