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Link: http://en.wikipedia.org/wiki/Disability
The World Health Organization defines Disability as follows: "Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. 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.'"[1]
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 intellectual impairments. Mental disorders (also known as psychiatric or psychosocial disability) and various types of chronic disease may also be considered qualifying disabilities.
A disability may occur during a person's lifetime or may be present from birth. A physical impairment is any disability which limits the physical function of limbs or fine or gross motor ability.
Contents [hide]
1 Current issues
2 Disability rights movement
3 Definitions and models
3.1 The medical model
3.2 The social model
3.3 Other models
4 Terminology
4.1 Handicap
4.2 People First Language
4.3 Literature
4.3.1 Masculinity
4.3.2 Femininity
5 Government policies and support
5.1 United Nations
5.2 Costa Rica
5.3 United Kingdom
5.3.1 Employment
5.4 United States
5.4.1 Discrimination in employment
5.4.2 African Americans and disability
5.4.3 Social administration
5.4.4 Education
5.4.5 Insurance
6 Demographics
6.1 Difficulties in measuring
6.2 Estimates worldwide
7 Disability insurance—nationalized and private
8 Adaptations
8.1 Assistive technology
8.2 Adapted sports
8.3 Accessible computing
9 See also
10 Notes
11 References
12 Further reading
13 External links
[edit] 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 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.
[edit] 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.
[edit] 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 mental disorders)
In concert with disability scholars, 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. These models include the following:
[edit] The medical model
Main article: Medical model of disability
The medical model is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition which therefore requires sustained medical care provided in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at a "cure," or the individual’s adjustment and behavioral change that would lead to an "almost-cure" or effective cure. In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming healthcare policy.
[edit] The social model
Main article: Social model of disability
The social model of disability sees the issue of "disability" as a socially created problem and a matter of the full integration of individuals into society (see Inclusion (disability rights)). In this model, 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 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 both cultural and ideological, requiring individual, community, and large-scale social change. From this perspective, equal access for someone with an impairment/disability is a human rights issue of major concern.
[edit] Other models
The spectrum model refers to the range of visibility, audibility and sensibility under which mankind functions. The model asserts that disability does not necessarily mean reduced spectrum of operations.
The moral model (Bowe, 1978) refers to the attitude that people are morally responsible for their own disability. For example, the disability may be seen as a result of bad actions of parents if congenital, or as a result of practicing witchcraft if not. This attitude may also be viewed as a religious fundamentalist offshoot of the original animal roots of human beings when humans killed any baby that could not survive on its own in the wild.
The expert/professional model has provided a traditional response to disability issues and can be seen as an offshoot of the medical model. Within its framework, professionals follow a process of identifying the impairment and its limitations (using the medical model), and taking the necessary action to improve the position of the disabled person. This has tended to produce a system in which an authoritarian, over-active service provider prescribes and acts for a passive client.
The tragedy/charity model depicts disabled people as victims of circumstance who are deserving of pity. This, along with the medical model, are the models most used by non-disabled people to define and explain disability.
The legitimacy model views disability as a value-based determination about which explanations for the atypical are legitimate for membership in the disability category. This viewpoint allows for multiple explanations and models to be considered as purposive and viable (DePoy & Gilson, 2004) (Elizabeth DePoy & Stephen Gilson).
The social adapted model states although a person’s disability poses some limitations in an able-bodied society, often times the surrounding society and environment are more limiting than the disability itself.[2]
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 economic model is used primarily by policy makers to assess distribution of benefits to those who are unable to participate fully in work. In recent years, however, the preoccupation with productivity has conflicted with the application of the medical model to classify disability to counter fraudulent benefit claims, leading to confusion and a lack of co-ordination in disablement policy.
The challenge facing the economic model is how to justify and support, in purely economic terms, a socially desirable policy of increasing participation in employment. Classical economic laws of supply and demand stipulate that an increase in the labor market results in decreased wages. Arguably, extending access to work through equal opportunities reduces an employer’s labor costs, but other factors come into play.
The value of labor is based upon its contribution to marginal cost, i.e. the cost of producing the last unit of production. This only works when employees make an equal contribution to marginal cost. However, evidence suggests that disabled employees make a lower contribution than their work colleagues do, resulting in losses in production and lower profits for the employer.
Employers may recognize compensations for any loss in employing less-productive disabled employees through kudos, publicity, customer alignment and expansion arising from their presentations as an organization with community values. However, employers are not generally altruistic and hold the economic viability and operational effectiveness of their organization as higher priorities than demonstrating social awareness. Their economic option is to pay disabled employees less or have the losses met through subsidy.
The problem for the users of economic model is one of choice. Which is better: to pay the disabled employee for loss of earnings, or the employer for loss of productivity? The first carries stigma for the disabled person by underlining their inability to match the performance of work colleagues. With the latter, difficulties arise in correctly assessing the correct level of subsidy. The productivity of a disabled employee may well change, as well as the marginal costs of the total workforce.
This leaves one outstanding difficulty for the socially minded economist. How do we achieve an equitable, effective, value-for-money distribution of disability related benefits? It is likely that there will be people with disabilities that prevent them from working. There will be others whose productivity levels are so low that the tax benefits to the public purse are outweighed by the employment subsidy. In economic terms, these people are unemployable and should be removed from employment to supplementary benefits, saving the expenditure on the subsidy. But is this socially acceptable? This apparent conflict has created ambiguity in agreeing on social security goals and has led to stigmatization of disabled people as a burden on public funds rather than partners in the creation of general social prosperity.
Social security benefits are not designed to remove disabled people from poverty. The policy maker needs to balance equity (the right of the individual to self-fulfillment and social participation through work) and efficiency. The true value of the economic model is maintaining this balance in the macroeconomic context of trade cycles, inflation, globalization and extraordinary events such as wars.[3]
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. In other words, this model “empowers” the individual to pursue his/her own goals.[2]
The market model of disability is minority rights and consumerist model of disability that recognizing people with disabilities and their Stakeholders as representing a large group of consumers, employees and voters. This model looks to personal identity to define disability and empowers people to chart their own destiny in everyday life, with a particular focus on economic empowerment. By this model, based on US Census data, there are 1.2 billion people in the world who consider themselves to have a disability. An additional two billion people are considered Stakeholders in disability (family/friends/employers), and when combined to the number of people without disabilities, represents 53% of the population. This model states that, due to the size of the demographic, companies and governments will serve the desires, pushed by demand as the message becomes prevalent in the cultural mainstream.[4]
[edit] Terminology
[edit] 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, appears to not be the true origin of the word. It originated in a lottery game known as Hand In Cap in the 1600s 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 the disabled, when it was used to describe crippled children.[5]
[edit] 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 their workplace.[6] 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).
Many people with autism spectrum disorders do not like people first language, because they feel that autism is a part of their personality. In their opinion, to call someone a "person with an autism spectrum disorder" implies that the ASD is somehow separate from the core of the person, or is a transitory or curable condition. [2]
[edit] 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.
[edit] Masculinity
According 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.[7]
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).[8]
[edit] 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 the woman has a disability.[7]
According to the "Survey of Income and Program Participation," as described in the book Gendering Disability," 74 percent of women participants and 90 percent of men participants without disabilities were employed. In comparison, of those with a form of disability, 41 percent of women and 51 percent of men were employed. Furthermore, the nondisabled women participants were paid approximately $4.00 less per hour than the nondisabled men participants. With a disability, women were paid approximately $1.00 less than the nondisabled women participants and the men were paid approximately $2.00 less than the nondisabled men participants. As these results suggest, women without disabilities face societal hardships against men, but then add disability to the equation and the hardships increase.[7]
[edit] Government policies and support
[edit] 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.[9] 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.
[edit] Costa Rica
Under the Ley de Igualdad de Oportunidades (Law of Equal Oportunities), 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 these 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, who is blind.
[edit] 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.[3]
A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance [4].
[edit] 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.[10]
[edit] United States
[edit] 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 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).
[edit] 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,[11] slightly higher than the overall disability rate of 19.4%.[11] Although people have come to better understand and accept different types of disability, there still remains a stigma attached to the disabled community. African Americans with a disability are subject to not only this stigma but also to the additional forces of race discrimination. African American women who have a disability face tremendous discrimination due to their condition, race, and gender. Doctor Eddie Glenn of Howard University describes this situation as the "triple jeopardy" syndrome.[12]
[edit] 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.
[edit] 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).
[edit] Insurance
It is illegal for California insurers to refuse to provide car insurance to properly licensed drivers solely because they have a disability.[13] 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).[14]
[edit] Demographics
[edit] 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.[citation needed]
[edit] 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.[15] 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.[15] According to the U.S. Bureau of the Census, as of 2004, there were some 32 million disabled 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.[16]
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.[17] The number of disabled U.S. veterans has jumped by 25% since 2001 — to 2.9 million.[18]
After years of war in Afghanistan, there are more than one million disabled people.[19] This is one of the highest percentages anywhere in the world.[20] An estimated 80,000 Afghans have lost limbs, mainly as a result of landmines.[21]
[edit] Disability insurance—nationalized and private
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.[22][23] Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension.[24]
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. [5] 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.
[edit] Adaptations
[edit] Assistive technology
A hand-operated device allows normal driving for persons with leg disabilities in an automatic car.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.[25]
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 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.
A number of symbols are in use to indicate whether certain accessibility adaptations have been made[6].
[edit] Adapted sports
Main article: Disabled sports
Wheelchair basketball at the 2008 Summer ParalympicsThe Paralympic Games (meaning 'alongside the Olympics') are now held after the (Summer and Winter) Olympics. The Paralympic Games include athletes who have a wide range of disabilities. In many 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).
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. The College Park Industries, a manufacturer of prosthetic feet, organized this 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, FL includes competitions in skateboarding, wakeboarding, rock climbing, mountain biking, surfing, moto-x and kayaking. Non-profit organizations have created programs to advance adaptive sports for regular recreation and sport opportunities.
[edit] Accessible computing
This section requires expansion.
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 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, were not developed specifically for people with disabilities, but can be used to increase accessibility.
Furthermore, organizations, such as AbilityNet and U Can Do IT, provide assessment services that determine which assistive technologies will best assist an individual client. These organizations also train people with disabilities in how to use computer-based assistive technology.
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.
The World Health Organization defines Disability as follows: "Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. 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.'"[1]
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 intellectual impairments. Mental disorders (also known as psychiatric or psychosocial disability) and various types of chronic disease may also be considered qualifying disabilities.
A disability may occur during a person's lifetime or may be present from birth. A physical impairment is any disability which limits the physical function of limbs or fine or gross motor ability.
Contents [hide]
1 Current issues
2 Disability rights movement
3 Definitions and models
3.1 The medical model
3.2 The social model
3.3 Other models
4 Terminology
4.1 Handicap
4.2 People First Language
4.3 Literature
4.3.1 Masculinity
4.3.2 Femininity
5 Government policies and support
5.1 United Nations
5.2 Costa Rica
5.3 United Kingdom
5.3.1 Employment
5.4 United States
5.4.1 Discrimination in employment
5.4.2 African Americans and disability
5.4.3 Social administration
5.4.4 Education
5.4.5 Insurance
6 Demographics
6.1 Difficulties in measuring
6.2 Estimates worldwide
7 Disability insurance—nationalized and private
8 Adaptations
8.1 Assistive technology
8.2 Adapted sports
8.3 Accessible computing
9 See also
10 Notes
11 References
12 Further reading
13 External links
[edit] 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 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.
[edit] 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.
[edit] 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 mental disorders)
In concert with disability scholars, 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. These models include the following:
[edit] The medical model
Main article: Medical model of disability
The medical model is presented as viewing disability as a problem of the person, directly caused by disease, trauma, or other health condition which therefore requires sustained medical care provided in the form of individual treatment by professionals. In the medical model, management of the disability is aimed at a "cure," or the individual’s adjustment and behavioral change that would lead to an "almost-cure" or effective cure. In the medical model, medical care is viewed as the main issue, and at the political level, the principal response is that of modifying or reforming healthcare policy.
[edit] The social model
Main article: Social model of disability
The social model of disability sees the issue of "disability" as a socially created problem and a matter of the full integration of individuals into society (see Inclusion (disability rights)). In this model, 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 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 both cultural and ideological, requiring individual, community, and large-scale social change. From this perspective, equal access for someone with an impairment/disability is a human rights issue of major concern.
[edit] Other models
The spectrum model refers to the range of visibility, audibility and sensibility under which mankind functions. The model asserts that disability does not necessarily mean reduced spectrum of operations.
The moral model (Bowe, 1978) refers to the attitude that people are morally responsible for their own disability. For example, the disability may be seen as a result of bad actions of parents if congenital, or as a result of practicing witchcraft if not. This attitude may also be viewed as a religious fundamentalist offshoot of the original animal roots of human beings when humans killed any baby that could not survive on its own in the wild.
The expert/professional model has provided a traditional response to disability issues and can be seen as an offshoot of the medical model. Within its framework, professionals follow a process of identifying the impairment and its limitations (using the medical model), and taking the necessary action to improve the position of the disabled person. This has tended to produce a system in which an authoritarian, over-active service provider prescribes and acts for a passive client.
The tragedy/charity model depicts disabled people as victims of circumstance who are deserving of pity. This, along with the medical model, are the models most used by non-disabled people to define and explain disability.
The legitimacy model views disability as a value-based determination about which explanations for the atypical are legitimate for membership in the disability category. This viewpoint allows for multiple explanations and models to be considered as purposive and viable (DePoy & Gilson, 2004) (Elizabeth DePoy & Stephen Gilson).
The social adapted model states although a person’s disability poses some limitations in an able-bodied society, often times the surrounding society and environment are more limiting than the disability itself.[2]
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 economic model is used primarily by policy makers to assess distribution of benefits to those who are unable to participate fully in work. In recent years, however, the preoccupation with productivity has conflicted with the application of the medical model to classify disability to counter fraudulent benefit claims, leading to confusion and a lack of co-ordination in disablement policy.
The challenge facing the economic model is how to justify and support, in purely economic terms, a socially desirable policy of increasing participation in employment. Classical economic laws of supply and demand stipulate that an increase in the labor market results in decreased wages. Arguably, extending access to work through equal opportunities reduces an employer’s labor costs, but other factors come into play.
The value of labor is based upon its contribution to marginal cost, i.e. the cost of producing the last unit of production. This only works when employees make an equal contribution to marginal cost. However, evidence suggests that disabled employees make a lower contribution than their work colleagues do, resulting in losses in production and lower profits for the employer.
Employers may recognize compensations for any loss in employing less-productive disabled employees through kudos, publicity, customer alignment and expansion arising from their presentations as an organization with community values. However, employers are not generally altruistic and hold the economic viability and operational effectiveness of their organization as higher priorities than demonstrating social awareness. Their economic option is to pay disabled employees less or have the losses met through subsidy.
The problem for the users of economic model is one of choice. Which is better: to pay the disabled employee for loss of earnings, or the employer for loss of productivity? The first carries stigma for the disabled person by underlining their inability to match the performance of work colleagues. With the latter, difficulties arise in correctly assessing the correct level of subsidy. The productivity of a disabled employee may well change, as well as the marginal costs of the total workforce.
This leaves one outstanding difficulty for the socially minded economist. How do we achieve an equitable, effective, value-for-money distribution of disability related benefits? It is likely that there will be people with disabilities that prevent them from working. There will be others whose productivity levels are so low that the tax benefits to the public purse are outweighed by the employment subsidy. In economic terms, these people are unemployable and should be removed from employment to supplementary benefits, saving the expenditure on the subsidy. But is this socially acceptable? This apparent conflict has created ambiguity in agreeing on social security goals and has led to stigmatization of disabled people as a burden on public funds rather than partners in the creation of general social prosperity.
Social security benefits are not designed to remove disabled people from poverty. The policy maker needs to balance equity (the right of the individual to self-fulfillment and social participation through work) and efficiency. The true value of the economic model is maintaining this balance in the macroeconomic context of trade cycles, inflation, globalization and extraordinary events such as wars.[3]
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. In other words, this model “empowers” the individual to pursue his/her own goals.[2]
The market model of disability is minority rights and consumerist model of disability that recognizing people with disabilities and their Stakeholders as representing a large group of consumers, employees and voters. This model looks to personal identity to define disability and empowers people to chart their own destiny in everyday life, with a particular focus on economic empowerment. By this model, based on US Census data, there are 1.2 billion people in the world who consider themselves to have a disability. An additional two billion people are considered Stakeholders in disability (family/friends/employers), and when combined to the number of people without disabilities, represents 53% of the population. This model states that, due to the size of the demographic, companies and governments will serve the desires, pushed by demand as the message becomes prevalent in the cultural mainstream.[4]
[edit] Terminology
[edit] 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, appears to not be the true origin of the word. It originated in a lottery game known as Hand In Cap in the 1600s 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 the disabled, when it was used to describe crippled children.[5]
[edit] 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 their workplace.[6] 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).
Many people with autism spectrum disorders do not like people first language, because they feel that autism is a part of their personality. In their opinion, to call someone a "person with an autism spectrum disorder" implies that the ASD is somehow separate from the core of the person, or is a transitory or curable condition. [2]
[edit] 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.
[edit] Masculinity
According 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.[7]
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).[8]
[edit] 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 the woman has a disability.[7]
According to the "Survey of Income and Program Participation," as described in the book Gendering Disability," 74 percent of women participants and 90 percent of men participants without disabilities were employed. In comparison, of those with a form of disability, 41 percent of women and 51 percent of men were employed. Furthermore, the nondisabled women participants were paid approximately $4.00 less per hour than the nondisabled men participants. With a disability, women were paid approximately $1.00 less than the nondisabled women participants and the men were paid approximately $2.00 less than the nondisabled men participants. As these results suggest, women without disabilities face societal hardships against men, but then add disability to the equation and the hardships increase.[7]
[edit] Government policies and support
[edit] 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.[9] 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.
[edit] Costa Rica
Under the Ley de Igualdad de Oportunidades (Law of Equal Oportunities), 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 these 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, who is blind.
[edit] 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.[3]
A number of financial and care support services are available, including Incapacity Benefit and Disability Living Allowance [4].
[edit] 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.[10]
[edit] United States
[edit] 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 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).
[edit] 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,[11] slightly higher than the overall disability rate of 19.4%.[11] Although people have come to better understand and accept different types of disability, there still remains a stigma attached to the disabled community. African Americans with a disability are subject to not only this stigma but also to the additional forces of race discrimination. African American women who have a disability face tremendous discrimination due to their condition, race, and gender. Doctor Eddie Glenn of Howard University describes this situation as the "triple jeopardy" syndrome.[12]
[edit] 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.
[edit] 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).
[edit] Insurance
It is illegal for California insurers to refuse to provide car insurance to properly licensed drivers solely because they have a disability.[13] 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).[14]
[edit] Demographics
[edit] 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.[citation needed]
[edit] 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.[15] 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.[15] According to the U.S. Bureau of the Census, as of 2004, there were some 32 million disabled 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.[16]
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.[17] The number of disabled U.S. veterans has jumped by 25% since 2001 — to 2.9 million.[18]
After years of war in Afghanistan, there are more than one million disabled people.[19] This is one of the highest percentages anywhere in the world.[20] An estimated 80,000 Afghans have lost limbs, mainly as a result of landmines.[21]
[edit] Disability insurance—nationalized and private
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.[22][23] Several studies have reported a link between increased absence from work due to sickness and elevated risk of future disability pension.[24]
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. [5] 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.
[edit] Adaptations
[edit] Assistive technology
A hand-operated device allows normal driving for persons with leg disabilities in an automatic car.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.[25]
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 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.
A number of symbols are in use to indicate whether certain accessibility adaptations have been made[6].
[edit] Adapted sports
Main article: Disabled sports
Wheelchair basketball at the 2008 Summer ParalympicsThe Paralympic Games (meaning 'alongside the Olympics') are now held after the (Summer and Winter) Olympics. The Paralympic Games include athletes who have a wide range of disabilities. In many 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).
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. The College Park Industries, a manufacturer of prosthetic feet, organized this 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, FL includes competitions in skateboarding, wakeboarding, rock climbing, mountain biking, surfing, moto-x and kayaking. Non-profit organizations have created programs to advance adaptive sports for regular recreation and sport opportunities.
[edit] Accessible computing
This section requires expansion.
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 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, were not developed specifically for people with disabilities, but can be used to increase accessibility.
Furthermore, organizations, such as AbilityNet and U Can Do IT, provide assessment services that determine which assistive technologies will best assist an individual client. These organizations also train people with disabilities in how to use computer-based assistive technology.
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.
