ABSTRACT
In this chapter, we* question and rethink “normal development” as the primary organizing concept in children’s rehabilitation. Normal development understands childhood as a predictable trajectory from infancy to adulthood characterized by a series of developmental stages that cover all aspects of personhood, including physical, intellectual, emotional, and social. This “ages and stages” framing provides the underlying rationale for a host of health and education interventions designed to maximize young people’s physical and mental capacities as they “progress” toward adulthood. In the traditional rehabilitation context, therapeutic goals and treatments are designed to assist disabled children to achieve developmental milestones and approximate developmental norms and trajectories. This link between rehabilitation therapies and development is accepted almost universally as uncontroversial (Goodley and Runswick-Cole 2010) and underpins dozens of standardized scales used to assess motor, language, and social development and to guide interventions (Effgen 2005, p. 42). Pick up any text on children’s rehabilitation and you will find tables, charts, and descriptions of the stages of development, accompanied by statements regarding how an understanding of developmental progression is essential for the design of treatments aimed at ameliorating disability. For example, Pediatric Therapy (Porr and Rainville 1999) suggests:
However “obvious” it may seem, development is only one way of understanding childhood and approaching children’s rehabilitation. In what follows, we situate current dominant understandings of the child and development in their historical origins, ask how well they are serving disabled children, and consider how things could be otherwise. Our project of examining “normal” development and the effects it produces aligns with the post-critical project of the book in interrogating claims to truth, how they emerged, and how they shape rehabilitation practices. We examine how biomedicine and rehabilitation divide, classify, and judge the recipients of care, and how these practices may contribute to unintentional harms. The goal is not to suggest that rehabilitation necessarily discards development, but that we remain ever vigilant in recognizing that organizing concepts are not natural but contingent human inventions that have myriad effects and are open to revision.
