Abstract
This paper explores contradictions of care that emerge as mothers raising children with Down syndrome in Amman encounter therapeutic paradigms of early intervention (al-tadakhul al-mubakkir). Early intervention encompasses a constellation of physical, speech, and occupational therapy programs designed to address the needs of children who experience or are at-risk for developmental delays. Most children with Down syndrome have low muscle tone, which can affect developmental milestones like crawling, grasping, walking, and speaking. As such, they are prime candidates for early intervention services. By cultivating an objectifying and progress-oriented gaze, early intervention invests young children with seemingly limitless potentiality. But what complications arise, and for whom, when bodies are framed as capable of endless progress?
Across the Middle East and North Africa (MENA), one particular model of early intervention, the Portage program, has proven especially popular since it was first introduced in the mid-1980s (Faour et al. 2006). Although its efficacy remains disputed (Oakland 1997), the program offers low-tech and low-cost solutions by training mothers to work with their children at home, using everyday household items and activities as therapeutic tools. During fieldwork conducted in Amman between 2013 and 2015, I watched mothers largely embrace early intervention training (tadrib) as empowering and not radically different from other pedagogical sensibilities that shape local approaches to child development. Yet mothers also struggled to navigate their own positionality within this new therapeutic nexus.
In thinking through the ways that therapeutic regimes intervene in forms of embodied knowledge, I draw from Marcel Mauss’s concept of “techniques of the body” (1968). Mauss stressed that all techniques of the body are acquired through informal modes of teaching and learning. But what happens if we instead foreground techniques of the body as uncertain outcomes of care? Anthropologist Lisa Stevenson describes care as “the way someone comes to matter and the corresponding ethics of attending to the other who matters” (2014, 3). In the presence of childhood disability, mothers learned to reassess their children’s “natural” skills as well as their own methods of mothering. Transmitting techniques of the body became sociotechnical projects with heightened moral stakes, and they took shape through exercises, drills, checklists, and evaluations. Yet children’s bodies did not always conform, and moments of “failure” raised questions about bodily difference, acceptance, and the limits of care.
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