1. 1 Models of Disability Oct 1 st, 2008

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

3. 3 Definitions Impairment Handicap Disability

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

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

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

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

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

9. 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. 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. 11 Sequence of Concepts WHO 1980 Impairment Disease or disorder Disability Handicap ---------------------------------------------------------------------------------- impairment at the organ level disability at the person level handicap at the societal level

12. 12 WHO 2001 Disability : outcome or result of a complex relationship between an individual’s: health condition personal factors external factors

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

14. 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. 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. 16 Where is the subjective (QOL)?

17. 17 Other classification systems DSM IV ICD

18. 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. 19 67 US acts / programs that define disability 35 have self-contained definitions (although some contain more than one definition)

20. 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. (1 st articulation of the “Social Model of Disability”)

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

22. 22 Models of Disability Moral Personal Tragedy Medical Social

23. 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. 24 Moral Model (cont.) 2 nd part of moral model: Character weakness Corruptness Immoral-ness Examples: villains in movies, refrigerator mothers, faking, unmotivated

25. 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. 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. 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. 28 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. (1 st articulation of the “Social Model of Disability”)

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

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

31. 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. 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. 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. 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. 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. 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. 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. 38 Social Model Variants – Dismodern Theory L. Davis Sees imperfection as the norm Normal is a fairly new term…

39. 39 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 Social Model Variants – Summary

40. 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. 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. 42 Models – Summary Problem is the Individual Moral Personal Tragedy Medical Problem is Society Social

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

44. 44