5th	
  NATIONAL	
  DISABILITY	
  SUMMIT	
  	
  
MELBOURNE,	
  17/	
  18	
  MARCH	
  2014	
  
Effectively	
  Setting,	
  Me...
`I	
  wonder	
  why	
  it	
  wouldn't	
  do?'	
  thought	
  Alice,	
  as	
  
she	
  groped	
  her	
  way	
  among	
  the	
...
Topic	
  points:	
  
• SupporAng	
  people	
  with	
  disability	
  to	
  plan,	
  set,	
  
measure,	
  and	
  review	
  g...
GAS:	
  goal	
  attainment	
  scale	
  
• based	
  on	
  a	
  medical	
  framework	
  of	
  understanding	
  
disability	
...
Who	
  tracks	
  the	
  trackers?	
  
Numbers	
  cannot	
  be	
  understood	
  without	
  
probing	
  how	
  they	
  are	
...
Quality	
  of	
  life	
  vs	
  Outcomes	
  
Measures	
  obey	
  the	
  law	
  of	
  the	
  hammer:	
  Give	
  a	
  
small	...
Capability	
  Approach	
  
Expansion	
  of	
  capabiliAes	
  and	
  equity	
  in	
  capabiliAes	
  
are	
  needed	
  for	
...
Stocktake	
  
In	
  working	
  towards	
  our	
  common	
  goal	
  of	
  a	
  be9er,	
  
more	
  inclusive	
  society	
  f...
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Donna Mc Donald

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Donna Mc Donald

  1. 1. 5th  NATIONAL  DISABILITY  SUMMIT     MELBOURNE,  17/  18  MARCH  2014   Effectively  Setting,  Measuring  and   Evaluating  Outcomes:    The  Capability   Approach  -­  an  alternative  perspective   Dr  Donna  McDonald   Griffith  University  
  2. 2. `I  wonder  why  it  wouldn't  do?'  thought  Alice,  as   she  groped  her  way  among  the  tables  and  chairs,   for  the  shop  was  very  dark  towards  the  end.  `The   egg  seems  to  get  further  away  the  more  I  walk   towards  it.  Let  me  see,  is  this  a  chair?  Why,  it's  got   branches,  I  declare!  How  very  odd  to  find  trees   growing  here!  And  actually  here's  a  liEle  brook!   Well,  this  is  the  very  queerest  shop  I  ever  saw!‘   Lewis  Carroll  Through  the  Looking  Glass  Chapter  5  -­‐  Wool  and  Water  h9p:// www.literature.org/authors/carroll-­‐lewis/through-­‐the-­‐looking-­‐glass/ chapter-­‐05.html  
  3. 3. Topic  points:   • SupporAng  people  with  disability  to  plan,  set,   measure,  and  review  goals  is  criAcal.   • How  can  providers  develop  the  capacity  to  track   outcomes  for  the  people  they  support?   • What  are  the  challenges  of  measuring   outcomes?   • HighlighAng  the  value  of  Goal  a9ainment  scaling   (GAS).  
  4. 4. GAS:  goal  attainment  scale   • based  on  a  medical  framework  of  understanding   disability  experiences:   • this  does  not  sit  comfortably  alongside  the  socio-­‐ economic  and  poliAcal  frameworks—including  the   Sen-­‐Nussbaum  CapabiliAes  Approach—within  which  I   pracAce.   • described  as  an  individualized  approach  for  establishing   and  measuring  the  a9ainment  of  goals  for  a  diverse   populaAon  of  clients  with  varying  levels  of  disability  and   support  needs:   • provides  a  numerical  schema  for  measuring  the   a9ainment  or  non-­‐a9ainment  of  changes  or  “success”   in  a  client’s  performance.  
  5. 5. Who  tracks  the  trackers?   Numbers  cannot  be  understood  without   probing  how  they  are  produced.  What  and   why  are  they  counAng,  measuring,   evaluaAng    .  .  .  and  for  whom?     In  the  NDIS  world  of  person-­‐centredness   and  choice  a  more  appropriate  quesAon  is:   •   How  can  people  with  disabiliHes  develop   the  capacity  and  skills  to  evaluate  the   supports  or  services  for  which  they  have   negoHated  and  purchased  from  providers?  
  6. 6. Quality  of  life  vs  Outcomes   Measures  obey  the  law  of  the  hammer:  Give  a   small  boy  a  hammer  and  he’ll  find  plenty  of  things   that  need  pounding.   In  this  context,  let’s  explore  the  CapabiliHes   Approach  as  a  more  progressive  way  of   measuring,  assessing  and  evaluaAng  that  which   needs  to  be  measured,  assessed  and  evaluated.  
  7. 7. Capability  Approach   Expansion  of  capabiliAes  and  equity  in  capabiliAes   are  needed  for  a  person  to  parAcipate  fully  and   flourish  in  society.  The  capability  approach  allows   us  to  examine  how  changes  affect  a  person’s  well   being  and  agency.    (Sen).   “abiliAes  to  take  part  in  …  fundamental  human   experiences,  and  to  live  a  good  human   life…”  (Nussbaum).   See  more  at:  Human  Development  and   CapabiliAes  AssociaAon  (HDCA)  at  hEp://hd-­‐ ca.org/  
  8. 8. Stocktake   In  working  towards  our  common  goal  of  a  be9er,   more  inclusive  society  for  all—including  people   with  disabiliAes—we  need  to  be:   • responsive  to  the  policy  paradoxes  inherent  in   such  goals  as  equity  and  efficiency,  and   “soluAons”  such  as  rights  and  powers  that  can   confuse,  bewilder  and  divert  us  from  the  main   game.     • Vigilant  to  quesAons  that  are  framed  in  such  a   way  that  we  risk,  yet  again,  falling  into  the   looking  glass,  darkly.  
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