What is Considered to be a Disability?

The following paper outlines some of the more common disability definitions in use today. There are legal definitions from governmental agencies such as the Americans with Disability Act (ADA)  and medically oriented definitions such as those put out by the Center for Disease Control (CDC). A great overview of disability definitions is provided by Disabled World.

What is Considered to be a Disability?

Robin N. Akins, Ph.D.

Disability Researchers

October 7, 2019

 

 

 

 

People with disabilities form one of the more special groups in our society. This is based mostly on the challenges that these people face on a daily basis. As a result, society makes deliberate efforts to ensure that persons living with disability are protected from any form of discrimination resulting from their disability. However, there is a major challenge in defining exactly what constitutes a disability. There is no universal definition of disability and this usually locks out some of the people from the protection and special attention afforded to individuals living with disability. The broad nature of disabilities also makes it difficult to define these conditions under one universally accepted definition. The following paper thereby aims to provide an informed analysis of what is considered to be a disability based on the definitions of some of the bodies tasked with roles related to disability as well as from a medical perspective. The aim is to ensure that as comprehensive a disability definition is provided by the end of the analysis with a proper understanding of some of the conditions recognized as a disability.

The United States Equal Employment Opportunity Commission (EEOC)

The United States Equal Employment Opportunity Commission (EEOC) is one of the bodies in the country dealing with disability cases. The EEOC is a federal agency established in 1965 and that is charged with administering and enforcing civil rights laws against discrimination in the workplace. One of the areas that the body deals with is disability discrimination. Cases of persons being discriminated against in the workplace due to disabilities are quite common and the body ensures that any persons who suffer such are well represented and the responsible agency held to account. It is thereby critical to look at how the EEOC defines disability in their books.

The EEOC states that not everyone with a medical condition qualifies as being disabled and thereby gets protected by the law. In order to be protected by this law, one must be qualified for the applied job and meet the definition of disability as per the law. The EEOC thereby defines a person with a disability as being in one of the following three conditions: a person is disabled if he/she has a physical or mental condition that substantially limits major life activity such as walking, talking, hearing, seeing or learning. A person is also disabled if he/she has a history of a disability such as cancer in remission. A person may also be disabled if they are believed to have a physical or mental impairment that is not transitory (lasting six months or less) and minor (even if he does not have such impairment). 

The first definition by EEOC covers the most basic form of disability and the one that most people think of whenever the term disability/disabled is mentioned. It states that a person is disabled if he/she has a physical or mental disability that substantially limits major life activities such as walking, hearing, seeing, talking or learning. A person is thereby considered to be disabled if they cannot see, walk, hear or talk. These four groups form the most basic forms of disability and ones that are universally recognized. A blind, deaf, dumb or crippled person will be recognized as disabled by almost every individual regardless of where they have any legal or medical training. In relation to learning, however, the definition is not as straightforward. There are certain conditions that substantially limit a person’s ability to learn which are recognized as a disability. It is thereby necessary to look deeper at what constitutes learning disabilities and how they are defined either by law or by relevant organizations.

Learning Disabilities Association

The Learning Disabilities Association of America (LDA) defines learning disabilities as neurologically based learning problems that can interfere with learning basic skills such as reading, writing and/or math. The LDA states that these disabilities may also affect an individual’s higher-level skills such as time planning, organization, abstract reasoning, attention and long- or short-term memory. The LDA thereby explains that these learning disabilities affect an individual beyond academics and may impact their relationships with friends, family and at the workplace. The LDA explains that the term learning disabilities is an umbrella term used to describe different specific learning disabilities such as dyslexia, dyscalculia, dysgraphia and APD among others.

Auditory Processing Disorder

This is one of the specific learning conditions listed by the LDA as a learning disability. According to Jerger and Musiek (2000), APD is broadly defined as a deficit in the processing of information specific to the auditory modality. The critical word in the definition is “specific”, considering there can be many reasons for which one has difficulties in the processing of information. Hall (2014) also hails the concept of specificity as there can be several reasons causing a patient to have problems with background sounds or ineffective communication. These include tension problems, emotional problems, cognitive deficits or an auditory nervous system problem (Hall, 2014). This indicates that APD can only be diagnosed by qualified medical personnel. It is not enough then for one to declare themselves as possessing a learning disability specifically APD simply because they have trouble communicating or processing information. The auditory modality has to be the main reason causing the individual to experience these deficits in order for the person to be recognized as having ADP.

According to Moore (2018) though, there are major difficulties in the diagnosis of ADP mainly due to the assumption that the deficit in processing of information is attributed to the central auditory nervous system (CANS). According to Moore (2018), listening involves three main elements namely the ear, the central auditory nervous system and the cortical systems beyond the auditory cortex. Moore states that whereas it is quite easy to diagnose a person with a hearing loss problem, it is much more difficult to diagnose an individual with a hearing difficulty and no hearing loss. Moore thereby calls for better diagnosis procedures in dealing with the condition. This is because some deserving people are not recognized as possessing a learning disability despite being as affected as the recognized group.

Dyscalculia

The LDA defines dyscalculia as a specific learning disability affecting a person’s ability to understand numbers and learn math facts. People suffering from the condition may have poor comprehension of math symbols, struggle with memorizing and organizing numbers and may also have difficulties counting and telling time. According to Butterworth (2003), number sense is similar to being color blind, the lack of which makes it hard to differentiate quantities. Persons with number blindness thereby have difficulties connecting the numbers to the real world. This makes it difficult for them to understand basic math facts and numbers hence have difficulty learning.

Other specific learning disabilities recognized by the LDA include dyslexia, language processing disorder, nonverbal learning disabilities and visual motor deficit. Dyslexia affects language-based processing skills and reading with the severity of the condition differing among individuals. Persons with dyslexia may have difficulties in reading fluency, reading comprehension, decoding, recalling, spelling, and writing and sometimes even speech difficulties. Dysgraphia on the other hand is related to difficulties in handwriting ability and fine motor skills. Persons with this condition usually have problems in spacing, illegible handwriting, poor spelling, poor spatial planning and difficulty composing writing.

The Washington Group on Disability Statistics

The Washington Group on Disability Statistics that serves under the United Nations Statistical Commission provides internationally comparable disability statistics. The Washington Group (WG) was founded in 2001 and some of the reasons behind its formation include the need for common definitions, concepts, methodologies and standards in the production of statistics on disability. As a result, it is important to analyze the definition of disability provided by the group as this is usually used in the formulation of disability statistics around the world. The WG defines disability as an umbrella term referring to problems such as impairment, activity limitation, or participation restrictions that indicate negative aspects of functioning. According to the WG then, anything that limits, impairs or restricts participation in certain functions qualifies as a disability. However, the WG notes that all such cases can be referred to as disability and thereby provides criteria that it uses in the production of statistics surrounding disability. In order to be as brief, simple and comparable as possible, the WG thereby focuses on limitations in domains of basic activity functioning and which are considered universal, often lead to social exclusion and that occur frequently. The WG thereby aims to represent the majority but not all persons with limitation in basic activity functioning, represent most commonly occurring limitations and capture people with similar problems across different countries. Some of the areas that the definition thereby looks to cover are thereby employment, education and family life and how individual participation in these areas is affected by certain limitations. Any basic limitation that thereby affects an individual’s ability to gain an education, employment or lead a family life and is consistent across countries as well as commonly occurring is thereby covered by the WG.

The United Nations Convention of the Rights of Persons with Disabilities (CPRD)

The United Nations Convention on the Rights of Persons with Disabilities (CPRD) describes persons with disabilities as including those who may have long term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with other persons. Some of the key words to note from this definition are “long term” “equal” and “full and effective participation.” The CPRD thereby notes that for a person to be considered disabled, the impairment should be long term. Short term impairments which although might as hindering or even more as those termed as disabilities are thereby not considered. Classifying a long-term condition may be relative in some states or countries but the idea behind the definition makes lots of sense. The term “full and effective participation” is also critical to the definition as some disabilities may not be as straight forward to recognize as others. A person born with one shorter leg, for example, may not be seen as adversely affected as a person without one leg or limb. The truth though is that the person with one shorter leg is impaired in his/her interactions and the full and effective participation in some activities can thereby not be achieved. The person’s impairment can also not be naturally corrected as there is no way the shorter leg will ever grow naturally to the length of the other leg unless some sort of operation is conducted. Even then, the person will be limited in performing certain activities such as carrying heavy objects. The CPRD thus aims to protect even such individuals whose disabilities may not appear as obvious to the wider society from any sort of discrimination and afford them protection under the UN.

Social Security

Disabled people are usually eligible for assistance from the government through the social security program. As a result, it is important to identify the definition of disability provided by social security as it is one of the most impactful on people’s lives. One can derive the wider definition from the child disability definition under social security. A child is considered disabled if the child’s physical or mental impairment is so severe that it leads to marked and severe functional limitations. Since social security is involved in paying benefits to deserving individuals, the definition is considerably stricter than that of other agencies. Social security, for example, places emphasis on the severity of the impairment such that it should not be a simple impairment but one that is considered detrimental to an individual’s functioning. Social security is also more exact in terms of its definition of long-term impairments. It states that the impairment must last or expected to last for a period of at least 12 months or lead to an individual’s death. Social security rules also consider one disabled if the impairment prevents one from doing work they did before, if they decide that an individual cannot adjust to other work as a result of the impairment or if the disability has lasted or expected to last for 12 months or result in death. This definition locks out persons with impairments that may be under 12 months or which do not necessarily lock out a person from adjusting to other work. If one, for example, used to work in a more physical field and then develop a physical impairment preventing them from working in that field, they may still not be considered as disabled under the social security definition if they can adjust to another field of work. There is of course a monetary motivation to this as the goal is to ensure that the very deserving of individuals benefit from the social security program and not just anyone who has had an impairment. Social security thereby assumes that anyone who was working and then becomes impaired for a short-term period has in place measures that allow them to survive comfortably until the impairment period ends.

The United States Census Bureau

The United States Census Bureau is a federal agency charged with collecting and producing data on the American people and the economy as well. Persons living with disability are a key part of this data as they inform factors such as budgetary allocations to agencies such as social security. The data also influences policy for the American government as well as formulating agenda in the country. People living with disabilities rely heavily on government intervention in order to participate in the community as well as those living with no disabilities (Brault, 2012). As a result, it is critical that data on persons living with disability is collected and defining what qualifies as a disability is usually the first part of the process.  According to Brault (2012), estimates on the size and characteristics of persons living with disability rely heavily on the definition of disability which usually differs from those in the medical, social or legal areas. According to Brault (2012), medical models define disability as an extension of a physiological problem requiring treatment or therapy. Federal programs on the other hand refer to disability as the impairment or limitation leading to a need for the program’s benefit such as social security. The most comprehensive definition of disability offered by Brault however falls under the International Classification of Functioning, Disability and Health (ICF) that aims to form a unified definition of disability under the different contexts. The ICF considers disability an umbrella term for activity limitations, impairments and participation restrictions. The ICF thereby views disability not as a dichotomous concept but as a gradient on which every individual performs at different levels based on personal and environmental factors (Brault, 2012). This means that it is possible for one to be considered as disabled under certain factors but not under others. The best example of this is in the concept of disability as a demographic similar to race or gender where certain individuals may not consider themselves disabled under certain parameters presented to them but then under different parameters view themselves as disabled. The same can also be said for a child who may be considered to have a learning disability in class but then upon finishing school is not considered as disabled based on the non-severity of the learning disability or the context of the agency involved. Social security would for example lock many people from the benefits program who would qualify as disabled in terms of their learning ability.

Taylor’s definition of disability in a report for the United States Census Bureau is consistent with the one provided by the ICF and indicates the body’s inclination to a certain type of definition. Taylor states that disability encompasses impairments, activity limitations and participation restrictions that may impact people in their daily lives (2018). The definition is quite broad as well but also sets a high bar in terms of what qualifies as a disability. The inclusion of the concept of impacting on an individual’s daily life means that the impairment, restriction or limitation needs to be such that it has significant impact on an individual’s ability to live an equal life. The idea is thereby to ensure that not every impairment, restriction or limitation has to qualify as a disability considering that the data collected will be used in informing government decision making and intervention. Taylor (2018) also looks at two categories of disability, namely non-severe disability and severe disability. This is based on the degree to which people experience limitations or restrictions to certain activities as a result of their condition. A person with one limb cut off, for example, will not be as severely limited in his daily life as another with both limbs missing. Both, however, still qualify as disabled and it is just the degree that differs. The data on severity is mostly used by the government to determine the number of individuals who may be fully dependent on their family members or friends as a result of their disability and those who may still be able to function effectively but with a degree of difficulty.

National Center for Health Statistics

Hendershot (2002) writing for the National Center for Health Statistics highlights some of the problems that come with defining disability. Hendershot touches on the new paradigm of disability and how this has led to emerging definitions of the same in order to subscribe to this paradigm. Hendershot (2002) states that the previous paradigm of disability viewed disability as a disease. This meant that individuals who were considered disabled had deficits that required interventions. It is no surprise then that this paradigm was characterized by lots of discrimination and stigmatization of persons living with disability. This further led to changes in the disability nomenclature. Some of the terms associated with disability have since been rendered offensive and are banned in certain countries or states. The new paradigm on disability, on the other hand, views disability as discrimination and a deficit in person-community relationships which should be addressed through social interventions. The difference in the old and new paradigms can also be seen in how each paradigm addresses disability. The old paradigm’s goal was to cure, prevent and/or ameliorate disability. Under the new paradigm, the goal is to facilitate full participation of persons with disability in the society. The new paradigm on disability has definitely improved how the society views and treats persons with disabilities. On the flipside, the new paradigm could be as a result of the society’s change in its perspective on persons living with disabilities. New buildings, for example, now need to be friendly to persons with physical impairments through the provision of both stairs and a runway on which wheelchairs can operate freely. Such provisions were not available under the old paradigm as the focus was not on facilitating such people’s full participation in the society but rather focused on the treatment of prevention of such disabilities. These changes are also reflected in the introduction of programs such as social security for disabled people. The new paradigm recognizes that these people cannot participate fully and equally in the society and thereby seeks to facilitate it through benefits or compensation.

Conclusion

One clear conclusion from an analysis of the constitution of disability is the broad manner of the term. This broadness means that one can be considered disabled in one context but also nor qualify as disabled in another context. Certain themes however emerge from the analysis that would be helpful in understanding disability and determining the statistics regarding disability in the country. One of these themes is the longevity of the impairment, limitation or physical restriction in order for it to be considered as disability. Short term limitations or impairments are usually not considered as disabilities seeing as those affected are expected to bounce back from the same. However, long term impairments, limitations and restrictions are usually considered disabilities with long term in this case referring to a period of at least 12 months. This is not the standard definition of long term available under the law in the country but the various definitions that were specific enough provide 12 months as the minimum period from which one can qualify to be categorized as disabled. This definitely has an impact on the statistics on disability in the country seeing as there are a number of people who would be considered disabled if the period was shortened to a period or maybe 3 months or 6 months. The decision be these bodies, mostly federal agencies, to set the limit at 12 months is however informed by the need to look after itself in terms of what will be expected of the government once the numbers increase. This has a lot do with the new paradigm of disability which makes it more favorable for persons living with disability compared to those with the same difficulties under the old paradigm.

Critical to the shift in paradigm has been the goal of the government or the society in general in relation to dealing with disabled individuals. Previously, the goal was to treat persons with disability as well as prevent more persons from becoming disabled with the hope that the society can one day be free of persons living with disability. This was because disability was viewed as a disease and the approach to any disease is similar to the approach to disability under the old paradigm. In the new paradigm though, the goal is to facilitate persons with disability and ensure that they can be as participatory in the society as other individuals. Under the new paradigm, disability is viewed as a socially acceptable consequence of life as opposed to being just a disease with its negative connotations. The goal is thus to end disability discrimination and the best way of doing this is by facilitating the participation of the person in our social fabric as would be the case without the impairment, limitation or physical restriction. Persons living with disability, for example, are facilitated entry to stadiums and have a section reserved for these individuals at such areas in order to facilitate their participation in these social activities as much as the next person. The goal is to improve the person-community relationship for people living with disabilities so that they are no longer discriminated against and treated as second-class citizens.

The effects of the new paradigm are visible in the treatment of persons living with disability not just in the society but also from federal agencies. Persons living with disability, for example, are eligible for social security disability benefits in order to facilitate their daily lives. These benefits are offered only to eligible individuals and it is no surprise that such agencies have a higher bar in terms of their definition of disability. This introduces another concept in the perspective of disability, namely severity and how it affects disability benefits. For persons to qualify for these benefits they need to be severely affected by the impairment, limitation or physical restriction such that they are unable to be fully effective in certain life activities. The decision by social security to consider the severity of the impairment is of course understandable considering that the result is increased dependency on the government if the bar is not sufficiently high. The statistics may thereby be quite low if they are based on agencies such as the LDA which may have a higher figure of persons living with disability based on their statistics. Social security, for example, would not consider a person affected by dyscalculia to be disabled despite the fact that the LDA considers them disabled as they are impaired by this condition to participate fully in math facts and number sense. The context is thereby critical in collecting, processing and interpreting data on disability and persons living with disabilities.

The analysis also reveals an interesting aspect on disability namely that it is a demographic such as race or gender in certain contexts. In this case, disability is defined by the degree to which a person feels affected by a certain impairment, limitation or restriction from completing daily activities. Some people may thus choose not to identify as disabled based on how they perceive themselves and their ability to complete basic and even complex tasks in their daily activities. In such cases, the statistics can be mixed based on what people perceive to be the benefits of associating with a certain disability. If there are no lucrative gains or benefits that people feel they may get from identifying as disabled, they may then opt out of doing so or if they feel that the result is discrimination.

Understanding and analyzing what is considered to be a disability can thereby be a complex and complicated endeavor depending on the context involved and the perceived benefits/losses attached to either. It is however clear that certain limitations, restrictions or impairments, whether physical or mental, are usually too marked or too severe for any individual or agency to ignore and in such cases have to be identified as disabilities. It is however encouraging to note that the government and the society at large has changed its perspective of persons living with disabilities and taken proactive measures to ensure adequate facilitation of these people. The future also looks bright for these individuals, and it is the least they deserve considering that they already have enough difficulties navigating daily life and the last thing they would need are more barriers.

 

 

 

 

 

References

Brault, M. (2012, January 18). Americans With Disabilities: 2010. Retrieved from https://www.census.gov/topics/health/disability.html

Butterworth, B. (2003). Dyscalculia Screener. Rep. London: NferNelson. Dyscalculie.com. Web. https://www.mathematicalbrain.com/dysclink.html.
Hall, J. W. (2014, June 9). Auditory Processing Disorders: An Overview of Current Research James W. Hall III. Retrieved from https://www.audiologyonline.com/articles/auditory-processing-disorders-overview-current-12703.

Hendershot, G. (2002). Integrating Comparable Measures of Disability in Federal Surveys: The National Center for Health Statistics. Department of Health and Human Services. retrieved from https://www.cdc.gov/nchs/data/series/sr_04/sr04_032.pdf

Jerger, J., & Musiek, F. (2000). Report of the consensus conference on the diagnosis of auditory processing disorders in school-aged children. Journal of the American Academy of Audiology, 11(9), 467-474.

Moore, D. R. (2018). Challenges in Diagnosing Auditory Processing Disorder. The Hearing Journal, 71(10), 32. doi: 10.1097/01.hj.0000547404.44337.7d

Taylor, D. (2018, November 28). Americans with Disabilities: 2014. Retrieved from https://www.census.gov/topics/health/disability.html

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

What is the Most Common Disability Definition?