Inclusiveness

Chapter 1
Understanding Disability and
Vulnerability

Instructor: Dargie Y.
Outlines
 Definitions of disability and vulnerability
 Causes of impairments and vulnerability
 Types of impairments and vulnerable groups
 Historical background of modalities moving towards inclusion
 Evolution of the concept of disability
 Brainstorming Questions
1. What is impairment?
2. How do you understand the concept of disability?
3. Is there any difference between impairment and disability?
1.1. Definitions of disability and vulnerability
• Disability is not uncommon and it is part of human
diversity.
• It is estimated that 15% of the world’s population
has a disability, a percentage that is expected to
grow because of:-
poor health care
nutrition early in life,
growing elderly populations and
violent civil conflicts.
Cont..
• Among the population of people with disabilities, approximately
80% live in developing countries and are disproportionately
represented among the poor.
• For instance, of the total population of Ethiopia, 17.6% are
estimated to live with some sort of impairment (WHO & World
Bank, 2011, p. 272).
• Understanding the concept of disability varies between cultures
and evolves with in a culture over time.
• People are using the two key terms, impairments and
disability interchangeably but there is a visible conceptual
distinction between these terms as described below:
1.1.1. Impairment
• Impairment is the “purely factual absence of or loss of
functioning in a body part.”
• Hence, the term impairment is used to notify the physical
condition of a person such as visual, physical, hearing, and
intellectual disabilities.
• It may result in activity limitation based on the degree/
severity, type and onset of the impairment.
 1.1.1. Impairment Cont..
• It refers to any loss or abnormality of a physiological,
psychological, or anatomical structure or function.
• It is the absence of a particular body part or organ.
• It could also a condition in which the body exists but doesn‘t
function.
• Some children, for instance, have impairments such as eyes that
do not see well, arms and legs that are deformed, or a brain not
developing in a typical way, etc.
• If these problems are addressed, an impairment may not lead to
disability.
 1.1.2. Disability
• The concept of disability is defined as “the interaction between
persons with impairments and attitudinal and environmental barriers
that hinders their full and effective participation in a society on an
equal basis with others” (UN CRPD, 2006).
• Disability is, therefore, a negative reaction of people towards persons
with impairments that results in “participation restriction.”
• Disability, as a concept is referred: as an umbrella term that include
impairment, activity limitation and participation restriction.
 1.1.2. Disability Cont..
• Hence, Article 1 of the CRPD describes persons with disabilities
as “those who have long-term physical, mental, intellectual, or
sensory impairments which in interaction with various barriers
may hinder their full and effective participation in society on an
equal basis with others.”
• Disability means functional limitations due to physical,
intellectual, or psychic impairment, health or psychic disorders
on a person (WHO, 1996).
 Reflections
[Link] is the concept of vulnerability?

[Link] you believe that all people are

vulnerable? How?
1.1.3. Vulnerability
• Vulnerable means being at risk or harmed.
• Everyone can be harmed, so being vulnerable is part of being
human.
• In principle, everyone is vulnerable to some adverse event or
circumstance, but some people are more vulnerable than others.
• For instance, people with disabilities are more likely as a group
to experience greater vulnerability.
• They are also often more severely affected by the vulnerability
they experience.
1.1.3. Vulnerability Cont..
• Vulnerability refers to state of being exposed to the possibility of
being attacked or harmed, either physically or emotionally.
• Accordingly, vulnerable groups belong to the people who are
physically and emotionally hurt and attacked as a result of various
forms of social injustice and malpractices.
• Vulnerability is classified into four categories as described below:
Physical vulnerability,
Economic vulnerability,
Social vulnerability, and
Attitudinal vulnerability.
A. Physical Vulnerability:
• The physical vulnerability of an area also depends on its
geographic proximity to the source and origin of the disasters
e.g. if an area lies near the coast lines, fault lines, unstable
hills etc.
B. Economic Vulnerability:
• Economic vulnerability of a community can be assessed
by determining how varied its sources of income are, the
ease of access and control over means of production
(e.g. farmland, livestock, irrigation, capital etc.),
adequacy of economic fall back mechanisms and the
availability of natural resources in the area.
C. Social Vulnerability:
A socially vulnerable community has weak family
structures, lack of leadership for decision making and conflict
resolution, unequal participation in decision making, weak or
no community organizations, and the one in which people
are discriminated on racial, ethnic, linguistic or religious
basis.
•Limited access to facilities such as transportation, schools,
libraries, or medical services;
•Lack of social support from social networks: no assistance
from family members, friends, neighbors, or colleagues
D. Attitudinal Vulnerability:
• A community which has negative attitude towards change and
lacks initiative in life resultantly become more and more
dependent on external support.
• This brings about disunity and individualism in the society.
• Thus, they become victims of conflicts, hopelessness and
pessimism which reduce their capacity of coping with a
disaster.
Brainstorming Questions
1)What are the major causes of impairment?
2)What are the contributing factors for vulnerability?
1.2. Causes of impairments and vulnerability
• The issue of disability/impairment is not yet being
scientifically understood and treated by the society
particularly in the low-income countries including Ethiopia.
• As a result, the cause of impairment is not appropriately
understood due to the reason that people still believe that
impairment is caused by curse, sin and wrath of God.
• However, even though some causes of impairment are
unknown, scientific research conducted on the issue
confirmed that the cause of impairment is classified into 2
major categories as described hereunder:
1.2.1. Biological Factors
• Under this category of the cause of impairment, genetically
induced factors are commonly known reasons.
• These include:
- Abnormalities in genes and genetic inheritance that may cause
intellectual disability, down syndrome and other multiple
impairments on children.
- Sometimes, diseases, illnesses, and over-exposure to x-rays
can cause a genetic disorder.
- Pre-term and underweight birth also may result in different
forms of impairment.
 1.2.2. Environmental Factors
• The adverse effect of poverty and starvation such malnutrition,
lack of access to health care and treatment etc. may cause
impairment to the child during pre- and- postnatal period.
• The use of drugs, alcohol, tobacco, the exposure to certain
toxic chemicals and illnesses, toxoplasmosis, cytomegalovirus,
rubella and syphilis by a pregnant mother can cause intellectual
and other types of disability to the child.
• Childhood diseases such as a whooping cough, measles, and
chicken pox may lead to meningitis and encephalitis. This can
cause damage to the brain of the child.
• Toxic material such as lead and mercury can damage the brain
too.
 1.2.2. Environmental Cont..
• Unfortunate life accident such as drowning, car accidents, falls,
landmines, war, etc. can result in people losing their sight,
hearing, limbs and other vital parts of their body.
• As in the case of impairment, among several examples of causes
of vulnerability, the following are the most known contributing
factors to vulnerability:
- Poor governance;
- Poverty;
- Discrimination;
- Inequality and inadequate access to resource and livelihood.
1.3. Types of impairments and vulnerable groups
• Regardless of the existence of a number of types of impairments, the
commonly known and major kinds of impairments are listed below.
1.3.1. Visual impairment (Generic terminology for blindness and low vision
1.3.2. Hearing Impairment (Generic terminology for deafness and hard of
hearing)
1.3.3. Specific Learning Disability (Dyslexia, Dysgraphia, Dyscalculia)
1.3.4. Speech and Language Impairments including fluency disorder
1.3.5. Autism
1.3.6. Emotional and Behavioral Disorders
1.3.7. Intellectual Disability
1.3.8. Physical /Orthopedic Impairments
1.3.9. Health related Impairments Such as:
- Heart disease;
- Acquired immune deficiency syndrome (AIDS);
- Hemophilia;
- Asthma;
- Diabetes;
- Tuberculosis;
- Cancer;
- Epilepsy;
1.3.10. Multiple Impairment:
- Deaf blindness
• Children, pregnant women, elderly people, malnourished
people, and people who are ill or immune-compromised,
are particularly vulnerable when a disaster strikes, and
take a relatively high share of the disease burden
associated with emergencies (WHO, 2020).
• Significant number of children are vulnerable and at risk
for development.
• In general poor and socially disadvantaged people are
the most known vulnerable groups throughout the world.
• The following features depict the common characteristics
of the vulnerable groups stated above:
- Less physically or mentally capable (infants, older
adults, people with disabilities);
- Fewer material and/or financial resources (low-
income households, homeless);
- Less knowledge or experience (children, illiterate,
foreigners, tourists);
- Restricted by society to grow and develop according
to their needs and potentials.
 Individual assignment (10%)
 Briefly explain the concepts, causes, and
intervention mechanisms of the following types of
impairments.
1. Visual impairment
2. Hearing Impairment
3. Autism
4. Emotional and Behavioral Disorders
5. Intellectual Disability
6. Physical /Orthopedic Impairments
1.4. Historical background of modalities moving towards inclusion
• In the postindustrial period legislations and litigations created opportunities
for children with disabilities to access education in public schools.
• The following modalities were applied to teach children with disabilities.
1.4.1. Specialized and or residential schools
• These schools were established with an intention to provide
educational services in specialized approach only for children with
disabilities.
• Consequently, schools for the deaf, schools for the blind etc. came
into being as separate institutions throughout 19 th and 20th century.
 [Link]
• In the 1960 and 70s special needs education classes were established in public
schools with an intention to create least restrictive environment for children with
disabilities.
[Link]
• The approach was introduced and applied in 1970s with an objective to
integrating students with disabilities in general class setting without the change of
regular school/education system.
• In this situation, students with disabilities are required to fit the system.
• This approach is characterized by the following realities:
- System stays the same;
- Round pegs for round holes;
- Change the child to fit the system;
- Make the square peg round;
- Child must adapt or fail.
Integration
 [Link] Education
• This approach was applied as of the last quarter of 20 th century
focusing on regular education system change to fit the special
educational needs of students with disabilities as discussed in the next
section in detail.
• This approach is characterized by the following factors.
- Flexible system;
- Children are different;
- All children can learn: (Different abilities, Ethnic Groups, Size,
Age, Background, Gender, Persons with disabilities);
- Change the system to fit the child.
Inclusive
 1.5. Evolution of the concept of disability
• In order to understand how disability is currently viewed, it is helpful to
look at the way the concept of disability has evolved over time as described
below.
[Link]/Charity Model
• Historically, disability was largely understood in mythological or religious
terms, e.g. people with disabilities were considered to be possessed by
devils or spirits; disability was also often seen as a punishment for past
wrongdoing.
• These views are still present today in many traditional societies.
PWDs outside of society and society
giving to PWDs
 [Link]/Medical Model
• In the nineteenth and twentieth centuries, developments in
science and medicine helped to create an understanding that
disability has a biological or medical basis, with impairments in
body function and structure being associated with different health
conditions.
• This medical model views disability as a problem of the
individual and is primarily focused on cure and the provision of
medical care by professionals.
PWDs outside of society and PWDs should
adapt to fit society
 1.5.3. Social Model/Human Rights-Based Model
• In the 1960s and 1970s, the individual and medical view of disability
was challenged and a range of social approaches were developed, e.g.
the social model of disability.
• These approaches shifted attention away from the medical aspects of
disability and instead focused on the social barriers and discrimination
that people with disabilities face.
• Disability is a highly varied and complex condition with a range of
implications for social identity and behavior.
 1.5.3. Social Model/Human Rights-Based Model Cont..
• Disability largely depends on the context and is a consequence of discrimination,
prejudice, and exclusion.
• Emphasizes the shortcomings in the environment and many organized activities in
society, for example on information, communication, and education, which
prevent persons with disabilities from participating on equal terms.
• Disability was redefined as a societal problem rather than an individual problem
and solutions became focused on removing barriers and social change, not just
medical cure.
PWD as part of society
 Activities

[Link] the following short story and identify the phrase that
clearly shows the meaning of impairment and disability.

Ten-year-old Mesfin’s eyes are damaged = ________________

due to an eye disease, and he develops difficulties in seeing =
_________________________. His school refuses to take him
back as they don’t have the resources to support a child with
visual impairment =_______________. There are no other
schools in his community and therefore Mesfin cannot go to
school = ______________________.
2. Which modality applied to teach children with disabilities isolated from
their non disabled peers? Why?
3. What factors make inclusive education as a modality to teach children
with disabilities and other vulnerable groups different from integration?
4. Who are exposed to vulnerability? Why?
5. What are the major and common characteristics of vulnerable groups?