Above all, barrier-free speech is also a question of recognizing the other person who experiences barriers
From my point of view, it can be stated that in everyday practice, the medical model of disability is applied unconditionally and mercilessly in assistance and therapy, especially in those areas where the importance of meeting in a joint interaction according to the social model would be decisive.
This observation is of explosive relevance when it comes to the issues of speech and language impairments:
If a person is disabled in a way that involves their speech and/or language ability, they are usually addressed and categorized in society in a categorical way using the explanations provided by a medical model of disability.
If one complains, for example as a compensatory assistant, about assignments that arise in this way, and which usually amount to the assumption and assertion of a cognitive limitation, this criticism is not taken seriously with reference to medical, diagnostic assessments of the respective forms of disability and physical constitutions.
In practice, this means that the self-perception and own experiences of people with speech/language impairments, as well as the valuable and also crucial communicative experiences that are made with the affected person in their environment, are ignored, giving priority to an external assessment that follows a schematic approach and the medical model of disability.
The experiences of the environment are not taken into account and a gap is created > between the interaction level of important parts of the environment of the person with disabilities, as excluding the person with disabilities themselves or excluding their level of experience on the one hand > and the interaction between the person with disabilities and the people from their environment (or the people in society in a non-ableist context) who take a different, non-ableist view of the person’s ability to communicate.
The level of interaction is subordinated to an “official” medical description of the condition of a person with a disability, the moment criteria are applied such as: the person would not pass normal intelligence tests, the person would not be able to communicate a situation “normally” so that it could be understood easily or at all, etc. (anything that would amount to communication could not be used functionally).
At that moment, the topics of language and communication are viewed in a reduced way and are ableistically linked to assessments of cognitive performance and conditions, to the detriment of those affected and their supporters. In this case, the reference to the medical model also leads to an extension of a very limited view of communication complexity in general.
Therapies therefore have a limited effect on many of those affected, which can further deepen their insecurity, as the paradigm of > speech impairment and cognitive deficits is maintained for many ‘forms of disability’. The focus is on medical classifications, and not on individual experiences, wishes and needs, which therapists can only tap into if they consistently engage with the realities that are not captured by medical assessments and approaches that cannot even be captured in this way.
If medicine could fully explain how people function, we would be dealing with a radically biologistic world view of people. In the case of disabilities that affect speech, this is exactly what happens. In my opinion, the assumption that “communicating differently” means “communicating in a reduced way” is an ableist fallacy that cannot even be proven, but in reality works ruthlessly with communicative exclusion and misguided assumptions.