Category: Human Rights

Is it enough for the occupational therapy profession to just focus on clients and their occupation goals? Barriers faced by people with disability, are complex and multi-faceted and go beyond specific individual solutions. So, at what point should occupational therapists engage in issues of social justice? And can universal design thinking help?

Two researchers, one from social science and one from occupational therapy, offer an interesting discussion on this topic. They argue that occupational therapy practice and research should incorporate social justice and universal design perspectives. They add that they should join with the disability community to call for a more just society. One way to do this is to also promote the principles of universal design.

Incorporating social justice and universal design perspectives more effectively requires a change of mindset and ways of working. Expanding Person-Centred and Person-Environment theories to understand social and structural barriers is one solution. The occupational therapy profession has the potential to pave the way for more equitable services and policies.

The title of the discussion paper is, Drawing on critical disability and universal design perspectives within occupational therapy and is open access.

From the abstract

Socio-political influences have gained increased attention within the occupational therapy profession. Critical disability studies question prevailing assumptions about disability and how disabling ideologies and practices are perpetuated in society. A universal design approach aims to address issues of inclusion and justice.

This paper discusses how the tenets of critical disability studies and universal design can contribute to occupational therapy practice and research.

We provide ideas on how practice can be guided by the tenets of disability studies and universal design to promote social equity.

Incorporating both perspectives in occupational therapy practice and research requires a change in mindset and ways of working. Occupational therapy knowledge needs to be expanded to scrutinise disabling hindrances hidden within social and structural spaces, and implemented in services.

We recommend working with disability communities to raise awareness and combat disabling barriers at various level of society.

Choosing whether to disclose that you are autistic is an individual decision. But what happens when an individual tells others they are autistic? Under what circumstances do they disclose their autism? And how can this information help others decide about their own autism disclosure? These key questions were the focus of two studies by Aspect Research Centre for Autism Practice.

Feeling excluded and misunderstood has implications for both physical and mental health. Personal interactions are part of the story, but the way we design policies, places and services also add to exclusion.

Study one – disclosing

Most participants participating in an online survey told at least one other person they are autistic. About one third told most of their regular contacts. Only 2% didn’t tell anyone. Half the participants preferred to tell people face to face. Delving deeper into the responses, a lot depended on who they told.

Telling healthcare workers, family and friends generally received a positive response. However, telling co-workers had a higher negative impact. If the individual feels that being autistic is part of their identity, they are more likely to tell others.

Study two – experiences

In study two, participants used a smart phone app to record disclosure opportunities over a 2 month period. Telling others in a conversation was the preferred way to disclose. The experiences of disclosing in different settings was generally positive overall. Surprisingly, disclosing at home had the lowest positive score while the community had a high score.

The researchers found that disclosure led to a wide range of reactions and the decision to disclose was influenced by the context. However, participants learned from telling others, and developing skills in disclosing was important.

Disclosure guides

The findings from these studies were used to inform a set of guides for autistic people and non autistic people. The Autism Spectrum Australia website has separate downloadable guides:

The full report

The full report, I am Autistic: Disclosure experiences of Autistic adults, summarises the two studies with more detail than the guides. Two quotes from the report illustrate the importance of identity:

The UN Convention on the Rights of Persons with Disabilities embraces human differences and disability as part of human diversity. People with disability have rights which must be respected, protected and fulfilled, just like everyone else. The UN human rights video on ableism explains succinctly.

The short video animation below aims to raise awareness of the barriers faced by people with disabilities in everyday life. The video is intended for the general public, advocacy organizations, policymakers, human rights defenders, and educators.

Other human rights videos in the United Nations series.

Legal capacity for all explains how people with disability are denied their rights because they don’t have supported decision-making available.

Participation of people with disabilities benefits all makes the case for involving people with disability in making decisions about their lives.

Sexual and reproductive rights of girls and young women with disabilities discusses abuse and neglect and harmful practices and forced sterilisations.

Ableism and urban planning

 The COVID pandemic lockdowns have shown more people what it’s like not to be able to get out and about when you want to. But do the calls for “not going back to the way things were” include everyone? Lisa Stafford says that the planning profession and society have learned little. Planners, perhaps unwittingly, are still favouring the idealistic view of the “able body”. So we need to discuss ableism and urban planning.

In her article, Lisa Stafford explains how ableism is inherent in urban and regional planning. Planning is not neutral – it’s not value-free. Planners make decisions on what and who to plan for.  

“Time and again I have heard universal design omitted in the provision of social infrastructure…” Stafford writes. “Budget shortfalls”, and it’s “too hard” (read too costly) are their excuses. 

Talking about ableism

Where to start? Where you are now. Share and discuss readings with colleagues – look up “ableism” in Google. Low hanging fruit is checking your own ableism by asking “for whom are we planning?” Ableism intersects with other identities and experiences. Planners must think more deeply about the connection between planning, design and society.

Stafford advises we look to the work of the American Planning Association and their universal design approach. They promote intergenerational neighbourhoods and smart growth. Norway’s leadership in universal design is also a good reference. 

The chapter concludes with a short discussion on transport and active transport. 

The title of the article is, Planners, We Need to Talk about Ableism. The title of the open access special edition is Disability Justice and Urban Planning. 

Other articles cover bathrooms, physical access, disability and climate justice and an artist view of disability justice and planning.

There are several posts on the work of the Norwegian Government on this website that link to Stafford’s references.

 

Disability rights, accessibility and inclusion have come a long way. But we are not there yet. It’s taken more than 50 years to get to this point. That’s despite legislation, public policy statements, and access standards. Ableism and ableist attitudes are alive and well. Yet many people aren’t aware of how this undermines inclusion and equitable treatment. The same goes for ageism. 

An article in Forbes magazine sums up the sentiments well. The word ‘ableism’ gives voice and substance to real experiences. But it can also discredit people for an offensiveness they don’t see or don’t agree exists. The title of the article is, Words Matter, And It’s Time To Explore The Meaning Of “Ableism.”

The Wikipedia definition explains Ableism “is discrimination and social prejudice against people with disabilities or who are perceived to have disabilities.” Ableism defines people by their disability and assumes certain abilities, skills, or character traits. 

Ableism is expressed in ideas and assumptions, stereotypes, attitudes and practices. Physical and social barriers in the environment is also a form of ableism. Usually it is unintentional and most people are completely unaware of the impact of their words or actions.

Different types of ableism

Andrew Pulrang discusses both personal and systemic ableism. Here is his list on personal ableism.

1. Feeling instinctively uncomfortable around disabled people, or anyone who seems “strange” in ways that might be connected to a disability of some kind. This manifests in hundreds of ways, and can include:

• • • Being nervous, clumsy, and awkward around people in wheelchairs.
    • Being viscerally disgusted by people whose bodies appear to be very different or “deformed.”
    • Avoiding talking to disabled people in order to avoid some kind of feared embarrassment.

2. Holding stereotypical views about disabled people in general, or about certain sub-groups of disabled people. For example:

• Assuming that disabled people’s personalities fit into just a few main categories, like sad and pitiful, cheerful and innocent, or bitter and complaining.

• Associating specific stereotypes with particular conditions. For example, that people with Down Syndrome are happy, friendly, and naive.

• Placing different disabilities in a hierarchy of “severity” or relative value. 

3. Resenting disabled people for advantages or privileges you think they have as a group. This is one of the main flip sides of condescension and sentimentality towards disabled people. It’s driven by a combination of petty everyday resentments:

• Disabled people get good parking spaces, discounts, and all kinds of other little unearned favors.

• Unlike other marginalised groups, everyone likes and supports disabled people. They aren’t oppressed, they are coddled.

• Disabled people don’t have to work and get government benefits for life.

Overcoming ableism: challenging values

Overcoming ableism takes more than attending a disability awareness workshop. It’s also more than checking out the right words to use when talking about disability. If things are to change for people with disability, we have to challenge values and assumptions. 

Pulman says the stereotype of people with disability is one of fragility and weakness – it’s associated with illness. Disability services are ‘care’ services, not just services for practical assistance. Workplaces assume people with disability can’t handle the pressures of work. 

He concludes his article with, “The roots of ableism run deep. Sometimes to get at them we have to dig deeper, and disrupt not just our habits, but some of our most basic ways of thinking.” 

The title of Pulrang’s article is, Fighting Ableism Requires Us To Challenge Some Of Our Most Cherished Values. 

A last word

Pulrang concludes with a few reminders. People with disability can be ableist too. They grew up in an ableist society. Ableism isn’t a new ‘ism’ – it is a word that sums up longstanding oppression and injustice. So when it is used, don’t take it as an insult. Ableism is a way of talking about a set of real experiences that people with disability experience. It’s a way to talk about them. 

Depending on personal experience, the term “access and inclusion” means different things to different people. The idea of who is currently included and excluded is often framed by this experience. People with invisible disability are easily left out of “access and inclusion”. For example, people with intellectual disability, different cognitive conditions, and people with mental health issues. Consequently, inclusive cities need more than a ramp and tactile markers. 

Planning and social policies talk of inclusive cities and social sustainability, but making it happen is another matter. Gains have been made in terms of accessibility for wheelchair users and people with vision impairment. That’s because it is written into the building code. What we don’t have is a code for all the other types of disability that are, at first glance, invisible. People with intellectual disability are one group who find themselves sitting outside of community activities. So, in what ways can we ensure their inclusion in the city?

A literature review of research papers on this topic found some useful information. Australian researchers applied the ‘Inclusive Cities Framework’ to the papers and found that local authorities can take actions to improve inclusion at a local level. For the most part they involved community groups, local businesses and civic activities.

Key points

• • Information and support for community groups, local businesses, potential employees and potential mentors.
  • Shared activities (both structured and unstructured) to share learning, activities and build relationships
  • Conversation and sharing of stories – in formal and informal ways, to share information and networking both across and within community groups and all citizens, whether they identify as having an intellectual disability, as potential employers, employees, and com-munity leaders. 

Inclusion of people with intellectual disability relies on having interpersonal relationships within the community. It has to be more than just being on the member list or in the room with other people. Quality of participation is the point of an inclusive city. 

The title of the article is: Towards inclusive cities and social sustainability: A scoping review of initiatives to support the inclusion of people with intellectual disability in civic and social activities. It is an open access article.

Highlights

New Zealand has taken a human rights approach to housing in its proposed housing guidelines. The draft guidelines circulated for comment late last year contain no specific design features. Rather, the draft is based on a set of explicit values that a decent home is a human right. The use of the term ‘decent’ is grounded in the Treaty of Waitangi and the impact of colonisation.

The guiding value is that a home is “more than a shelter, bricks, mortar or a house”. It also means a village, relationships and responsibilities to place, people and the natural environment. Consequently, the guidelines mean a decent home is a warm, dry, safe, accessible, and healthy home. The right to a decent home also takes account of the historical, social, economic and legal context in New Zealand.

The private sector is expected to play their part in implementing decent homes. Human rights are not just government business, and that universal design has a role to play:

“One way for individuals, communities, government and the private sector to implement the UN ‘decency’ housing principles is to promote universal design. Universal design advances inclusive, accessible, healthy building and environment and respect for cultural diversity. It considers people throughout the life cycle from childhood to old age, and is alert to different scenarios, including disability.”

The inclusion of first peoples in the construction of the guidelines contrasts with other countries and their housing policies. 

UN Conventions cited

The draft guidelines are underpinned by New Zealand’s obligations to several UN Conventions, which it lists as: 

– Universal Declaration of Human Rights (1948)
– International Covenant on Economic, Social and Cultural Rights (1966)
– Convention on the Elimination of All Forms of Racial Discrimination (1965)
– The Convention on the Elimination of All Forms of Discrimination Against Women (1979)
– Convention on the Rights of the Child (1989)
– Convention on the Rights of Persons with Disabilities (2008)
– UN Declaration on the Rights of Indigenous Peoples (2007)

There are 19 Guidelines in total each with a rationale, history and context. The document is 37 pages but easy to read.  There is also a Word version on the New Zealand Human Rights webpage together with an overview of the guidelines.