UNDERSTANDING DISABILITY & SOCIETY

OT101 | OT-1B Caitlin Tagarda

UNDERSTANDING DISABILITY → Impairments – are specific decrements in body functions

and structures, often identified as symptoms or signs of
health conditions
→ Disability is complex, dynamic, multidimensional, and
contested
★ CONVENTION ON THE RIGHTS OF PERSONS WITH DISABILITES
→ Over the recent decades, the disabled people’s movement,
(CRPD)
together with numerous researchers from the social and health
→ Acknowledges that disability is “an evolving concept”,
sciences have identified the role of social and physical barriers
but also stresses that “disability results from the
in disability
interaction between persons with impairments and
→ The medical model and the social model are often presented
attitudinal and environmental barriers that hinder their
as dichotomous, but disability should be viewed neither as
full and effective participation in society on an equal
purely medical nor as purely social: persons with disabilities can
basis with others”
often experience problems arising from their health condition

★ ENVIRONMENT
★ NEW EMPHASIS ON ENVIRONMENTAL FACTORS
→ A person’s environment has a huge impact on the
The International Classification of Functioning, Disability
experience and extent of disability
and Health (ICF) (17) advanced the understanding and
▪ A deaf individual without a sign language
measurement of disability. It was developed through a long
interpreter
process involving academics, clinicians, and persons with
▪ A wheelchair user in a building without an
disabilities (18). The ICF emphasizes environmental factors
accessible bathroom or elevator
in creating disability, which is the main difference between
▪ A blind person using a computer without screen-
this new classification and the previous International
reading software
Classification of Impairments, Disabilities, and Handicaps
(ICIDH). In the ICF, problems with human functioning are
★ DISCRIMINATION
categorized in three interconnected areas:
→ Negative attitudes towards disability can result in
1. IMPAIRMENTS
negative treatment of people with disabilities
→ Are problems in body function or
▪ Children bullying other children with disabilities
alterations in body structure (ex. paralysis
in schools
or blindness)
▪ Bus drivers failing to support access needs of
2. ACTIVITY LIMITATIONS
passengers with disabilities
→ Are difficulties in executing activities (ex.
▪ Employers discriminating against people with
walking or eating)
disabilities
3. PARTICIPATION RESTRICTIONS
▪ Strangers mocking people with disabilities
→ Are problems with involvement in any
area of life (ex. facing discrimination in
employment or transportation)

★ DISABILITY
★ THE DIVERSITY OF DISABILITY
→ refers to difficulties encountered in any or all three areas
→ Persons with disabilities are diverse and heterogenous,
of functioning. The ICF can also be used to understand
while stereotypical views of disability emphasize
and measure the positive aspects of functioning such as
wheelchair users and a few other “classic” groups such as
body functions, activities, participation, and
blind people and deaf people
environmental facilitation. The ICF adopts neutral
→ Disability encompasses the child born with a congenital
language and does not distinguish between the type and
condition such as cerebral palsy or the young soldier who
cause of disability for instance, between “physical” and
loses his leg to a land-mine, or the middle-aged woman
“mental” health
with severe arthritis or the older person with dementia,
→ arises from the interaction of health conditions with
among many others
contextual factors – environmental and personal factors
→ Health conditions – are diseases, injuries, and disorders

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UNDERSTANDING DISABILITY & SOCIETY
OT101 | OT-1B
→ Women with disabilities experience the combined
disadvantages associated with gender as well as
disability, and may be less likely to marry than non-
disabled women
→ People who experience mental health conditions or
intellectual impairments appear to be more
disadvantaged in many settings than those who
experience physical or sensory impairments
→ People with more severe impairments often experience
greater disadvantage
★ DISABILITY AND HUMAN RIGHTS
→ People with disabilities experience inequalities
→ People with disabilities are subject to violations of dignity
→ Some people with disability are denied autonomy
→ General principles of CRPD
1. Respect for inherent dignity, individual autonomy
including the freedom to make one’s own
choices, and independence of persons
2. Non-discrimination
3. Full and effective participation and inclusion in
society
4. Respect for difference and acceptance of persons
with disabilities as part of human diversity and
humanity
5. Equality of opportunity
6. Accessibility
7. Equality between men and women
8. Respect for the evolving capacities of children
with disabilities and respect for the right of
children with disabilities to preserve their
identities
GLOBAL ISSUES ON HEALTH & WELFARE
★ HEALTH
→ A large number of disabilities are preventable, including
those arising from medical issues during birth, maternal
conditions, malnutrition, as well as accidents and injuries
→ There is a lack of affordable access to proper health care,
aids and appliances
→ Healthcare facilities and poorly trained health workers in
rehabilitation centers is another concern
★ EDUCATION
→ The education system is not inclusive. Inclusion of
children with mild to moderate disabilities in regular
schools has remained a major challenge
Caitlin Tagarda
→ There are various issues such as availability of special
schools, access to schools, trained teachers, and
availability of educational materials for the disabled
★ DISCRIMINATION/SOCIAL EXCLUSION
→ Negative attitudes held by the families of the disabled,
and often the disabled themselves, hinder disabled
persons from taking an active part in the family,
community or workforce.
★ ACCESSIBILITY
→ Physical accessibility in buildings, transportation, access
to services etc. still remain a major challenge
★ EMPLOYMENT
→ Even though many disabled adults are capable of
productive work, disabled adults have far lower
employment rates than the general population
★ POOR IMPLEMENTATION OF POLICIES AND SCHEMES
→ This hinders the inclusion of disabled persons, Though
various acts and schemes have been laid down with an
aim to empower the disabled, their enforcement face
many challenges
HEALTH & SOCIAL POLICIES
★ PUBLIC/SOCIAL POLICY
→ “Public policy is anything a government chooses to do or
not to do”
→ American with Disabilities Act (1990)
★ 5 CATEGORIES OF LAWS AFFECTING PEOPLE WITH DISABILITIES
→ Civil right status
→ Entitlement programs
→ Discretionary grant programs
→ Regulatory statues
→ Miscellaneous provision
★ CORE PRINCIPLES
→ Equality of opportunity
→ Full participation, empowering individuals and families
→ Independent living
→ Economic self-sufficiency
★ ENTITLEMENT PROGRAMS
→ Social Security Disability Insurance
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UNDERSTANDING DISABILITY & SOCIETY
OT101 | OT-1B
→ Supplemental Security Income
→ Medicaid
→ Medicare
★ POLICIES IN THE PHILIPPINES
→ Batas Pambansa blg. 344
→ Accessibility Law – an act to enhance the mobility of
disabled persons by requiring certain buildings,
institutions, establishments and public utilities to install
facilities and other devices
→ Republic Act No. 7277
• “Magna Carta for Disabled persons and for
other purposes”
• An act providing for the rehabilitation, self-
development and self-reliance of disabled
person and their integration into the
mainstream of society and for other purposes
OCCUPATIONAL JUSTICE
★ OCCUPATION
→ Occupation is used to mean all the things that people
want, need, or have to do, whether of a physical, mental,
social, sexual, political, spiritual, or any other nature,
including sleep and rest activities
→ Occupation is shaped by time, place, and social
conditions and is a unit of economy
★ JUSTICE
→ “Truth of action”
→ The term justice is most often applied to legal systems,
but it is also used in arguing for equal distributions of
resources and positive discrimination in terms of
marginalized persons
★ SOCIAL JUSTICE
→ Social justice is a concept about rights, equity, and
fairness
→ Social justice is applied to the ethical distribution and
sharing of resources, rights, and responsibilities between
people recognizing their equal worth as citizens, “their
equal right to be able to meet basic needs, the need to
spread opportunities and life chances as widely as
possible, and finally the requirement that we reduce and
where possible eliminate unjustified inequalities”
★ OCCUPATIONAL JUSTICE
Caitlin Tagarda
→ Occupational justice is a justice of difference because
people have different natures, needs, and capacities that
are expressed through what they do
★ OCCUPATIONAL JUSTICE WITHIN OCCUPATIONAL THERAPY
→ The profession uses the term “occupational justice” to
refer to the concept that acts as a complementary
extension to social justice. Occupational justice provides
a framework for asking questions about inequities of
opportunity for occupational development, or inequities
related to lack of appropriate enablement for those living
with a disability
→ WFOT recognizes an increasing need for occupational
justice to counter the sociopolitical and economic factors
that underlie and are a consequence of disability
→ Today’s practice of occupational therapy may actually
rest on the profession’s success in putting occupational
injustice explicitly on the public agenda and showing
what an occupation-focused, justice-driven profession
can accomplish
★ OCCUPATIONAL INJUSTICE AND OLD AGE
→ Many older adults remain interested in the future and
the part they will play in it. They remain interested in
doing whatever has meaning to them unless, as too
commonly happens, they are confined in or shackled to
restricting, disempowering situations in the care of
patronizing, “for your own safety”, overzealous
caregivers
→ Provision of opportunity to meet unique occupational
wants and needs is a matter of justice as part of an active
aging process
→ Fear of legal action should accidents occur if older people
engage in more than self-care occupations has resulted
in many excellent programs being axed owing to risk
management concerns
→ OCCUPATIONAL INJUSTICE AND SENIORS: A CHECKLIST
1. Sitting alone in nursing homes or other
confined settings with nothing to do except to
watch others in the same situation or a
television that shows program after program
that they did not choose
2. Taken for outings they have no interest in
3. Not attended to when they talk about what
they have done in their lives
4. Not asked for advice or listened to when they
give it
5. Given no chance to help others
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UNDERSTANDING DISABILITY & SOCIETY
OT101 | OT-1B Caitlin Tagarda

6. Prevented from doing what they want in the

name of risk management
7. Told they can’t do something they would enjoy
“for their own good”
8. Not allocated resources, helpers, services, or
support to find satisfying occupations
9. Social contract only with paid service providers
who bring food and change their bedding
10. Restricted, deprived, or alienated by the
policies of people in authority or by legislation

★ OCCUPATIONAL INJUSTICE AND SOCIAL PROBLEMS

→ Economic rationalism and bureaucratic legislation
have led to many people being unable to obtain
regular paid employment that meets their interests
and skills or to be self-employed
→ People might refer to accept social security instead of
paid employment because there are no financial or
social incentives to work part-time
→ QUESTIONS AN OT MAY ASK:
• What are the occupational concerns for
children and adolescents who are not
thriving in poor social conditions? For single
women or men?
• Who are the occupational therapists’ allies in
working for occupational justice?

★ HOW TO ADVOCATE TO ENABLE CLIENTS TO PARTICIPATE IN

MEANINFUL OCCUPATION
→ Delivering occupationally just programs may entail
keeping awareness of the occupational nature of clients
in the forefront during any interaction; engaging people
in dialogue about their perceived occupational needs;
assessing according to those needs; and implementing
programs that ensure that needs are met