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Background: Supporting participation in decision making is complex, dynamic and multifactorial. The aim of this study was to understand more about the difficulties parents of adults with intellectual disabilities experienced in providing decision support and their strategies for resolving them. Method: Participants were 23 parents who regularly provided decision support for their adult with intellectual disabilities. Most of the adults (19) lived at home. Parents participated in semi-structured interviews at least three times during the study. We applied a social-constructionist theoretical perspective and a template approach for analysis. Results: Findings fell into three core categories, making the right decision, factors that made decision support difficult, and strategies to manage uncertainty, which included controlling, influencing, expanding the adult's horizons and enabling risk. Conclusions: The knowledge gained will help in building the capacity of parents to provide decision support that better understands and respects the will and preferences of the person they support.

Background: Unpredictability, the risk of harm and possibility of rewards, are integral elements of encounter. Risk literature offers insight on the complex ways in which risk perceptions and attunements shape behaviours and interactions in encounter between people with and without intellectual disability. Method: The paper draws on risk literature, encounter literature, and examples from the authors' previously published studies on encounter and work integrated social enterprises. Results: Encounters between people with and without intellectual disability are shaped by perceptions of possible rewards and harms skills and experience in attunement to risk signals; disposition towards, and strategies of, risk aversion, management or enablement and environmental attributes of encounter settings. Conclusions: There is a need to shift community and disability services' understanding of risk in encounter, by developing a positive appreciation of encounter risk, and development of risk enablement strategies that are learned through experiential practice.

Article 12 of the United Nations Convention on the Rights of Persons with Disabilities has been instrumental in driving the development of the concept and practice of supported decision making. An important feature has been the development of "supported decision making pilots." This paper identifies, describes and analyses pilot programmes providing support for decision making for people with cognitive disabilities in Australia and internationally between 2016 and 2021. It finds that challenges included providing support for socially isolated people and adequately resourcing those programmes. However, most pilots reported positive outcomes for decision makers, adding to the evidence base for claims to be made about the positive impact of supported decision making on the lives of people with disabilities. The pilots demonstrate that, internationally, there is an emerging set of programmes that seek to promote supported decision making incrementally through developing focussed community awareness and practice. While still small‐scale, time‐limited and experimental, with different levels of rigour in practice and evaluation, they provide some foundation and a preliminary evidence base for larger interventions and reforms in the future. [ABSTRACT FROM AUTHOR]

In many countries around the world, individualised budgets are replacing ‘block funding’ as the primary way in which disability service provision is funded. These models assume that dynamics of competition improve services for people with disabilities. This article presents the findings of research on the accessibility and inclusiveness of mainstream services for people with intellectual disabilities in four Australian cities in the wake of the rollout of individual support budgets. We use the concept of ‘repair’ and the conceptual framework of ‘landscapes of care and support’ to analyse interviews with mainstream service managers. Our findings reveal that not-for-profit organisations perform crucial tasks in persuading for-profit service providers to collaborate with them to improve their accessibility and inclusion. When these services collaborate to repair service access, not-for-profit organisations often take on associated responsibility, costs and risk to encourage reparative adjustments in for-profit services. Not-for-profit organisations are also more likely to be tasked with the relational and interpersonal work that is crucial for successful service repair. Our findings challenge assumptions that free-market competition is the main driver of more accessible and inclusive service delivery and suggest how policy can support more equitable collaborative repair work. [ABSTRACT FROM AUTHOR]

BackgroundMethodResultsConclusionsDespite growing recognition of their right for inclusion in society, people with intellectual disabilities are often excluded from mainstream services, or experience poor service outcomes.Taking a relational approach that considers the interpersonal relations and interactions that occur in mainstream service settings in Australia, this paper examines the features of services that research participants considered more inclusive.Relations between service users with and without intellectual disabilities, mainstream service staff and disability support workers in inclusive mainstream services were characterised by; respect; warm, welcoming and convivial interpersonal engagement; active listening; proactive assistance; flexibility; mediation to create a safe environment; and collaboration and shared responsibility by both mainstream staff and disability support workers in supporting a service user with intellectual disability.Building on these results, we put forward a set of principles for facilitating inclusion of people with intellectual disabilities in mainstream services. [ABSTRACT FROM AUTHOR]

The National Disability Insurance Scheme ('NDIS') has been criticised for failing adequately to live up to the promise of individualised resource packages tailored to the needs of each participant, instead applying bureaucratic, standardised administrative logics. This paper analyses the legal architecture, policy assumptions and administration of the NDIS to establish the extent to which its guiding philosophy lies in professional person-centred case planning, an insurance logic, or principles of equity and efficiency of decision-making; and then assesses the contribution of legal remedies in ensuring fidelity of purpose to policy goals. It is argued that whatever the validity of criticism of NDIS Taylorist administrative standardisation and data-driven planning, it is neither an error of law nor responsive to merits review avenues. Undue weighting of equity and efficiency goals over the preferences and needs of individual participants nevertheless remains ethically problematic in unduly elevating an ethics of justice (impartial planning based on abstract principles applied consistently to all participants) over an ethics of care that views each participant as unique, as arguably the NDIS was designed to promote., Contents I Introduction II The NDIS and the Planning Framework A Contemporary Human Services Delivery Models and the NDIS B The Legislative Framework for NDIS Participation and Planning 1 The [...]

This paper examines the adjustments made to include people with intellectual disabilities in mainstream services. Drawing on in-depth interviews with both people with intellectual disabilities and mainstream service managers in four urban regions in Australia, the paper points to three modes of practice that are operationalised, to different degrees, when people with intellectual disabilities seek access to mainstream services: a commitment and adjustments to support inclusion of a wide range of marginalised people (diversity and inclusion ethos); adjustments to support inclusion of people with intellectual disabilities more specifically (differentiated adjustments); and, personal support for service users with intellectual disabilities. We argue that these three modes, at the service level, correspond in complex ways with three broader approaches to social inclusion: mainstreaming, differentiation and individualisation. Rather than contradictory modes of inclusion, our analysis suggests these approaches should be understood as complementary. Some mainstream services that value 'inclusion' make adjustments to their service in order to better include people from different marginalised groups. Such adjustments have mixed outcomes for people with intellectual disability, whose specific needs are not always met. Some mainstream services operate separate activities for users with intellectual disability. This helps them manage behavioural and communication challenges, and can help people with intellectual disability experience a sense of belonging. But separate activities also limit opportunities for full inclusion in the mainstream. Often people with intellectual disability require their own personal support to be able to use mainstream services. Some mainstream services rely on such personal support as their main strategy to include people with intellectual disability. Other mainstream services work collaboratively with personal supporters to promote inclusion. [ABSTRACT FROM AUTHOR]

This paper offers more‐than‐care as a framework for analysing how vulnerability emerges in the lives of people with intellectual disability beyond relations of care. More‐than‐care detaches vulnerability from the identity category of disability. It provides a framework for conceptualising vulnerability in an unequal, neoliberalising, and ableist world and sheds new light on the ever‐evolving constitution of vulnerability and disability. This intervention breaks with conceptions of vulnerability centred on care needs that leave other circumstances that inform vulnerabilities unexamined. Importantly, the framework shifts responsibility for managing vulnerabilities away from carers alone. The more‐than‐care framework is grounded in socio‐material conceptualisations of disability and advances a tripartite framing of vulnerability. First, it grounds studies of vulnerability in histories of spatially uneven investment in infrastructure and resources that shape how care and other practices can assemble to produce, challenge, and manage vulnerability. Second, it recalibrates dominant conceptions of the temporality of vulnerability to ensure sensitivity to the unpredictability of emergent vulnerabilities. Third, in following a socio‐material conceptualisation of intellectual disability, more‐than‐care expands discussions about agency in the context of vulnerability. These concepts are empirically examined through an analysis of how vulnerability emerges in the lives of four self‐advocates with intellectual disability during Melbourne's first and second COVID‐19 lockdowns. The analysis shows that vulnerability was highly dynamic and unpredictable as it emerged in complex socio‐material assemblages that included care arrangements, embodied experiences and agencies, and past instances of neglect and exploitation. This paper offers more‐than‐care as a framework for analysing how vulnerability emerges in the lives of people with intellectual disability beyond relations of care. The framework breaks with conceptions of vulnerability centred on care needs that leave other circumstances that inform vulnerabilities unexamined. Applying the framework to the emergence of vulnerability in the lives of self‐advocates with intellectual disability during Melbourne's COVID‐19 lockdowns showed that vulnerability was highly dynamic and that the self‐advocates actively managed emerging vulnerabilities. [ABSTRACT FROM AUTHOR]

Promoting community participation for people with intellectual disability through encounter with strangers is an integral part of the mission of disability support workers. This paper offers detailed micro-level analysis of the practices of support workers when they accompany a person with intellectual disability outside their home and explores the subtle differences which make some staff practices more effective than others in promoting more convivial encounters with strangers. Based on 160 h of observations of twenty-six adults with intellectual disability in a variety of public places, and interviews and focus groups with their support workers, the paper points to some of the critical judgements support workers need to make when considering whether, when and how to initiate or intervene in such encounters.

'Elite communities' are the areas where the wealthy, and even 'superrich', live, socialize and raise their children as future economic and financial elites; they are the places where a few lead socially and economically privileged lives. Earlier studies have concentrated on the inner dynamics of these settings, focusing on the way residents are constructed and socialized as elites through their social, communicative and aesthetic abilities that are perceived as exemplary in contemporary neoliberal society. In this paper, we broaden the perspective, by exploring how these areas contribute to polarization, that is, how they generate distinctions based on money, morals and manners that are peculiar to neoliberalism's idealization of 'entrepreneurship', 'self-management', 'leadership' and the pursuit of an 'active lifestyle'. Our data come from two major ethnographic studies: one conducted between 2010 and 2015 of Sweden's wealthiest community, Djursholm, that is populated by the country's business and financial elites; the other conducted between 2016 and 2019 of three of Australia's most prestigious and economically privileged suburbs, Toorak (Melbourne), Mosman (Sydney) and Cottesloe (Perth). [ABSTRACT FROM AUTHOR]