The Social Model of Disabilities in UK - Research Paper Example

1. Introduction Disability can be broadly defined as that limiting factor which inhibits a person to carry out his social obligation towards his family and society at large, due to some physical or mental impairment. The last few decades have seen significant changes in the understanding of the plight of the people with disability. Efforts have been made to overcome the prejudices of the people to acknowledge disabled person as an individual with equal rights and issues. ‘Human competencies interact with the environment in a dynamic reciprocal relationship that shapes performance. When functional limitations exist, social participation is possible only when environmental support is present’ (IOM1, 1997). The social model of disabilities which advocated the support system of the existing environment as a major enabling factor that facilitates integration, both at physical and intellectual level, was the most prominent model to define the disability as per the environmental constraints within which it exists. Adopted in UK, it greatly facilitates proactive participation of the disabled population to make it a success. But the challenges of the not so visible disabilities, like learning disability or dyslexia, has been taken up on priority basis, mainly because of the initial intangibility of the problems, which are not only difficult to segregate but which are proving to be equally complex to understand and interpret. Hence the need of nursing intervention has been seen as the most effective way of understanding and facilitating the inclusion of the dyslexic patients in the mainstream population. 1.1. Case Study Dyslexia is a ‘specific learning difficulty’ that is broadly defined as ‘A specific difficulty, typically characterised by an unusual balance of skills. Dyslexia affects information processing (receiving, holding, retrieving and structuring information) and the speed of processing information. It therefore has an impact on skills such as reading, writing, using symbols and carrying out calculations’ (DfES, 2004). The essay would take up the case of dyslexic person to study the impact of nursing perspectives on learning outcomes of the various factors and issues that have significant impact on the person with dyslexia. 1.1.1 Background Angela is 22 years old psychology student. She was diagnosed as dyslexic at the age of 11 when she was having acute problems in reading and writing the reading material. She comes from affluent business class family. Her parents are highly educated and very successful business persons who have an enviable social standing. Her brother has recently passed out with honours from the Harvard University and parents are planning to offer him a place in the board of directors of their company. They are puzzled at her lack of academic talent. 1.1.2 Difficulties faced at the school and college level She has good grasp of the verbal instructions but slow at comprehension while reading and writing. She has much difficulty in keeping pace with the rest of her classmates. After the deduction of her problems and diagnosis of dyslexia, though the classroom pressure has slightly eased but she still founds it extremely limiting in interpreting her understanding of the subject through written work. Long stretch of the school hours were quite stressing for her so she often escaped to the creative hall in the school where she sketched people and painted at random. College was another harrowing experience till she met her mentor who motivated her towards this stream where interaction with other people became more important than the fixture towards written skills 1.1.3 Difficulties faced at social interaction She was initially a well behaved child but later on, developed defiant attitude and careless regard for people in general. She is highly intelligent but her lack of interest in the curricula was distressing for her family. After the diagnosis, it is observed that she had rebelled against the concept of help, which according to her ‘had made her feel as a disable when she was not one!’ Learning Outcome 1 Public healthcare is a crucial part of government healthcare initiatives. In the fast advancing technology and rapid globalization, public healthcare imperatives have become key factors for department of health. The healthcare professionals monitor general health of the communities and identify their needs to develop programmes to reduce risks, create awareness for communicable diseases and overall manage change in the healthcare areas within the population (White paper, DoH, 2001). The wide scope of public healthcare has brought the nursing perspective to forefront of the public healthcare who is taking especial care to disseminate information (NMC, 2006). Indeed the role of clinical nurse has become crucial as socio-economic and cultural environment has considerable impact on the welfare and timely intervention in the case of persons with disability, which is especially true for dyslexic patients. It is observed that awareness within the family and community about the needs and requirements of the people suffering from learning difficulties greatly facilitates the integration of the person with the mainstream population. While sometimes, the specific cultural paradigms may hinder early clinical intervention but the nursing perspectives helps to create an understanding for the requisite physical and emotional support, intrinsic to the welfare of the disabled person. The emotional and moral support of the family goes a long way to inculcate confidence within the person to accept his or her limitations and actively seek support. In the case of Angela, apathetic attitude of the parents and their disappointment in her was visibly harming her physical and emotional well being. It was imperative that proper information be disseminated to them so that they could appreciate the qualities that their daughter had and not be made to feel inferior for what she lacked. Once the parents were able to understand the wider implications of dyslexia and found that she had qualities and talents that could be nurtured, they actively encouraged her. The emotional support followed by community acceptance greatly helped Angela to accept her limitations and work towards conquering it with hard work. Learning Outcome 2 Public health and general well being of the masses has become pivotal to the development of a nation. The government’s initiatives in the healthcare imperatives are focused towards health education and developing programmes and policies for the promotion of healthcare modules for all segment of the society, including the vulnerable segment and the immigrant population. The social determinants of health have now become major developmental issues for the political parties and health agencies. The rapid globalization has promoted pluralistic society that comprises of people coming from different culture, race, colour and ethnicity. The changing paradigms in the social reconstruction have produced huge diversity in the socio-economic status and cultural values that seems to have adversely affected the overall healthcare of the society. Hence the nations across the world have shown increasing concern for the deteriorating healthcare system. British government’s initiative in health education and health promotion are commendable steps to improve and improvise the overall health of the population. According to McKenzie, Niegel and Thackeray, the ‘health education is a profession of educating people about health’ (2009). The wide scope of health modules range from physical, mental, spiritual well being to environmental related health and incorporate information about the ways and means to promote healthy living. World Health Organization has defined health education as ‘constructed opportunities for learning involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health’ (WHO, 1998). Health promotion, on the other is the process of empowering people to actively participate in activities that are designed to improve their general health condition and well being. It is people centric and relies on public health policies and initiatives of the government and implemented through strategic objectives and plans, on individual basis or as community based programmes. The health promotion facilitates skill development and strategic plans to mitigate the circumstances that are detrimental to health and inculcate lifestyle that is conducive to healthy living. Health education and health promotional guidance for Angela’s family were successful nursing intervention that greatly facilitated the learning environment for Angela. The information regarding dyslexia enabled the family and the community to change their perspectives towards the so called disease and prompted them to focus their attention on her versatile personality and become proud of her. The step has greatly enhanced her self worth and self confidence. Learning Outcome 3 Legislations and laws in the area of health and related field are intrinsic part of effective healthcare delivery system of a nation. They are important means of policy formulation and development of guidelines for efficient and safe healthcare deliverables. UK governments, has promulgated various legislative initiatives to meet the challenges in the field of health and social care. NHS has been the key player which overlooks the wider welfare of the public at large. Health and Social Care Act 2008 has incorporated vital measures to strengthen its health and social care within and outside the precinct of NHS which is its key healthcare facilitator. The Act has focused on four vital policy areas that have significant impact on the quality and safe health care services. Care Quality Commission; Professional regulation; Public health protection measures; and Health in pregnancy grant. While the commission has brought together the two disparate bodies: health and social care under one umbrella thus greatly facilitating quality services, the others have considerably enhanced public confidence and empowered them to access safe healthcare at affordable cost. The health and social care are highly relevant to the people with disability and carers. Disability Discrimination Act (DDA) 1995, promoting ‘rights of access to goods, facilities, services and premises’ has been further amended to include the equal opportunity for disabled people. 2008 Act has strengthen the cause of the disabled people and now provides them with widespread opportunities to make them part of mainstream population through creation of effective environment. The laws and policy framework in the area of disability take cognizant of the problems and difficulties faced by the family members and make necessary guidelines for the health professionals to include their perspectives. Indeed, the reforms in the laws acknowledge that “effective advocacy can transform the lives of people with earning disabilities by enabling them to express their wishes and aspirations and make real choices” (NHS, 2003). The legislative acts and subsequent policies and programs, have facilitated qualified health professionals that provide the parents with emotional support to understand the complexities of the problems, both of the disability and the child and later guide them to formulate strategies that best suit the child and the his/ her environment. The nursing perspective has become critical to the empowerment of the disabled person primarily because they provide the tangible and intangible support and understand the inequalities in the provision of services. Indeed, their intervention has helped create appropriate environment support that turned the defiant and aggressive Angela into a confident young adult with a bright future. Learning Outcome 4 Learning disability can be defined as the disability where persons find it difficult to coordinate and co-relate information received and respond with an appropriate action and reaction. The organization and processing of information in certain sequence so as to come to a desired result is not possible because of the problems in the brain. The different parts of the brain, storing information, are unable to coordinate and thus their responses are slow and often inaccurate. Learning disability or the developmental disability as the neurological science calls them, are normally characterized by high IQ which is not discernable chiefly because of the uncoordinated processing of the information by the brain which is often taken as low IQ (Gates, 2007). Another main point of the learning disability is that despite high IQ, they work below their intellectual capabilities and are often identified as persons with learning disability, much later in life. It often takes years to identify them because often their slow and inaccurate responses are taken as normal. Nursing perspective and health professionals facilitate better understanding of the challenges faced by the persons with learning disability and everyone associated with them. ‘In the past 20 years or so, the number of children diagnosed as learning disabled has steadily increased, and children with learning disabilities (LDs) now form the single largest category of students receiving special education services’ (Swerling et al., 1998). The most common learning disability is Dyslexia which causes problems with reading and is increasing becoming common among the students. The others areas where it affects can be seen are writing, calculation, reasoning, language and motor skills. ‘CBR2 workers provide information to people with disabilities and their families, .. CBR worker also acts as an advocate for people with disabilities by making contacts with schools, training centers, work places and other organizations to promote accessibility and inclusion’ (JPP3, 2004). Role of clinical nurses, therefore, is highly pertinent and crucial in identifying the children with learning disability. The early deduction of the disability enhances the chances of rehabilitating the child with much more understanding both from the parents and the teachers. The collective efforts make much deeper impact on the child’s learning abilities and help him evolve as an independent and self sufficient adult. Learning Outcome 5 The changing socio-economic status of the people with disabilities has significantly contributed their empowerment and the changing statistics in the number of disabled people, throughout the world, has now been taken as a challenge, both by the disables and the governments. ‘Recognizing that people with disabilities are important contributors to society and that allocating resources to their rehabilitation is an investment’ (WHO, 2005). The governments are keen to promote policies and create facilitators so that disabled people become differently abled persons and contribute positively towards national growth. The people with disabilities, on the other hand, are intent on overcoming the disadvantages of their disabilities and confidently strive towards financial independence. This very positive attitude among this segment of society has impelled the government and voluntary agencies to redefine their goals with regard to long term objectives, policies and plans for the people with disabilities. According to WHO4 there are around six hundred million people living with disability of various types. 80% of these are living in under developed and developing countries (2005). The number of disabled people is increasing because of various factors like population growth, misuse of drugs, accidents, war casualties, landmines, HIV/AIDS, poverty and lack of medical facilities, chronic diseases, increase in life expectancy, environmental causes etc. The growing number of people with disabilities has necessitated our need to improvise and improve the existing infrastructure of rehabilitation and other services that are needed to counter the growing menace of external factors that lead to the disabilities and provide a solid platform for the disabled to rehabilitate their life. The social model of disability elaborates on the needs and requirements of the disabled population in order to provide them with requisite infrastructure and opportunities so that they can become financially independent and socially integrated. ‘It changed the centre of analysis from focusing on individual’s medical conditions to social structures, institutions, environments and attitudes’ (Kwiotek). ‘the social model acts as a powerful and important reminder to face issues of inclusion as fundamental, moral issues’ (Terzi, 2004). It has become much more popular and effective because of its inherent sensitivity towards the external factors that influence the level of disability in the person. Angela’s case the prime example of social model who has greatly benefited. Learning Outcome 6 The disability sector has long been considered as one of the least attended sector so far as empowerment of the people with disability are concerned. ‘People with disabilities have historically been marginalised in education, employment and community living’ (Keys, 2001). This sector must be recognized as having potential to succeed with the ability of contributing substantially to the overall development of the society and nation as a whole. The rapid advancement of technology has facilitated a wide ranging scope of enabling the people with disability. The various enabling factors, facilitated by the emerging technologies, especially in the field of computers and information technology, have proved a milestone in the lives of the people with disabilities. They have restored the faith in the vast potential that was hitherto hidden and provided them with a means to achieve socio-economic independence, giving them self respect and a future to look forward to. Hence, all these factors trigger the accessing of multi-professional health and social services for the people with disabilities. The accessibility options that allow people with different types of disability is one of the most important key issues that facilitates empowerment of the people with disability and creates requisite environment that promotes self confidence in their abilities to use and exploit the emerging new opportunities in almost all areas (Laverack, 2007). Indeed gaining knowledge and acquiring skills in all areas of professional arena become as important as the facility to access various health services and social care that may be required due to changing environmental paradigms. The role of nurses in disseminating information about the disability in general and learning disability in specific, among the public is crucial in creating a congenial and encouraging environment for the child (Bichenall & Bichenall, 1998). They act as a link between the complexities that is represented by the learning disability and people who are directly affected by the disability. They not only alleviate the worries and tensions of the parents but guide them through an emotionally challenging journey at the most crucial time of their life. Thereby, lending credibility and trust to my role as an effective support worker. Indeed, with the nursing help and encouraging environment, Angela is no more a disabled person but can be rightly considered as differently abled person who is capable of contributing constructively to the socio-economic development of the society. (words 2954) Reference Bichenall, M & Birchenall, P. (1998). Sociology as applied to nursing and health care. London: Bailliere Tindall, Department of Education & Skills. (2004). Delivering Skills for Life. The national strategy for improving adult literacy and numeracy skills. A Framework for Understanding Dyslexia. DfES Department of Health. (2001). Valuing People a new strategy for learning disability for the 21st century. A white paper. London. The Stationary Office. Disability Discrimination Act. (1995). Available from: < http://www.opsi.gov.uk/acts/acts1995/ukpga_19950050_en_1> [Accessed 12 May 2009]. Enabling America: Assessing the Role of Rehabilitation Science and Engineering. (Institute of Medicine. (1997). Chapter 6, pp 148. Available from: [Accessed 12 May 2009]. Gates B. ed., (2007). Learning disabilities: towards inclusion. 5th ed. Edinburgh: Churchill Livingstone. Health and Social Care Act 2008. Available from: [Accessed 12 May 2009]. Joint Position Paper (2004).CBR: A Strategy for Rehabilitation, Equalization of Opportunities, Poverty Reduction and Social Inclusion of People with Disabilities. Available from: [Accessed 12 May 2009]. Keys, Christopher, B and Dowricks, Peter, W. Ed.(2001). People with Disabilities: Empowerment and Community Action. Haworth Press Inc. Kwiotek , Rita G., PhD Student , Department of Sociology & Political Science, National University of Ireland, Galway. Available from: [Accessed 12 May 2009]. Laverack G. (2007). Health promotion practice: building empowered communities.Maidenhead: Open University Press National Health Services. (2003). Valuing People: More choice and control for people with learning disabilities. Chapter 4. HMSO. Available from: [Accessed 12 May 2009]. McKenzie, J., Neiger, B., Thackeray, R. (2009). Health Education and Health Promotion. Planning, Implementing, & Evaluating Health Promotion Programs. (pp. 3-4). 5th edition. San Francisco, CA: Pearson Education, Inc. Nursing and Midwifery Council. (2006). A – Z Advice Sheet. Disability Discrimination. Available from: [Accessed 12 May 2009]. Spear-Swerling, Louise , Sternberg, Robert J. (1998). Curing Our Epidemic of Learning Disabilities. Questia Journal. Vol.79. 1998. Available from: [Accessed 12 May 2009]. Terzi, Lorella. (2004). The Social Model of Disability: A Philosophical Critique. Journal of Applied Philosophy 21 (2), 141–157. doi:10.1111/j.0264-3758.2004.00269.x World Health Organization.(2005). 58 World Health Assembly. pp108. Available from: [Accessed 12 May 2009]. World Health Organization. (1998). List of Basic Terms. Health Promotion Glossary. (pp. 4). Available from: [Accessed 12 May 2009]. Read More