1. Health and social care practice perspective?
2. Disability issues in specific group?
3. Policies on this issue in Lewisham borough ?
4. Physical and medical model of disability?
Given the area of disability and mainly the physical and medical model around this vis-à-vis anti-discrimination practice and anti-oppressive policies, and having gathered much recognition among policy makers, it is necessary to understand the concept cutting through various facets in a systematic way (Lane and Videbaek, 2015). In this context the social policy associated with this concept is also another important aspect for deliberation. Against this backdrop the current piece of paper dwells upon a detailed study taking model of disability in Lewisham community in London Borough of Lewisham, Greater London into consideration. This has a lot of significance to professional in social and health care practice. Clear understandings of the issues from prevalence, practice and contextual points of view can be for academic as well as for program people and policy design.
Out of 32 London borough councils with local authority in the United Kingdom capital of London, Lewisham London Borough Council is one. This council is directly controlled by an elected (directly) mayor after its creation by an Act in 1963 and later bifurcated into two local authorities, with Lewisham Metropol Borough being one such. Around the borough, are the Greenwich Royal Borough, the Borough of Bromley, Borough of Southwark with river Thames at the north. The demographics of the council as per the recent census reveals that the population of Lewisham is 275,885 with bit more than half being whites and others as BME, and little less than half are owner occupiers of their house.
1. Health and social care practice perspective
Seeing from an angle of profession in health and social care practice person, many issues in this council (Lewisham) population emerge to be relevant. Among health and social care projects, some are undertaken on Lewisham Learning Disability aspects, with objective for improving local level infrastructure to support people living with disabilities in learning and participate in work. For this, audit of available skills among localites in terms of disabilities in learning across different service categories within the Lewisham council is conducted so as to develop employment related profiles by categories of people with varying level of learning disability (O'Brien et al. 2014). This is supplemented by information about employment and training aspirations of the people, which can in turn help in production and dissemination of relevant resources for support from local organisations towards people learning disability.
Further a clear understanding about landscape for persons employed with learning disabilities and attitude of employers towards putting these people into employment in their institutions is useful for health and social care practitioners to design an employment map for future (Duncan, 2015). In this line, lot of disability related awareness, information, training and advice should be provided to potential employers for recruitment consideration for persons with learning disabilities into their current workforce. Overall improvement in supporting networks and required infrastructure for enhanced paid employments is seen as a sustainable option.
2. Disability issues in specific group
Someone with a disability is generally defined as a person with physical or mental impairment having substantial magnitude of and longer term impact on her or his ability for carrying out day-to-day normal activities. While this definition comprises of broader range of impairments like autistic, Tourette syndrome, communication difficulties and so on, SEN (special educational need) among children encompass many others such as difficulty in specific learning, moderate and severe learning difficulty; speech, language and communications needs, visual and hearing impairments etc. School-going children with SEN may have significant difficulty in learning than other children.
Within the incidence of overall disability issues in Lewisham, it is observed that prevalence of the disability among children is around 4 percent with similar prevalence up to children of 16 years age within Lewisham population. There are minor variations in estimation of exact figure however across studies.
3. Policies on this issue in Lewisham borough
Given the significance of the issue in Lewisham borough, many policy documents for children living with disability issues are given shape in last 5 years. Furtherance to major policy documents, some specific ones on Speech as well as Language related Therapy have been designed.
SEND-- Special education needs and disability Green Paper, 2011: This green paper follows a new and innovative approach encompassing aspiration as well as support for giving special type of education needs deliberated during 2011 March. It emphasised for support and choices for care at family level for special education needs and need for clear identification of children living with the SEN for necessary support provision. Also a new approach in assessment process was designed for bringing together support for children and families for relying on education and social health care.
The Review on Ofsted Special Educational Needs and Disability, 2010: this review focused on children with severe type needs with clear clinical diagnosis in terms of identification at early age for effective management. However these measures to identify different types of disabilities are consider still far from optimum for higher needs of therapy.
4. Physical and medical model of disability
Guided by different principles and philosophy, mainly 2 models of disability is popular among discussions: medical model and social model of disability
The Medical Model: In medical model, the medical condition or illness is emphasised and used to identify disabled people, and it adheres to individual problems in defining so. This model promotes philosophy of dependency and need of disabled persons for care and some way justifies systematic exclusion of such people from society of which they are a part, and by virtue of this this model visualize disabled people to be the real problem rather than the society as such. This Model reflects such philosophy in International level Classifications for Impairments and Disabilities in a way that impairment referring to any abnormality or loss of physiological structure or function, whereas disability limiting up to restriction in ability of or lack of it in performing normal activity as others (Barber, 2012).
Many times, society perceives the disability as a real tragedy experienced by individual which create burden on family as well as society, which gives rise to medical model of disabilities. The focus of this model thus relies on lack in physical or mental work which needs clinical help to bring back the ability of the same individual. Likewise the norms are developed in this model for human behaviour and categorises, in terms of the impairments casting the persons to be victim and even a problem (Roush. and Sharby, 2011). For this reason, many people with disability reject this medical model altogether complaining of affecting their self-esteem, level undermining their skill level, employability etc. Even this model is also seen as breaking the natural fabric of relationships in families and communities including societal fabric (Martin, 2013).
The Social Model: With a response to discriminatory or oppressive perceptions against disability, protests emerge during 60-70s which gave rise to social model of impairment or disabilities based on alternative definition and meaning. This went beyond the functional-only aspects of normal life condition rather incorporating differentials accruing due to barriers of social and physical nature. This way the impairment are ceased to be visualised as problem of an individual rather a social type of issue as a result of flaws in perception, policies and practice. The dominant belief of this model dwells on the idea that the individual level or collective level disadvantage among disabled people is a result of discrimination at institution and societal level (Anastasiou and Kauffman, 2013).
Better understanding of people with disability and enhanced acceptance of this model of people without disability can help people building community towards positive change in attitude, and emerging a society free of barriers to people with disability thereby ensuring fullest benefit of potentials and talents in all spheres of life (Oliver, 2013).
Summary and Conclusion:
With change in attitude of people across the world towards disability and persons living with this, anti-discrimination practice and anti-oppressive policies are developed ibn a big way (Rush and Keenan, 2014), which this paper examines in the case of Lewisham community in London Borough, This is not only because of its significance to professional in social and health care practice, but also soceitisation of the issue beyond medicalisation only.
The incidence of such issue among children is considered outmost for care hence proper understanding and implementations are required so as to provide special learning needs. The existing policy frameworks are continuously evolving and looks at emphasising care at family level for special education needs, better identification of children (SEND), and some others on early clinical diagnosis for effective management. Finally the discussion about medical and social models examine the positive and negative aspects, whereby the predominant thought process of medical model seeing the problem only from clinical angle, rather than social model looking at this problem from a social and holistic point of view is well represented by arguments. Based on these deliberations, finally recommendations emerge for adopting social models rather than victimising the impairment problem or the people living with this (medical model of disability). The understandings from these points are useful not only for academic but also for program and policy purpose.
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