People who have a disability are viewed as a minority group; however, they are the largest minority group in the world, comprising over 500 million people, two-thirds of whom live in developing countries. One in five Australians have a disability and most of us will experience a disability at some time during our lives.
There are various ways of understanding of disability. These are contentious and the subject of much debate but are important because perceptions of people with disability are socially and culturally conditioned. Our understanding of disability influences the way we behave towards them and the way in which structure our educational institutions.
The medical model for many years has been the dominant approach to disability. This model locates the "problem" of disability in the deviant body of the individual, rather than in society itself or in the way the deviant mind or body is perceived. It is based on the World Health Organisation's (WHO's) original classification system:
- Impairment: any loss or abnormality of psychological, physiological or anatomical structure or function.
- Disability: any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.
- Handicap: a disadvantage for a given individual, resulting from an impairment or 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.
This model has been strongly criticised for promoting the view that individual impairments determine disability and handicap, rather than attempting to explain the way in which society "disables" people. It leads us to forget the significance of the social context in which we all live.
In contrast, the social model sees disability as a result of environmental and social factors: people with impairments are disabled by barriers in society, by its structures and norms. Alison Davis, a person who identifies as having spina bifida, writes:
If I lived in a society where being in a wheelchair was no more remarkable than wearing glasses, and if the community was completely accepting and accessible, my disability would be an inconvenience and not much more than that. It is society which handicaps me far more seriously and completely than the fact that I have spina bifida.
We have a significant opportunity to change that context, to make sure that our society recognises and embraces the needs of all people, including people with disability. So, for example, rather than using the medical model to exclude someone with vision impairment from a laboratory, the way the laboratory is designed in the first place can address the needs of a diversity of people - this inclusive approach benefits everyone, not just a student with vision impairment.
There is considerable debate among disability-studies scholars about the social model. Some, such as Tom Shakespeare, argue for a more interactional and relational approach, which views disability as the result of the interplay between the individual and contextual factors.
The ICF model
The World Health Organisation recently defined disability as a complex interaction between body structures and functions, health issues, and environmental and personal factors which affect the participation of people in activities.
According to this International Classification of Functioning, Disability and Health approach, restriction of participation in activities is central to disability, placing emphasis on impact rather than cause. Disability can therefore occur to a greater or lesser extent, depending on the fluctuating nature of certain factors. For instance, a person who uses a wheelchair who is healthy and in an accessible environment may experience little disability. Another person who once had a psychotic episode, may have no ongoing mental health issues, but may be treated in a negative manner by people who recall this episode. This person will experience disability without any underlying impairment.
Disability is therefore a complex phenomenon that involves environmental factors (such as policies and attitudes), key activities (such as education and employment programmes), personal factors (such as familiarity with assistive technology or orientation and mobility skills), as well as access to appropriate health and disability services. Successful participation in educational and employment activities for people with a disability cannot be achieved without addressing each of these aspects.