Thoughts about Dedifferentiation
5 November 2019 in Opinion
Thoughts about Dedifferentiation by Interchange Support Worker Linda Oliver
Interchange sponsored me to attend a discussion on Dedifferentiation by the Australasian Society for Intellectual Disability (ASID). The main speaker was Prof. Chris Bigby, director of the Living With a Disability Research Centre at LaTrobe. She is a social worker with an international reputation for research on the social inclusion of adults with intellectual disability. Prof. Bigby highlighted debates about dedifferentiation for people with intellectual disabilities using examples from the NDIS.
Dedifferentiation refers to the policy and practice of not separating people with an intellectual disability from the broader group of people with disability. In Australia, legislation and policy conforms to the dedifferentiated approach, an approach which has undeniably strengthened the collective voice of people with disability. Evidence also suggests that people with mild intellectual disability prefer to avoid the label of intellectual disability. Finally, by shifting the focus to all people with disability, dedifferentiation more strongly supports a social model way of thinking about obstacles to inclusion, thereby avoiding an impairment or deficit focus.
ASID’s position on dedifferentiation is that while there have been gains, there are also potentially negative aspects, most particularly the obscured visibility of people with intellectual disabilities. Prof. Bigby cited several studies indicating that people with intellectual disability are largely silent in the disability rights movement, and that access and communication issues remain unaddressed. The design and consultative processes of the NDIS reflected this, being informed mainly by people with physical rather than intellectual disabilities. Early warnings sounded by academics and practitioners about the specialised needs of people with intellectual disabilities were reportedly largely ignored, as was international research on prerequisites for an individualised funding scheme.
Another problem with the dedifferentiated approach is that it does not recognise the need for the significant and specialist knowledge often required to adequately support or adapt services to a person with intellectual disability. Support staff are not always trained in ways to support people with intellectual disability, particularly those with more profound intellectual disability. In 2001, Prof. Bigby predicted that a dedifferentiated world would result in the loss of irreplaceable knowledge and know-how about support and would reduce commitment to changing society by shifting responsibility back onto families.
While ASID does not recommend a separate or different system for policy and practice as it relates to intellectual disability, its first recommendation is to “(d)esign different types of services for different types of people. Treat people with intellectual disability as members of the broad disability group wherever possible, and protect and develop differentiated opportunities, services and research whenever necessary.” They are equally unequivocal on the necessity to equip staff with the knowledge and skills to respond to the unique needs of people with intellectual disability, both profound and mild.
On a practical level, a major shortcoming of the NDIS for people with intellectual disability is that there is no funding for advocacy or independent brokers. While recognising the capacity of each person, people with intellectual disability need access to very considerable support and skills training to make their presumption of choice and control real. The scheme also lacks an embedded policy for supported decision making and safeguards such as criteria for judging the quality of informal or formal information sources.
I had been drawn to this discussion because it seemed to me that the issue of dedifferentiation, while having an immediate and practical effect on the lived experience of people with disability, corresponded with that deeper philosophical quandary which never seems to go away. Distinctness vs. commonality, individualism vs. universality, the particular vs. the general. It is a dilemma that I see all around me, and not just with respect to my work as a disability practitioner. When should I advocate for the uniqueness of a person or a situation, and when do I insist that they be treated or viewed the same as everyone else? Prof. Bigby contends that the debate around dedifferentiation is essentially one of “competing logics” and this is a distillation that I find fit for purpose.