Everyone has their own idea of what a disability is, but are we talking about the same thing? Does disability affect many people in our society?
These are just a few of the questions this module seeks to address.
The module also presents a current view of the main difficulties that persons with disabilities still face when seeking work and, and finally, it will explain why and how to address the stigma and discrimination that often affect people with disabilities.
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Historically, people thought of disabilities as individual characteristics. Disability was the equivalent of personal impairment, primarily physical. Today, that idea still exists, but it does not correspond to the present scientific concept. Disability is the outcome of the interaction between the individual and his or her mental and physical characteristics and the social and physical environment. We can therefore define disability as the outcome of the interaction of the disabled person with the behavioural and environmental barriers that block the person’s full participation in society at the same level as other people.
The concept has gone from a medical model to a social model.
Historically, people thought of disabilities as individual characteristics. Disability was the equivalent of personal impairment, primarily physical. Today, that idea still exists, but it does not correspond to the present scientific concept. Disability is the outcome of the interaction between the individual and his or her mental and physical characteristics and the social and physical environment. We can therefore define disability as the outcome of the interaction of the disabled person with the behavioural and environmental barriers that block the person’s full participation in society at the same level as other people.
The concept has gone from a medical model to a social model.
According to the ICF “The medical model views disability as a problem of the person, directly caused by disease, trauma or other health condition” (WHO, 2001, p.20).
Those who follow this perspective focus on the individual problem and deal with disability as a problem that needs a solution, therefore a remedy or adjustment of the person and behavioural change.
“The social model of disability, on the other hand, sees the issue mainly as a socially created problem, and basically as a matter of the full integration of individuals into society” (WHO, 2001, p.20).
Adopting the social model, the focus is on social integration and social action. Society as a whole has a responsibility to remove barriers, changing attitudes and disability is considered a human rights issue.
The International Classification of Functioning, Disability and Health, known as ICF, has been published by the World Health Organization (WHO) aiming an International standard Classification as a “framework for the description of health and health-related states (WHO, 2001, p.3). The ICF is not a classification of diseases, it focuses on the level of functioning of a person relative to his particular condition, in a social and physical environment. The CFI therefore focuses on health and its components, not on the causes or consequences of disease. Under the ICF and the social model of disability, the concept of “disability” has two distinct parts.
Part 1. Functioning and Disability
The concept of ‘disability’ always has to do with our ‘functioning’ as an individual.
How disability affects our functioning, happens in two dimensions:
(a) Body Functions and Structures and impairments
In ICF “body” refers to the whole individual with their physical and psychological systems. So body functions are physical functions, but also mental functions.
Body structures are the anatomical parts of the body, such as limbs, spinal cord, eyes, etc.
Impairments are problems in body functions or structures as a significant deviation or loss.
(b) Activities and Participation
Activity is the execution of the action. If a person cannot execute a task where other people will do, we talk about activity limitation, but this can find a solution through the technology, for example, avoiding the activity limitation.
In the old WHO classification, the word disability was used just like activity limitation.
Participation is every involvement in a life situation. Sometimes there are participation restrictions when an individual may experience problems in involvement in life situations when compared to an individual who does not experience the same problems in a particular culture. That is, participation may or may not be restricted in accordance with cultural norms.
In the old terminology instead of participation restriction the word handicap was used. Example of participation restriction; a wheelchair user could have problems in a ballroom, depending on the social attitudes toward dance by a wheelchair user, although a wheelchair user can also participate as a dancer in some contexts.
Part 2. Contextual Factors
Apart from our functioning as an individual, disability also relates with the context that implies whether someone is seen as someone who has a disability, or not. This part of the concept of disability also has two dimensions:
Environmental Factors Environmental factors describe the social and physical context where the persons lives. They are an important component of the contextual factors
Personal Factors Personal factors are the individual characteristics which interact with the environmental factors such as physical barriers and social attitudes toward Disability.
Here is a quick overview of certain disabilities. I have to mention just the conditions that are most in the public knowledge because they are more visible and could lead to a refusal by employers when a person with one of these disabilities applies for a job.
Physical disability
Physical disability is the total or partial dysfunction of some parts of the body like the lower or upper limbs that limit mobility in several human activities like “moving by changing body position or location or by transferring from one place to another, by carrying, moving or manipulating objects, by walking, running or climbing, and by using various forms of transportation” (WHO, 2001, p.142)
Intellectual disability
In adults, intellectual disability is defined as intellectual capacity (IQ), which is inferior to the average population.
Intellectual disability limits communication skills, academic achievement, daily performance, and safety and work performance.
Intellectual disability should not be confused with a mental disorder that is a situation that occurs in the individual regardless of his intellectual capacity and that also has negative impacts on his or her social, occupational, family and personal life.
Visual disability
Visual disability refers to total or partial loss of vision and can be congenital or acquired. There are many types of visual impairments that require an individual to adapt specifically to personal, social or professional activities.
Deafness
Hearing loss or deafness results in partial or full hearing loss in one or both ears.
Deaf people need to adapt to personal, family, social and work situations.
Multiple disability
Multiple disability consists of the occurrence of two or more disabilities simultaneously – whether intellectual, physical or both combined.
The World Health Organization recognises that disability is an important human rights issue “because people with disabilities experience inequalities – for example, when they are denied equal access to health care, employment, education, or political participation because of their disability.
People with disabilities are subject to violations of dignity – for example, when they are subjected to violence, abuse, prejudice, or disrespect because of their disability. Some people with disability are denied autonomy” (WHO, 211, p. 9).
The rights of persons with disability are promoted and protected by all the states which subscribed the UN convention on the rights of persons with disabilities. Under international law, a convention is a formal agreement between states. The convention is mandatory for the states which subscribe it.
The first article in the convention states the following: “The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity. Persons with disabilities include 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” (United Nations, 2006, article 1).
In the final module, you will find an expansion of this topic.
Activity limitations
Activity limitations are the difficulties that a person may have in carrying out activities that other people are able to do. However, activity limitations are dependent upon personal characteristics and the environmental and social context.
Activity limitations can occur in self-care such as dressing and bathing, or in everyday situations such as shopping.
In the activities of working life there are limitations, but in many situations they can become smaller with the help of technology.
Participation restrictions
Participation restrictions are problems an individual may experience in involvement in life situations. As in the case of activity limitations, participation restrictions depend on individual health status and contextual factors.
Participation in family, social and civic activities play a major role in a person’s life. In many cases, these restrictions are the result of stigmatisation and negative attitudes towards people with disabilities.
Attitudes from the immediate family and family network
Attitudes are enduring beliefs about an individual, subject, group or situation that tend to react negatively or positively. These attitudes influence individual behaviour and social life at all levels and may motivate positive or discriminatory practices. Negative family attitudes towards the disabled member or his or her health status can cause difficulties in the activities, participation and social integration of people with disabilities. It could happen in the immediate family, in other words, people living in the same household or in the family network.
Employers’ attitudes
The negative attitudes of employers towards disability constitute a major difficulty in labour market integration. These negative attitudes may be linked to the misconception that persons with disabilities perform very poorly.
Aside from employers’ negative attitudes, people with disabilities face another work integration issues, such as environmental barriers in the workplace and lack of accessibility in the built environment.
For further information about how to engage employers to hire someone with a disability, go to module 6.
Stigmatization is a negative social response to a characteristic or condition that is perceived as bad, repugnant or abnormal. People tend to react this way when they know or imagine a person who is associated with a deformity, disability or difference that generates anxiety or fear. The person’s anxiety or fear can result in feelings of rejection and discrimination.
So, Social stigmatisation is the discrimination of an individual based on perceptible bodily, behavioural or social characteristics that are considered abnormal, inferior and to devaluate the individual.
Persons with disabilities are many times discriminated because the existence in society of wrong ideas on disability. Sometimes stigmatization is an unconscious process of cultural origin, as it happens under the influence of myths or popular beliefs which are accepted as granted by the majority of the population.
In the next section we will give some examples.
Myths about disabilities promote negative images and discrimination and origin barriers to the realization of human rights of persons with disabilities.
These are some frequent myths about disabilities:
Persons with disabilities are in constant pain
Disabled people are very brave and courageous
People with disabilities should be treated differently
People with disabilities are dependent and need help
People with disabilities are not able to work and cannot be as productive as other people.
What does bias mean? Bias is the tendency to be unfair to an individual or group based on an uninformed judgement. Bias is a synonym of prejudice. This may occur due to the lack of objective information or our own opinions that are developed in the society we live in. Because our personality interiorises what we think others think, we develop prejudices based on social class, religion, political participation, race, and ethnicity and so on. Very often, personal prejudices are unconscious, but they are embedded in our way of thinking.
Upcoming activities focus on biased behaviour. We hope they will contribute to that discussion.
In this module you have now learned about what disability is and how the scientific concept of disability has evolved, starting with the medical model; after with the social model and recently with the human rights approach (visit in this module, sections 1.1 and 1.2 for revision of the concept.
You have also learned how disability can affect everyday life (point 2) and the importance of demolishing stigma barriers to improve the quality of life and the respect of the human rights of people with disabilities (point 3).
Disabilities cannot be considered only as a problem of the individual, they must be considered from a bio-psycho-sociocultural perspective, that is, in a continuous interaction between the individual and the social and physical environment in which he lives. This perspective will help persons who have longterm physical, mental, intellectual or sensory impairments to reach “full and effective participation in society on an equal basis with others” (Convention on the Rights of Persons with Disabilities. Article 1)
Convention on the Rights of Persons with Disabilities – Articles | United Nations Enable United Nations (2018). United Nations Disability Inclusion Strategy. New York: United Nations.
