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date: 05 October 2022

Disabilityfree

Disabilityfree

  • Dawn ApgarDawn ApgarSeton Hall University Department of Sociology, Anthropology, Social Work, and Criminal Justice

Summary

Characteristics associated with contemporary definitions of disabilities have existed in the human population from earliest recorded history. However, societal views on disability and those who have them have varied greatly over time. Disability has been viewed as a blessing from deity or the deities, a punishment for sin, or a medical condition. Social workers have worked with people with disabilities from the inception of the profession and have critical roles in the prevention and treatment of disabilities. Practice is driven by the promotion of the core values of the profession, including the dignity and worth of all people. Social workers recognize that variability in physical and cognitive abilities should not compromise access to opportunities and human rights. Social and political action focused on people with disabilities aim to promote inclusion, foster self-determination, and fight discrimination. Despite increasing services and policies to promote the well-being of people with disabilities, significant income, employment, housing, and quality of life issues still exist for those with disabilities. Macro social work practice is greatly needed to ensure that laws, organizations, and policies do not marginalize or oppress based on varying physical and/or intellectual abilities. Social work’s focus on policy and community development is well suited for reforming existing structures that prevent people with disabilities from achieving full integration within schools, work settings, and community living. Macro social work methods are needed to ensure that quality supports are provided to those with disabilities, to maximize their well-being and participation in all aspects of society.

Subjects

  • Disabilities
  • Health Care and Illness
  • Populations and Practice Settings
  • Social Justice and Human Rights

Updated in this version

Article updated for the Encyclopedia of Macro Social Work. Updates address the importance of macro methods for protecting the rights and promoting the well-being of individuals with disabilities and challenges for social work education and practice.

Introduction

The World Health Organization (WHO, 2011) estimated that 1 billion people, that is about 15% of the world’s population, live with disabilities, and one-fifth of them have significant impairments due to their conditions. An estimated 61 million or 26% of all adults in the United States live with a disability (Okoro et al., 2018). In the United States, the most common functional disability is serious difficulty walking or climbing stairs (13.7%), followed by cognitive disabilities (10.8%), hearing difficulties or deafness (5.9%), and blindness or vision (4.6%). Due to disabilities, 6.8% of adults have difficulty with independent living, and 3.7% are limited in their self-care, such as bathing or dressing (CDC, 2018).

Disability prevalence is higher in developing countries (Hosseinpoor et al., 2013). People with disabilities are more likely to experience adverse socioeconomic outcomes such as less education, poorer health outcomes, lower levels of employment, and higher poverty rates. In addition, many people with disabilities have underlying health needs that make them particularly vulnerable, including to contracting and experiencing severe impacts of COVID-19 (an infectious disease first reported in 2019 that became a worldwide pandemic in 2020) (WHO, n.d.a).

Disability can have many etiologies, including but not limited to disease, injuries, cognitive or emotional problems, or alcohol or drug misuse. Historically, disability has been defined as pathology contained within individuals. However, contemporary conceptualizations and measurement of disability have acknowledged environmental contexts, as well as the relevance of associated health conditions and their effects, on the functioning of those with underlying disorders (WHO, 2001). The International Classification of Functioning Disability (ICF) recognizes that individuals can have the same disorder and the same functional impairments, but different degrees of disability, depending on environmental context such as physical factors (e.g., climate, terrain, and/or building design) and social factors (e.g., attitudes, institutions, and/or laws). Considering the impact of larger systems on the functioning of individuals is consistent with the ecological perspective that governs social work practice.

The view that the impact of disability can vary significantly despite the existence of the same disorder or condition is gaining acceptance in the United States. The American Psychiatric Association (APA, 2013) urged the use of the World Health Organization Disability Assessment Schedule version 2.0 (WHODAS 2.0), an assessment tool based on the ICF framework, as an emerging measure for further research and clinical evaluation (see also Üstün et al., 2010). While disability may be related to medical or psychiatric disorders, the WHODAS 2.0 recognizes that personal and environment factors mitigate impairments, thereby necessitating the need to measure them separately from the etiological conditions which have caused them. Some studies have provided widespread support for this approach to assessing disability for clinical assessment and service eligibility with the WHODAS 2.0 translated into 47 languages and dialects and used in 27 areas of research (Federici et al., 2017; Garin et al., 2010; Marx et al., 2015).

As life expectancies increase and with technological advancements, the numbers and proportions of people living with disabilities will continue to expand. Thus, more social workers will be needed to work directly with this population. Additionally, all social workers must enhance their proficiency in addressing the needs of those with disabilities. Macro social work, which focuses on management and administration, community development and organization, and policy practice, will be essential to ensuring that those with disabilities maximize their independence and are afforded the same rights and opportunities as those without disabilities.

History

Throughout history, societies have attempted to explain the place of disability in the social order (Mackelprang, 2013). Neolithic tribes believed that disabilities were caused by spirits, and skull surgeries were performed to release spirits believed to be evil (Petrone et al., 2015). Ancient Greeks believed persons with disabilities were not human and that they should be abandoned to die (Plato, 1991; Stavrianos et al., 2018). Romans left children with severe disabilities to die and also used those with physical deformities for their own amusement (Trentin, 2011). Concomitantly, not all disabilities were problematic, particularly those that did not manifest with physical differences. For example, Julius Caesar had epilepsy, known as falling sickness, and claimed that he had visions during his seizures. In ancient Asia, disability was viewed similarly to that done in Western culture. Life with disability was viewed as substandard with people with disabilities often having to beg to meet their basic needs for survival. However, because religious vows of poverty were common in some parts of Asia, this activity was not stigmatized as it was in Western culture. Both heroic and malevolent characters with disabilities were featured in ancient Asian history (Miles, 2007). Contrarily, ancient Zoroastrian scripture dating back 2,500 years in Persia envisioned a perfect world without disabilities.

Judeo-Christian and Muslim histories portray disability negatively. The Koran displayed those who were deaf, blind, and “dumb” as being without understanding. The Old Testament forbade people with physical atypicalities and those of short stature from officiating in temple and priesthood ordinances. In the New Testament, blindness and other disabilities were believed to be caused by sins of those with these conditions or their parents. Those with erratic behavior, which would now be linked to mental illness, were thought to be possessed by devils (Espí Forcén & Espí Forcén, 2014). However, disability was not universally condemned. For example, both the Koran and the Bible describe Moses as having a significant speech impediment that did not disqualify him from leading the Israelites out of Egypt. The New Testament portrayed disability as arising from sin and spiritual deficiency. However, Jesus also displayed compassion for people with disabilities, setting an archetype for subsequent charitable efforts in Western culture.

In the Middle Ages, disability continued to be explained in religious and supernatural terms in which persons with disabilities were out of harmony with god or the natural order of the universe. However, although moral explanations prevailed during the Middle Ages, there was no singular, unifying perspective (Singer, 2012). When disability was attributed to demonic or evil influences, people were ostracized and killed. Many clergy espoused the belief that people with disabilities provided an opportunity for those without disabilities to display charity. People with leprosy were segregated to protect society physically and spiritually; however, some also believed lepers’ infirmities helped them to progress to salvation faster than others.

The Enlightenment era brought a new emphasis on rational inquiry that competed with morally-based explanations of disability. As early as 1600, Francis Bacon refuted the idea that “madness” resulted from moral punishment (Mackelprang, 2012). People with disability from birth were blamed for their conditions while those with disabilities acquired later in life were less stigmatized— these disparate views persist even today (Bogart et al., 2019). Those wounded in action were given special consideration and support. In Europe, people who were blind were especially afforded higher status resulting from the wartime practice in which prisoners of war were blinded by their captors and allowed to return to their homes. This practice was considered a humane alternative to execution while neutralizing the captives’ threat to the victors.

The Enlightenment coincided with industrialization and increased urbanization, all of which influenced societal reactions to disability. As scientific inquiry increasingly supplanted religious and supernatural explanations of disability, medical and rational explanations began to supersede moral explanations of disability. The rising reliance on medicine brought increased emphasis on curing, or at least treating, disabilities. Increasingly, people’s worth was measured by their ability to work and contribute to the economy. As contrasted to rural, agrarian societies, in which families and communities integrated those who were different, institutions that housed “the unproductive,” including people with disabilities, proliferated. Originally these congregate settings had the goal of segregating and confining those with disabilities who were viewed as dangerous to themselves or others as their conditions were incurable (Appleman, 2018). The number of people confined to institutions quickly rose, resulting in them serving as warehouses often with subhuman conditions.

The 1800s and the Victorian era brought increasing modernity and scientific advances. Charles Darwin’s observations challenged perceptions about the nature and development of humanity. Darwin observed that biological natural selection benefited species, whereas social Darwinists advocated eugenics, wherein social engineering would discourage undesirables from reproducing while promoting the proliferation of desired classes, primarily White, affluent people without disabilities (Appleman, 2018; Wiggam, 1924).

In the first half of the 20th century, both moral and medical approaches to explaining disability were firmly entrenched in Western culture. Disability was shameful, and people with disabilities were isolated. Professionals encouraged parents to institutionalize their children with disabilities. People with mental health problems were segregated in mental hospitals. People with mobility disabilities were denied access to public and private facilities. The United States’ Supreme Court decision in Buck v. Bell (274 U.S. 200, 1927) legitimized forced sterilization of people with disabilities by upholding a 1924 Virginia statute that allowed state governments to sterilize those who were deemed genetically unfit. This decision was one of the first times that the federal courts intervened in a case involving the rights of people with developmental disabilities, greatly limiting their rights by excluding them from protections afforded by the United States Constitution (U.S. Const. amend. VIII, XIX). Buck v. Bell paved the way for 30 other states to enforce similar laws, resulting in more than 60,000 men, women, and children in the United States being sterilized without their consent from the 1920s to the mid-1970s (Cohen, 2016).

Eugenics policies embedded in Western culture also provided impetus for the genocide of between 75,000 and 200,000 people with physical and/or cognitive disabilities in Nazi Germany. World War I produced hundreds of thousands of veterans and civilians with disabilities in Europe and the United States, and responses to their needs helped to shape the views of those with disabilities overall, with soldiers seen as worthy of treatment. Care of soldiers moved from provision of financial assistance, in the form of a pension and possibly custodial care in soldiers’ homes, to widespread conviction that the government should train and educate ex-service men so that they could return to productive lives (Rostker, 2013). Franklin D. Roosevelt was elected as President of the United States despite having a disability due to polio, though he went to great lengths to hide his physical limitations from the public. Increased survival rates of persons born with or acquiring disabilities, public responsibility to care for veterans disabled by wars, and technological advances led to increased awareness and attention to “treat” people with disabilities.

In the early decades of the 20th century, disability rights’ seeds were planted. The League of the Physically Handicapped was organized in the 1930s, to fight for employment during the Great Depression. In 1950, several local groups came together and formed the National Association for Retarded Children (NARC) (The Arc, n.d.). By the 1960s, the civil rights movement began to take shape, and disability advocates joined forces with those fighting for other minority groups to demand equal treatment, equal access, and equal opportunity. The Rehabilitation Act 1973 was passed in the United States, and for the first time in history, civil rights of people with disabilities were protected by federal law.

The Education for All Handicapped Children Act 1975 was passed to guarantee equal access to public education for children with disabilities. This legislation specified that every child had a right to education and mandated the full inclusion of children with disabilities in mainstream education classes unless a satisfactory level of education could not be achieved due to the nature of children’s disabilities. The Act was amended and renamed the Individuals with Disabilities Education Act (IDEA, 1990). The IDEA further promoted the inclusion of children with disabilities into regular classes and established the rights of parents to be involved in the educational decisions affecting their children. The IDEA required that Individual Education Plans (IEPs) be designed with parental approval to meet the educational needs of children with disabilities.

After decades of campaigning and lobbying, the Americans with Disabilities Act (ADA, 1990) was also passed, mandating equal treatment and access of people with disabilities to employment opportunities and to public accommodations. The ADA, inspired by the Civil Rights Act of 1964, prohibited discrimination in employment, services rendered by state and local governments, places of public accommodation, transportation, and telecommunications services based on disability status. President Obama signed the Workforce Innovation and Opportunity Act (WIOA, 2014) into law, which amended the Rehabilitation Act of 1973 to further stress full, competitive integrated employment for all people with disabilities and greater training for youth specifically.

Advances in technology are providing persons with disabilities new opportunities to participate fully in society. However, they still face significant social and economic problems. There remain barriers to employment, education, accessible and affordable housing, voting, and healthcare. Despite the passage of the ADA, deep-rooted assumptions and stereotypical biases continue to exist, resulting in ongoing prejudice toward and bias about people with disabilities. Current advocacy in the United States’ disability rights movement is primarily focused on empowerment and self-determination of people with disabilities. However, people with disabilities worldwide continue to face serious obstacles to humane treatment and realizing their rights on an equal basis with others. Current abuses such as violence, discrimination, segregation, and unlawful detention of people with disabilities worldwide is well documented (HRW, 2020).

In the future, social work as a profession must be at the forefront of advancing policies and services for those with disabilities given its ethical mandate of respecting difference and promoting equity and inclusion of those who are marginalized or oppressed. Macro social work will be particularly important as advocacy, mobilization, planning, development, and leadership in larger systems are needed to make critical structural changes that have prevented unequal treatment of and opportunities for those with disabilities in the past.

Social Work’s Commitment

The social work profession has a strong history of responsibility to work with and advocacy for the those who are disadvantaged and oppressed in society. The mandate to assist those who are marginalized, including those with disabilities, is driven by the core values of the social work profession and its ethical code (NASW, 2018). Each of the six ethical principles which govern the social work profession directly affirms social work’s commitment to ensuring that those with disabilities receive needed supports that maximize their independence and autonomy to make choices that impact their lives.

Service

Social workers help those in need and address social problems. Every social issue is a disability issue as one in four Americans has a condition that can limit functioning. Social workers are likely to work with those with disabilities daily regardless of their employment setting or specialization (Kim & Sellmaier, 2020). The demand for social workers, particularly in healthcare, is projected to increase by 14% from 2019 to 2029 (BLS, 2021). Given the high comorbidity of health conditions among people with disabilities, it is likely that social workers will serve those with disabilities in medical and other settings. Additionally, social workers must be knowledgeable about how to serve those with varying cognitive or physical disabilities as a requirement of cultural awareness and a recognition of social diversity (NASW, 2018).

Social Justice

People with disabilities have systematically been denied equal access and opportunities, resulting in widespread marginalization and lack of inclusion in society worldwide. Creating equal opportunities and justice for people with disabilities, as well as others who have been oppressed, is at the heart of social work practice and identified as a grand challenge for the future (Calvo et al., 2018). Social work’s commitment to social justice compels those in the profession to advocate for nondiscriminatory laws, policies, and practices that promote the well-being of people with disabilities. Social justice promotes participation of individuals with disabilities in decision making about their own care, as well as ensures that social service systems have those with varying abilities in authoritative positions with decision-making power.

Dignity and Worth of the Person

Social workers use a strengths perspective when working with those with varying abilities, fighting against ableism which devalues and views those with developmental, emotional, physical, or psychiatric conditions as less capable. Social workers recognize that people with disabilities have the right to make decisions for themselves and that language should reflect the inherent worth of individuals. Social workers advocate for use of “person first language” to indicate that people are not defined by their disabilities. “People with disabilities” replaces the use of “disabled people.” Social workers recognize that individuals should not be called by their conditions, such as “the mentally ill” or “the disabled,” as these terms are used to dehumanize and stigmatize groups of people. “Person first language” recognizes that all individuals first and foremost have the same collective needs and rights, regardless of their differences. Social workers are sensitive to the impact of language and stereotypes on societal views of people with disabilities and the self-esteem of those with disabling conditions. Social workers eradicate policies and practices which are built on deficit-focused views of those with disabilities.

Importance of Human Relationships

Social workers understand the importance of viewing people with disabilities within a family systems perspective, with each member critical to the functioning of another. Family members often serve as key natural supports for people with disabilities, helping people to remain living at home and in the community (Grossman & Magaña, 2016). Disability is or will be part of life for most contemporary families. Therefore, understanding the impact of disabilities on social–emotional relationships and family well-being is critical for social work assessment. While much has been written about the stressors placed on families when members are disabled, there are also life-enhancing and affirming impacts on family dynamics, including enhanced interconnectedness, belonging, and resilience (Farrell & Krahn, 2014). Understanding the influence of physical, cognitive, and/or psychological conditions on social connections with others is critical to the use of the biopsychosocial model in social work practice (Browne, 2019). Social workers are dedicated to enhancing social supports of people with disabilities to promote their mental health and wellbeing, as well as strengthen relationships with their families and friends.

Integrity

People with disabilities are more likely to experience abuse than people without them (Hughes et al., 2012). Furthermore, abuse and disability often coexist in the lives of children, as children who are abused are at a higher risk of developing a disability, and children with a disability are at a higher risk of being abused (Corr & Santos, 2017). Abuse occurs when people misuse their power and control, and people with disabilities often face barriers to accessing help that make them more vulnerable. Social workers are charged with treating others with respect and taking action to discourage, prevent, expose, and correct maltreatment of others, including those with disabilities. Often people with disabilities rely on the physical assistance of others to perform personal care. Social workers understand that this support must be done with integrity, respecting the need for privacy and self-direction to the extent possible. Social workers design and institute quality assurance systems that safeguard against the exploitation or abuse of individuals with disabilities, as well as ensure accountability of services meant to support them.

Competence

Since 2008, social work has used a competency-based approach to educating those entering the profession (CSWE, 2015). Those graduating from undergraduate and graduate social work programs must demonstrate that they understand how diversity and difference, including those related to physical and cognitive abilities, influence the human experience and are critical identity formation. To ensure that disability content is integrated into social work education and students with disabilities are supported in social work education, the Council on Social Work Education (CSWE) established a Commission for Diversity and Social & Economic Justice, which supports the work of its Council on Disability and Persons with Disabilities (CDPD). In response to a need for resources to assist with integrating disability content into social work courses (Ogden et al., 2017), CSWE (2019a) published the Curricular Resource on Issues of Disability and Disability-Competent Care, making it publicly available to educators through its Center for Diversity and Social & Economic Justice. Recent examination of the Educational Policy and Accreditation Standards (EPAS) indicate a greater emphasis on social workers being able to not just recognize diversity and difference but demonstrate practice behaviors that promote equity and inclusion (CSWE, 2019b). Macro practice competencies are increasingly important for social workers who are likely faced with institutional barriers that compromise competent treatment of those with disabilities, preventing or limiting their full participation and infringing on their rights.

Macro Social Work Practice: Protecting Rights and Enhancing Inclusion

Macro social work practice includes three primary focus areas: administration and management; community development and organization; and policy practice (CSWE, 2018). At its core, macro social work practice identifies and dismantles ableism and other forms of marginalization, oppression, and discrimination in organizations, communities, and public policies. There are many challenges in each of the macro practice areas that require attention by social workers to protect the rights and enhance inclusion of those with disabilities.

Management and Administration

Social workers in management and administration must be well versed on the laws that protect individuals with disabilities, as well as on how to support those with disabilities who require extra assistance in the workplace. The ADA (1990) prohibited employment discrimination based on disability, ensuring that those with disabilities equally benefit from the full range of employment-related opportunities available to others. Social workers must ensure that recruitment, hiring, promotions, training, pay, social activities, and other privileges of employment do not unfairly advantage those without disabilities. When hiring, social work managers and administrators should not ask about applicants’ disability status before job offers are made.

Accommodating employees with disabilities in the workplace is critically important. Social work managers and administrators understand the importance of having a diverse workforce and recognize the contributions that those with disabilities can make to achieving desired organizational outcomes.

A critical priority for the United States’ Department of Labor is increased community-based, integrated employment opportunities for individuals. This priority, called Employment First, is based on the premise that all citizens, including individuals with significant disabilities, are capable of full, integrated employment and community living (U.S. DOL, 2020).

About 14% of all social workers work in state and local government (NASW, 2020). Social workers are managers and administrators of public programs aimed at assisting those with disabilities, including those focused on obtaining and maintaining employment. Additionally, social work managers and administrators in non-governmental organizations (NGOs) work closely with existing public and private programs to provide support to employees with disabilities. Social work managers and administrators must be knowledgeable about entitlements and resources available to employees with disabilities and/or who have relatives with disabilities. Under the Family and Medical Leave Act (FMLA, 1993), employees who have spouses, children, or parents with serious health conditions, or who themselves have serious health conditions, that makes them unable to perform essential job functions can take job-protected leave with health coverage.

Social work managers and administrators must ensure that those with disabilities are able to easily access services delivered by their organizations, regardless of service type or target population. Additionally, social work managers and administrators should ensure that decision-making bodies at all levels within their organizations have diverse representation, by including those with disabilities and/or their family members. Social work managers and administrators must recognize the impact that caregiving can have on employees and use supportive supervision to assist employees who are struggling with managing caregiving responsibilities with work demands. Being cognizant of the impact of disabilities is essential for social work managers and administrators charged with ensuring achievement of organizational goals and fulfillment of agency mission.

Community Development and Organization

Much of the work on providing opportunities for people with disabilities has focused on maintaining and integrating them in the community (Stone, 2016). There is widespread recognition that communities are void of valuable perspectives when people with disabilities are not a part of them and that individuals with disabilities are healthier and happier when there live in community settings. The deinstitutionalization movement that began in the 1980s reduced the warehousing of people with disabilities, but many remained institutionalized unnecessarily. In 1999, the Olmstead decision by the United States’ Supreme Court mandated states to discharge eligible people with disabilities from psychiatric hospitals, nursing homes, and other institutional settings into the community (U.S. Reports, 1999).

The movement of individuals with disabilities into the community requires adequate housing and supportive services, only available with sufficient funding and proper resource allocation. The need for macro methods has been identified as pivotal for resource management and other activities required for greater community inclusion and integration of people with disabilities. Specific foci for social workers include, but are not limited to, interpreting the Olmstead decision through the political process, attaining true service integration, reducing service fragmentation, assuring funding for successful institutional-community transitions, creating assessment tools, addressing workforce issues, promoting service and housing accessibility and quality, forging community collaborations, and engaging in public advocacy (Zendell, 2007). Central to these macro practice aims is the need to create systems of service integration that are based on and driven by the desires and wants of people with disabilities and their families (Yong, 2007).

Social workers engaged in community development provide education and advocate to combat the “Not in My Backyard” (NIMBY) phenomenon which is rooted in unwarranted fears and prejudices against individuals with disabilities and those in other stigmatized groups. Activism by social workers is essential in these situations to ensure full community integration and combat segregation which results in unequal access and marginalization. Social workers who work with communities understand the importance of mobilization and ensuring that people with disabilities are not just living in communities but are fully integrated into all aspects of community life.

Policy Practice

Policy practice to advance the civil rights of people with disabilities has been critical as this population has historically been persecuted and neglected without adequate protections. The WHO (n.d.b) urged the review and revision of existing legislation and policies that adversely impact people with disabilities and the development of disability strategies and action plans worldwide. Social workers are well suited for this work as policy practice includes analyses to understand potential impact of laws and regulations on people with disabilities, as well as advocacy for policy changes when needed. Passage of new laws and revisions of old ones requires social workers to build coalitions and develop coordinated strategies with stakeholders.

Though the United States has strengthened protections for people with disabilities, the recent COVID-19 pandemic illustrates how those with disabilities are still discriminated against in public policy decisions. Despite federal direction not to show prejudice when prioritizing medical attention or the use of life-saving equipment if demands exceed available resources, a review of 30 state policies during COVID-19 indicate that all but five had provisions that would result in the needs of people with disabilities being placed lower than their non-disabled counterparts (Whyte, 2020).

Policy development and advocacy should not be limited to the United States. Social workers must advocate for continued support of the first United Nations’ human rights treaty of the 21st century, the Convention on the Rights of Persons with Disabilities (CRPD), and its Optional Protocol. As of July 2020, it had 163 signatories, 182 parties, 181 countries, and the European Union (UN, 2020). The CRPD is endorsed by the International Federation of Social Workers (IFSW, 2010), that also called for the development of public, private, and commercial income security programs to adequately meet the needs of people with disabilities, especially women. Those with disabilities are more likely to live in poverty (Mitra et al., 2013), with women with disabilities among the poorest adults in the United States (Parish, 2006).

A Look to the Future

Despite progress made toward advancing the treatment, views, and rights of people with disabilities, inadequate care, stereotypes, and discrimination still exist, even within the social work profession. For example, in October 2020, the Texas Board of Social Work Examiners voted unanimously, based on a recommendation from their Governor’s office, to change a section of its code of conduct that would allow social workers to refuse to serve others based on disability status, as well as sexual orientation or gender identity (Walters, 2020a). This action was highly criticized by the National Association of Social Workers and others as antithetical to the profession’s core values and principles (Walters, 2020b). Based on the outcry of social workers and other advocates, this decision was reversed two weeks later, but this incident highlights the need for social workers to stay vigilant in monitoring public policy to ensure that nondiscrimination protections are not removed.

The social work profession has a responsibility to promote equity and social justice. Social workers must continue to advocate for policies and practices that provide the same opportunities for all, regardless of cognitive or physical ability. The belief that rights of all are diminished when the rights of one are threatened remains as relevant today as it did more than 60 years ago during the civil rights movement (John F. Kennedy Library, 1963). The social work profession must partner with others to engage in social and political action to ensure existing protections for those with disabilities are not repealed and new legislations, regulations, and policies consider the supports needed to ensure that those with disabilities are able to fully participate. Central to all advocacy efforts must be the empowerment of those with disabilities. Social workers should embrace the slogan, “nothing about us, without us,” which was first used by disability advocates in the 1990s to stress that no decisions should be made about people with disabilities without their full and direct participation (Charlton, 1998). Social workers doing management and administration, community development and organization, and/or policy practice must ensure that people with disabilities are represented on decision-making bodies. Social workers must also promote policies and practices that maximize self-determination and self-directed service delivery systems.

Helping social work students with disabilities is a needed first step to obtaining greater representation of those with varying physical and cognitive abilities in the profession. Research shows that social work students with disabilities face challenges navigating college campuses and classrooms, as well as in their field settings (Sellmaier & Kim, 2020). Recent data reveals that some social work students experience ableist microaggressions and feel unsupported at times, as well as have an unfulfilled need for a disability-focused community within their programs (Kattari et al., 2020). Social work educators must develop tangible strategies to address these and other related problems to have more inclusive social work education. If social work programs cannot support students with disabilities, then who? If not now, then when?

Despite the importance of understanding the needs of individuals with disabilities, research indicates that disability content has been slow to be integrated into social work curricula, though most programs now have it infused into course content. A decade ago, data revealed that only 27%–37% of schools of social work included content on developmental disabilities in their curriculum (Laws et al., 2010). Analyses of course titles and descriptions indicated that this content was more likely to be infused in curricula rather than contained in dedicated courses (Bean & Krcek, 2012). Few, if any, undergraduate social work programs provide certificates in disabilities studies, and disability concentrations by graduate social work students are so infrequent that they are not even listed as an response option on surveys completed by accredited programs (CSWE, 2020; George Washington University, 2019). Additionally, social work curricula appear to be overly inclusive of a medical model of disabilities and not fully aligned with social work theory and values (Fuld, 2020). Assessment of social work curricula and revisions to future accreditation standards need to ensure that disability content is adequately covered and students can competently work with those with disabilities. Such competence requires getting more disability content into the core curriculum and development of disability specializations and certifications within undergraduate and graduate social work programs.

The recent United States’ federal election has highlighted Americans’ access to voting, a central right in any democracy (Levine, 2020). In assisting to eradicate the power dynamic which exists between those with and without disabilities, it is essential that social workers focus their social action efforts on removing barriers to voting for those with cognitive, physical, or other challenges. A recent report published by the United States Government Accountability Office found that 60% of polling locations had at least one impediment, such as steep ramps located outside buildings, lack of signs indicating accessible paths, and poor parking or path surfaces, which could deter individuals with mobility limitations from voting (GAO, 2017). Voter suppression has resulted in continued oppression and the maintenance of systemic social inequities within the United States. As one in four Americans has a disability, there are issues of access, equity, and representation which are universal across the diverse population of those with impairments. Social workers must focus their efforts on ensuring that people with disabilities have access to and exercise their right to vote to continue the path to building a just society with opportunities for all.

References