Physical Disabilities

by

Michael Wolf-Branigin

• LAST REVIEWED: 25 June 2013
• LAST MODIFIED: 25 June 2013
• DOI: 10.1093/obo/9780195389678-0190

Introduction

Physical disabilities can be an intriguing and yet a confusing field for conducting research. Confusion can arise from unclear definitions and the frequent presence of coexisting intellectual and developmental, sensory, communication, or cognitive disabilities. To begin, the term physical disability must be defined. For the purposes of this article, physical disability covers a broad sweep of areas. Types may include congenital disabilities (e.g., cerebral palsy), acquired disabilities (e.g., spinal cord injury), and sensory/communication disabilities (e.g., low vision). Although co-occurring intellectual and developmental disability may be present, this article focuses solely on persons with a physical disability. Similar to responses to the other disabilities, these individuals and their advocates increasingly focus on concerns to improve environmental accessibility and inclusion in their communities. Causes of physical disabilities include prenatal, perinatal, and postnatal. Prenatal disabilities are acquired before birth and may occur because of an illness carried by the mother during pregnancy or by a genetic problem between the parents. Perinatal disabilities occur during birth and may be acquired because of a lack of oxygen or the obstruction of the respiratory tract, damage to the brain during birth, or premature birth. Postnatal disabilities are acquired after birth and are caused by accidents, infection, or other illnesses. Several themes arise when considering the roles of social work and civil rights when supporting persons with physical disabilities. The following addresses several vital issues, including conceptualization of new perspectives arising from the field of disability studies in which the traditional medical model is rejected in favor of inclusive and interconnected lives. This shift from a medical model to a social model of disability touches on topics that include relevant employment issues and services that lead to increased community participation (e.g., supported employment); health issues; the projected increase of incidence; housing; community in which increasing use is made of approaches based on person-centeredness, peer support, consumers, the independent living movement, and person-first language; legislation and court decisions to support inclusive and community-based environments; maintenance of independence; types of physical disabilities that range from acquired to congenital; veterans issues; and the built environment in which the person with a physical disability lives.

Conceptualizing Physical Disability

Consistent with social work’s person-in-environment perspective and emerging social policy for more inclusive and accessible environments, the current literature focuses on issues such as employment, housing, transportation, health care, and education. Since the 1970s, several initiatives have provided the underpinning framework to shift to community-based and inclusive services (Rothman 2010). Most prominently, the disability rights movement emerged in which individuals with disabilities advocate for full inclusion (Fleischer and Zames 2001, cited under Violence and Discrimination). Disability advocates applied political pressure to local, state, federal, and international decision makers to fund services, including accessible transport, education, housing, employment, health, and communications. A significant paradigm shift occurred in 1970 in the United States with enactment of Section 504 of the Rehabilitation Act. This act banned discrimination on the basis of disability for entities receiving federal funding. Subsequent legislation followed in the 1970s and 1980s as countries shifted disability policy from a medical, institutional model to a set of services that supported community living and that viewed a person’s ability to function across several life domains. In the United States, these laws culminated in passage of the Americans with Disabilities Act (ADA) in 1990. This section includes entries that seek to frame how people with physical disabilities are perceived and to offer contemporary views of what constitutes disability (Mary 2007, O’Brien 2011), to question what is normal (Clear 1999), to identify perceptions of what constitutes disabling conditions (DePoy and Gibson 2004, Russell 1981), and to explain how these views have shifted since the 1970s (Hilbourne 1973, Saleeby 2007).

• Clear, M. 1999. The “normal” and the monstrous in disability research. Disability and Society 14.4: 435–448.

  DOI: 10.1080/09687599926055

  This article serves as a preliminary work on the evolving concept of ableism, a form of social discrimination against people with disabilities. Ableism perceives a disability as a barrier that someone must overcome in order to be “normal” and conform to societal expectations.

• DePoy, E., and S. F. Gibson. 2004. Rethinking disability: Principles for professional and social change. Belmont, CA: Brookes-Cole.

  The authors apply their Explanatory Legitimacy Theory to build upon the current disabilities studies literature by providing a conceptual framework. This framework uses the interactive elements of description, explanation, and legitimacy to underpin the many perspectives on disability.

• Hilbourne, J. 1973. On disabling the normal: Implications of physical disability for other people. British Journal of Social Work 3.4: 497–504.

  Physical disabilities were traditionally regarded as attributes of individuals. This article suggests that the physical disability of one individual may become a substantially disabling attribute for others, particularly family members with whom the person is associated. The author explores this issue and some of its consequences are examined.

• Mary, N. L. 2007. An approach to learning about social work with people with disabilities. Journal of Social Work in Disability & Rehabilitation 6.1–2: 1–22.

  DOI: 10.1300/J198v06n01_01

  The construct of “disability,” it is argued, is in the eye of the beholder. The author provides an outline for an introductory course in working with people with physical, cognitive, developmental, and psychiatric disabilities. Common themes used in practice as well as the unique role played by social workers in interagency collaboration are discussed.

• O’Brien, G. V. 2011. Eugenics, genetics, and the minority group model of disabilities: Implications for social work advocacy. Social Work 56.4: 347–354.

  DOI: 10.1093/sw/56.4.347

  Genetic research and related practice innovations have expanded as indicated by human genome mapping, growth of genetic counseling, and other biogenetic research. Concurrently, the disability rights movement has expanded. The concerns of disability rights activists relative to genetic innovations and the role of the social work community are discussed.

• Rothman, J. C. 2010. The challenge of disability and access: Reconceptualizing the role of the medical model. Journal of Social Work in Disability & Rehabilitation 9.2–3: 194–222.

  DOI: 10.1080/1536710X.2010.493488

  Numerous frameworks for understanding disability exist; however, these are polarized between problem-centered “medical” models and “disability as construction” models. Four foundational theoretical models are considered in terms of integrating disability frameworks. The bio-psycho-socio-cultural-spiritual model is suggested as the optimal model to both resolve the disability frameworks’ duality and optimally integrate service provision.

• Russell, R. A. 1981. Concepts of adjustment to disability: An overview. Rehabilitation Literature 42.11–12: 330–338.

  Since the 1980s the person-oriented approach that has gained prominence is disability services. This paper on socio-environmental approaches discusses influences of external situations on individuals, the social construction of reality, and effects of labeling. An integrative approach appears most comprehensive because it views adjustment as occurring through interactions between individuals and their environments.

• Saleeby, P. W. 2007. Applications of a capability approach to disability and the International Classification of Functioning, Disability and Health (ICF) in social work practice. Journal of Social Work in Disability & Rehabilitation 6.1–2: 217–232.

  DOI: 10.1300/J198v06n01_12

  The capability approach and the International Classification of Functioning, Disability and Health (ICF) provide helpful tools for social worker training. The capability approach emphasizes the need to assess individual abilities in real-life environments (capabilities) rather than capacity or functional status. The ICF provides disability-related terminology to assist in developing interventions that facilitate capability development.