INDEPENDENT LIVING AND TRADITIONAL PARADIGMS*

This chart compares traditional approaches to medical and vocational rehabilitation services with the consumer-driven, independent living approach

	MEDICAL MODEL & REHABILITATION PARADIGM	INDEPENDENT LIVING or DISABILITY PARADIGM
Definition of problem	physical or mental impairment; lack of vocational skill (in the VR system); lack of abilities	dependence upon professionals, family members & others; it is the attitudes & environments that are hostile & need fixing
Locus of problem	in the individual (individuals are sick and need to be "fixed")	in the environment; in the medical and/or rehabilitation process itself; disability is a common part of the human condition
Solution to the problem	professional intervention; treatment	civil rights & advocacy barrier removal self-help peer role models & peer support consumer control over options & services
Social role	individual with a disability is a "patient" or "client"	individual with a disability is a "consumer," "customer" or "user" of services and products
Who controls	professional	"consumer" or "individual"
Desired outcomes	maximum self-care (or "ADL" - activities of daily living); gainful employment (in VR system	independence through control over ACCEPTABLE options for every day living in an integrated community

Developed by Gerben DeJong in 1978; adapted/expanded by Maggie Shreve and June Isaacson Kailes
Revised 1/2002

*paradigm: a model, example, archetype

Models of Disability

Prior to 1970's disability policy revolved around a "Segregation Model" which involved:

legally sanctioned segregation and exclusion based on widespread fears, myths and stereotypes

segregated schools

Institutions without options for integration often referred to a "special"

why 'special' is not a popular word among disability advocates

'special' often connotes unequal and separate!

In the 1970's Rehabilitation/Charity/Medical Model emerged

burden of dealing with consequences of disability rested with person

attempts made to medically and vocationally rehabilitate people, but society had no responsibility to remove barriers.

example:

wheelchair user: no accessible parking spaces - negotiates long distances to get to work site from vehicle

at site, needs to negotiate two flight of steps, to get to job on third floor of a non-elevator building

uses braces and crutches to laboriously make way up steps, takes 20 minutes, not efficient.

Gradually disability policy model began to move to a Socio-political rather than Rehabilitation/charity model. A few of the key pieces of legislation that illustrate this transition are:

Civil Rights Act of 1964

prohibits discrimination on basis of race, religion, national origin, and sex.

did not include disability

prohibits discrimination in:

employment

public accommodations

programs and activities receiving federal funds

could not discriminate based of peoples characteristics

Architectural Barriers Act of 1968

Requires federal buildings to meet access standards

Symbolic first step - first act to reflect an integration model

Why Wash DC is fairly accessible

Rehabilitation Act of 1973

a tiny but very important paragraph: Section 504 prohibits discrimination against people with disabilities in programs and activities receiving federal funds equal to or greater than $2500 and in federally conducted programs

504 was modeled after the Civil Rights Act of 1964

Air Carrier Access Act of 1986

Prohibits discrimination against people with disabilities in air travel by private airlines

Americans with Disabilities Act of 1990

ADA reinforces 504, with new and stronger enforcement!

Equality theme became moral force behind the ADA

Prohibits discriminate against people with disabilities in:

Employment

Public accommodations (museums, theaters, malls, grocery stores, doctors offices, schools, hotels, restaurants

Activities of state and local government

Transportation

Telecommunications

The Socio-political model for the first time, recognized that all people with disabilities belong to a class regardless of which disability they have.

Everyone in this class has in common the experience of discrimination.

major shift here in public policy:

Discrimination recognized as root cause of

isolation

segregation

second-class citizenship

Marked a significant shift of the burden to change from the individual to society.

back to those steps (mentioned above):

people with disabilities have as a civil right, the right to enter a building, to work, to not be discriminated against by barriers