Paradigmatic thinking

  • The development of special educational needs support services can be described with the help of paradigms.
  • Paradigmatic thinking means the unity of beliefs that guide the planning and implementation of actions. The following paradigms have directed the implementaion of special needs education.
    • Institutional paradigm
    • Rehabilitation paradigm
    • Support paradigm

*Saloviita,T., Lehtinen, U. & Pirttimaa, R. 1997 . Tie auki työelämään. Tuetun työllistämisen käyttäjäkeskeiset työtavat.

*Nygård, T. & Tuunainen, K. (toim.) 1996. Avun kohteesta itsensä auttajaksi: Katsaus Suomen vammaishistoriaan. Jyväskylä: Atena.

*Vehmas, S. 2005. Vammaisuus: Johdatus historiaan, teoriaan ja etiikkaan. Helsinki. Gaudeamus

 

Service Paradigms

Different societal circumstances will affect the implementation, ideology and content of the services for those people who would need special or extra support. Traditionally, disability services materialised by cascading in two ways: people were capable of accessing such services or not (e.g. employment services; avotyö – suojatyö (supported employment in a public place or in a closed environment).  The individuals’ abilities and restrictions dictated which services they were able to access.

The development of disability services can be described through action philosophy; paradigms.  “Service paradigms mean the unity of belief forms the basis of design and implementation of disability services at any given time” (Saloviita et al 1997, 42).

The era of the institutional paradigm can be said to have begun during the post-war period of the latter 1940s.  Up to this time, ‘simpletons’ were divided into those capable of development and those who were not and the responsibility of caring for them was with their respective families.  The institutional paradigm then emphasised state-run rehabilitation.  The industrialisation of society after the war allowed the building of a wide network of mental hospitals, particularly towards the end of the 1960s.  These institutions developed into ‘mini-societies’ where the activities were termed ‘therapy’.  The institutional paradigm was based upon the idea that patients were ill and was implemented through the strong hierarchical structure of the institutions.  Society’s ability to accept difference was weak and the strong institutional network exacerbated the gap between so called ‘normals’ and ‘non-normals’. (Saloviita et al 1997, 42)

After moving to a post-industrial service society between the 1960s and 70s, attitudes in Finland towards those who were different softened.  Differences became more acceptable; methods for their care and rehabilitation began to be reviewed and revised.  Disabled people were slowly transferred to an open-care environment were they lived among society, but with their individually-diagnosed abilities dictating which support services they required.  If a person proved capable of coping in open-care, they would be given the possibility of moving ‘upwards’ in the chain of services.  Rehabilitation can be referred to as a series of steps, “there is a normal society looming on the horizon”. (Saloviita et al 1997, 43)  Rehabilitation was still very professional and diagnosis-centred.  In Finland , thinking along rehabilitation paradigm is still relevant but the global movement towards the independent living of all disabled people has caused some domestic discussion on the topic.  The Independent Living movement has criticised the professional-centred rehabilitation programme and the isolation of disabled people from normal society through the services system.  The discussion in the United Nations instigated by the Disabled Association resulted in 1975 in the Declaration on the Rights of Disabled Persons according to which the position of disabled people is considered alongside other national minority groups rather than categorising them as patients.  (Saloviita et al 1997, 46)

Critical debates were also conducted among professionals, of which the critique of the rehabilitation paradigm by the American, Taylor , (Saloviita et al 1997, 47-) is an example:

  1. The structure of the service steps enables discrimination and the isolation of the disabled from society.
  2. The service steps confuse the place of rehabilitation and the degree of frequency of support.  If a person is found to be in need of full-time care and support, it does not require institutionalisation, which however, is the thinking behind the rehabilitation paradigm.
  3. The thinking behind the rehabilitation paradigm is based upon the idea that the individual needs to ‘deserve’ their place on the next step of services; individuals need to prove they are able to act in a certain manner.   The right to be a part of normal society needs to be earned, it is not self-evident.
  4. Lower steps of services do not, in reality, rehabilitate individuals.  For example, in institutions people are not taught the skills required to function in normal society.
  5. The rehabilitation paradigm interprets the moral solution technically and prevents self-determination through the power of the professionals.
  6. Most of the resources are centred towards the lower-level service steps which enhances institutional thinking.
  7. According to the rehabilitation paradigm a person needs to move each time their ‘level’ changes.  Compulsory, continuous movement from place to place is embedded in the paradigm.
  8. The structure of steps entitles the existence of the isolation environments which are grounded on the general philosophy of the paradigm.
  9. The steps of services are crowded; individuals do not move ‘up’ according to the number of available places.
  10. The need for service support for the disabled is interpreted as a requirement for a place.  If needed new schools or centres, etc will be built for them.
  11. The steps of services label its users; medical diagnosis decides the placement and status of a person.
  12. The life of a disabled person is characterised by rehabilitation; all other decisions concerning an individual’s life are dependent upon it.

The opposite model to the rehabilitation paradigm progressive programme of steps could be called the support paradigm which has been developed in the disability political programmes approved by the UN, such as The World Programme of Action Concerning Disabled Persons (1982) and The Standard Rules on the Equalization of Opportunities for Persons with Disabilities (1993). According to the latter, the support paradigm can be defined as follows:

“UN’s general rules on the rights of disabled persons

Persons with disabilities are members of society and have the right to remain within their local communities. They should receive the support they need within the ordinary structures of education, health, employment and social services.” (Saloviita et al 1997, 50)

The support paradigm changes our thinking from professional-centred, diagnostic and level-based placement to individual and customer-based thinking where the right to a normal living environment is self-evident. It includes the updated opinion that disability is an individual’s deficiency within society and supports the removal of disadvantages caused by the deficiency. Attention is given individually, from person to person, and to their local communities. The withdrawal of diagnosis-centred actions means moving from formal professional decisions to informal ones, listening to the desires of the individual.

Paradigm Need for institutional care Normalisation and integration Full participation
Time 1945- 1970- 1995?-
Day Care Special day care homes Special groups in day care homes Ordinary day care homes
Education Special schools Special schools, groups with special needs Ordinary classrooms
Work Work activities in institutions Work centres in society Ordinary work places
Leisure time Institutions’ common rooms Often in special groups Ordinary environment
Housing Institution Supported home care, institutions,
nursing homes and residential care homes
Supported home care
and own homes

Table 1.  Paradigms of care for the mentally disabled (Saloviita et al 1997, 57)

 

Entitlement Institutional care Stepped open care Support model
Morals Values of society: the disabled need institutional care Values of society:  As normal life as possible Values of society:  full participation and equality
Technical Produces the best results for certain groups Produces the best results. The steps are technically necessary Produces the best results.  It is possible to realise a support model structure in practice
Economics Institutional care is the most inexpensive alternative Open care becomes cheaper than institutional care Support model becomes cheaper than open care

Table 2.  Levels and arguments of entitlement of service paradigms (Saloviita et al 1997, 60)