Defining disability Oct 08, 2009 Dennis Lang

Agenda I) Review – Language – Stereotypes II) Defining disability -Examining the Body/Mind (INDIVIDUAL MODEL) -Medical -Moral -Personal Tragedy -Disability Rights Movement Pushes Back (The Social Model)

What Do I say?

What Do I Say USE EITHER: Person with a Disability (PWD) (People 1 st Language) or Disabled Person; Deaf (Identity Language)

May Also See/Hear People who experience Disability The Only Given is That Language Will Change

Language YES: Person who has/is…. (intellectual disability; deaf/hard of hearing; learning disability; mental disorder; mobility impairment….) YES: wheelchair user 6

What is the Difference Between: Deaf & deaf?

Stereotypes 1. Pitiable and Pathetic 2. "Super-Crip.“ 3. Sinister, Evil and Criminal. 4. Better Off Dead. 5. Maladjusted. 6. A Burden. 7. Unable to Live a Successful Life. 8

Pitiable and Pathetic

Heroic, inspiring Super-crip / “Overcoming your disability ” 10 Terry Fox

“Super-Crip” “disability as hero by hype:” When not pitied, persons with disabilities are sometimes seen as “heroes,” or outrageously admired for their “courage. Placing persons with disabilities on a pedestal is another way to denote this social group as “other”. Is often linked to the idea that disability in one area is complimented with superior abilities in another area (for example, the belief that people who are blind have superior hearing)

Talk (DRC UK):

Question What is the greatest factor that influences one’s QOL? 13

Differences from Other Minority Groups – 1. Public: a confusing mix of conflicting emotions: Pity, Charity, Disgust, Fear – 2. Lack of “Safe Havens“ ( Gill, “Divided Understandings,” Handbook of Disability Studies, Albretch, et al 2000) – OTHER: Sexless, Rudeness OK – Anybody can find themselves belonging at anytime. 14

Question How do you treat a Person With a Disability? 15

What is Impairment?

Disability Models Some Ways to Understand Disability Two Groupings: 1)The problem is the INDIVIDUAL 2)The problem is Society (Social Model)

II) Disability Models Examining the Body/Mind (INDIVIDUAL MODEL)

The medicalization of the body/ mind (Individual-Medical Model): The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR):

Evaluation of the DSM-IV-TR – Criteria used are based on the clinical judgment of a few psychologists – There are still problems differentiating between normal and abnormal – Some criteria are still based on clinical judgment

21 Evaluation of the concept of MENTAL ILLNESS Subjective, shifting, contested assumptions/examination? – There are no objective diagnostic tests – “biomedical assumption that there are clear boundaries between diseases and between the sick and healthy.” Psychiatric survivors movement since 1970s. – Argue that their differences are not helpfully categorized or treated as impairments. Insiders’ POV; narratives of living with bodily/mental difference. Sick or criminal? Problems of deinstitutionalization. Newly invented disabilities (and treatments) – Social anxiety disorder

The medicalization of the body/ mind (Individual-Medical Model): World Health Organization (WHO): International Classification of Impairments, Disabilities, and Handicaps, or ICIDH, 1980 International Classification of Functioning, Disability, and Health or ICF, 2001

23 WHO, ICIDH 1980 WHO, ICIDH 1980 Impairment ImpairmentDisease or ordisorderDisability Handicap impairment at the organ level disability at the person level handicap at the societal level “…uses a bio-physiological definition of 'normality'. P14 Disability: A Choice of Models; Barnes & Mercer

Health Condition ( disorder/disease ) WHO, ICF 2001 Environmental Factors Personal Factors Body function&structure (Impairment ) Activities(Limitation)Participation(Restriction)

WHO, ICF 2001 Disability : outcome or result of a complex relationship between an individual’s: health condition personal factors external factors “…retains individualistic medical notions of disability and its causes.” P15 Disability: A Choice of Models; Barnes & Mercer

The medicalization of the body/ mind (Individual-Medical Model): Americans with Disabilities Act – ADA 1990 – (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.

Examining the Body/Mind INDIVIDUAL = MORAL MODEL Religious and Spiritual origin Character weakness

28 Moral Model Two Parts I)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)

29 Moral Model (cont.) II) Character weakness: Examples: villains in movies, refrigerator mothers, lazy, faking, unmotivated

30 Examining the Body/Mind INDIVIDUAL =PERSONAL TRAGEDY MODEL Disability is considered a tragedy Society needs to take care of / protect persons with disabilities Ties in with the “super crip” Often mixed with Moral and Medical Models Examples: inspiration news story, telethons, charities

31 Examine Society= Social Model Instead of disability originating within the person, disability originates from society Disability results from society, (Ableism), and the environment: – Physical barriers – Attitudinal barriers – Political/Policy barriers

Social Model – Origins (Britain) Union of Physically Impaired Against Segregation UPIAS definitions of impairment and disability, 1976: Impairment: Lacking part or all of a limb, or having a defective limb, organ or mechanism of the body. 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 participation in the mainstream of social activities

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

34 Social Model Variants – UK Social (Creation) Marxist and materialist interpretation of the world: – 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

35 Social Model Variants – US Social (Construction) Culture & Attitudes – Assumes that inappropriate and discriminatory social attitudes and cultural phenomena are the central problem for people with impairments

36 Social Model Variants - Minority Political based used to counter discrimination and advocate for civil rights – Primarily US disABILITY identity / Pride / Culture

37 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

38 Social Model Variants – Human Variation Universal Design – re-think design= 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.

39 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)

40 "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

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

42 Social Model Variants – Summary 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

43 What About Impairment? Initially: Social model tries to breaks the bio- medical chain of causation: Impairment Disability Why was this strategically important to DRM (Disability Rights Movement) ?

44 ISSUES: While the social model redefines “disability,” it stops short of questioning the status of “impairment” Impairment is a necessary condition for disability. (Is it?) 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 (But I am Blind, Have pain, Different!)

45 Others: impairment should not be taken as simply a “natural state” Some disability studies work challenges whether impairment is just biological, an “objective, trans-historical, trans-cultural entity.” (Disability/Postmodernity, eds. Corker & Shakespeare). – Carol Thomas: impairments are “shaped by the interaction of biological and social factors, and are bound up with processes of socio- cultural naming.” – Thomas Laqueur, Making of the Modern Body (1987): “Scholars have only recently discovered that the human body itself has a history…. It has been lived differently, brought into being within widely dissimilar material cultures, subjected to various technologies and means of control….”

46 Don’t we all have negative experiences of our bodies? DS and feminist writers – Jenny Morris: “There is a tendency within the social model to deny the … personal experience of physical and intellectual restrictions, of illness, of the fear of dying.” – Liz Crow: “experiences of our bodies can be unpleasant or difficult.” – Susan Wendell: “live with the suffering body, which that which cannot be notices without pain, and that which cannot be celebrated without ambivalence.”

47 WHY CARE? How Disability Is Defined Determines What Is Measured = Allocation Of Resources

48 EXAMPLES Social Security Disability Insurance University of Washington Accomodations World Bank Oregon In 1989, passed legislation rationing health care to all state residents who were on Medicaid.

Difference Is Normal (UN):

50 Models – Summary Problem is the Individual – Moral – Personal Tragedy – Medical Problem is Society – Social & its variants