Different Ways of Thinking About Disability.

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Different Ways of Thinking About Disability.

• Richard Olsen
• Nuffield Community Care Studies Unit
• University of Leicester
• 18/2/03

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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

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Background

• 14.2 of the adult population described as
  disabled (OPCS, 1988). 6.5 million people
• Disability Discrimination Act 1995 and Disability
  Rights Commission http//www.drc.org.uk
• A more accessible environment
• Radical changes in the way in which assistance is
  provided (eg. Direct payments)

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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

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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)

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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

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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

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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

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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

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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

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• 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 projectWe also
  expect proposals to be located within - or to
  draw on - the social model of disability and
  related social models.Joseph Rowntree Foundation
  webpage httpwww//jrf.org.uk

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Implications for practice

• Alternative solutions to the problem
• Not everyone will see impairments as bad
• Examples cochlear implants, conductive
  education, genetic screening and counselling

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(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, 3137.

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• 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.14-21.

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(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.175, added emphasis)

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• Attitudes towards disabled people are tainted by
  obsessive concern with normative goalsThe
  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 http//www.leeds.ac.uk/disa
  bility-studies/archiveuk/finkelstein/A20Tale20of
  20Two20Cities.pdf

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(3) Genetic screening and counselling

• Human genetics poses a threat to us because while
  curesare 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 areopening the door to a new
  eugenics which directly threatens our human
  rights
• Disabled Peoples International Position Statement
• http//www.dpieurope.org/htm/bioethics/dpsngfullre
  port.htm
• Also, The disability rights critique of prenatal
  genetic testing
• http//www.thehastingscenter.org/oldsite/pdf/sups
  eptoct_99.pdf

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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