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Peter Oakes provides an analysis of learning disability to show that the essential relationship of service providers and users remains unchanged
Abstract
This article seeks to place current methods of identifying and assessing people with learning disabilities into a historical context. It suggests that, although the roles played by service providers and users throughout history have changed, the relationship between them has always been, and continues to be, characterised by an inequality of power. This inequality has contributed to a series of restrictive and abusive practices, and to the perpetuation of an institutional model of care. The author then evaluates the appropriateness of current assessment scales.
Key words
Historical perspective, assessing learning disability
The history of the treatment and management of people with intellectual disabilities can appear to be one of constant progress. Accounts of the subject often begin in the 14th century, when one of the first laws referring specifically to people with enduring disabilities was passed (Blackstone 1765). They include the era of reforms initiate by Lord Shaftesbury, and end with the recent work of the normalisation movement, and may give the impression that further developments in the field are unnecessary. However, they do not take into account whether the reforms were profound or superficial, and may not make clear that the relationship between people with learning disabilities and wider society throughout the period have been largely unchanged.
The history of learning disability can also be understood by exploring the changing relationships between what today are called service providers and service users. If service providers adopt the role of experts, people with learning disabilities, and their families or carers, are obliged to take the role of amateurs. This way of studying history is known as the transactional approach.
Historical roles
The treatment and management of people with learning disabilities has a distinct character during five periods of history: before the 19th century, the 19th century, the early 20th century, the late 20th century, and the 21st century (Table 1, page 16).
Before the 19th century Until the end of the 18th century, formal distinction was rarely made between people who were unable to work, whether or not they had learning or any other form of disability. The chief service for such people...