Understanding Disability: Types, Classification, and Global Impact

Disability:

This term defines the impact of impairments on an individual’s life rather than focusing on the causes of the impairments themselves.

Impairment:

Any loss or abnormality of psychological, physiological, or anatomical structure.

Disability:

A restriction or lack of ability (resulting from an impairment) to perform an activity in a manner or within the range considered normal for a human being.

Handicap:

A disadvantage for a given individual, resulting from an impairment or disability, that limits or prevents the fulfillment of a role that is normal for that individual, considering their age, sex, and social and cultural factors.

Technical Aids and Disability:

The ICIDH framework illustrated the potential consequences of diseases on individuals: Disease – Impairment – Disability – Handicap.

This framework outlines the definitions generated by CIDMM to guide health and social action, focusing on:

  • Deficiency (prevention)
  • Disability (rehabilitation)
  • Disability (integration and equal participation)

Evolution of Classification:

In 2001, the World Health Organization (WHO) approved a new International Classification of Functioning, Disability (ICF), also known as ICIDH-2. This classification introduced new definitions for disability and handicap.

ICF Key Concepts:

Challenges:

Problems in body function or structure, such as a significant deviation or loss.

Limitations on Activity:

Difficulties an individual may experience in performing activities.

Restrictions on Participation:

Problems an individual may encounter in involvement in life situations.

Disability as a Global Problem:

Physical impairment has existed throughout human history, with archaeological evidence dating back to the Neanderthal era. However, societal responses to disability have varied greatly.

In the 19th century, theories like social Darwinism emerged, suggesting that in societies with limited resources, weaker individuals (including those with disabilities) were more likely to be marginalized.

While some argue that negative perceptions of disability are linked to capitalism, it’s important to note that even in pre-capitalist societies, like ancient Greece, where physical perfection was highly valued, disability was often stigmatized.

Understanding Different Types of Disability:

The International Classification of Disability provides a framework for understanding how different societies address disability. To better understand this complex issue, it’s crucial to examine the various types of disabilities:

Historical Context:

The need for standardized criteria for defining and classifying disabilities led to the development of the first International Classification of Impairments, Disabilities, and Handicaps (ICIDH-1) by the WHO in 1980. This classification aimed to move beyond a purely medical model and consider the social and environmental factors impacting individuals with disabilities.

ICIDH-1 Disability Categories:

  • Neuromotor: Any damage or injury to the brain or spinal cord, causing difficulty with speech, movement, or sensation.
  • Visual: Total or partial loss of sight, making it difficult to perform activities that rely on vision. This can be congenital or acquired.
  • Hearing: Total or partial loss of hearing, which can be congenital or acquired due to illness or injury.
  • Intellectual: Brain damage affecting intelligence, leading to difficulties in learning and development across various environments.

Shifting Perspectives with ICF (2001):

The ICF introduced significant changes in how disability is conceptualized:

Part 1: Functioning and Disability

This part focuses on two components:

  • Body structure and function, including changes in physiological functions and anatomical structures.
  • Activities and Participation, encompassing an individual’s capacity to perform tasks and their actual performance in real-life situations.

Part 2: Contextual Factors

This part emphasizes the importance of environmental and personal factors:

  • Environmental Factors: External influences, such as physical, social, and attitudinal environments, that can act as facilitators or barriers.
  • Personal Factors: Internal influences, such as an individual’s personal attributes, that can impact their functioning and experience of disability.

Key Definitions in ICF:

  • Functioning: Encompasses bodily functions, structures, activities, and participation. It highlights the positive aspects of interaction between an individual’s health condition and contextual factors.
  • Disability: Includes impairments, activity limitations, and participation restrictions. It acknowledges the negative aspects of the interaction between an individual’s health condition and contextual factors.
  • Activity: The execution of a task or action by an individual.
  • Participation: Involvement in life situations.
  • Contextual Factors: All aspects of the external world that form the context of an individual’s life and influence their functioning.

The ICF represents a significant shift towards a more holistic and nuanced understanding of disability, recognizing the interplay of individual and environmental factors.