The Principles and Practices of Universal Enhancement (Volumes One–Four). Thomas E. Pomerantz. Homewood, IL: High Tide Press, 2001.
Some fortunate workers, in locations across North America who try to support people with developmental disabilities, will be puzzled by these volumes. This series apparently grew from materials used by the author in his work as a trainer and consultant with direct support workers in residential settings. Those workers who are puzzled are involved with services that have clearly separated themselves from the institutional past. Most of us in the developmental disabilities field will, by contrast, be unpuzzled by the circumstances about which Pomerantz writes. The portrait he paints of contemporary services fits like the proverbial old glove. Readers can profit from the guidance that his new volumes offer.
The entire compilation of these volumes is offered to a field that has not shed its past. The average community service for people with developmental disabilities daily reflects what Pomerantz helpfully terms “characteristics of the institutional state of mind” (e.g., lack of privacy, restriction of freedom of movement, group treatment, and portrayal of adults as though they were children). The volumes that make up this compilation bring these characteristics to life through stories and offer workers guidance about how to replace unfortunate characteristics with more dignifying, more enhancing ways to support people.
Volume One is subtitled: “It Matters How We Say It.” Pomerantz here introduces “the institutional state of mind” as a problem and focuses on how this problem is evident in the language we often use to speak to and/or about people with disabilities. In Volume Two, “Challenging the Gatekeepers,” Pomerantz describes two prevalent “models” operating within services for people with developmental disabilities—the developmental model and the habilitative model—and offers a brief analysis of their strengths and weaknesses with suggestions for improvement. People (perhaps especially those who work as direct support workers) may spend their entire careers working with people who have disabilities without encountering a discussion of the existence of “models” and their power to shape what we do. This discussion is an especially valuable section of The Principles and Practices of Universal Enhancement.
The third volume carries the subtitle “Obstacles to Opportunities,” and under this heading Pomerantz confronts the tendency to see people with developmental disabilities as perpetually child-like. He begins to offer alternatives to that tendency and to related views that sequester these individuals from the world of risk and personal responsibility. Finally, in Volume Four, “Venturing Beyond the Iron Gate” the author offers a definition of universal enhancement and an outline of a way of thinking and acting that may help workers live with the people they try to support outside of the old institutional pattern.
I think that these slim volumes may be useful either to orient workers new to the job of assisting people with developmental disabilities or to renew or refresh the practice of experienced workers. I have two reservations.
First, the term, universal enhancement, with its inferred (by me, anyway) parallel to universal design in architecture, is potentially helpful as a descriptor of an overall approach to supporting people with developmental disabilities. The sharpness of the term, however, gets lost in these volumes. For example, the introduction to each volume says that universal enhancement is about the opportunity for individuals to develop valued relationships with others and take part in activities that they choose so that their lives will be richer. Elsewhere universal enhancement is said to relate to “inclusion for all people” and to be the “result of participation in one's own life and the life of the community in which one lives.” It is not until early in Volume Four that a more formal description is offered. There, universal enhancement is seen as “an increase in the quality of life of all people, without restrictions or limits, regardless of ability or disability.” These varying and inexact approaches to definition leave universal enhancement a fuzzy idea. What might have been a useful concept dissolves and the opportunity to build on a firm construct is lost.
Second, I wished for a more generous acknowledgement by the author of the contributions to the ideas in these volumes by several pioneers, whose work provides the foundation upon which the volumes rest. For example, much of the way of thinking outlined in Volume I (“It Matters How We Say It”) was developed by Wolf Wolfensberger and has been taught by him and many of his associates over the past 30 years. Because this way of thinking has been widely shared it has gained a sort of common knowledge status in the developmental disabilities arena. It may be said that these ideas have become part of the public domain, and other writers, like Pomerantz, have both a right and a duty to use and engage them. In Volume Two (“Challenging the Gatekeepers”), Pomerantz explicitly credits Marc Gold with shaping the ideas about teaching that are presented there. This acknowledgement is generous. I wanted similar acknowledgement for the other forerunners such Wolfensberger, Erving Goffman, Lou Brown, and Burton Blatt.
I do think, though, that many of the particulars within these volumes will make them useful to agencies and especially to agency staff responsible for staff development. These volumes are meant, I think, to be a guide to the orientation or further development of workers with agencies that support people with developmental disabilities. Some of these particulars include:
A brief set of observations, in Volume One (“It Matters How We Say It”), about disability as a medical issue. New workers in services for people with developmental disabilities will, without being aware of it, slip easily into the view that the people with whom they work are sick. After all, workers are regularly warned to put people's “health and safety” before all other concerns because “Medicaid” demands this. Pomerantz provides a short explanation of the dangers of this view that could help counter such unconscious learning.
An analysis of some unexpected results of the application of the developmental model as a replacement for an overarching medical design in services. Volume Two (“Challenging the Gatekeepers”) offers both descriptions and examples (see “Alfred's Lunch,” Volume Two, pp. 50–54) of how the idea of development can become tyranny. As well, the chapter entitled “Learning Through Participation” outlines guidelines that could be useful for anyone who needs to evaluate the quality of any program that is explicitly about the teaching of people with developmental disabilities.
“Elements of Getting a Life.” That is the title of a chapter in Volume Four (“Venturing Beyond the Iron Gate”) in which Pomerantz outlines the processes that he thinks will help workers avoid old pitfalls and be more effective helpers to the people with whom they work. The chapter contains a checklist that workers can use to figure out how they are doing and to plan changes in their approaches.
Pomerantz recognizes an underlying tone to services for people with developmental disabilities in North America. This recognition becomes most clear in the chapter in Volume One (“It Matters How We Say It”) that is titled “Two Visits and Some Observations.” Here he conducts readers on tours of two different places where people with disabilities reside. The first place is what might be termed an old-style institution—the kind of place that seems, thankfully, to be disappearing from our landscape. The second place, though, is the kind of place that has come to stand in for the first. Pomerantz describes it as “a neat brick home on a quiet residential street in a small town, maybe your town.” In this second tour we witness routines and rhythms of life and styles of interaction between those who reside there and those who are paid to work there that also characterized the first place with the tall smokestacks. Pomerantz warns about the need for vigilance, so that we notice what is actually happening in settings rather than just paying attention to “the architecture of the buildings.” I recognized both settings, and the second one is all too often said to be “home” for people who have developmental disabilities. The legacy of the first place carries into the second, and Pomerantz's treatment of this culture-transfer is a strength of The Principles and Practices of Universal Enhancement.