Approaches to Understanding and Addressing Disability

The situation of persons with disabilities is in many ways affected by societal perceptions of disability. How disability is understood or misunderstood can have a tremendous impact on all aspects of life for persons with disabilities and at all levels, for example from the ways in which one is treated within one’s community to the ways in which one is treated by policy-makers at national level in the course of their work.

It is generally considered that there are four approaches to, or models for, understanding and addressing disability. These are reflected in the following table:

Older Models	Newer Models
The Charity or Welfare model	The Social Model
The Medical Model	The Human Rights Model

Approaching Disability Issues: Older Models

Historically, disability has been seen as a charity or medical issue. Under the Charity Model, disability has been seen in terms of tragedy. Persons with disabilities have been seen as helpless, to be pitied and in need of care. This perspective has viewed disability as a burdensome condition and persons with disabilities as passive, not active, members of society.

Under the Medical Model, disability has been understood as a medical problem that needs medical or rehabilitation attention in order to “fix” or “cure” an individual. This perspective has viewed a person with disabilities as having a condition that sets him or her apart from the rest of society, or as “broken” or “sick” and needing to be made “normal,” if they are to participate in society. To be sure, persons with disabilities require medical care like all people. Moreover, disability may require certification from a medical doctor. However, defining disability simply as a medical situation or in terms of charity overlooks the many barriers that prevent persons with disabilities from enjoying full participation in society and contributes to the marginalization and disempowerment of persons with disabilities.

Approaching Disability Issues: Newer Models

The Charity and Medical Models of disability have increasingly been superseded by broader understandings of disability, reflected in the Social and Human Rights models.

The Social Model of disability understands barriers in society as disabling – under this view, society limits the participation of persons with impairments by creating obstacles. These may take many forms, including legal, attitudinal and physical barriers, as well as barriers to communication. For example, when a person who uses a wheelchair comes across a staircase, the result - that is, the interaction between the fact that the person is using a wheelchair and the inaccessibility of the staircase - is a disability.

Conversely, when a building has a ramp, persons who use wheelchairs can enter the building without any distinction between persons with or without disabilities. Likewise, if

a teacher makes negative assumptions about a child with autism, these attitudes create a barrier to the child’s education: the disability in this case is the interaction between

the cognitive functioning of the child and the negative attitudes of the teacher. Another example is persons who are blind. Where a teacher writes on the chalkboard but does not read aloud, a student who is blind cannot access the information. If the teacher read aloud or had another student read material aloud, the educational experience is made accessible.

The Social Model of disability regards people living with disabilities as full members of society who have important contributions to make to their families and community. It recognizes that persons with disabilities should determine the course of their lives to the same extent as other members of society and it paves the way for social action by persons with disabilities challenging barriers to participation, as well as exclusionary practices.

Integrated Approaches to Disability

Some governments apply the Social Model with elements of the Medical Model, for example by utilizing the World Health Organization’s International Classification of Function (ICF). The ICF views disability as the interaction between individuals with an impairment and personal and environmental factors (for example, negative attitudes and inaccessible environments). The ICF itself represents a shift towards the social model of disability, as it focuses on levels of health and functioning, rather than on impairment or disease.

Disability as a development issue can be understood through the lenses of the Social and Human Rights Models. This Social Model acknowledges the need to break down socially discriminatory barriers – including those relating to all aspects of development, whether economic development, poverty reduction, access to basic needs, education, democratic governance, or access to health and rehabilitation. This Social Model therefore helps create awareness of the many obstacles that exclude persons with disabilities from full integration into society. Once there is awareness and appreciation of these barriers, it becomes easier to identify and correct human rights problems that impact on persons with disabilities in the context of development.

Country Checkpoint

Do you think the Social Model is reflected in your country’s approach to disability? Can you think of examples of how it is or is not being applied?

The Human Rights Model of disability, as reflected in the CRPD, builds on the Social Model, placing it within a framework of rights and responsibilities. Under the human rights model, persons with disabilities are identified as rights holders and subjects of human rights law on an equal basis with all other persons. A person’s disability is recognized and respected as an element of natural human diversity on the same basis as race or gender, and the Human Rights Model addresses disability-specific prejudices, attitudes and other barriers to the enjoyment of human rights. The Human Rights model further places the responsibility on governments and society for ensuring that the political, legal, social, and physical environments support the human rights and full inclusion and participation of persons with disabilities.

The Social and Human Rights Models of disability highlight the responsibility of countries to identify and remove barriers that inhibit human rights realization for persons with disabilities. Together the two Models offer a holistic and progressive framework for promoting and protecting the rights and inclusion of the many persons with disabilities in the world in all aspects of society and development.

Country Checkpoint

How can the social and human rights models inform strategies for disability-inclusive development in your country? For instance: How might DPOs be included in development planning or poverty reduction strategy processes? How might DPOs be included in an HIV and AIDS education programme? How will inclusion in development planning and implementation help foster human rights realization for persons with disabilities?

Language

The different models for understanding disability are also often reflected in language, which may be used in different ways to support both negative and positive attitudes to disability. This can been demonstrated, for example, in terms of words used for persons with disabilities, words that describe their disability, or words used to describe their role in the family or community.
Attitudes may also be reflected in the words that persons avoid using.

Examples of affirmative phrases or negative phrases include:

Affirmative Phrases	Negative Phrases
person with an intellectual, cognitive, developmental disability	retarded; mentally defective
person who is blind, person who is visually impaired	the blind
person with a disability	the disabled; handicapped
person who is deaf	the deaf; deaf and dumb
person who is hard of hearing	suffers a hearing loss
person who has multiple sclerosis	afflicted by MS
person with cerebral palsy	CP victim
person with epilepsy, person with
seizure disorder	epileptic
person who uses a wheelchair	confined or restricted to a wheelchair
person who has muscular dystrophy	stricken by MD
person with a physical disability, physically disabled	crippled; lame; deformed
unable to speak, uses synthetic speech	dumb; mute
person with psychiatric disability	crazy; nuts
person who is successful, productive	has overcome his/her disability; is courageous (when it implies the person has courage because of having a disability)

See Learning Activity 2.C. titled Language.