RTC:Rural Rural Institute University of Montana

logo for Montana Disability & Health Program: Living well under the Big Sky

Strategic Plan 2006-2010

description of table 2

A Medical-Social-Ecological Model of Disability.  This model is from the U.S. Department of Education, Office of Special Education and Rehabilitative Services, National Institute on Disabilities and Rehabilitation Research, Long-Range Plan 1999-2003. Washington, DC: GPO, 2000.

This table contrasts three perspectives: (1) Medical Perspectives; (2) Social Perspectives; and (3) Ecological Perspectives; and describes how each approaches six basic issues regarding disability and health.

Definitions. The Medical Perspective defines disability as an individual being limited in life activities by his/her impairment or condition.  The Social Perspective defines disability as an individual with an impairment requiring an accommodation to perform functions necessary for life activities. The Ecological Perspective defines disability as a person being limited in life activities by the interaction of his or her capacities and the demands of the environment.

 Domain of Disability.  The domain of disability in the Medical Perspective is as a medical “problem”. The domain of disability in the Social Perspective is as a socio-environmental issue involving accessibility, accommodations, and equity. The domain of disability in the Ecological Perspective is all aspects of the person/environment interaction that inhibit full participation.

 Strategies to Address Disability.  The Medical Perspective seeks to improve functional limitations of the individual. The Social Perspective seeks to remove barriers, create access through accommodation and universal design, promote wellness and health. The Ecological Perspective seeks to help individuals maximize function and to provide environmental accommodations.

 Methods to Address Disability.  The Medical Perspective provides medical, vocational, or psychological rehabilitation services. The Social Perspective provides supports (e.g., assistive technology, personal assistance services, job coach). The Ecological Perspective provides services, supports and opportunities to facilitate achievement of participation in goals.

 Source of Intervention. The Medical Perspective uses professionals, clinicians, and other rehabilitation service providers.  The Social Perspective uses peers, service providers, and consumer information services.  The Ecological Perspective uses professionals, clinicians, peers, and policy makers.

The Role of the Disabled Individual. The Medical Perspective sees the disabled individual as the object of an intervention, as a patient, a beneficiary or a research subject.  The Social Perspective sees the disabled individual as a consumer or customer, an empowered peer, a research participant, and a decision maker.  The Ecological Perspective sees the disabled individual’s expertise on accommodations needed for full participation .

 Entitlements. The Medical Perspective bases eligibility for benefits on severity of impairment,  The Social Perspective sees eligibility for individualized accommodations as a civil right. The Ecological Perspective deems environmental accommodations necessary for full participation of all citizens.

 Return to text