You Are Here:
Toolkit Contents
>>
Who benefits?
>>
Changing Views on Disability

Changing Views on Disability


Edited by K. Anne-Rivers Forcke, IBM Human Ability and Accessibility Center.
Contributors: James Thurston, Microsoft Trustworthy Computing Group; Martin Gould, Accessibility Expert; Andi Snow-Weaver, IBM
Human Ability and Accessibility Center; Susan Schorr, Head, Special Initiatives Division, ITU Telecommunication Development Bureau (BDT)

Section Summary
Disability was historically seen either as a philanthropic notion or a regulatory burden. This was then replaced with the ‘medical model of disability’, which sees disability as a physical, mental, or psychological condition that limits a person’s activities. This section contrasts this with the recent ‘social model of disability’, which sees disability as arising from the interaction of a person’s functional status with the physical, cultural, and policy environments. According to the social model, disability is the outcome of the interaction of a person with his or her environment and thus is neither person- nor environment-specific. The social model of disability is thus much broader and more inclusive than its earlier iterations.

“Persons with disabilities are often invisible in official statistics," Education for All Global Monitoring Report 2006, UNESCO, 2007

There are gaps today in our understanding of the economics of disability and accessibility, including the relationships of the four fundamental elements of digital inclusion, or e-Inclusion: 1) availability 2) affordability 3) accessibility and 4) applicability or relevance. However, using the basic principles of supply and demand one can form the following primitive description of their relationship from a commercial perspective:

Little data exists on the purchasing power and preferences of persons with disabilities; with that lack of market data describing the demand for accessible ICT there is little in the way of financial models to support commercial decisions to design or redesign products and services which are accessible other than the punitive models reflecting fees, fines and  lost sales due to regulatory non-compliance. Where there is data available on persons with disabilities, it generally reflects the prevalence of specific medical disabilities, each very often a small percentage of an overall population, thus perpetuating the idea that accessibility is a market “niche.” With this niche market label and lack of coordinated commercial focus on accessibility, the supply and availability of accessible ICT and assistive technologies remain limited and fragmented. Finally, with that fragmented availability and limited supply, prices of accessible ICT and AT are correspondingly higher, thus impacting their affordability.

Historically accessibility has been viewed by policymakers, researchers, and businesses as a philanthropic notion or regulatory compliance burden. Such a perception has created a skew in the global accessibility paradigm. This skew is reflected today not only in the lexicon of disability (which focuses primarily on medical disabilities), but also in the allocation of resources toward identifying unique accommodation and assistive technology (AT) for a specific medical disability. The results of this skew are that accessible ICT and assistive technologies remain too often ad-hoc, unnecessarily expensive, and not easy to replicate or scale within a community or across an enterprise.

The “medical model of disability” – the model most widely understood and interpreted today – considers disability “a physical, mental, or psychological condition that limits a person’s activities,” linked to various medical conditions and viewed as a problem residing within the affected individual. Considering this model of disability, along with statistics reported in both developed and developing countries, the World Bank in its 2007 report “Measuring Disability Prevalence” estimated the number persons with disabilities to be between 10-12% of the global population.

While the medical model is the construct for disabilities that we are historically most accustomed to using, over time the international community has largely come to recognize that the medical model is not a sufficiently effective or empowering conceptual framework for promoting the full inclusion of persons with disabilities in society, as pointed out in an earlier World bank report entitled “Making Inclusion Operational: Legal and Institutional Resources for World Bank Staff on the Inclusion of Disability Issues in Investment Projects”. As a result the paradigm of disabilities is expanding to include both the medical model as well as the more recently defined “social model of disability.” 

Unlike the medical model of disability, the social model of disability views disability as “arising from the interaction of a person’s functional status with the physical, cultural, and policy environments,” an approach which closely follows the work done by the UN Washington Group on Disability Statistics (more information is available at http://www.cdc.gov/nchs/washington_group.htm). According to the social model, disability is the outcome of the interaction of a person with his or her environment and thus is neither person- nor environment-specific. Within the social model, then, a disability results when a person attempts to communicate, yet does not understand or speak the national or local language. Similarly, a disability results when someone who has never before operated a phone or computer attempts to use one – with no success.  In both cases, a disability has occurred, because the person was not able to interact with his or her environment.

Compared to the medical model of disability, the social model of disability inevitably encompasses more of the global population in more situations and under more circumstances. And it is based on the energetic and compelling leadership of the Washington Group on Disability Statistics and the World Bank’s Disability and Development team, along with the United Nations’s Convention on the Rights of Persons with Disabilities in December 2006 that the disabilities paradigm – and the way we view accessibility - has begun to shift.

Helpful tools and links about the changing views on disabilities and accessibility:

1.    UN Washington Group on Disability Statistics.

2.    Measuring Disability Prevalence, D. Mont et al, World Bank, March 2007.

3.    Making Inclusion Operational: Legal and Institutional Resources for World Bank Staff on the Inclusion of Disability Issues. in Investment Projects, K. Guernsey et al, World Bank, October 2006.

4.    Beyond Compliance: Business Advantage of Accessibility, IBM Executive brief, Human Ability and Accessibility Center, 2007. 

Suggested Reading
Shakespeare and Watson, "The Social Model of Disability: An Outdated Ideology?"