DISABILITY MODELS

What is a model?
- A set of guiding assumptions
- Human made tool for understanding
- Human made tool for guidelines for action
- A representation of reality
- However, models of disability result in the daily, lived experience of PWDs
- - No single model completely describe the disability experience
- - All of these models describe disability as one-dimensional.
- - Further, no PWD thinks of his or her life in terms of these three, neat models.
- - Disability is a complex, multivariate experience.

What is a Model of Disability?

- Label
- Belief
- Perception
- Meaning
- Thought
- Views
Views about Disability or people with Disability appears into sets of attitudes/ attitudinal
behaviours against people with Disability
-VE and +VE views about people with Disability. The majority of the society feel negative
hence express negative behaviour against people with Disability. The –VE views were
deliberately constructed by the majority of the society hence Social Model of Disability. + VE
views are with people with Disability, they are regarded as sick people that need care and support
by the medical personnel hence call Medical Model of Disability. Several disability models have
been developed and used, a few are described below:
Medical model/Biomedical model
Considers disability as a problem of an individual directly caused by a
disease or health related problem requiring medical treatment by
professionals.
- This model considers people disabled on the basis of not being able to function
as normal people.
- The medical model or illness approach is based on the view that disability is
caused by disease or trauma and its resolution or solution is intervention provided
and controlled by professionals
- Disability is perceived as deviation from normality and the role of persons with
disability is to accept the care determined by and imposed by health professionals
who are considered the experts
- In this model, disability is considered as residing within the individual.
- In this approach rehabilitation has a role to play in bringing people close to
normal.

This approach to disability has been rejected by many individuals with disability and disability
advocacy groups
- Because it does not cover the full spectrum of issues related to living with a
disability
- It ignores the ability of many individuals to live full and successful lives and to
be independent
- It also ignores the impact of a disability on access to health care, and the need to
modify how care is delivered because of a disability.
- The medical model reinforces the view that physicians, nurses and other health
care professionals are best qualified to make key decisions about health issues.
- Individuals with disabilities are often regarded as tragic
- This model is criticized for viewing medical care as the main issue in disability
as its major concern is health care and rehabilitation services
Social Model
This model view disability as a social construct.
- The social model of disability views disability as socially constructed and a
consequence of society’s lack of awareness and concern about those who may
require some modifications to live full, productive lives
- The model, referred to by some as the barriers model, views the medical
diagnosis, illness or injury as having no part in disability.
- Rather, society is considered the cause of disability, which is considered a
consequence of an environment created for the able-bodied majority.
- Disability is not viewed as an attitude of an individual but rather a complex
collection of conditions created by social environment and requiring social
change.
- This model blames society for disabling physically impaired people through
isolation and exclusion of people with impairment from active participation in
a society.
- The social model proposes that collective action of the society is necessary to
make environmental modifications for people with disabilities in all areas of
social life.
- It furthermore indicates that persons with disabilities are under privileged
because of attitudinal and ideological issues making disability a human right
issue.

This model has been criticized

- Because it ignores or dismisses disease or injury as part of the picture
- Although such factors and their consequences may have a major role in the life of a
person with a disability and may require intervention by health care providers at times.
People with disabilities are encouraged to see any problems they encounter as emerging from
barriers and negative attitudes of others in their social environment

Bio-psychosocial model
- This model is based on the integration of both medical and social
models also referred to as the International Classification of Function
(ICF).
The bio-psychosocial approach or model of disability views disability as arising from a
combination of factors at the physical, emotional and environmental levels
- This approach or model takes the focus beyond the individual
- It addresses issues that interact to affect the ability of the individual to maintain as high a
level of health and wellbeing as possible and to function within society.
- This approach is consistent with the WHO’s revised definitions of disability.
- It recognizes that disabilities are often due to illness or injury and does not dismiss the
importance of the impact of biological, emotional and environmental issues on health,
well-being, and function in society.
- Critiques of this model have suggested that:
The disabling condition, rather than the person and the experience of the person
with a disability, is the defining construct of the bio psychosocial model
- The ICF attempts to achieve a synthesis of both medical and social
models in order to provide a coherent view of different perspectives of
health from biological, individual and social perspectives.
- The ICF recognises that genesis of disability is precipitated by both health and
environmental conditions that give rise to impairment and then activity
limitations.
- The bio-psychosocial model establishes the basis for more comprehensive
description of the experience of patients suffering from determined disease
- Under this model function is viewed in relation to a health condition, personal
factors and environmental factors.
- Function denotes the positive aspect of the interaction
 - While disability the negative aspect of the interaction between an individual
with a health condition and the environment

Evolution of the ICF model

- From International Classification of Impairment,
- Disability and Handicap (ICIDH 1) to IC1DH 2
- The ICIDH1 was introduced in the 1980s and was used as a framework
- It was criticized for adopting the medical-biological view on disability where
disability issues were getting medicalized
ICDH2
- Criticized for maintained stigmatization of people with disabilities hence it was a
threat to the disability community
- People with disabilities were classified in the same way as disease instead of
functional level which guides selection of interventions
- Such type of classification contributes to abuse of priority setting (ministry of
health instead of ministry of disability)
- This has negative impact on some of the necessary conceptual development and
debate
- Distinction between disability and function is not easily made since there is no
clear standards to determine whether a person is disabled (impairment considered
disability)

Interface Model
Related to the bio psychosocial model
The interface model is based on the premise that disability exists at the meeting point or interface
between the person’s medical diagnosis and the environmental factors that affect disability.
- Disability is seen as neither the medical diagnosis nor the environment alone.
- In this model those individuals with disability define their own problems and seek
solutions, which may include intervention by health care professionals including nurses.
- However, these interventions are designed collaboratively by those with disabilities and
health care professionals.
- Disability is viewed as a life experience in which the person with the disability is in
control and empowered