Models of Disability

Oct 1st, 2008

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Review of Last Class
 Language
 Person First Language
 Pride Language
 Basic Concepts
 Ablism
 Overcoming
 Pity
 Super Crip
 Definitions
 Impairment
 Handicap
 Disability

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Definitions

 Impairment

 Handicap

 Disability

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Impairment:

 Refers to physical or mental limitations such

as difficulty walking

 Represents a deviation from the person's

usual biomedical state.

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Impairment:

 When does physical / mental

variation become an impairment?

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What is the difference between:

 Impairment

 Illness / “being sick”

 Chronic Health Conditions?

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 MIND / BODY STATE (Condition)

Unexpected Variation
(DISABILITY)

Minor Variation

Minimal Expected Variation State

Minor Variation

Unexpected Variation
(DISABILITY)
Impairment (aches/pains, illness/sick/injury, chronic illness/disease,
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short/tall, manic/depressed…. ) =Variation
Handicap

 Different meanings throughout time and

situation…
 The disadvantage experienced by a person
as a result of impairments

(Now considered offensive)

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Disability

 Oh so many definitions…
 Let’s start with the legal (US) definition:

 ADA (Americans with Disabilities Act):

 (1) has a physical or mental impairment that
substantially limits a major life activity,
 (2) has a record of such an impairment, or
 (3) is regarded as having such an impairment.

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 World Health Org. (WHO) 1980

 Disability
 Restriction or lack (from an impairment) of ability
considered normal for a human being

 Handicap
 The disadvantage experienced by a person as a result of
impairments

*ICIDH-1 (1980)

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 Sequence of Concepts
WHO 1980

Disease
or Impairment Disability Handicap
disorder

----------------------------------------------------------------------------------
impairment at the organ level
disability at the person level
handicap at the societal level
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WHO 2001

 Disability :
 outcome or result of a complex relationship
between an individual’s:
 health condition

 personal factors

 external factors

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 Interaction of Concepts
WHO 2001
Health Condition
(disorder/disease)

Body Activities Participation

function&structure (Limitation) (Restriction)
(Impairment)

Environmental Personal
Factors Factors
Classifying
classification b11420 Hierarchy:
b Bodily structures
b1 Mental functions
b11 Global mental functions
b114 Orientation functions
b1142 Orientation towards others
b11420 Orientation towards one-self.

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Quantifying
Quantifying functionality:
0-4% 0 No impairment
5-24% 1 Light impairment
25-49% 2 Moderate impairment
50-95% 3 Serious impairment
96-100% 4 Total impairment
8 Non specified
9 Non applicable

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Where is the subjective (QOL)?

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Other classification systems
 DSM IV
 ICD

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Review of some of the definitions:
 ADA
 An individual with a disability is defined as a person who has a
physical or mental impairment that substantially limits one or
more major life activities
 a person who has a history or record of such impairment,
 or a person who is perceived by others as having such
impairment.

 ICF
 Disability is an umbrella term for impairments, activity
limitations or participation restrictions.
 Environmental and personal factors influence all aspects of
health, functioning and disability.

 Surgeon General July 26, 2005

 “… disabilities are characteristics of the body, mind, or senses
that, to a greater or lesser extent, affect a person’s ability to 18
engage independently in some or all aspects of day-to-day life.”
 67 US acts / programs that define disability
 35 have self-contained definitions (although
some contain more than one definition)

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Disability Activists (UK)1976
(UPIAS - Union of Physically Impaired Against Segregation)

 Disability

 “the disadvantage or restriction of activity caused

by a contemporary social organization which
takes no or little account of people who have
physical impairments and thus excludes them
from the mainstream of social activities”

 Changes the focus of disability away from the

individual to Society. (1st articulation of the “Social
Model of Disability”)

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 Which definition do you choose?
 Obviously no one has this figured out…

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Models of Disability
 Moral
 Personal Tragedy
 Medical
 Social

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Moral Model
 Two Parts
 Religious and Spiritual origin
 Punishment from God (ie: due to displeasure)

 Evil spirits (possessed)

 Witchcraft
 Bad Karma (did something evil in the past)
 Gift from God (cross to bear, angelic)
 Character weakness
 Corruptness

 Immoral-ness

 Examples: villains in movies, refrigerator mothers,

faking, unmotivated

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Moral Model (cont.)
 2nd part of moral model:
 Character weakness
 Corruptness

 Immoral-ness

 Examples: villains in movies, refrigerator mothers,

faking, unmotivated

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Personal Tragedy Model
 Disability is considered a tragedy
 Society needs to take care and protect
persons with disabilities
 If someone with a disability achieves
something that a “normal” person does, then
the person with a disability is looked at as
inspirational (super crip)
 This is often mixed with the Moral and
Medical Models
 Examples: inspiration news story, telethons,
charities
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Medical Model
 An individual with a disability has a physical
or mental impairment
 The disability is within a person
 Focus is on minimizing or eliminating the
impairment
 Examples: think bell curve, rehabilitation,
pharmaceuticals

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Social Model
 Instead of disability originates within the
person, disability originates from society
 Disability results from barriers in society and
the environment
 Physical barriers
 Attitudinal barriers

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 Disability Activists (UK)1976
(UPIAS - Union of Physically Impaired Against Segregation)

 Disability:
 “the disadvantage or restriction of activity caused by a
contemporary social organization which takes no or
little account of people who have physical impairments
and thus excludes them from the mainstream of social
activities”

 Changes the focus of disability away from the individual to

Society. (1st articulation of the “Social Model of Disability”)

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Social Model

States that inappropriate and discriminatory

 Social Attitudes (Ableism),
 Sociopolitical Structures, and
 Cultural Phenomena
are the central problem for disabled people

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Social Model Variants

 Social (Creation)- UK
 Social (Construction)- US
 Minority (Political/Cultural)
 Independent Living Model- ILM
 Human Variation
 Post-Modern / Dismodern

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Social Model Variants - Social (Creation)

 UK
 The historical convergence of industrialization
and capitalism as restricting impaired people’s
access to material and social goods, which
results in their economic dependency and
creates the category of disability
 Marxist and materialist interpretation of the
world

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Social Model Variants - Social (Construction)

 US
 Assumes that inappropriate and discriminatory
social attitudes and cultural phenomena are
the central problem for people with
impairments

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Social Model Variants - Minority

 Inappropriate and discriminatory social

attitudes, sociopolitical structures - cultural
phenomena are the central problem for
disabled people
 political based used to counter discrimination
and advocate for civil rights
 disABILITY identity / Pride / Culture

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 Social Model Variants –
Independent Living Model (ILM)

 States that current sociopolitical structures

produce access barriers for and dependency in
impaired people resulting in disability

 is based on a consumer driven movement that

fosters autonomy, self-help and the removal of
societal barriers and disincentives

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Social Model Variants – Human Variation
 Universal Design
 re-think= The built environment; economic,
social, cultural, and political entities including
organizations that provide employment,
education, health care, transportation,
communication, and the full range of public
services.

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Social Model Variants – Postmodern Theory
 sees disability as constructed via discursive
practices (Talk / write=create disability)
 perceives disability identity as fluid and its
boundaries dependent on context and the
dynamic interaction of other self-identities
 emphasizes a dialogic relation between
impairment and disability (not an analytical
privileging of one over the other)

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"Through framing disability,
through conceptualizing,
categorizing, and counting
disability, we create it.”

Higgins, Paul. (1992) Pp. 6-7 Making Disability: Exploring the Social
Transformation of Human Variation. Springfield, Il: Charles C. Thomas

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Social Model Variants – Dismodern Theory

 L. Davis
 Seesimperfection as the norm
 Normal is a fairly new term…

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Social Model Variants – Summary

1. disability is restricted activity (caused by

social barriers)
2. disability is a form of social oppression
3. disability is created by categorizing
bodies/minds as normal or abnormal

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Initially: Social model tries to breaks the bio-
medical chain of causation:
Impairment Disability

Why was this strategically important to DRM

(Disability Rights Movement)?

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While the social model redefines “disability,” it
stops short of questioning the status of
“impairment”

 Impairment is a necessary condition for

disability.
 Impairment is a “real entity,” a condition of the
body, which remains the exclusive domain of
medical interpretation and/or intervention.
 Minimizes the experience of impairments

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Models – Summary

 Problem is the Individual

 Moral
 Personal Tragedy
 Medical

 Problem is Society
 Social

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Why should we care?

 How Disability Is Defined Determines What Is

Measured
 Policy implications
 Allocation of resources

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