The document discusses disability as an interaction between impairment and environment. It defines disability according to the WHO and explores theoretical perspectives on disability, including the biomedical, economic, sociopolitical, and normalization models. Barriers to disability services are also examined, such as funding, rigid rules, linking to income, and attitudes. The experience of living with disability is discussed in terms of onset, course, outcome, limitations, and visibility/invisibility of disabilities. The key message is that disability is a difference that results from the mismatch between impairment and an unsupportive environment.

1. Disability As A Difference

2. WHO-Definition of Disability
• Disability is defined as:
the unsuccessful interaction between a person
with an impairment and an unsupportive
environment
Environment has four dimensions:
– Physical
– Social
– Financial
– Political

3. Disability as a social construct
Differently Abled

4. Theoretical Perspectives
1. Biomedical: emphasis on impairment &
abnormality
Patient is sick and society has an obligation to provide
basic level of health care
2. Economic Model: emphasis on the economics
of disability
How does impairment affect capacity consequently
limiting ability to be productive

5. Theoretical Perspectives (Continued)
3. Sociopolitical Model: represents current
trends
• Disability is a form of social injustice due to stigma,
discrimination and marginalization
4. Normalization Theory: right to live life
normally
• Explains de-institutionalization/integration for people
living with developmental & psychiatric diagnosis e.g.
group homes, independent living, etc

6. The Future
• Number of people living with disability will
increase because:
1. population is aging
2. medical technology is improving
3. increasing # of infants survive with chronic
impairments

7. Barriers to Services
1. Funding Barriers:
 Inequality amoung people with disabilities – varies
greatly depending upon their source of income
2. Rigid Rule Barriers:
– Programs tend to require the consumer to adapt or
adjust to its requirements instead of being flexible based
upon individual needs

8. Barriers to Services (continued)
3. Linking Services to Income:
– Some people living with disability seem to have
access to major funding however, we forget how
much it costs to be disabled and how much are
spent on care needs
4. Administrative Barriers:
– Access to services can be a complicated process or
has long waiting lists

9. Barriers to Services (continued)
5. Attitudinal Barriers:
– Occurs within the community re: integration
– E.g. not in my backyard mentality

10. Understanding the Disability
Experience
Onset, Course & Outcome

11. Onset of the disability
• Way in which person becomes disabled has a
major effect on self-perception
– Disability at birth or early on – person never
knows themselves without the disability
– Acquiring a disability suddenly/traumatically
– Gradual onset

12. Course of the Disability
• Progressive
– Disability progresses to greater levels of
impairment e.g., ALS
• Chronic
– Once the adjustment to the disability is made
there is reasonable levels of stability
• Relapsing
– Exacerbation-remission cycle e.g., MS & Lupus

13. Outcome
• Outcome looks at the changes in lifespan
changes
– Some disabilities may shorten life. Others shorten
it slightly, while other reduce life expectancy
dramatically.
– We live in a society that avoids thinking of death

14. Understanding the Experience of
Disability
Living with the limitations &
stereotypes

15. Types of Disabilities
• Limitations on mobility & energy
• Sensory limitations
• Limitations in communications
• Limitations in reasoning ability and mental
functioning
Note: many disabilities are impairments only because
of the social context and the built environment

16. Mobility Limitations – things to consider
• Independent Wheelchair Mobility
– Necessary to look up to make eye contact
– Counters often too high
– Harder to use many public facilities
– Public transit – not all bus routes equipped
– Wheelchair accessible bathroom stales often the furthest
away
– Shopping hard to manage
– Accessible entrances not always where you think they are
– Our bodies are not designed for sitting all the time
– Textures of floor coverings

17. Mobility Limitations – things to consider
• Dependent Wheelchair Mobility
– Greater dependency on others to care for them
e.g., eating, bathing, toileting

18. Limitations due to Energy Levels
• Often having a condition or disability or being
treated for it can use up enormous energy
– Medications can weaken,
– Receiving chemotherapy.
• Certain types of disabilities are particularly
associated with losses in energy – Chronic
fatigue, Fibromyalgia, diseases related to lung
capacity

19. Sensory Limitations – Vision & Hearing
• Limitation can be complete or a partial
absence
• Blindness
– Vision our favourite sensory
– A social construct
• Visual impairment
– Easier to navigate
– Takes enormous energy

20. Sensory Limitations – Vision & Hearing
• Deafness & Hearing Limitations
– Strong social component – Deaf culture
– Has all the distinguishing marks for culture – a
language, terminology & expressions, criteria for
admittance and an established way of interacting
– Deafness as a social construct – ability to learn
other languages

21. Sensory Limitations – Vision & Hearing
• Hearing Impairments
– Rarely identify with deaf culture
– Assistive devices have gotten significantly better

22. Limitations in Communications
• Expressive Aphasia & Other Limitations in
Speech
– Expressive Aphasia
• Individual unable to use the proper words or to form
words to communicate
• Often seen with cerebral damage and head trauma
• Limiting – often only the most basic needs that are
communicated due to effort involved in
communicating

23. Limitations in Communications
• Receptive Aphasia
– Seen with some types of learning disorders
• The person has difficulty in processing verbal and /
written communication
• What reaches the brain is not comprehensible
• Difficulty individual facing is often not noticeable

24. Limits in Reasoning Ability & Mental
Functioning
• A very broad group including:
– Developmental disabilities
– Mental illness
– Alzheimer’s disease
– Senile dementias
– Brain injuries

25. Cognitive Limitations:
Developmental Disabilities
• Constant state of dependency results in high
levels of abuse – 80%
• Compliance is a learned social behaviour
• Very vulnerable out in the community
• Sexuality and sexual identity often
discouraged

26. Limitation in Cognitive Functioning: Alzheimer’s &
Senile Dementia
• Different from Developmental disabilities in that
they occur later in life
• Person experiences changes in – personality and
behavioral, and reasoning ability and perception
• Wide variation in the experiences – some become
anxious, agitated, aggressive, confrontational, other
become peaceful, happy and pleasant
• Very difficult on the families as relationships change

27. Limitation in Cognitive Functioning:
Mental Illness
• Mental illness as social construct – something
that society has created to explain behavior
that is outside the norm
• One of the most negatively judged limitations
in society

28. Visibility: Special Challenge
• When people with disabilities interact with
others in society, the disability itself becomes
one of the factors of the interaction, often
determining the quality and quantity of
relationships.
• Some disabilities are visible and recognizable
and others are not

29. Invisible Disabilities
• Sharing is voluntary much of the time.
• Sharing makes the invisible visible – it
identifies you as having a difference from
others
• When do you share?

30. Disability As A Difference
Disability is not the issue. The issue is the fit of
disability with the social, attitudinal, medical,
architectural, economic & political
environment!