E’s Iceberg [PDF]

page1image3704858704Supporting a Journey From Chaos to Contribution

John O’Brien

Sept. 2016

This documents the organization of assistance for a person with a developmental disability, known here as E. It was constructed in September 2016 by John O’Brien based on a group interview with some of the people most involved in supporting E’s journey from chaos to contribution. It takes the perspective of those responsible for providing E’s assistance and reflects their intentions and design without conscious evaluation. It is not a portrait of E or a statement of a plan for him. It describes the supports that he counts on.

The framework for this description is borrowed from Systems Thinking.* The iceberg metaphor invites a look below the surface to the deeper aspects of assistance that account for what we see; in E’s case a period of developmental growth that gives him the opportunity to participate in an expanding variety of community roles. It calls our attention to four aspects of assistance at work below the surface.

What we see is shaped and sustained by recurrent Practices and Patterns of Activity: daily, weekly, monthly routines and schedules; physical and social responses to a person’s impairments; social rituals; responses to requirements and rules; ways of reflecting on, renewing and updating what’s meaningful; decision making and exercise of authority. The shape of these practices embody the form that power takes in the daily life of people and their assistants.