Week 8 Presentation: Disability, Community, Culture, and Identity

Definition(s) of “Disability”: Socially Constructed Nature of Disability (Nagi, 1991)

• Disability refers to social rather than organismic functioning

• It is an inability or limitation in performing socially defined roles and tasks expected of an individual within a sociocultural and physical environment

• Brings in task and role function

Definition(s) of “Disability”: Americans with Disabilities Act (ADA)

• A physical or mental impairment that substantially limits one or more of the major life activities of an individual

• A record of such an impairment

• Being regarded as having such an impairment

• Focus is major life activities

  • Important role of OT in evaluating and recording these effects on major life activities

  • OT’s can be involved in the disability determination process

Definition(s) of “Disability”: Social Security Act

• A person is disabled under the Act if he/she can’t work due to a severe medical condition that has lasted, or is expected to last, at least one year or to result in death

• The person’s medical condition must prevent him/her from doing work that he/she did in the past, and it must prevent the person from adjusting to other work

• Rules how much money they can make and remain on this act

• SSDI payments

• SSI

• Work

Definition(s) of “Disability”: World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF)

• Umbrella term for impairments, activity limitations, and participation

• Impairment

  • Results from problems with body functions or structure

• Activity limitation

  • Occurs when a person has trouble executing a task or action

• Participation

  • A person’s difficulty engaging in a “life situation” (or roles/occupations)

WHO-ICF Model

• Focused on how individuals participate in those roles and occupations

Person Environment Occupation (PEO) Model

• Concept of occupational performance supports our social construct of disability

• Are they able to perform?

• Independence

Ableism

• Discrimination and prejudice experienced by people with disabilities and in favor of being able-bodied

• View people with disabilities as having or being a defect that needs to be fixed, as opposed to a view of disability as a dimension of difference

• Views of inferiority and devaluation have had a profound impact on creation and implementation of public policy toward people with disabilities

6 Forms of Ableism that OT’s Should Resist

• Failing to offer a full range of accessibility options (wheeled mobility, low vision, hearing loss, SPD…)

• Using discriminatory (ableist) language in pejorative ways

  • Being careful on the words you use

• Acknowledging that many temporarily able-bodied individuals rarely check their privileges (use accessible bathroom stalls, using disability-only parking, etc.)

• The assumption that disabled have no agency or autonomy by automatically assuming that they need help

• The assumption that it is ok to ask how a person’s disability occurred

• Assuming that disability is obvious and apparent

Models of Disability

• Moral model of disability

• Welfare model of disability

• Medical model

• Social model

• Minority group model

Moral Model of Disability

• Early model

• Disability is explained by a divine action to provide the person with a challenge to overcome

Welfare Model of Disability

• People with disabilities are considered part of the “worthy poor”

• Worthy

  • Through no part of their own are worthy to receive government support and benefits that support their existence (even in institutions)

• Created work disincentives in the US; invoke pity/contempt by able-bodied

• Vocational Rehab and Workers comp emerged to support their employment

• These define levels of disability based on an economic value

Medical Model

• “Medicalization”

• The individual with an illness or impairment is deficient and abnormal

• A professional is required to heal, fix, or cure the deficiency though medication, surgery, technology, therapy

• Independence is the ultimate goal and measure of success

• Needing to be fixed

• Focus on independence

Social Model

• Focuses focuses on the interaction of the person with their environment and the resulting effect on what the disabled person can do to participate in society

• Disability is simply another type of difference on the human continuum of difference and disablement is a result of oppressive social structures

Minority Group Model

• Systemic oppression, marginalization, alienation, social and political isolation

• Develop disability culture, disability pride, disability identity

Legislation and Policies

• 1973 Rehabilitation Act Section 504

• 1990 Americans with Disabilities Act (ADA)

1973 Rehabilitation Act Section 504

• Prohibits discrimination against people with disabilities in federal agencies, contractors, and those receiving federal grants, including universities

1990 Americans with Disabilities Act (ADA)

• Creates equal opportunities for people with disabilities in USA in the areas of employment, public services, public accommodation, transportation, and telecommunication

• Enabled having to have telephones interact with different disabilities, being able to have wheelchair access and different types of access, transportation, etc.

Events Impacting People with Disabilities