Anyone who knows anything about Direct Access likely understands that as a consultancy founded by people with disabilities, we take an empathetic, person-focused approach to accessibility and inclusive design.
Of course, as a business, we also try to highlight how providing disability access provides social and financial value to our clients, but crucially, our framing of disability is one that reflects the social model of disability, a framework that asserts people are disabled only by the failings of societal barriers like inaccessible environments, discriminatory attitudes, and inflexible policies, rather than by their own impairments or conditions. The latter way of thinking about this is of course, the medical model, which is a conversely restrictive framework that places the ‘fault’ on the disabled person and rather removes the burden of responsibility from the way our society is structured.
So when working on a new TikTok for Direct Access’ social media that related to my own disability as an autistic person, the fact that I had a moment where I framed a video I created about my lived experience, with a caption focused on “how many traits” the viewer could relate to, it came as a surprise to me only when pointed out by a colleague how regressive that was. They weren’t mean about it, only pointed out how unusual the choice was.
While the framing of that video “Signs you may be autistic” mighty seem fairly innocuous and minor slip, and was indeed intended as a light-hearted piece of social media, such an approach can easily promote viewers to self-diagnose themselves, which is not an idea that we want to promote, especially in the modern social media age.
So, I subsequently asked myself, why is it that I moved back toward a medical-model framing when pulling this video together? Does it speak to some deeply held beliefs about disability?
Having thought about it quite a bit, my theory is that because the medical model has been the dominant mode of thinking for centuries, and because disability has been repeatedly ‘othered’ as a group separate from the norm, my momentary lapse of reason boils down to the fact that this is simply how I have been taught to understand my own experience. That the problems I face as a disabled person is somehow an exception, rather than the rule.
Despite consciously knowing that disabled people actually account for millions of the population, and that many of us will eventually become disabled ourselves in one way or another, I realised I had adopted a very hardline, binary idea of my disability in that particular moment, precisely because on some level, as an autistic person, my brain believes that my experience of the world is one that does not reflect the majority, and is defined by common traits or characteristic, which is categorically not true.
Autism more than anything else exists on a spectrum of experience, hence the term autism spectrum disorder. And that’s not to say my brain was entirely wrong in its unconscious assessment. After all, if the world was built for everyone, then surely Direct Access and all accessibility consultancies would cease to exist.
From a very young age, the world around me consistently communicated that disability is a personal problem, through school, healthcare, media portrayals, and even the attitudes of family and friends. Messages like these make it almost inevitable to internalise a medical way of thinking about disability, even if, through my work, I logically support systemic, social approaches to disability.
There’s also the simple fact that the medical model is easier for our brains to grasp because it offers a quick, straightforward explanation. Thinking “I struggle because of my body or brain” is immediate and intuitive, whereas the social model requires us to step back and consider the wider context, how environments, systems, and attitudes create barriers.
Many of us are also raised with the assumption that medical treatment or personal adaptation is the primary path to success. As a result, our earliest understanding of disability is often shaped by the medical model, while awareness of the social model tends to come later, once we have more experience and exposure to disability advocacy.
There’s no question of the importance of the medical model, but beyond its value as an identifier of disability, it does not offer the same value as the medical model to either the disabled individual or the wider system in which we live. Even if disability feels medical in day-to-day life, adopting a social-model mindset allows both individuals and organisations to focus on solutions, inclusion, and performance, rather than limitations.
For the disabled individual, the benefits of social-model thinking includes;
Empowerment: Disabled people are given the freedom to identify actionable accommodations and adjustments rather than feeling personally “broken”, and to actively contribute to the world around them.
Improved Collaboration: Framing barriers as environmental rather than personal encourages dialogue between decision makers, managers and disabled individuals.
Better built environments: Design chocies like ramps, tactile paving, clear signage, and public transport modifications, make infrastructure usable for disabled people, but also parents with strollers, older adults, and people with temporary injuries.
But above all else:
Mental Health: Feeling and actively believing that the world can be adapted contributes to reduced stress, frustration, and burnout.
A social-model mindset also improves collaboration. By viewing obstacles as systemic or environmental, disabled people in employment like me are more likely to engage in open dialogue with managers and colleagues about what they need to succeed. This shared understanding strengthens teamwork and builds a culture where I feel supported but also reassures my managers that my work will be achieved sufficiently.
Direct Access wouldn’t exist either if the social model only benefited disabled individuals. In reality, organisations also gain tangible advantages from embracing it. When employers take the time to understand disability and provide appropriate accommodations, disabled employees are better able to contribute and perform at their full potential. Such benefits from that approach include:
Productivity: Disabled employees perform at full potential with proper accommodations.
Retention: Inclusive practices reduce turnover and associated costs.
Innovation: Diverse, accommodated perspectives foster creativity and problem-solving.
Reputation: Companies seen as inclusive attract talent, clients, and investors.
The medical model, by contrast, shifts the responsibility onto the disabled person, creating barriers to performance, inclusion, and engagement and subsequently leading to an organisation lacking diversity, and thus diverse perspectives, innovations and reputational hazards like poor employee and customer retention (by the way, read this blog if you’re interested in learning just how much expendable income disabled people have).
So, as I reflect on my earlier mistake, which I believe to be born from my experience as a disabled person in a world that wasn’t built for me, my conclusion is that even though most disability advocacy today, especially in policy and professional contexts, relies on the social model, my instinct reverted me to the medical model when creating content surrounding my own disability because it’s the understanding embedded in me through years of indoctrination through various cultural norms and forms.
Our job as access consultants is to create change, but no change worth advocating for comes without a wider benefit to all of us, so if you’d like to hear more about why inclusive design and policy choices benefit organisations, businesses, and charities, not just people like me – check out our “Insights” page for more articles on the business case for accessibility.