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Disability

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This article is about the concept of disability. For the poem by Wilfred Owen, see Disabled (poem).
Look up disability in Wiktionary, the free dictionary.
International Symbol of Accessibility

A disability is any condition that interferes with someone's ability to perform everyday tasks. The term is often used to refer to individual functioning, including physical impairment, sensory impairment, cognitive impairment, or mental disorder. This usage is associated with a medical model of disability. By contrast, a human rights or social model focuses on ability as an interaction between a person and their environment, highlighting the role of a society in labelling, causing or maintaining disability within that society, including through attitudes or accessibility favoring the majority.

Common usage refers to 'a person with a disability' or a person who is 'disabled' or, more controversially, who is 'handicapped'. Some prefer to only refer to specific 'disabilities' rather than to a generalised sense of 'disability'.


Definitions and Models

The International Classification of Functioning, Disability and Health (ICF), produced by the World Health Organization, distinguishes between body functions (physiological or psychological, e.g. vision) and body structures (anatomical parts, e.g. the eye and related structures). Impairment in bodily structure or function is defined as involving an anomaly, defect, loss or other significant deviation from certain generally accepted population standards, which may fluctuate over time. Activity is defined as the execution of a task or action. The ICF lists 9 broad domains of functioning which can be affected:

  • Learning and applying knowledge
  • General tasks and demands
  • Communication
  • Mobility
  • Self-care
  • Domestic life
  • Interpersonal interactions and relationships
  • Major life areas
  • Community, social and civic life.

(see also List of disabilities)

The introduction to the ICF states that a variety of conceptual models has been proposed to understand and explain disability and functioning, which it seeks to integrate:

The medical model

"The medical model views disability as a problem of the person, directly caused by disease, trauma or other health condition, which requires medical care provided in the form of individual treatment by professionals. Management of the disability is aimed at cure or the individual’s adjustment and behaviour change. Medical care is viewed as the main issue, and at the political level the principal response is that of modifying or reforming health care policy.

The social model

The social model of disability, on the other hand, sees the issue mainly as a socially created problem, and basically as a matter of the full integration of individuals into society. Disability is not an attribute of an individual, but rather a complex collection of conditions, many of which are created by the social environment. Hence the management of the problem requires social action, and it is the collective responsibility of society at large to make the environmental modifications necessary for the full participation of people with disabilities in all areas of social life. The issue is therefore an attitudinal or ideological one requiring social change, which at the political level becomes a question of Human rights. For this model disability is a political issue.” (p.20)

The person should come first

The American Psychological Association style guide states that in professional writing following this style, the person should come first, and nominal forms describing the disability should be used so that the disability is being described, but is not modifying the person. For instance: people with Down syndrome, a man with schizophrenia, and a girl with paraplegia. (This applies only to English and possibly other prepositional languages, not postpositional languages.) 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 "in" it or "confined" to it.

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.

The late Prime Minister Olof Palme of Sweden, speaking at the Stanford University Law School in the 1970's, summed up the difference between U.S and Swedish attitudes toward disabilities:

  • Americans regarded the able-bodied and the disabled as two separate species.
  • Swedes regard them as humans in different life stages: all babies are helpless, cared for by parents; sick people are cared by those who are well; elderly people are cared by those younger and healthier. Healthy, young people are able to help those who need it, because they know their turn will come.

Palme maintained that if it cost the country $US 40,000 per year to enable a disabled person to work at a job that paid $40,000, the society gained a net benefit, because the society benefited by allowing this worker to participate cooperatively rather than being a drain on other people's energies.

Moral model

On the other hand, a "moral model" (Bowe, 1978) refers to the attitude that people are somehow morally responsible for their disability, including at one extreme as a result of bad actions of parents if congenital or as a result of practicing witchcraft. This attitude can be seen as unjust and causes unnecessary suffering.

Activism and Movements

Various groups work to improve conditions for people with disabilities.

The 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.[1] Countries that sign up to the convention will be required to adopt national laws, and remove old ones, so that persons with disabilities would, for example, have equal rights to education, employment, and cultural life; the right to own and inherit property; not be discriminated against in marriage, children, etc; 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.

The 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 that 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 US civil rights and consumer movements of the late 1960s, the movement and its philosophy have since spread to other continents influencing people's self-perception, their ways of organizing themselves and their countries' social policy.

Adapted sports

Sports adapted for people with disabilities developed from the 1950s. The Paralympic Games (meaning 'alongside the Olympics') are now held after the (Summer and Winter) Olympics

Current issues

Current issues and debates surrounding 'disability' include social and political rights, social inclusion and citizenship. In developed countries the debate has moved beyond a concern about the perceived cost of maintaining dependent people with a disability to the struggle to find effective ways of ensuring people with a disability 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 persons with disabilities reside. A great deal of work -- from basic physical accessibility through education to self-empowerment and self-supporting employment -- is needed.

Government policies and support

United Kingdom

Under the Disability Discrimination Act (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.[1]

A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance[2].

United States

Discrimination in employment

The US Rehabilitation Act of 1973 requires all organizations that receive government funding to provide accessiblity programs and services. A more recent law, the 1990 Americans with Disabilities Act (ADA), which came in to effect in 1992, prohibits private employers, state and local governments and 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 critiera 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).

Social 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 in to one of a dozen disability categories (e.g., specific learning disability) and adds that, to be eligible, students must require both special education (modified instruction) and related services (supports such as speech and language pathology).

Demographics

Difficulties in measuring

The demography of disability is difficult. Counting persons with disabilities is far more challenging than is counting males, say, or 16-to-24 year-olds. 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. The World Health Organization, for example, estimates that there are as many as 600 million persons with disabilities. The United Nations estimate is 650 million. In the United States, for example, 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. According to the U.S. Bureau of the Census, as of 2004, there were some 32 million adults (aged 18 or over) in the United States, plus another 5 million children and youth (under age 18). If one were to add impairments -- or limitations that fall short of being disabilities -- Census estimates put the figure at 51 million.

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

Adaptations

Assistive Technology (AT) 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.[2] A more recent notable example is the wheelchair, dating from the 17th Century. The curb cut is a related structural innovation. Other modern examples are text telephones, accessible keyboards, large print, Braille, & speech recognition Computer software. Individuals 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. A number of symbols are in use to indicate whether certain accessibility adaptations have been made[3].

Accessible computing

As the personal computer has become more ubiquitous, various organisations have been founded which develop software and hardware which make a computer more accessible for people with disabilities. Some software and hardware, such as SmartboxAT's The Grid and Freedom Scientific's JAWS has been specifically designed for people with disabilities; other pieces of software and hardware, such as Nuance's Dragon NaturallySpeaking, was not developed specifically for people with disabilities, but can be used to increase accessibility.

Further organisations, such as AbilityNet and U Can Do IT, have been established to provide assessment services which determine which assistive technologies would best assist an individual client, and also to train people with disabilities in how to use computer-based assistive technology.

Famous people with disabilities

Some famous individuals widely recognized as having a disability include:

See also

Wikiquote has quotations related to Disability.

Footnotes

  1. ^ ENABLE website UN section on disability
  2. ^ Disability Social History Project

References

  • Frank Bowe, Handicapping America:Barriers to disabled people, Harper & Row, 1978 ISBN 0-06-010422-8
  • Encyclopedia of disability, general ed. Gary L. Albrecht, Thousand Oaks, Calif. [u.a.] : SAGE Publ., 2005
  • David Johnstone, An Introduction to Disability Studies, 2001, 2nd edition, ISBN 1-85346-726-X
  • Michael Oliver, The Politics of Disablement, St. Martin's Press 1997, ISBN 0-333-43293-2
  • Tom Shakespeare, Genetic Politics: from Eugenics to Genome, with Anne Kerr , New Clarion Press, 1999, ISBN 1-873797-25-7
  • Kaushik, R.,1999, " Access Denied: Can we overcome disabling attitudes ," Museum International (UNESCO) , Vol. 51, No. 3, p. 48-52.
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