Working with “Disability”

A Presentation for Social Workers

Theories of “Disability”

Demographics of “Disability”

Social Work and “Disability”

Ettiquette of “Disability”

Working with “Disability”

Theories of “Disability”

The various models for understanding and defining “disability” are grounded in different

traditions.

One tradition in the United States is to view the concept of “disability” through a morally based model. Judeo-Christian values have strongly influenced the portrayal of people with “disabilities” by suggesting not only that these individuals are being punished for past wrong doing, but also implying that they are the cause of their “disability”.

This tradition is closely linked to ancient Greek and Roman cultures, in which parents often abandoned “disabled” or “deformed” children to die (Pardeck, 2002).

The medical model, which emerged in the early 20th century, is grounded in the moral model, and also shares the belief that people with “disabilities” are flawed and must be fixed.

• The medical model obscures this view under the auspices of science, the moral model under theology.

• The medical model sees people with “disabilities” as having biological inadequacies; the moral sees them as having spiritual flaws.

Theories of “Disability”

In contrast to the medical and moral models, the

social/minority model sees “disability” as a socially constructed category much like race or gender. Therefore, the limitations of “disability” are created by society - not the individual.

In simple terms, it is not the inability to walk that prevents a person with a “disability” from entering a building unaided but the existence of stairs that are inaccessible to a wheelchair-user and the absence of a wheelchair ramp or/and an elevator.

Theories of “Disability”

Demographics of

“Disability” According to Degener (1995), more than 500

million people, or 10% of the world’s population, suffer from some type of “disability”. In the majority of countries, this means that 1 out of 10 persons has a physical, mental, or sensory impairment, and at least 25% of the entire population is adversely affected by the presence of “disability”. In 2001, the U.S. Census Bureau reported that 53 million people (nearly 20% of the nation’s population) have some level of “disability” and that 33 million (nearly 14% of the population) have a severe “disability” (National Association of Social Workers [NASW], 2009).

“Since a sixth of the nation’s population has some form of disability,

disability impacts practically every family”

- former Rep. Tony Coelho (D – Cali.)

Demographics of

“Disability”Americans with “disabilities” are the largest,

poorest, least employed, and least educated minority in America (Griffin, 1991). Their experience has largely been one of isolation, segregation, and discrimination. They have been described as diseased, deformed, abnormal, and undesirable.

Throughout the majority of the history of the United States discrimination against people with “disabilities” was socially, morally, and legally acceptable.

“Disability” →

PovertyThroughout the world the “disabled” constitute a

disproportionate number of the poor. The World Bank (1999) points out that one in five of the world’s poorest individuals are “disabled” (Issac, et.al, 2010).

Individuals with “disabilities” are often excluded from the labor market. Fears of increased costs, inflexibility in considering necessary accommodations, and outright prejudice, all contribute to an artificially small job market for people with “disabilities”. Even when included, people with “disabilities” often work fewer hours and in lower-paying or lower-skilled positions.

In some instances, individuals with “disabilities” are unable to work in the competitive marketplace. For those who are so “disabled” that competitive work is an impossibility, Social Security Disability Insurance and Supplemental Security Income are most often relied upon. However, federal benefits do not provide a living wage, making poverty an inevitability.

Poverty almost necessarily leads to insufficient nutrition, sub-

standard or crowded housing, and inadequate physical and mental healthcare.

These factors alone or in combination lead to an increased risk of impairment in which individuals who live in poverty are likely to be food insecure (defined as having limited or nutritionally inadequate food as a result of lack of money or resources to gain access to it).

Recent medical studies have demonstrated a strong association between children who are chronically food insecure and physical and mental health problems. School aged children with severe hunger were more likely to have low birth weights, chronic health problems, and stressful life events. They were also more likely than non-hungry children to have developmental delays, emotional problems including anxious and depressive symptoms, and learning disabilities.  

Poverty → “Disability”

The extent to which people with “disabilities” are

segregated also contributes to their marginalization. Thousands with “disabilities” remain institutionalized, unable to participate in society in ways that others take for granted. For these individuals, voting, having a family, and working are illusory promises. For other people with “disabilities” living in the community, the array of options is similarly limited.

People with physical “disabilities” may only be able to access a fraction of the housing that people without “disabilities” may access. People with cognitive “disabilities” are often congregated in group housing, or supervised apartments, where their only neighbors are others with similar disabilities. Living in the community of one’s choosing—a basic American right—thus has a different meaning for people with “disabilities” (Atkins & Guisti, 2004).

“Disability” → Segregation

According to a 2009 study by the U.S. Bureau of Labor,

employment percentages for persons without a “disability” was 64.5 percent, but only 19.2 percent among those with a “disability”.

The unemployment rate of people with a “disability” was 14.5 percent, higher than the rate for those with no “disability”, which was 9.0 percent.

For all age groups, the employment - population ratio was much lower for persons with a “disability” than for those with no “disability”. However, across all age groups, persons with a “disability” were much less likely to be employed than those with no “disability”.

“Disability”→↑Unemployment

Women and girls with “disabilities” are subjected

to double discrimination: “disability” bias as well as sexism.

A variety of factors contribute to this situation: the greater life expectancy of women women with “disabilities” are more likely to be

unemployed; if employed, they receive considerably lower wages than men with “disabilities”

women with “disabilities” have not been part of able-bodied women’s increases in the paid labor force.

“Disability” and Gender

Among major race and ethnicity groups, the

prevalence of a “disability” was higher for blacks and whites than for Asians and Hispanics

In their study of “disability”, Devlieger and Albrecht (2000) found that blacks have a higher percentage of “disability” in the 15 – 64 year old range than others (20.8% as compared to 17.7% of whites and 16.9% of Latinos)

Moreover, results indicated that rates of blacks with a severe “disability” is almost double that of whites

“Disability” and Race

Social Work &

“Disability”The most relevant and important of any “disability” policy in the United

States is the Americans with Disabilities Act, passed in 1990.

The four goals of the ADA are: to provide a national mandate to eliminate discrimination against individuals

with “disabilities” to provide an enforceable standard addressing discrimination to ensure that the federal government will play a central role in enforcing

those standards and to involve congressional authority in order to address the major areas of

discrimination faced by people with “disabilities”

These goals seek to address the grievances of the target population of people with “disabilities” by increasing their ability to fully and equally

participate in society and by decreasing unlawful and unjust discriminatory practices and ideals.

The goals of the ADA are almost identical to

the goals of social workers as quoted in the preamble of the NASW code;

“Social workers seek to enhance the capacity of people to address their own needs. Social workers

also seek to promote the responsiveness of organizations, communities, and other social institutions to individuals’ needs and social

problems”.

(Social Work Speaks, 2009)

Social Work & “Disability”

5 general rules

Etiquette of “Disability”

Rule 1: Ask before you

helpJust because someone

has a “disability”, don’t assume s/he needs help. If the setting is accessible, people with “disabilities” can usually get around fine. Adults with “disabilities” want to be treated as independent people. Offer assistance only if the person asks for it, or appears to need it. And if s/he does want help, ask how before you act.

Rule 2: Be sensitive about

physical contact

Some people with “disabilities” may have difficulties with balance. Grabbing them—even if your intention is to assist—could knock them off balance. Avoid patting a person on the head or touching their wheelchair, brace, scooter, service animal, or cane. People with “disabilities” consider their equipment part of their personal space.

Rule 3: Think before you

speakAlways speak directly to the

person with a “disability”, not to their companion, aide or sign language interpreter. Making small talk with a person who has a “disability” is great; just talk to them as you would with anyone else.

Respect their privacy. If you ask about their “disability”, s/he may feel like you are treating him as a “disability”, not as a human being. (However, many people with “disabilities” are comfortable with children’s natural curiosity and do not mind if a child asks them questions.)

Rule 4: Don’t make

assumptionsPeople with “disabilities”

are the best judge of what they can or cannot do. Don’t make decisions for them about participating in any activity. Instead, make sure your activity is accessible.

Depending on the situation, it could be a violation of the ADA to exclude people because of a presumption about their limitations.

Rule 5: Respond graciously to

requestsWhen clients or fellow

employees who have a “disability” ask for an accommodation at your business, it is not a complaint. It shows they feel comfortable enough in your establishment to ask for what they need. And if they get a positive response, they will probably come back again and tell their friends about the good service they received just like anyone else.

“Disabilities” that may be

encountered Mobility Impairment/Wheelchair Blind/Low Vision Deaf/Hard of Hearing Speech Impairment Short/Tall Stature Cerebral Palsy Look Different

Epilepsy Multiple Chemical

Sensitivity Mental Illness Respiratory Illness HIV/AIDS Learning Disabilities Traumatic/Acquired

Brain Trauma

Not all “disabilities” are apparent. A client may make a request or

act in a way that seems strange to you. That request or behavior may be “disability”-related.

For example, you may give seemingly simple verbal directions to someone, but the client asks you to write the information down. S/he may have a learning “disability” that makes written communication easier for her/him.

Or an apparently healthy person may ask to sit, rather than stand. This person may be fatigued from a condition such as cancer, or may be feeling the effects of medication.

Even though these “disabilities” are hidden, they are real. Please respect the

person’s needs and requests whenever possible

Hidden “Disabilities”

Works Cited American with Disabilities Act of 1990 (The). (1990). P.L.101 – 336, 105 Stat. 327. Retrieved September 22, 2010

from Thomas online database Atkins, D. & Guisti, C. (2004). The Confluence of Poverty and Disability, in The Realities of Poverty in Delaware,

2003-2004. Dover: Delaware Housing Coalition Bureau of Labor Statistics (2010). Washington, DC: U.S. Department of Labor. Retrieved on October 7, 2010 from

the Statistical Abstract of the United States online database Degener, T. (1995). Human rights and disabled persons: Essays and relevant human rights instruments. The

Hauge: Martinus Nijhoff Publishers Devlieger, P.J. & Albrecht, G.L. (2000). Your experience is not my experience. Journal of Disability Policy Studies,

11:1, 51-60 Froschl, M., Rubin, E. & Sprung, B. (1999). Connecting Gender and Disability. WEEA Digest, WEEA Equity Resource

Center. Newton, MA: Retrieved on November 5, 2010 from http://www2.edc.org/WomensEquity/pdffiles/disabdig.pdf

Griffin, R.D. (1991). The Disabilities Act. CQ Researcher, 1, 993-1016. Retrieved September 22, 2010 from CQ Researcher online database

Issac, R., William, D.R., & Ravanan, M.P. (2010). Integrating people with disabilities: their right – our responsibility. Disability and Society, 25:5, 627-630

Pardeck, J.T. (2002). Knowledge, tasks and strategies for teaching about persons with disabilities: implications for social work education. Journal of Social Work in Disability & Rehabilitation, 1:2, 53-72. Retrieved September 22, 2010 from Social Work Abstracts online database

Social Work Speaks (8th ed.). (2009) Baltimore, MD: NASW Press Disability Ettiquette (2008). United Spinal Association: Jackson Heights, NY: Retrieved May 12, 2011 from

http://www.unitedspinal.org/disability-etiquette/