Normalisation (people with disabilities)

Overview
“The normalization principle means making available to all [people with disabilities]] people patterns of life and conditions of everyday living which are as close as possible to the regular circumstances and ways of life or society.” (Bengt Nirje, The basis and logic of the normalisation principle, Sixth International Congress of IASSMD, Toronto, 1982.)

History
The principle of normalization was developed in Scandinavia during the sixties and was first developed and articulated by Bengt Nirje (The normalisation principle and its human management implications, in R. Kugel & W. Wolfensberger (Eds.) Changing patterns in residential services for the mentally retarded,(although the term 'those with additional support needs' is now recognised as being more appropriate) Washington, D.C, President’s Committee on Mental Retardation.)

The principle was developed during the seventies, especially by Wolfensberger in Canada through the National Institute on Mental Retardation (NIMR) (Normalization. The principle of normalisation in human services, Toronto, NIMR, 1972).

Normalization has had a significant effect on the way services for people with disabilities have been structured throughout the UK, Europe, North America, Australasia and increasingly other parts of the world. It has led to a new conceptualisation of disability as not simply being a medical issue (the medical model which saw the person as indistinguishable from the disorder), but as a social situation. Government reports began from the 1970s to reflect this, e.g. the NSW Anti-Discrimination Board report of 1981 made recommendations on “the rights of people with intellectual handicaps to receive appropriate services, to assert their rights to independent living so far as this is possible, and to pursue the principle of normalization.”

Definition
Normalization involves the acceptance of people with disabilities, with their disabilities, offering them the same conditions as are offered to other citizens. It involves an awareness of the normal rhythm of life – including the normal rhythm of a day, a week, a year, and the life-cycle itself. It involves the normal conditions of life – housing, schooling, employment, exercise, recreation and freedom of choice. This includes “the dignity of risk”, rather than an emphasis on “protection”. (Bank-Mikkelsen, 1976, Misconceptions on the principle of normalisation, Address to IASSMD Conference, Washington, D.c.)

The theory of Social Role Valorisation is closely related to the principle of normalization, having been developed with normalization as a foundation.

Misconceptions
There are a few misconceptions about the principle of normalization:

Wolfensberger himself, in 1980, suggested “Normalizing measures can be offered in some circumstances, and imposed in others.” (Wolfensberger, W. (1980) The definition of normalisation: update, problems, disagreements and misunderstandings. In R.J. Flynn & K.E. Nitsch (Eds). Normalization, social integration and human services. Baltimore: University Park Press) This view is not accepted by most people in the field, including Nirjie. Advocates emphasize that the environment, not the person, is what is normalized.
 * a) Normalization means making people “normal” – forcing them to conform to societal norms.

Normalization has been blamed for the closure of services (such as institutions) leading to a lack of support for children and adults with disabilities. However support services which facilitate normal life opportunities for people with disabilities – such as special education services, housing support, employment support and advocacy – are not incompatible with normalization, although some particular services (such as special schools) may actually detract from rather than enhance normal living bearing in mind the concept of normal 'rhythms' of life.
 * b) Normalization supports “dumping” people into the community or into schools without support.

Some misconceptions and confusions about normalisation are removed by understanding a context for this principle. There has been a general belief that 'special' people are best served if society keeps them apart, puts them together with 'their own kind, and keep them occupied. The principle of normalization is intended to refute this idea, rather than to deal with subtlety around the question of 'what is normal?'

Arguments about choice and individuality, in connection with normalization, should also take into account whether society, perhaps through paid support staff, has encouraged them into certain behaviours. For example, in referring to normalization, a discussion about an adult's choice to carry a doll with them must be influenced by a recognition that they have previously been encouraged in childish behaviours, and that society currently expects them to behave childishly. Most people who find normalisation to be a useful principle would hope to find a middle way - in this case, an adult's interest in dolls being valued, but with them being actively encouraged to express it in an age-appropriate way, and discouraged from behaving childishly. However, the principle of normalisation is intended also to refer to the means by which a person is supported, so that (in this example) any encouragement or discouragement offered in a patronising or directive manner is itself seen to be inappropriate.

Normalization in Contemporary Society
In the United States most large public institutions housing adults with developmental disabilities began to be phased out as a primary means of delivering services in the late 1980s. Unfortunately the impetus for this mass deinstitutionalization was typically complaints of systematic abuse of the patients by staff and others responsible for the care and treatment of this traditionally vulnerable population. In many states the process of deinstitutionalization has taken 10-15 years due to a lack of community supports in place to assist individuals in achieving the greatest degree of independence and community integration as possible. A significant obstacle in developing community supports has been ignorance and resistance on the part of "typically developed" community members who have been taught by our culture that "those people" are somehow fundamentally different and flawed and it is in everyone's best interest if they are removed from society (this developing out of 19th Century ideas about health, morality, and contagion). Part of the normalization process has been returning people to the community and supporting them in attaining as "normal" as life as possible, but another part has been broadening the category of "normal" to include all human beings. People with disabilities are not to be viewed as sick, ill, abnormal, subhuman, or unformed, but as people who require significant supports in certain (but not all) areas of their life. With this comes an understanding that all people require supports at certain times or in certain areas of their life, but that most people acquire these supports informally or through socially acceptable avenues. The key issue of support typically comes down to productivity and self-sufficiency, two values that are central to our society's definition of self-worth. If we as a society were able to broaden this concept of self-worth perhaps fewer people would be labeled as "disabled."