1. THE MEDICAL MODEL OF DISABILITY (The Individual Model of Disability)
The society we live in tends to consider disability to be a tragedy for the individual and a burden for the family and society.
This is based on the ‘individual’ or ‘medical’ model of disability. This model focuses on the lack of physical or mental functioning and uses a clinical way of describing an individual’s disability.
This model leads to a dehumanising view, where only the nature and severity of the impairment is important, together with the extent to which the difference can be put right. It casts the individual as victim.
When people such as policy makers think about disability in this individual way, they tend to concentrate their efforts on ‘compensating’ people with impairments for what is ‘wrong’ with their bodies by targeting ‘special’ welfare benefits at them and providing segregated ‘special’ services for them and so on.
It can also affect the way disabled people think about themselves. Many disabled people internalise the negative message that all their problems stem from not having ‘normal’ bodies/minds, and can be led to believe that their impairments automatically prevent them from participating in society.
It is an accepted fact that disabled people historically have been excluded from mainstream society and continue to face discrimination and prejudice leading to disadvantage and oppression. There are two different ways of explaining what causes the disadvantage an individual (or medical) model of disability, and, a social model of disability.
The medical model of disability encourages explanations in terms of the features of an individual's body, whereas a social model encourages explanations in terms of characteristics of social organisation. When people think about disability in this individual way they tend to concentrate their efforts on 'compensating' people with impairments for what is 'wrong' with their bodies by targeting 'special' welfare benefits at them and providing segregated 'special' services for them and so on. Disabled people too can be led to believe that their impairments automatically prevent them from participating in social activities. This internalised oppression can make disabled people less likely to challenge their exclusion from mainstream society. 
In the medical model, disability has predominantly been viewed as the consequence of disease or injury in the form of functional losses or impairments. The onus has been on the individual to make efforts to become ‘rehabilitated,’ restore their function, or to cope effectively with their disabling condition.

2. `The messages we receive are very strong and clear and we have little access to different values which may place a more positive value on our bodies, ourselves and our lives. Our self image is thus dominated by the non-disabled world's reaction to us'
Jenny Morris
The medical model of disability sees the person as the problem, and the solution as making the person ‘normal’. The medical model leads to the provision of special schools, special transport, sheltered jobs, physiotherapy and speech therapy, charities and benefits. It also leads to eugenics – getting rid of disabled babies by stopping disabled people and others having them.
Simon Aspis
QUICK GROUP DISCUSSION POINTS:
Who knows most about a particular disability – a doctor or someone with the condition?
Talk with TRAINEES about the realities of living with an impairment. How many of the day-to-day issues that a disabled person faces are truly medical matters? What other issues are likely to matter more?

3. The Social Model of Disability
Disability as expression of human diversity and not as something in need of ‘cure’ or ‘correction’
People are disabled by their environment, the attitudes of others, and the policies, practices and procedures of organisations
Learning disabled people have fewer opportunities and a lower quality of life than non-disabled people.
We believe that it is not their impairments that prevent them from enjoying full citizenship but the way society is organised and its attitude to difference.
QUICK GROUP DISCUSSION POINTS:
Discuss the way society makes things harder or easier for different groups of people. Don't think initially of people with impairments. For example, see how life is made difficult for pedestrians on pathless country roads. Compare that with how cyclists are catered for in some areas, or car drivers on motorways. Discuss how much money we spend as a nation, providing facilities for some, not others.

4. Examples of what disables people …
The social model of disability makes the important distinction between 'impairment' and 'disability'. and is the response of the disabled people's civil rights movement to the oppression of disabled people. Disability is caused by 'barriers' or elements of social organisation that take no or little account of people who have impairments. It follows that if disabled people are to be able to join in mainstream society, which is their human right, the way society is organised must be changed. Removing the barriers which exclude (disable) people who have impairments will bring about this change.
This was the explanation I had sought for years. Suddenly what I had always known, deep down, was confirmed. It wasn't my body and mind that was responsible for all my difficulties, it was external factors, the barriers constructed by the society in which I live. -Liz Crow
QUICK GROUP DISCUSSION POINTS:
Think of other examples, where someone without an impairment might be disabled. Talk about someone with no useful sight who put no light bulbs in their home. Would it be reasonable to ask friends who visited at night to bring a torch? Discuss how that might be compared with the way disabled people are expected to find their own solutions to problems that could be sorted by town planners or building designers.
Examples of what disables people …
“I can’t speak; I am disabled by the fact that you won’t take the time and trouble to learn how to communicate with me.”
“I have a learning disability. I am disabled by the fact that you don’t produce your leaflets in easy-to-read language and symbols, so that I can find out about the services you offer.”

5. Medical model Social model
Rehabilitate Disabled Persons
Charity, Medical treatment
Adjustment to the norm
Exclusion
Little consultation
Rehabilitate Society
Rights
Acceptance of differences
Inclusion, participation, citizenship
‘Nothing about us without us’
From To
Disability is an individual problem ► Disability is a problem in society
Differences in abilities are inadequacies ► Differences in abilities are assets
Seeing deficits ► Seeing strengths
Patient ► Citizen
Special service provision ► Accessible mainstream services
Society choosing for ‘them’ ► Disabled people choosing for themselves
Institution orientated ► Community orientated
Us and them: exclusion - tolerance ► All of us: inclusion – valuing
Medical model of disability ► Social model of disability
- control or cure change environment and attitudes
QUICK GROUP DISCUSSION POINTS:
Invite students to imagine what a room - for example, a kitchen - might look like if it was designed just for someone who used a wheelchair. High level wall shelves or low cupboards would not be useful. But a suspended gantry running the length of the room to hang equipment from might be. If that was in reach of someone sitting in a chair, it could well be around 1.6 metres from the ground – or chin height for an able-bodied person standing up. With that installed, who would be disabled when using that kitchen?

6. Disability Discrimination-MYTH Disability is something an individual
“suffers” from.
Disability Discrimination-FACT
Disability is the product of an
interaction between the person and the environment.
Challenging Prejudice –
Medical Model Thinking
􀂄 Individual is faulty
􀂄 Diagnosis
􀂄 Labeling
􀂄 Impairment becomes focus of attention
􀂄 Assessment, monitoring, therapy imposed
􀂄 Society remains unchanged
Challenging Prejudice –
Social Model Thinking
􀂄 Individual is valued
􀂄 Strengths and needs defined by self and others
􀂄 Identify barriers and develop solutions
􀂄 Resources are available for ordinary services
􀂄 Relationships nurtured
􀂄 Diversity welcomed, individual is included

7. Coming out of the shadows
With a group that has a good rapport, invite contributions about disabled people that students know well. How do they regard their disability? Talk about the difference involved in seeing the person first, and the impairment as secondary.
YOU MAY CHOOSE TO STOP AT THIS SLIDE. BUT GIVE ALL THE SLIDES OUT AS HANDOUTS AFTER WARDS
EXERCISES:
USE THE SOCIAL MODEL EXERCISES:
GIRL IN WHEELCHAIR POSTER
Then ‘STATEMENTS’ ask them to read statements and say what problem is from ‘social model’ and ‘medical model’ perpective.
Then place them as either –ve or +ve under the 5 headings.
Then discuss how, as an advocate. You might tackle the issue/make them more +ve
Disabled people, health and social inclusion

8. Why is a social model of disability needed?
The standard way of thinking about disability in the past was the so-called medical model. That remains fine for doctors, but it is less useful for others. The medical model, naturally enough, concentrates on disease and impairments. It puts what is wrong with someone in the foreground. It is concerned with causes of disease. It defines and categorises conditions, distinguishes different forms and assesses severities.
All these are important in diagnosis, prognosis, devising treatment programmes and in prevention. But they are not very relevant to the way that someone with a disability lives their day-to-day life. If you have epilepsy, you know what your seizures are like. It isn't necessary to know whether doctors regard them as mild, moderate or severe. It may be interesting for someone to know that the Latin name for their movement disorder is hemiplegia. But the chances are they are concentrating on more practical things.

9. What is unhelpful about
the medical model?
It is likely to inspire pity, or even fear. Pity is not a useful commodity.
Many people are scared of impairments, sometimes irrationally so.
The model risks objectifying people, lumping them together because of their condition, not because of who they are.
It is not nice to be told you are a typical case of something or other – and even worse to be viewed like that.
Perhaps the most important consequence of the medical model is that bringing the impairment into the foreground risks pushing the person into the background. They become less of a person, and more a collection of symptoms.
What is more, it doesn't have very much to say about people's lives and how they live them.

10. How is the social model of disability different?
Instead of emphasising the disability, the social model puts the person at the forefront. It emphasises dignity, independence, choice and privacy.
A key concept of the social model is that society disables people. Another way of saying this is that disability is a social construct. How we organise things in our culture limits and restricts what some of its members can do.
That takes some understanding, so first it is worth clarifying some terminology……

11. Words are important, not because of the need to use the fashionably correct terms, but because the terminology reveals the thinking behind them. Here are some definitions of two key words:
Impairment. Having an impairment means there is something not working properly with part of the body, mind or senses. Someone who has had a leg amputated has an impairment. So does someone whose learning disability makes it difficult for them to remember things. So does someone is partially blind, or deaf, or who has epileptic seizures, or who has unwanted muscular spasms, or any number of things that don't work properly.
Disability occurs when a person is excluded, because of their impairment, from something that other people in society take for granted. That might be the chance to attend an event, access some service or get involved in an activity. It might be to live independently, to earn a living, to be kept informed, or just to make choices for themselves.

12. You might assume that the impairment causes the disability. Wrong
You might assume that the impairment causes the disability. Wrong. It is the choices society makes that causes someone to be disabled. Organise things differently, and they are suddenly enabled, though the impairment hasn't changed. An obvious example might be a deaf person wanting to attend a conference. If no sign language interpreter is there, or no loop for a hearing aid, there is not much point in going. The person is excluded – disabled. But with a signer operating alongside the speakers, or a loop, the person can take part just the same as anyone else. They still have the same hearing impairment. But they are not disabled.

13. So the impairments themselves don't matter
So the impairments themselves don't matter? Obviously, they still matter. Not being able to see, hear, walk, has an important effect on people. But generally speaking people find ways to cope – they get used to living with the impairment. And in any case what someone with an impairment cannot do is always much less than what they can do – if they are given the chance. The idea of the social model of disability is to give them a chance, remove the barrier that society places.

14. So impairment does not have to lead to disability. That is right
So impairment does not have to lead to disability? That is right. Think about people who are have poor vision – short sight or astigmatism. Without spectacles or contact lenses very many would have a much reduced quality of life. They could not join in many events and activities, and may even be a danger to themselves and others in certain circumstances. But society provides an ophthalmologist on every high street, and a system of getting affordable corrective lenses. As a result, people with bad eyesight don't have to be excluded from anything. If we ordered life differently, the same could be true of people with learning disabilities, epilepsy, spina bifida, deafness, arthritis and all the other conditions we think of as "disabilities". People with these impairments could live the lives they wanted, getting involved with others and making informed choices about what they do.

15. Isn't using aids and adaptations for everyday life still a disability
Isn't using aids and adaptations for everyday life still a disability? No. Or if it is, we are all disabled. We all rely on aids and adaptations of some sort in our daily lives.
We use motor vehicles for transport, electronic aids for entertainment and accessing information. We rely on flushing toilets and water on tap for comfort and hygiene. We need electrical gadgets for cooking and washing clothes. Our society would disable everyone if these were not so readily available.
How disabled would you be if you had to find a private space and dig a hole every time you wanted to use the toilet?

16. What does the social model mean for disabled people?
The logic is that only disabled people – as individuals or groups – know how their ability to participate in society in the way that they want to is affected.
It is not something you can easily identify from outside. So, to find out what needs to be different, disabled people need to be listened to.
That puts them at the centre of things, replacing the paternalistic "we know what's best" approaches of the past

17. Models of disability
Individual: Disability is located in the individual with an emphasis on individual coping and acceptance
Medical: Disability defined in reference to the person’s functional status or condition with an emphasis on cure/reduction of functional deficits
Disability associated with loss (e.g. loss of function, impairment, deficits)

18. The Social Model of Disability
Disability is a function of the interaction of individuals and the social and physical environments
Focus on barriers, disabling and enabling factors in the physical environment and society
Concept of “functional limitations” as influenced by social roles, as opposed to medical quantifiers (e.g., ability to care for a child vs. how many lbs. can be lifted)

19. The Social Model of Disability, cont.
Disability as expression of human diversity and not as something in need of ‘cure’ or ‘correction’
More ‘in tune’ with the views and experiences of people with disabilities
Emphasizes social and economic participation over medical orientation

20. Disability, according to the social model, is all the things that impose restrictions on disabled people; ranging from individual prejudice to institutional discrimination, from inaccessible buildings to unusable transport systems, from segregated education to excluding work arrangements, and so on. Further, the consequences of this failure do not simply and randomly fall on individuals but systematically upon disabled people as a group who experience this failure as discrimination institutionalized through society. (Oliver, 1996)
Disability researchers like Mike Oliver have pointed out that the social model highlights society’s failure to accommodate human diversity and that the exclusion of people with disabilities from social participation is discrimination.
The Social Model urges health professionals to reflect on (a) how individuals views, experiences and priorities can be effectively recognized, and (b) how the outcome of medical support and intervention is not necessarily cure or symptom management, but social participation.

21. Impairment vs. Disability
biological, functional, cognitive
Disability
reduced participation due to society’s failure to accommodate the needs of individuals
For example, as a person with paraplegia I may not be able to control my legs (impairment) but I can use a device like a wheelchair that makes it possible for me to be as mobile as anyone else. If I cannot enter a building because it has steps, but no ramp, it is not the impairment of my legs that precludes me from entering the building, but rather the existing physical environment that does. I am fully capable of entering the building, provided a ramp is available.
It comes down to accommodating human diversity.

22. Subjective interpretations of ‘disability’: Which of the following statements reflects the medical vs. the social model?
“My doctor’s office is not accessible since it has no wheelchair access. This keeps me from seeing my doctor for check-ups.”
“I have a spinal cord injury and use a wheelchair, so I can’t see the doctor because of this.”

23. Key Points to Remember
The individual/medical model identifies ‘disability’ as a problem located in the individual and emphasizes the biological differences compared to the general population.
Most people with disabilities think about their lives in terms of the social model of disability.
The social model looks beyond the individual and focuses on the barriers that are imposed on individuals by society and environment.

25. Now imagine some problems they have, based on your 2 descriptions.
Exercise
Think about a person with a disability you may have met. Use the different models, the individual/medical and social model, to describe this person.
Now imagine some problems they have, based on your 2 descriptions.
What support would you suggest based on the needs resulting from the individual/medical model and the social model description?