A photo of Georgia a white woman in a green outfit with glasses on. To her left is her mum, white female in a red dress and her dad, white male, on her right in a black top. They are stood round a pool trees and mountains are behind them.
Cerebral Palsy, Disability Rights, Occupational Therapy

The Medical Model of Disability and Standardised Assessments

The Medical Model of Disability is often talked about in occupational therapy and in fact, it’s debated a lot. The Medical Model was most recently debated at the start of 2022 when the Royal College of Occupational Therapists changed its logo from the Phoenix which as I’m sure many will remember generated lots of conversations. 

I can only speak as a newly qualified occupational therapist, therefore, I am only going off what I’ve read and had conversations about. But I think it would be fair to say that the occupational therapy profession is shifting away from the Medical Model towards other models the most famous opposing model being the Social Model of Disability as spoken about in a few of my blogs. The shift in occupational therapy is also being noticed by other professions and those we serve I had a little moment of joy when I watched a live a few months ago from two well-known disabled activists talking about how occupational therapists are using the Social Model. 

But occupational therapy is a very big field that comes with lots of different roles and responsibilities meaning that some areas of practice are still very medical. Look, if you’re an occupational therapist working on an acute ward I am not denying that you’re not doing a fabulous job but a lot of that job centres around discharge which of course means the Medical Model is going to come into play because it kind of has to. Yet, are we critically thinking about this and evaluating the potential systemic ableism that is being perpetuated here? 

Another example is standardised assessments, yes, of course, standardised assessments are needed on some occasions but most standardised assessments are still rooted in the Medical Model and ableism. For example, when, I was younger, I was made to do the 9-Hole Peg Test a fair few times due to my lack of fine motor coordination. Look, I know, I know, in some ways, it was practice and a good tool that could be used as an outcome measure but again it was focusing on my ‘deficits’ and forcing me into a box that I was never made to fit in which is ableist.

I know and hope the practice and changed now and I understand we are talking about something that happened 15 to 20 years ago, but how damaging is this to families? My parents owe me nothing they were by my side every step of the way and practising exercises I’d been given by all of the healthcare professionals I was under and I’m very glad they did as I may have not been able to walk as far or even type this blog as quickly as I am. Yes, of course, there would have been other ways to access these occupations but I’m happy with what I can do and have achieved. 

Yet, I didn’t fit the box in the first place and didn’t meet developmental milestones or the norm on standardised assessments and I’m not saying that wasn’t a hard pill to swallow for my parents at the time who had little to no idea about cerebral palsy. But, is it a bad thing, that I don’t fit in that box? No, it’s not, because I am my individual with my own needs and do you want to know a secret? I will never fit in that box because most standardised assessments are standardised on non-disabled people to get the bell curve! Therefore are not made for my fabulous chronic self. 

So, next time you go to do an assessment make sure you ask yourself what you are assessing, if you really need to know the outcome, what difference this will make and what model this aligns with.

Thank you for reading, 

Georgia x 

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