Exploring Health and Social Service Navigational Barriers Experienced by Children with Intellectual Disabilities: A Discourse Analysis.

Abstract

Children with intellectual disabilities (ID) experience a higher prevalence of dental disease, obesity, challenging behaviours, and mental health disorders compared to children without ID; and health and social service navigational barriers associated with unresolved health needs. The research literature has identified the types and implications of service navigational barriers experienced by children with ID and their carers , and the demographics of people vulnerable to them; however, the literature has not identified how ID is currently understood within social policy and by carers of children with ID. Using a Foucauldian discourse analysis, I explored how ID is understood and the subsequent materializations on service navigation trajectories for children with ID. I collected four governmental agency documents and conducted six interviews with eight carers of children with ID, between the ages of six to 14, residing in a rural Ontario area. I interpreted the dataset themes using Powers’ framework. I found three major findings: (1) ID is understood as an impaired identity, an experience of disabling barriers, and heterarchical difference; (2) children with ID participate in a standardized assessment-diagnostic-treatment process; (3) the hegemony of service providers to make decisions for children with ID contributes to tensions with carers, and unresolved needs of children with ID. Nurses should enhance collaboration with children with ID and their carers to deliver client-centred care.