The terminology above in some ways reflects a tension between the medical model and the social model of disability. In the medical model, disability reflects a deficit in the person who is unable to...

The terminology above in some ways reflects a tension between the medical model and the social model of disability. In the medical model, disability reflects a deficit in the person who is unable to lead life in traditional or accepted ways. In the social model, fault for dysfunction is shifted to society, wherein systems and environments are viewed as enabling or disabling, such as creating barriers to performance and effective participation. Occupational therapists may appraise environments as being enabling or disabling, yet there is continuing tension between devoting resources to “fixing the person” and devoting them to “fixing the environment.” For example, accessible and universal design are promoted as a means to create more enabling environments for everyone, yet the and designing with universal design ideas from the start are often viewed as excessively costly and unachievable. After its passage, the ADA was soon regarded as one of the U.S. government’s largest unfunded mandates. What are your thoughts (and conflicts) relative to fixing the community to enable better participation, versus fixing the person or enabling the person to deal better with participation challenges in unaltered communities?