Images can be conveyed (usually unconsciously) by the physical proximity of a service setting to certain other settings and locations, by the history of a setting, and by other attributes of a setting. Care should be taken to facilitate positive (or at least neutral) image potential in choosing settings. Frequent negative examples - cemeteries, garbage dumps, residences next to industrial settings, in run-down sections of the city, donation plaques on bedrooms or in living areas of residences; use of hospital beds when they are not required; presence of nurses' stations in chronic care facilities; bolted down furniture; security-type windows; extraordinary safety features; decorations which promote image of ridicule; etc.

Groupings, associations (juxtapositions), and relationships of the clients of programs that are arranged, controlled or otherwise mediated by the program should convey positive messages about clients' roles, status, competencies, and miscellaneous other characteristics. The physical proximity of one human service program to another can affect image transfer in both directions. Services for people at risk should avoid locations near other services for people whose social image is poor, and seek locations where positive transfer of social image is likely to occur. The likelihood that the number and type of devalued people in a service will be absorbed and integrated into the non-devalued social systems of the surrounding neighbourhood declines if devalued people are congregated together in areas where community resources are not readily available or accessible, if non-devalued people are not present in large enough numbers, or if other barriers to integration are present. Intra-service client groupings will have an effect on both clients' competencies and clients' image.

The service provider should be particularly careful to avoid, whenever possible, grouping together of clients who have different types of highly visible devalued conditions, constituting groups of clients with the same devalued condition, but in which a large proportion have a more severe degree of that condition, grouping together of a small (or insufficient) number of non-devalued people with a larger number of devalued people, and making groupings that do not conform to patterns for grouping by sex in culturally valued analogous services. Care should also be taken to evaluate the impact of the image of the people with whom clients interact; the image of the activities in which clients participate with valued people; the impact of the image of the settings in which interactions take place; the image impact of worker personal appearance; image impact of worker personal history; image impact of worker personal social role and status; and impact of service-worker client image match.

Activities and patterns of time use are imbued with value in all cultures; some more than others. The rhythms and patterns of the workweek, workday, weekend, school, holidays, etc. are all considered in the principle of normalization. Services should try to convey positive images of their clients through the structure of their daily, weekly and yearly activities, and the way programs are structured with respect to time use culturally valued in the wider community. Particular concerns are noted over the mixing of varied program activities within a single setting when this is typically not found in culturally valued analogues. The activities and timing should a) match cultural expectations for valued members of the society, regardless of age; b) match cultural norms for the particular age group; c) avoid adding to, or propagating existing negative images. This is particularly relevant to bedtimes, rising times, breaktimes, holidays and vacations, and the division between academic, life skills, and work related activities, both by time and place. Finally, the extension of autonomy and rights consistent with the cultural norm is considered within this area. Conditions which limit autonomy or expression of individual rights must be carefully rationalized from an individualized assessment in which the welfare of the client, and the welfare of others, are paramount considerations. Whenever rights are restricted, care should be taken to follow the Least Restrictive Alternative principle and to due process.

The posture; social graces and expressive mannerisms; stigmata of impairment and/or of human differences; dress; grooming; and other miscellaneous personal characteristics of the client (i.e. drooling) should be attended to in ensuring maximum positive social image of clients. Likewise, so too should service workers be conscious of the language used to refer to programs and people; the name, logo, funding sources and fund-raising mechanisms of the agency; and various other miscellaneous ways in which image of the service and/or of its clients may be affected. Evidence of programs to optimize a clients' personal impression and the image it conveys should be visible through: teaching and reinforcement of positive personal appearance; exposing clients to models of appropriate appearance; providing access to equipment and other supports that can enhance appearance; and providing advocacy for this purpose with other agencies or bodies. The possessions of a person go a long way to convey their social status and image.

A service should not only allow these possessions, but make available space for them, and attempt to assist the client in maintaining worthwhile, image-enhancing material possessions appropriate to their age. Language used to refer to clients should: interpret people as filling positively valued social roles; enhance the social status of a person or group; be appropriate to, and respectful of, peoples' ages; convey and facilitate identification with valued people; convey the impression that the person or group is competent, and have potential for further development; and convey a positive image of current life circumstances rather than a negative one. Some particularly poor, but very common examples are: referring to people by their handicapping condition ("autistics"); service site or funding source ("Jerry's kids"); prosthesis ("wheelchair person"); prognosis ("chronic", "trainable"); diagnosis ("kidney failures"). Program name examples are "Home for Wayward Girls and Unwed Mothers"; "Orphanage"; "Sex Offender Program". Fund-raising efforts should try to avoid associations with garbage or worthlessness (i.e. rummage sales); spare change boxes ("charity"); carnivals and bazaars ("fools", objects of ridicule) and instead aim to conduct them in the most dignified ways possible (i.e. dinners with speakers, raffling highly valued objects, etc.). Finally, negative images should be avoided where staff use nicknames for the service, or former names continued in use by staff ("the Funny Farm", "the Ontario Hospital"); other ways in which activities are labelled (i.e. "feeding time"; "work therapy"); age-inappropriate or negative-image logo and letterhead; negative-image names or associations created by coordinating, regulating or licensing bodies related to the service; negative-image publicity conveyed in print or films; and materials or equipment owned by the service (i.e. elementary school reading materials used in adult education centers).

2. Personal Competency Enhancement

The domains subject to consideration in personal competency enhancement are: bodily integrity, including prevention or rehabilitation of physical impairments, and development or preservation of health and physical ability; self-help skills, including walking, eating, dressing, and grooming; intellectual ability and adaptiveness; communication skills; social skills, including etiquette, friendliness, hospitality and the conduct of adaptive interpersonal interactions; work skills, including the attainment of maximum feasible economic self-sufficiency; recreational abilities, including physical abilities, ability to work within and as a team, and development of creative leisure options; self-awareness, including pride in oneself, one's appearance, and one's work, and the expression of reliability, discipline, courage and reasonable risk-taking; skills for the maintenance and upkeep of one's environment, especially one's abode; security in physical and social space, including one's relationships; and various other areas, including: development and expression of spirituality; the capacity to exercise certain rights; and pursuit of diverse and enriching life experiences. Attainment of personal competency is important in that: a) the more skillful a person is, the better s/he will be able to function and interact in a normative way in typical societal contexts and with valued people. In turn they are more likely to elicit reciprocal interactions from valued people. b) personal competency by itself is a worthwhile and valued attribute. c) society will likely be more accepting of differences of individuals if they have compensatory skills and competencies. d) this is the essential mission of almost all human service agencies. If this does not occur the agency may be contributing to further devaluation, life-wasting, deterioration or even destruction. The normalization principle requires that a human service optimize the likelihood that competency enhancement is maximized.

It is critical that a service capitalize upon the potential for competency development that is inherent in the physical environment. Setting accessibility relates to a number of factors, first for the clients and their families, and secondly, for the general public: the nearness of service to people who would come to it; the number and variety of means and routes of access to and from the site; the cost of means of access; any congestion of traffic or means of dealing effectively with traffic patterns; parking and embarking convenience; and the safety and access of the neighbourhood. Availability of relevant community resources (relevance; speed and convenience of access; wide range of resources) also figures importantly in this area. The physical comfort of a setting is rated by its ability to "invite" and "attract" people; whether it influences the productivity, efficiency and effectiveness of users; whether it confers value upon, and enhances the image of, its users by enhancing opportunities for competency development. The challenge or safety features of a setting are also important. Among other things, there is the corollary of "dignity of risk". This acknowledges that life without risk - even when misfortune or tragedy may result - is unnatural ("infantilizing"), and certainly non-developmental. The corollary makes clear that devalued or handicapped people should be exposed to the amount of challenge that is normal for age peers in typical society, or at least the amount of risk with which the person can reasonably be expected to cope. On the other hand, normalization also requires that settings be appropriately safe such that people's needs for protection are not unheeded, especially if opportunities for growth and learning are not obvious in the situation. Finally, settings should have features which maximize individualizing of attention and interaction. This is evident where there are well-defined personal spaces for each client; options for privacy of clients; and furnishings which are mobile and flexible so that personalizing of the space is possible.

Competency development is influenced greatly by the expectations held by service providers of clients, as well as by the models provided by such service providers. A service can be evaluated on the basis of how well it capitalizes on the power of role expectancies and modelling and imitation opportunities. Client competence will be affected by the degree to which the size and composition of groups allow workers to effectively manage and provide the appropriate structure and supervision to maximize individual learning opportunities. This is also true of group composition. Some other factors which enter into this formulation: number of more competent interactors in a person's life; variety of occasions and settings for integrative interactions; frequency of integrative interactions; respect and valuation of integrative interactions; depth, individualization, and continuity of integrative interactions. Life-enriching interactions among clients, service personnel, and others requires honest and open communications while struggling to remain essentially positive; development of genuine feelings of warmth, mutuality and respect for each other; warmth and thoughtfulness should be apparent at all times within the service by the way in which people treat each other and are concerned for each other; minimizing the practice of putting physical or social distance between clients and personnel, or among clients, and between either of these and the public; worker-client interactions should be characterized by respect, directness and sincerity, and even as appropriate, affection; service worker-service worker interactions should set the tone for other interactions with clients; service worker-public interactions should function to "invite" members of the public to become involved with clients, and foster integration activities; client-client interactions should indicate training and good role modelling opportunities.

Client-public interactions should also "invite" reciprocation and integration opportunities. Individualized opportunities should exist for clients, such that there is clear differentiation of each person from others and there is encouragement and support for expression of one's unique self. The ability of a program to individualize is evident in staff's intimate knowledge and understanding of clients; staff sensitivity to individual clients; absence of unnecessary regimentation; positive staff attitudes toward client self-expression; curriculum including teaching of ways clients can seek out and pursue individual interests; recognition of events of special meaning (i.e. birthdays, religious holidays); and ways and means of dealing with individuals in spite of "grouped" programs. Finally, services should make available opportunities for sharing, companionship and affection, not only between heterosexual pairs, but also within the sexes and within groups. This can be done by providing age-appropriate activities and privacy options; teaching people to respect the privacy of others; having co-ed programs where appropriate; having both male and female staff, modelling age- and culture- appropriate and valued sex roles and behaviours; making available models of single, married, parental, and other "typical" relationships; providing informal sex education on a routine basis as the issues come up, capitalizing on incidents with sensitive and instructive responses, and on modelling opportunities within the group; obtaining or providing formal sex education and counselling as required; avoidance of unnecessary sex role stereotyping while still maintaining the conservatism corollary for clients.

Human services should provide challenging developmental programs, and move clients along a "continuum" of development as fast and as far as possible. Programs must be relevant to the client's needs, and arranged closely in priority consistent with the ranking of the client's needs; they must make intense and efficient use of whatever time clients spend in them (presuming also, appropriate material supports and equipment); make available competency-enhancing personal possessions along with sufficient space for clients to store such possessions.

Notes:

Some Definitions from Normalization/Social Role Valorization

"Deviancy-Casting" occurs to a person when:

"Distantiation"

The creation or placing of some kind of distance between oneself and something else (person, animal, object, etc.) that one fears or dislikes. (Wolfensberger and Thomas, 1983, p. 17)

"Integration"

The open participation of people with other people in culturally normative amounts, settings, and activities. Physical integration consists of the physical presence of a (devalued) person or persons in ordinary settings, activities and contexts, where non-devalued people are also present. Social integration consists of participation by a (devalued) person or persons in social interactions and relationships with non-devalued citizens that are culturally normative both in quantity and quality, and that take place in normative activities and in valued, or at least normative, settings and contexts.

"Isolated Dislocation"

Location of a service that would usually be found in a certain type of neighbourhood instead in an area which, for all intents and purposes, there is no neighbourhood.

"Normalization"

The use of culturally normative, and optimally even culturally valued, means to enable (societally devalued) persons to achieve and maintain valued social roles. (Wolfensberger and Thomas, 1983, p. 18)

Systemic Maltreatment of People with Disabilities

Through a process described eloquently by Wolfensburger (1972) and his followers (i.e. Miller, 1986), history and current example shows that it seems to be a sad fact of "human nature" to submit people with disabilities (visible disabilities especially) to systematic and widespread processes of "Distantiation" which, when unchallenged, has resulted in dramatic forms of abuse with state sanctioning. The processes are largely unconscious, may be present in even the most humane and well-intended of people, and take a sequential, logical course toward full-scale abuse if not for the intervention of humane people and the application of law. Although it is thankfully rare to witness the full course of this systematic maltreatment of people with disabilities within a single "developed" society (Nazi Germany was the last such example), it is possible to see examples of each level (including the extremes) of maltreatment around the world today. It should be noted that only the latter stages reach conscious awareness for most people, and only the last few reach a level of maltreatment that most people would term "abusive".

Here is the process as it unfolds. Understand that the process does not follow the "orderly" course outlined here, but one can often see the various stages of development of these processes at work when one intervenes or advocates for people with disabilities, often right here, right now.

People with differences that are easily visible are most at risk. Examples are people with different skin colours, bizarre affectations, stigmata, or those who have different styles of dress or grooming.

For people with some level of visibility of their developmental disabilities, a strategy to avoid taking steps down the pathways to abuse or maltreatment can be to minimize these visible differences. A clear example is seen in the cosmetic surgery being offered to children with Down's Syndrome, not only to have therapeutic and functional benefit (such as tongue control for clearer speech), but also to minimize the stigma of the "typical" Down's Syndrome appearance. Lesser examples are the high standards of grooming and dress that some groups stress in their clientele to not only minimize conspicuous difference, but to facilitate positive image transfer. This perceptual process is not only unconscious, but accorded little recognition as the beginning point for some negative image building which can later have seriously debilitating effect on persons with disabilities.

Differences themselves are not unusual - in fact, it defines our world that differences abound. Some differences, however, are perceived as significant. This can be taught (through formal or informal means, i.e. at school, or through images and advertising). This is a social and psychological phenomenon, varying culturally and over time.

A strategy to avoid taking the first few steps down the pathway to abuse or maltreatment, where perceptible differences cannot be minimized, is to work hard to create the notion that such differences are not significant, or do not have the significance typically attributed to them by society. Advertising, public relations and political science have advanced techniques which can be helpful to advocacy efforts on behalf of people with disabilities. Again, not only is this process unconscious, but accorded relatively little importance in the process of negative image building, even by professionals in advocacy for persons with disabilities. Integration is thought to have a major impact on minimizing perception of significant differences by having people with disabilities regularly taking part in "normal life". This also inhibits the growth of later opportunities for systemic maltreatment.

Where differences cannot be made imperceptible, and their significance can not be successfully minimized, there is a human tendency to imbue perceived significant differences with value, either positive or negative. Of course, it is important to imbue these significant differences with positive images or interpretations. More importantly, and more frequently forgotten, it is often necessary to defend strenuously against tendencies to view such differences negatively. Such tendencies are influenced strongly by other societal values (productivity, standards of beauty, etc.) and image shaping by media and communication.

Advertising, public relations and political science have advanced techniques in this area which can be generalized to advocacy efforts on behalf of people with disabilities. While these processes are still largely unconscious, there is by this stage a recognition by professionals that active efforts need to be made to prevent erroneous or unfounded negative image building, and to shape more informed, positive images. Such things as "destroying" myths and attempting to damage the credibility of views held which are negatively associated with perceived significant differences are obviously good tactics.

It appears again to be a sad fact of "human nature" to associate characteristics of one perhaps less visible type with other more visible characteristics. Most of the time this is innocuous. However, this process can also be malignant, as with the association of negative images with essentially unrelated characteristics, moreover with no evidence (i.e. all mental patients are dangerous; all retarded people are sick, etc.) Prevailing historical views, which are without substance when applied generally to people with developmental disabilities, include seeing such people as: subhuman organisms lacking the needs, wishes, goals and sensibilities of other human beings; criminal menaces to society; sexual menaces to society; menaces to population characteristics because of wanton reproduction of defective children; eternal children; irreversibly diseased persons whose condition is hopeless and who can only be assigned to indefinite custodial care; object of pity or charity rather than a partner in society with the same rights and privileges as everyone else.

Once again, advertising, public relations and political science offer techniques to either "debunk" these "wrongful" associative tendencies or "re-establish" more positive associative tendencies.

With enough time and societal energy, rather large numbers of characteristics, real or imagined, can become associated together in full "stereotypes", and become symbolized as complete entities identified by only the slightest visible characteristic. This is so especially if nothing is done to counter this "natural" but frequently destructive process. Race, religion, ethnic, sex, age, and disability stereotypes, for example, are well established in popular notions. It is at this level of the chain of events that there finally is a relative awareness of the phenomenon of stereotyping and symbolism itself. However, people may still hold and act on such false, stereotypical notions, even while disavowing any such prejudice.

It takes a very strong advertising and promotional campaign, acting over a long period of time, for there to be significant changes to the popularly held negative notions once this level is reached. Protective legislation and supportive policing may be needed at this point.

When offered the choice, people will tend to physically avoid individuals with perceived differences which are negatively valued. Those individuals with stereotyped characteristics symbolized by visible stigmata which are viewed as threatening or discomforting are most at risk. There is a whole range of excluding behaviours, some subtle and some brutally obvious. These are largely unconscious and may even be rationalized and defended by otherwise well-intended and humane people, including professionals who might see themselves as progressive in other respects. When unable to physically distance themselves from such individuals, there is also a whole range of exclusionary tactics including "social distancing" which has been described by Wolfensburger (1972) and his followers in the concept of "Distantiation" (Miller, 1986):