Challenging Categories: An Ethnography of Young Adults with Down Syndrome in a Community in Ontario By Abigail Kidd A thesis submitted to the Faculty of Graduate and Postdoctoral Affairs in partial fulfillment of the requirements for the degree of Master of Arts in Anthropology Carleton University Ottawa, Ontario © 2014, Abigail Kidd Abstract This thesis explores the impact that being categorized into a specific category of disability has on the lives of a group of young adults with Down syndrome in Ontario. It is an ethnography of young adults who attend a community-based day program and the staff and guardians with whom they regularly relate. It also tracks the influence categories of intellectual disability have had historically, and currently have, on the lives of individuals with Down syndrome. It shows the ways in which the participants are complicatedly resisting a disabled, Down syndrome identity, and the ways in which the program is both complicit in and in resistance to the limitations imposed on these individuals. This thesis ultimately points to the ways in which social perceptions, power relations, and widely held understandings of Down syndrome largely determine the opportunities and experiences of people categorized as having Down syndrome. ii Acknowledgements While there are many individuals who have supported me as I have completed this thesis, I first and foremost need to thank my older sister, Gemma. She has been both the inspiration and driving force of this thesis. She is my biggest cheerleader and best friend. She is an intelligent, witty, proud, optimistic, compassionate, and motivated person, and witnessing the successes and barriers she experiences as a young woman with Down syndrome has been the primary motivation for this project. She supports me unconditionally and I love her dearly. I owe a great deal of gratitude to my supervisors, Alexis Shotwell and Jen Pylypa. Without their support, knowledge, insights, and expertise this thesis would not have been possible. I feel very lucky to have had a committee made up of female academics whose approach I both respect and admire. I would like to thank the program for hosting me. Additionally, thank you to the participants at the program for sharing their days with me, and the participants’ guardians for making time to meet with me. The work the program is doing is both unique and incredibly important. Finally, I would like to thank my parents for supporting me unconditionally throughout this process. Particularly, my mother, Janie, who has spent countless editing papers and being my emotional support throughout my academic degrees. iii Table of Contents Abstract ...................................................................................................................................................... ii Acknowledgements...................................................................................................................................iii List of Illustrations ................................................................................................................................... vi CHAPTER 1: INTRODUCTION ........................................................................................1 Background to the Research .................................................................................................................... 5 Present Context ....................................................................................................................................... 12 Project Description ................................................................................................................................. 19 Methods .................................................................................................................................................... 22 CHAPTER 2: “TO CLASSIFY IS HUMAN”: THE CATEGORIZATION OF INDIVIDUALS WITH DOWN SYNDROME .................................................................26 Social Role................................................................................................................................................ 30 Intelligence ............................................................................................................................................... 51 Education ................................................................................................................................................. 57 Conclusion ............................................................................................................................................... 67 CHAPTER 3: COMPLICATING DOWN SYNDROME: RESISTING, REJECTING, AND DISCIPLINING THE CATEGORY ........................................................................70 Rejection of Down Syndrome ................................................................................................................. 73 Disassociation from Down Syndrome .................................................................................................... 78 Redefinition of Down Syndrome ............................................................................................................ 80 Acceptance of Down Syndrome ............................................................................................................. 84 Identifying Down Syndrome .................................................................................................................. 86 The Program’s Approach to Down Syndrome ..................................................................................... 89 Conclusion ............................................................................................................................................... 92 iv CHAPTER 4: DISCIPLINING DOWN SYNDROME .....................................................97 My Role at the Program ......................................................................................................................... 99 Reporting Back on Participants ........................................................................................................... 102 Modeling “Good” Behaviour ............................................................................................................... 107 The Risk of Being a Pedestrian with Down Syndrome ...................................................................... 110 Reminders .............................................................................................................................................. 112 Plans ....................................................................................................................................................... 113 Managing Down Syndrome .................................................................................................................. 115 Stagnation and School .......................................................................................................................... 118 Adult Behaviour and Adult Treatment ............................................................................................... 120 Conclusion ............................................................................................................................................. 128 CHAPTER 5: WORKING AND WORKING OUT ........................................................133 Working ................................................................................................................................................. 135 Working Out .......................................................................................................................................... 150 Conclusion ............................................................................................................................................. 157 CHAPTER 6: CONCLUSION .......................................................................................161 The Program .......................................................................................................................................... 163 Significance of Research ...................................................................................................................... 164 Further Research ................................................................................................................................. 166 References .............................................................................................................................................. 170 v List of Illustrations Figure 1.1 .......................................................................................................................48 Figure 1.2 .......................................................................................................................49 Figure 2 ........................................................................................................................156 vi Chapter 1: Introduction When I began fieldwork at a day program that facilitates employment and integrated, daily lives for young adults with Down syndrome, I planned to explore the ways in which the young adults conceptualized themselves as well as their knowledges, skills, and capabilities. However, after spending two months at the program gathering data and sitting down to write about my findings, I found that my goal changed. While I still focus on the experiences of the young adults I worked with in this thesis, my priority is to show the ways in which their daily lives are shaped by their categorization as individuals with Down syndrome. I still aim to explore their self-conceptions within or outside of a Down syndrome identity and the ways in which that imposed identity shapes and is shaped by their lived reality. However, my experience with the program and its clients also led me to explore the ways in which their medical positioning, social positioning, and the specific positioning within the community and the program all come together to create a particular experience of what being categorized as having Down syndrome looks like for individuals. In this thesis, I will track the social relations, assumptions and implications tied to their identity, and the power relations that further contribute towards their lived experiences. I aim to do these things as a means of understanding what exactly being a young adult with Down syndrome means for these individuals. I will discuss the major actors and actions that contribute towards the meaning of having Down syndrome for my participants. I chose to focus on young adults with Down syndrome for a number of reasons. First, my older sister by 16 months is a young adult with Down syndrome. She attends 1 the day program where I did my research, but was not a participant in the project, although she is mentioned occasionally within this thesis. As a result of growing up with her, the implications of her categorization and the barriers she experiences have always been sources of frustration for me. Experiencing her intelligence, wit, complexity, and passion have been positive, central aspect of my life. She is the biggest source of my desire to do this research. Second, individuals with Down syndrome are often left out of disability activism and research. They are a significant portion of the population of people with intellectual disabilities, but they are often either the source of biological research or ignored in favour of autism research. Additionally, while their presence in the media and general recognisability results in the majority of people recognizing the disability, the general public are often ill-informed and unaware of their lived realities. I frequently have people tell me they “don’t know much about Down syndrome,” and react with surprise when they find out that the participants of this project work, read, and are learning to cook. Third, individuals with Down syndrome occupy a unique category. Their disability has been biologized and medicalized through the identification of trisomy 21. Their disability is associated with both physical characteristics and intellectual capacity. They are targeted for pre-natal abortions, but are also widely represented as universally cheerful, happy individuals. They also have a variety of experiences. Individuals with Down syndrome have varying cognitive capabilities and different individuals may be sub-categorized as high or low functioning. Their social skills, interests, talents, motor skills, and clarity of speech vary. They also have varying experiences of health: some of 2 them may have heart defects, lung problems, sleep apnea, or childhood leukemia, while others may have no health issues. Their category, then, is complicated. However, trisomy 21 and the physical indicators of the syndrome solidify and stabilize their abnormal categorization and assign their membership to the category. That they have the same chromosome-based syndrome that has been named “Down syndrome” is not contested, but what having this syndrome means for their lives, experiences, and identities, and what it should mean, is certainly contested by this thesis. In order to do this, I think it is important to first define how I understand the ontology of Down syndrome. I understand the category of Down syndrome as varied and unstable. By this, I mean that I acknowledge that there is a dominant understanding of Down syndrome which has been shaped by centuries of historical factors that contributed towards the creation of the category. This dominant understanding is held as relatively stable by the culturally prevailing ideologies of the biomedical system, the Canadian education system, and general Canadian culture. I argue that there are power relations involved in the conception of the category of Down syndrome that have shaped and continue to shape the experience of the syndrome for those who are diagnosed. Once applied, the category works to both enable and disable those with the syndrome. I contend that the diagnosis of an individual with Down syndrome places a set of inherent assumptions, expectations, and limitations on the individual. These significantly influence the individual's social and cultural positioning, resource access, and self- conceptions. 3 I take up Bowker and Star’s (1999) social categorization theory in which they explain that the enforcing and spread of categories and standards involves negotiations of force; that is, apparently universal categories are the “result of negotiations, organizational processes, and conflict” (1999:44). So, while there is a dominant understanding of the ontology of Down syndrome, this is the case because it has been constructed and held as stable by these dominant forces, and so the ontology can be understood as much more varied and unstable than it is presented by the medical and education systems. There is no one universal experience of Down syndrome and it does not mean one universal thing. By this I mean that while having Down syndrome may currently mean experiencing certain learning difficulties within the dominant education system, experiencing particular co-morbidities of health, and being born with an extra twenty-first chromosome, for those who have the syndrome it may also mean excessive disciplining, atypical limitations, frustration and unnecessary barriers within a social reality and disabling society that creates obstacles for them, or a variety of other things. This thesis attempts to track the meaning of having Down syndrome for a group of young adults based on their understandings, the understandings imposed upon them by the program they attend, and the hegemonic understandings held by Canadian society. That a dominant understanding of the category exists and is held as the universal, stable understanding of the ontology is important. If medical, educational, and political professionals are all in the powerful position to determine how these categories are understood and used, then the desires, experiences, and social contributions of individuals with Down syndrome can easily be erased and ignored. I am curious about the impact that this cultural positioning has on these individuals and their ability to effectively 4
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