Chances & Choices: Making Integration Work
Deborah Fullwood is a Director of WestWood Spice [www.westwoodspice.com.au], a specialist consulting group working with non-government organisations and government departments, individuals and communities to make a difference in the lives of disadvantaged Australians. Our passion is for ideas and programs that achieve positive impacts for the 'clients of our clients'. Deborah has qualifications in both Applied Science and Social Science, plus editing and writing.
Deborah has provided consultancy, social research, teaching, training and project management services to government and non-government agencies across Australia for over 30 years. Deborah's experience includes working with government and stakeholders in sector reform, redesign and redevelopment, program evaluation, new program roll-out and policy research development and advice. She has worked across children's services, health, mental health, disability, youth services and housing. For her clients, Deborah brings particular expertise in blending social impacts with commercial realities. For the clients of her clients, she specifically and consistently works to understand stakeholder views as a platform for developing consulting solutions and to encourage considered action from among diverse stakeholders.
Since 2006, Deborah manages a long-term contract to increase national awareness and information about the National Relay Service [www.relayservice.com.au] – a phone solution for people who have a hearing or speech impairment.
Deborah is also a parent of two adults – her 34 year old son Rohan has Down Syndrome and associated hearing and vision impairments. Her daughter and two grandchildren live in San Diego, USA. Rohan lives in Sydney on his own and in 2011 celebrated 10 years work - making him eligible for long service leave. Rohan takes pride in his roles of 'employee', 'neighbour', 'train commuter' and 'basketball team member'. However, the role is most proud of is his role as devoted 'uncle'.
The PHAB concept is to enable persons with or without disabilities of all ages to participate in all kinds of social, recreational, developmental, educational, training, employment and community support services for better cooperation and integration in a barrier-free environment.
Hong Kong PHAB Association, through 40 years, has developed, reviewed and grown its services to meet this original PHAB concept. I feel humbled that Hong Kong PHAB Association has found my approach to integration is one that has helped her service development.
2. Let's look at integration
What is there to see?
- A movie of interactions [not a set of still photographs]
- A broad landscape view [not a portrait focus]
- A close-up look at individuals plus a wide-angled view of people in communities
- A person's whole life [not just segment by segment]
- Both formal and informal supports
Community is the key
What do I know about integration? I know that communities that demonstrate particular attitudes are more likely to be where we see integration working. In those communities, we will see attitudes that focus on:
- Non- categorisation
- Recognition of people's rights
- Acceptance of individuality
- Respect [for disability]
- Personal responsibility
A community is that sense of belonging that occurs when a group of people get together for a purpose, do things together and all play a part in keeping things going [Fullwood 1990].
John O'Brien  comments about community that
“Community cannot be manufactured; it is not a commodity of the reliable outcome of any professional activity. It arises when valued personal involvements with a network of others gives rise to purposeful activity and celebration” [Cocks 1989 p4]
3. Four aspects of integration
Community is the key. But what is happening in communities that make the possibility of integration more likely?
Figure 1: Four Aspects of Integration
Attendance: A physical presence may occur at a club. Peripheral, fleeting contact?
Figure 2: Attendance
Participation: Involvement in the community's activities.
Figure 3: Participation
Interaction: Between community members – mediated by personal skills and choices, and group decision-making
Figure 4: Interaction
Interdependence: Between community members - mediated by group choices and decision-making.
Figure 5: Interdependence
4. Behaviour makes communities
What do these pictures show us? What does our own experience tell us? These pictures tell us that it is behaviour that counts – what people actually do and how they do it.
Behaviour is what sets communities apart. There are certainly some attitudes that support integration – non-categorisation, recognition of rights, respect for individual. But those attitudes are only important if they translate into behaviour. We only know that community members have those attitudes because of what they do and say.
Certainly, legislation can be an outward reflection of society's attitudes but the significant sign is behaviour – both verbal and non-verbal behaviour of individuals. Let's not downplay legislation – it provides a framework but its enacting lies in the hands of people.
You can't legislate for particular attitudes.
“Morality cannot be legislated but behaviour can be regulated. Judicial decrees cannot change the hard-hearted but they can restrain the heartless. ” Martin Luther King
5. Attitudes affect integration
What are attitudes? How do attitudes affect behaviour?
We know that attitudes are important to support integration. We know that there is a link between behaviour and attitudes. But what are attitudes?
Attitudes are a mindset, a mental focus, the way a person looks at things. Attitudes can be thought of as a relatively consistent and enduring set of opinions
A predisposition of the individual to evaluate some symbol or object or aspect of this world in a favourable or unfavourable manner' [Katz 1990 p83].
Attitudes have both a thinking and feeling component.
- An affective component – the feeling of liking or disliking
- A cognitive component – a belief about the object and its characteristics
Attitudes are caught through experience not taught through instructions. Our attitudes reflect our experiences. The development of attitudes is a social process that occurs through experience not through verbal instruction. Attitudes develop through direct experiences but can also develop through indirect experience. People develop attitudes based on their personal experience and on the attitudes they see reflected in the behaviours of people around them.
Together, individual people and their attitudes create a public attitude, society's attitude - similar to the averaging of the attitudes of individual people towards particular groups that make up society.
“The raw material out of which public attitude develops is to be found in the attitude of individuals” .
Attitudes are the gatekeepers of what is possible, of what is allowed to happen.
Research on social networks of people with disabilities and research on social networks in general has shown that people actively choose with whom to interact, based upon those people that are available for interaction [through proximity] and based upon personal choices which reflect attitudes. People's attitudes are played out through behaviour – [contact or avoidance].
So, how are attitudes developed, challenged, reinforced or changed?
People use categories as a way of perceiving, processing and storing enormous amounts of information and experiences. They develop and keep in mind a prototype for each category – a sort of typical member – based on experience. People, objects and situations can each be categorised in many ways. A person is stimulated by features that are relevant to the prototype – 'prototype-relevant' stimuli.
Ideally, we look at each new experience, person or situation, compare it to known prototypes, and decide if it is similar enough to go in a known category. However, humans are fallible; we look to affirm what we expect. We selectively recall information that is congruent with the prototype, disregarding slightly incongruent or irrelevant information.
Categorisation is an ordinary process; stereotyping is a rigid application of this process. Stereotyping is a form of attitude development that occurs when a person develops a fixed impression of a group and it uses this to evaluate each group member regardless of their individual characteristics. Stereotyping occurs when people have limited experiences to interact and so can't see the individuality between similar members in a particular category. This is a particular risk when people with a disability participate in the community in groups. If they are usually seen in groups, then even when they do appear individually, their category may overwhelm everything else. It leads to silly, unthinking behaviours.
What is the attitude of this person?
Figure 6: Categorisation
Survey data on attitudes to disability: Hong Kong and Australia
Both Australia and Hong Kong have undertaken surveys on attitudes to disability. The Equal Opportunities Commission in Hong Kong commissioned a baseline survey on Public Attitudes towards persons with a Disability in 2010. And Australia commissioned a scoping project on Community Attitudes to people with a Disability in 2011.
The two surveys were intended for different purposes – the Hong Kong survey in 2010 repeated a survey undertaken in 2008 and was able to compare findings and note any changes in the two time periods. The Australian survey undertook a literature review of research into community attitudes towards disability and also investigated policies, programs and initiatives for changing community attitudes.
They are both very valuable. Here are some highlights
Figure 7: Attitudes to people with a disability
6. We can influence change
Although direct experience is a powerful force in developing attitudes, in practice many attitudes are developed through second-hand experiences, through the experience of others. People's direct experiences are limited so they copy the behavioural example of significant people around them.
That is where we all come in … as major sources of influence.
The good news is that attitudes can and do change by much the same process as those through which they originally develop. In theory, attitudes are never static; they are an ongoing, dynamic, sensitive perceptual process requiring repeated confirming experiences to maintain them. New experiences, and many of them, tend to lead to inconsistencies becoming apparent with currently held attitudes; a person may then attempt to reduce discrepancies by appropriate changes in attitudes and behaviour – and we can influence the critical incidents in the change of other people's attitudes.
Figure 8: Attitudes develop and ...
The power of 'influence'
There are really two key questions that shape our behaviour
- Can I do what is required? - ability
- Will it be worth it? – motivation
A very useful book called 'Influencer' – the power to change anything - argues there is often a small number of behaviours, if consistently done, which can bring about massive and lasting change. The challenge is to find those 'vital behaviours'. They may not be as obvious as you think.
These two domains [of ability and motivation] are further divided into
- personal factors [which draws on learnings from psychology]
- social factors [which draws on learnings from social psychology]
- structural factors [which draws on learnings from organisational theory]
This creates six forces of influence.
Figure 9: Forces of influence
Six sources of influence: Our challenge with integration is how to use these six forces in a structured way.
- Personal motivation: how to make the undesirable desirable.
- Personal ability: practice
- Social motivation: find strength in numbers
- Social ability: find people who support the change
- Structural motivation: ensure costs and incentives support desired behaviour
- Structural ability: change the environment
How can we harness these sources of influence? We know change is inevitable, so how can we influence change in ways that support integration?
Change is inevitable ... how can we influence 'moments of truth'?
- Every contact counts – moments of truth 
- How can we influence 'moments of truth'? How can we make each contact helpful for integration?
Change is inevitable ... how can we influence change through the 'badges of belonging'?
- What are the 'badges of belonging'?
- What gives a message that says 'I belong here'? 'I know what I am doing here'. 'I am part of this group'.
- What are the behaviours, words, habits, clothes, abilities, knowledge that say loudly and clearly 'I belong'?
- What are the vital behaviours for belonging to this group or that group? What meaning are other people taking from what they see? [e.g. if people in wheelchairs are frequently seen out and about in groups with other people in wheelchairs, then someone who saw this would think: OK – that is where people in wheelchairs belong, with other people in wheelchairs. This may confirm their stereotype about people in wheelchairs - 'they are best with their own kind' - rather than challenge them to think again.]
- How can we influence the badges of belonging so they influence the attitudes and behaviour of other people?
- How can we strengthen the badges of belonging so they influence the confidence and behaviour of the person with a disability?
Change is inevitable ... how can we create and harness the power of a web of inclusion?
Interdependence has many personal, physical and social barriers. However, situations can be contrived where the capacity of a person to become interdependent is apparent and the opportunities – the chances to become interdependent – are increased.
- What are the qualities in experiences that we want to support?
- What experiences are we looking for and trying to develop so that opportunities for interaction and interdependence will be increased?
- How can we help make it more evident that this person has a capacity to contribute and is available to interact?
- How can we help everyday contacts move from initial association with someone who has a disability to long term engagement rather than rejection?
The role of services can usefully be seen as having [Collins 1988]:
- A complementary role – balancing the whole
- A supplementary role – completing, reinforcing or making up for deficiency of the whole
Your services can work to create powerful webs of inclusion. A web is different to a network  - think of the flexibility, adaptability, variety of connections, and capacity for change in a web.
Have a presence/ attend
Does your service help people get out and about:
- Be seen in situations with different people? Go places, become a regular?
- Be seen where and when other people go?
- Go to ordinary places with ordinary people?
Participate in the community
Does your service
- Understand the skills required in a particular community?
- Use existing community members to 'introduce' a client to the community?
- Use minimal supervision – use natural supports and resources?
- Encourage a variety of relationships with a variety of people not just friendships?
- Help people to use many communities, make repeat visits, try again?
- Help people with a disability learn how to show openness, communicate the behaviour and language of 'friendship' and 'availability'?
Interact and become interdependent with community members
Does your service
- Help people establish ties, connections and relationships?
- Look for flexible communities and co-operative attitudes where people share equipment, space, facilities?
- Look for vital behaviours in a community?
- Help with community-relevant skills that demonstrate contributions to the community, make others feel valued and appreciated?
- Help people develop and demonstrate capacity for responsibility, show practical and social roles, volunteer for things?
- Help contrive situations that demonstrate skills, strengths, capacities?
- Help your clients communicate 'belonging' and 'membership' to other members – help them develop and use the 'badges of belonging' - wear the 'right' clothes, do the 'right' things?
- Establish a cycle of opportunities, competencies and self-esteem rather than a cycle of restriction, deviancy and despondency?
Change is inevitable ... harness the power of stories
Does your service use the power of personal stories? Stories can help create changes in behaviour - altering the mental map of cause and effect. Stories avoid 'telling people what they should do'. Stories transport people away from the role of 'listener' into the role of 'participant'.
Stories let people see the 'movie length feature' rather than the 'snapshot', understand the 'whole' rather than a 'part'.
I believe we need to lead change or it won't happen as we would like it to. Our leadership has the ability to influence other people's opinions, attitudes and actions.
We, as staff, family members, community members, support people, neighbours … need to take on a leadership role to help people who have a disability and their families become empowered through community attitude change.
We can use community inclusion to help individual community members develop particular attitudes towards people with a disability – attitudes built on experiences that support a presence, participation, interaction and interdependence. The image of people with a disability in the minds of the public then becomes one of individuality.
We can help people with a disability and their families develop positive attitudes about themselves – a positive identity where they recognise and control their choices with strong self-esteem to match.
We can help people with a disability and their families through demonstrating our own attitudes. We will use interdependence through inclusive webs to demonstrate and foster acceptance.
We will create a script, provide the cast, act as coach and audience. We will help the person with a disability present themselves and their activities in ways that guide and control people's impressions of them. We can provide many, many opportunities for other people to interact with a person who has a disability in order to reduce the risk of stereotyping. We can provide opportunities for direct experiences using scripts that provide evidence that this person is not similar to the category prototype. We can direct attention towards positive, valued roles and contributions. We can provide activities which push other people's negative stereotypes towards the threshold of discrepancy and prompt change. We can create reinforcing scripts so that people don't disregard a single positive behaviour. Attitude change requires long term strategies on many levels.
If we believe that the 'treatment', 'teaching', 'management' or 'servicing' of a person with a disability is not an end in itself - but part of an enabling strategy for moving through socio-economic space, for developing social competence and facilitating community inclusion - then we must act now. We must act in all our communities – homes, schools, clubs, childcare, work, the neighbourhood – and in services.
Inclusion is not about preparation for community involvement at some time when this person with the disability has become easier, older, more prepared, better, prettier; when his behaviour is more manageable, when he is toilet trained, when his communication is clearer. Inclusion is not about waiting for the right person who is able enough, communicative enough, compliant enough or attractive enough to make it work. Above all, inclusive webs are not about community participation when the political climate is right, when attitudes are more accepting, when the community is more ready, when staff have finished their training, when the Government has got the money, when we have finished our policies, when the building has the ramp built.
Inclusion is about community participation and community member interdependence right now. It is right now that other people's attitudes are currently being developed and shaped.
We, as leaders must be there while this is happening so that we can influence the development of personal and public attitudes that support the chances and choices that community participation and interdependence offer. Services cannot afford to ignore the conscious or unconscious role they play in supporting the development of inclusive webs, of interdependent relationships – relationships that can last a lifetime, protect a life and promote a real quality of life.
 O'Brien, J. (1989). Signs of community building.
 Katz, D. (1960). The functional approach to the study of attitudes. The public opinion quarterly, vol. 24, summer.
 Patterson, K., Grenny, J., Maxfield, D., McMIllan, R. & Switzer, A. (2008). Influencer: The Power to Change Anything. NY: McGraw Hill.
 Helgesen, S. (1995). The web of Inclusion. NY: Currency and Doubleday.