A Critical Interrogation of Inclusion in the Context of Residential Service Provision for Persons with Developmental Disabilities in Ontario

In an occupationally just context, people can experience social inclusion through enablement of occupation. Thus, social housing provision has power to shape occupational possibilities and inclusion of residents. Despite the goals of deinstitutionalization, persons with developmental disabilities continue to experience social exclusion (e.g., in terms of quality/quantity of available social housing). In Ontario, Canada, thousands of persons with developmental disabilities are inadequately housed. In order to surface occupational injustices experienced by persons with developmental disabilities in social housing, I adopted a critical occupational science (COS) approach to consider discourses (e.g. what is said) and practices (e.g., what is done) that constitute an ‘inclusive home’. I aimed to problematize inclusion shaped and was shaped within the situation (i.e., sociopolitical, economic, cultural, and material) of residential service provision in Ontario by considering the complex transactions amongst discourses about inclusion, everyday practices, and macro-level forces.I conducted a community-based, multimethod qualitative study. I interviewed 9 agency directors from five housing agencies and 18 residents with developmental disabilities across 14 residences. Each resident was interviewed twice using participatory (i.e., go along and photo elicitation) methods. In Session 1, we toured their residence while I interviewed them about daily life and how they are or want to be included in it (or not) and took photos with them. In Session 2, we explored the photos to deepen conversations about inclusion and home. Interview data (N= 42.5 hours) were audio recorded, transcribed, and abductively coded. Drawing on COS, I wrote analytic summaries for each participant to ‘interrogate’ the data with problematizing questions. I attended to rigour through prolonged engagement, multiple data sources, and extensive field/reflexive memos. I linked participant accounts to five interlinked dimensions of inclusion (Mainstream to Specific; Far from to Near Others; Private to Collective; Transient to Stable; and Unsupported to Supervised) each of which had effects on inclusion (e.g., through available resources and practices). At one extreme, the accounts echoed neoliberal notions of personal responsibility and individualism. At the other extreme, the accounts included types of resistance about intentional community and disabled spaces. From these accounts, I interpreted an inclusive home as accommodating diverse needs through spatial flexibility, balancing private/communal spaces, intentionally considering disability-specific needs/choices, and having stable connections to meaningful community networks that may open up occupational possibilities for residents through inclusion. These culminated in five principles of an inclusive home: Fluidity of Design, Flexibility of Space, Proximity to the Centre, Stable Connections to Varied and Active Networks, and Building Opportunities for Active Involvement of Residents in Housing Planning. By applying the socially transformative COS lens, these findings contribute to a richer understanding of assumptions and ideologies that underlie occupation in residential service provision for persons with developmental disabilities, and potentially, other disabled populations.

Keywords: Critical studies
Developmental Disabilities
Home
Housing
Occupational Science
Social Inclusion
Advisor: Gibson, Barbara
Nalder, Emily