Historical Overview and Key Guidance
Key Research Findings
Implications for Practice
SEN: ‘A Child has special educational needs if he or she has a learning difficulty which calls for special educational provision to be made for him or her' (DfES, 2001)
Disability: ‘A physical or mental impairment which has a substantial or long term adverse effect on his or her ability to carry out normal day to day activities' (Disability Discrimination Act , 1995)
Inclusion: ‘Educational inclusion is about equal opportunities for all pupils....it pays particular attention to the provision for, and achievement of, different groups of pupils' (Ofsted, 2001)
Historical Overview and Key Guidance
The concepts of disability, SEN and inclusion are inextricably linked. In order to understand how Special Educational Needs and inclusion have developed it is important to understand the cultural and historical journey of disability frameworks.
Historically, perfection of both mind and body were revered. The ancient Greeks were besotted with aesthetics, reflecting the perfectly formed body as the ultimate achievement in many of their sculptures and works of art. Disposing of babies that were imperfect was so widely advocated by the Greek Philosopher Aristotle that measures were put in place by Greek law suggesting a baby should not be considered a child until it had been born seven days. This effectively enabled Greeks to dispose of unwanted children whilst maintaining a clear conscience. Feudal systems in Medieval Europe ensured that most disabled people were valued members of the family and community, working on the land and in small workshops.
However, cultural change during the 15th and 16th Centuries began to identify those with disfigurement or illness as sinners. Churches and religious advisors were held responsible for the values of society and the mysteries of the world could be explained with reference to the bible. Countries torn apart by plague and smallpox epidemics therefore looked to religion to provide them with answers. Flagellation as a demonstration of penitence was widely practiced in Europe during the plague to avoid illness and death.
The assumption was that only those who were unholy contracted disease. Similarly, those suffering from leprosy in 16th Century Holland were viewed as sinners, having all their worldly goods confiscated by the state and being forced to rely on alms. Making meaning of situations and trying to understand their origins underpinned most of the philosophies at this time. Ignorance and a lack of medical knowledge reinforced by fear drove people to look for scapegoats. It can therefore be argued that the medical model at first could be used to support people with illnesses and disabilities to participate in society.
The benefit of developing knowledge
But, even with the benefit of developing knowledge, the picture for those affected by disability did not improve. During the 19th
Century, Social Darwinian theories gave rise to notions of selectivity based on ‘breeding out' inferior genes and developing a stronger society. Francis Galton, founder of the Eugenics movement and cousin of Charles Darwin, set out his theories in 1883 suggesting that there were schemes of ‘marks' for high ranking and intelligent families which should be encouraged to procreate and produce offspring. Unfortunately, the reverse of this theory was also seen to be true and taken to the extreme would suggest that all those displaying any form of defect should be prevented from reproducing. These notions were taken on board by eminently powerful individuals across Europe, including Sidney and Beatrice Webb (founders of the labour party, economist John Maynard Keynes and several notable authors thus altering the face of legislation and ultimately leading to further segregation and isolation. Sir Winston Churchill, Home Secretary at the time of the Mental Deficiency Act (1913) and a supporter of eugenics was recorded as stating:
"The unnatural and increasingly rapid growth of the feebleminded classes, coupled with a steady restriction among all the thrifty, energetic and superior stocks, constitutes a race danger. I feel that the source from which the stream of madness is fed should be cut off and sealed up before another year has passed."
From agents of reform to agents of custody
At an International Convention in Milan in 1881 sign language was made illegal to prevent non-hearing people from out breeding hearing people. Similarly in the United States at around the same time, women who were born deaf and those with an IQ of below 70 were automatically sterilised to prevent procreation (www.bfi.org.uk). People with disabilities began to be seen as a burden on society at a time when commercial and industrial competition amongst developing countries was at its height. Overshadowed by simplistic social interpretations of Darwinian theory, institutions turned from being agents of reform to become agents of custody, enforcing social control by segregation of those deemed sub-normal. The early 19th Century saw the advent of workhouses and poor law relief to provide for those who could not contribute to the growing economy.
Single sex institutions became common with the advocacy of sterilisation for those affected. Bodies such as the Royal Commission on Mental Deficiency eventually lead to the Mental Deficiency Act 1913 with definitions including idiots, imbeciles, feeble minded and morally defective. Such Acts lead to the incarceration of 50,000 children and over 500,000 adults with physical and communication difficulties, many of whom were not released until as recently as the 1970's and 1980's.
The 20th Century
Century saw a more sinister turn of events, with selective breeding of superior races dominating the agenda in Germany. Propaganda films depicted disabled people as a burden on society suggesting they should be sterilised or disposed of. Such films were shown at every cinema throughout Germany. This media hype resulted in 140,000 people with physical and mental disabilities being murdered between 1939 and 1940 by the Third Reich. Although riots reduced this activity clandestine killings of over 100,000 disabled children continued until 1945.
The disability rights movement began in 1890 and gained momentum in the 1920's & 30's as veterans from the First World War began to campaign for the right to work. In 1920 the sheer numbers and force of the protests in the UK resulted in the Government taking action to ensure that 3% of every workforce was comprised of people with disabilities. This legislation was eventually replaced by the Disability Discrimination Act 1995.
Despite the movements for social change over the last 30 years, the extent to which disabled people are stereotyped through the media has affected the efficacy of Government legislation. Stereotypes can undermine a persons character and, although all pervading, are the result of cultural social constructs which bear little resemblance to reality. A media website looking at disabling imagery identifies ten stereotypes which are damaging to those with disabilities and associated media portrayals:
1. Pitiable & pathetic; sweet & innocent; miracle cure - (Tiny Tim in A Christmas Carol)
2. Victim or object of violence (Whatever Happened to Baby Jane)
3. Sinister or evil (Nightmare on Elm St)
4. Horror or comic shows (Phantom of the Opera)
5. Triumph over Tragedy (My Left Foot)
6. Laughable or butt of jokes (Forrest Gump/Mr Magoo)
7. Chip on shoulder or aggressive/angry (Hook/Candyman)
8. Burden or outcast (Hunchback of Notre Dame)
9. Non sexual (Born on the Fourth of July)
10. Incapable of participating fully in life (Children of a lesser god)
Clearly, the attractive nature of visual material and its widespread availability can have enormous impact on cultural perceptions of disability, particularly amongst children. Ensuring young people have positive portrayals of disability are crucial to changing culturally determined stereotypes.
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Key Research Findings
Models of disability are tools for defining impairment which enable strategies to be put in place by society and Government to support the needs of disabled people. Whilst it is important to have a framework within which to provide appropriate services, some models of disability have been criticised for the way in which disabled people are portrayed with resultant provision serving to undermine and devalue rather than empower the people for which it was intended.
Based upon the historical context outlined above, two major models of disability have emerged. The medical model reflects the deficit approach which dominates much of the historical journey for those with disabilities. This model depicts people as dependent upon society leading to provision which segregates and discriminates. The social model is a more recent reaction to the medical model, placing the onus on society to change and adapt rather than the individual.
The Medical Model of disability
The Medical Model stems from an approach towards classifying and treating illness and disease. As knowledge and wisdom expanded, so religion was replaced by science and answers sought within the realms of medicine. The World Health Organisation Classification of Impairments, Disabilities and Handicaps (1980) created definitions devised by doctors to include:
Impairment: any loss or abnormality of psychological or anatomical structure or function.
Disability: any restriction or lack of ability (resulting from an impairment) to perform an activity in the manner or within the range considered normal for a human being.
Handicap: any disadvantage for a given individual, resulting from impairment or a disability that limits or prevents the fulfilment of a role that is normal for that individual.
Providing a framework
This approach to providing a framework for understanding and supporting disability clearly grounds its focus on the intrinsic nature of disability as residing within the individual. It is perceived therefore that services which attempt to address individual deficit in terms of curing or containing the disability will be successful in ‘normalising' the person to be able to access society. It is easy to see how such a model could derive from the historic notions of disability where blame is laid upon the individual for either not conforming to societal norms by being different or not being a productive member of society. As such, government and societal approaches have historically tended towards investing heavily in medical and psychological intervention in anticipation not only of curing or normalising the disabled but of adding value to economic growth through an expansion of the workforce. This model has both an active and passive aspect. From an active aspect it places the onus of change firmly upon the individual with society having a remit towards supporting individual change, taking no account of social or environmental factors. This model is limited, therefore, as the individual may not necessarily be sick and indeed, in many instances, may not have a condition which can be improved by remedial treatment. The only choice then is to accept themselves as ‘abnormal' with the resultant problems this creates. Personal capacity and ability are assessed as incapacity and inability to determine eligibility for financial assistance further reinforcing the deficit aspects within the individual. From a passive perspective, the framework enables professionals to follow a process of identifying and addressing impairments within a context of power relationships balanced in favour of the professional. The person with disabilities is merely a passive recipient of professional services designed to address their deficits.
The Charity/Tragedy Model
A further model which is a subsidiary of the Medical Model is the Charity/Tragedy Model. This model, as outlined in the media portrayals above, depicts people with disabilities as victims of circumstance, to be pitied and provided for. Many charities utilise media channels to raise funds and to foster benevolence towards people deemed to be in tragic circumstances. Whilst this is no doubt a worthy cause it has been criticised from a number of perspectives. People with disabilities themselves see this approach portraying them with a negative victim image which is not empowering and the cause of discrimination. They fear that this approach perpetuates the notion that people with disabilities are there to be ‘cared for' and that this in turn validates institutionalisation. The ideology of being recipients of charity lowers the individuals self esteem and fosters expectations of gratitude from those with disabilities.
The Medical Model and its derivatives are becoming largely outdated. Whilst they are important milestones to be recognised in terms of placing the notion of disability within the realms of science, they function to label and stigmatise people through their condition. In turn, legislation has supported this model by generating services to address inherent deficits rather than to celebrate difference. The active, passive and charitable aspects of this model have done much to serve professionals and little to serve those with disabilities.
The Social Model of disability
The Social Model of disability is based on the proposition that it is society and its institutions that are oppressive, discriminatory and disabling and that attention therefore needs to be focused on the removal of obstacles to the participation of disabled people in the life of society and in changing institutions, regulations and attitudes that create and maintain exclusion (Campbell & Oliver cited in Mittler, 2000).
The Social Model arose in response to the Medical Model and as a consequence of a disability activist movement. Its origins are attributed to a variety of sources, the two main proponents being Paul Hunt and Mike Oliver. In an essay published in 1966 by Paul Hunt entitled ‘A Critical Condition' Hunt asserts that people with impairments are viewed as unfortunate, useless, different, oppressed and sick and as such pose a direct challenge to commonly held Western values. This Model was then further developed by disabled lecturer Mike Oliver who, in the mid-seventies, adapted a booklet by the Union of Physically Impaired against Segregation (UPIAS) called "Fundamental Principles of Disability". This extended the thinking beyond those with physical disabilities to encompass all people with disabilities. Oliver (1996) further commented on the relationship between the definitions of disability, which were predominantly constructed by able bodied people and issues of power which forced people with disabilities to receive services that professionals deemed they required rather than those which people with disabilities themselves chose. Oliver (op cit) suggests that viewing disability as a ‘tragedy' leads to services which are compensatory in nature.
Whilst the Disability Discrimination Act (1995) defines disability in accordance with the Medical Model, the Social Model stresses important distinctions between impairment and disability stating:
- Impairment - Lacking part or all of a limb or having a defective limb, organ or mechanism of the body (including psychological mechanisms)
- Disability - The restrictions caused by the organisation of society which does not take into account individuals with physical or psychological impairments
The philosophical underpinnings of this model move away from a social constructionist perspective of disability to a model which views the structures of society as barriers to the individual (Borsay, 1986). The concept of the Social Model rests on the premise that whilst it is recognised that a person may suffer from physical or psychological impairments which affect their ability to function in society, the onus is on society to adapt and not the individual. This suggests that people are not disabled by their impairments but by the barriers put up by society. For example, people who are short-sighted are not classified as disabled. They have access to affordable interventions to address these problems which means this impairment does not prevent them from fully participating in society. However, if access to such interventions were not the norm (as is the case in many developing countries) the impairment would indeed be experienced as severely disabling, limited the extent to which the individual could access their community.
The British Council of Disabled People puts these barriers into three categories:
Environment: Environmental adaptations may be required to ensure all members of the community can access facilities. For example, someone using a wheelchair is now afforded access into most public areas and onto transport by means of adaptations. The same does not currently held true for those with intellectual disabilities who experience a range of sensory and experiential limitations within the environment. For example, many individuals with autism are particularly disturbed by colours and over stimulation in terms of sensory processing. Whilst these adaptations may be more difficult to facilitate, it is important that these ‘hidden/invisible' disabilities are not overlooked.
Economic: Economically, people with disabilities have historically been under represented in the workplace with discrimination starting in school and following them throughout their career path. Within schools pedagogical adaptations can be made to facilitate people with impairments. For example, a student with dyslexia can be supported and achieve equally alongside their non-dyslexic peers when adaptations are made to facilitate their learning.
Cultural: A shift in thinking needs to occur in order to ensure that prejudiced, stereotypical and negative attitudes do not dominate. Much of this stigmatisation has arisen as a result of medical labels which have defined people with disabilities in terms of their condition and not as a person. Stereotypes have long dominated media images of people with disabilities and reinforced negative attitudes (see above).
Although the Social Model has fundamentally altered the way disability is viewed, many academics and policy makers feel another shift is necessary to move forward from the current position.
SEN & Inclusion
The ways in which disability has been defined throughout history has clearly impacted upon the ways in which policies are written and services delivered. Based predominantly upon the Medical Model policies have been drafted which define people by their disability rather than creating a world in which they can, through interdependent support, become autonomous, self determined individuals accessing a wide range of services. This approach has resulted in children being categorised according to their diagnosis with subsequent segregation and isolation.
In the mid-seventies when the tide of the Medical Model was turning in favour of the Social Model, the Warnock Report (1978) was the overarching policy for the education of children with special needs. The Report advocated that the education of children with special educational needs would be enhanced by close working links between mainstream and special schools. Link integration schemes were a popular result of the Warnock Report which focused on the benefits of raised awareness and understanding of special educational needs amongst their peers. It is important here to make the distinction between integration versus inclusion and to consider the impact of Models of Disability.
Integration: locational, social or functional
Integration was defined in the Warnock Report as being locational, social or functional. Each term resting on the premise that the disabled child should be afforded opportunities to be educated alongside mainstream peers but that they themselves should adapt to the educational environment rather than the environment adapt to meet their needs. This approach is clearly underpinned by the Medical Model which locates the person as the problem and not the environment and society. In contrast, inclusion is underpinned by the Social Model, emphasising the need for society, values and environments to change in order to support the individual's needs. The following table illustrates the differences between segregation, integration and inclusion:
(Tends to emphasize)
(Tends to emphasize)
(Tends to emphasize)
Services to Disabled People
Needs of Disabled People
Rights of Disabled People
Categorizing Disabled People
Changing Disabled People
Changing Schools / Colleges / Organisations
'Special' / different treatment
Equality - each receives support they need to thrive & achieve their potential
Disability is a problem to be fixed (in a special place)
Disability is a problem to be fixed
Everyone has gifts to bring
Services available in segregated setting
Benefits to disabled person of being integrated
Benefits to everyone, including all
Political struggle, friends & support
Power of ordinary experience
Categorisation & marginalisation
Competition for parts of Disabled Person
Transforming power of relationship
Stress on inputs
Stress on process
Stress on outcomes; have a dream
Integration 'for some' is not desirable
Integration can be delivered
Inclusion must be struggled for
Children with special educational needs may need different or additional help from that given to other children of the same age in school. It is important to note the distinction between SEN and disability. A child with a disability may have special educational needs but not necessarily and many children with SEN are also disabled but by no means all.
A continuum of need
SEN is experienced on a continuum of need, with some children having mild or moderate learning difficulties to children who experience severe and complex needs. Support will accordingly be tailored to meet a child's different needs. What is central and key to the delivery of this tailored service is a whole school approach based on attitudes which celebrate diversity rather than fear it (Whitehurst & Howells 2006), skills which are gained from experience and models of good practice, and ensuring all children have access to resources which meet their needs. For most children it is envisaged that this support will be provided in a mainstream setting, with a continuing role for special schools in fostering strong partnerships with mainstream schools at both a practical level and in terms of providing expertise in the area of disability and SEN.
The drive towards inclusion is now at the ‘heart of both education and social policy' (Mittler, 2000, p2). Despite the importance of inclusion to the educational framework within which teachers and educators operate, official definitions of inclusion are elusive. Ofsted (2001) provides a definition which suggests that:
‘Educational inclusion is about equal opportunities for all pupils....it pays particular attention to the provision for, and achievement of, different groups of pupils'
The Government's new strategy for SEN asserts that:
"All children, wherever they are educated, need to be able to learn, play and develop alongside each other within their local community of schools" (Dfes 2004 p5), going further to state that "inclusion is about much more than the type of school that children attend: it is about the quality of their experience; how they are helped to learn, achieve and participate fully in the life of the school" (p25).
A shift is occurring
Whilst much Government legislation in relation to educational policy has been rooted in the Medical Model, a shift is occurring from a ‘deficit based' model to a Social Model. However, it is wise not to view these two approaches as dichotomous in a good versus bad manner. Many of the procedures in place to assess and diagnosis children with disabilities and special educational needs are required in order to ensure they have the appropriate statement and subsequent Individual Education Plan (IEP) which will inform the framework of support they will require to thrive in school. This ‘within-child' approach is evidently located firmly within the Medical Model but is a necessary step towards providing the right education for the child. The important step then is to ensure that the environment in which the child finds themselves is one which is supportive, enabling and empowering to ensure they are able to learn, thrive and develop, at an academic and emotional level.
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1) This is a video made by Mark from Birmingham. Mark is a young man with disabilities talking about the Social Model of Disability.
2) This video is made by Dr Stevens who is a lecturer at Anglia Ruskin University. Dr Stevens looks at moving forward from the Social Model of Disability.
3) Disability means Possibility.
A very powerful commercial promoting the person not the disability.
4) Teachers TV
5) Teachers TV
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Implications for Practice
a) For teacher educators including mentors
- Consider what makes an inclusive school.
- Consider the implications of models of disability on educational practice
- Consider inviting a person with disabilities to share their experiences with student teachers
- What constitutes a ‘Special Educational Need'?
- Use videos as springboards for discussion
b) For trainee teachers
- Understanding ways in which models of disability have influenced policies and practice within education
- Consider how the media influences our understanding and perception of disability
- Consider ways in which prejudice can be challenged
- What does an ‘inclusive setting' look like?
c) For experienced teachers
- Understanding the scope of inclusion and how to ensure a whole school approach is implemented.
- How can diversity be celebrated in schools?
Glossary Item Written by: Teresa Whitehurst
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- Borsay, A. (1986) Disabled People in the Community. London : Bedford Square Press
- Department of Education and Science (1978) Special Educational Needs : Report of the Committee of Enquiry into the Education of Handicapped Children and Young People (The Warnock Report) London : HMSO
- Department for Education and Skills (DfES) (2001) Sepcial Education Needs: Code of Practice. London: DfES
- Department for Education and Skills (2004) Removing Barriers to Achievement : the Government's Strategy for SEN. Nottingham : DfES Publications
- Mittler, P. (2000) Working towards inclusive education. London: David Fulton Publishers
- Ofsted (2001) Evaluating Educational Inclusion : Guidance for Inspectors and Schools http://www.ofsted.gov.uk/
- Oliver, M (1996) Understanding disability : From theory to practice, Basingstoke: Macmillan
- Whitehurst, T & Howells, A (2006) ‘When Something is Different People Fear it: Children's Perceptions of an Arts Based Inclusion Project'. Support for Learning Vol 21 (1) 40-45
- Disability Equality in Education http://www.diseed.org.uk/