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Models of Disability

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  1. Models of Disability Oct 1st, 2008

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

  3. Definitions • Impairment • Handicap • Disability

  4. Impairment: • Refers to physical or mental limitations such as difficulty walking • Represents a deviation from the person's usual biomedical state.

  5. Impairment: • When does physical / mental variation become an impairment?

  6. What is the difference between: • Impairment • Illness / “being sick” • Chronic Health Conditions?

  7. MIND / BODY STATE (Condition) Minimal Expected Variation State Unexpected Variation (DISABILITY) Minor Variation DEATH BIRTH Minor Variation Unexpected Variation (DISABILITY) Impairment (aches/pains, illness/sick/injury, chronic illness/disease, short/tall, manic/depressed…. ) =Variation

  8. Handicap • Different meanings throughout time and situation… • The disadvantage experienced by a person as a result of impairments (Now considered offensive)

  9. 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.

  10. 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)

  11. Impairment Handicap Disability Sequence of ConceptsWHO 1980 Disease or disorder ---------------------------------------------------------------------------------- impairment at the organ level disability at the person level handicap at the societal level

  12. WHO 2001 • Disability : • outcome or result of a complexrelationship between an individual’s: • health condition • personalfactors • external factors

  13. Body function&structure (Impairment) Activities (Limitation) Participation (Restriction) Environmental Factors Personal Factors Interaction of Concepts WHO 2001 Health Condition (disorder/disease)

  14. 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.

  15. 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

  16. Where is the subjective (QOL)?

  17. Other classification systems • DSM IV • ICD

  18. 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 engage independently in some or all aspects of day-to-day life.”

  19. 67 US acts / programs that define disability • 35 have self-contained definitions (although some contain more than one definition)

  20. 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”)

  21. Which definition do you choose? • Obviously no one has this figured out…

  22. Models of Disability • Moral • Personal Tragedy • Medical • Social

  23. 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

  24. Moral Model (cont.) • 2nd part of moral model: • Character weakness • Corruptness • Immoral-ness • Examples: villains in movies, refrigerator mothers, faking, unmotivated

  25. 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

  26. 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

  27. 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

  28. Disability Activists (UK)1976(UPIAS - Union of Physically Impaired Against Segregation) • Disability: • “the disadvantage or restrictionof 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”)

  29. Social Model States that inappropriate and discriminatory • Social Attitudes (Ableism), • Sociopolitical Structures, and • Cultural Phenomena are the central problem for disabled people

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

  31. 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

  32. Social Model Variants - Social (Construction) • US • Assumes that inappropriate and discriminatory social attitudes and cultural phenomena are the central problem for people with impairments

  33. 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

  34. 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

  35. 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.

  36. 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)

  37. "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

  38. Social Model Variants – Dismodern Theory • L. Davis • Sees imperfection as the norm • Normal is a fairly new term…

  39. Social Model Variants – Summary • 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

  40. Initially: Social model tries to breaks the bio-medical chain of causation: Impairment Disability Why was this strategically important to DRM (Disability Rights Movement)?

  41. 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

  42. Models – Summary • Problem is the Individual • Moral • Personal Tragedy • Medical • Problem is Society • Social

  43. Why should we care? • How Disability Is Defined Determines What Is Measured • Policy implications • Allocation of resources