Impairment is the loss or limitation of physical, mental or sensory function on a long term, or permanent basis.
Disablement is the loss or limitation of opportunities to take part in the normal life of the community on an equal level with others due to physical and social barriers.
Disabled People include people with: physical impairments; sensory impairments (deaf people, blind people); chronic illness or health issues including HIV and AIDS; all degrees of learning difficulties and emotional and behavioral problems. It also includes people with hidden impairments such as epilepsy, diabetes, sickle cell anemia; specific learning difficulties such as dyslexia, speech and language impairments, children labeled as ‘delicate’; people who identify as ‘disfigured’; people of diminutive stature and people with mental distress.
All are excluded by barriers though not all have impairments. There are two ways of viewing disablement: the ‘Medical Model’ or the ‘Social Model’.
The ‘Medical Model’ of Disability
The ‘medical model’ sees the disabled person as the problem. They are to be adapted to fit into the world as it is. If this is not possible, then they are shut away in some specialised institution or isolated at home, where only the most basic needs are met. The emphasis is on dependence, backed up by the stereotypes of disability that call forth pity, fear and patronising attitudes. The power to effect change seems to lie within the medical and associated professions, with their talk of cures, normalisation and science. Disabled lives are often handed over to them.
Other people’s assessments, usually non-disabled professionals, are used to determine schooling, support and what type of education; where they live; whether or not they can work and what type of work they can do and indeed whether or not they are born at all, or are even allowed to procreate. Similar control is exercised by the design of the built environment presenting many barriers, thereby making it difficult or impossible for disabled needs to be met and curtailing life chances. Whether it is in work, school, leisure and entertainment facilities, transport, training and higher education, housing or in personal, family and social life, practices, and attitudes are disabling. Powerful and pervasive views are reinforced in the media, books, films, comics, art and language. Many disabled people internalize negative views of themselves that create feelings of low self-esteem and achievement, further reinforcing non-disabled people’s assessment of their worth. The ‘medical model’ view creates a cycle of dependency and exclusion, which is difficult to break. ’Medical model’ thinking predominates in schools where special educational needs are thought of as resulting from the individual who is seen as different, faulty and needing to be assessed and made as normal as possible.
The ‘Social Model’ of Disability
If people were to start from the point of view of all children’s right to belong and be valued in their local school we would start by looking at ‘what is wrong’ with the school and looking at the strengths of the child. This second approach is based on the ‘Social Model’ of disability thinking which views the barriers that prevent disabled people from participating in any situation as what disables them. The Social Model arises from defining impairment and disability as very different things.
In addition to this, the obsession with finding medically based cures, distracts from looking at causes of either impairment or disablement. In a worldwide sense, most impairments are created by oppressive systems – hunger, lack of clean water, exploitation of labour, lack of safety, child abuse and wars.
Clearly, this thinking has important implications for our education system, particularly with reference to primary and secondary schools. Prejudicial attitudes toward disabled people and, indeed, against all minority groups, are not inherited. They are learned through contact with the prejudice and ignorance of others. Therefore, the challenge to discrimination against disabled people must begin in our schools. The fight for the inclusion of all children, however ‘severely’ disabled, in one, mainstream, education system, will not make sense unless the difference between the ‘social’ and the ‘medical’ or individual model of disability is understood.