Person Centred Planning

For a long time, the voices of adults with learning disabilities have been diminished, muted or lost. 

In Singapore, rehabilitation to maximise the skills and quality of life of a child with learning disabilities are not typically considered. There are many possible reasons. One of which may be the lack of or mis-understanding about our brains. Many people assume that we are born with our brains which are static in their growth. ("No point giving therapy to my child with learning disabilities cos s/he has been born with this global developmental delay.") But science has proven to us that this is not true. From the time we are born, our brains are plastic and can continue to develop and learn if the environment is stimulatory and facilitates positive growth. 

Another reason for not providing rehabilitation is probably the lack of it. From all my conversations with health care professionals (i.e. occupational therapists, speech and language therapists, physiotherapists) from Singapore, I know that this is definitely true. We do not have enough therapists in Singapore. Precisely because there is a low supply and high demand, costs for engaging a therapist is pretty high (about $120 and above per hour). Access is inequitable and provision is insufficient. 

The third reason is, I suspect, due to the society's and carer's unhelpful attitudes of persons with learning difficulties. For example, it has been reported that carers tend to underestimate individuals' skills and abilities. As a result, certain assumptions are formulated and these may lead to carers’ use of language that reinforces the stereotypes, constrains opportunities for communication, resulting in lowered expectations of the individual. 

In the U.K., the world of rehabilitation for adults with learning disabilities is currently in a flux of change. There is now an increased recognition of the need to maximise an individual's participation in the process of therapy and to plan intervention that reflects the individual's life aims and priorities. For the first time, we are asking them, "What do you want? What are your dreams?"

I have become a big fan of Helen Sanderson Associates' philosophy and approach called Person Centred Planning.This represents a shift in thinking because now the voice of the client - the adult with learning needs - is sought, heard and considered. It challenges carers' perception (e.g. 'X has always been like this') and invites all stakeholders to consider possibilities (what the individual can do, might be able to do, want to do) rather than limitations (what the individual can't do, will never be able to do).  

I wonder how long Singapore will take to embrace such a philosophy and approach. 

When will our paradigm shift on how we perceive people with learning difficulties begin? Have we began? 

Have you?