REHABILITATION SCIENCE

AND DISABILITY STUDIES:

ARE THEY
COMPLEMENTARY?
Katherine D. Seelman, Ph.D.
Associate Dean and Professor
School of Health and Rehabilitation Science
University of Pittsburgh and
Visiting Prince Fellow
Rehabilitation Institute of Chicago
September 5, 2001
Rehabilitation Science and
Disability Studies

Do they supply mutual needs:

Do they offset mutual lacks?

Definition: Rehabilitation
Science
“The field of study that encompasses
basic and applied aspects of the health
sciences, social sciences and
engineering to restore functional
capacity in a person and improving their
interactions with the surrounding
environment…understand the nature of
the enabling-disabling process….
 Definition: Disability
Studies
“A multidisciplinary approach to the
analysis of the dynamic/evolving social,
psychological, economic, political, legal,
biomedical and technological context of
people with disabilities in society…
involves the empowerment and
evaluation of the experiences of
disabled people.”
Two Windows on Disability

Rehabilitation Science lacks knowledge

that is subjective and social, sufficient to
explain the experience of the
patient/client.
Disability Studies lacks knowledge that
is objective, sufficient to support a
scientific base for medical treatment.
 Two Windows on Disability:
Professional and Patient/Client

Health professionals can develop a view

of disability that is at substantial variance
from its reality for many disabled people.

Disabled people can develop a view of

health care that is at substantial variance
to its value for them.
Different Roles: Health Care
Professionals
The role of health care professionals is
associated with knowledge that is objective,
scientific and derived from fields related to
Rehabilitation Science.
Physicians make decisions important to
disabled people, including decisions about life
and death and prescriptions for long term
care interventions such as assistive
technology and physical therapy.
 Different Roles:
Patient/Client
The role of the patient/client is
associated with subjectivity, emotion
and personal experience and is related
to Disability Studies.
Experientially-based knowledge is often
under valued.
.
Example: M.D. and Disabled
Patient:

<I began> to examine his nervous

system…felt a sense of horror come
over me. You can’t feel anything here
on your shoulder? You can’t move your
legs.”
M.D. as a Disabled Patient
“I next met this man in a spinal cord unit
in 1985 as I was pushed to the
computer next to him in occupational
therapy. A few months earlier, I had
severed my cervical spinal cord playing
rugby and I was a quadriplegic—slightly
more impaired than was my former
patient.”
M.D. as a Disabled Person
“Now, 15 years after becoming
disabled, I find myself completely at
home with the concept of…being me.”
“Now I know that my assessment of the
potential quality of life of severely
disabled people was clearly flawed.”
Studies of Quality of Life
Neurologists were significantly more
likely to believe that physical
impairment was an important
determinant of quality of life than were
disabled people.
92 per cent of people with quadriplegia
reported being glad to be alive while
only 18 per cent of emergency service
personnel believed they would be glad
to be alive.
 Social Consequences of
Illness and Disability: Are
They Different?

Disabilities do not have the same social

consequences as illnesses.
Social Consequences of
Disability and Illness

People with People with

illnesses are usually disabilities
cured. frequently live with
disabilities for life.
 Social Consequences of
Disability and Illness: Are
They Different?
People who are ill People with long-
are patients who try term disability are
to get well. often not ill.
People who are ill People with
may be temporarily disabilities cannot
relieved of their be permanent
family and work patients who forfeit
roles. their family and work
roles.
 Social Consequences of
Disability and Illness: Are
They Different?
People who are ill People who have
rarely have to acquired disabilities
radically change may find they need
their lifestyles, i.e., support to learn how
where they live, their to live a new life.
friends, their job.
Implications for Attitudes,
Research, Training and
Practice
Identify holistic paradigms and models that
inform attitudes, research, training and
practice.
Incorporate into training and practice,
disabled people and Disability Studies.
Identify and incorporate into research,
problems that are important to disabled
people.
 Paradigms and Models
Biophysical model

Social model

Integrative model
Integrative Model: Important
Reports and Studies
World Health Organization: ICIDH-2

Institute of Medicine: Enabling America

National Institute on Disability and

Rehabilitation Research: Long Range Plan

Centers for Disease Control: Healthy People

2010
 Training for Whom?
Medical students, practitioners

Allied health care students and practitioners,

including nurses, pharmacists, physical
therapists, occupational therapists,
audiologists and rehabilitation engineers

Disabled people
 Training Initiatives
Incorporation of Rehabilitation Science
and Disability Studies into curricula
development:
 Primary Care
 Clinical Prevention

 Long Term Care and Rehabilitation

 Emergency Services
 Training
At the level of the individual patient

At the Health Care System level

At the Public Policy Level

 Integrative Framework for
Research, Teaching and Learning
about Disability in Medicine and
the Health Sciences
Knowledge based in Rehabilitation Science
and Disability Studies, especially ICIDH-2
Development of Integrative paradigm and
models
Development of curricula, internships and
practicum