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By: Rose B
Qualification: M.Sc.
Disability and Special Educational Needs as a Social and Medical Construct

Senior Blogger:


Disability and special education are constructs that have multiple layers in contemporary thinking. This was not always the case. Previously the medical model of disability dominated special education concepts. The medical model views disabilities as a result of physiological impairments due to damage or disease and focuses on alleviating the impairment or interrupting the disease in order to eliminate or, at least, reduce disability.


Barnes and Mercer (2010) describe the medical knowledge as widely accepted in Western societies. This model considers the degree of disability by looking at the extent of deviation in physiological or intellectual performance from standardized norms. The greater the degree of deviation, the greater the degree of disability.


The medical model emphasizes precautionary and therapeutic action within a medical framework. The basic tenets of the medical model of disability include a deviation from normal biological functioning, a doctrine of specific etiology, the universality of disease taxonomy, and scientific neutrality of medicine. However, social scientists dispute all four tenets (Barnes & Mercer, 2010).


The social model considers disability as a social construct and that individuals become impaired because social and cultural norms reflect a preoccupation with normality. People with disabilities are unable to perform to the norms of society and this may result in oppressive and discriminatory experiences (Topping and Maloney, 2005). This model differentiates between impairment and disability. Impairment refers to the physical aspect of a condition and disability relates to the barriers that an oppressive society places on the impaired individual. Therefore, disability is a socially created or constructed phenomenon (Farrell, 2009).


The social model places emphasis on adjustment of the individual, both to the physical environment and to the variety of roles and relationships. Disability must consider the meaning, expectations, roles and relationships within society (Shakespeare, 2006).

Goodley, Hughes and Davis (2012) describe the medical and social models of disability as competitors. The medical model considers disability as a problem requiring medical intervention while the social model views it as a political problem needing corrective actions by citizen activists. The latter is accused of being unequipped and reluctant to address contextual, economic, and historical aspects among others. However, a clear change of paradigm is becoming apparent as medical professionals accentuate the importance of social dimensions and the interaction between physical and social environments. 


The WHO developed the International Classification of Impairments, Disabilities and Handicaps (ICIDH) as a tripartite definition and can be compared to the social models of disability. ICIDH is much more than a simple set of definitions. It determines research and policy-making as well. It has been developed by non-disabled people and disabled individuals did not participate in its construction. It represents the idea that disabled people are defined by their physical and/or intellectual deficits (Shakespeare, 2006). ICIDH represents a break from the traditional medical model of disability with the inclusion of the concept of social handicap. It is considered a social-medical model.


Barnes and Mercer (2010) are in agreement with Shakespeare (2006) that the social model of disability does not give a universal solution. It is overloaded with unrealistic expectations, and is also considered as contextual. There is a tendency within this model to deny bodily experiences and to insist that physical differences and restrictions are entirely socially created.


Shakespeare (2006) believes that the dichotomy of the medical and social models of disability is dangerous. He suggests that people are disabled by both society and their bodies. It is important to bridge the gap between the two definitions. Shakespeare (2006) argues that a diversity of disability approaches exist, and this diversity is needed to challenge the dichotomy of medical versus social models.


One of the most important distinguishing features of the two models can be summed up by the questions “What is wrong with you?” for the medical, and “What is wrong with society?” for the social model. Shakespeare (2006) suggests that rejecting the social model with its inadequacies and contradiction could be beneficial for disability studies. People with impairments experience specific problems, both in the medical and social sphere. Focusing on social barriers can imply a neglect of medical interventions.

Disability studies must consider the perspectives of people with disabilities instead of simply accepting medical terms. Medical responses regarding impairments such as their effectiveness, potential side effects, prevention, and funding are important. The quality of life for people with disabilities is also an important issue to deal with, and it requires minimizing the impact of the impairments and the associated complications. Specific barriers, such as poverty or social exclusion, not only cause impairments but can also strengthen the effects of the impairments.


Topping and Maloney (2005) describe the old model of special education as focusing on deficits or defects of the individual. Later models emphasized needs and they represented a move away from the medical model of disability toward a social and educational model. The latter suggests that educational difficulties also depend on factors outside the child, such as educational context and the type and quality of teaching. Topping and Maloney (2005) argue that ‘special educational needs’ are no longer helpful because of connections to the medical model of disability. Other models offer a more inclusive and broad approach of planning, like emphasis on human rights, concern about individual progress, and the different levels of needs.   


The social model of disability analyzes the way disability is created by historical, social, economic, cultural, and relational exclusion of people with impairments. It is assumed that disability theories and writings from the West, especially from the UK are transferable across cultures, contexts and people. This is academic neo-colonialism, which comes with gross generalizations, simplifications, and omissions when confronted with different realities (Goodley, Hughes & Davis, 2012).


Barnes and Mercer (2010) consider human rights and the links between poverty and disability as major themes within the disability discourse. The denial of equal opportunities and human rights for people with disabilities was a driving force behind political activity, promoting anti-discriminatory legislation, social inclusion, and life chances. Goodley, Hughes and Davis (2012) cite the opinion of a person with a disability. This individual feels that the most important thing is not to overcome the disability but to recognize the impairment. It is part of the person, but that person still has the right to be equal in society. The government has more to do than merely abstaining from measures that negatively affect disabled people. To help make disabled people feel respected, protected and fulfilled takes increased awareness and appropriate policy measures. One of the slogans of Disabled People’s Organizations was “rights, not charity”, which indicates that people with disabilities do not require charity from the non-disabled society; they require equal rights regardless of their disability.


Goodley (2011) also sees disabled people as being more likely to be victims of violence and being excluded from mass education, less likely to receive legal protection, and more reliant on state benefits and charity. Disabled people’s movements have campaigned for anti-discriminatory legislations and have demanded that their concerns be taken into account when decisions that affect their lives are being made. They want civil rights, not charity.  Civil rights are the way to solve the problems disabilities represent, not pity or charity. If able-bodied individuals see the disabled as their potential selves, they would realize that charity is an inappropriate way to think about disabled people and the resources allocated to them (Davis, 2006).


Goodley (2011) states that the meaning of impairment and disability changes over time, not just because of the developments of science, but also based on changes in social policy, government guidelines and legislation. An inclusive society is not a society of equals, but a society where everyone has qualities to meet their needs. People do not need to be equal in terms of ability or skills, but they can still make a meaningful contribution to society. Treating everyone equally does not mean treating everybody the same way.








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