Different Ways of Thinking About Disability. Richard Olsen Nuffield Community Care Studies Unit University of Leicester 18/2/03

Aims To subject conventional classification of disability to critical scrutiny To introduce differences between medical and social models of disability To illustrate the implications of different models of disability for research and practice

Background 14.2% of the adult population described as disabled (OPCS, 1988). – 6.5 million people Disability Discrimination Act 1995 and Disability Rights Commission A more accessible environment Radical changes in the way in which assistance is provided (eg. Direct payments)

Conventional classification of disability Impairment: an impairment is any loss or abnormality of psychological, physiological or anatomical structure or function Disability: a disability is a restriction or lack (resulting from an impairment) of ability to perform an activity in a manner or within the range considered normal for a human being

Conventional classification of disability Handicap: a handicap is a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal (depending on age, sex and social and cultural factors) for that individual Source: International Classification of Impairments, Disabilities and Handicaps (Scambler, 1997, p.80)

Important points Being disabled is the result of flaws in the body The answer lies in medical terms - hence, the ‘medical model of disability’ This model is commonly accepted as the way in which disability should be categorised

Alternative classification of disability: Impairment: lacking part of or all of a limb, or having a defective limb, organism or mechanism of the body Disability: the disadvantage or restriction of activity caused by a contemporary social organisation which takes no or little account of people who have physical impairments and thus excludes them from the mainstream of social activities Source: Oliver, 1990, The Politics of Disablement, p.11

Important points Disability is a result of social organisation The answer lies in identifying and removing ‘barriers’ in the way society is organised – hence, the ‘social model of disability’

Why are the differences between medical and social models of disability important for sociology? Sociologists instrumental in developing the ICIDH Sociological interest in chronic illness The origin of the ‘social model of disability’ in the disability movement itself

Important points for research Different terminology/different focus Research informed by different models will ask different questions Research funding often tied to a ‘social model’ approach Implications for collaborative work

A core criterion in judging all proposals is the extent to which those whom projects are intending to benefit (or research) are involved in identifying the issues to be addressed, and in planning and carrying out the project…We also expect proposals to be located within - or to draw on - the social model of disability and related social models. Joseph Rowntree Foundation webpage

Implications for practice Alternative solutions to ‘the problem’ Not everyone will see impairments as ‘bad’ Examples: cochlear implants, conductive education, genetic screening and counselling

(1) Cochlear implants in childhood: ‘There is little reason to condemn anyone to be a prisoner of deafness...it is not only to the advantage of the child and his or her family to eliminate hearing loss, but also to society, which will see increased benefits from these productive individuals.’ Pulec, J. (1994) ‘The benefits of the Cochlear Implant’, Ear, Nose and Throat Journal, 3:137.

‘The deaf child no less than the hearing child has all the requisite skills that will enable her to achieve a different, but no less human, expressive potential.’ Crouch, 1997, ‘Letting the deaf be deaf - reconsidering the use of cochlear implants in prelingually deaf children’, Hastings Center Report, Vol.27, No.4, pp

(2) Conductive education: Conductive education philosophy is imbued with the concept of orthofunction. After graduation from a conductive education program, graduates should be able to function as normally as possible....neuro-motor-disabled individuals should be able to approach normal function and lead age-appropriate lives while making choices of a lifestyle that can include maximal independence (Spivack, 1995, ‘Conductive education perspectives’, Infants and Young Children, Vol.8, No.1:75, added emphasis)

Attitudes towards disabled people are tainted by obsessive concern with ‘normative’ goals…The extraordinary intensity and time spent in trying to make disabled children ‘normal’ must, surely, inculcate idealised images of the able-bodied form and lifestyle. Finkelstein, V. (1990) Conductive Education: A Tale of Two Cities, at studies/archiveuk/finkelstein/A%20Tale%20of%2 0Two%20Cities.pdf studies/archiveuk/finkelstein/A%20Tale%20of%2 0Two%20Cities.pdf

(3) Genetic screening and counselling: Human genetics poses a threat to us because while cures…are promised, what is actually being offered are genetic tests for characteristics perceived as undesirable. This is about eliminating or manipulating foetuses which may not be acceptable for a variety of reasons. These technologies are…opening the door to a new eugenics which directly threatens our human rights Disabled Peoples International Position Statement Also, The disability rights critique of prenatal genetic testing

Concluding points SMOD very influential but not without critics Ambiguous place of medicine and PAM Conflict between medical and social models of disability have real implications Particularly because so many differences focus on the appropriate way to ‘treat’ disabled children About awareness and not identification