The medical and social models of disability are two different ways disabilities can be viewed. In short, the medical model sees disability as a problem with the individual – whereas the social model sees barriers from an inaccessible society instead. As a society, we seem to be moving towards a future of the social model, with most organisations for disabled people preferring it, as well as the government equalities office endorsing it. However, this decision is not clear cut, and it may not be that one is right and one is wrong. In this blog post, I will be exploring this, and discussing whether I prefer the medical or social model, in relation to autism.
The medical model describes a disability as being a problem with the individual whose body doesn’t work the way it should. It also states it is the individual’s fault, and that they should have to deal with it. When applying the medical model to autism, it might not be as clear, since autism is a developmental disability, not a physical one. If you approached autism through the medical model, you would be saying our brains have developed incorrectly, and you would be looking for a cure and/or aiming to get autistic people to fit in to society. This is already ringing many alarm bells for me.
In this day and age, it is accepted by most that autistic people do not want a cure. Never mind that since autism is a life-long developmental condition a cure is impossible anyway (if you don’t traumatise us so much we are forced to change ourselves, that is). There is no denying that the autistic brain is different from a non-autistic brain – but this does not mean that one is right and one is wrong; it does not mean that either type of brain is better than the other – they are simply different. We do not have to change, like the medical model may suggest.
In comparison to this, the social model believes that it is society that should change. Those who support this model understand that there are lots of barriers that stop disabled people accessing daily life. These barriers might be physical (such as no ramps or lifts), social (such as exclusion from communities), or attitudinal (such as the stigma and lack of knowledge surrounding disabilities).
One reason to favour the social model, was that it was disabled activists themselves that coined the term, during the civil rights movement in the 1990s. It was around the same time that we saw the “nothing for us, without us” slogan and the Disability Discrimination Act was passed by the UK government. It was a time of positive progress in the area of disability rights, which further suggests that the social model is the most equal and respectful model.
To further this point, the social model of disability uses language that I agree with, such as Autism Spectrum Condition, traits of autism, and identity first language (autistic person). On the other hand, the medical model uses language such as disorder or deficit, symptoms of autism and person-first language (person with autism); all of which I would never use myself.
So far, we have learnt that the social and medical model of autism are very different, but neither can be decided as the “correct” viewpoint. Below, I describe some examples that put the social and medical models of autism into more understandable scenarios.
The medical model of autism would argue that we have deficits in understanding and initiating conversations, as well as issues picking up social cues. However, when given access to a way of communication that validates autistic people’s needs (e.g., clear and short instructions, avoiding sarcasm, visual aids) the deficit does not exist anymore. If we acknowledge that there are different communication preferences and neither is more favourable than the other, then us autistic people are no longer in the wrong.
Similarly, stimming is viewed by some as a distracting and destructive behaviour and is listed as a negative of autism. In reality, stimming is a necessary self-regulating technique that allows autistic people to manage. Furthermore, stimming – when viewed in a positive light – is also a unique way of expressing emotions and it can be very joyful.
As the above examples display, the social model aims for equal and complete social inclusion. Surely as autistic people, who particularly struggle with social isolation, this is an obvious way forward for us.
Unfortunately, like a lot of debates within the topic of autism, there is no obvious solution. If we were to follow the social model completely, then the idea that disability is a social construct would mean that barriers could be broken down, so I am not disabled or disadvantaged by my autism. But I am.
Contrary to the last two examples, there are traits of autism that are challenging and impact daily life (hence autism being a disability), and I’m not sure if society can do anything about this. For example, there are lots of things that trigger my meltdowns and cannot be avoided: plans changing causes me immense anxiety, but they’re unavoidable because life happens; fire alarms will make me cry immediately, but they are also necessary for the safety of everyone; thunder and lightning makes me curl up in a ball and hide under my bed covers, and that’s just nature doing it’s thing.
It is also important to note that some of the common co-occurring disabilities associated with autism, such as epilepsy, digestive issues, or connective tissue disorders, are painful and definitely not a social construct. There is nothing society can do about pain within someone’s body. Simply being understanding or making accommodations does not take away the possibly excruciating, sometimes chronic, pain. The same applies for mental health conditions that are more common amongst autistic individuals, such as depression, anxiety, or OCD. Because these mental health issues exist inside the brain, there is nothing society can do as an outsider to make these go away.
So, finally, what is my conclusion? When taking everything I have discussed into consideration, I would prefer to use the social model of disability when talking about autism. It encourages more inclusive language, aims for equality, and tells us that my autistic brain is not wrong.
I am autistic 