Four models of thinking in disability

Updated: Jan 13, 2020

How development around disability has evolved over time.

In recent years, there has been a growing awareness around disability and disability issues in South Africa. We see this from the public response to the Life Esidemeni tragedy, which brought a new social consciousness and wave of activity around it, and certain other political developments, for example, the establishment of the Presidential Working Group on Disability, and the Ministry of Women, Youth and Persons with Disabilities. There is a dedicated sector of non-profit and professionals organizations that do work here and the rise of social media has supported the cause by connecting the public on a more personal level to the stories, lives and experiences of people with disabilities.

Despite this, work in the disability sector remains largely fragmented and there is a lack of cohesion in efforts. If you are doing work in the sector, it is really important to continuously review the fundamental thinking and approach behind your work and seek opportunities for greater collaboration. This is because the ability to attract funding, make your project sustainable and have a significant impact in the long run depends on your ability to look at your work from a wider lens and to understand the required direction. To understand how to do this, it can be helpful too look at how disability has been traditionally viewed and approached in the past, and how this has evolved over time. We will describe the four main models of thought around disability support, and you can click on the links to learn more about each.

1) The Charity Model -Throughout the course of history, and to this day, disability has been seen as something to be pitied, and in need of charity. While efforts within this model were well meaning, they seldom included the voice of people with disabilities themselves and remain limited in what they can achieve, and can be in many opinions, actually disruptive to progress.

2) The Medical Model - The medical model then came and dominated the field, and it was based on the thinking that people with disabilities solely needed to be fixed and cared for from a medical point of view, and did not consider any factors outside of this. Therefore, the disability itself is not a concern of anyone else besides the person themselves, and the professional who might try to treat the condition.

3) The Social Model of Disability -The social model of disability emerged in the 1970s as a response to the medical model , and it has played a huge role in shaping policies and development efforts in many countries. It basically states that disability itself is not a core problem, but rather it’s the attitudes, structure and accessibility of society that creates the problem and prevents people with disabilities from living the lives they aspire to.

4) The Human Rights-Based based Model - In response to some of the limitations of the Social Model of Disability, this model has entered the forefront of thinking and holds that participation is a human right that can and should be held by everyone, and all efforts should be combines and directed to achieve this.

The Human-Rights based model is so far the most encompassing way of thinking of development around disability, as it includes all the factors listed before. For instance, one cannot consider social barriers only, as people with disabilities do have pain and need access to medical intervention and support services. Furthermore, social support from non-disabled people as well as financial resources are required if progress is to be made. At present, most professions, entities and organization position their work within one of these spheres only and there is very little collaboration between them.

What does this mean for you?

Whichever sphere you might be in, to move forward as a society we need to consider this on three levels. Firstly, it is important to re look at the marketing and communication messages being sent out, and the ideas you might be promoting in a subtle way. Your messages must reflect contemporary thinking around the subject of disability. For example, using a message like 'We help people with disabilities to participate to their full potential through our work' is much better than just 'We are an organization or school for the disabled or we look after disabled people. This is they way a lot of organisations and non-profits continue to describe themselves in society, and in reality they harm your organisation by confining your position and they also harm the disability movement as a whole.

Secondly, the work you do on a daily basis needs to reflect a strong commitment to the messages you are sending. To reflect this commitment, you need to demonstrate that you are a learning and developing organisation, by setting out relevant indicators measure around different aspects of your service. For example, if you are improving participation of people with disabilities by providing therapy services, measure the frequency and quality of these services, and what outcomes for the beneficiary were able to be met through them.

Finally, the largest area potential for development lies in asking broader questions around your work. If you are a non-profit organisation, do you engage sufficiently with the needs of your beneficiaries beyond the services you currently provide? For healthcare providers, does your service delivery model allow you to adequately consider and intervene around the social aspects of disability, and to what extent do you also liaise with other spheres? Finally, if you are in the corporate or funding space, have you truly considered where your funds will have the most impact, and how they can best be used?

*Nabeela Laher is a rehabilitation professional and social development consultant for healthcare and disability. She can be contacted at

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