Module Three: Frameworks of Disability
Introduction
Disability influences aspects of daily life—from communication and self-care to recreation, employment, and relationships. Yet, the lived experience of disability is not defined by diagnosis alone; it is shaped by how society structures opportunities, environments, and attitudes. This section explores how social and physical contexts either support or hinder inclusion, drawing on the social model of disability, which positions barriers as the true source of limitation.
3.1 Understanding the Models of Disability
The medical model views disability as a defect or disorder within the individual, focusing on cure, correction, or normalization. By contrast, the social model recognizes that people become “disabled” when environments, attitudes, or systems restrict full participation.
Medical Model
Focus: Disability as an individual defect or medical condition that must be fixed or cured.
Goal: Restore normality through treatment, rehabilitation, or intervention.
Responsibility: Lies with doctors and professionals to correct or manage the problem.
Language: “Patient suffers from,” “handicapped,” “impairment.
Impact: Can lead to pity, stigma, and exclusion by framing disability as an aspect that needs to be changed.
Social Model
Focus: Disability results from barriers in the environment and attitudes, not from the individual’s body or mind.
Goal: Remove barriers, redesign spaces, and promote accessibility and inclusion.
Responsibility: Lies with society to adapt, accommodate, and create equitable systems.
Language: “Person with a disability,” “accessible,” “inclusive design.”
Impact: Promotes dignity, participation, and interdependence as part of human diversity.
Video: The Medical Model of Disability
This clip illustrates how the medical model frames disability as an individual problem to be treated or corrected, highlighting the limitations of deficit-focused approaches in health care.
Video: Medical and Social Models: A Lived Perspective
This video demonstrates how medical and social frameworks of disability coexist in a lived experience. Genetic counselors have a role in applying an integrated biopsychosocial approach rather than relying on a single model.
Biopsychosocial Model
A more contemporary model of understanding disability has been deemed the biopsychosocial model of disability. The biopsychosocial model of disability is an integrated framework that views disability as the result of a complex interaction between a person’s health condition and their social and physical environment (Tait & Silveira, 2023). Instead of choosing between the “Medical Model” (which focuses only on fixing the impairment) and the “Social Model” (which focuses only on removing societal barriers), this model combines them to provide a more holistic understanding.
Biopsychosocial Model
Focus: Disability results from the dynamic interaction between biological factors (health/condition), psychosocial factors (thoughts, emotions, coping), and social factors (environment, culture, relationships).
Goal: Optimize overall well-being and functioning by addressing medical needs, supporting mental and emotional health, and reducing social and environmental barriers.
Responsibility: Shared among healthcare providers, the individual, and society, which integrates medical care, psychosocial support, and inclusive environments.
Language: “Whole-person care,” “functioning,” “quality of life,” “strengths-based,” “person-centered.”
Impact: Promotes holistic care, empowerment, and participation by recognizing that health, mindset, and environment all shape the lived experience of disability.
The Three Core Components
The model is defined by the overlap of three distinct areas (Tait & Silveira, 2023):
- Biological: This includes the physical or mental impairment, such as genetics, tissue injury, or physiological pathology.
- Psychological: This focuses on the individual’s internal experience, including their self-esteem, emotions, coping styles, and personal beliefs about their disability.
- Social: This refers to the external environment, including cultural attitudes, social support systems, accessibility in the workplace or community, and government policies
Strengths of BPS in Education and Care
For teachers and allied health professionals, this model is preferred because it moves away from “pathologizing” a person (viewing them as a “problem” to be cured) and instead focuses on how to improve the “fit” between the individual and their environment (Tait & Silveira, 2023).
- Holistic Assessment: It recognizes that a person’s wellbeing is affected not just by their diagnosis, but by how they perceive themselves and how their community supports them.
- Multi-dimensional Support: Intervention might involve medical treatment (Biological), counseling to build confidence (Psychological), and structural changes like adding ramps or changing school policies (Social).
- Inclusive Language: It encourages terms like “participation restriction” and “activity limitation,” which emphasize the interaction between the person and the context they are in.
Video: More than MPS I: A Mother’s Perspective
In this video, a mother describes her daughter’s life with MPS I (Mucopolysaccharidoses 1) beyond the diagnosis. This perspective reinforces the biopsychosocial model of disability, reminding clinicians that a medical condition is only one part of a person’s identity and lived experience.
Further Resources for Learners:
- Easing the tension between Medical and Social Models of Disability: The Biopsychosocial Model of Disability (PDF)
- Common Measures of Disability ( Alyafei A, Chauhan PR. Common Measures of Disability. [Updated 2025 Feb 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-.)
- The Nora Project: Models of Disability
👉 For genetic counselors, embracing the biopsychosocial model means moving beyond pathologizing language and instead collaborating with patients to identify and address external barriers; whether in health care, communication or family life.
3.2 Social Environments
Disabilities can affect multiple dimensions of daily life: communication, mobility, self-care, and recreation. However, these challenges are often intensified by inaccessible systems—such as limited, transportation, complex, healthcare navigation, and inflexible social structures.
Video: The Scrappy Ones
In this video, Rebekah tells a story that details an innovative “scrappiness” that is built in individuals with disability due to the mismatch between social environments and disability.
- People with intellectual or developmental disabilities report frustration when independence is limited by lack of transportation or support for community engagement (ALSOWeb, 2024).
See: Gigi’s Playhouse-Resources & Testimonials regarding this topic. - Adaptive technologies, community inclusion programs, and peer support networks enhance autonomy and belonging.
Video: Assistive Devices and Environmental Fit
This video demonstrates how assistive devices support autonomy and participation, emphasizing that disability-related barriers often arise from environments, not bodies.
- Environments that provide options, like adjustable workspaces, visual schedules, and assistive communication, tools, support equal participation for all.
👉 Genetic counselors can enhance daily living outcomes by connecting patients and families to adoptive support, community programs, and advocacy resources that promote independence and inclusion. (See section titled “enhance daily living outcomes” in the provider resource section to view a list of resources).
3.3 Relationships, Community, and Identity
Relationships are central to quality of life. People with disabilities, describe social connection, acceptance, and recognition as key to identity and mental well-being (ALSOWeb, 2024). Unfortunately, stigma and misconception still lead to isolation, overprotection, and limited opportunities for self-expression. Positive relationships—with families, workplace, and communities—can counter these barriers by affirming competence and belonging
👉 Genetic counselors can foster this by using inclusive communication, encouraging, patient, self-advocacy, and involving patients directly in decision-making, regardless of disability type or communication method.
Key Takeaways
🔑Takeaway 1
The social model reframes disability because of environmental and attitudinal barriers, not personal deficits.
🔑Takeaway 2
Accessibility and inclusion enhance participation, independence, and overall well-being.
🔑 Takeaway 3
Relationships and social connection are vital components of health and identity.
🔑 Takeaway 4
Genetic counselors, play a key role in identifying and addressing barriers—helping patients navigate systems, access supports, and build autonomy.
Reflection Prompt for Learners:
After viewing the video narratives, reflect on one narrative that resonated most of you. Why did it stand out?