Models of Disability In the field of Social Work

This post provides a brief overview of the various models of disability, including the social model, the transactional model, the systems model, and the medical model.

Introduction
The Medical Model
The Social Model
The Transactional Model
The Systems Model
The Professional Model of Disability
The Charity Model of Disability
The Moral Model of Disability
The Legitimacy Model of Disability
The empowering Model of Disability
The Social Adapted Model of Disability
The Economic Model of Disability
The Market Model of Disability

Introduction

Social workers can utilise disability models as the foundation for a methodical approach to comprehending the causes and settings of impairment (Imrie, 1997). Models of disability serve as a lens through which a person's condition is understood, highlighting some characteristics while ignoring others (Fougeyrollas & Beauregard, 2001). This shows that social workers strategically employ models based on the key difficulties that an individual faces given his or her age, type of developmental disability, and social milieu.

Disability models have typically been applied to shed light on the objectives and experiences of impaired adults (Marks, 1997). Parents of children with impairments may not have the same experiences or goals in mind for their children. The majority of these parents don't have disabilities themselves, know little to nothing about the "disability community," and undoubtedly start off raising a child with a disability by interacting with the medical and healthcare systems. Parents seek medical attention for their children with the goal of "fixing" them, if not completely, then at least partially. This goal moves from a medical intervention focus to an adaptable environment focus over time as parents gain information and understand that many disorders are lifelong.

Disability models refer to conceptual frameworks for comprehending the root causes of disabilities and, implicitly, the remedies for addressing them (Altman, 2001). The decision about the intervention programme and, consequently, the disability model is one that has very high stakes for children with disabilities, their families, and social workers. Developmental disabilities place a strain on a child's, family's, and community's resources due to their multifaceted and stage-sensitive needs. A model of disability can help by outlining which aspects of the situation are crucial, how they work together, and how an ideal end might be achieved, which is necessary for successfully addressing such demands. Handicap models implicitly represent not only the disability but also the circumstances that mitigate its detrimental effects on functioning. As a result, different models of disability imply various intervention strategies, and no single model can adequately underpin the full range of interventions strategies. However, each model also has a distinct, and inevitably constrained, approach to reducing the effects of impairment. These drawbacks support the strategic tool use of models rather than their use as independent action plans. Unfortunately, parents frequently choose an intervention for their child without having a good understanding of what the intervention would include. Another reason why the parents might not be able to employ the appropriate intervention is a lack of awareness among disability specialists. Professional ignorance causes misleading information to spread, which influences parents to adopt the medical model rather than the social model. In the area of disability rights, activists frequently use the social model.

Therefore, a deeper comprehension of the disability models underlying the interventions will undoubtedly enhance both the ability of parents and social workers to make decisions and the ability of service providers to create interventions. For people with disabilities, social workers, and service providers, there are four main models of disability that are particularly useful: the medical model, the social model, the transactional model, and the ecological or systems model.

The Medical Model:

The strength and reputation of the medical practitioners, insurers, and institutions on whose opinions, expertise, and influence the medical model is founded make it likely the most influential and pervasive model in use today (Llewellyn & Hogan, 2000). The medical model frames disability in terms of pathology and impairment, such as sensory, neurological, and cognitive impairment resulting from trauma or a disease process (Danforth, 2001). Due of its emphasis on inadequacies, the medical paradigm is sometimes portrayed as being demeaning or dehumanising (Bax, 1998).

The medical model makes the assumption that the symptoms of an illness, syndrome, disease, or condition, which is then diagnosed and categorised, cause the disability. Its objectives include the reduction or elimination of the pathology associated with disability as well as secondary disorders through the prevention, treatment, and management of disease processes and traumas (Drake, 2001). The youngster with a disability and his or her social workers can find much to like about interventions based on this concept. For a person with a handicap to develop a disabling condition, environmental and social factors are more to blame. This eventually results in psychological disorders. Ignoring these causes of the incapacitating circumstances and placing more importance on the physical symptoms does not produce a better outcome. Therefore, there are good reasons to believe that the physical aspects of disability pale in comparison to the environmental, social, and psychological aspects connected to incapacitating illnesses.

Despite these benefits, a disability model based on the diagnosis of a specific disease only offers a helpful framework for management when there is some indication of an underlying pathogenic process. This isn't always the case with developmental impairments. Some developmental disorders, such mental retardation brought on by recognisable genetic defects like Down syndrome or fragile X syndrome, are based on a medical diagnostic technique with measurable results. Others, like autism spectrum disorders, are determined by observing the child's behavioural characteristics in a clinical context and frequently lead to an ambiguous or uncertain diagnosis. Even in cases when a precise medical diagnosis has been made, treating the underlying cause or symptoms of many developmental impairments cannot be done with a single, dependable medical treatment. Parents frequently have a diagnosis but are unsure about what to do next as a result. Parents are completely confused as a result of the practitioners' failure to offer them counselling. As a result, the powerless parents have a negative attitude toward the role model and permit their children to stay inside the home while placing less importance on them. This paradigm has detrimental psychological effects on people and promotes stigmatisation, discrimination, and exclusion.

These situations highlight the crucial problem of adaptation to disability, which highlights the relationship between the individual and environment as they change over time. Considerations of person-environment interaction as elements actively influencing disability are particularly inappropriate to the medical model (Fougeyrollas & Beauregard, 2001). In this sense, disability encompasses both the experience of and the effects of a handicap, both of which are closely related to another idea called "functioning," or what a person is able to perform regardless of a diagnosis. For a number of reasons, the distinction between level of functioning and diagnosis is not one to be taken lightly.

According to studies, a person's diagnosis may not be the best indicator of how well they will operate if they have a disability (Common Language for Functioning, Disability and Health, 2002). Furthermore, functioning moderates the effect of a diagnosis on need rather than acting as a good predictor of service need. Functioning is the crucial link between diagnostic and need (Ustun et al., 1998). In particular, this insight applies to kids who have developmental difficulties. Following a sequence of diagnoses, not all disabilities are amenable to medical treatment. Pathogenic disorders may not always be the underlying cause of disability. Making the proper choice may be aided by both medical and functional assessments. In order to increase an individual's functional abilities, curriculum may be constructed with a higher importance placed on the functional characteristics of the person. For children with the same medical diagnoses, functional impairment in children with developmental impairments can range from minor to severe, making them "spectrum disorders." Children's functional abilities may differ even within the low category of impairment. This implies that a child's self-perceived needs, as well as the views of parents, siblings, teachers, or peers on the child's requirements, are all directly influenced by the child's physical or psychological functioning as well as his or her social functioning at home or school. The social model of disability is an additional model of disability that takes functioning into account and offers a framework for comprehending how the social environment affects functioning and, as a result, service demands.

The Social Model:

According to the social model of disability, which holds that "disability" is a social construction created by society by placing barriers in the way of people with varying capacities participating fully in society (Oliver, 1983; UPIAS, 1976). These obstacles include unfavourable attitudes, actual obstacles, and institutional, communicative, and social hurdles. According to the social model, social behaviours that separate and stigmatise people with disabilities serve to distinguish them from others who are impaired (Goodley, 1997). The social model of disability advocates claim that society unfairly prioritises some appearances, levels of functioning, or demands as "normal" while marginalising others, leading to social exclusion as well as economic and political marginalisation (Dowling & Dolan, 2001). Persons who do not fit the behaviours, requirements, or aesthetic standards set for people without disabilities are viewed as inferior and are given a subnormal status. Similar to this, society evaluates each person's rights and community obligations differently based on how those decisions will affect the dominant, non-disabled group. This framework affirms the rights of people with disabilities to the necessary accommodations for them to participate fully in society (Asch, 2001). In actuality, however, the limits of such rights have given rise to contentious arguments when public and private organisations have been forced to make expensive changes to accepted procedures or services. This discussion may become relevant for young children with disabilities when mainstreaming children with cerebral palsy or Down syndrome necessitates additional teacher training and a teacher's aide for every integrated classroom.

The social model accords children with disabilities the same accommodations as their classmates without disabilities (Ravaud & Stiker, 2001). The social model also acknowledges the significance of the institutional, social, and political environment in promoting or preventing circumstances that guarantee such rights (Barton & Armstrong, 2001). The social model, perhaps even more so than the medical model, depends on the involvement and understanding of parents and social workers to develop an effective, child-specific response for every child with a handicap. It is crucial to recognise the value of informed parental involvement in the intervention process.

The social model allows for the consideration of prejudice and discrimination based on socioeconomic class, ethnicity, and culture. Cultural hurdles to understanding, disparities in access to care, and service providers' unfamiliarity with the cultural beliefs of ethnic minorities all raise the risk of developmental disorders becoming worse and having longer-lasting effects (Brookings, 1993). According to Porterfield (2002), a major component important to the equitable receipt of services, families with disabilities frequently have greater financial need than other families. The social model emphasises this issue to social professionals particularly. The social model can thus offer a crucial dimension to the therapies and services that are typically considered to be the sole domain of the medical model. The social model advocates proactive measures to anticipate and reduce barriers to full participation in the institutional, social, and political environment as the young child transitions from home to preschool and preschool to school environments, much like the medical model emphasises prevention and prompt remedial intervention. The social model adds a macro-level viewpoint to the medical model's micro or individual focus. Unfortunately, neither the social nor the medical models adequately take into account the meso-level activities that mediate both the impacts of institutional policies or practises and the consequences of physiological or psychological deficits. This discussion may become relevant for young children with disabilities when mainstreaming children with cerebral palsy or Down syndrome necessitates additional teacher training and a teacher's aide for every integrated classroom.

The Transactional Model:

Transpersonal elements, such as interpersonal, family, and organisational dynamics, have an impact on a child's quality of life at the meso level, where disabled children and their families interact with institutions like schools and social care organisations (Ferguson, 2001). The transactional model offers a conceptual framework for understanding how these dynamics impact the child's and his or her support system's experience of disability (Llewellyn & Hogan, 2000). The transactional model postulates numerous feedback loops between the kid with a disability's behavioural patterns, beliefs, and emotional responses and his or her immediate social environment. Thus, it considers how a child with an autism spectrum disorder interacts with her parents and how those interactions lead to reciprocal responses that shape the child's self-presentation and self-esteem, which have clear implications for the child's experience of disability when she or he enters the school environment.

The Systems Model:

An ecological approach is necessary in order to take into account all three aspects simultaneously: individual (medical model), societal (social model), and transpersonal (transactional model). Llewellyn and Hogan (2000) propose a "systems analysis" model inspired by Bronfenbrenner's (1992) process-person-context model in their search for ecologically sound models of disability for research and therapeutic applications with children. According to Bronfenbrenner's model, individual characteristics are the result of the interaction of personality traits and environmental circumstances over the course of a lifetime. Kurt Lewin, who developed the Field Theory approaches to human behaviour, published his work in 1947, which served as the foundation for Bronfenbrenner's ecology or systems theory. Lewin noted that attempting to explain human conduct solely in terms of the human psyche operating independently constituted an unreasonable solipsism. It implies that behaviour cannot be fully explained in terms of cognitive structures, desires, and expectations alone and that a solution must be developed to deal with the pressures, opportunities, resources, and restrictions that result from the social, political, and technological environments. (1993) Schwartz

Lewin's Field Theory's premise proposed a "life space" at the nexus of the individual and environment. This "life space" was the "area," partially accessible and partially inaccessible, where the person interacted with their surroundings and shaped their psychological experiences. As a result, Field Theory positioned results in relation to a structure and process.

To Lewin's Field Theory, Bronfenbrenner added a new perspective. Evolution over time. Lewin demanded that study on person-environment interactions focus on a moment in time, whereas Bronfenbrenner was interested in how the relationship changed over time and developed the idea of "chronosystem" (Berry, 1995). Lewin endorsed the use of the Field Theory in macro-environments, but he was more interested in how small-group social interactions affect an individual's conduct than in the wider social issues (Gold, 1992). In contrast, Bronfenbrenner focused his efforts on creating a framework that could be used to conceptualise the environment in terms of concentric circles of impact, starting with its closest proximity to the individual and moving outward from there. Bronfenbrenner specifically thought of person-environment interactions as nested structures that are spatially ordered according to their proximity to the subject. He discussed the mesosystem (e.g., direct relationships such as neighbours), the exosystem (e.g., indirect ties such as school systems), the macrosystem, and then the most distal structure, the microsystem, starting with the most nearby structure, the microsystem (e.g., family) (e.g., overarching influence systems such as cultural influences). The benefit of ecological or systems theories of disability is that they situate the disabled kid in a setting that has the potential to influence their developmental trajectory (Llewellyn & Hogan, 2000). A "circle of friends" or peer support group, for instance, might operate as a barrier between a child and her surroundings, assisting the child in navigating challenging circumstances and offering a setting for social interaction. These are the classmates who view the young person as a buddy rather than someone who wears a label (Taylor, 1997). Defining the parameters of a systems model of impairment is the main challenge. An ecological or systems model, much like ecological theory, does not provide predictions but rather maps out broad correlations. Llewellyn and Hogan (2000) and Lewin (1947) were both guided by Bronfenbrenner's theory.

The Professional Model of Disability

This approach, which can be considered as a spinoff of the medical model, has provided a conventional response to handicap challenges. In accordance with its guidelines, experts diagnose the disability and its limitations (using the medical model) and then take the required steps to strengthen the position of the impaired person. This has a tendency to create a system where a dictatorial, overbearing service provider dictates to and takes care of a passive client. This is referred to as an expert model (Ian Langtree, 2010).

The Charity Model of Disability:

This model depicts disabled people as victims of circumstance who are deserving of pity. This along with the medical model, are the models most used by non-disabled people to define and explain disability.

The Moral Model of Disability:

It alludes to the belief that individuals are ethically accountable for their own disabilities. For instance, if the impairment is not hereditary, it might be blamed on the parents' terrible behaviour or, if it is, on witchcraft. This mindset may also be seen as a religious fundamentalist outgrowth of the early human animal roots, when people would murder any infant that lacked the ability to survive on its own in the wild. Indian faiths' karma doctrine echoes this in certain ways (Ian Langtree, 2010).

The Legitimacy Model of Disability:

According to this paradigm, determining which explanations for the abnormal are acceptable for inclusion in the disability category is based on values. This point of view enables a variety of explanations and models to be taken into account as valid and useful (DePoy & Gilson, 2004).

The empowering Model of Disability:

permits the disabled person and his or her family to choose the type of therapy and services they want to receive. As a result, the professional now serves as a service provider whose job it is to advise clients and carry out their decisions. To put it another way, this paradigm "empowers" the person to pursue their own objectives (Ian Langtree, 2010).

The Social Adapted Model of Disability

States although a person’s disability poses some limitations in an able-bodied society, oftentimes the surrounding society and environment are more limiting than the disability itself (Ian Langtree, 2010).

The Economic Model of Disability:

The incapacity of a person to engage in employment is used to define disability. It evaluates the impact of impairment on productivity as well as the financial impact on the person, the employer, and the government. These effects include the individual's loss of earnings and the need to pay for assistance; the employer's reduced profit margins; and state welfare payments. This paradigm has a clear connection to the tragedy/charity model (Ian Langtree, 2010).

The Market Model of Disability:

A consumerist, minority rights approach to disabilities that acknowledges the importance of stakeholders including consumers, workers, and voters with disabilities. With a focus on economic empowerment, this paradigm uses human identity to define disability and allows individuals to design their own futures in daily life. According to this paradigm, because of the size of the demography, businesses and governments will cater to consumer demand as the message spreads across the culture (Ian Langtree, 2010).