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The rationale for this study was the need to bring a social science perspective to developing approaches for person-centred outcome measures in rehabilitation settings for older people. To date this field has largely been dominated by clinicians and the biomedical model of impairment, disability and handicap. Qualitative methods (findings from focus group discussions informed later focus interviews with individuals) were used to establish and explore the views of older people about a range of issues linked to conceptualising outcome, including participating in decisions regarding their health, to examine how older people made judgements, what they valued and prioritised, what their expectations were, how care was experienced and how changes are sustained over time. Symbolic interactionism and grounded theory provided the overall theoretical approach to the methods used. A distinction is made between older people's 'public' and 'private views'. This analytical distindon provides the framework within which the accounts are explored and presented in the thesis. The public accounts focus on the social and moral obligations associated with the experience of being an older citizen. The thesis explores the role of reciprocity, justice and conscience in these accounts. The private accounts reveal the wide range and diversity of opinion and experiences that exist. Three groups of people were identified: empowered, reluctant collaborators; and dominated. It is argued that future best practice for outcome evaluation in health and social care professionals will need to explore the private views of older people in greater depth. Institutionalised ageism and structured dependency are major barriers to empowering older people to participate in identifying outcomes. Until these issues are recognised and resolved, more meaningful participation in the identification and method of assessment of outcomes is unlikely. The findings should be of relevance to researchers, to users of health services and to clinicians working in rehabilitation settings for older people.

Sport is a cultural phenomenon that has spread throughout the world (Harvey & Houle, 1994). For youth, sport is perceived as a context that can play a major role in person’s psychosocial development across their life-span (Danish, Petitpas, & Hale, 2007). However, despite the increase in research in this field, very little work has examined how sport may play a role in the psychosocial development of youth with intellectual disabilities (ID). Moreover, an area of study that has also grown related to the lived experiences of individuals living with a disability including ID is social inclusion (SI). Similar to research related to psychosocial development, very little research has been conducted to examine whether the context of sport can foster social inclusion for youth with ID. Special Olympics Canada (SOC) is an organization “dedicated to enriching the lives of Canadians with an intellectual disability through sport” (SOC, 2010, “SOC Mission Statement”, para.1) and may be an organization that has the potential to positively impact the lives of its youth participants. Thus, the purpose of this research was to examine whether stakeholders perceived SO as impacting the psychosocial development and social inclusion. The results indicated that SO, by all stakeholders, is perceived as an organization that is facilitating the psychosocial development of its athletes through the incorporation of strong social support networks and the development of life skills. In addition, SO was perceived as facilitating social inclusion for youth, particularly in the context of school and their surrounding community.

In this thesis, I use Foucault’s methods of discourse analysis and genealogy, and my own experiences as a Paralympic athlete, to analyze and critique the power relations of the Paralympic Movement. In Chapter 1, I contextualize my study by discussing relevant literature in Critical Disability Studies, Sociology of Sport and Adapted Physical Activity, and by introducing my methodological and epistemological frameworks. In Chapter 2, I analyze two historical accounts of the Paralympic Movement to demonstrate how they discursively represent, reproduce and justify Paralympic power relations. In Chapters 3 through 5, I use genealogy to critique Paralympic power relations: analyzing their systems of differentiation, types of objectives, instrumental modes, forms of institutionalization and degrees of rationalization. This analysis brings to the forefront how discourses of empowerment reproduce, justify and conceal the increasingly rationalized structures that enable Paralympic experts to act upon the actions, bodies and identities of those experiencing disabilities.

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