To help clear up some of the confusion, we would like to introduce the distinction between what is called the “medical model” and the “social” or “cultural model” in the disability studies world. A medical model represents an attitude toward difference in which any type of biological deviation from what is expected (and understood as “normal”) becomes a form of pathology or deficiency. The medical model treats disability as a deficiency existing at the level of an individual person. Managing disability within the medical model is thus achieved almost entirely by seeking cures or rehabilitation within the individual body and person.
Speech pathologists and those within the medical model view stuttering and other dysfluencies as the main difference between the lives of “normal” speakers and those who cannot pass as normal. The medical paradigm views difference as disorder, often affirming a view of life that starts with birth, climaxes at marriage and ends in death. In such a view, stuttering is disruptive because it hinders attempts at normalized socialization and economic productivity. Stutterers are less than ideal citizens.
We at Did I Stutter subscribe to what is called a cultural model of speech. We view differences in speech not as causes of problems, but as a sign of unusual embodiment that, when identified by society, leads to the devaluation of the speech disabled individual. The cultural model argues that bodies are tremendously varied, but only some forms of variation are marked as abnormal and deficient (for example, red hair is a genetic mutation, but no one talks about the “risk” of having a red haired child in the way that we routinely talk about the “risk” of having a child with Down syndrome). The cultural model of disability refuses to assume that any bodily variation—be it hair color or disability—is somehow naturally deficient or bad. Rather, it is primarily social and cultural barriers discriminating against disabled bodies in a thousand ways that turn the ‘difference’ of disability into a deficiency.
Of course, experiencing disability produces challenges that other bodies may not have—we often have physical pain, and our bodies can move (or not move) in ways that can at times be frustrating. The cultural model of disability does not deny this. However, it also believes that pain and frustration are in part shaped by a world which is designed for certain sorts of bodies while failing to accommodate others. The point is that disability is never an individual issue, but must always be understood in a social context. The medical and individual model of disability is far too simplistic to understand everything that disability is.
A cultural view of stuttering might think that social attitudes toward deviance and appearance weigh heavier in the treatment of stutterers than the sound of the voice itself. A cultural view might be curious to look at the treatment of dysfluent individuals in non-western cultures, wondering if the stigma attributed to stutterers is associated with an idealistic attitude held toward efficiency. Finally, a cultural view of speech might encourage individuals to think about how they learn to speak and what “good speech” even means. Furthermore, it would contend that our learning about “good speech” has a heavy influence on our experience; if an individual experiences pain when they stammer, that pain is inseparable from the faces made by our conversation partners and the way their reactions condition our thinking about dysfluency.
While medical professionals may seek to identify causal biological issues, those interested in the social or cultural models of disability are deeply involved in considering how the social and representational environment affects the condition of dysfluent people.
It is important that a social or cultural model does not entirely exclude medicine or speech therapy, but that we use it to ask critical questions about how some of the assumptions of a curative model of speech might injure dysfluent individuals.