Disability Models and the Capability Approach Sophie Mitra Fordham University mitra@fordham.edu Conference on Inclusive Education for Children with Disabilities Moscow, 27 September 2011

Models used to Define Disability - The Medical Model - The Social Model - The Nagi Model The ICF (International Classification of Functioning, Disability and Health)

The Medical (or Bio-Medical) Model The medical model considers disability as a problem of the individual that is directly caused by a disease, an injury or other health conditions. The medical model locates the problem with the person. A person is in the ‘sick role’ (Parsons, 1975). This model is strongly normative. The major concern at the political level is to provide health care and rehabilitation services.

The Social Model Disability is not a problem of the individual, it is a problem created by the social environment and requires social change. This model has many different versions. We review briefly below two versions. The UK social model: At the heart of this model lies societal oppression (Oliver, 1990).

The Social Model (Cont.) The oppressed minority model. Persons with disabilities face discrimination and segregation through barriers in the environment. Their experiences are therefore perceived as similar to those of an oppressed minority group. Social inequalities encountered by persons with disabilities are considered as similar to those encountered by other minorities (Hahn, 2002, p. 171).

The Nagi Model The Nagi model is widely used in the economics of disability field. It identifies functional limitations as the restrictions that impairments impose on the individual’s ability to perform the tasks of his or her roles and normal daily activities. Disability is a social construct. For instance, a 12-year old girl with mental retardation does not attend school, she stays home with her parents helping with household chores.

The ICF model

The Capability Approach: What it is ‘Capability’ as ‘practical opportunity’, ‘ability to achieve’ ‘Functioning’ as ‘activity’, ‘actual achievement’ Achievements vs. Freedoms Use of capability approach in development and welfare economics, for evaluation of well being and poverty in particular. Read up on what Sen means by achievements and freedoms. – KIM – TIE INTO CAPABILITY. Jeanne will consider proper wording for it.

How can the Capability Approach help us Define Disability?

Under the Capability Approach: Disability has been defined in terms of capability or functioning deprivation (Burchardt 2004; Mitra 2006; Morris 2009; Terzi 2005; Welch 2007) Disability occurs when an individual is deprived of practical opportunities or functionings as a result of an impairment or health condition.

The Capability Approach allows us to differentiate between: Potential Disability is a Capability Deprivation, a reduction in the range of practical opportunities. Actual Disability is a Functioning Deprivation, a reduction in the valuable doings and beings of the person.

The Capability Approach is a holistic approach It accounts for the variety of factors that may lead to disability. In particular, the Capability Approach recognizes that poverty can be the cause of disability.

The Determinants of Capabilities and Functionings Social and Cultural Environment (law, custom, policy, regulation, representations) (affects slope of gradient) Capability Set Resources and Commodities locally valued beings and doings Choices Actual Functionings individual and collective owned and shared + Personal Capacity Opportunity Gradient (human capital, drive, impairment, gender, race, ethnicity) 13

Other advantages of the Capability Approach: It assesses disability at two levels: capabilities and functionings. It recognizes that the selection of dimensions of capabilities or functionings to define disability is a social exercise.

Can we consider existing disability models as interpretations of the capability approach of disability with specified dimensions of capabilities? - The Medical Model? The Social Model? The Nagi Model? The ICF Model?

Implications of the Capability Approach for Disability and Justice It demonstrates the centrality of disability for the fields of poverty, development and global health. It calls for the systematic collection of data to identify persons with disabilities so as to make it possible to compare their lives to the lives of those without disabilities and derive implications for justice. It provides a conceptual framework for the evaluation and monitoring of programs, policies and legislations related to persons with disabilities in general, and of the implementation of the Convention in particular.

Implications (Cont.) At the very least, the capability approach provides a distinct formulation of the overarching objective of disability and justice initiatives: to improve the actual lives of persons with disabilities by expanding their freedoms to do or be what they value.

Main sources Thank you! mitra@fordham.edu Burchardt T. (2004) Capabilities and Disability: the Capabilities Framework and the Social Model of Disability. Disability & Society, 19(1). Mitra, S. (2006) The Capability Approach and Disability, Journal of Disability Policy Studies, 16, No. 4, pp. 236-247. Mitra, S. (2011) Sen’s Capability Approach, Disability and Justice, working paper. Sen, AK. (2009) The Idea of Justice. The Belknap Press of Harvard University Press, Cambridge, Massachusetts. Thank you! mitra@fordham.edu