Showing posts with label stigma. Show all posts
Showing posts with label stigma. Show all posts

Friday, July 19, 2019

Diverse dolls help children 'appreciate themselves as they are'

By Louise Kinross

Winnie Mak is part of a multicultural family. She is Chinese, from Hong Kong, and her husband Rafael is French and Greek. They live in London, U.K., and after their son Alex, now 4, was born, Winnie learned that the vast majority of dolls were white, girls and able-bodied.

She wanted to create soft dolls targeted to boys and girls that “reflect the diversity of the world.” So she launched One Dear World with four dolls that represent children from Ghana, Mumbai, Norway and Hong Kong. This fall she's adding six new dolls that have disabilities (including the boy doll with Down syndrome, above. Scroll down to see the five others).

“Each doll has an identity and comes with a story, and can be used as a tool to help children build a positive self-image and a respect for each other’s differences,” she says. 


BLOOM: Why did you decide to create dolls with disabilities?

Winnie Mak:
When I first launched the company I wanted to include all kinds of diversity. But I decided to start with cultural diversity, because I was just one person starting the company at the dining room table.

Last summer my story got featured on BBC, and I got some messages from parents asking for dolls with disabilities. For example, one mother who had a daughter with Down syndrome wanted me to consider creating dolls with Down syndrome. I contacted different charities in London and messaged with parents of children with disabilities through Instagram, and I found them very welcoming to my idea, and willing to have a chat with me. That gave me the confidence to think this was something I should try.


BLOOM: How did you choose which conditions to include?

Winnie Mak:
I wanted to show a range of visible and non-visible disabilities. My nephew had been diagnosed with autism, so I had become more knowledgeable about that. There’s a doll with autism, a doll with an amputation, a doll with Down syndrome, a wheelchair user, and dolls with visual and hearing impairment.

I was speaking with a consultant in London who gives advice to big corporations on disability policy, and she mentioned that mental [illness] has been classified as a disability. One of my dolls has anxiety. I think young children should learn about mental health and wellbeing.


BLOOM: How are the disabilities conveyed?

Winnie Mak:
The doll with hearing loss has a pink hearing aid. The doll with vision impairment is wearing glasses and has a guiding cane. When I was designing the doll with Down syndrome, I met with some family support groups to get feedback on the facial features. I wanted things to be subtle, not exaggerated.


Each doll comes with a booklet which gives their name, place of birth and a short story about themselves. For example, one doll is Irish and she’s experiencing anxiety after she learns that her parents are getting separated. She finds she likes hiking and drawing, and these two activities give her some peace of mind and help with her anxiety.

Each doll has a hero. The role model of the doll whose right leg was amputated after a car accident is Sudha Chandran, an amputee and also a famous Indian dancer. The booklet also has a section called ‘Do you know?’ about the doll’s disability. 


BLOOM: I know Barbie just introduced a black doll who uses a wheelchair, and American Girl has dolls that come with accessories like hearing aids. What makes yours different?

Winnie Mak:
What makes my brand unique is that each doll comes with a story, which is a guide for parents or educators to start the conversation about differences. My plan is to develop more stories and content around the doll characters. For example, if I exceed my crowdfunding target, I will write a story that includes all of the dolls, or create a card game that can be played with the dolls. The mission of my company is to nurture future global citizens.


BLOOM: What message do you hope the dolls give children?

Winnie Mak:
For children with disabilities, my message is that there are people like them, and they’re not alone. We want all children to grow up having a secure self-image, and appreciating themselves as they are.


I want non-disabled children to learn about disabilities and embrace differences. My son is of the age where he’s very interested in dinosaurs. There are so many dinosaurs and they have difficult to pronounce names, and lots of different features, like running speed. My message is that if young children can learn about all of these complicated dinosaurs, and remember all of the names of the Pokemon monsters, there’s no reason they can’t learn about different disabilities.

BLOOM: How do you make the dolls?

Winnie Mak:
I’m not a doll maker myself. I started with some sketches in a notebook and then did a digital drawing on the computer. I’m originally from Hong Kong and used to travel a lot to China when I worked for an electronics manufacturing company. I found a doll-making factory there that is helping me develop the six new dolls.


BLOOM: What ages are they targeted to?

Winnie Mak:
Because they are cuddly and soft, they are targeted to children from one to two years old, up to five to six years old.


BLOOM: What do the dolls cost?

Winnie Mak:
The new dolls will cost between $40 and $50, because they are more detailed than my first dolls, and more resources were put into developing the booklets that come with them. For each doll sold, 10 per cent of sales will go back to a charity that supports that particular disability. For example, the dolls with visual impairment will support Sightsavers. They work in some of the poorest parts of the world to prevent avoidable blindness and to promote disability rights.


Winnie’s new dolls will be launched in early September through a crowdfunding campaign. You can sign up for more information here. They will be shipped internationally. The wheelchair below comes separately, and can be used for play with any of the dolls.


Monday, June 17, 2019

Off-duty officer kills non-verbal man, injures parents in Costco

By Louise Kinross

This is a horrifying story for all of us in the disability community who love someone who doesn't speak, and may not be able to comply with police orders in conventional ways.


On Friday night, Kenneth French, 32 (in photo above right, with his parents), was shot and killed by an off-duty police officer in a California Costco store. The officer also shot and critically injured French's parents, who were grocery shopping with him.

Police, speaking to reporters just after the incident, said it happened after an argument between two men. According to this news release from the Corona Police Department, "Without provocation, a male unknown to the officer's family assaulted the officer while the officer was holding his young child. This attack resulted in the officer firing his weapon, striking the male and two of the male's family members." The child was not injured.

However, French's cousin, Rick Shureih, told the Los Angeles Times that French was nonverbal and had an intellectual disability, so a verbal argument wasn't a possibility. 

"Speaking about his cousin, Shureih told the paper, 'He was a gentle giant...He's never been violent in the past. He's always been very cooperative and kept to himself.' Shureih said it's possible his cousin may have bumped into someone but he wouldn't have been able to communicate that he was sorry."

Police have not named the officer involved, who was released from hospital with minor injuries. 

This BBC piece 'Don't shoot, I'm disabled,' looks at the hundreds of people with disabilities who are killed by police in the United States each year, because they don't respond in conventional ways to police commands. It could be a person who is deaf, or mentally ill, or who, like French, has an intellectual disability.

In a more recent Los Angeles Times piece, we learned that the French family was from Toronto. "Sandra Serrao, who lives in the Toronto area and has been friends with the French family for more than a decade, said the couple and Kenneth moved to California from Mississauga a few years ago to help care for [their] elderly parents...She said Kenneth French was not the type of person to provoke anyone..."

Friday, May 31, 2019

Friday bonus watch


This short film about living with a dad who has cerebral palsy, uses a wheelchair, and communicates with a pointer and letterboard, is now available on YouTube. My Dad Matthew is seen through the eyes of Elijah, who was then 14, and considers his father Matthew “a pretty normal dad.” 


Want to hear directly from Matthew, who's a professor in disability studies at Northern Arizona University? Read our interview with him. Happy Friday!

Tuesday, May 21, 2019

'I'm trans because that's who I am'

By Louise Kinross

Logan Wong is known for his stylish bow ties. But in this photo, he's
wearing a shirt with the colours of the transgender flag: blue and pink, the traditional colours for boys and girls, and white, representing people who are intersex, transitioning or a neutral or undefined gender. Logan is a transgender man who has cerebral palsy and grew up receiving services here. He's also the co-chair of Holland Bloorview’s youth advisory, and works as a host to inpatients in our teen lounge. He’s going into his fourth year of social work at Ryerson University. We talked about his experiences and how Holland Bloorview can better support young adults like him.

BLOOM: What does it mean to be transgender?

Logan Wong:
It’s when the gender you’re assigned at birth doesn’t match with what you believe to be your gender. Trans is an umbrella. It can mean you’re a guy, you’re a woman, or you’re both. There are new labels coming up every day.

BLOOM: How did you recognize you were transgender?

Logan Wong:
I came out publicly last September. But I’ve known I was trans since I was seven. When I was that age I presented as a male, and I was really self-conscious about my body. I don’t think anyone—including me—recognized it as being trans at the time. I thought I liked boy stuff, and I wouldn’t leave the house in a dress.

I have two older brothers. We have a home video of my birthday party when my parents gave me a Barbie. I threw it on the floor and started playing with my brothers’ hot wheels.

My parents recognized how terrible I felt about myself, and how much of a struggle it was for me. And my mom got better at buying gender neutral clothes and clothes that weren’t pink.

BLOOM: What’s been the greatest challenge?

Logan Wong:
Definitely finding accessible and trans-friendly health-care, and my name change stuff and government forms. Changing everything from my name on my insurance to my name at school are examples.

I’m lucky to have finally found a doctor that is really educated in both transgender stuff and disability—which is really rare. I go to Parkdale Community Health Centre, and I had to transfer my whole primary care over there to be able to access testosterone. Before that, when I saw my regular family doctor, they were going to refer me to a hormone specialist. But there was a year wait list.

BLOOM: What’s been the greatest joy?

Logan Wong:
How much pride I have, and how much I can use my experience, both as trans and having a disability, as representation for both communities at the same time. I really appreciate that opportunity.

BLOOM: What advice would you give parents whose disabled child is questioning their gender?

Logan Wong:
I would say listen to what they have to say about themselves. Don’t make assumptions about what they’re thinking. Let them express themselves the way they want to.

BLOOM: Did having a disability make it easier or harder to accept your transgender identity?

Logan Wong:
In some aspects it made it easier. I’m in a wheelchair and no one expects me to stand up and pee. So I don’t have to worry about facing harassment in the bathroom. I usually use a single stall bathroom.

Growing up, my life didn’t revolve around the fact that I had a disability. My parents believed that my life shouldn’t just be about therapy. That made me willing to explore other parts of my life and identity, so it made it easier for me to recognize who I am.

BLOOM: Is there anything about having a disability that made being transgender harder?

Logan Wong:
Making people realize that I’m not trans because I have a disability, or because of other things that happened in my life. I’m not trans because I’m oppressed by other things, or because I’m attention-seeking. I’m trans because that’s who I am.

BLOOM: How does the disability community view transgender people?

Logan Wong:
I definitely find more community within the trans and queer community. I do associate with the disabled community, but I’ve found able-bodied friends who are trans and queer are way more accepting of my identity. I think it goes back to some people thinking that I’m trans because I want attention.

I do feel I’m more welcomed in the trans and queer community. They don’t see my disability as a thing. It’s part of my identity, of course, but they don’t emphasize it as much as it’s focused on in the disability community.

Do I necessarily tell new people with disabilities that I meet that I’m trans? Not necessarily.

BLOOM: What would you like our staff to know about how they can best work with youth who are transgender?

Logan Wong:
Ask them what their name is, and what pronouns they use. It’s very simple. Recognize that the documents you get might not have the name that they prefer on it. Don’t take the paper as the most important thing. Value what they say.

BLOOM: Have you ever received health care that wasn’t respectful or affirming of who you are?

Logan Wong:
I’ve only had one experience, and it was recent. My cerebral palsy specialist at an adult hospital was blatantly transphobic.

BLOOM: In what way?

Logan Wong:
He refused to refer to me with my now legal name, because he knew me before. I’ve chosen to not go to that person since. I called and explained that I was transferring to another specialist, because I don’t want this happening to another person.

BLOOM: What could we do at Holland Bloorview to better support youth who are gay, transgender or bisexual?

Logan Wong:
I like the steps the equity, diversity and inclusion committee is taking.

BLOOM: Are you on that committee?

Logan Wong:
Yes. They’ve encouraged staff to put their pronouns in their e-mail signature, which is really important, and created gender-neutral bathrooms. Instead of using mom and dad, just say parents. We have to think about it, not only in terms of children and youth, but the parents who are potentially trans.

BLOOM: What about creating some kind of peer support here for clients who are transgender?

Logan Wong:
I think support groups, with the right intention, can always be a good opportunity to express the values of Holland Bloorview.

BLOOM: Why did you decide to be a youth leader?

Logan Wong:
I decided to become a youth leader before I publicly transitioned. I wanted a platform to advocate for people with disabilities, and specifically youth voices. I feel we don’t hear enough from youth about their opinions on what’s happening in the disability community, or politics, or the world.

BLOOM: What are your hopes for the future?

Logan Wong:
I’m hoping to be a social worker. I haven’t confirmed it yet, but I’m hoping my placement will be at the Ronald McDonald House. I’ve gained a lot of clinical experience in my work here, and I’d like to continue that in another space.

After I graduate I’m thinking about master’s programs, both social work and women and gender studies.


In Toronto, there are lots of trans-specific supports at The 519. 

Friday, March 29, 2019

Nick turns to teens to help raise reporting of concussions

By Louise Kinross

Nick Reed is an occupational therapist who joined Holland Bloorview as a research associate. In almost six short years, he’s become a senior clinician-scientist, co-director of our pediatric concussion centre, and most recently, the Holland Family Chair in acquired brain injury. He’s passionate about bringing an occupational therapy lens to rehab for children with sports and other concussions.

It all began when he followed a youth hockey team for a season as part of a graduate research project. Nick put sensors in the players’ helmets, then tracked the number of times they were hit in the head, and how hard. “That opened my eyes to what research could be,” he says. “There weren’t a lot of occupational therapists working in pediatric concussion. I saw it as an opportunity to carve out a niche.” We spoke about his early days and how he’s grown Holland Bloorview’s concussion centre into an internationally recognized leader.


BLOOM: How did you get into the field?

Nick Reed:
Growing up I played every sport under the sun. I started lacrosse at age five and played through university and Junior A and was drafted into the National Lacrosse League. So sports were big for me, and I always had injuries. I thought I wanted to bring health care and sports together, and that I’d go to med school or physio school.

One night in third year of my undergrad, I went to an information night on physio. But they ended up presenting first on occupational therapy. It blew me away: This idea that a knee isn’t just a knee—it’s a knee on a body on a person in a family in the community. Thinking about this holistic focus on the person and asking the person what they need—not making assumptions—excited me. I took the leap and changed my plans.

BLOOM: What is a typical day like now?

Nick Reed:
A busy one. It’s an exercise in prioritizing across different demands. I’m no longer directly in the clinic but I support our clinics with advice and integration of research. In the early days it was the physicians and me—I was the rehab team. As the clinic grew and we secured more funding and brought on more staff, my role transitioned to focus more on the research, teaching and advising.

BLOOM: One of the clinics it the persistent symptoms clinic.

Nick Reed:
It’s our flagship clinic. It’s a globally funded outpatient clinic for kids who have had concussion symptoms for four weeks or longer. We also have an early care clinic that is fee for service for children with a concussion that’s four weeks or less old. They come in to get diagnosis, consultation and rehab.

While I advise these clinics, the majority of my time is spent growing and directing our research program as a clinician scientist.

BLOOM: Can you tell me about that?

Nick Reed:
It’s quite large. We have about 20 projects, and five or six of them are major grants. The one I’m most excited about now is a Canadian Institutes of Health Research grant. We want to extend our thinking in novel ways about how to raise awareness of concussions and change behaviour in reporting them among youth.

BLOOM: Why is there still a problem with teens pretending they’re okay when they’re not?

Nick Reed:
There are two reasons. The sport culture of never being allowed to be hurt: ‘Just rub some dirt on it and get back out there.’ I had my own concussions, and we didn’t talk about it, we just kept playing. And people didn’t know a lot about concussions—they didn’t know the signs and symptoms.

Eighteen high schools across Canada will be part of a project we’re launching in September. We’ll be getting them to create concussion clubs—to raise awareness of symptoms and what to do, and to provide support to peers who have concussions. Young people will come up with creative and relevant and meaningful ways to educate their peers.

All through this process we’ve had high school students tell us what works and what doesn’t. They’re co-investigators. For example, we created an online portal to support them, and we thought it looked amazing. We took it to a local high school that has a cyber arts program to get their opinions and they didn’t like it at all.

BLOOM: Why?

Nick Reed:
They said the colours and feel were too corporate. So we handed over the reins to them and they came up with a whole new colour scheme, logos and flow. One of our family leaders—Gideon Sheps—linked us to that high school. It goes back to that occupational therapy idea of anyone you sit down with is the expert in their own domain. The real strengths come from the person we engage with—whether it’s clinically, or in this case youth in their high school.

BLOOM: What’s the greatest joy of your job?

Nick Reed:
People. Engaging with people and watching and supporting people do amazing things. Whether that’s working with and learning from my PhD and master’s and undergrad students, watching them develop and grow and become inspired. It’s a dream, a real luxury of academia. You’re able to build relationships over time, over years.

And it’s not as ‘I’m a supervisor,’ but ‘We’re in this together. I’m learning from you as much as you from me.’ Working with people—whether it’s with sports organizations in the community, schools or youth or family members—is what drives me to get up every day. To be part of a team and engage as many people as possible in a meaningful process that will make a difference.

BLOOM: What is the greatest challenge?

Nick Reed:
My role is unique. I’m not just a scientist, or a clinician or an educator. I see myself as all of these things, and we’ve attempted to design our program to integrate all of them. We want to break down the silos. So trying to bring it all together is the greatest challenge. You can’t do meaningful research without the knowledge and experience of sitting down with the families who need it. We’re here to help at every step of the way, be it in our clinics, or through the research and education and support. But these programs fall under different areas in the hospital. So it’s trying to integrate them so we have proper communication and all work together.

BLOOM: What’s the biggest misconception about concussion?

Nick Reed:
There are two ends of the spectrum. One is that continued thinking that ‘it’s not a big deal.’ It is a brain injury and it’s a serious injury if you don’t receive medical attention and diagnosis, so you have the potential to prevent repeated injury.

On the other end of the spectrum is hysteria about concussion. We read a lot in the media about brain disorders like depression and Alzheimer’s, or we hear about a professional athlete with serious issues who has died by suicide. A parent may feel ‘If my child has a concussion, everything will change forever.’

We need to tailor a message to land in the middle. It is an injury you want to get treated, and to have rehab support along the way. But it’s also an injury we can manage, for the most part, for most kids. About 70 per cent of kids will feel well within a month. The probabilities of getting back to what you love to do are extremely high.

BLOOM: What emotions come with the job?

Nick Reed:
Being in academia and health care, there are always challenges with regards to funding, or to sustaining a program. But I’m a very positive person and I’m always optimistic. That’s good for someone in my role. I truly believe if you put good stuff out, that good stuff will come back. And if you co-create with the people who need it, you will do work that matters.

BLOOM: Do you have problems with overworking?

Nick Reed:
I do wear a lot of hats and have a crazy schedule. I think we all do. There was one time two years ago when I got shingles and my body shut down. I had three little kids at home, and I was balancing that with work and my personality of ‘go, go, go.’ I live off adrenaline. I don’t have caffeine, but I get up early, at 5:30.

Three days a week I go to Variety Village. I run the track, do a little bit of weights or play a bit of basketball and swim. I need to be home by 7 to make my kids’ lunches. The other days I tend to get up early and work, either at home or here. Physical activity is a big part of my life. My father had a heart attack at 45, when I was in early high school, and he did his rehab at Variety Village. I really appreciate the opportunity there for my family to be exposed to individuals of all abilities and ethnicities and cultures. I get great questions from my kids, who are seven, five and three.

BLOOM: If you could change one thing about children’s rehab as it applies to concussion, what would it be?

Nick Reed:
It’s what we’re trying to do—really focusing on the child. So having the perspective that what this child needs, and loves to do, really matters. They have an opinion, even if it’s a little guy, and we need to engage the child actively in rehab. I’m really proud that we do that at Holland Bloorview, and not just in concussions. We need to move past a focus just on symptoms like headaches to ‘How do you feel? What do you want to do today? What can I do to help you do the things that make you happy?'

Tuesday, February 5, 2019

'I'm calling attention to the whiteness' of health care

By Louise Kinross

Sarah Jama is a co-founder of the Disability Justice Network of Ontario. She has a long history of disability rights and anti-racism activism. While studying at McMaster University, Sarah headed the National Educational Association of Disabled Students for a two-year term. She also founded Maccess—the first peer-run service for students with disabilities at McMaster. This Wednesday Feb. 6, Sarah is speaking on Moving Toward A Disability Justice Revolution at Hart House at the University of Toronto. I learned a lot about her work through this video of a talk she gave last year called We All Deserve the Right to Life.


BLOOM: In your video, you talk about how you learned at age four that as a black, disabled girl, you didn’t have the same right to bodily autonomy as others. This happened here, at what was then the Hugh MacMillan Rehab Centre, when you came for your first physiotherapy appointment.

Sarah Jama:
I was saying ‘No, I don’t want to do this,’ and they started to stretch my leg and my mom was freaking out, because she didn’t understand why it was painful. They asked her to leave the room, in order for the physio to continue, and she watched behind a two-way mirror, because she didn't want to get a coffee as they suggested.


When I talk about navigating the medical system with an immigrant family, a lot of times, without meaning to, people in medical positions play the role of the expert: ‘We know what’s best, therefore these things over time will be the best for your daughter.’ When the parent, or the person, isn’t seen to be the expert, there’s a lack of communication.

BLOOM: You said you and your mother were both in tears. Another time, when you were a teen, doctors wanted you to have a surgery. You didn’t want to have it, because it would mean you wouldn’t graduate on time with your peers. You had also had the same surgery at age 12, and it didn’t give you the result you expected.

Sarah Jama:
 The surgery, from my perspective, was an aesthetic one. It didn’t work the way I thought it would when I was 12. And it took four months for me to be fully rehabilitated. The surgeon looked at my mom like she was absurd in supporting me in my right to say no.

I talk about how these kinds of interactions, over time, can influence someone’s perception of bodily autonomy—that it means not having a say over certain areas of your life. Some people are viewed as experts over racialized bodies, which is dangerous when coupled with a lack of cultural competency.

An example is the criminalization of black and indigenous folks with invisible disabilities. Soliman Faqiri and Abdirahman Abdi and so many others with autism or schizophrenia have been killed by those meant to serve and protect, because being a person of colour, while having invisible disabilities, gets you perceived as being violent.

Our education system fails people with disabilities. In high school, I was given a spare in place of physical education. The school, at the time, didn’t have proper supports to support me in physical education. But that meant that I missed a lot of the sexual health education that’s taught.

We know from Statistics Canada that 82 per cent of women with disabilities will be assaulted once in their life in Canada. Sexual violence and education aren't linked at all, but we're missing key information on how to protect ourselves. The more I talk about how I missed out on that education, other people with disabilities tell me that they missed it, too.

When I’m talking about disability justice as a means to tackle forms of oppression, I’m coming at it from an intersectional perspective. The leadership, the people in positions of power, don’t reflect the disability community itself.

Within that, I’m calling attention to the whiteness of the structures that prevent people with disabilities from diverse backgrounds from being able to participate in all facets of education and health care, or result in them being perceived as violent.

BLOOM: You are the founder of the Disability Justice Network of Ontario. What is the purpose of that network?

Sarah Jama:
Our vision is to create a world where people with disabilities are free to be. Our mission is to build a just and accessible Ontario where people with disabilities have personal and political agency, can thrive and foster community, and can build the power, capacity and skills needed to hold people, communities and institutions responsible for the spaces that they create.

BLOOM: What needs to change?

Sarah Jama:
The problems are structural. The conversations around accessibility today are stuck in the ‘90s. We talk about people needing access so we can expend our economic purchasing power. There aren’t enough conversations around how people with disabilities who move through our education, medical and prison systems have a right to equity in these spaces, and how racialized people with disabilities navigate these spaces differently.

Another structural change that needs to occur is in our provincial and federal budgeting. A lot of funding goes towards children with disabilities. That funding becomes minuscule in adulthood. It’s as though people with disabilities don’t exist in our adulthood—we disappear.

The lack of education created for people with disabilities needs to be addressed. How are we training young people in the history of disability justice? Where do you learn this? I had to do a lot of self-learning about how disability rights came to be.

Systemically, I was taught that when you have a problem, there are systems in place to support you. For example, if you have a problem in school, you go to 'student accessibility services.' But what do you do when that system doesn’t work for you? The conversation around justice and rights is not happening in our education system. 

The important thing for young people with disabilities to know is that you don't have to resign yourself to using the structures in place.

We're the largest minority in the world: we fit every religion, race and geographical location. Someone with a disability who experiences structural issues should understand that not being able to navigate spaces easily is tied to root causes. People with disabilities don’t fit the common understanding of productivity, so we are least likely to have a system in place that fits us, especially if we’re seen as not being able to contribute back.

I was able to push my university to allocate $30,000 to fix elevators that were broken. I also created Maccess, which is an organization run by students with disabilities for students with disabilities. At Maccess, students taught self-advocacy skills and had peer supports in place.

BLOOM: Something I valued in your video was that you talked about the rights of people with all kinds of disabilities—including people with intellectual disabilities and mental illness. I often see people with one type of disability distancing themselves from people with other types.

Sarah Jama:
I think it has a lot to do with funding levels. Autism Ontario is funded one way, the Ontario Federation for Cerebral Palsy is funded another, and all of these groups end up competing for support, fracturing community instead of building it.

Disability organizations aren't built to be part of a greater community that collaborates. The way to combat that, 100 per cent, is for everyone to come together and acknowledge that we're part of a larger community that historically has been left out of many parts of society.

We're also part of an ever-growing community. One of the leading causes of disability is old age, so everyone at some point will experience it. The sooner we come together to build a community that fits all people with disabilities, the sooner we’ll have a world that fits everyone.

BLOOM: You talk about how people in our culture confuse the rights of people with disabilities with their value to the economy.

Sarah Jama:
I think that’s a faulty and harmful argument. So many people with disabilities can’t work, and do they have the right to exist then, if they can’t contribute? It’s similar to the way seniors are treated. Once they age out of the workforce, they're seen of as disposable.

We see conversations in the public media now about the right to assisted suicide. What about the rights to supports during life? Why does more funding go toward prenatal screening of Down syndrome—and I’m pro-choice—but not toward supports for adults with Down syndrome? The issue lies with institutions  pre-deciding where someone can access support. Who really deserves life, and who has the right to exist?

You have to earn your value, or you’re a burden on society. Couple that with youth with disabilities not knowing about their rights, or that there’s a community of people who have fought for their rights, and by the time they turn 18, depending on their capacity, they struggle with self-esteem, with having community and with understanding their worth. They don’t know that it’s their right to have help and support.

BLOOM: I liked the way you question our culture’s obsession with independence.

Sarah Jama:
We’re obsessed with the idea that you’re worth more if you don’t need anybody. It’s a strange cultural phenomenon that doesn’t make sense. No one is truly independent from anyone else.

Mia Mingus has written a lot about interdependency, and how we should be able to go to our communities and find supports, and not see it as a loss of autonomy, but moving toward a larger collective of potential.

For example, nobody tends to be able to survive without going to a grocery store. But that food comes from a farmer. You didn’t package that food and put it in the grocery store. You’re dependent on the structures that are in place, and the community that puts that grocery store in place. We need to teach kids that we all sort of rely on each other, and that’s okay.

BLOOM: I noticed you're working with the Hamilton Wentworth District School Board to create curriculum to address anti-black racism. Is this something we need to work on with staff and families in children’s rehab?

Sarah Jama:
Yes, I think so. I’ve created a black youth mentorship program for 40 black youth that meets monthly at Sir John A MacDonald Secondary School in Hamilton to talk about their worth and the way to navigate society and the supports in place for them.

On Feb. 12 we have Robyn Maynard coming to speak with them. She wrote Policing Black Lives, which is an acclaimed book on the history of policing in Canada. We also have Sandy Hudson coming, who is one of the founders of Black Lives Matter in Canada. On Feb. 25, the same youth will be meeting with black elected officials at Queen’s Park to talk about being black and navigating politics.

BLOOM: What advice would you give parents raising kids with a wide variety of disabilities?

Sarah Jama:
As much as possible, have conversations around the history of disability in Canada, and how we got to a point where we have a federal piece of legislation. Who are the movers and shakers in our communities? 
What provincial legislation do we have? What communities have pushed for the rights of people with disabilities to exist equally and freely? It’s important for kids to grow up knowing that there’s a community, because a lot of us internalize our experiences. 

Thursday, January 31, 2019

Women with autism at higher risk for suicide, study finds

By Louise Kinross

Utah women with autism were over three times more likely to die by suicide than their peers without autism between 2013 and 2017, according to the first American population-based study on suicidality in autism. 


The study, published in Autism Research this month, used surveillance data in Utah from 1998 to 2017. The researchers broke the study into four periods of five years. During the first three periods, the risk of suicide between autistic and non-autistic people was similar. But from 2013 to 2017, death by suicide in the autism population was significantly higher than in the general population, and this increase was driven by suicide in females.

BLOOM interviewed lead author Anne Kirby, assistant professor in occupational and recreational therapies at the University of Utah.

BLOOM: Why was there a need for this study?

Anne Kirby: There's been a lot of talk lately that people with an autism diagnosis might be at higher risk for suicide, but most of the research has used clinical samples of people who have come in to a certain clinic, or convenience samples. We didn't have any good population-based research, except for one study done in Sweden a few years ago. 

The Swedish study looked at all causes of mortality in autism, and found people who had an autism diagnosis were more likely to die from suicide than others. We wanted to look at that, and expand that population-based research in the United States.

BLOOM: Were you surprised by your findings?

Anne Kirby: In general, yes. Because autism is less diagnosed in females, and suicide is known to be a less common cause of death for females, we wouldn't have had any reason to believe we would find the higher risk in women. It was consistent with what was seen in the Swedish study. 

BLOOM: I think it's important to emphasize that even though there was an increased risk, the actual number of deaths was small. From 2013 to 2017, seven women with autism died by suicide.

Anne Kirby: Suicide is a rare occurrence, so even though the risk is three times higher, it's still rare. The conventional wisdom is that females are much less likely to die from suicide, but with females with autism, we found that's not the case. 

One of the things that's interesting to me is that for a long time, even mental-health clinicians who worked with this population didn't think autistic people would consider suicide.

BLOOM: Why's that?

Anne Kirby: It's hard to say exactly, but it's possibly related to a general belief about suicide. It's often thought that there are social influences, but there's a long-held misconception that people on the autism spectrum aren't affected by their social surroundings. 

In the past, we weren't as worried about loneliness and the influence of bullying. Certainly, clinicians and the broader research community have really clued into the fact that those are real concerns autistic people have.

So they may face some of the same social influences as the general population, but there's an array of other reasons why they may experience suicidalitybiological, neurological, genetic, social. Employment is something many adults with autism struggle with.


BLOOM: What might be the factors that contribute to suicide in women with autism?

Anne Kirby: That's an area that needs a lot more research. There was one study that talked about how camouflaging, or masking or hiding, your symptoms, and trying to fit in, was more associated with suicidality. It also suggested that females might be more likely to camouflage, and to be better at it. So they may have added pressures around fitting in and identity.

The other thing I've been thinking about is how there's a growing awareness of autistic adults and self-advocates. But still, our stereotype is very male. So females may feel especially isolated, even from the autistic community.


BLOOM: Were any of the deaths of women with autism in Utah medically assisted deaths? I know a study in the Netherlands looked at cases of medically assisted suicide that included people with autism.

Anne Kirby: To my knowledge, no. It's illegal here in Utah.

BLOOM: Are there studies looking at the effectiveness of treatments for depression and anxiety, specifically in people with autism?

Anne Kirby: The research on mental health in conditions like autism right now is scant. Most of the research out there is descriptive, looking at the prevalence of conditions, and they're highly prevalent. To my knowledge, there's not much research looking specifically at interventions.

Before we even get to treatment, there's a lot of concern, and hopefully some research being done, on whether or not our evaluation tools are appropriate for identifying depression, suicidality and anxiety in people with autism. The measures we use haven't been validated for people on the spectrum.

I don't think we have a good sense of whether the interventions that have been shown to be successful with other groups are appropriate for this population, or if they need to be tailored. This is a huge priority area for many autistic adults. I hear, repeatedly, that adults with autism have trouble finding mental-health providers who are really familiar with autism.


BLOOM: What are the next steps for your research?

Anne Kirby: In the paper we just published, we had some demographic data about the group that had autism and died by suicide. We're hoping to get medical billing data, so we can have a sense of what co-occurring conditions they had, and what might be potential risk factors, or warning signs, from a co-occurring condition standpoint. We're eager to do that.

We're also eager to look at data on suicide attempts as well. To get a sense of whether people with autism are attempting suicide more often than their peers, or if the difference we saw is really in suicide deaths.


Read our BLOOM story about Sweden's 2016 population-based study on suicide in people with autism. 

Wednesday, January 23, 2019

Doctors need to get comfortable with intellectual disability






















By Louise Kinross


Global developmental delay (GDD) isn't a long-term diagnosis, write two doctors
 in a commentary piece this week in The Journal of Pediatrics. So why does it appear so frequently in medical charts across a person's lifetime?

"Disability becomes the Lord Voldemort of clinical medicinesomething so terrible it ought not to be named," write Dr. Eyal Cohen, a pediatrician at SickKids in Toronto, and Dr. Amy Houtrow, chief of pediatric rehab medicine services at Children's Hospital of Pittsburgh.

The doctors note that clinicians contribute to the stigma of intellectual disability by continuing to use the label of GDD. They attribute this word choice to doctors' unconscious bias against people with intellectual disability, to not wanting to upset parents, or to worrying that they don't have adequate time to explain the disability. "The unwillingness to name intellectual disability is widespread in medicine," they say.

They note that the word delay often causes confusion in parents, who assume it means their child will eventually catch up to peers.

Doctors need to be precise in using the term intellectual disability. "Disability is not a disaster," they write. "People with disabilities live with the realities of their disabilities every day, and our inability to acknowledge this does not stop them from being real; it just stops us from providing the best care possible."

The authors offer a suggested dialogue between a doctor and parents, who say they didn't realize their child's problems would be permanent.

It includes saying "I would be happy to talk more with you about the disabilities that he has...I know having these conversations can be stressful and sad."

Something that is missing for me, as a parent of a child with disabilities, is the message that my child has value. It's one thing to tell parents that disability is not a disaster, it's another to encourage parents to consider what it is that gives humans, and their child, value. I've written about this here: Why parents get hooked on 'normal'.

But I wonder how many doctors have truly had the time to sit and ponder human worth, either as a medical student or as a clinician? Is our value tied only to what we do? Is it something to be earned through how we perform? Is it our paycheque, our IQ score, or how well we fit Western
 conceptions of beauty and athleticism?

If we can't measure up, does our value as a human being plummet? 

Because if you haven't actually wrestled with these questions, I think it will be hard to convey to parents that their child with an intellectual disability has value. 

It's not something you can fake. 

It reminds me of an interview we did with the author of a study that looked at 68 transcripts of conversations between doctors and parents discussing life and death medical decisions for their children.

Lead investigator Dr. Tessie October, who is a pediatric intensive-care doctor at Children's National hospital in Washington, D.C. said: "We don't think of how we talk with families as being a procedure, in the same way we think of putting in a central line or a breathing tube." As a result, it's not taught and evaluated in the same way in medical school.

I think that needs to change, whether the topic is describing high-stakes medical decisions to parents, or telling them that their child has an intellectual disability.

Because that kind of medical training benefits the emotional health of families and doctors alike.

Friday, January 18, 2019

What works in children's rehab, and why, is researcher's passion

By Louise Kinross

De-Lawrence Lamptey has a PhD in rehabilitation science and a master’s degree in clinical psychology. He has right-sided weakness related to cerebral palsy and grew up in Ghana. “When I was growing up I was less aware of my disabilities than I am now,” he says. “I was born with a disability, but I was never raised as a person with a disability.” De-Lawrence is a postdoctoral fellow doing research in inclusion and participation at Holland Bloorview with senior scientist Gillian King.

BLOOM: How did you get into this field?

De-Lawrence Lamptey:
I was born with a disability. I have a form of CP that affects my right arm and leg. But I grew up in Ghana feeling I was just as normal as any typically developing child.

BLOOM: Doesn’t that culture hold negative attitudes about disability?

De-Lawrence Lamptey:
Yes. They attach superstitious beliefs to disability, so they believe it’s caused by a sin or a curse. I was teased, but it didn’t affect my goals in life, or the way I perceived myself. My identity was formed in my family, as opposed to the culture around me.

A second barrier I faced was that I’m left-handed, and in Ghana using your left hand with people in your interactions is culturally considered a sign of disrespect. So if I raised my left hand to answer questions in school, some teachers wouldn’t take my answer because they weren’t aware I was disabled.

In the culture, if you want to use your left hand in interactions you're expected to apologize beforehand, in order not to make people feel disrespected. Can you imagine if I had to say ‘I’m sorry I used my left hand’ to everyone I interacted with on a daily basis? I didn’t do that, so many people thought I was being disrespectful, especially those who weren't immediately aware that I had a disability.

I give a lot of credit to my mom. I was allowed to do everything, and I wasn’t overprotected. I wanted to do what I saw everyone else doing, so I learned how to ride a bike and to play the bass guitar, the drums and the piano. I felt whatever I wanted to do was possible and that things shouldn't be easy before they can be possible for me. I had a supportive family who said ‘Go for it.’

My mom told my teachers in school not to treat me any different from the other kids, so my teachers weren't overprotective either. This made my classmates more accepting because when we got into trouble during play we all got the same amount of punishment. And this made me feel no different from the other kids as well.

The only issue was that equal treatment didn't always take into account what I couldn't genuinely do because of my disability, and so it was cruel sometimes. It also meant that I had no accommodations, which was lacking in Ghana anyway. So you either learn to swim or you drown. In a way, this encouraged me to think out of the box to learn how to live without accommodations and still thrive.

BLOOM: What made you want to do research about children with disabilities?

De-Lawrence Lamptey:
In Ghana, many adults with disabilities beg on the streets. If I was begging on the streets, I would be classified as a person with a disability. But when I did an internship in clinical psychology and families came to see me at the hospital, they felt I didn’t classify as a person with disabilities. They would say ‘You’re not disabled.’

It meant disability was not how I looked, but what I could do. That shifted my focus. It made me realize it’s what we do with children that would eventually decide whether they will beg on the streets, or not, in adult life. If I put myself in the shoes of those begging on the street, and grew up in their family, maybe I would have ended up in the street. I needed to get into pediatric rehab where I would be able to look at how to promote inclusion and participation of children with disabilities so they could reach their optimal potential.

Eliminating barriers in society is very critical, but sometimes it can be difficult to do in the short term. For example, initiatives to remove attitudinal barriers  have been going on for years and some progress has been made, but we still have a long way to go. Another example that takes time is redesign of existing architectural structures.

So if we can’t remove the barriers in the short-term, is it possible to work with children to help them work around the limitations of their disabilities, and the social barriers they face, to reach their optimal potential?

How can we teach children to be able to say, regardless of the barriers I face, that I should strive to live to my full potential? That’s why I was interested in working with Gillian on some of her resilience projects.

BLOOM: You mentioned you’re writing up a paper here about a study that looked at parents’ expectations of residential life-skills programs. For example, our Independence Program has youth spend three weeks living on a university campus. Why was there a need for this study?

De-Lawrence Lamptey:
Even though residential life-skills programs have been going on for a long time, and people have studied various aspects of them, what parents expect their children to achieve, or the program to deliver, is relatively unknown.

How participants do after they go home to their family depends partly on the expectations of the family. I grew up in a family that was less protective. But what if parents have low expectations that their child will acquire certain skills? We want to be able to add valuable knowledge to improve the program, so that parents are better positioned to give their children the best support.

BLOOM: What kind of research do you most enjoy?

De-Lawrence Lamptey:
I’ve been privileged to work in the world of describing and evaluating programs. I like to identify best practices in program design and delivery. I enjoy looking at what impact a program actually has on clients and families, for the purpose of using that knowledge to improve.

This research helps you do two things. One, most of the time when we look at the services we’re providing, we don’t know what is working, or even when it’s not working. And if it is working, we don’t know why. Every child is so different that even though most of the services we provide are evidence-informed, they may work for some and not for others. It’s very important that we optimize the service for a large group, so we can share the knowledge around the world about the effects of the program.

Second, this kind of research gives accountability to funders of the program. They need to know what impact the program is having to determine whether to continue funding it or, if it’s not working, what are the ways we can make it better.

BLOOM: What’s most challenging about your research?

De-Lawrence Lamptey:
It’s mostly work I do sitting in front of a computer and typing, so sometimes I don’t have that much of a social life. I’m always working at a computer or reading and I’m always thinking. It can be difficult to turn it off. Even when I’m on my bike I’m thinking about the paper I’m writing, and if an idea comes to me in the subway, I have to write it down so I don’t forget. Subconsciously my mind is always working.

BLOOM: I read an article yesterday by a disabled researcher who said that people working in the field often don’t have disabilities, and tend to view themselves as experts, instead of listening more closely to people with disabilities.

De-Lawrence Lamptey:
We all have different experiences. I have been fortunate to overcome many barriers to get a PhD as a person with a disability. People with disabilities face multiple barriers that make it difficult for them to acquire the necessary expertise to do the level of research we do. So it’s very important that we work together.

The greater challenge, I believe, is that the research we produce should make a lot of sense to users. But unfortunately, if we write in a language that makes sense to people with disabilities or service providers, it can limit the chances of it being accepted for publication into a scientific journal. Every discipline has their own language that they use. So I’m torn. To rise in my career, I need to publish. But that means writing in a way that people who need to implement the research may have difficulty understanding.

BLOOM: It bothers me that the research world makes itself exclusive by using jargon that the average person can’t understand.

De-Lawrence Lamptey:
I think it's really important for us to write in a way that everyone can understand, especially those who use the knowledge.

BLOOM: What kind of work do you want to do in the future?

De-Lawrence Lamptey:
The work I want to do ultimately would be to look at how we could mobilize resources to help people with disabilities in under-served communities in Western countries and in developing countries. I feel the world has given me a lot and I need to give back, and giving back means giving back to people who are most in need.

Tuesday, January 15, 2019

Retarded, imbecile, morons. Why does The New York Times still use these words?

By Louise Kinross

I could hardly believe my eyes when this New York Times piece popped into my feed yesterday: Donald Trump and his Team of Morons.


Way back in 2012 I wrote to Philip Corbett, the Times' then associate managing editor of Standards,  to criticize the paper's use of the words "retarded" and "imbecile" in headlines. 

On Oct. 26 of that year, Corbett wrote to say "our health editor and our mental-health reporter both agree that we should give stronger guidance to the newsroom about the use of 'retarded.' I will be working with them to draft a new style note."

Retarded. Imbecile. Morons. They're interchangeable, and they all originate from medical words used to describe people with intellectual disability. 

Seven long years ago, the American Psychiatric Association stated that "Mental retardation is no longer used internationally [as a medical term] or in U.S. federal legislation." 

The words retarded, imbecile and moron are not neutral words. They are slurs used to demean a marginalized population. Odd that the Times would continue to use them, when its own style guide counsels neutral language and respect for "preferred group descriptors."

People with intellectual disabilities have spoken. Everyone is familiar with the 'R-word: Spread the word to end the word' campaign. Almost a million people signed a pledge at the website in support of ditching the use of the word retard for a simple reason: It hurts people.

Imagine if the Times, instead of using the word 'morons,' had selected a word that stigmatizes a different group. What if they had written "Donald Trump and his Team of Psychos." Would anyone on the news desk have raised a red flag? Probably, because people with mental illness are a more powerful group than those with intellectual disabilities. 

Why, at arguably the world's best news organization, are editors incapable of coming up with something more imaginative and neutral than a slur for a headline? Why didn't they try: "Donald Trump and his Team of Twits." Anyone can be a twit. A twit is not associated with any devalued group. A twit, as described in the dictionary, is neutral: "an insignificant, silly or bothersome person." 

In a back and forth correspondence with me in 2013, Corbett wrote: "While imbecile,' 'moron' and 'idiot' were all used in the past to refer to people with intellectual disabilities, I don't think most modern readers or speakers of English make any such connection today."

It doesn't matter what individual staff at The New York Times "think." It matters that the paper follows its style guide and shows respect for marginalized groups. A memo to staff on ableism is in order. 

Friday, October 12, 2018

My daughter is not an animal at the zoo

By Christina Herbers

We saw pandas! We saw lemurs! We saw bears and zebras and hippos.

We were just a family visiting the zoo.

And then we heard it: “Mom, I don’t like her face.” And, “Dad, what is that face?” And we saw you shooing your kids away from us, as if we were somehow contagious. And oh, the staring!

Yep, this still happens to us. In fact, it happened on our summer family trip to the Calgary zoo.

On a brighter note, there was an older man who came up to my husband and shook his hand. He told him that the umbrella that we use to shade my daughter Jaina’s eyes from the sun had shifted, and that her eyes were in the sun. To him, I say thank you. Thank you for not being afraid of us. Thank you for seeing us. Thank you for holding a door open for us. Thank you for teaching your kids and grandkids that it’s okay to talk to us! 


Questions are a natural part of human behaviour. So maybe it’s not your children's questions that are the problem, but that you don't want to hear the answers?

How can your child know the answer to “what is that face?” if you don't ask me? If you ask, I will tell you about the car accident we were in when I was pregnant with Jaina. She isn't able to move her face that well because of her brain injury. She isn't able to smile. She isn't able to close her mouth. She suffered from a brain injury before she was born.

She has always been this way. 

She is also mellow and calm and quiet.

Talking about why my daughter is different from the rest of us may be natural for your kids, but please know that we hear you. Respect us.

Teach your kids that we are all different. Different colours, sizes, genders, sexual orientations, ages, beliefs and abilities. Teach your kids that it’s okay to be different. I can’t think of any two people who are exactly the same. Can you? Even the pairs of identical twins that I know who look the same have their own individual personalities.

Please don’t treat my daughter like a caged animal at the zoo. Don’t stare and comment and point and judge. Talk to us. Ask your questions, and take the time to listen to our answers.

Let’s work on seeing each other for who we really are. Because in the end, aren’t we all just people, trying to make it through this journey called life?

Share your thoughts below. I’d love to hear from you!


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Thursday, October 4, 2018

U of T course makes room for kids who grow 'sideways'

Photo by the University of Toronto

By Louise Kinross

A couple of years ago I connected with Anne McGuire, an assistant professor in the Equity Studies Program at the University of Toronto, after she co-wrote a critique of the Hospital for Sick Children's SickKids VS ad from a disability perspective.

Since then I learned that Anne teaches 
a class called Disability and the Child. It draws on history, psychology, neuroscience, policy studies and the arts, as well as critical theories of race, class, gender, sexuality and disability, to explore how disability is largely viewed in today's culture as a threat to the goodness of a 'normal' childhood. "What alternate depictions and narratives of disabled childhood exist and what can they teach us?" asks the course outline.

This is an undergraduate course, but it struck me that it would be valuable for medical and other health-care students, and for anyone working in the field of children's rehab. We did this interview by e-mail.


BLOOM: Why is there a need for your course?

Anne McGuire:
I teach a number of disability studies courses in the Equity Studies Program at New College U of T. For the most part, my other courses tend to focus on adult worlds
we talk a lot of about disability rights and justice activism, disability arts, culture and representation, disability histories as well as more contemporary debates. Despite this focus on adult issues and struggles, the disabled child is nonetheless a key figure that both haunts and motivates these struggles. Developing this course was an opportunity to explore the relationship between how we imagine children and how we build our world. 

The child is often treated as a figure or symbol of innocence, purity, and simplicity. The child is understood to be ever vulnerable, and because of this, always in need of adult protection. Many scholars have described how the child figure works as a powerful political tool, one that is commonly used to argue for a wide range of different social outcomes.

Paying attention to the child as a powerful cultural symbol can teach us about how our society is put together. By studying the child figure, we can learn a lot about what adults think and about how they create hierarchies in the world.

Disability studies tells us that disabled peopleincluding disabled children and youthare often placed very low on social hierarchies. I developd this course in the hopes that thinking about the child as a figure or symbol can help us to better understand the ways our world is made inaccessible and exclusionary for a great many disabled people, including disabled kids. 

BLOOM: You mention in the course description that disability is often seen as a threat to the presumed goodness of a normal childhood. Can you give some examples?

Anne McGuire:
In class, we’ve been talking about how disability is often constructed in polar opposition to the notions of purity and innocence that commonly define the time of childhood. 

In mainstream, popular culture, disability is very often talked about as something which taints or takes away disabled children’s childhoods. For example, in my book War on Autism, I discuss how, in the first decade of the 21st century, it was very common to encounter advocacy campaigns that depicted autism as a kind of invader, or as something that threatened or stole otherwise neurotypical children. New York University’s 2008 Ransom Notes campaign is a really overt and glaring example of this: '
We have your son' read a campaign ad designed to look like a ransom note. The note was signed 'autism.' 

These days, we’re seeing disability campaigns that are a lot more positive and hopeful in tone. Louise, you and I have both written about the memorable 2016 Sick Kids VS. campaign ad, which depicted sick or disabled kids fighting back against conditions ranging from cystic fibrosis to cancer to autism. While this spot is much more upbeat and hopeful, I worry that the underlying message is not all that different from more glaringly problematic campaigns like Ransom Notes.

In both NYU’s Ransom Notes and Sickkids VS, disability is framed as that which prevents pure and innocent kids from realizing their potential. While, of course, there are many childhood disabilities and illnesses that are life threatening and that do threaten to eclipse a child’s long-term future, there are also many disabilities and illnesses that are chronic and ongoing.

These conditions are almost always a central aspect of a person’s lived experience, and sometimes even an important part of their identity. The idea that disability or illness is naturally or inherently devoid of future and potential is very problematic for disabled people of any age. It stops us from paying attention to the complex, and often very radical, ways that disabled and sick kids and adults are negotiating their bodies, minds, and worlds.

BLOOM: One of your readings looks at children in the future and “investments in human capital and waste.” How do perceptions of a child’s value change when they may not be able to be productive in conventional, money-making ways?

Anne McGuire:
This notion of the ‘child as future’ often invites a kind of economic way of thinking about children and childhood
this sense that we need to invest in children in the here and now to secure more prosperous futures for them and for us all. 

I hear this economic logic everywhere these days and it's often very literal: children’s development is made synonymous with the production of human capital.

Just a quick example of this. In class we’ll be taking a look at the well documented association between extended breastfeeding and increased infant brain development. 


According to the research, breastfeeding promises to also boost cognitive, motor and language skills, and even raise kids’ IQ’s. A number of studies have even suggested that extended breastfeeding might lead to greater productivity of the breastfed individual later in life, boosting their earning capacity and, with it, their chance at a more economically successful future.

Putting aside the debate as to whether or not ‘breast is best,’ what’s interesting is the way this research frames good (i.e., normal or beyond normal) child development as the outcome of good parental (read: mothers') choices. What's also interesting is how normal child development has become deeply entangled with a nation's economic development.

Looking at how the breastfeeding research has been adopted by government and other agencies, we can start to see how a child’s normal development is not only being framed as a parent's private obligation to their child, but also as a kind of civic responsibility.

This economic way of thinking about children’s developing bodies and minds is really harmful when it comes to kids who develop in ways other than the norm. 


Too often, the atypically developing body or mind is framed by researchers, policy makers, politicians and the media as just too-costly, or as a draining on the public purse. 

The underside of notions about human capital are ideas about human waste. In economic terms, those disabled people who do not, choose not or cannot contribute in economically profitable ways, are very often cast as burdens. Of course, there are many other non-economic, yet valuable ways of contributing to the social whole! What and who do we miss when we only measure human contribution and value in monetary terms?

BLOOM: Do you talk in your course about hierarchies of value within disability? That some disabilities are seen as being more valuable than others? And that there is stigma even within the disability community?

Anne McGuire:
I think this question links back to the last one. We live in a world that seems to measure and value people in general, and disabled people in particular, in terms of their capacity to act as producers and consumers within a capitalist economy. 


This means that a disabled person who can near seamlessly blend into their school or workplace, who does not ask for too many accommodations or cause too many disruptions to the productive flow of a school or work or social environment, might be readily celebrated, welcomed and included. However, the culture of disability inclusion is not hospitable to all disabled people. This division exists, as you mention, even within disability communities.

We talk a lot about the existence of these hierarchies of privilege and oppression and about how they continue to operate within disability communities and within the discipline of disability studies itself. We also discuss how we might redress this unevenness. 


Disability justice activism has placed an important emphasis on cross-ability organizing and on ensuring that our disability scholarship and activism is responsive to those communities of disabled people who are the most, and multiply, marginalized.

BLOOM: What themes in your course might be eye-opening/useful for parents of children with disabilities?

Anne McGuire:
Invariably, we end up talking a lot in this class about parent culture, and about how parents are often framed by society as solely personally responsible for their child’s future. This is true for parents of disabled and non-disabled kids alike, but parents of disabled kids may face unique and heightened social scrutiny over their parenting choices.

We talk about the common idea that parents can and should always be working to ensure their child’s normal (or at least more normal) development by making “good” choices (e.g., by exposing their child to classical music in utero, buying organic foods, seeking out private therapies, or buying developmentally stimulating toys).

This approach to child development seems to promise that all kids can and should grow up to be astrophysicists (or whatever society deems as its ideal), if only parents expose them to culturally enriched experiences or the latest in development toys.

We talk about the sheer pressure this 'consumer choice' model of parenting puts on all parents. Not only does this way of thinking assume that all parents and kids agree on what counts as a good future, it also draws our attention away from very real social and structural conditions that often make it difficult for disabled people and their families to negotiate and thrive in their communities. Often, good futures are less determined by where our bodies and minds fall on a standard developmental timeline, but by the accessibility of our schools, homes, social spaces or workplaces, or by the quality of our community supports or the availability of respectful medical care and personal attendants.

Not all kids are going to grow and develop in the same way and that’s not a bad thing! Social ideals are very often built to exclude ordinary disabled kids and people more generally. One of the central premises of disability studies is that disability is itself valuable to both individuals who live with it, as well as to the social whole. 


The assumption that atypical development is a state simply to be avoided or fixed or enhanced flies in the face of the many disabled people (and their parents) who speak openly about the ways disability has enriched their lives.

Of course, when I say disability is valuable, I’m not discounting the very real struggles faced by disabled people and their families. And I don’t think there’s anything wrong with buying organic, or exposing your child to music in the hopes that they will one day turn out to be a great musician! What becomes problematic is this idea that there is only one way to be great or healthy or successful, or that a particular set of abilities is a prerequisite to having access to a good life.

BLOOM: Do you have a favourite topic to teach? Why? 

Anne McGuire: I’ve been doing some writing (with Prof. Kelly Fritsch at Carleton) on disability and genetic risk, and am really looking forward to the prospect of bringing some of this research into the class when we look at genetic narratives of the child and the current debates about tailoring educational curriculums and environment to a student’s genetic risks profiles.

I’m also really looking forward to tomorrow’s class, which is called Child’s Play! We’re all bringing in an artifact of childhood
be it a toy or a piece of clothing or an object that is commonly used by or with children. Our group task is to read or interpret these objects for how they anticipate a particular kind of child-user. What would a course on the child be without a few opportunities to play? 

BLOOM: Why did you get interested in disability in the first place?

Anne McGuire:
I have a disabled sibling and so I think that has made me more attuned to the ways our society thinks and speaks about disability. I found a home in disability studies because of a series of experiences and relationships, and I continue to be invested in understanding disability as a relationship between bodies, minds and their environments. A byproduct of thinking about disability as a relationship is that all of our bodies and minds are implicated in disability politics, albeit in different ways!

BLOOM: What have you learned from teaching the course?

Anne McGuire:
I’ve come to better appreciate just how important and central this figure of the child is to the making of adult worlds, and how cultural ideas of the child shift and change. What the child is and what it means is very political. 


We have to ask: how do we define 'child?' Which kids are not readily recognized as kids, and which adults are cast as perpetually child-like? How does society readily mobilize to protect certain children from all manner of risk, while at the same time, refusing to protect other kids from social, political and state violence? 

I've been surprised by how the students have harnessed the idea of the child as an entry-point for all kinds of important discussions about equity: they have shown me how the child pushes us to address questions of racial justice, decolonization, class politics, and, environmentalism, immigration, gender politics and, of course, underpinning this, questions of disability rights and justice.

Of course all of these justice issues and social phenomena have very real, material consequences in the lives of actual children. And so the task before us is to think about how we might use what we’ve learned to work for a world that is more accessible and welcoming to, and for, disabled youth and kids.

BLOOM: Have you seen any significant changes in mainstream talk about disabled children?

Anne McGuire:
Back in the early 2000s, when I first started collecting examples of representations of autism that were being circulated by advocacy and awareness organizations (what would later become the basis of my PhD research), there was a very uniform and widespread sense of tragedy, fear and doom that was being communicated. 


At the time, autism advocacy routinely depicted autism as a kind of social menace or evil villainsome 'thing' that threatened children and their families, something that should be lessened, cured and/or eliminated at all cost.

Over the past two decades or so, mainstream representations of autism have changed quite a bit. These days, we are most likely to encounter more positive campaigns focused on inclusion, spectrums and neurodiversity. While the tone and tenor of the conversation has changed, I worry that the emphasis on child enhancement and normalization is still very present. 


We're seeing disabled children included in mainstream ad campaigns and celebrated in many facets of this culture
for example, the 2018 Gerber baby is a child with Down syndrome. I’m really happy to see these developments, but I still think it’s important to question which disabled kids are readily included in mainstream celebrations of diversity, and which continue to be left out.

When it comes to childhood disability, it's common to talk in terms of classifications like low and high functioning, and severe or mild. These divisions, unfortunately, continue to produce moral hierarchies of better and worse ways of being disabled. All too often, the more positive campaigns and mainstream representations of disability celebrate the so-called high functioning disabled child, or the child who can approximate society’s normative ideals. 

I admire Holland Bloorview’s latest Dear Everybody campaign
including the ad with the image of a teenage girl who uses a wheelchair and the text: 'This is what a storyteller looks like.'  On the one hand, it asks viewers to attend to the ways disabled youth are flourishing in, and with, a wide array of bodies and minds, while, on the other, naming and pointing to social conditions like discrimination and inaccessibility that can compromise this flourishing.

BLOOM: Does your course examine both intellectual and physical disability in children?

Anne McGuire:
I’ve tried to make sure that my course readings address a broad range of topics and lived experiences. Perhaps, because of my own research background, the course this year is focused on neurological, genetic and psychiatric disabilities, as well as notions of neurodiversity. For example, we're reading work that addresses the cultural politics of autism, ADHD, and various psychiatric labels given to children and youth.

We look at the media surrounding the outbreak of the Zika virus a few years ago in Central and South America, and critically engage with the reports and images that emerged of infants with microcephaly.

There are weeks that look at the racial and gendered politics of school streaming, and the over-representation of students of colour in special-education classrooms. We key into contemporary debates around genetics and education and ask what this might mean for disabled kids and youth as they negotiate already inaccessible school systems. We also look at popular debates about the over-diagnosis of children and youth with psychiatric labels.

BLOOM: Isn’t the academic world problematic for people with intellectual disabilities?

Anne McGuire:
The last time I taught this class, we had a number of pretty interesting discussions about the ways we, as a society, value intelligence. Intelligence has, for a long time, been used as a means of creating hierarchies of people. This was deeply influenced by the rise of eugenics in the 19th and early 20th centuries, with its racist, classist, sexist and ableist fears of the so-called 'feebleminded.'

We talked about the everyday ways in which we might reaffirm the superiority of conventional intelligence over other ways of knowing. These kinds of questions are, of course, especially relevant in the context of the university, and somewhat ironic given that students in the class are graded on their individual intellectual outputs.

One conclusion was that we need to attend not only to the ways intellectually disabled people are made absent from academia (which is certainly important), but also to the ways intellectual disability is present within the university. As a class, we read texts and screen films and podcasts written or created by people with the label of intellectual disability. There have been some students in courses I have taught who have shared that they were given the label of intellectual disability in their childhoods. 

Many students in disability studies speak and write about their encounters with special education. Other students are parents of kids with intellectual disabilities. All of these students carry their perspectives and experiences with them into our classroom.

Listening to, learning from, and being changed by these diverse experiences and perspectives offers us opportunities to push back against conventional assumptions that intellectual disability is incompatible with university education, and to imagine and practise a more accessible university.

BLOOM: Recently there’s been a big social media campaign with the hashtag #docswithdisabilities. But every time I read about it, I can’t help thinking that they’re talking about physical disability. I sat at a conference about how cultural devaluing of kids with disabilities may compromise their care, and a neonatologist stood up and said: 'There is a feeling among my colleagues–an unspoken and probably unconscious bias–between physical and mental disability. Sometimes neonatologists think if you're not perfect, mentally, you're better off dead. But when it comes to physical disability, they will go a long way with interventions.' How, and will, that ever be challenged in the academic world?

Anne McGuire:
We live in a 21st century world that privileges the mind/brain. This idealization of the brain or the mind marks our time as somewhat different from, say, the height of the industrial revolution or even the WWII era, where physical agility and strength was the mark of the ideal body. Technologies today mean that some physically disabled people are able to fit, nearly seamlessly, into their school, work and home environments (though certainly not all or even most, and the vast majority of disabled people worldwide don’t have access to these technologies).

Disabled people who might be classed as severely intellectually disabled or low functioning
people who, in other words, do not fit seamlessly into the normative requirements of school or work or homeare disproportionately and acutely vulnerable to systemic and interpersonal discrimination and even physical and psychological violence.

This troubling fragmentation of the disability community into those deemed to be deserving of life, and those deemed to be better off dead, has long been challenged by scholars and activists in disability studies. Of course there are really important journal articles and books written on the topic, but I think what makes me the most hopeful is that these conversations come up regularly in the disability studies classroom. 

Disability justice writer and activist Eli Clare writes that we need a disability studies that always and firstly 'points us towards justice.' Our students are so thoughtful, incisive and critical and when they move on to pursue their careers, or as they simply live in the world, they carry forward their questions and experiences, challenges and insights.

BLOOM: You and I spoke about the new Nike ad with Colin Kaepernick. The campaign has brought in $6 billion for the company, so it appears the public loved it. What message do you think it sends, why is this such a popular message now, and why is it problematic?

Anne McGuire:
A big part of the Disability and the Child course is dedicated to thinking about the fact that kids (disabled and non-disabled, alike, I think) are expected to not only be 'normal' or average but rather to be 'extranormal' or 'better than average' in all ways, all the time. 'Lose 120 pounds and become an iron man
after beating a brain tumour' says Nike spokesperson Colin Kaepernick in the ad. Kaepernick is himself a very powerful voice here, as he's lived the effects of widespread systemic racism. 

There’s something really compelling and empowering about this ad, and its promise that freedom and justice and equality are simply ours for the taking. And yet, we know that losing 120 pounds or becoming a high performance athlete, these things are not only or simply a matter of decision: body size, access to athletics, the capacity to excel in athletics
these things are deeply influenced by, for example, social class, genetics and a variety of other social and biological factors. 

'Beating' cancer almost never comes down to personal choice or positive outlook. The Nike ad seems to suggest that everyoneand maybe disabled people and others who face social injustice in particularneeds to be superhuman as a means of achieving social equality. I would question this idea that social justice only can be achieved when everyone has the freedom to be one thing, or even a limited range of things. For me, justice looks more like moving together with, and across, and towards our differences. 

BLOOM: Was there ever thought given to making your course available to medical students?
  
Anne McGuire: The courses I teach are housed in the Equity Studies program, which is an undergraduate program, and so I don’t often have the opportunity to cross paths with med students on campus. 

That said, I have former students who have gone on to medical school, nursing or occupational and physical therapy programs. I’m glad for this. I think a background in disability studies is incredibly valuable and really essential for people doing work in the health and medical fields. While disability studies certainly critiques the medicalization of disabled people, I think the field has an important role to play in pushing for more accessible healthcare for disabled people. I’m always supportive of conversations to explore more options in this area.

BLOOM: Your last reading on the list you sent is called Growing toward a question mark. What is the question mark?

Anne McGuire:
The title of the last week of class refers to a beautiful piece of writing by queer theorist Kathryn Bond Stockton. In her book, Stockton is concerned with the queer child, or the child, she says, who develops non-normatively–who is out of pace or at odds with the norms, ideals or requirements of society. 

Stockton’s work turns toward the child who is faced with nowhere to grow, precisely because the idea of what counts as a proper or good childhood has been so thoroughly defined to exclude his or her body or mind. I just love how this essay offers an affirmation of the possibility of growing and developing otherwise
where kids who don’t, or can’t, grow up in accordance with the developmental demands of our society, might instead grow 'sideways.' Kids and adults alike might yet grow toward a 'question mark,' she says, or towards a future that holds and supports their difference. 

You can follow Anne @anneemcguire.

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