sou · GMB316 · 1999-01-01 00:00:00 — Benämningen är med andra ord, säger , ett viktigt instrument i konstruk- tionen av den sociala verkligheten, eftersom språket är det instrument genom vilket medvetandet formas. anser däremot att språkliga förändringar inte alltid lett till ändrade atti- tyder. Hon menar att förändringar i terminologi inte räcker för att åstadkomma större attitydförändringar. Detta beror på, säger , att fördomar vilar på förutfattade meningar och myter och dessa är djupt rotade. Människorna är ofta inte ens medvetna om att de har dessa attityder. Också mediernas betydelse som opinionsbildare av attityder har studerats. I en engelsk undersökning om hur personer med funktionshinder framställs i brittisk television konstateras att de framställs på ett negativt sätt och att deras roller all- tid står i relation till deras funktionshinder. ret och inte personen som framhålls. På samma sätt förhåller det sig, enligt Klobas, i de filmer där någon av skådespelarna gestal- tar en person med ett funktionshinder. Hon menar att det finns en stor skillnad mellan hur en person med funktionshinder framställs på film jämfört med hur andra människor gestaltas i filmen. Fort- farande framställs funktionshindret som ett personligt problem som man måste övervinna. Personens karaktär är endimensionell och framställs inte som en integrerad del av handlingen. Det finns också, säger hon, många filmer som förmedlar ett emotionellt budskap – en person med funktionshinder skall "acceptera", "besegra" eller "övervinna" sitt funktionshinder eller t.o.m. "bli botad". De flesta forskare är överens om att det är mycket svårt att för- ändra människors attityder. Det fordras att man själv kan granska sin egen inställning och sina egna fördomar. Det måste också finnas möjlighet att kunna bearbeta sina attityder. Det framhålls mycket ofta att ett effektivt sätt att förändra attityder och bemötande är ökad information och ökad kunskap. På motsvarande sätt menar flera forskare att en attitydförändring kan åstadkommas genom ökad kontakt mellan personer med funktionshinder och andra medborgare. Ofta anses en kombina- tion av ökad utbildning, information och interaktion ge bäst resultat. Men för att interaktionen skall utvecklas i positiv rikt- ning fordras, enligt Yuker, att vissa villkor är uppfyllda. Samar- bete och ömsesidigt engagemang måste finnas. Mötet skall vara givande för båda parter. Det skall resultera i att personerna lär känna varandra och i att en kontinuitet finns i relationen. Det finns emellertid också forskare som menar att ingen av de här åt- gärderna ger önskad effekt varken var för sig eller sammantaget. Flera forskare har påpekat att det mycket ofta är de personliga egenskaperna hos den funktionshindrade personen själv som av- gör hur bemötandet och de sociala relationerna utvecklas. Den egna självuppfattningen kan vara utslagsgivande för möjlighe- terna att leva i delaktighet och jämlikhet med andra. This survey of knowledge about attitudes to persons with disabi- lities has been conducted at the request of the #OMMITTEE OF )NQUIRY INTO !TTITUDES TO 0ERSONS WITH $ISABILITIES. pose of the survey was to study the problem of attitudes as described in Swedish and international research, and the know- ledge that has emerged. The inventory mainly describes more re- cent research, but some older material has also been included. The reason for this is that while no more recent research was av- ailable in certain fields, the findings were nevertheless deemed to be of such interest that it was worthwhile to present them. Research material from and the other Scandinavian countries, the , the UK and has been included. Background and demarcations, theories and definitions An extensive body of research material on ATTITUDES to persons with disabilities is to be found, particularly outside . In the view of many researchers, attitudes are opinions that lead to action. According to several researchers, peoples inclination to act is in some way in with their attitudes. , it is possible to influence actions by influencing attitudes. In simple terms, you might say that an individuals attitudes to a person with a disability is the sum of all the actions which this particular individual has performed in relation to that person. Other resear- chers are critical of this approach to the concept of attitude. In their opinion, it is not at all certain that attitudes alone influence the way in which people act; rather their actions are largely determined by social and structural factors. Moreover, some researchers think that it is peoples fear and anxiety when faced with the unknown and the different that shape Such feelings often give rise to dissociation but also to inner conflicts between a persons own reactions and the values and norms about what is right and proper that prevail in society. If one looks for research focusing on the concept of attitude the result is discouraging. Relatively has been written about how persons with disabilities are treated by, for example, public officials, politicians and people who work in the social services, the health and care sector, and the social insurance sys- tem. The term "attitude" has been defined in various different ways in the reports submitted by two previous committees of inquiry. In "RISTER I OMSORG EN FR¥GA OM BEM¶TANDE AV ¤LDRE (Shortcomings in Care – the Question of Attitudes to the Elderly, Swedish Government Official Reports no. 1997:51), "attitude" is defined as a mutual relationship, the attitudes that people have towards each other. But the word is also defined as "the overall view prevalent in society as it is expressed in laws and ordinan- ces". In the report entitled *¤MST¤LLD V¥RD /LIKA V¥RD P¥ LIKA VILL KOR (Equal Care. Different Forms of Care on the same Terms, Swedish Government Official Reports no. 1996:133) a more limited definition is used. Here the word is taken to mean "the general behaviour of welfare and nursing staff towards the patient, information, communication, interaction, patientinfluence and various aspects connected with the quality of the service pro- vided." "Attitude" can be interpreted to mean "behaviour" or "treatment", but in a more negative sense it also comes close to the word "prejudice". "Prejudice" is often defined by the resear- chers as an "unfounded opinion, a preconceived idea". Many researchers say that there is a probable connection between "attitude" and "treatment", but they are not agreed on the exact nature of that connection. Some say that it is the structural circumstances, for example, organization and the atmosphere at a workplace that shape attitudes and behaviour. Other researchers say that it is underlying attitudes – people's ideas, opinions and values that determine behaviour. Some researchers take a stance that is somewhere between these two poles. In their view it is impossible to distinguish between cause and effect. A new approach to handicaps is gaining ground. According to this approach, a handicap should be regarded as the effect of societys failure to adapt to the needs of persons with disabilities, rather than the individuals inability to fulfil the demands of soci- ety. According to Finkelstein, who has conducted research on atti- tudes to persons with disabilities, one consequence of this new concept of handicap is that research should cease to focus on the individual. Instead, research should consider the role that social circumstances and the "professional helpers" have come to play as well as the behaviour of these "helpers" as it is expressed in roles, perceptions and attitudes to persons with disabilities. Such a switch in focus from the individual to his or her surroundings and the perception of the person with a disability, should, according to Finkelstein, mean that the view of persons with disabilities will also change, and they will be regarded as subjects rather than objects. This switch of focus is basically a consequence of the new concept of handicap. On the other hand, thinks that the problems should not be regarded as being associated exclusively with the sphere of the individual or exclusively with their surroundings, but rather as a result of interaction between these two. That means, says , that persons with disabilities are confronted by problems that others do not encounter, but that the responsibility for alleviating those problems devolves upon society. However, responsibility also lies with the person who has a disability. He or she can and should seek to influence the situation and also the quality of the treatment he or she receives. Attitudes from various perspectives Most research projects and studies that have been examined focus on how people in various professional categories regard persons with disabilities, their education, socio-economic status, etc., or on attitudes to different types of disabilities. Research based on the perspective of a person with a disability is very rare. However, in the last few years, some Swedish researchers have studied how social factors affect the general situation of persons with mobility disabilities, their families and the existential condi- tions under which they live. studied the implications of growing up with severe arm- and leg deformities for a group of thalidomide children. In her opinion, the reason that the children almost without exception were equipped with prostheses was so that they could conform to the "demand to be normal". It was a way to conceal the childrens injuries thereby protecting them from the negative attitudes of the community. According to , this faith in prostheses and research in the field meant that for a long time the childrens need of emotional, social and intellectual development went unnoticed, which made their circumstances even more difficult rather than alleviating them. studied how persons in great need of personal assi- stance experience their situation. According to her, it is precisely because that need is so marked that it almost invariably leads to a power-dependence relationship. People who administer or actually provide help wield power in the sense that they are in a position to determine the nature and scope of the assistance recei- ved, as well as when and how it is provided. This inequitable distribution of power, can, according to , lead to people who need a great deal of assistance being violated. This in turn has a negative effect on their perception of themselves and their sense of identity. Research shows that the foundations of negative attitudes are very often laid by historically and culturally shaped values, soci- alization processes, childhood fears and lack of contact with those concerned. People often express negative attitudes to visible disa- bilities; attitudes to persons with hearing or visual impairments are as a rule the most positive. On the other hand, persons who are intellectually handicapped or suffer from mental illness often arouse feelings of vulnerability and anxiety in people who have no disabilities themselves. The values and experiences of staff members also play a crucial role in how people with disabilities are treated. A notable feature in a number of studies is that there is a commitment in principle – you might call it the equal-rights argument – or an allegedly positive attitude towards persons with disabilities, but resistance in a person's practical life as employer, neighbour or teacher to the integration of disabled people into the community at large. There is a notion that the general public has different attitudes to different types of disabilities and that there is a hierarchical order between these different types. Certain research results would confirm this. Persons with visual impairments are at the top of the scale, while persons with intellectual handicaps or mental illnesses are at the bottom. However, some studies dispute the claim that such a hierarchy exists. People are unsure of them- selves generally and anxious when meeting persons with disabili- ties regardless of the type of disability. Variations in attitude are differences of degree rather than differences in kind. With respect to people with hearing impairments, a number of research results confirm that people who wear hearing aids often encounter negative attitudes. Reports refer to the "hearing aid effect", that is to say, if a person is wearing a hearing aid, he or she will encounter negative attitudes. This is also true of children who wear hearing aids. On the other hand, people who cannot see nearly always arouse sympathy and are regarded as helpless, while persons with intellectual or functional impairments often meet with prejudice and sometimes negative treatment. When it comes to attitudes towards women with physical disabilities it can be ascertained that virtually no research exists in this field. According to , who raised this issue, this shows two things: firstly that persons with disabilities are regarded as sexless beings, secondly that the social obstacles encountered by these people are not perceived as being attributable to sex roles. The results are unequivocal – women with disabilities are treated with a lack of confidence and respect in society. The attitude of members of staff and various professional groups toward persons with disabilities and their relatives has been examined by many researchers. The same is true of child- ren's attitudes and values in relation to other children, as well as the attitudes of neighbours, particularly to persons with mental illnesses or people with intellectual handicaps. Most of these studies were carried out during a period in the 1980s and at the beginning of the 1990s when institutions and residential homes were being phased out and replaced by other support and forms of housing. Research into the attitudes of professionals is based on the premise that their attitudes are of crucial importance to how the results of treatment, etc., are received. This is true regardless of whether treatment is good or bad. The attitudes of staff members determine the quality of personal treatment. Many, more recent studies show that most of the people who come in contact with persons with disabilities professionally have a fairly positive attitude towards them. This was the case for, e.g., supervisors and managers in a number of companies. Teachers attitudes to teaching students with disabilities along- side other students have been examined in a large number of Swedish and foreign studies. Various Swedish research findings indicate that the attitude of teachers depends on what type of disability the student has and how complex it is. A recent study by the American researcher (1996) confirms these fin- dings. Researchers have also examined whether there is a connection between the education the teachers have received, for example, training for remedial teaching, and their attitudes to teaching students with disabilities alongside other students. No connection was shown. However, research findings indicating the opposite also exist. According to them, the more advanced the remedial training, the more positive the attitude. In connection with the phasing out of institutions for persons with intellectual handicaps and persons with mental illnesses, a number of studies were made of i.a. the attitudes of those who were about to become the neighbours of the new arrivals. In part the findings are contradictory. On the one hand, some research findings indicate that moving persons with disabilities from an institution to a more normal form of housing did not result in positive contacts with neighbours and other people. On the contrary, the move resulted in conflicts and negative attitudes towards the new arrivals on the part of the neighbours. On the other hand, some researchers have come to the opposite conclu- sion. People who live in areas where a great many persons with intellectual handicaps reside have greater understanding and more positive attitudes to such neighbours than people who have not come in contact with them. Reason for negative attitudes and unfriendly behaviour Many different approaches are adopted by researchers trying to explain the underlying causes of attitudes and behaviour. However, the results are contradictory and researchers do not agree on the reasons for attitudes to people with disabilities in va- rious contexts. Several models are described in research literature in an attempt to answer the question of why persons with disabilities so often encounter negative attitudes. Explanations may be socio-cultural, psychodynamic, historical, demographic or based on personality. As always, one model alone cannot explain the origin of negative attitudes. Various causes are interwoven and one explanation need not exclude others. The general view among researchers is that the cause of nega- tive behaviour is often the unclear formal system of rules which invites authorities, companies, organizations and others who are to interpret the rules to implement them in a way which affects disabled persons chances of obtaining the support and help they need. One of the few Swedish women carrying out research into disabilities, , who has studied the formulation in social insurance legislation concerning allowances for people with disabilities, points out that the most serious obstacles in contacts with the public sectors various allowance systems are to be found in the hidden structures. The approach and attitude of officials are governed by these structures. Insufficient knowledge of what a disability means and of the intentions underlying various systems of rules are other factors which considers are of decisive importance for attitudes and approaches. Other researchers are of the opinion that peoples anxiety and fear of anything different is the cause of attitudes. It is fear of the unknown, a fear which most people know nothing about and con- sequently cannot handle. Attitudes can then help people to understand the world around them by organizing and simplifying it to protect themselves from unpleasant truths or to adapt to a complex reality. Peoples tendency to categorize and classify other people on the basis of certain characteristics (disabled, blind, etc.) rather than of individual traits may also lead to negative attitudes. member of "the group" is perceived in the same way and enco- unters the same negative expectations. Researchers say that in this way an erroneous perception of a situation from the outset gives rise to new behaviour on the part of the individual and as a result the first erroneous perception becomes reality – a case of a self- fulfilling prophecy. It is often stressed that language is of decisive importance for people's perception of people with a disability. In this context, the organizations for people with disabilities have played a major role in changing terminology. Many researchers have paid great attention to the matter. For example, the Swedish researcher, Hännestrand considers that the concept "disabled" in general use acts as a stamp to put people with disabilities in a subordinate position. Other researchers, for example Eayrs, share that view. To brand a person as disabled means that people in that person's environment begin to act in a certain – notably in the in which one is expected to react when told that someone is, for example, mentally handicapped. In other words, the term given is an important instrument in shaping the social reality, since language is the instrument by which awareness is formed. , on the other hand, considers that linguistic changes do not always lead to changes in attitudes. She is of the view that changes in terminology do not suffice to achieve major changes in attitudes. This, says , is because prejudice is based on preconceived ideas and myths and these are deeply rooted. Often, people are not even aware that they have these attitudes. The effect of the media as a moulder of attitudes has also been studied. An English inquiry into how people with disabilities are presented on British television establishes that they are almost always portrayed in a negative way and that their roles are always related to their disability. The disability is emphasized rather than the personality. The same applies, according to Klobas, to films in which one of the actors plays a person with a disability. In her view, there is a big difference between how a person with a disa- bility is presented in a film compared with other people in the film. The disability is still presented as a personal problem that must be overcome. The character of the person is one-dimension- al and is not presented as an integral part of the action. films, she says, convey an emotional message – a person with a disability shall "accept", "conquer" or "overcome" his/her disabi- lity or even "be cured". Most researchers are agreed that it is very difficult to alter people's attitudes. To achieve this, people themselves must be able to examine their own attitudes and prejudices. And they must be able to revise their attitudes. It is often claimed that an effective way to change attitudes and behaviour is to provide more information and knowledge. In a similar way, several researchers think that attitudes can be changed by increased contact between persons with disabilities and other members of the community. A combination of more training, information and interaction is often recommended as yielding the best result. But for that interaction to evolve in a positive direction, certain conditions must be fulfilled, according to Yuker. There must be cooperation and mutual commitment. The encounter must be of mutual benefit to both parties, lead to the persons becoming acquainted with each other and offer conti- nuity in the relationship. However, in the opinion of some resear- chers, none of these measures – either separately or in combina- tion – produce the desired effect. Several researchers have pointed out that it is often the perso- nal qualities of the person with the disability that determine how attitudes and social relations develop. A person's perception of him- or herself can be the factor that determines his or her possi- bilities for taking part in community life on an equal footing with others. Grundad på erfarenhet. Grundad i fakta utan att ingå i någon teori- Inbegripa, innefatta, innebära. Inte klart utsagd, underförstådd. Oförenligt, motsägelsefullt. Ett socialt beteende där människor med hjälp av språk, symboler och gester för- medlar budskap till varandra och därige- nom påverkar varandra. grundläggande social process som upp- kommer vid kommunikation och ömsesi- Då en individ accepterar värden, normer eller attityder vilka omfattas av en annan grupp som sina egna. Möjlighet som ännu inte kommit till uttryck, möjlig, men ej fullt ut förverkligad. Konsekvent, överenstämmande. 6ETENSKAPLIGT: Den uppsätt- ning av omständigheter, förhållanden eller fakta som omger en specifik händelse, Består av eller hänför sig till uppsikt, för- var, förmynderi. ment som återspeglar en norm eller under- stödjer dess införande. Dubbelsidig förlamning beroende på rygg- radssjukdom eller skada. förlamning i båda benen eller nedre delen Varseblivning, förnimmelse. Det beteendemönster som förknippas med skyldigheter och rättigheter i en viss social position; roll är nära förbundet med status (på den som innehar en viss roll ställer om- givningen vissa krav). Statistiskt säkerställd skillnad. En urskiljning av hierarkiskt ordnade posi- tioner i ett samhälle på grundval av status och de med positioner förbundna skillna- derna i privilegier, prestige, makt och infly- Indelning i skikt, klasser. Överföring till individen – ofta en livslång process – av för gruppen eller samhället betydelsefulla värderingar, kunskaper, fär- digheter etc. genom en process av social Inlärning av samhällets nor- mer, värderingar, etc. Undersökning i stor skala genom frågetek-