The International Classification of Functioning, Disability and Health (ICF), produced by the World Health Organization, distinguishes between body functions (physiological or psychological, e.g. vision) and body structures (anatomical parts, e.g. the eye and related structures). Impairment in bodily structure or function is defined as involving an anomaly, defect, loss or other significant deviation from certain generally accepted population standards, which may fluctuate over time. Activity is defined as the execution of a task or action. The ICF lists 9 broad domains of functioning which can be affected:
Learning and applying knowledge
General tasks and demands
Communication
Mobility
Self-care
Domestic life
Interpersonal interactions and relationships
Major life areas
Community, social and civic life
(see also List of mental disorders)
The introduction to the ICF states that a variety of conceptual models has been proposed to understand and explain disability and functioning, which it seeks to integrate.
The medical model
Main article: Medical model of disability
The medical model is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition which therefore requires sustained medical care provided in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at "cure", or the individual’s adjustment and behavioral change that would lead to an "almost-cure" or effective cure. In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming healthcare policy.
The social model
Main article: Social model of disability
The social model of disability sees the issue of "disability" mainly as a socially created problem, and basically as a matter of the full integration of individuals into society (see Inclusion (disability rights)). In this model disability is not an attribute of an individual, but rather a complex collection of conditions, many of which are created by the social environment. Hence, in this model, the management of the problem requires social action, and thus, it is the collective responsibility of society at large to make the environmental modifications necessary for the full participation of people with disabilities in all areas of social life. The issue is both cultural and ideological, requiring individual, community, and large-scale social change. Viewed from this perspective equal access for people with impairment/disability is a human rights issue of major concern.
Impairment, culture, language and labeling
The American Psychological Association style guide states that, when identifying a person with an impairment, the person's name or pronoun should come first, and descriptions of the impairment/disability should be used so that the impairment is identified, but is not modifying the person. Improper examples would be "A Borderline, a "Blind Person." For instance: people with/who have Down syndrome, a man with/who has schizophrenia (instead of a Schizophrenic man), and a girl with paraplegia/who is paraplegic. It also states that a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits a person, e.g. "a woman who uses a wheelchair" rather than is "in" it or is "confined" to it.
A similar kind of 'people first' terminology is also used in the UK, but more often in the form 'people with impairments' (e.g. 'people with visual impairments', etc.). However, in the UK, the term 'disabled people' is generally preferred to 'people with disabilities'. It is argued under the social model that while someone's impairment (e.g. having a spinal cord injury) is an individual property, 'disability' is something created by external societal factors such as a lack of wheelchair access to their workplace.[3]. This distinction between the individual property of impairment and the social property of disability is central to the social model. The term 'disabled people' as a political construction is also widely used by international organisations of disabled people, such as Disabled Peoples' International (DPI).
Many books on disability and disability rights point out that 'disabled' is an identity that one is not necessarily born with, as disabilities are more often acquired than congenital. Some disability rights activists use an acronym TAB, "Temporarily Able-Bodied", as a reminder that many people will develop disabilities at some point in their lives, due to accidents, illness (physical, mental or emotional), or late-emerging effects of genetics.
The late Prime Minister Olof Palme of Sweden, speaking at the Stanford University Law School in the 1970s, summed up the divergence between U.S. and Swedish attitudes towards people with disabilities:
Americans regard the able-bodied and the disabled as, effectively, actively or not, consciously or subconsciously, two separate species, whereas,
Swedes regard them as humans in different life stages: all babies are helpless, cared for by parents; sick people are cared by those who are well; elderly people are cared by those younger and healthier, etc. Able-bodied people are able to help those who need it, without pity, because they know their turn at not being able-bodied will come.
Palme maintained that if it cost the country $US 40,000 per year to enable a person with a disability to work at a job that paid $40,000, the society gained a net benefit, because the society benefited by allowing this worker to participate cooperatively, rather than to be a drain on other people's time and money.[citation needed
Other models
The spectrum model refers to the range of visibility, audibility and sensibility under which mankind functions. The model asserts that disability does not necessarily mean reduced spectrum of operations. Instead, it could also include distorted/shifted spectrum. For instance, a blind person may be extra sensitive to infrared or ultraviolet waves. See also ESP.
The moral model (Bowe, 1978) refers to the attitude that people are morally responsible for their own disability, including, at one extreme, as a result of bad actions of parents if congenital, or as a result of practicing witchcraft if not. This attitude can be seen as a religious fundamentalist offshoot of the original animal roots of human beings, back when humans killed any baby that could not survive on its own in the wild.
The expert/professional model has provided a traditional response to disability issues and can be seen as an offshoot of the Medical Model. Within its framework, professionals follow a process of identifying the impairment and its limitations (using the Medical Model), and taking the necessary action to improve the position of the disabled person. This has tended to produce a system in which an authoritarian, over-active service provider prescribes and acts for a passive client.
The tragedy/charity model depicts disabled people as victims of circumstance, deserving of pity. This and Medical Model are probably the ones most used by non-disabled people to define and explain disability.
Social Adapted Model[citation needed]
Economic Model[citation needed]
Empowering Model[citation needed]
