What Is Disability, and How Do You Define It?

Disabilities are categorized into four groups:

• physical disabilities,
• developmental disabilities,
• sensory disabilities, and
• psychiatric disabilities.

"Disability" is a very broad concept with no well-accepted, standardized definition. What happens is that disability is defined based on the purpose and needs of a law, an agency, or a country. According to Scotch (2001), lawmakers have developed some disability policies for specific disabilities, such as for people who are blind or have visual impairments, or those who are Deaf or hard of hearing. Other policies have broadly defined disability to include “a nearly infinite variety of impairments and etiologies” (Scotch, 2001, p. 385).     

Part of what makes disability difficult to define is that it can be highly complex with a variety of bodily functions affected, including:

• vision,
• mobility,
• cognition,
• learning and memory,
• communication,
• hearing, and
• mental health.

Disability ranges in severity, with two people with the same condition affected very differently. For example, missing one of your fingers as a result of an accident may be catastrophic if you were a musician, but perhaps not as devastating if you worked as a teacher. Additionally, people can cope and adjust very differently to disability. A person who has a solid family support system and stable home life may respond differently than a person without these benefits. The environment must also be considered, such as a person’s living or work environment, availability and use of accommodations, access to services and types of services, local and national policies, and physical and societal barriers. Finally, the complexity and multiple variables involved create for significant issues in the ability to accurately measure disability, and therefore to develop a standardized definition.

Examples of two different definitions of disability include those from the Social Security Administration and the Americans with Disabilities Act.

The Social Security Administration (SSA) is a U.S. federal agency that may pay disability benefits to people if they have a long-term medical condition. To qualify for benefits, the SSA has a strict view of disability, with focus on one’s ability to work. A person is considered disabled if

1. the person cannot do the work one did before,
2.  the SSA decides that a person cannot work due to health, even with accommodations, and
3. the disability has lasted or is expected to last for at least 1 year or to result in death.

The Americans with Disabilities Act (ADA) is the civil rights legislation in the United States for people with disabilities. The ADA defines disability as the following:

A person who has a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such impairment, or a person who is perceived by others as having such impairment.

However, neither of these definitions provide a full picture of what, exactly, disability is. These definitions do not include the specific health condition and severity; personal factors, such as the individual appraisal process and coping strategies, attitudes, values, beliefs, emotional regulations, behaviors, temperaments, and self-images; and social factors, including level and type of support, community, and societal attitudes. Nor do they include the environment, including physical barriers, socioeconomic status, health insurance, availability and access to care, and service provisions. Such factors can add complex layers to the functioning and needs of the individual. Furthermore, the SSA and ADA definitions do not include specific illnesses and impairments. While such exclusions can be helpful for people living with a wide variety of disabilities, they also leave much confusion for society to sort out what health conditions and impairments exactly constitute disabilities and how to best serve a people. They leave some health conditions and impairments to be decided upon through court precedent as to whether or not they qualify as a disability, such as post-traumatic stress disorder (PTSD), for example.

Disability policy researchers have criticized the limited definitions of disability that have been provided, stating that these limited definitions often create for a dichotomous, or black and white, view of disability. For example, Scotch (2001) criticizes disability policy’s focus in terms of a person’s ability to work, such as the SSA’s strict definition of disability. Monahan and Wolf (2014) have criticized policy makers for poor attention to the needs of vulnerable populations, such as those with disabilities, including the lack of programming that focuses on quality of life and overemphasizes institutional care, stating “disability can be said to occupy the margins of social policy” (p. 1).

The World Health Organization (WHO) also recognizes the complexity of disability and has pushed for the move away from limited definitions. The International Classification of Functioning, Disability and Health (ICF), developed by WHO in 2001, provides a richer understanding of disability compared to others. The goal of ICF (2001) is to “assess the health, functioning, activities, and factors in the environment that either help or create barriers for people to fully participate in society” (p. 24).

Disability itself is seen as an umbrella term with a focus on three dimensions:

• Impairment in a person’s body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision, or memory loss.
• Activity limitation, such as difficulty seeing, hearing, walking, or problem-solving.
• Participation restrictions in regular daily activities, such as working, engaging in social and recreational activities, and obtaining health care and preventive services.

The ICF includes the following in the categories of activities and participation:

• learning and applying knowledge;
• managing tasks and demands;
• mobility (moving and maintaining body positions, handling and moving objects, moving around in the environment, moving around using transportation);
• managing self-care tasks;
• managing domestic life;
• establishing and managing interpersonal relationships and interactions;
• engaging in major life areas (education, employment, managing money or finances); and
• engaging in community, social, and civic life.

As well as understanding society's attitudes towards disability, the ICF recognizes the complexity and intertwining of variables, such as environment, level and types of support, availability and use of assistive technology, availability and accessibility of services, and policy.

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References

Scotch, R. (2001). American disability policy in the twentieth century. In P. K. Longmore, & L. Umansky, (2001). In The new disability history: American perspectives. (375–392). NYU Press: New York, NY.

The World Health Organization. (2011). World report on disability. Retrieved from https://www.who.int/disabilities/world_report/2011/report/en/