Lecture 4 - Medical & Social Models of Disability

Question 1

disability is NOT…

Answer 1

• > a chronic disease or traumatic injury
• > a process of sequence

Question 2

disability is _____

Answer 2

• > an umbrella term for impairments in structure and function that affect activity and participation within the context of person al environmental factors
• > a medical and/or social construct

Question 3

what is a disability MODEL

Answer 3

a framework for enabling the classification of limitations in activity and function and for identifying the barriers to participation

Question 4

why do we need disability models

Answer 4

• > consistent terminology and meaning for improved communication
• > uniform/standardized measures of health indicators
• > assessing rehabilitation intervention efficacy
• > organizing and analyzing health information i.e. epidemiology, population health research

Question 5

evolution of the disability model

Answer 5

two distinct types of models emerged during the global rise of global conflict and high rates of morbidity and with the civil rights movement
- > medial model
- > social model

Question 6

medical vs social models of disability

Answer 6

Medical model (science, numbers ect.)
Context: person centric
Language: “person with a disability
Origin: bodily impairments
Action: identify and reduce impairments
Social Model (how society must change to accommodate)
Context: society centric
Language: a disabled person
Origin: systemic societal barriers
Action: identify and remove barriers

Question 7

ICIDH

Answer 7

International Classification of Impairments, Disability and handicaps
- > created by the WHO in 1980
- > attempted to model disability as a continuum from disease/injury to its consequences, described as “handicaps”
Disease - > Impairment - > Disability - > Handicap

Question 8

ICIDH disease vs disorder

Answer 8

Disease
- > a pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms
Disorder
- > and ailment that affects the function of mind or body

Question 9

ICIDH impariment

Answer 9

any loss or abnormality of psychological, physiological or anatomical structure or function

Question 10

ICIDH disability

Answer 10

any restriction or lack of ability (resulting from impairment) to perform an activity in the manner or within the range considered normal for a human being

Question 11

ICIDH Handicap

Answer 11

a disadvantage for a given individual, resulting from an impariement or a disability, that limits or prevents the fulfillment of a role that is normal (depending on sex, age, and social/cultural factors)

Question 12

disability model vs framework

Answer 12

a framework is better than a model with regards to classifying disability due to the variability of the individual and their limitation

Question 13

Limitations of the ICIDH model

Answer 13

published research shows classification were too closely aligned w/illness
- > does not include sociological, environmental or cultural or other influences in the definition of handicap
- > consider how 2 ppl can have the same disability but impairments differ
the limitations ultimately led to the rejection of the ICIDH by the World Health Assembly

Question 14

1991 Nagi model of disability

Answer 14

was commissioned by US Social security Administration to develop a framework for determining eligibility for disability benefits
- > very similar to ICIDH model but with a few differences
Pathology - > impairment - > functional limitation - > disability

Question 15

Nagi Pathology

Answer 15

interruption or interference with normal processes, and effort of the organism to regain normal state

Question 16

Nagi impariment

Answer 16

a loss or abnormality at the tissue, organ, and body system level

Question 17

Nagi functional limitation

Answer 17

limitation in performance at the level of the whole organism or person

Question 18

Nagi disability

Answer 18

Limitation in performance of socially defined roles and tasks within a sociocultural and physical environment

Question 19

Compare and contras ICIDH vs Nagi models

Answer 19

See slide 23
in the ICIDH, the language infers the barrier (handicap) is due to the persons disability and Nagis Model introduces the concept that disability, at least in part, is related to the sociocultural and physical environment of the person

Question 20

IOM Model (Rehab model)

Answer 20

Disability <- > Functional Limitation <- > Impairment
this model considers…
Risk Factors
- > predisposing factors present prior to disabling event
Intra-individual Factors
- > such as lifestyle and behavioural changes, psychosocial attributes, and coping skills, willingness to make accommodations, ect.
Extra-Individual Factors
- > pertain to the physical as well as the social context in which the disabling process occurs

Question 21

Social Model of Disability and how it is applied in our society

Answer 21

Read slides 32-40

Question 22

2001 ICF Disability Model

Answer 22

International Classification of Functioning, Disability and Health
- > there was still a need for a classifying system that captured all aspects of health in all cultures and societies of the world
- > organized into a framework suitable for measuring and reporting health at the individual and population levels
- > the major difference between this models and others is that “disability” is treated as an umbrella term for impairments in structure and function that affect activity and participation within the context of personal and environmental factors
SEE SLIDE 44 FOR DIAGRAM

Question 23

core domains of the ICF disability model

Answer 23

all three core domains (body system level, person level, society level) are able to interact with on another and do not follow sequence
- > personal (intra-individual) and environmental (extra-individual) domains act to determine the relationships between the three primary domains

Question 24

Capability Model

Answer 24

application of the ICF model
the capability model concerns turning “comodities” (goods and services) into functionings which can translate into improvements in well being
- > determines if an individuals commodities are actually helpful in their day to day life; just because a wheelchair may be available does not mean its is available, or desired by all those who might use it