Relational justice pedagogy in social care education: key insights from critical perspectives on intellectual disability

Individual versus social models

The individual or medical model views disability as a problem within the person, caused by illness, injury or impairment, and focuses on diagnosis, treatment and rehabilitation to ‘fix’ or manage the condition. It sees disability as a range of impairments – physical, sensory, intellectual, cognitive or related to mental health – that may limit daily functioning or social participation. From the 1960s onwards, this model faced major criticism and reform, particularly during movements for deinstitutionalisation, normalisation and disability rights, which drove significant legal, policy and practice changes in western societies.

Especially advanced by people experiencing physical and sensory disabilities, the social model arising in the 1970s and 1980s (Finkelstein, 2001) rejected the notion of disability as a medical condition and presented disability as a form of oppression. It emphasised how societal barriers, such as inaccessible infrastructure, discrimination and lack of support, contribute to disabling experiences (Shakespeare, 2017). This approach makes a strong and clear distinction between impairment and disability. Shakespeare (2017) notes an ‘Impairment is the deficit of body or mind; disability is the social oppression and exclusion’ (p. 13). The distinction is drawn between an individual approach – implying pity, compassion and charity – which tends to perceive the impairment as the individual’s problem, and the social model, which highlights environmental and attitudinal barriers as primary factors in disabling individuals – involving rights and justice (Oliver, 2018). For Oliver (2018, p. 90) the disabled are people who: (1) have an impairment; (2) experience oppression as a consequence; and (3) self-identify as a disabled person. Emancipation is central to the social model, both in terms of transforming oppressive social structures and the internalised oppression created by these structures (Oliver, 2018). Oliver (2018) criticises services that create dependency and calls for a strong, independent disability movement led by disabled people themselves. The social model then is a form of identity politics that emphasises the importance of removing systemic and exclusionary material and cultural barriers along with consciousness raising and political mobilisation by disabled people using the mantra of ‘nothing about us without us’ (Shakespeare, 2017).

The social model has been enormously influential in modifying earlier medical approaches. The World Health Organization (WHO, 2001) through the International Classification of Functioning, Disability and Health defines disability as an umbrella term that includes impairments, activity limitations and participation restrictions. It recognises that disability results from the interaction between a person’s health condition and environmental and personal factors. This biopsychosocial model moves away from a purely medical perspective, emphasising the role of social and structural barriers in disability, but medical and psychological factors remain central. The United Nations’ (2006) Convention on the Rights of Persons with Disabilities goes further by defining persons with disabilities as those who have ‘long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others’ (Article 1). This definition is more strongly influenced by the social model because it focuses on the removal of barriers to participation rather than just the impairment itself. These definitions have influenced disability rights laws, social policies and inclusive practices worldwide by shifting the focus from an individual’s limitations to systemic and societal barriers. Not discounting the ongoing limitations of rights discourse including its essential individualism and the challenge of enforcing positive social rights (Ellis, 2005), the Convention on the Rights of Persons with Disabilities establishes a new rights-based dialogue, strengthens civil society and makes human rights more accessible to persons with disabilities than ever before (Harpur, 2012).

Nonetheless, when it comes to IDS the influence of the medical model remains strong. The American Association on Intellectual and Developmental Disabilities’ definition characterises intellectual disability as ‘significant limitations in both intellectual functioning (reasoning, learning, problem-solving) and in adaptive behavior, which covers a range of everyday social and practical skills. This disability originates before the age of 18’ (Schalock, 2010, p. 5). This definition emphasises both cognitive impairments and difficulties in adaptive functioning, recognising that supports and environmental factors play a role in shaping a person’s abilities. It has influenced legal definitions in the United States and internationally. The WHO’s (2025) International Classification of Diseases (ICD-11) notes ‘Disorders of intellectual development are a group of etiologically diverse conditions originating during the developmental period characterised by significantly below average intellectual functioning and adaptive behaviour.’ The ICD-11 further categorises intellectual disability based on severity (mild, moderate, severe and profound) and considers both social and environmental factors. This definition is widely used in medical, educational and social care settings globally (Schalock et al., 2021). The highly medicalised view of intellectual disability is reflected in the ongoing pervasive influence of reformist approaches to normalisation and the biopsychosocial perspective, although rights-based discourse has gained prominence following the Convention on the Rights of Persons with Disabilities.

Reformist versus radical change

The reformist theories of normalisation (Wolfensberger and Nirje, 1982) and social role valorisation (SRV) (Wolfensberger, 2013) are hegemonic ideas in IDS (Simpson, 2018). They propose to challenge stigma, exclusion and negative attitudes affecting people with disabilities and provide individuals with disabilities access to living conditions and life patterns that are as close as possible to those typical for society. They highlight the importance of enabling people with disabilities to engage in everyday life activities (for example, work, education or relationships) in mainstream settings, reducing segregation and stigmatisation. SRV expands on normalisation by focusing on the importance of individuals with disabilities occupying valued social roles. According to SRV, people are more likely to be treated positively when they are seen in roles that are valued by society (for example, worker, student or friend). This reduces the risk of devaluation and marginalisation, thereby enhancing opportunities for meaningful social participation and acceptance. Both theories aim to challenge societal attitudes that marginalise people with disabilities and work towards their full inclusion and acceptance in valued social roles.

However, normalisation theory is widely critiqued. While the defenders of normalisation theory argue that it has been instrumental in deinstitutionalising services and shifting policy to community-based approaches that have dramatically improved the lives of people with intellectual disabilities, critics of normalisation argue that it reinforces ableist expectations by prioritising assimilation over genuine inclusion and fails to recognise disability as a valued form of human diversity. Although Oliver (2018, p. 90) acknowledges that his original outline of the social model (Oliver, 1990) did not examine the oppression of people with intellectual/learning disabilities, it presents, nonetheless, a sharp critique of normalisation and SRV theories. Oliver (2018) suggests that SRV or normalisation theory has nothing to offer a social theory of disability because it fails to tackle the underlying oppression of disabled people in capitalist societies. Its lack of a materialist analysis of social structure, he suggests, is because of its foundation on functionalist and interactionist sociology.

McDonnell (2007) also critiques normalisation for focusing on minimising difference rather than valuing it. From a normalisation perspectives success was judged by how well disabled people conformed to societal norms, with professionals controlling both environments and experiences. Activists instead emphasised recognising difference, centring disabled voices and tackling material and conceptual discrimination. While normalisation promoted community-based care over institutions, it often led to segregated services and individual adjustment, rather than real inclusion. Its persistence, McDonnell suggests, was due to its compatibility with professional control, existing systems and political cost-saving goals. Though framed as progressive, normalisation reinforced inequality by favouring assimilation over diversity.

Simpson (2018), however, highlights the differential impact of two distinct discursive strands of normalisation theory. The first builds on the humanistic origins of the concept in supporting an ideology of liberal equality using behavioural psychology to promote skills acquisition and conformity with social norms, while a second strand, emphasising independence and self-determinism, has promoted social inclusion and citizenship rights. In addition, Foley (2016) argued, while exploring the philosophical and theoretical differences between normalisation theory and its opponents from social model and social constructionist perspectives, ‘when it comes to issues of praxis the competing ideologies’ (p. 177) have more in common than they would like to admit.

Notably, the social model is also subject to critique. Meekosha and Shuttleworth (2009) argue that there are some ‘conditions that did not easily sit within its narrow conceptual framework, such as chronic illness and learning disability’ (p. 65). Shakespeare (2017), while acknowledging its importance in promoting disability rights, has described it as a ‘crude approach’ (p. 19) that overlooks the significance of the debilitating experience of impairment and the multifaceted nature of disability. Instead, he supports the bio-psycho-social model that recognises social barriers, psychological dimensions and impairment all as contributing factors to disability. Haegele and Hodge (2016) critique the medical model for its focus on impairment and the social model for sometimes overlooking individual experiences, advocating for a more nuanced, integrative approach to disability discourse. Similarly, Zaks (2024) highlights the importance of bridging the tensions between the medical and social models without losing sight of the crucial insights of the social model. Such observations have been instrumental in promoting a more critical perspective in IDS.

Critical intellectual disability studies

Shakespeare (2017, p. 158) characterises the development of critical theories of disability in terms of the different phases of critique of the medical model. The first, a materialist and Marxist inspired phase, is represented in the work of Mike Oliver (1990) and the disability rights movement that lays the foundations for the original social model. The second phase, Shakespeare suggests, is a critical realist one, within which he includes his own contributions. While taking on board important elements of the social model, this phase was also attentive to the debilitating impact that impairments could have for individuals and gave greater attention to the interaction between a person’s health and disability. The third phase he refers to as critical disability studies (CDS), which takes a more poststructuralist and postmodernist approach inspired by literary theory that aims to deconstruct dominant ablest discourses. CDS provides a social analysis of impairment within the context of discourses of the body and seeks to create a greater dialogue between disability and impairment (McDonnell, 2007).

Some of the most innovative studies that grapple with many of the debates and dilemmas in intellectual disability have emerged from critical intellectual disability studies (CIDS). CIDS draws on social constructionist, post-structuralist or critical realist frameworks and focus on how intellectual disability is not just a medical or biological condition or solely an oppressed identity but also a socially constructed identity shaped by cultural, political and economic contexts. CIDS has gone beyond traditional models by examining disability through power, culture and global inequality while considering intersectionality and the diverse experiences of disabled people (Meekosha and Shuttleworth, 2009). CIDS places greater emphasis on the effects of language (for example, whether referring to people with disabilities or disabled people) and on how psycho-medical discourse can reinforce a problematising, individualising and disempowering gaze (McDonnell, 2007). In CIDS there is frequently a focus on the intersection between different forms of oppression including class, gender and race (Ben-Moshe and Magaña, 2014). Meekosha and Dowse (2007) note the role of CIDS is to develop alternative paradigms for understanding disability, to map ‘networks of power’ (p. 173) and the ‘discourses of exclusion’ (p. 172) that govern complex relationships and interactions shaping power and social status. Nunkoosing and Haydon-Laurelut (2012), for example, use Foucault’s and Goffman’s theories to critically analyse the concept of ‘challenging behaviour’ in intellectual disability services. They argue that such behaviour is often socially constructed and managed through institutional power and surveillance, calling for a more person-centred and rights-based approach to support.

CIDS seems to be better equipped to build on progressive elements of both normalisation and social models and move debates beyond simplistic binaries. For example, Titchkosky (2003) explores how disability is socially constructed and understood through everyday interactions and institutional structures. She emphasises that disability is not just a biological condition, but a complex social phenomenon shaped by cultural meanings, personal identity and societal expectations. The complex and subjective experience of disability is hidden by an overriding view of it as oppressive. Rather she emphasises disability as a teacher. She notes how disability is commonly understood as the inability to do activities or engage in roles that ‘normal’ people do. However, from a sociological perspective, disability reveals the taken-for-granted social and cultural expectations of the ‘normal doing of things’ (Titchkosky, 2003, p. 16). She argues that disability draws our attention not only to roles and doing but to the interactions, contexts and dynamics of everyday life and the social construction of identity and meanings. Importantly however, different disabilities, such as blindness or dyslexia, disrupt social norms in different ways (Titchkosky, 2003). Similarly, Goodley et al. (2012) suggest a cultural account of disability ‘that regards it as a way of being in the world from which we can learn’ (p. 28). They suggest also to ‘start with disability but never end with it: disability is the space from which to think through a host of political, theoretical and practical issues that are relevant to all’ (Goodley et al., 2012, p. 28).

Critical practices

IDS studies teach us that if relational pedagogy is to foster critically reflective thinking about care and social justice values, theories and concepts, students need to appreciate the implications of different perspectives on intellectual disability for their practices and for service provision. After exploring this literature, I suggest that there are four overlapping and interfacing paradigms on IDS that can inform critical practices in social care (Figure 3):

1. The individual-medical paradigm emphasises the debilitating experience of impairment and technological and medical responses to it.

2. The social-structural paradigm emphasises material and cultural barriers and oppressive experiences with rights and political emancipation being the most important response.

3. The social-integration paradigm emphasises social exclusion with normalisation, assimilation and SRV being the most appropriate response.

4. The social-constructionist paradigm emphasises disability as a politically constructed experience shaped by power, inequality and cultural values, and advocates for justice, intersectionality and the reimagining of disabled identities and futures.

Figure 3

Overlapping paradigms of disability 

While an individual-medical paradigm remains important in helping to identify issues of health care and technological solutions to support people with disabilities, it needs to take on board the oppressive social structuring and politics of disability. While integration strategies are valuable, they go only so far and should be combined with a more radical appreciation of the social and cultural construction of disability in everyday interpersonal and institutional contexts.

Developing critical practices is challenging in education and in professional practice. For example, the social model of disability is an important threshold concept for students from social care, social work and other health and social professions, entailing a paradigm shift from a hegemonic personal-tragedy narrative framed by the individual-medical model’s focus on impairment to the social context of disablement (Morgan, 2012). Morgan (2012) notes this transformational educational journey can be troublesome for students because it challenges preexisting values and assumptions including the benign view of social care professions. This is superseded with ‘a more holistic evaluation of the extent to which societal structures, processes and cultures are disabling and the identification of strategies to remove these barriers and promote more inclusive environments and practises’ (Morgan, 2012, p. 218). Burghardt et al. (2021) reflect on their journey towards CDS and how they came to question the ableist assumptions within their professional disciplines of health and social work. Their conceptual shift was influenced by personal experiences, exposure to disability activism and engagement with CDS literature, which challenged the dominant medical and individual models of disability in their fields. Like others, they understood that social care professions can be part of the problem when informed and governed by neoliberal, regulatory and exclusionary discourses (Meekosha and Dowse, 2007). Burghardt et al. (2021) highlight key challenges in bringing CDS into professional practice, including institutional resistance, tensions between CDS’s radical critique and everyday practice and difficulties aligning CDS’s systemic focus with the individualised nature of many professions. They also struggled to embed CDS in education and training, often facing pushback from those who viewed it as too political or impractical.

Countering this, Fenton (2025) criticises critical social justice perspectives in social work education that she suggests are increasingly dominant on the basis that they promote ideological conformity and discourage open debate. These cautions are important and worthy of reflection, especially where a simplistic identity politics supplants rather than complements a material analysis, and where the skills and complex nature of reflective practice in the classroom is underappreciated. However, critical social justice is not about imposing dogma, and should be about challenging dominant ideologies that sustain inequality. The aim of critical social justice is to equip students to critically examine power structures, question social norms and work towards a more equitable society, and this depends on our capacity to develop critical dialogue in practice.

Developing critical practices in social care education means appreciating the oppressive history of the medical model, the emancipatory potential of the social model, and that ongoing tensions between these approaches are played out in law, policy and everyday practice. It means being mindful of how disability is socially constructed and the normalising tendencies in policy and practice within the context of a neoliberal society. Critical practices recognise the effects of stigma, stereotyping, prejudice and discrimination without reducing peoples’ experiences and identities to those of the oppressed. Critical practice requires being reflexive to how personal and professional attitudes, values, and practices are shaped by ablest ideologies and discourses.

Caring practices

People with disabilities often depend heavily on professional caring services. This makes them especially vulnerable to experiencing affective inequality (Lynch et al., 2009), whether being marginalised from communities, institutionalised in congregated settings or reliant on stretched family and social support systems (Emerson and Hatton, 1996). The moral, academic and political critique of institutionalisation (for example, Foucault, 2013; Goffman, 2017; Szasz, 2011) and the social model critique of medical and charity approaches have led many disabled activists and scholars to criticise the discourse of care because of its association with dependency-creating services and paternalistic professional practices (Herring, 2014). Institutional and other forms of segregation can limit opportunities to develop friendships outside care settings, with adverse effects on quality life and well-being (McCausland et al., 2021). In response an emphasis of disability studies has been on promoting autonomy, agency and social justice (Shakespeare, 2000).

However, the politics of autonomy must confront a major dilemma. Disability services are caught between the historical context of institutionalisation (overly interventionist state response) and the neoliberal context of privatisation (hands-off state response). Although liberal democracy has advanced inclusion for people with intellectual disabilities in the form of de-congregation (although incomplete) and person-centred planning (though limited), neoliberalism has exacerbated exclusion (Treanor, 2020). Neoliberal policies, variably embraced by different societies and contexts, promote a market-led approach, reducing expenditure, deregulation, privatisation and individualism.

Treanor (2020) notes the paradox under neoliberalism, whereby people traditionally considered dependent are expected to be autonomous while simultaneously policies are not advanced to address dependency. That means people with intellectual disability continue to be dominated by the decision-making interests of families, government and service providers. Countering the philosophy of neoliberalism, Treanor (2020) promotes a different vision of flourishing that recognises the inherent vulnerability and interdependency of persons and the idea of common good and emphasises the importance of policy and practice focusing on ‘creating social, emotional and physical spaces of encounter’ (p. 167) where there is physical presence in communities that are not isolating.

Developing friendships outside institutional settings is a challenge for many people with intellectual disabilities. Although people with intellectual disability may list staff members and other professionals among their friends, and without discounting the importance of these relationships (McCausland et al., 2021), they are, nonetheless, qualitatively different than non-commodified/contractual care relationships (Lynch, 2007) because of their ambivalent emotional and ethical boundaries (Hanlon, 2021). Yet, while the aim should be for people with intellectual disability to be afforded opportunities to develop meaningful friendships beyond community presence, such encounters may still be important for people with severe or profound disabilities who have highly complex needs and benefit from greater predictability, consistency and familiarity (McCausland et al., 2022). This requires a supported decision-making culture in services and among professionals (Rogers et al., 2020).

Feminist care theorists such as Fineman (2004) have long argued that the ideal of individual autonomy is a myth because it ignores the reality of human dependency and the societal structures that support it. Fineman advocates for a more collective approach to responsibility, emphasising the state’s role in ensuring care for dependents rather than placing the burden solely on families, particularly women. The caring practices of relational pedagogy are based on the understanding that human relationships are fundamental to our well-being and quality of life, recognising an ontology of interdependence instead of independence and autonomy (Tronto, 1993). Relational pedagogy follows Tronto (2013, 1993) in emphasising the attributes of attentiveness, responsibility, competence and responsiveness along with justice (Hanlon, 2024a). McDonnell (2007, p. 197) notes, while paternalism and expertism reinforce social injustice for disabled people by heightening dependency relations, divisions between social justice and care can be overcome with a broader model of equality that includes care. Good care should ensure both relational, compassionate care and respect for individuals’ rights, autonomy and equality (Barnes, 2005). Relational pedagogy seeks to counter the disempowering tendencies inherent in traditional approaches to care.

IDS can inform the teaching of caring practices in social care education by exposing the power differences between service users and professionals, the dangers of dependency-inducing and institutionalising practices, and by highlighting the importance of creating a broad range of opportunities for people with intellectual disability to develop meaningful affective relations including, but beyond familial, to friendships and social networks. Developing caring practices in social care education requires taking a person-centred approach that appreciates the segregation, institutionalisation, patronising, infantilising, paternalistic and dependency-creating history and tendencies in service provision. In recognising the central importance of professional caring relationships and the qualities and phases of developing them it is also mindful of much wider sets of caring relations across families, friendship groups, workplaces and communities and the challenges and exclusions experienced in trying to access them.

Emancipatory practices

Relational pedagogy recognises the four interfacing sources of social injustice: (1) resources (economic); (2) recognition (status-based); (3) representation (political); and (4) relational (caring) injustices (see Hanlon, 2022). I have expanded on this elsewhere (Hanlon, 2024b) but, in summary, emancipatory practices should deploy resources efficiently and effectively to enhance well-being; promote dignity, respect and recognition for individual and groups; encourage empowerment, representation and participation; and nurture affective relations of love, care and solidarity. In addition, emancipatory practices can drive positive and progressive change across various levels of practice – from direct service user interactions (micro-level) to community and organisational policy (meso-level) and broader institutional frameworks, including national law and policy (macro-level), and to consider objectives from the minimalist (basic) to the maximalist (substantive) (Figure 4). (For a more detailed outline see Hanlon, 2024b.)

Figure 4

The quadrant of emancipatory objectives 

IDS teach us that if relational pedagogy is to promote emancipatory practices, students need to begin by recognising the extent to which people with intellectual disabilities are denied full access to citizenship (Roets and Dean, 2019). The main legal and policy mechanisms for promoting equality and social inclusion for people with disabilities are generally based on human rights, non-discrimination and equality of opportunity discourses, while also recognising the importance of positive action measures that promote accessibility, inclusivity and participation in areas such as housing, accommodation, care, education and training, employment and personal supports. There are various approaches to rights in practice, such as the human rights-based approach (Curtice and Exworthy, 2010) or Browne and Millar’s (2016) seven-dimensional framework of rights for children with intellectual disability based on citizenship and social inclusion, recognition, agency, voice, capabilities, equality and self-realisation.

Whatever approach, advocacy takes centre stage in practice and social care professionals need to understand key debates in advocacy theory and practice to avoid disabling practices. Regressive and reactionary attacks on equality, diversity and inclusion (McFadden, 2025) means workers and agencies need to double down in promoting, protecting and defending even minimal programme policies and practices. More radical approaches would involve reconsidering the normative model of work in capitalist societies or the revaluing of care and interdependency (McDonnell, 2007). Vorhaus (2022), for example, argues that typical views of equality and inclusion often exclude people with profound disabilities by relying on ideas of cognitive ability or contribution. He calls for a broader approach that affirms everyone’s moral worth and supports full participation regardless of capacity. Watson et al. (2004) advocate for an emancipatory model of care that blends disability and feminist perspectives, emphasising interdependence and viewing care as a reciprocal, socially rooted practice, rather than a sign of weakness.

Self-advocacy has become particularly important in promoting empowerment while combatting dependency. Research highlights that participation in peer-led self-advocacy groups enhances social engagement and individual agency, allowing members to voice concerns and influence issues that matter to them (Anderson and Bigby, 2017; Bellon et al., 2024). Such participation has been linked to improved subjective well-being, fostering a sense of autonomy and positive identity (Tilley et al., 2020). Fenn and Scior (2019) note the ‘substantial and wide-ranging positive impact that self-advocacy group membership has on the psychological and social well-being of people with intellectual disabilities’ (p. 1357). Promoting self-advocacy not only fosters independence and dignity but also challenges societal stereotypes, contributing to a more inclusive society (Anderson and Bigby, 2017). CIDS emphasises the importance of self-advocacy and the voices of people with intellectual disabilities in research and policy making, promoting agency and empowerment. Disabling discourses that value productivity under the mantra of inclusion and employability can supplant a rights-based focus on institutional exclusion and social injustice and implicitly devalue unpaid work or other social contribution (Van Aswegen, 2020). CIDS offers a critical lens to deconstruct neoliberal governmentalist practices in education that favour human capital and labour market activation and undermine developmental education as the ‘key to all human capabilities’ (Van Aswegen and Shevlin, 2019, p. 640).

In practice, the role of family and professional advocate overlaps with that of self-advocate. Petri et al. (2020) go further in suggesting the lines between advocacy and self-advocacy are rather blurred in how a range of supportive practices are interwoven in everyday practices in ways that are both essential to speaking up and ancillary to them. What they call para-advocacy amounts to regular and tacit practices, including consuming and producing media content, the use of social media, supporting others or informing and being informed (Petri et al., 2020, p. 216). The challenge for advocacy is to balance support and allyship against reproducing dependency (Parrott, 2013), yet within a context of neoliberalism that values independence and scorns dependency (Gappmayer, 2019).

Creative practices

Creative practices are the skills, methods and innovative approaches to meaningful intervention that promote real choices and opportunities (the normative essence of the equality of condition approach) (see Baker et al., 2004) for all in professional practice. Social care professionals have employed a wide variety of imaginative, innovative and dynamic interventions to support individuals with intellectual disabilities in leading fulfilling lives.

Although the specific contributions of different creative interventions to the model of relational pedagogy are underdeveloped, in a broad sense many approaches have been important in advancing care and social justice. Person-centred planning approaches such as PATH (Planning Alternative Tomorrows with Hope) have been shown to enhance self-determination, inclusion and future-orientated goal setting (Robertson et al., 2007). Effective individual supports require well-resourced, person-centred practice that fosters social inclusion, friendships and well-being (McCausland et al., 2021). This involves actively listening to individuals, focusing on strengths over deficits and collaborating with families, communities and professionals to build holistic support.

Creative practices facilitate co-design and participation that meaningfully involve people with intellectual disability in decision-making about their care, environment and daily lives (Raman and French, 2022). Building Circles of Support fosters natural support networks and encourages active community participation (Forrester-Jones et al., 2006). Universal design for learning principles can ensure accessibility and multiple means of engagement in education and skill-building (AlRawi and AlKahtani, 2022). Arts-based interventions, including music, drama and visual storytelling, have demonstrated benefits for emotional expression, communication and well-being (Hackett et al., 2017; Şahin, 2022). Assistive technologies, such as communication apps and cognitive aids, can improve independence and quality of life, although challenges around access and training remain (Boot et al., 2018; Guedes et al., 2024). Alternative and augmentative communication, visual aids and storytelling enhance understanding and expression. Supportive employment or social enterprises can offer meaningful roles, enhancing self-worth and promoting valued social identities (Hall, 2010).

These types of approach reflect a shift towards relational, rights-based care that centres the aspirations, voice and citizenship of people with intellectual disabilities. IDS heighten the need for us to develop not only a broad range of individual supports such as expressive, artistic, educational and therapeutic approaches, but also address environmental, organisational and community constraints. Creative practices are environmentally aware in adapting and modifying physical and social spaces to improve autonomy, engagement and inclusion. They must be innovative in making small but meaningful changes in routines, activities or service delivery that lead to greater autonomy and choice. They are problem-solving in thinking flexibly to address barriers, whether in accessibility, participation or service delivery. By integrating these creative practices, social care professionals can transform everyday interactions into meaningful opportunities that enhance autonomy, dignity and inclusion for people with intellectual disability.