British Journal of Learning Disabilities Vol. 23 (1 995) - 33

An Observational Case Study of Staring Behaviour

John Fallon, 18 Green Lane, Padgate, Warrington, WA1 4JA.

This paper describes the use of empirical data to test a popularly-held subjective view of the attitude of a man with learning disabilities towards children fol- lpwing incidents involving attacks on children after his resettlement into the community from long-term institutional care. An heuristic was developed making use of a marked behavioural trait, i.e. his propensity to stare. Relative instances of this behaviour directed towards adults and children respectively were recorded during a sample of twenty-four, one-hour sessions. A statistical analysis of the recorded data revealed no sig- nificant difference between attention paid to adults and to children. The observers, therefore, concluded that it was unreasonable to assume an unhealthy pre- occupation with children.

Introduction The principle of normalisation underlies much current

thinking among the agencies responsible for the care of people with learning disabilities. The widespread clos- ure of long-term institutions for people with learning disabilities reflects a change in society’s attitude towards such people and their resettlement into the community provides an opportunity to examine these attitudes in practice. Wolfensberger (1983) a major proponent of the normalisation principle, identified a particular problem which could tend to segregate resettled individuals from the wider community.

He suggests: ‘A person can be considered ”deviant” or devalued when a significant characteristic (a difference) of his/hers is negatively valued by the segment of society that constitutes the majority or that defines social norms.’ (p. 23). According to Lemert (1951) in his formulation of ‘societal reaction theory’ (colloquially, ’labelling theory’) such a definition would constitute an example of primary deviance.

Lemert makes a distinction between this initial label and secondary deviance which is defined by societal reac- tions to the behaviours of the persons thus labelled. In these terms a learning disability, which may be coupled with a physical stigmata, such as those associated with Downs Syndrome or a circumstantial stigma, for exam- ple time spent in an institution, may be regarded as pri- mary deviance. This paper seeks to illustrate, through

the medium of a single case study, an example of a label- ling process and describes the use of objective data col- lection and analysis to test the validity of a secondary label.

Case History Paul is a 41-year-old man who was resettled into the

community in March 1990, having lived for twenty-four years in Calderstones Hospital. Within four months of his return to the community, two incidents occurred where Paul attacked young children. On the latter occasion the parent threatened to sue. The social services network responsible for resettlement, fearing the nega- tive effects that bad publicity carried for the future of the resettlement programme, made an out-of-court settlement. The implications for Paul’s future in the com- munity were also serious. A worse-case scenario involv- ing the recurrence of his abberant behaviour could, con- ceivably, lead to his being sectioned under the terms of the Mental Health Act (1983). Notwithstanding the latter possibility, the present situation has serious implications for Paul’s future.

Paul lives in a small, two-bedroomed house with two other men recently resettled from long-term, insti- tutional, care. Twenty-four hour cover is provided. Scheduling problems among the paid staff, in the normal course of events, raise serious doubts as to the suitability of the situation, including the rights of the residents to proceed beyond the confines of the house. In Paul’s case this situation is exacerbated by a further constraint on his freedom that was imposed by management after receiving legal advice. This requires that Paul be accompanied at all times by two members of staff on any excursion outside the house. The case was referred to the local Community Support Team. The team works specifically with people with learning disabilities. The focus of thehervention has been to observe and analyse Paul’s behaviour in a variety of contexts, for example, going shopping, where he will encounter people of all ages. This has involved outings with two team members, typically on a twice-a-week basis. The obvious questions which the intervention addresses are: why has Paul acted in this way; what is the likelihood of a recurrence; how may a recurrence be prevented? However, at a more fundamental level, the question as to whether Paul has an unhealthy pre-occupation with children needs to be addressed. It is evident that the residential social

34 British Journal of Learning Disabilities Vol. 23 (1 995)

workers believe this to be the case. This is not really sur- prising from the point of view of individuals with pri- mary responsibility for Paul’s actions. In the case of those staff members who were actually involved in the incidents described above, the issue has a particular salience.

There is little past evidence to cast light on Paul’s attitude towards children except for one potentially damning entry in his file which records that he was ’particularly hostile towards children when he was first admitted’. There is, also, an entry which refers to his tendency to hit other patients. The combination of the subjective view of staff, supported by a file entry, plus a management tendency to err on the side of caution has produced a labelling process that could have severe repercussions for Paul and his future in the community.

Rationale Tversky & Kahneman (1990) refer to a ‘judgemental

heuristic’ known as ’Availability’. This explains how judgements about the probability of events occurring are influenced by the relative ease with which examples of such events can be summoned from memory. Any experience which increases the salience of an event, and therefore makes it more easily accessible, will tend to affect a person’s judgement about the likelihood of a similar event happening. For example, the perceived probability of a traffic accident occurring is likely to be increased for a person who has recently witnessed a car crash. Whilst judgemental heuristics have a certain com- mon sense value in everyday decision-making, they are seriously limited in that they are prone to systematic errors and biases. In Paul’s case an heuristic needed to be developed to provide a less subjective view. There was little to be gained in assessing Paul’s attitude by talking to him, as his expressive language is very lim- ited. It seemed more profitable to analyse his actions. In this regard, a considerable period of naturalistic obser- vation had revealed a particularly marked trait; Paul had a tendency to stare at people and to be seemingly unaware of any social inhibitions regarding this action. This trait was well-known by the staff and it is note- worthy that this had become incorporated into their view of Paul. One staff member could not contemplate a relaxation of the status quo because, ’I’ve seen the way he stares at kids’. The observers reasoned that, if Paul was obsessed with children, that this would be reflected in the attention paid to them.

Hypothesis The null hypothesis (Ho) proposed that there is no sig-

nificant difference between the attention paid to children and the attention paid to adults as expressed by the fre- quency of instances of staring behaviour.

Method Staring behaviour was defined as, ’A fixed gaze in

excess of three seconds directed at another individual’. Argyle (1990) defines gaze as: ’Glances, typically of two to three seconds.’ (p. 153). The average length of ’mutual gaze’ is given as, ’. . .typically, about one second’. (p.154). Argyle notes that gaze directed at strangers in public places is often interpreted as either a threat signal,

or a bizarre piece of rule-breaking. In addition to the function of gaze as a non-verbal signal for the recipient, Argyle stresses its importance as an information-gather- ing channel for the gazer.

For the purposes of this study, all gazes in excess of three seconds directed at individuals (effectively strangers) during the sampling frame were recorded. An initial sampling frame of six one-hour sessions was established followed by three additional blocks of six, totalling twenty-four one-hour sessions. The observers defined specific roles during sessions. One observer, who had completed a Home Office approved course in applying physical restraint, took sole responsibility for intervention, should it prove necessary, to prevent inci- dents. The second observer took responsibility for rec- ording instances of staring behaviour.

The observations were to be as unobtrusive as poss- ible. Instances were marked in pencil on a small rec- ording sheet. The three-second intervals were achieved by the recording observer counting to himself, ’One- million, two-million, three-million’. A reliability study was introduced at a later stage to test for observer bias.

Venues were chosen on the basis of availability of people of a sufficiently mixed age-range. A venue in reg- ular use was a local supermarket where Paul was used to shopping. Managers at the supermarket were approached and they advised that Mondays between the hours of 11 am and 2 pm yielded a fair mix of adults and young children. Other venues included streets in the centre of Manchester and the Arndale Centre.

The problem of a cut-off point in deciding the adult/child status of individuals was discussed and a few instances arose where the observers were required to consult and make on-the-spot judgements. However, such instances were relatively few and it was felt that these were unlikely to systematically bias the data.

The possibility of reactivity on the part of the person being observed was considered. Paul showed no signs of awareness of being observed, probably as a result of the low-key nature of the observations. Furthermore, the systematic collection of data only began after a consider- able period of naturalistic observations during which the two observer’s became well-known to Paul and the twice-a-week outings had become part of his normal routine.

Results The observational data are summarised in Table 1.

Each set of six consecutive observations was treated as a sample and statistically analysed. The Wilcoxon Signed Rank Test was used to compare the frequency of stares at children and stares at adults lasting 3 seconds or more (Table 2). Secondly, all twenty-four observations were treated as a sample and a paired t-test was applied. This may be regarded as the parametric equivalent of the Wil- coxon Signed Rank Test. All probabilities are two-tailed.

Reliability study An extra observer was recruited for the samples of

22-2-91 and 14-3-91. The data collected by this observer was correlated with the data collected by the regular observer. The method used was Pearson’s Y and a corre- lation of 0.96 was obtained suggesting a good measure

British Journal of Learning Disabilities Vol. 23 (1995) - 35

Table 1 Frequencies of stares of 3 seconds or more in any one hour of observation

Date Children Adults

~

Date Children Adults

Sample 1

Sample 2

8-1 0-90 29-1 0-90 1-1 1-90 5-1 1-90 8-1 1 -90

12-1 1-90

mean scores standard deviations

16-1 1-90 22-1 1 -90 26-1 1-90 6-1 2-90 7- 1-91

24- 1-91

mean scores standard deviations

24 12 22 23 19 14

19 6.8

15 24 26 25 15 9

19 7.2

8 7

13 10 20 13

11.8 4.3

15 14 14 13 15 9

13.3 2

Sample 3 28-1-91 3-2-91

18-2-91 22-2-91 25-2-91 4-3-9 1

mean scores standard deviations

Sample 4 7-3-91

14-3-91 18-3-91 25-3-91 1 5-4-9 1 2-5-91

mean scores standard deviations

29 1 1 9 18 9 18 5 21 9 25

15 36

12.6 21.5 7.9 7.7

10 17 12 23 16 27 18 22 16 45 21 19

15.5 25.5 3.6 9.3

Table 2 Comparison of stares lasting 3 seconds or more at children and adults for each block of observations

(a) Wilcoxon Signed Rank Tests

Sample 1 Sample 2 Sample 3 Sample 4

Marginal Not Not Significant P = 0.059 P = 0.108 P = 0.248 P = 0.046

significance significant significant

(b) Paired t-test for combined data

P = 0.555 Not significant

Table 3 Inter-observer reliabilities: Number of stares recorded by 1st and 2nd observer

22-2-91 14-3-91

1 st observer 2nd observer 1 st observer 2nd observer

Child Adult Child Adult Child Adult Child Adult

5 21 6 17 12 23 9 23

of agreement. Raw data from these observations are given in Table 3.

Discussion The findings of the initial sample of six observation

sessions suggest that there may be cause to suspect that

children did indeed provide a focus for Paul's attention. However, the only other occasion when statistical sig- nificance obtained was in Sample 4 when more stares were directed at adults. Analysis of the combined data from all four samples failed to show any statistically sig- nificant preferences in Paul's staring.

Subsequently a meeting was held with staff and their line-manager, where the case for restrictions on Paul's movements was reviewed. The evidence compiled dur- ing the series of observations was crucial in satisfying staff that Paul was not obsessed with children. As a consequence of the findings of this meeting a decision was taken at a higher managerial level to lift the restric- tions on Paul's movements.

This study was part of the information-gathering pro- cess of a psychological intervention and as such its limits need to be acknowledged. For instance, only one meas- ure of respective interest in adults or children was recorded, namely, relative frequency of stares. A more elaborate data-gathering method to include relative length of stares would have provided useful additional data. However, an essential point was made, in that empirical method can and does have a function of chal- lenging a labelling process on behalf of individuals who are not in a position to mount such a challenge for them- selves.

The crude nature of the data collection would seem justified by the consideration that it be unobtrusive. A more elaborate method could serve to: (a) draw unwar- ranted attention to the subject, and (b) possibly provoke greater interactions between the subject and persons encountered during the observations as a result of that attention. The need for unobtrusive data collection also supports the use of the three-second counting device described above. A visual aid, such as a stop-watch would probably draw attention to the observations.

36 - British Journal of Learning Disabilities Vol. 23 (1 995)

If normalisation is to be achieved the conditions for achieving it should, by definition, be as normal as poss- ible. It is only by constant exposure to their new social world that changes will be wrought in previously insti- tutionalised individuals. This process can be seriously hindered if the effects of labelling encourage the restric- tive coping strategies associated with the institutions.

There were three elements from the psychologist's armamentarium at work in this study:

(1) knowledge of labelling theory, (2) use of empirical data-collecting method, and (3) analysis of data using statistical method.

The latter two are specialist tools. The former should be the sort of information made known to staff working with people with learning disabilities through training. However, this would not of itself be a panacea. In-house myths can be powerful and reinforced from within parti- cularly in the sort of trying situation in which people working with people with learning disabilities may find themselves. In such a situation an outside agent may be better placed to take an objective view.

References

Argyle, M. (1990) Bodily Communication. London: Routledge. Lemert, E. (1951) Social Pathology. New York McGraw-Hill. Mental Health Act (1983) London: HMSO. Tversky, A. and Kahneman, D. (1990) Judgment under

uncertainty. In D. Kahneman, P. Slovic and A. Tversky (eds) Judgement Under Uncertainty: Heuristics and Biases. Cambridge: Cambridge University Press.

Normalisation Goals. Toronto: NIMR. Wolfensberger, W. (1983) PASSING: Implementation of

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Judith McBrien is a Principal Clinical Psychologist with Plymouth Health Authority David Felce is the Director of Research for Mental Handicap in Wales and a former Director of BILD.

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