Disability

A disability (or lack of a given ability, as the "dis" qualifier denotes) in humans may be physical, cognitive/mental, sensory, emotional, developmental or some combination of these.

An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives."

An individual may also qualify as disabled if he/she has had an impairment in the past or is seen as disabled based on a personal or group standard or norm. Such impairments may include physical, sensory, and cognitive or developmental disabilities. Mental disorders (also known as psychiatric or psychosocial disability) and various types of chronic disease may also qualify as disabilities.

Some advocates object to describing certain conditions (notably deafness and autism) as "disabilities", arguing that it is more appropriate to consider them developmental differences that have been unfairly stigmatized by society.

A disability may occur during a person's lifetime or may be present from birth.

Types of disability

Disability is caused by impairments to various subsystems of the body - these can be broadly sorted into the following categories.

Physical disability

Any impairment which limits the physical function of limbs or fine or gross motor ability is a physical disability. Other physical disabilities include impairments which limit other facets of daily living, such as severe sleep apnea.

Sensory disability

Sensory disabilities relate mainly to sight and hearing. The inability to smell or taste is relatively rarer and is not always considerered to be a disability. Other sensory impairments such as of the skin senses, the sensing of touch, heat, cold or pain also exist and are commonly associated with physical disabilities involving paralysis.

Visual impairment

Visual impairment (or vision impairment) is vision loss (of a person) to such a degree as to qualify as an additional support need through a significant limitation of visual capability resulting from either disease, trauma, or congenital or degenerative conditions that cannot be corrected by conventional means, such as refractive correction, medication, or surgery. This functional loss of vision is typically defined to manifest with # best corrected visual acuity of less than 20/60, or significant central field defect, # significant peripheral field defect including homonymous or heteronymous bilateral visual, field defect or generalized contraction or constriction of field, or # reduced peak contrast sensitivity with either of the above conditions.

Hearing impairment

Hearing impairment or hard of hearing or deafness refers to conditions in which individuals are fully or partially unable to detect or perceive at least some frequencies of sound which can typically be heard by most people. Mild hearing loss may sometimes not be considered a disability.

Olfactory and gustatory impairment

Impairment of the sense of smell and taste are commonly associated with aging but can also occur in younger people due to a wide variety of causes. There are a wide variety of olfactory disorders:

Anosmia – inability to smell

Dysosmia – things smell different than they should

Hyperosmia – an abnormally acute sense of smell.

Hyposmia – decreased ability to smell

Olfactory Reference Syndrome – psychological disorder which causes the patient to imagine he has strong body odor

Parosmia – things smell worse than they should

Phantosmia – "hallucinated smell," often unpleasant in nature

Complete loss of the sense of taste is known as ageusia, while dysgeusia is persistent abnormal sense of taste,

Somatosensory impairment

Insensitivity to stimuli such as touch, heat, cold, and pain are often an adjunct to a more general physical impairment involving neural pathways and is very commonly associated with paralysis (in which the motor neural circuits are also affected).

Balance disorder

A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by symptoms of being giddy, woozy, or have a sensation of movement, spinning, or floating. Balance is the result of several body systems working together. The eyes (visual system), ears (vestibular system) and the body's sense of where it is in space (proprioception) need to be intact. The brain, which compiles this information, needs to be functioning effectively.

Intellectual disability

Intellectual disability is a broad concept that ranges from mental retardation to cognitive deficits too mild or too specific (as in specific learning disability) to qualify as mental retardation. Intellectual disabilities may appear at any age. Mental retardation is a subtype of intellectual disability, and the term intellectual disability is now preferred by many advocates in most English-speaking countries as a euphemism for mental retardation.

Mental health and emotional disabilities

A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which are not a part of normal development or culture. The recognition and understanding of mental health conditions has changed over time and across cultures, and there are still variations in the definition, assessment, and classification of mental disorders, although standard guideline criteria are widely accepted.

Developmental disability

Developmental disability is any disability that results in problems with growth and development. Although the term is often used as a synonym or euphemism for intellectual disability, the term also encompasses many congenital medical conditions that have no mental or intellectual components, for example spina bifida.

Sociology of disability

"Handicap"

Some people with disabilities do not like the term "handicap" because of a belief that it originally meant someone who could not work and went begging with their cap in hand. This, however is not the true origin of the word. It originated in a lottery game known as hand-in-cap in the 17th century which involved players placing money in a cap. It moved later into horse racing where it meant bringing the strongest competitors back to the field by giving them extra weight to carry. In golf, it became the number of strokes a player could subtract from his score to give him a chance against better players, so a bigger handicap is actually an advantage in golf. Only in 1915 did it become a term to describe disabled people, when it was used to describe crippled children.

People-first language

The American Psychological Association style guide states that, when identifying a person with an impairment, the person's name or pronoun should come first, and descriptions of the impairment/disability should be used so that the impairment is identified, but is not modifying the person. Improper examples are "a borderline", "a blind person", or "an autistic boy"; more acceptable terminology includes "a woman with Down syndrome" or "a man who has schizophrenia". It also states that a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits a person, e.g. "a woman who uses a wheelchair" rather than "a woman in/confined to a wheelchair."

A similar kind of "people-first" terminology is also used in the UK, but more often in the form "people with impairments" (e.g. "people with visual impairments"). However, in the UK, the term "disabled people" is generally preferred to "people with disabilities". It is argued under the social model that while someone's impairment (e.g. having a spinal cord injury) is an individual property, "disability" is something created by external societal factors such as a lack of wheelchair access to the workplace. This distinction between the individual property of impairment and the social property of disability is central to the social model. The term "disabled people" as a political construction is also widely used by international organisations of disabled people, such as Disabled Peoples' International (DPI).

Literature

Many books on disability and disability rights point out that "disabled" is an identity that one is not necessarily born with, as disabilities are more often acquired than congenital. Some disability rights activists use an acronym TAB, "Temporarily Able-Bodied", as a reminder that many people will develop disabilities at some point in their lives due to accidents, illness (physical, mental or emotional), or late-emerging effects of genetics.

Masculinity

According to author Daniel J. Wilson, the characteristics of masculinity include strength, activeness, speed, endurance, and courage. These characteristics are often challenged when faced with a disability and the boy or man must reshape what it means to be masculine. For example, rather than define "being a man" through what one can physically do, one must re-define it by how one faces the world with a disability and all the obstacles and stereotypes that come with the disability.

In Leonard Kriegel's book, Flying Solo, he describes his fight with poliomyelitis and the process of accepting his disability in a world that values able-bodiedness. He writes, "I had to learn to be my own hero, my own role model – which is another way of saying that I had to learn to live with neither heroes nor role models" (pg. 40).

Femininity

Some note that women who are disabled face what is called a "double disability", meaning they must not only deal with the stereotypes and challenges posed by femininity, but they must also deal with those posed by being disabled. Culture also tends to view women as fragile and weaker than men, stereotypes which are only heightened when a woman has a disability. The economic model defines disability by a person’s inability to participate in work. It also assesses the degree to which impairment affects an individual’s productivity and the economic consequences for the individual, employer and the state. Such consequences include loss of earnings for and payment for assistance by the individual; lower profit margins for the employer; and state welfare payments. This model is directly related to the charity/tragedy model. The empowering model allows for the person with a disability and his/her family to decide the course of their treatment and what services they wish to benefit from. This, in turn, turns the professional into a service provider whose role is to offer guidance and carry out the client’s decisions. This model “empowers” the individual to pursue his/her own goals.

Management

Assistive technology

Assistive Technology is a generic term for devices and modifications (for a person or within a society) that help overcome or remove a disability. The first recorded example of the use of a prosthesis dates to at least 1800 BC. The wheelchair dates from the 17th century. The curb cut is a related structural innovation. Other examples are standing frames, text telephones, accessible keyboards, large print, Braille, & speech recognition computer software. People with disabilities often develop personal or community adaptations, such as strategies to suppress tics in public (for example in Tourette's syndrome), or sign language in deaf communities. Assistive technology or interventions are sometimes controversial or rejected, for example in the controversy over cochlear implants for children.

As the personal computer has become more ubiquitous, various organizations have formed to develop software and hardware to make computers more accessible for people with disabilities. Some software and hardware, such as Voice Finger, SmartboxAT's The Grid, Freedom Scientific's JAWS, the Free and Open Source alternative Orca etc. have been specifically designed for people with disabilities while other software and hardware, such as Nuance's Dragon NaturallySpeaking, were not developed specifically for people with disabilities, but can be used to increase accessibility. The LOMAK keyboard was designed in New Zealand specifically for persons with disabilities. The Internet is also used by disability activists and charities to network and further their goals. Organizations, such as AbilityNet and U Can Do IT in the US, provide assessment services that determine which assistive technologies will best assist an individual client. These organizations also train disabled people in how to use computer-based assistive technology.

Adapted sports

match between South Africa and Iran at the 2008 Summer Paralympics]] The Paralympic Games (meaning "alongside the Olympics") are held after the (Summer and Winter) Olympics. The Paralympic Games include athletes with a wide range of physical disabilities. In member countries organizations exist to organize competition in the Paralympic sports on levels ranging from recreational to elite (for example, BlazeSports America in the United States).

The Paralympics developed from a rehabilitation programme for British war veterans with spinal injuries. In 1948, Sir Ludwig Guttman, a neurologist working with World War II veterans with spinal injuries at Stoke Mandeville Hospital in Aylesbury in the UK, began using sport as part of the rehabilitation programmes of his patients.

In 2006, the Extremity Games was formed for people with physical disabilities, specifically limb loss or limb difference, to be able to compete in extreme sports. A manufacturer of prosthetics, College Park Industries, organized the event to give disabled athletes a venue to compete in this increasingly popular sports genre also referred to as action sports. This annual event, held in the summer in Orlando, Florida, includes competitions in skateboarding, wakeboarding, rock climbing, mountain biking, surfing, motocross and kayaking. Non-profit organizations have created programs to advance adaptive sports for regular recreation and sport opportunities.

Discrimination, government policies, and support

United Nations

On December 13, 2006, the United Nations formally agreed on the Convention on the Rights of Persons with Disabilities, the first human rights treaty of the 21st century, to protect and enhance the rights and opportunities of the world's estimated 650 million disabled people. As of December 2010, 96 of the 147 signatories had ratified the Convention. Countries that sign the convention are required to adopt national laws, and remove old ones, so that persons with disabilities will, for example, have equal rights to education, employment, and cultural life; to the right to own and inherit property; to not be discriminated against in marriage, etc.; to not be unwilling subjects in medical experiments.

In 1976, the United Nations launched its International Year for Disabled Persons (1981), later re-named the International Year of Disabled Persons. The UN Decade of Disabled Persons (1983–1993) featured a World Programme of Action Concerning Disabled Persons. In 1979, Frank Bowe was the only person with a disability representing any country in the planning of IYDP-1981. Today, many countries have named representatives who are themselves individuals with disabilities. The decade was closed in an address before the General Assembly by Robert Davila. Both Bowe and Davila are deaf. In 1984, UNESCO accepted sign language for use in education of deaf children and youth.

Costa Rica

Under the Ley de Igualdad de Oportunidades (Law of Equal Opportunities), no person can be discriminated by their disabilities if they are equally capable as another person. This law also promotes that public places and transport should have facilities that enable people with disabilities to access them.

May 28 is the Día Nacional de la Persona con Discapacidad (National Disabled People Day) to promote respect for this population.

Currently the political party Partido de Acceso Sin Exclusión (Access Without Exclusion Party) fights for the rights of disabled persons, and one congressman, Oscar López, is blind.

United Kingdom

Under the Disability Discrimination Act (DDA) (1995, extended in 2005), it is unlawful for organisations to discriminate (treat a disabled person less favourably, for reasons related to the person's disability, without justification) in employment; access to goods, facilities, services; managing, buying or renting land or property; education. Businesses must make "reasonable adjustments" to their policies or practices, or physical aspects of their premises, to avoid indirect discrimination.

A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance.

Employment

The Employers' Forum on Disability (EFD) is a membership organisation of UK businesses. Following the introduction of the DDA the membership of EFD recognised the need for a tool with which they could measure their performance on disability year on year.

In 2005 80 organisations took part in the Disability Standard benchmark providing the first statistics highlighting the UK's performance as a nation of employers.

Following the success of the first benchmark Disability Standard 2007 saw the introduction of the Chief Executives' Diamond Awards for outstanding performance and 116 organisations taking the opportunity to compare trends across a large group of UK employers and monitor the progress they had made on disability.

2009 will see the third benchmark, Disability Standard 2009. EFD have promised that for the first time they will publish a list of the top ten performers who will be honoured at an award ceremony in December 2009.

United States

Discrimination in employment

The US Rehabilitation Act of 1973 requires all organizations that receive government funding to provide accessibility programs and services. A more recent law, the Americans with Disabilities Act of 1990 (ADA), which came into effect in 1992, prohibits private employers, state and local governments, employment agencies and labor unions from discriminating against qualified individuals with disabilities in job application procedures, hiring, firing, advancement, compensation, job training, or in the terms, conditions and privileges of employment. This includes organizations like retail businesses, movie theaters, and restaurants. They must make "reasonable accommodation" to people with different needs. Protection is extended to anyone with (A) a physical or mental impairment that substantially limits one or more of the major life activities of an individual, (B) a record of such an impairment, or (C) being regarded as having such an impairment. The second and third criteria are seen as ensuring protection from unjust discrimination based on a perception of risk, just because someone has a record of impairment or appears to have a disability or illness (e.g. features which may be erroneously taken as signs of an illness).

African Americans and disability

According to the 2000 U.S. Census, the African American community has the highest rate of disability at 20.8 percent, slightly higher than the overall disability rate of 19.4%.

Social Security Administration

The US Social Security Administration defines disability in terms of inability to perform substantial gainful activity (SGA), by which it means “work paying minimum wage or better”. The agency pairs SGA with a "listing" of medical conditions that qualify individuals for benefits.

Education

Under the Individuals with Disabilities Education Act, special educational support is limited to children and youth falling into one of a dozen disability categories (e.g., specific learning disability) and adds that, to be eligible, students may require both special education (modified instruction) and related services (supports such as speech and language pathology).

Insurance

It is illegal for California insurers to refuse to provide car insurance to properly licensed drivers solely because they have a disability. It is also illegal for them to refuse to provide car insurance "on the basis that the owner of the motor vehicle to be insured is blind," but they are allowed to exclude coverage for injuries and damages incurred while a blind unlicensed owner is actually operating the vehicle (the law is apparently structured to allow blind people to buy and insure cars which their friends, family, and caretakers can drive for them).

Demographics

Difficulties in measuring

The demography of disability is difficult. Counting persons with disabilities is challenging. That is because disability is not just a status condition, entirely contained within the individual. Rather, it is an interaction between medical status (say, having low vision or being blind) and the environment.

Estimates worldwide

Estimates of worldwide and country-wide numbers of individuals with disabilities are problematic. The varying approaches taken to defining disability notwithstanding, demographers agree that the world population of individuals with disabilities is very large. For example, in 2004, the World Health Organization estimated a world population of 6.5 billion people, of those nearly 100 million people were estimated to be moderately or severely disabled. In the United States, Americans with disabilities constitute the third-largest minority (after persons of Hispanic origin and African Americans); all three of those minority groups number in the 30-some millions in America.

There is also widespread agreement among experts in the field that disability is more common in developing than in developed nations.

Nearly eight million men in Europe returned from the World War I permanently disabled by injury or disease.

About 150,000 Vietnam veterans came home wounded, and at least 21,000 were permanently disabled. The number of disabled U.S. veterans has jumped by 25% since 2001 — to 2.9 million.

After years of war in Afghanistan, there are more than one million disabled people. This is one of the highest percentages anywhere in the world. An estimated 80,000 Afghans have lost limbs, mainly as a result of landmines.

Political issues

Political rights, social inclusion and citizenship have come to the fore in developed and some developing countries. The debate has moved beyond a concern about the perceived cost of maintaining dependent people with disabilities to an effort of finding effective ways to ensure that people with disabilities can participate in and contribute to society in all spheres of life.

Many are concerned, however, that the greatest need is in developing nations—where the vast bulk of the estimated 650 million people with disabilities reside. A great deal of work is needed to address concerns ranging from accessibility and education to self-empowerment and self-supporting employment and beyond.

In the past few years, disability rights activists have also focused on obtaining full citizenship for the disabled.

However obstacles reside in some countries in getting full employment, also public perception of disabled people may vary in areas.

Disability rights movement

The disability rights movement, led by individuals with disabilities, began in the 1970s. This self-advocacy is often seen as largely responsible for the shift toward independent living and accessibility. The term "Independent Living" was taken from 1959 California legislation which enabled people who had acquired a disability due to polio to leave hospital wards and move back into the community with the help of cash benefits for the purchase of personal assistance with the activities of daily living.

With its origins in the U.S. civil rights and consumer movements of the late 1960s, the movement and its philosophy have since spread to other continents influencing self-perception, organization and social policy.

Disability insurance

Disability benefit, or disability pension, is a major kind of disability insurance, and is provided by government agencies to people who are temporarily or permanently unable to work due to a disability. In the U.S., disability benefit is provided within the category of Supplemental Security Income, and in Canada, within the Canada Pension Plan. In other countries, disability benefit may be provided under Social security systems.

Costs of disability pensions are steadily growing in Western countries, mainly European and the United States. It was reported that in the UK, expenditure on disability pensions accounted for 0.9% of Gross Domestic Product (GDP) in 1980, but two decades later had reached 2.6% of GDP. Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension.

A study by researchers in Denmark suggests that information on self-reported days of absence due to sickness can be used to effectively identify future potential groups for disability pension. These studies may provide useful information for policy makers, case managing authorities, employers, and physicians.

Private, for-profit disability insurance plays a role in providing incomes to disabled people, but the nationalized programs are the safety net that catch most claimants.

See also

Adaptive recreation

Developmental disability

Disability discrimination act

Disability etiquette

Disability rights movement

Disability studies

Disabled robotics

Ergonomy

Human variability

Invisible disability

Learning disability

List of disability rights organizations

List of physically disabled politicians

Convention on the Rights of Persons with Disabilities

Orthopedics

(traveling exhibition)

Passing

Psychophobia

Sexuality and disability

Special education

Ugly law

References

Further reading

Frank Bowe, Handicapping America: Barriers to disabled people, Harper & Row, 1978 ISBN 0-06-010422-8

Burch, Susan, “(Extraordinary) Bodies of Knowledge: Recent Scholarship in American Disability History,” OAH Magazine of History, 23 (July 2009), 29–34.

DePoy, E., & Gilson, S.F. (2004). Rethinking disability: Principles for professional and social change. Pacific Grove, CA: Wadsworth. ISBN 978-0-534-54929-9

Encyclopedia of disability, general ed. Gary L. Albrecht, Thousand Oaks, Calif. [u.a.], SAGE Publications, 2005

Glenn, Eddie. March 20, 1997. "African American Women with Disabilities: An Overview."

David Johnstone, An Introduction to Disability Studies, 2001, 2nd edition, ISBN 1-85346-726-X

Kaushik, R., 1999, "Access Denied: Can we overcome disabling attitudes," Museum International (UNESCO) , Vol. 51, No. 3, p. 48–52.

Lansing, Michael J., “‘Salvaging the Man Power of America’: Conservation, Manhood, and Disabled Veterans during World War I,” Environmental History, 14 (Jan. 2009), 32–57.

Longmore, Paul, “Making Disability an Essential Part of American History,” OAH Magazine of History, 23 (July 2009), 11–15.

Oliver, Michael. The Politics of Disablement, St. Martin's Press 1997, ISBN 0-333-43293-2

Nikora, L.; Karapu, R.; Hickey, H.; & Awekotuku, N., Researchgateway.ac.nz , Disabled Maori and Disability Support Options, 2004. Retrieved on April 19, 2009.

Charlotte Pearson (2006) Direct Payments and Personalisation of Care, Edinburgh, Dunedin Academic Press, ISBN 1-903765-62-5

Tom Shakespeare, Genetic Politics: from Eugenics to Genome, with Anne Kerr, New Clarion Press, 1999, ISBN 1-873797-25-7

Carmelo Masala, Donatella Rita Petretto, 2008, From disablement to enablement: conceptual models of disability in the 20th century, Disability and Rehabilitation, vol. 30(17), 1233-1244.

Carmelo Masala, Donatella Rita Petretto, 2008, Psicologia dell'Handicap e della Riabilitazione,Kappa, Rome .

External links

Category:Disability Category:Educational psychology Category:Population