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This chart compares traditional approaches to medical and vocational rehabilitation services with the consumer-driven, independent living approach
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
  1. civil rights & advocacy
  2. barrier removal
  3. self-help
  4. peer role models & peer support
  5. 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

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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
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    © 1998-2002 June Isaacson Kailes, Disability Policy Consultant, All Rights Reserved.
     Created June 1997  |  Updated  1/31/02  |  Accessed #