There is only a small amount of research regarding the general attitudes of support workers toward people with intellectual disability; typically research has focused on attitudes towards sexuality, challenging behaviour and policies for people with intellectual disability. It is known that one of the factors influencing quality of support is the attitude of support workers (Mansell, et al., 2008).

The attitudes of staff have a powerful influence over their everyday practice (Emerson, Hastings, McGill, 1994). To ensure quality services, staff attitudes need to be aligned with current policy visions such as: inclusion, human rights, equality, autonomy, dignity and respect. A large investment of resources and effort has been made in training support workers to adopt certain values (Bigby et al 2009).

Golding and Rose recently did a study to find out about the attitudes and knowledge of support workers toward people with intellectual disability, and to see if existing measurement tools were adequate. The researchers found that mostly support workers attitudes were positive, and concluded that existing attitude scales did not adequately capture all attitudes and knowledge.

They recommended that a new attitude scale be developed, based on their findings. There were however, some problems with the study, which the researchers acknowledged, but there were some important issues presented in the data that warrant further discussion and analysis, prior to the development of a new attitude scale.

Methods

The researchers used qualitative methods. They held four focus groups with 20 support workers from one disability service. The researchers asked the support workers a set of questions about their attitudes and knowledge. After the focus groups, a researcher did a thematic analysis of the support worker’s responses. Patterns in the support workers’ responses formed the main themes or findings of the study.

Findings

There were 5 main themes to emerge:

1. Discrimination of people with intellectual disability: Support workers felt that people with intellectual disability were still discriminated against by society.
2. Attitude change: Support workers felt that working with individuals made attitudes more positive, they also felt that adult members of society were less understanding and more judgemental than children.
3. Impacts of integration: Support workers believed that both society and individuals with intellectual disability would benefit from integration by achieving empowerment and independence.
4. Their role as carer: Support workers felt it was their role to promote independence, as well as protect people with intellectual disability. They also felt that it was their role to help people achieve things and make choices (as long as they felt the person had capacity to do so).
5. Impacts of training: Support workers reported that training was informative; providing an in-depth understanding of why individuals with intellectual disability behave the way they do.

When the researchers compared these 5 themes to existing attitude scales, the found that only ‘impacts of integration’ was sufficiently represented. They recommended that new attitude scales be developed to adequately measure support worker attitudes.

Discussion

The study had 2 aims:

1. to explore support workers attitudes,
2. to see whether a new attitude scale was needed

Regarding the first aim, it could be argued that the findings reflected what support workers think society’s attitudes are, their understanding of their role, and what influenced their attitudes. These things are very different to the actual attitudes of support workers toward people with intellectual disability.

Comments from support workers were included throughout the article and were used to exemplify the 5 main themes; however, of themselves they provided greater insight into the underlying attitudes of support workers. For example, a participant comment used to represent the theme ‘attitude change’ was:

I was scared to speak to them, I wouldn’t have approached them because I didn’t know how to. The more I work with people, the more I understand them, their thinking and their understanding.”

Clearly, this support worker’s opinion had changed, he or she became no longer scared of people with intellectual disability; but it could be argued that the support worker still had the attitude that people with intellectual disability are different. The comment reflected an attitude that people with intellectual disability are somehow ‘other’.

In another comment, provided to give an example about negative societal beliefs about integration, one support worker stated:

Yeah, because if you release some of these people onto the street without proper medication and support they could do harm to society”.

This statement seemed to reflect the attitude that people with intellectual disability must be controlled and segregated, and that an individual’s behaviour must be suitably managed by medication before going into the community.

I agree with Golding and Rose; it is necessary to understand the attitudes of support workers, and we need reliable and valid tools to measure these. However, further analysis of the qualitative data is needed to reveal the subtle yet pervasive attitudes evident in many of the support workers’ comments.

The value of Golding and Rose’s study is the contribution of an understanding of the influences on, or effects of attitude (rather than support workers’ attitudes per se). Before new scales are developed, further analysis of existing data is required to explore what support worker’s attitudes are. Golding and Rose stated that they found support workers attitudes to be positive, yet some of the attitudes expressed in the examples provided are not aligned with current service ideals.

Link

Exploring the attitudes and knowledge of support workers towards individuals with intellectual disabilities, Golding N S & Rose J in Journal of Intellectual Disabilities, Published online before print December 26, 2014, doi:10.1177/1744629514563777 [abstract]

References

Bigby, C., Clement, T., Mansell, J., & Beadle-Brown, J. (2009). ‘It’s pretty hard with our ones, they can’t talk, the more able bodied can participate’: staff attitudes about the applicability of disability policies to people with severe and profound intellectual disabilities. Journal Of Intellectual Disability Research 53(4), 363-376 [abstract]

Emerson, E., Hastings, R. P., & McGill, P. (1994). Values, attitudes and service ideology. In E. Emerson, P. McGill & J. Mansell (Eds.), Severe learning disabilities and challenging behaviours. Designing high quality services. London: Chapman & Hall.

Mansell, J., Beadle-Brown, J., Whelton, B., Beckett, C., & Hutchinson, A. (2008). Effect of service structure and organisation on staff care practices in small community homes for people with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 21, 398-413 [abstract]