"Border crossing" as a route to inclusion: A shared cause with people with a learning disability?
Background: A raft of legislation and social policy has been published in the United Kingdom to progress social inclusion for people with disabilities. Access and participation are central to the notion of inclusive living, which is about being part of a community that is sensitive to the ways of living and the needs of all its members. However, having a disability means that opportunities are not dealt out in equal measure and occupying a "place in society" is rarely an assured thing. The opposite of inclusion is exclusion. This implies barriers to and remoteness from mainstream activity, where fewer opportunities may be available for self expression and to influence the actions of others (Scott Larcher, 2002) Aims: This paper seeks to broaden the debate on inclusion for people with aphasia by drawing on the documented experiences of people with learning disabilities, the development of practice initiatives, and visions for the future. The extent to which the narratives of people with aphasia find resonance in the life course of people with a learning disability gives rise to a simple question: "Is inclusion a shared cause?" Main Contribution: Addressing diverse client groups, such as people with aphasia and people with a learning disability, draws out the common experience, despite their separate traditions of service provision. Living with a disabling condition, whether physical, communicative, or intellectual, whether developmental or acquired in type, means that the usual determinants of social inclusion often appear elusive. Review of UK government policy and assessment of its impact on the two communities (people with aphasia and people with a learning disability) reveals the limitations of a single track approach. The need for collaborative action involving multiple agencies at the mutually dependent levels of self, community, and society becomes clear. Synthesis of the literature and practice development initiatives from the two clinical groups serves to strengthen the ongoing debate. The right to be included is shared by all human beings regardless of individual characteristics. It is about having the opportunities to perform roles that are personally meaningful, to develop relationships, to engage in self determination, and to have presence in the places that other people occupy. Conclusion: No matter the primary cause of the disability, marginalisation is frequently a feature of the lived experience. For people with aphasia, it is the impact of having a communication difficulty on quality of life that leads to disruptions to sense of self, autonomy and choice, social life and community participation (Cruice, Worrall, Hickson, Murison, 2003) For people with learning disabilities, it is the incremental disempowerment with regard to the uptake of societal roles as maturation takes place (Barnes, 1997) The concept of "border crossing" is pertinent to the cause of both groups. It captures the many different ways in which individuals break out of the traditional roles cast for people with disabilities, and engage in self advocacy. For individuals who grow up with a learning disability "border crossing" is affected by the surrounding social support infrastructure offered by statutory services, which is informed by targeted government policy. For people with acquired language impairment, the terrain is less clear. After the initial medical crisis has passed, it is the individual's personal context (characterised by the roles and responses of marital partner, family members, work colleagues, etc. rather than statutory service provision, that affects the degree to which individuals are able to resume former life courses.