Disability and Rehabilitation

The Nagi Model of Disablement considers social and environmental factors crucial in determining the degree of disability that an individual experiences.  A person’s disability is not simply defined by its presence, but how well social and environmental surroundings are adapted to allow the person to function in a more typical fashion.  For example, a person who uses a wheelchair for mobility in a non-adapted environment will experience significant disability and functional limitations.  But that same person in an adapted environment (adapted car or other transportation, wheelchair ramps, doors that allow easy entrance to work and other public spaces, work space accommodated to the wheelchair, a job that can be done while sitting, support from family and friends), will experience much less functional disability during the typical day.

Disability as a Social Concern

Nagi’s work in the 1960’s and 1970’s advanced the Disablement Model and transformed the way disability was viewed in the U.S. and globally.  It was through his 1965 article that the “social model of disability” was born.  Disability had previously been viewed as a strictly medical concern.  Nagi was the first to assert that the most significant restrictions in living with disabilities are generally not the actual medical impairments, but the lack of adaptation in a person’s social environment.  This furthered research into the social aspects of disability and rehabilitation, and redirected policy-making with regards to the disabled.  This work includes the introduction of the Nagi Scale of Functionality.  

Research was done under the auspices of agencies and organizations such as the Social Security administration and the World Health Organization.  The Americans with Disabilities Act (ADA) is an outgrowth of this philosophy of full consideration of an individual’s social and environmental circumstances.  This perspective also underlies the World Health Organization’s approach to disability and the general practice of physical therapy.