Disability paradigms, models and professional practice in rehabilitation
Lesley Jordan, School of Health and Social Sciences, Middlesex University
Abstract
In the UK, speech and language therapy has been located for many years within health organisations, the prime source of individual/medical model approaches to disablement. However, speech and language therapists' business of personal communication differs from the core medical concern with the body in that language is essentially 'social'. This theoretical paper stems from a long-standing research interest in the potential for speech and language therapists to adopt practices informed by the social model of disability (e.g. Jordan & Kaiser, 1996). The paper draws on evidence in relation to aphasia (impairment following damage to the language centres in the brain) from academic literature, professional publications and the websites of relevant voluntary organisations.
The paper explores the applicability of disability paradigms and models to aphasia therapy practice and values. Priestley's disability research paradigms (1998, 2003) are seen as a valuable heuristic device to aid thinking about different approaches to studying disability, and Priestley's four perspectives - focusing on the body, psychology and identity, social structure, and culture - are considered in relation to aphasia therapy. The paper identifies some implications for aphasia therapy of the contrasting value systems associated with the individual and social models of disability.
It is suggested that such frameworks might benefit people with communication impairments both directly and indirectly: directly by shifting power relations - perhaps subtly - between them and therapists; and indirectly as an aid to professional understanding of sources of dissonance within provider organisations such as the NHS. An important underlying assumption, that rehabilitation professionals can have the 'agency' to become allies to disabled people in the struggle against social oppression, is discussed.
References:
Jordan, L & Kaiser, W (1996) Aphasia -; A Social Approach, Stanley Thornes, Cheltenham.
Priestley, M (1998) 'Constructions and Creations: idealism, materialism and disability theory' Disability & Society, 13(1), 75-94.
Priestley, M (2003) Disability: A Life Course Approach, Polity, Oxford.