Regulations place control and power in the hands of regulators, and not people with developmental disabilities and their families. Rules and regulations, whether imposed by federal programs, state agencies, or courts, place regulators and monitors as the guardians and protectors of people with developmental disabilities and their families and, in so doing, deprive them of control over their own lives. Regulations direct attention to concrete and tangible things and trivialize the most important things in life. A final paradox of regulations is that the most important things in life are the most difficult to measure objectively. As a consequence, tangible things, such as the number of square feet per bed, and trivialize the most important aspect of services.
Active treatment comes to be equated with paperwork, rather than the quality of programming.
This is why dismal programs with good policies and plan can attain certification and good programs with insufficient paperwork can be cited for deficiencies. Regulations are often criticized for their narrow focus on the medical and treatment aspects of services to the exclusion of community integration and normalization, or social role valorization. Because regulations emphasize tangible things and trivialize important things, such schemes are doomed to suffer from the same problems characterizing other regulations. First of all, we need to be modest in our expectations of regulations. In view of the historical pattern of abuse and neglect of people with developmental disabilities in institutions and other settings, regulations are a necessary evil to content with evils in the world.