3.1. Compare and contrast medical and social models of learning disability

This guide will help you answer 3.1. Compare and contrast medical and social models of learning disability.

Understanding learning disabilities requires looking at the perspectives that influence how they are identified, understood, and addressed. Two key models – the medical model and the social model – provide distinct ways to view and respond to learning disabilities. These models shape policies, practices, and attitudes in health and social care.

The Medical Model of Learning Disability

The medical model focuses on the individual and their condition. It views a learning disability as a problem within the person, caused by biological, genetic, or medical factors. This model sees the disability as something that needs treatment, cure, or management through medical interventions.

Features of the Medical Model:

• Deficit-Based Approach: This model identifies what the individual cannot do due to their learning disability. It categorises the condition by medical terms, aiming to address the limitations.
• Diagnosis-Led: Professionals use assessments like IQ tests or medical scans to diagnose, label, or categorise the type and severity of the learning disability.
• Treatment-Focused: The medical model prioritises interventions such as therapies, medication, or surgeries to improve the condition or minimise its impact.

Strengths of the Medical Model:

1. Clarity Around Diagnosis: It offers clear definitions and understanding, which can help individuals and families access treatment and support.
2. Legal and Financial Benefits: A formal diagnosis can help individuals qualify for specific benefits or educational support.
3. Focus on Medical Interventions: Some conditions associated with learning disabilities, such as epilepsy or sensory impairments, benefit from medical treatments.

Limitations of the Medical Model:

• Narrow Perspective: It ignores societal and environmental factors that can exacerbate challenges for individuals with learning disabilities.
• Focus on “Fixing” the Person: The approach can pathologise the individual, treating the learning disability as a flaw needing correction rather than part of human diversity.
• Undermining Autonomy: Emphasis on professional decision-making can diminish an individual’s or their family’s role in shaping support.

The Social Model of Learning Disability

The social model shifts focus from the individual to society. It argues that learning disabilities are not inherently a “problem” but are disabling due to barriers in the environment, attitudes, and systems that prevent full participation.

Features of the Social Model:

• Environment and Society as Barriers: The model identifies obstacles like inaccessible education, inflexible workplaces, and prejudice as the main causes of disability.
• Equality and Inclusion: It demands changes in attitudes, practices, and environments to enable individuals with learning disabilities to participate fully in all aspects of life.
• Empowering Individuals: It values the unique abilities of individuals and emphasises their rights and autonomy.

Strengths of the Social Model:

1. Inclusive Approach: Encourages inclusive practices such as altering environments, changing discriminatory policies, and promoting understanding.
2. Focus on Equality: Shifts responsibility from the individual to society, advocating for the removal of barriers to participation.
3. Human Rights-Based: Aligns with legislation like the Equality Act 2010, which promotes access to services, protections from discrimination, and reasonable adjustments.

Limitations of the Social Model:

• Practical Challenges: Changing societal attitudes and infrastructures can be slow and resource-intensive.
• Risk of Overlooking Medical Needs: By focusing on social factors, some medical or therapeutic interventions might not be prioritised.
• Generalised Approach: It might not fully account for individual needs and differences in levels of support required.

Comparing the Medical and Social Models

While these models present differing viewpoints, they interact and overlap in real-world applications. Comparing their aspects helps to highlight their differences and where they can complement one another.

Areas of Difference:

Focus of the Model:

• The medical model targets the individual and aims to treat or reduce the disability.
• The social model shifts the focus to societal and environmental change to accommodate the individual.

Definition of Disability:

• The medical model defines it based on the individual’s impairment.
• The social model defines it as the result of barriers that restrict opportunities.

Responsibility for Change:

• In the medical model, professionals and treatments work to “fix” the individual.
• In the social model, society must change to remove barriers and create access.

Outcome Goals:

• The medical model aims for improvement in functionality and capabilities.
• The social model seeks equality, rights, and inclusion.

Areas of Overlap:

Despite their differences, these models can complement each other:

• Integrated Support: Combining both approaches can lead to a balance between medical interventions (such as speech therapy) and societal changes (like ensuring education accessibility).
• Recognition of Diversity: Both models, when applied together, can address unique biological needs while promoting individuality and inclusivity.

Impacts of These Models on Practice

The models influence how practitioners provide care and support individuals with learning disabilities.

Impact of the Medical Model:

In health and social care, professionals using the medical model might:

• Conduct in-depth clinical assessments to diagnose conditions.
• Focus on interventions like physical therapy, occupational therapy, or medication to manage the disability.
• Develop individualised care plans based on identified “deficits.”

This approach can be helpful for individuals whose disabilities have a significant physical or cognitive component requiring specific treatments. However, relying solely on this model risks neglecting the broader societal barriers that individuals face.

Impact of the Social Model:

Using the social model, practitioners might:

• Advocate for inclusive policies in education, employment, and public services.
• Empower individuals and their families to make decisions about their support.
• Work to remove barriers, such as creating accessible public spaces or challenging stigma.

This model fosters equality and dignity but may not fully address the medical needs of the individual, such as managing symptoms or co-occurring conditions.

Moving Towards Person-Centred Approaches

In modern health and social care, person-centred thinking blends elements of both models. This approach tailors support to the individual’s unique needs, preferences, and aspirations, addressing both medical challenges and social barriers.

Examples of Person-Centred Care:

1. Education: Combining learning support (medical) with teacher training on inclusion (social).
2. Employment: Providing occupational therapy for work-related skills (medical) while encouraging inclusive hiring practices (social).
3. Community: Offering accessible transportation (social) alongside managing mobility needs (medical).

Legislation and guidelines in the UK, such as the Care Act 2014, promote this kind of integrated, individual-focused approach.

Final Thoughts

The medical model and social model of learning disability are two distinct frameworks that provide valuable insights into how learning disabilities are understood and addressed. The medical model considers the disability as an issue within the individual, aiming to treat or manage it. In contrast, the social model emphasises that societal and environmental barriers create disability.

By understanding both models, health and social care professionals can create more comprehensive strategies to support individuals with learning disabilities, addressing both personal and systemic barriers. A combination of these approaches offers the most balanced way forward, promoting health, inclusion, and equality.