1 models of disability oct 1 st, 2008. 2 review of last class language person first language pride...
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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
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Definitions
Impairment
Handicap
Disability
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Impairment:
Refers to physical or mental limitations such as difficulty walking
Represents a deviation from the person's usual biomedical state.
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Impairment:
When does physical / mental variation become an impairment?
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What is the difference between:
Impairment
Illness / “being sick”
Chronic Health Conditions?
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Minimal Expected Variation State
Minor Variation
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
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Handicap
Different meanings throughout time and situation…
The disadvantage experienced by a person as a result of impairments
(Now considered offensive)
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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.
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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)
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Sequence of ConceptsWHO 1980
Impairment
Disease ordisorder
Disability Handicap
----------------------------------------------------------------------------------
impairment at the organ level
disability at the person level
handicap at the societal level
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WHO 2001
Disability : outcome or result of a complex relationship
between an individual’s: health condition personal factors external factors
Health Condition Health Condition ((disorder/diseasedisorder/disease))
Interaction of ConceptsWHO 2001
Environmental Environmental FactorsFactors
Personal Personal FactorsFactors
Body Body function&structure function&structure
(Impairment(Impairment))
ActivitiesActivities(Limitation)(Limitation)
ParticipationParticipation(Restriction)(Restriction)
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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.
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Quantifying
Quantifying functionality:0-4% 0 No impairment5-24% 1 Light impairment25-49% 2 Moderate impairment50-95% 3 Serious impairment96-100% 4 Total impairment 8 Non specified
9 Non applicable
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Where is the subjective (QOL)?
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Other classification systems
DSM IV ICD
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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.”
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67 US acts / programs that define disability 35 have self-contained definitions (although
some contain more than one definition)
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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”)
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Which definition do you choose? Obviously no one has this figured out…
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Models of Disability
Moral Personal Tragedy Medical Social
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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
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Moral Model (cont.)
2nd part of moral model: Character weakness
Corruptness Immoral-ness
Examples: villains in movies, refrigerator mothers, faking, unmotivated
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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
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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
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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
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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”)
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Social Model
States that inappropriate and discriminatory Social Attitudes (Ableism), Sociopolitical Structures, and Cultural Phenomena
are the central problem for disabled people
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Social Model Variants
Social (Creation)- UK Social (Construction)- US Minority (Political/Cultural) Independent Living Model- ILM Human Variation Post-Modern / Dismodern
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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
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Social Model Variants - Social (Construction)
US Assumes that inappropriate and discriminatory
social attitudes and cultural phenomena are the central problem for people with impairments
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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
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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
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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.
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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)
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"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
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Social Model Variants – Dismodern Theory
L. Davis Sees imperfection as the norm Normal is a fairly new term…
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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
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Initially: Social model tries to breaks the bio-medical chain of causation:
Impairment Disability
Why was this strategically important to DRM (Disability Rights Movement)?
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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
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Models – Summary
Problem is the Individual Moral Personal Tragedy Medical
Problem is Society Social
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Why should we care?
How Disability Is Defined Determines What Is Measured
Policy implications Allocation of resources
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