Statistics Canada defines disability as “an activity limitation or participation restriction associated with a physical or mental condition or health problem.”
Institutional approaches to disability are full of labels. Some labels relate to a diagnosis. Others relate to managing symptoms in people who have not been formally diagnosed. Labels may be useful when they allow people to access programs or funding. But there is a danger of boxing a person in by using a label. Remember to work with the person, not the label.
You may encounter a range of disabilities among your clients. While this article provides general context common to most disabilities, you may want to explore further context specific to 4 main client groups:
- Persons with developmental disabilities. These include general developmental disabilities, autism spectrum disorders, and fetal alcohol spectrum disorder.
- Persons with learning disabilities. These include disorders in use of oral and written language, reading, and mathematics, as well as non-verbal learning disorders.
- Persons with mental health disabilities. These include anxiety disorders, eating disorders, mood disorders, personality disorders, schizophrenia, problem gambling, and substance abuse, as well as co-existing diagnoses.
- Persons with physical and neurological disabilities. Physical disabilities include sight, hearing, and mobility disabilities, as well as chronic pain and autoimmune diseases. Neurological disabilities include acquired brain injury, epilepsy, Tourette syndrome, and attention deficit hyperactivity disorder.
History and legislation
The role of persons with disabilities in society continues to evolve. The ways we define disability, view community, and provide supports and services have changed. Over time, these changes are leading toward a more responsive person-centred or person-directed approach.
Evolution of models of disability
For much of the 20th century, the medical model of disability was the rule. People saw it as a medical issue requiring treatment, rehabilitation, and passive care. A diagnosis of disability meant that a person could not work. Barriers were seen as unavoidable.
In 1959, California law allowed people disabled by polio to leave hospitals. They could move back into the community. The resulting independent living model helps persons with disabilities to see themselves differently. It promotes capacity building and a strength-based approach.
In the 1970s, a functional view of disability emerged. This view considered the disability to be the cause of any problems a person had. Advocates believed that rehabilitation and therapy would make people more able to work. Advocacy in the 1970s also led to a social oppression model. This model saw disability more as a social construct than a medical reality. It viewed any limitations on a person as resulting from society’s response to that person’s needs.
Rights and duty to accommodate
The Canadian Charter of Rights and Freedoms was enacted in 1982. Section 15 guarantees equality rights and freedom from discrimination for persons who have a disability. Resulting court decisions have led to a duty to accommodate. This is the legal obligation to take appropriate steps to eliminate discrimination resulting from a rule, practice, or barrier that affects persons with disabilities.
People and organizations must try to make accommodations up to the point where they would suffer undue hardship by doing so. Undue hardship means difficulties such as high financial costs or serious disruption to business.
Canada’s 1986 Employment Equity Act defines persons with disabilities as those who have a long-term or recurring physical, mental, sensory, psychiatric, or learning impairment. They must believe they are disadvantaged in employment by reason of that impairment or believe that an employer will consider them to be disadvantaged in employment. Because this is a federal act, it applies only to industries that are federally regulated.
With government playing a larger role in determining the place of persons with disabilities in the workplace and society, the citizenship rights approach gained influence. This approach focuses on the role of persons with disabilities and supportive organizations in shaping public policy.
In 2006, the United Nations adopted the Convention on the Rights of Persons With Disabilities. Rather than viewing persons with disability through the lens of charity, medical treatment, and social protection, the convention called for them to be viewed as full and equal members of society. This includes a full host of human rights: civil, political, economic, social, and cultural.
Employment counselling practice today takes a broad approach to helping persons with disabilities. More often and across a wider spectrum of disabilities, people are no longer seen as not being able to work or function normally. Instead, the focus is on defining workplaces as either barrier-free and accessible or barriered and inaccessible.
Barriers and challenges
Clients’ financial concerns
Clients may receive public financial supports, such as a pension plan, a long-term disability pension, or income support. If so, they may fear losing their benefits if they take a full-time job. Many are especially afraid of losing their medical benefits. Some fear losing benefits not just because of the cost, but also because it may be hard to get the benefits back if the job does not last.
People in Alberta who receive financial assistance are encouraged to be as self-sufficient as possible, which for some clients means working. Those who are working while receiving financial assistance may receive a supplement to their earnings. In calculating benefits, a portion of the client’s wages may be exempt. In Alberta, people who leave income assistance for jobs may continue to receive health benefits both for themselves and their children.
Try to become familiar with financial assistance programs. Encourage clients to get more information about income exemptions and health coverage before deciding against getting a job.
Common environmental barriers include:
- Inaccessibility of workplace, restrooms, water fountains, and parking
- Lack of elevators, suitable floor surfaces, and furniture
- Lack of transportation
- Limited financial support
- Lack of support services, such as technical aids or assistants
- Lack of money for adapting workplaces
Common systemic barriers include:
- Others focusing on the disability rather than on the ability
- Inflexibility of employers in adapting the demands of the job to the employee
- Misinterpretation of an employer’s legal duty to accommodate
- Challenges in co-ordination of available services
- Low income
- Lack of personal care assistance in the workplace
- Irrelevant job requirements
Common social challenges include:
- Lack of understanding due to fear
- Lack of awareness of abilities of persons with disabilities
- Stereotypes about poor workmanship, poor health, and poor attendance
- Unfair treatment because of differences
- Exclusion from work-related and social activities
Common personal challenges include:
- Low level of education and training
- Minimal work experience
- Lack of self-awareness
- Low self-confidence
- Low self-esteem
- Underdeveloped social, interpersonal, and self-management skills
- Lack of transportation resources
- Communication difficulties
- Fear of loss of medical benefits upon gaining employment