Evolving Models of Disability: From Charity to Inclusion

How we understand disability shapes everything – how schools teach, how workplaces are designed, how communities are built, and how individuals with disabilities are treated. For most of history, disability was seen as a personal misfortune, a condition to be pitied, fixed, or managed. That view has changed dramatically. Today, disability is increasingly understood as a product of interaction between individuals and the environments around them – and the models that frame this understanding have driven real shifts in law, education, and social inclusion. Tracing these models, from charity to inclusion, is essential for anyone working in education or policy.

Why models of disability matter
The charity model: disability as personal tragedy
The medical model: disability as a condition to be fixed
The social model: disability as a product of barriers
Limitations of the social model
The bio-psychosocial model: bridging medicine and society
The ICF and inclusive education
From models to inclusion: what the shift demands

Why models of disability matter

Models of disability are frameworks used to define and explain disability. They directly shape how governments design policies, how institutions allocate resources, and how professionals interact with disabled people. Each model carries different assumptions – about what disability is, where it comes from, and whose responsibility it is to respond to it. Understanding these frameworks is not just theoretical; the model in use at any given time directly determines whether a disabled person is seen as a patient to be treated, a beneficiary to be supported, or a citizen whose rights must be protected.

The charity model: disability as personal tragedy

For much of recorded history, disability was understood through what is now called the charity model. This model positions disabled people as pitiable victims of tragic misfortune, and non-disabled people as their benevolent saviours. In this framing, disability is inherently sad, and the appropriate response is generosity – donations, care institutions, and philanthropic support.

The charity model is closely related to the tragedy model, which holds that living with a disability is a personal catastrophe. Pity, in this view, is seen as a natural and appropriate response. The charity model centres those giving help rather than those receiving it – disability becomes a vehicle through which non-disabled people demonstrate their goodness, rather than a condition requiring structural change. Fundraising campaigns that portray disabled individuals primarily as helpless recipients of support, rather than as capable people facing external barriers, are a common real-world expression of this model.

The consequences are significant. The charity model fails to recognise the rights, capabilities, and aspirations of people with disabilities, reducing them to passive recipients of support. It reinforces stereotypes, lowers self-esteem, and creates a cycle of dependency rather than empowerment. Charitable institutions often provide care without consulting the people they serve, which means services are rarely shaped by those who actually understand the needs of disabled individuals.

The medical model: disability as a condition to be fixed

As medicine advanced through the 19th and 20th centuries, the charity model gave way to the medical model. Under the medical model, people with disabilities were treated as sick individuals requiring cure, correction, or clinical management. The experts on disability became medical professionals – doctors, therapists, and nurses – rather than disabled people themselves or the communities around them.

The medical model views disability as a medical condition to be diagnosed and treated by specialists. It is built on the idea that the problem lies within the individual – in their body or mind – and that the goal is to bring them as close to “normal” functioning as possible. This framing drove the development of rehabilitation services, special education systems, and assistive technologies, many of which have genuinely improved lives.

However, the medical model frames disability as an aberration – a defect that must be cured or eliminated. At its most extreme, this thinking justified segregation, institutionalisation, and the removal of bodily autonomy, all under the premise that disabled people were incapable of making their own decisions. The language it generates reflects these assumptions: terms like “wheelchair-bound,” “suffering from,” or “special needs” frame disability as inherently tragic and the disabled person as fundamentally diminished. By focusing on fixing the individual, the medical model also ignores the need for changes to the surrounding environment – removing physical barriers, creating accessible spaces, or challenging exclusionary attitudes.

In the 1970s, a fundamentally different way of thinking began to emerge – one that placed the problem not in the individual, but in society. The social model of disability proposes that people are disabled by systemic barriers, negative attitudes, and social exclusion rather than by their own physical or mental differences. It emerged from the disability rights movement, challenging the medical model’s assumption that the body needs to be fixed to fit a perceived norm.

In 1975, the UK organisation Union of the Physically Impaired Against Segregation (UPIAS) argued that it is society which disables physically impaired people – disability being something imposed on top of impairments by the way people are unnecessarily isolated and excluded from full participation. In 1983, disabled academic Mike Oliver coined the phrase “social model of disability,” and his 1990 book The Politics of Disablement became a landmark text in disability studies.

The social model draws a critical distinction between impairment (the actual physical, sensory, or cognitive difference a person has) and disability (the restrictions imposed by a society that fails to accommodate that difference). A person who uses a wheelchair is not disabled by their inability to walk – they are disabled by the absence of ramps and accessible transport. A person with a visual impairment is not disabled by their blindness – they are disabled by the absence of braille signage or audio cues. The social model influenced the development of public policies on disability in education and employment across Europe and internationally, pushing governments and institutions to address structural barriers rather than individual deficits.

The social model represented a transformative advance, but it is not without its critics. Some scholars have pointed out that the social model can overlook individual differences in race, gender, and other identities, as well as the reality that some disabilities involve chronic pain or health challenges that are not simply resolved by removing social barriers. Removing barriers for one group can also inadvertently create barriers for another – for example, curb cuts for wheelchair users can make navigating footpaths with a cane more difficult for people who are blind. These limitations set the stage for a more integrated approach.

The bio-psychosocial model: bridging medicine and society

In the mid-1970s, psychiatrist George Engel proposed a model that moved beyond both the purely medical and purely social approaches. Engel called for a move away from reductive natural science approaches in favour of a biopsychosocial model that required medicine to consider psychosocial issues alongside biological ones. His framework retained a role for medical understanding while acknowledging that social and psychological contexts are equally important in shaping health and disability.

The World Health Organization incorporated the biopsychosocial model into its classification systems – first through the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) in 1980, and later through the revised International Classification of Functioning, Disability and Health (ICF), approved for use in 2001. The ICF explicitly integrates medical and social models, acknowledging that disability is multidimensional and interactive – shaped by biological conditions, psychological factors, and environmental contexts simultaneously.

The ICF biopsychosocial model views disability and disease as an intricate interaction of biological factors (genetic and physiological), psychological factors (attitudes, personality, and behaviours), and environmental and social factors (culture, socioeconomic status, and accessibility). None of these dimensions can be fully understood in isolation. In practical terms, a professional using this lens addresses both the clinical needs of the individual and the environmental conditions that shape their ability to participate in daily life.

The ICF and inclusive education

The WHO developed the ICF-CY – a companion classification specifically for children and youth – to apply the biopsychosocial framework across four age ranges from infancy through adolescence. This makes the model directly applicable to educational settings, where understanding a student’s functioning requires looking not just at their diagnosis but at how school environments, teaching approaches, and peer interactions either support or hinder their participation. The ICF’s emphasis on participation aligns with concerns about social exclusion: schools without inclusive policies effectively disable students with learning differences, and the solution lies in systemic change, not just individual intervention.

From models to inclusion: what the shift demands

Each of these models has shaped – and continues to shape – the systems disabled people encounter every day. It is rare for one model not to influence the others as they evolve; the medical model, for example, has incorporated aspects of the social model’s critique over time. But the direction of travel is clear: contemporary frameworks consistently move away from viewing disability as a personal problem and towards understanding it as a relationship between the individual and the environment.

This shift has real implications. The model a system adopts shapes real-world outcomes – whether a disabled child receives therapy aimed at making them appear “normal,” or therapy designed to help them navigate a world built for others; whether a disabled employee is seen as a liability, or as a person whose workplace needs to adapt. Disability advocates have long argued that the responsibility for change does not rest solely with the individual – it belongs equally with the communities and institutions willing to build a more accessible world.

Meaningful inclusion – in schools, workplaces, and public life – requires systemic change: accessible infrastructure, inclusive teaching methods, anti-discrimination legislation, and cultures that treat disabled people as active participants rather than passive recipients. Modern inclusion strategies move beyond charity toward structural design improvements, treating accessibility not as an afterthought but as a baseline expectation. The UN Convention on the Rights of Persons with Disabilities, which the ICF framework supports, frames this squarely as a matter of human rights and social justice – not benevolence.

What do you think? If the school or institution you work in were assessed today, which model of disability would most closely describe its current approach to students with disabilities – and what would genuinely shifting toward a social or biopsychosocial model look like in everyday practice? Are there specific barriers in your context that structural change could address, but that are currently being treated as individual problems?

References

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Table of Contents

Why models of disability matter 🔗

The charity model: disability as personal tragedy 🔗

The medical model: disability as a condition to be fixed 🔗

The social model: disability as a product of barriers 🔗

Limitations of the social model 🔗

The bio-psychosocial model: bridging medicine and society 🔗

The ICF and inclusive education 🔗

From models to inclusion: what the shift demands 🔗

References

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