Advocating for Inclusion: The Role of the Social Model in Disability Empowerment

Most people know someone who has a disability––or they have a disability themselves. According to the census, 13.4% of the total population in the U.S. is disabled. This means 44.1 million people live with various challenges, from ambulatory to cognitive to visual. 

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Disabilities can be visible or invisible, such as autism or mental health conditions. In addition to the great variations in disability, there’s also more than one way to view the concept of being disabled.

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Many autistic folks have engaged in discussion at one point or another about whether being autistic is a difference or a disability. This answer can change depending on which model through which we see autism. In the medical model, autism itself is the cause of a disability, but in the social model, autism is a difference, and it is the environment that disables us.

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Read on to explore the differences between the medical and social models of disability.

The medical model of disability views disability as an intrinsic condition that exists within a person—something that needs to be treated, cured and prevented. According to this model, an autistic person would be inherently disabled by their autism, no matter the context. But is this necessarily the case?

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Imagine an autistic individual who is unable to complete grocery shopping in person due to sensory processing differences. The radio, echoing voices of other shoppers and flickering lights may lead to sensory overload. They are unable to shop for groceries and, therefore, are disabled to participate in this aspect of society.

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The medical model would state that autism prevents this person from grocery shopping and would focus on medical intervention to fix the person.

In contrast, the social model of disability states that someone becomes a disabled person when a societal barrier or environment fails to accommodate their needs.

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Some grocery stores have sensory-friendly hours to accommodate autistic people and people with sensory processing differences, with lowered lights and muted sounds. This accommodates the autistic individual so they can meet their needs and participate in this aspect of society.

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The social model would state that the environment was disabling the autistic individual, and changes to the environment can ensure the inclusion of the autistic individual.

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Here, we can distinguish between an impairment and a disability. An impairment naturally occurs within the person, whereas a disability is socially constructed by the environment. Thus, a person becomes a disabled person––disabled by the environment––rather than a person with a disability.

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From the perspective of the social model, being disabled becomes about access needs, meaning what a person needs to access and fully participate in an environment.

Environments that favor the participation of people without disabilities over disabled people are referred to as ableist. Any ‘ism’ is a set of power structures that empower some and disempower others, such as racism and sexism. 

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Ableism describes systems that favor people without disabilities. These environments exist whether or not someone explicitly believes that disabled people are inferior to autistic people. Just as it would be ableist to fail to provide sign language interpreters for the accessibility of the Deaf or hard of hearing, it is ableist to fail to accommodate autistic access needs.

Ableism beyond the physical environment

Social barriers and negative attitudes play a role, as well. Studies show that people form negative impressions of autistic people and have trouble tolerating autistic communication and social differences. 

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To see the practical effects of such negative judgments, we can look at the estimated half of autistic people who are qualified for and desire work who are unemployed (compared to the 5% average in general). This is a higher unemployment and underemployment rate than individuals with other disabilities. 

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Job interview processes largely focus on whether you’re a social fit for a company. When you have social and communication differences, an interviewer may have a negative attitude toward you simply because you’re autistic. This doesn’t reflect ability and talent, but it is an ableist process that determines who gets an income. This is a societal barrier beyond the physical environment that’s also considered in the social model of disability.

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Healthcare access is another social barrier beyond the physical environment that significantly impacts autistic people. Neuropsychologist researcher Dr. Hirvikoski found that autistic people live an average of 16 years less than non-autistic people. While some of this is due to co-occuring conditions, much of it is attributed to social and communication barriers in healthcare services. 

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Many healthcare providers rely on social and verbal communication cues that they may misinterpret in autistic individuals who have social and communication differences. For example, a provider might interpret a flat affect or a lack of eye contact as a lack of seriousness of the patient’s condition. These dynamics reflect a healthcare system designed with neurotypical norms in mind, negatively impacting the well-being of autistic adults.

Disability rights activists state that disability rights are fundamental human rights. It’s in line with the social model of disability because it advocates for equal opportunities and non-discrimination.

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The social model provides a framework for understanding that disabilities arise from a mismatch between an individual’s needs and the environment. This shift in societal attitudes reframes the mechanisms of disability and emphasizes inclusivity.

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This perspective embraces the approach of collective responsibility to dismantle barriers and create environments that accommodate and celebrate differences. Building on this understanding, we can implement change to combat ableism.

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To combat ableism, we need to address attitudes and environments to ensure they are inclusive and affirming of diverse needs. This means shifting from trying to “fix” individuals to addressing societal and environmental barriers. The first step is to normalize accommodations that promote acceptance, understanding and celebration of diverse ways of being.

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Examples of accommodations

Public spaces should use inclusive strategies to consider diverse needs, making environments welcome and accessible for everyone.

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Sensory Accommodations in Public

Many autistic individuals experience sensory processing differences that can overwhelm the nervous system. This sensory overload can significantly impact mental health and well-being. Sensory needs are safety needs for autistic people.

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• Sensory-friendly performances with a relaxed atmosphere and quiet areas
• Sporting and entertainment with sensory-friendly quiet spaces
• Sensory rooms at airports, such as the one at Portland International Airport
• Venues that partner with the nonprofit Kulture City to provide sensory bags that  include sunglasses, headphones and fidget toys
  
  

Healthcare Accommodations

Given the disparity in health outcomes and life expectancy, researchers are studying autistic needs in healthcare to educate providers on how to serve autistic individuals best. The findings of Dr. Doherty are reflected here in the SPACE framework that stands for:

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• Sensory: Accounting for sensory sensitivities such as sound and light for individuals with sensory processing differences, which increases accessibility.
• Predictability: Providing clear and accurate expectations to reduce anxiety and cognitive load, creating a safer space.
• Acceptance: Embracing individuals for who they are without expecting them to conform to neurotypical norms, which promotes well-being.
• Communication: Adapting to different communication styles, such as assistive technologies, and using clear, respectful dialogue to support inclusion.
• Empathy: Understanding and validating the lived experiences of autistic individuals creates a compassionate, supportive atmosphere.

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Additionally, there are three types of space to keep in mind:

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• Emotional space: Ensuring that autistic individuals have the necessary time and support to process their experiences without judgment. 
• Physical space: Designing environments that accommodate diverse physical needs.
• Space for processing: Having time to think and respond, especially in high-demand or fast-paced situations.

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Airport and other public spaces

In an airport, you might wear an indication that you have an ‘invisible’ disability that conveys you’d benefit from more patience and understanding. There is a Hidden Disabilities Sunflower program for this purpose. It’s based in the U.K., but implemented worldwide.

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In addition to the Hidden Disabilities Sunflower, some autistic individuals choose to carry self-disclosure cards. These carry key information about autistic needs, such as the need for extra time, understanding and communication adjustments. These tools can help create a more accommodating experience in public spaces.

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Education and information technology accommodations

In areas such as education and information technology, the concept of universal design reflects the social model of disability since it intends to design with everyone in mind—those with and without disabilities. The principles of universal design are:

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• Equitable use
• Flexibility in use
• Simple and intuitive use
• Perceptible information
• Tolerance for error
• Low physical effort
• Size and space for approach and use

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For example, there are guidelines on the type and size of font, text spacing, and images to ensure as much accessibility as possible. Guidelines like these ensure that technology can be used by all.

Accommodating community

An ‘autism-friendly’ town in Ireland called Clonakilty is paving the way for inclusivity. They developed an inclusive infrastructure with sensory-friendly features and visual signage. Plus, they prioritize acceptance and education around autism, and local businesses and organizations participate in initiatives and training. These efforts aim to foster an inclusive community, combat stigma and reduce the societal barriers to autistic people’s accessibility.

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Clonakilty has inspired other towns in Ireland, such as Killarney, to work toward autism-friendly accreditation––but we don’t have to go all the way to Ireland to see these effects. Austin, Minnesota, has embraced an autism-friendly initiative focused on reducing stigma and offering valuable resources. In addition to local businesses, restaurants and health services focusing on autistic accommodations, the town provides autism-specific resources and programs in the community.

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With towns like Clonakilty and Austin leading the way, the momentum for focusing on accommodating differences continues to grow. Autism-friendly initiatives are not just beneficial––they’re necessary.

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According to the social model, autism itself is not inherently disabling. Instead, people become disabled by environments that aren’t accessible.

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If you’re an autistic adult disabled by your environment, Prosper Health can help. Living in a world that wasn’t designed for you can be difficult, but having a support system can help. If you are pursuing a diagnosis to seek accommodation or want to learn more about your needs as an autistic individual, Prosper Health offers virtual autism assessments. These assessments are covered by insurance and conducted by adult autism specialists.

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Prosper Health’s neurodiversity-affirming clinicians are here to support you in your journey and help you navigate the world more comfortably.