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For us, and hopefully for other readers, one of the key
messages of the book is the necessity for us all to listen to
people with learning disabilities and to acknowledge them
fully in their experiences of trauma, bereavement, the effects
of growing older and of abuse.
In discussing the book together, we were impressed by
both its depth and breadth. As (non-psychotherapist)
practitioners and academics who support people with
learning disabilities who have experienced traumatic pasts,
the book provides a wealth of pointers that we can
incorporate into day-to-day practice. As such, the book is
as accessible to those who are not versed in psychotherapy
as it is to those who are, aided by its use of non-technical
language and a useful glossary.
From this book, we came to a view that Respond is rightly
named. Accounts of how a telephone service was developed
and a chapter about working with people from diverse
cultures and religions reveal an organisation ready to
respond to new ideas and to exploring its own processes.
We believe that Respond’s model of reflective and sup-
ported practice could be of great benefit to those who
support people with learning disabilities outside of a
psychotherapeutic context. If adopted, it may reduce the
anguish and the often hidden pain of those whose lives are
described with sensitivity and with such concern for the
person within the pages of the book.
Kelley Johnson and Pauline Heslop
Norah Fry Research Centre,
University of Bristol, 3 Priory Road,
Bristol BS8 1TX
E-mail: [email protected]/
Intellectual Disability: Social Approaches
David Race. Maidenhead, McGraw Hill Open University
Press, 2007, pp. 288. ISBN: 978 0335 2213633. £18.99
(paperback)
doi:10.1111/j.1468-3156.2009.00547.x
David Race has written an idiosyncratic book, part biogra-
phy/autobiography, part comparative study of intellectual
disability policy and services, and part social and cultural
history of the normalisation/SRV movement. It is all the
stronger for having all of these elements and drawing fully
on the author’s experience and knowledge. It has plenty for
readers from around the world but at its centre lays a
personal but evidenced evaluation of the changing life
chances of people with intellectual disabilities in England
since the 1970s. Most importantly this is an evaluation that
is most definitely value based.
In the acknowledgements David Race refers to his
Down’s syndrome son Adam as the star of the book.
Adam’s life and achievements since his birth in 1985
provide the book’s critical edge. That Adam going to a
mainstream school, passing public examinations, getting
work and living independently are still not commonplace
for people with intellectual disabilities is the book’s pressing
issue. It is through the prism of Adam’s life experiences and
challenges that David Race visits, meets people and sees
services and opportunities in Sweden, Norway, New Zea-
land, Australia, Canada, the USA and returns to England to
take stock. These countries represent a range of welfare
states from the most comprehensive in Scandinavia,
through an agency based service system in New Zealand
to countries with varying degrees of regional as opposed to
central government power. The return to Britain provides
the opportunity to reflect on difference and the future by
imagining Adam’s life as if it were unfolding now in all
these countries.
By preceding each national chapter with an ‘instant
impact box’ David Race links a set of nuanced accounts.
The boxes are not examples of best practice but what they
purport to be, instant impacts which he found provoking
and surprising. He found that every country has pockets of
very effective and innovative initiatives that support
ordinary lives. Welfare analysts will not be surprised to
find that the opportunities in the Scandinavian nations tend
to be greatest. In Sweden and Norway the least financially
advantaged and lowest status are more likely to have access
to the best life chances. Nevertheless, he identifies the
continuing importance of ‘pushy parents’ as advocates in all
countries. Despite placing refreshing importance on the
different historical and social contexts some strong similar-
ities emerge. In particular, people with intellectual disabil-
ities continue to occupy a service-defined world that
delimits their life chances (people not services lead ordinary
lives). Nowhere are experiences like Adam’s the norm.
Back in England David Race draws on this comparative
work to examine the transformative power of Valuing People,
the latest government policy initiative launched in 2001. He
gives examples of improvements in the lives of people with
intellectual disabilities that meet the new policy objectives
but in their social dynamic were incidental to the new
policy. In contrast to the promotion of Valuing People as the
passport to staged progress towards fuller and finally full
lives for people with intellectual disabilities he finds its
achievements limited. He sees potential in In Control, a
person centred approach combining the ethos of citizen
advocacy with individual budgets (people directing their
own support packages). Over the year or so since the
publication of David Race’s book In Control has been largely
subsumed into the general implementation of individual
ª 2009 Blackwell Publishing Ltd, British Journal of Learning Disabilities, 37, 165–167
166 Book Reviews
British Journal of
Learning DisabilitiesThe Official Journal of the British Institute of Learning Disabilities
budgets for all social care users and early evaluations raise
doubts over their likely effectiveness (see the Individual
Budgets Evaluation Network project).
In looking to the future, David Race places importance on
what he terms external economic, social and value forces.
These are a mix of the global and the local including
challenges to shapers of values and ‘experts’, the dislocation
of government (local and national), and the ‘culture of
services’. His is a stimulating and well informed discussion
but there are variations on his analysis. It is interesting, for
example, that people with intellectual disabilities seem to
have benefitted little from the challenge to expertise. This
may best be understood in the context of ‘the risk society’
which it may be argued has developed a Zeitgeist that
perpetuates the equation of intellectual disability with
perpetual childhood. In the modern consultative state
welfare agencies are risk averse. Is it a coincidence that in
England the advent of individual budgets that purport to
empower the individual is accompanied by raising the
profile of adult protection?
Intellectual Disability: Social Approaches is essential reading
for those who live with, campaign for and deliver the
services that should give people with intellectual disabilities
an ordinary life. David Race has shared his considerable
experience and knowledge to produce a personal book that
advocates passionately for everyone like Adam to be
allowed to lead full lives as ordinary citizens.
Ian Buchanan
Department of Social Policy and Social Work,
University of York
ª 2009 Blackwell Publishing Ltd, British Journal of Learning Disabilities, 37, 165–167
Book Reviews 167
