Sophie Ferneeuw - nov 2004 Understanding disability Typology of approaches towards disability A global approach : the handicap creation process

Sophie Ferneeuw - nov 2004 Disability as Individual pathology 1)Biomedical Approach 2)Functional Approach Disability as Social pathology 1)Environmental Approach 2)Human Rights Approach Typology of approaches towards disability (Marcia Rioux, Roeher Institute, Toronto, 1997) (Jean-François Ravaud, INSERM, 1999) CTNERHI/CCOMS/CIF/2003

Sophie Ferneeuw - nov 2004 Disability as individual pathology Biomedical Approach Treatment Recovery through medical or technological means Prevention Biological or genetic intervention ; prenatal detection Social Responsibility Eliminate or cure the disability

Sophie Ferneeuw - nov 2004 Disability as individual pathology Functional Approach Treatment Functional rehabilitation services Prevention Early diagnosis and treatment Social Responsibility Improve and obtain comfort

Sophie Ferneeuw - nov 2004 Disability as social pathology Environmental Approach Treatment Accessibility, adaptation ; increased individual control over services and support Prevention Elimination of social, economic and physical barriers Social Responsibility Elimination of obstacles to integration

Sophie Ferneeuw - nov 2004 Disability as social pathology Human Rights Approach Treatment Reformulation of political, economic and social rules Prevention Acknowledgment that the disability is an inherent part of society Social Responsibility Elimination to obstacles to integration

Sophie Ferneeuw - nov 2004 Individual or medical approach 1 - the person is paralysed: medical approach (cf deficiency) 2 - the person cannot walk: functional approach (cf incapacity / limitation of activity) Social approach 1 – the building is not accessible: environmental approach (cf installation of the environment) 2 - the society is discriminative and segregative: political approach /inequality of the human or citizen rights (non-discrimination) CTNERHI/CCOMS/CIF/2003 Ex. : Access to town hall

Sophie Ferneeuw - nov 2004 Another approach of the difference From RIPPH/SCCIDIH and a presentation done by Raphaël de Riedmatten - Mai 2002 A global approach : the handicap creation process Human Development Model

Sophie Ferneeuw - nov 2004 Environmental Factors Life Habits Interaction Risk Factors Cause Personal Factors Organic SystemsCapabilities Integrity Impairment Facilitator ObstacleAbility Disability Social Participation Handicap Situation Help ! Too theoritical ! The handicap creation process

Sophie Ferneeuw - nov 2004 Risk Factor Cause 138 KS 986 The handicap creation process – Risk factors

Sophie Ferneeuw - nov 2004 Risk Factors Cause Personal Factors Organic Systems Integrity impairment Integrity Impairment Idea of « degrees » of impairment The handicap creation process – Personal factors

Sophie Ferneeuw - nov 2004 Personal Factors Organic SystemsCapabilities Ability Disability Disability (ex. with the age of the person) Ability (idea of « to be very fit ») Idea of « degrees » of ability Integrity Impairment Risk Factors Cause The handicap creation process - Personal factors

Sophie Ferneeuw - nov 2004 Environmentals Factors Facilitator Obstacle A hostile environment can be a determining factor in the handicap production process Roads in bad condition constitute an "obstacle" for certain people Shtimë, Kosovo, The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle Shtimë, Kosovo, An accessible restaurant can largely facilitate the social life of people with reduced mobility The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle An inaccessible school is a factor of exclusion (obstacle) … just as fears of the teachers … or as the negative attitude of the other parents… The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle Shtimë, Kosovo, Whereas a simple equipment can facilitate the participation (facilitator) … with the support of an attentive teacher … … the comprehension of the parents of the other pupils … The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle Equal Rights ! The existence of an effective legislation to support integration will have an important impact on the handicap situations in the daily life. A law for the equal rights constitutes a "facilitator" The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle A family, support or obstacle ? … as for a culture and a society ? Shtimë, Kosovo, The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle Shtimë, Kosovo, The handicap creation process - Environmental factors A ramp built by the father of the family, an obstacle which disappears ! An electric wheelchair, a facilitator

Sophie Ferneeuw - nov 2004 Environmental Factors Facilitator Obstacle The access to a computer and a good software to write in Braille: a facilitator An access to Internet, a facilitator to tie ! The handicap creation process - Environmental factors

Sophie Ferneeuw - nov 2004 Environmental Factors Life Habits Interaction Risk Factors Cause Personal Factors Organic SystemsCapabilities Integrity Impairment Facilitator ObstacleAbility Disability Social Participation Handicap Situation The handicap creation process – Life Habits The whole of this factors are in interaction with the life habits of each person. There is not a « handicap » in itself. There are only « handicap situations » more or less important which will restrict the social « participation ».

Sophie Ferneeuw - nov 2004 Life Habit Social Participation Handicap Situation « Life habit is a daily activity or a social role valued by the person or his/her sociocultural context according to his/her characteristics (age, sex, sociocultural identity etc …) which ensure his/her survival and well-being in his/her society throughout their lifetime » The handicap creation process – Life Habits

Sophie Ferneeuw - nov 2004 Life Habit « A situation of social participation corresponds to the full realization of the Life Habits » The handicap creation process – Life Habits Social Participation Handicap Situation

Sophie Ferneeuw - nov 2004 Life Habit Social Participation Handicap Situation « A handicap situation refers to the reduced or non accomplishment of life habits. » The handicap creation process – Life Habits

Sophie Ferneeuw - nov 2004 Life Habits Social Participation Handicap Situation Shtimë, Kosovo, The handicap creation process – Life Habits

Sophie Ferneeuw - nov 2004 Life Habits Social Participation Handicap Situation The handicap creation process – Life Habits

Sophie Ferneeuw - nov 2004 Facteurs environnementaux Habitudes de vie Interaction Facteurs de risque Cause Facteurs personnels Système organique Aptitudes Intégrité Déficience Facilitateur ObstacleAptitude Incapacité Participation sociale Situation de handicap The End !