Disability As A Difference

WHO-Definition of Disability• Disability is defined as:

the unsuccessful interaction between a person with an impairment and an unsupportive environment

Environment has four dimensions:– Physical– Social– Financial– Political

Disability as a social constructDifferently Abled

Theoretical Perspectives

1. Biomedical: emphasis on impairment & abnormality

Patient is sick and society has an obligation to provide basic level of health care

2. Economic Model: emphasis on the economics of disability

How does impairment affect capacity consequently limiting ability to be productive

Theoretical Perspectives (Continued)

3. Sociopolitical Model: represents current trends

• Disability is a form of social injustice due to stigma, discrimination and marginalization

4. Normalization Theory: right to live life normally

• Explains de-institutionalization/integration for people living with developmental & psychiatric diagnosis e.g. group homes, independent living, etc

The Future

• Number of people living with disability will increase because:

1. population is aging2. medical technology is improving3. increasing # of infants survive with chronic

impairments

Barriers to Services

1. Funding Barriers: Inequality amoung people with disabilities – varies

greatly depending upon their source of income

2. Rigid Rule Barriers:– Programs tend to require the consumer to adapt or

adjust to its requirements instead of being flexible based upon individual needs

Barriers to Services (continued)

3. Linking Services to Income:– Some people living with disability seem to have

access to major funding however, we forget how much it costs to be disabled and how much are spent on care needs

4. Administrative Barriers:– Access to services can be a complicated process or

has long waiting lists

Barriers to Services (continued)

5. Attitudinal Barriers:– Occurs within the community re: integration– E.g. not in my backyard mentality

Understanding the Disability Experience

Onset, Course & Outcome

Onset of the disability

• Way in which person becomes disabled has a major effect on self-perception– Disability at birth or early on – person never

knows themselves without the disability– Acquiring a disability suddenly/traumatically– Gradual onset

Course of the Disability

• Progressive– Disability progresses to greater levels of

impairment e.g., ALS

• Chronic– Once the adjustment to the disability is made

there is reasonable levels of stability

• Relapsing – Exacerbation-remission cycle e.g., MS & Lupus

Outcome

• Outcome looks at the changes in lifespan changes– Some disabilities may shorten life. Others shorten

it slightly, while other reduce life expectancy dramatically.

– We live in a society that avoids thinking of death

Understanding the Experience of Disability

Living with the limitations & stereotypes

Types of Disabilities

• Limitations on mobility & energy• Sensory limitations• Limitations in communications• Limitations in reasoning ability and mental

functioning

Note: many disabilities are impairments only because of the social context and the built environment

Mobility Limitations – things to consider

• Independent Wheelchair Mobility– Necessary to look up to make eye contact– Counters often too high– Harder to use many public facilities– Public transit – not all bus routes equipped– Wheelchair accessible bathroom stales often the furthest

away – Shopping hard to manage– Accessible entrances not always where you think they are– Our bodies are not designed for sitting all the time– Textures of floor coverings

Mobility Limitations – things to consider

• Dependent Wheelchair Mobility– Greater dependency on others to care for them

e.g., eating, bathing, toileting

Limitations due to Energy Levels

• Often having a condition or disability or being treated for it can use up enormous energy– Medications can weaken,– Receiving chemotherapy.

• Certain types of disabilities are particularly associated with losses in energy – Chronic fatigue, Fibromyalgia, diseases related to lung capacity

Sensory Limitations – Vision & Hearing

• Limitation can be complete or a partial absence

• Blindness– Vision our favourite sensory– A social construct

• Visual impairment– Easier to navigate – Takes enormous energy

Sensory Limitations – Vision & Hearing

• Deafness & Hearing Limitations– Strong social component – Deaf culture– Has all the distinguishing marks for culture – a

language, terminology & expressions, criteria for admittance and an established way of interacting

– Deafness as a social construct – ability to learn other languages

Sensory Limitations – Vision & Hearing

• Hearing Impairments– Rarely identify with deaf culture– Assistive devices have gotten significantly better

Limitations in Communications

• Expressive Aphasia & Other Limitations in Speech– Expressive Aphasia• Individual unable to use the proper words or to form

words to communicate• Often seen with cerebral damage and head trauma• Limiting – often only the most basic needs that are

communicated due to effort involved in communicating

Limitations in Communications

• Receptive Aphasia– Seen with some types of learning disorders• The person has difficulty in processing verbal and /

written communication• What reaches the brain is not comprehensible• Difficulty individual facing is often not noticeable

Limits in Reasoning Ability & Mental Functioning

• A very broad group including:– Developmental disabilities– Mental illness– Alzheimer’s disease– Senile dementias– Brain injuries

Cognitive Limitations: Developmental Disabilities

• Constant state of dependency results in high levels of abuse – 80%

• Compliance is a learned social behaviour• Very vulnerable out in the community• Sexuality and sexual identity often

discouraged

Limitation in Cognitive Functioning: Alzheimer’s &

Senile Dementia • Different from Developmental disabilities in that they

occur later in life• Person experiences changes in – personality and

behavioral, and reasoning ability and perception• Wide variation in the experiences – some become

anxious, agitated, aggressive, confrontational, other become peaceful, happy and pleasant

• Very difficult on the families as relationships change

Limitation in Cognitive Functioning: Mental Illness

• Mental illness as social construct – something that society has created to explain behavior that is outside the norm

• One of the most negatively judged limitations in society

Visibility: Special Challenge

• When people with disabilities interact with others in society, the disability itself becomes one of the factors of the interaction, often determining the quality and quantity of relationships.

• Some disabilities are visible and recognizable and others are not

Invisible Disabilities

• Sharing is voluntary much of the time.• Sharing makes the invisible visible – it

identifies you as having a difference from others

• When do you share?

Disability As A Difference

Disability is not the issue. The issue is the fit of disability with the social, attitudinal, medical,

architectural, economic & political environment!