COVID-19 pandemic among adults with intellectual disabilities: Implementing a social model of disability in crisis and trauma situations.

A growing body of evidence has attested to the higher impact of COVID-19 on individuals with intellectual disabilities (IDs) than on members of the general population during the pandemic, mainly showing their higher vulnerability. However, we believe it is important to better understand how their situation interacts with the specific circumstances of the pandemic. In this article we discuss recent findings regarding individuals with IDs through the lens of two theories - the social disability model and the ecological model of trauma and recovery - and propose an integration, namely a social model of disability in crisis and trauma situations. Such a model allows for a wider perspective on understanding the way people living with disabilities (PLWDs) cope in these situations, integrating the individual aspects of coping with the social and environmental ones.

Who needs the social model of disability?

Over the past two decades, there has been a growing shift away from the Social Model of Disability (SMD) in both theory and practice. This article aims to substantiate the relevance of SMD by addressing the main arguments against it and by identifying why and for whom it is still relevant. In the introductory section, we focus on the recent production of multiple disability models in order to contextualize their emergence and elucidate the reasons behind their proliferation. In the main section of the article, we critically engage with three lines of criticism against SMD in order to explain why it remains relevant and for whom. Our main point is that, in the context of the neoliberal capitalist era, the SMD is indispensable for all disabled persons who have been denied their dignity, both in material and cultural terms.

The United Nations Convention on the Rights of Persons with Disabilities and Social Work: Evidence for Impact?

The United Nations Convention on the Rights of Persons with Disabilities (hereafter CRPD) has provided a radical imperative for the reform of mental health and capacity legislation around the world. The interpretation of the CRPD has been controversial, ranging from the complete abolition of detention, forcible treatment, and substitute decision-making to accepting that elements of these measures need to be retained based on non-discriminatory criteria, additional safeguards, and a comprehensive shift towards supported decision-making. While the potential effects of the CRPD on mental health social work and social work generally are considerable given their shared commitment towards social justice, to date there has been no review of research evidence exploring their relationship. In addressing this knowledge gap, this study held a preliminary discussion with practitioners and academics at the European Association of Social Work Mental Health Special Interest Group in Amsterdam 2022, followed by a scoping literature review on the question: What impact, if any, has the CRPD had on social work practice? The review produced four main findings: impact on legislation; positive impact on practice; limited impact on practice; and impact on social work education and research. In sum, while there were some positive indications of social work and mental health social work practice being influenced by the CRPD, these were scant. Barriers to change included tendencies among some social workers to practise substitute decision-making, in part related to resourcing and policy contexts, and understandings of disability aligned to individualised/medical rather than social perspectives. The results indicate that legal reform on its own is insufficient to impact social work practice, and that realising the potential of the CRPD will necessitate good quality training, as well as improving social workers' knowledge of the human rights of people with mental impairment.

Toward the development of a training program that promotes a "social model of disability" for physical therapists: a discussion on experiential learning surrounding the use of "acceptance of disability" by physical therapists.

[Purpose] This study aimed to extract knowledge for the development of a training program for creating a social model of disability for physical therapists, focusing on the experiential learning of those physical therapists who did not use acceptance of disability according to their subjective judgment. [Participants and Methods] The study included 11 physical therapists who were interviewed about their use of acceptance of disability and the circumstances leading to its non-use. [Results] The study identified the past and current use of acceptance of disability, as well as cases and reasons for its discontinuation, along with changes in clinical content. [Conclusion] The study extracted knowledge for the development of training programs in line with the components of the experiential learning model.

Impairment, Disability, and Substance Use Disorder.

According to the social model of disability, it is not individuals' impairments, but societal barriers that cause these impairments to be disabling. Impairment refers to the "loss or abnormality of psychological, physiological, or anatomical structure or function," whereas disability is socially constructed and refers to the inability to independently complete one or more everyday tasks at a "normal" level of functioning. Existing research finds that disability serves as a chronic stressor, and those with disabilities report higher rates of substance use than their able-bodied counterparts. Therefore, this research will be among the first to combine the social model of disability with the stress process framework. It will examine the relationship between impairment and substance use and how disability, as a measure of chronic stress, may affect this relationship. More specifically, using data from the 2019 National Survey on Drug Use and Health (N = 42,739), this article examines the following two research questions: (1) What is the relationship between impairment and substance use disorder? and (2) Does disability, as a measure of chronic stress, mediate the relationship between impairment and substance use disorder? Findings reveal that those with an impairment have significantly greater odds of having a substance use disorder. However, the relationship between impairment and substance use disorder is fully mediated by disability. These findings indicate that disability or the chronic stress one faces living in an inaccessible society, not one's impairments, are what accounts for the increased likelihood of substance use disorder among individuals with disabilities.

What Can We Learn From a Human-Rights Based Approach to Disability for Public and Patient Involvement in Research?

Public and Patient Involvement can align both the research process and its outcomes with the values, needs and expectations of society. By fostering the design of inclusive, engaged, and sustainable practices, research and research integrity can be improved. Devolving power to involve patients and relevant publics in deliberative decision making can produce better research outcomes. Disabled people are often categorized as "Hard to Reach." There is a varied and complex ecosystem of societal challenges of living with a disability that reinforce this. However, if researchers are to meet their obligations under the UN Convention on the Rights of Persons with Disabilities, disabled people should be included in public and patient involvement for all research in which they have a stake. In this article we argue that a better understanding of rights-based approaches and the social model of disability within the wider research community can help to remove barriers to research involvement for disabled persons. We focus on articles 3, 4, and 9 of the Convention and discuss how the principles of participation, accessibility, and equality of opportunity can be applied to research involvement, and how their adoption can facilitate truly meaningful PPI in disability research.

Disabled in Society - A Scoping Review on Persons Living with Multiple Sclerosis and Disability.

Multiple sclerosis (MS) is a chronic neurological disease with an increasing prevalence. As such, most studies are devoted to various medical aspects of the disease. The theoretical framework used in this scoping review was the social model of disability - a perspective focusing on environmental barriers and discrimination that disabled people face in society. The aim was to explore previous research on disabling barriers and discrimination against persons with MS, and to identify research gaps in connection with this population. The scoping review was performed in two steps: (1) a main search in 8 databases, followed by (2) citation and reference searches. The final sample consisted of 96 included articles. The result showed that most studies had been conducted in the US, and the dominant area of research was employment discrimination. Previous research has studied MS related to various areas, such as employment, social welfare and social services, transportation, housing and accessibility of public places, health services, and in relation to others within society. However, this scoping review showed that although several areas of disability and MS had been included in the previous research, most of the identified areas were researched in few studies without the possibility to generalize the findings to a larger population or a cross-cultural context. Few studies compared differences between persons with MS based on gender, age, and ethnicity. What impact the invisible symptoms of MS had on disability was also researched to a limited extent. The findings have implications for future research and clinical practice. To better understand living conditions for persons with MS from a global perspective, more research across countries is needed. Healthcare professionals need to assess the individual's situation regarding both symptoms of the disease and the impact of societal barriers and discrimination to optimize care of persons with MS.

"Together in a pressure cooker": Parenting children with disabilities during the COVID-19 lockdown.

BACKGROUND: COVID-19 has had a disproportionate and unprecedented impact on children with disabilities, their parents and families. This impact has been particularly evident during periods of lockdowns and severe restrictions. OBJECTIVE: This study employed the social model of disability to illuminate negative and positive experiences of Israeli parents of children with disabilities during the first COVID-19 lockdown, as well as the way social environments, particularly educational and welfare services, shape that experience. METHODS: The study draws upon thematic analysis of written responses of 80 Israeli parents to open-ended questions. RESULTS: Three main themes were found: (1) lack of responsiveness of both informal and formal supports to family needs, mainly in the educational and welfare systems; (2) juggling multiple roles and tasks along with the parents' routinely intensive caregiving role; and (3) the impact on the family's wellbeing and relationships. CONCLUSION: These results are discussed in light of the social model of disability, showing how social restrictions and barriers affect both negative and positive experiences of these families. Also discussed are practical implications for future crises.

Annual Research Review: Shifting from 'normal science' to neurodiversity in autism science.

Since its initial description, the concept of autism has been firmly rooted within the conventional medical paradigm of child psychiatry. Increasingly, there have been calls from the autistic community and, more recently, nonautistic researchers, to rethink the way in which autism science is framed and conducted. Neurodiversity, where autism is seen as one form of variation within a diversity of minds, has been proposed as a potential alternative paradigm. In this review, we concentrate on three major challenges to the conventional medical paradigm - an overfocus on deficits, an emphasis on the individual as opposed to their broader context and a narrowness of perspective - each of which necessarily constrains what we can know about autism and how we are able to know it. We then outline the ways in which fundamental elements of the neurodiversity paradigm can potentially help researchers respond to the medical model's limitations. We conclude by considering the implications of a shift towards the neurodiversity paradigm for autism science.

Interactions between the Public and Assistance Dog Handlers and Trainers.

This research aimed to explore the experiences of handlers and trainers of disability assistance dogs in terms of the types of interactions they had with members of the Aotearoa NZ (NZ) public and how these interactions were perceived, interpreted, and managed. A qualitative method, guided by an interpretive approach and social constructionism, was utilised to collect data via semi-structured interviews with six handlers and six trainers of assistance dogs. Data were analysed using thematic analysis with the social model of disability as the theoretical base. Findings indicated that participants regularly faced a complex range of unique interactions due to various factors such as the public's lack of knowledge and understanding of the dog's role and right of access to public places. While participants encountered brief friendly comments about the dog and its role, other encounters involved long conversations, invasive personal questions, interference with their dogs, and denied access to businesses, cafés, restaurants, and public transport. These findings underpin the need to provide more education to the public on the etiquette of engaging with handlers and their assistance dogs and more support for businesses to understand the legal rights of handlers. Through education and support to change societal attitudes and remove structural barriers, disabled people using assistance dogs may be able to independently participate in community life and be fully included without hindrance.

Entre apagamentos e afirmações: reposicionamentos do trabalho e da deficiência / Between deletions and affirmations: repositioning of work and disability / Entre eliminaciones y afirmaciones: reposicionamiento del trabajo y discapacidad

O artigo objetiva discutir efeitos da reforma trabalhista no Brasil, em 2017, na relação deficiência e trabalho. Adotamos como questões: quais são os reposicionamentos que a multifuncionalidade do trabalhador, marca da especialização flexível, coloca para o modelo social da deficiência? E quais reposicionamentos estão colocados com o modelo social da deficiência, nas pistas de Débora Diniz, Marcia Moraes e Anahi Mello? Com base em pesquisa documental e bibliográfica, colocamos em cena o apagamento do trabalho no cenário brasileiro atual, com as leituras de David Harvey e Ricardo Antunes. A Carteira de Trabalho foi tomada como um analisador, pela escrita de Simone Guedes. A condição de contribuinte passa a ser determinante com a versão digital nas pactuações e contratações de trabalho, cada vez mais precárias. Junto com a "pejotização", cresce o trabalho informal e a marca do trabalho doméstico: a invisibilidade. O que apagamos e afirmamos com nossas escritas de pesquisa?

The article aims to discuss the effects of labor reform in Brazil, in 2017, on the relationship between disability and work. We adopt as questions: What are the repositioning that the multifunctionality of the worker, a mark of flexible specialization, poses to the social model of disability? And what repositioning are placed with the social model of disability, in the tracks of Deborah Diniz, Marcia Moraes and Anahi Mello? Based on a documentary and bibliographical research, we put on the scene the deletion of the work in the current Brazilian scenario, with the readings of David Harvey and Ricardo Antunes. The work card was taken as an analyzer by the writing of Simone Guedes. The condition of taxpayer becomes determinant with the digital version in the increasingly precarious agreements and hiring work. Along with "pejotização", informal work grows and the mark of domestic work: invisibility. What do we erase and affirm with our writing policies?

El artículo tiene como objetivo discutir los efectos de la reforma laboral en Brasil, en 2017, sobre la relación entre discapacidad y trabajo. Adoptamos como preguntas: ¿Cuáles son los reposicionamientos que la multifuncionalidad del trabajador, una marca de especialización flexible, pone para el modelo social de discapacidad? ¿Y qué reposicionamientos se colocan con el modelo social de discapacidad, en las pistas de Débora Diniz, Marcia Moraes y Anahi Mello? Basado en la investigación documental y bibliográfica, pusimos en escena la eliminación del trabajo en el escenario brasileño actual, con lecturas de David Harvey y Ricardo Antunes. La tarjeta de trabajo fue tomada como un analizador, por escrito de Simone Guedes. El estado del contribuyente se vuelve determinante con la versión digital en los acuerdos y contratos de trabajo, cada vez más precarios. Junto con la "pejotização", crece El trabajo informal y la marca del trabajo doméstico: invisibilidad. ¿Qué borramos y afirmamos con nuestros escritos de investigación?

Social vulnerability and the impact of policy responses to COVID-19 on disabled people.

In this paper, we propose a conceptual framework for understanding the impact of the policy responses to COVID-19 on disabled people. These responses have overwhelmingly focused on individual vulnerability, which has been used as a justification for removing or restricting rights. This suggests the need to shift the attention towards the social determinants of disabled people's vulnerability. We do this by bringing literature on social vulnerability in disaster risk management or 'disaster studies' in contact with key concepts in disability studies such as the social model of disability, independent living, intersectionality, and biopower. Empirically, we draw on the findings of the global COVID-19 Disability Rights Monitor (www.covid-drm.org), as well as on reports from academic journals, civil society publications, and internet blogs. We put the proposed conceptual framework to work by developing a critical analysis of COVID-19 policies in three interrelated areas-institutional treatment and confinement of disabled people, intersectional harms, and access to health care. Our conclusion links this analysis with strategies to address disabled people's social vulnerability in post-pandemic reconstruction efforts. We make a case for policies that address the social, economic, and environmental conditions that disproportionately expose disabled people to natural disasters and hazards.

Disability-competence training influences health care providers' conceptualizations of disability: An evaluation study.

BACKGROUND: Often, health care providers' approach to people with disabilities is grounded in a medical model perspective. This view highlights individual deficits and does not foster patient-centeredness. Learning about and adopting a more social model, focused on creating accessible and inclusive approaches and environments, could help providers to reshape their attitudes about disability, dismantling barriers to care. OBJECTIVE: This study used innovative methods to evaluate a recorded, online disability-competence training for health care providers. It was hypothesized that the training would 1) shift providers' conceptualizations of disability away from a medical model view toward a social model view of disability and 2) equip providers with actionable strategies to improve access to care for people with disabilities. METHODS: Quantitative and qualitative evaluation data were analyzed for n = 192 training participants. Measures included participants' pre- and post-training conceptualizations of disability, proposed actions steps to facilitate patient-centered care, and measures of satisfaction and self-assessed knowledge gain. RESULTS: Both hypotheses were supported. After the training, participants' conceptualizations of disability were more reflective of the social model, and participants were better able to articulate specific action steps they could take to promote accessible, responsive care. CONCLUSIONS: This study demonstrates that health care provider training can positively affect providers' knowledge, outlook, and approach to caring for people with disabilities. Its findings can inform broader efforts aimed at systematically changing the way health professionals are educated and trained to provide care in disability-competent ways.

Os sentidos atribuídos à deficiência pelos profissionais de saúde e o acesso das pessoas com deficiência aos serviços de saúde / The meanings attributed to disability by health professionals and the access of people with disabilities to health services

Objetivo: O estudo analisa como os profissionais da rede pública de saúde de doze municípios do Estado de São Paulo, Brasil - atribuem sentidos à "deficiência". Método: Foram realizadas 121 entrevistas semi-estruturadas, em 63 serviços. Os profissionais responderam a pergunta: Para você o que é deficiência/incapacidade? Os depoimentos foram organizados em núcleos temáticos e interpretados sob a perspectiva sócio histórica. Resultados: Constatou-se que predomina uma compreensão preconceituosa, assistencialista e paternalista sobre a deficiência. Observou-se nos depoimentos uma hesitação entre os sentidos atribuídos à deficiência e incapacidade, com abordagens reducionistas pautadas em paradigmas organicistas e/ou calcadas no senso comum. Não houve depoimentos que explicitassem conceitos de deficiência na perspectiva do modelo social de deficiência. Conclusão: É essencial que os serviços de saúde promovam espaços de reflexão entre profissionais sobre seus valores e sentidos que atribuem à deficiência e à prática assistencial, o que pode contribuir para a transformação cultural dos sentidos atribuídos ao fenômeno da deficiência e para o acesso aos bens de saúde

Objective: The study analyzes how professionals from the public health network in twelve municipalities in the State of São Paulo, Brazil - attribute meanings to "disability". Method: 121 semi-structured interviews were carried out in 63 services. The professionals answered the question: For you, what is disability? The testimonies were organized into thematic nuclei and interpreted from a sociohistorical perspective. Results: It was found that a prejudiced, charity and paternalistic understanding of disability prevails. A hesitation between the meanings attributed to disability and incapacity was observed in the testimonies, with reductionist approaches based on organicist paradigms and/or grounded in common sense. There were no statements that explained the concepts of disability from the perspective of the social model of disability. Conclusion: It is essential that health services promote spaces for reflection among professionals about their values and meanings they attribute to disability and care practice, which can contribute to the cultural transformation of the meanings attributed to the phenomenon of disability and to access to goods of health

In Defense of Madness: The Problem of Disability.

At a time when different groups in society are achieving notable gains in respect and rights, activists in mental health and proponents of mad positive approaches, such as Mad Pride, are coming up against considerable challenges. A particular issue is the commonly held view that madness is inherently disabling and cannot form the grounds for identity or culture. This paper responds to the challenge by developing two bulwarks against the tendency to assume too readily the view that madness is inherently disabling: the first arises from the normative nature of disability judgments, and the second arises from the implications of political activism in terms of being a social subject. In the process of arguing for these two bulwarks, the paper explores the basic structure of the social model of disability in the context of debates on naturalism and normativism, the applicability of the social model to madness, and the difference between physical and mental disabilities in terms of the unintelligibility often attributed to the latter.

"Our Voices, Our Meaning": The Social Representations of Sports for Brazilian Athletes With Disabilities.

This study aimed to identify the social representations of sports for Brazilian athletes with disabilities and to understand the extent to which sports can contribute to their empowerment. A total of 153 Brazilian athletes of various sports and with different types of disabilities took part in the study (122 men and 31 women; M = 31.91 years, SD = 9.46). The research was performed by an online survey by means of the free word association technique. All analyses were carried out using the Iramuteq computer program. The results indicated that the social representations of sports are related to individual and collective gains derived from practicing sports and that the representations are distinct according to the discipline practiced by the athlete. These results are discussed in light of the advantages of valuing the collective experience of athletes with disabilities as a group rather than as cases of individual overcoming. Social implications and possible future directions for research are presented.

Understanding Mental Ill-health as Psychosocial Disability: Implications for Assistive Technology.

Psychosocial disability involves actual or perceived impairment due to a diversity of mental, emotional, or cognitive experiences. While assistive technology for psychosocial disabilities has been understudied in communities such as ASSETS, advances in computing have opened up a number of new avenues for assisting those with psychosocial disabilities beyond the clinic. However, these tools continue to emerge primarily within the framework of "treatment," emphasizing resolution or improvement of mental health symptoms. This work considers what it means to adopt a social model lens from disability studies and incorporate the expertise of assistive technology researchers in relation to mental health. Our investigation draws on interviews conducted with 18 individuals who have complex health needs that include mental health symptoms. This work highlights the potential role for assistive technology in supporting psychosocial disability outside of a clinical or medical framework.

Mobility is a fundamental human right: Factors predicting attitudes toward self-directed mobility.

BACKGROUND: Emergent disability studies research is interested in the community's views on how disability, including self-directed mobility, influences social and environmental policies. We anticipate that individuals' alignment with disability models, or sets of assumptions about the cause, nature, and treatment of disability, will influence attitudes about self-directed mobility. Self-directed mobility is defined as mobility that is controlled by an individual and may include walking or assisted ambulation through the use of mobility technology such as prosthetics, walking aids, manual wheelchairs, or motorized wheelchairs. OBJECTIVE: The purpose of this study was to explore how demographic factors, contact with people with disabilities, attitudes toward people with disabilities, and alignment with social or medical models of disability predict attitudes toward self-directed mobility. METHODS: 1545 students at a public university completed demographic questions, and measures of disability attitudes, disability model orientation, and self-directed mobility. RESULTS: The predictors explained 16.60% of the variance in participants' attitudes toward self-directed mobility (R2 = 0.166, F(7,1537) = 43.9, p < .001). Significant predictors included: female gender (ß = -0.14, p < .01), more positive attitudes toward people with disabilities (ß = -0.30, p < .001), and social model orientation (ß = 0.59, p < .001). CONCLUSIONS: Participants who more strongly agreed with disability as a social construct (social model) were in stronger agreement that self-directed mobility is a fundamental right. Future research extending to rehabilitation professionals is warranted.

Perceptions towards disability among social work students in Israel: Development and validation of a new scale.

Over the last decades, the disability movement has been advocating for a paradigmatic shift in how disability is perceived and managed: from a medical or individual perspective focusing on the person's body and mind to a social perspective emphasizing the context and barriers of disability. However, we still know little about the perceptions of helping professionals, particularly social workers who work closely with disabled people. Thus, the aim of the current study is to develop and validate a scale-Perceptions Toward Disability Scale (PTDS)-to measure how social workers view disability: as an individual or social category. This paper describes the three phases of the scale's construction. First, scale items were formulated and its content validity was examined. Next, a pilot of 30 social workers completed a questionnaire and an initial exploratory factor analysis was conducted. In the third and main phase, the final draft was completed in 2016 by 565 Israeli social work students to assess its psychometric properties. Both exploratory and confirmatory factorial validity and discriminant validity analyses were conducted. The results of a confirmatory factor analysis revealed two distinct factors: an individual perspective of disability comprised of eight items (α = 0.77) and a social perspective of disability comprised of ten (α = 0.66). Subsequent analyses supported the scale's discriminant validity as indicated by the lack of an association between the Attitude Toward Disabled Persons Scale (ATDP) and the social model subscale (r = .13, p = .19) and by the weak negative relation with the individual model subscale (r = -.25, p = .01). These findings show that the PTDS possesses promising construct validity and provide support for its utility. This easy-to-administer instrument offers several practical benefits and can serve as a framework for further empirical research regarding social work practice with disabled people.