Parental agency, identity and knowledge: mothers of children with dyslexia

This is a postprint of an article whose final and definitive form has been published in the Oxford Review of Education© 2004 Copyright Taylor & Francis; Oxford Review of Education is available online at http://www.informaworld.comIn this paper we report and analyse findings from part of a two-year evaluation project which focuses on parent-professional communications over the issues of learning difficulties arising from dyslexia. The key concepts in this study are dyslexia friendly schools and parental partnership, which are discussed in the current policy interest in inclusive education and parent partnership. A conceptual framework has been derived from the study which focuses on parental strategies to ensure adequate provision for their children, knowledge about dyslexia and identity, in particular that of the mother of the child with dyslexia. Excerpts from in-depth interviews of parents are then presented to illustrate the framework. The significance of the findings is examined in relation to other studies of parent partnership. Implications for a more inclusive version of extended professionalism are also considered

Towards a social model approach to counselling disabled clients

The social model of disability has emerged over the past 30 years in Britain to challenge the dominant individual, particularly medical and tragedy, models. This social model is borne from the experiences of disabled people and essentially defines disability as the discrimination faced by people with impairments. This paper explores the possible conflicts between some counselling approaches that can individualise and personalise problems and disability as a political issue. Drawing on research with counsellors and disabled clients, we illustrate the social construction of disability as an individualised problem within the counselling process. Considering the implications for counselling practice, we argue for an approach to counselling which recognises the social model of disability as the basis for social change

Health risk escalators and the rehabilitation of offenders with learning disabilities

This paper presents a study of risk management in a hospital within the UK. National Health Service which attempts to rehabilitate offenders with learning disabilities. Analysis is based on the metaphor of a ‘risk escalator’. Health and social care systems can be characterised as risk escalators if they possess three attributes. Firstly, risk managers should agree the rough ordering of the severity of a set of related risks. Secondly, a repertoire of responses which provide different trade-offs between autonomy and safety, and which can be calibrated against risk severity, should be available. Thirdly, the potential for positive and/or negative feedback, which give risk escalators their dynamic character, should be identified. Risk escalators may be deliberately designed, or may, like the hospital regime discussed in this paper, coalesce from pre-existing sub-systems offering different autonomy/safety balances. They may carry service users upwards towards greater safety if needed, as in health screening systems, or downward towards greater autonomy if justified, for instance in rehabilitation systems. Their therapeutic status is contestable. Upward risk escalators can be accused of generating positive feedback, with iatrogenic effect. Downward risk escalators may be criticised for pushing service users too strongly towards less intense interventions, causing neglect. The present case study brings out emergent properties of a downward risk escalator, including: organisational disruption to system functioning; preferencing of safety over autonomy; active and reflexive system management by clients; multiple, organisational risk rationalities; and the reification of riskiness as a generic attribute of individuals

Health risk escalators and the rehabilitation of offenders with learning disabilities

This paper presents a study of risk management in a hospital within the UK. National Health Service which attempts to rehabilitate offenders with learning disabilities. Analysis is based on the metaphor of a 'risk escalator'. Health and social care systems can be characterised as risk escalators if they possess three attributes. Firstly, risk managers should agree the rough ordering of the severity of a set of related risks. Secondly, a repertoire of responses which provide different trade-offs between autonomy and safety, and which can be calibrated against risk severity, should be available. Thirdly, the potential for positive and/or negative feedback, which give risk escalators their dynamic character, should be identified. Risk escalators may be deliberately designed, or may, like the hospital regime discussed in this paper, coalesce from pre-existing sub-systems offering different autonomy/safety balances. They may carry service users upwards towards greater safety if needed, as in health screening systems, or downward towards greater autonomy if justified, for instance in rehabilitation systems. Their therapeutic status is contestable. Upward risk escalators can be accused of generating positive feedback, with iatrogenic effect. Downward risk escalators may be criticised for pushing service users too strongly towards less intense interventions, causing neglect. The present case study brings out emergent properties of a downward risk escalator, including: organisational disruption to system functioning; preferencing of safety over autonomy; active and reflexive system management by clients; multiple, organisational risk rationalities; and the reification of riskiness as a generic attribute of individuals.Risk management Learning disabilities Mental health Rehabilitation Offenders UK

Risk Management in the Rehabilitation of Offenders with Learning Disabilities: A Qualitative Study

This paper discusses the results of a qualitative study of risk management for offenders with learning disabilities residing in low/medium-secure accommodation within an NHS hospital in Northern England. The study had two phases: first, 13 staff, including psychiatrists, psychologists, nurses and a social worker, were interviewed about their views on risk management at the hospital; second, 11 case studies, based primarily on interviews with patients, were undertaken. The study identified tension between an anamnestic approach to risk, predicated on the assumption that patients have a propensity to reoffend, and a rehabilitative approach, which attempts to bring about personal change. Reconciling these two approaches will require recognition of the limitations of risk analysis as a guide to the uncertain future