INDEPENDENT LIVING AND TRADITIONAL PARADIGMS*
This chart compares traditional approaches to medical and vocational rehabilitation services with the consumer-driven,
Independent living approach
|MEDICAL MODEL & REHABILITATION PARADIGM||INDEPENDENT LIVING or DISABILITY PARADIGM|
|Definition of problem||physical or mental impairment; lack of vocational skill (in the VR system); lack of abilities||dependence upon professionals, family members & others; it is the attitudes & environments that are hostile & need fixing|
|Locus of problem||in the individual (individuals are sick and need to be “fixed”)||in the environment; in the medical and/or rehabilitation process itself; disability is a common part of the human condition|
|Solution to the problem||professional intervention; treatment||
|Social role||individual with a disability is a “patient” or “client”||individual with a disability is a “consumer,” “customer” or “user” of services and products|
|Who controls||professional||“consumer” or “individual”|
|Desired outcomes||maximum self-care (or “ADL” –
activities of daily living);
gainful employment (in VR system
|independence through control over ACCEPTABLE options for every day living in an integrated community|
by Gerben DeJong in 1978; adapted/expanded by Maggie Shreve and June Isaacson Kailes
Ten Principles of Independent Living
Civil Rights – equal rights and opportunities for all, no segregation by disability type or stereotype.
Consumerism – a person (“consumer” or “customer”) using or buying a service or product decides what is best for him/herself.
De-institutionalization – no person should be institutionalized (formally by a building program or family) on the basis of disability.
De-medicalization – individuals with disabilities are not “sick” as prescribed by the assumptions of the medical model and do not require help from certified medical professional for daily living.
Self-help – people learn and grow from discussing their needs, concerns and issues with people who have had similar experiences; “professionals” are not the source of help.
Advocacy – systemic, systematic, long-term and community-wide change activities are needed to ensure that people with disabilities benefit from all that society has to offer.
Barrier-removal – in order for civil rights, consumerism, de-institutionalization, de-medicalization and self-help to occur, architectural, communication and attitudinal barriers must be removed.
Consumer control – the organizations best suited to support and assist individuals with disabilities are governed, managed, staffed and operated by individuals with disabilities.
Peer role models – leadership for independent living and disability rights is vested in individuals with disabilities (not parents, service providers or other representatives).
Cross-disability – activities designed to achieve the first five principles must be cross-disability in approach, meaning that the work to be done must be carried out by people with different types of disabilities for the benefit of all persons with disabilities.