A Quick Note On: Disability vs Impairment

In the past couple of months, I’ve spent a lot of time reviewing curriculum and reading some research papers/essays that some people trying to be decent allies have done.  A lot of them do an okay job on some things, and a less great job on others. But the most common issue seems to be conflating “disability” and “impairment” in a way that reflects a relatively un-nuanced understanding of the larger disability rights movement.

The most basic definition of the Social Model is along the lines of a person is disabled not by their impairment, but by their environment. Sadly, many people fail to look at this and see more than “society alone is to blame for disability.” I see people who say that social model isn’t realistic, based on this misconception, for individuals with extensive support needs.

This fails to take into account the possible corollary that within an appropriate context, a person’s impairment would be irrelevant to their abilities. Here’s an illustration of that, and a very standard one:

Imagine a wheelchair user named Mary. Mary’s condition includes impairments in being able to support herself due to muscle weakness, so she needs to use a chair to get around. Mary goes into a general world, and there she finds that people who she shares interests with meet in a space that is up stairs without an elevator, and that the coffee shop that said it was accessible actually has a stoop too high to wheel over. But if Mary goes into Accessible Town, elevators are in the buildings and the buildings were built/modded in a way that doesn’t involve stoops, and where the halls and doors are wide enough for her electric chair.

Mary didn’t magically stop having her impairment. Instead, her environment no longer interfered with her ability to participate fully in the community of Accessible Town. Unfortunately, people look at the stories of hypothetical people like Mary and go on to claim that that is all well and good for people with physical impairments, but that those with intellectual, developmental, or psychological impairments. This is inaccurate.

Bob is non-speaking, and uses alternative communication. In general world, people become impatient or dismissive because they do not want to deal with alternative communication. (This is similar to someone who doesn’t speak the typical language in a country they are visiting, unfortunately.) Bob goes to Accessible Town to meet his friend Sue, who is Deaf. People wait for his responses, don’t try to speak for him without his permission, and ask for help understanding when they do not. Bob’s other impairments might preclude him being able to learn much of the sign language his friend Sue uses to communicate, but her interpreter is great at making sure both of them can understand each other, even though they are speaking different languages and styles.

Bob is still non-speaking and still has intellectual impairments. But he is able to not only be actively involved in this community, but to communicate and hopefully have a good time with people with different access needs entirely. In this particular context, his impairments are not disabling him from this sort of participation. He has the support, both technically and emotionally, to be a full participant.

Some people see this as just a fantasy. The standard that they hold up as “too disabled” shifts to higher and higher support needs each time we try to explain how that hypothetical person could be supported. At some point, it has become a game, which is why my examples of the hypothetical Accessible Town will end. The truth is that what access looks like will vary by person. It isn’t an easy thing at all, especially in our current world, to create environments or communities that balance people’s access needs. This seems especially true when the most needed aspect of that process is patience and trust.

Note, if you will, that a condition that may be referred to as a disability might have traits that are not impairments in and of themselves. While stimming can be a coping response to an impairment, perhaps with self regulation or sensory hyper awareness, it is not necessarily so. In some cases it is simply used as an expression of emotion- atypical, sure, but not an impairment. The only disabling factor when it comes to stimming, barring those which involve self harm, is that other people are jerks about it and project prejudices and bigotry about how people are supposed to look. Essentially, it is simply other people’s assumptions, not the behavior interacting with the environment, that creates barriers. Yet it is one of the traits by which Autistics are diagnosed.

The next thing is something that I don’t know how to introduce properly. I see a lot of people approach the idea of Neurodiversity as though it is some new big thing completely different from other disability things. The truth is that it simply is applying the larger disability rights movement to the experiences of people with certain impairments, often defined as Autistics.* It is not some great new thing that we came up with via spontaneous generation, without previous foundations. It was built on the work of many people who live with a wide range of disabilities.

When we talk about both needing disability supports and treating our impairments as differences, we are not being disingenuous. We are not “talking both ways.” And it is not about denying legitimate supports. It is an incredibly nuanced issue, but one that can be summed up in a phrase that isn’t terribly new or specific to Autistics, and is in fact used on materials put out by the Administration on Intellectual and Developmental Disabilities (AIDD):

“Disability is a natural part of the Human Experience.”

This is the core idea here. Disability is one of many natural variances in what the human experience is like. It is not inherently shameful,  “freakish,” or unnatural. It does not rob us of our humanity– that is instead done by the perceptions of people. It is part of the amazing and beautiful diversity of our amazing species, Homo sapiens sapiens. It is a part of who we are and how we are put together.

This diversity can be powerful whether you are a religious creationist (indeed, there are hymns about this), an Atheist who believes in an unmitigated evolution, or any combination thereof. On a personal level, I believe in theistic evolution, and the vast diversity which allows for the survival of the species is something amazing and beautiful and spiritual for me. But I believe that the fact that we are so amazingly diverse, that we live in such a diverse world and are such a diverse species, is something that can be beautiful and powerful regardless of your beliefs. (Reminder: this is not a post about evolution or religion. These are tangential issues.)

When we talk about Autism or any other condition as a difference, we are not inherently denying that people with those conditions face disability. We are talking about how our conditions, and the impairments that might come along with them**, are a natural difference in the species. That those differences, like any number of others, should not bar access, dignity, or respect. That our differences are not things that should be eliminated, but that we should work towards a society in which difference is not a bar to access, be that because of changing attitudes or changing our physical environments.

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Talking about these distinctions isn’t something new. Please consider checking out some of the links below in which a number of other writers have covered similar issues.

That Crazy Crippled Chick: A Musing on the Word “Disabled”
Radical Neurodivergence Speaking: In this place, in this activity, I am not disabled.
Yes, That Too: Ableism is to BlameA Social Construct
Autistic Hoya: Has an entire tag dedicated to this issue

Additionally, there’s a nice bullet-ed definition of the social model on the KASA website.

____

* I personally consider Neurodiversity an issue that covers a wide range of individuals whose brains don’t exactly fit the “typical” brains or ways of working.
** Some people do not follow this, but they are a small subgroup who are often not aligned with the principles of the movement.

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11 thoughts on “A Quick Note On: Disability vs Impairment

  1. Great post. I will add it to my disability links for my comp course; we look at disability and read a variety of texts relating to disabilities. We were just discussing impairment and disability today, in fact. 🙂

  2. My feeling is that for people exploring these models, there’s a mental line they draw on the accommodations of society. Things taxes pay for, or that are mandated by government, such as wheelchair accessibility and hearing loops and forms in braille are accepted as what a society should do for its disabled citizens.

    However, once you start talking about adjustments that people have to make themselves to their own daily interactions and attitudes to accommodate the neurodiverse (among others), it becomes a step too far and for many falls outside the social model of disability. Because no one should have to change themselves to accommodate disability, it is up to the disabled person to make 100% of the effort to fit in.

    I think it can be summed up in the general attitude that it’s not acceptable to dislike someone because they are paraplegic and to be with them you have to make sure everywhere is wheelchair accessible, but it is normal to dislike autistics because their communication disability is ‘annoying’.

    • Perhaps. However, people with physical supports still get barriers with attitude. I’ve talked with many PwD with various needs, and just because the physical supports for things are in the ADA doesn’t mean that all places follow them or that they are immune from additional barriers.

      (Please keep in mind people: this post is about the social model. It is not about social vs medical. There are lots of places online for that conversation. This post instead addresses mis-representations of the social model. )

      • At no point was I saying that because things are mandated that they actually happen; my point was that society is much more likely to agree that these are sensible and necessary supports, as opposed to asking them to do something that personally inconveniences them (imagine if there was a compulsory requirement to learn ESL/ASL in all gov’t jobs that interact with the public) or tells them that they do not have a legitimate reason to be rude to someone just because their communication is affected by a disability (as happens to autistics on a daily, if not hourly, basis).

        To me there is no difference – society can, by adapting, ameliorate the individuals difficulties, though it may not be able to do so to a degree that they become irrelevant. Impairment usually remains to some degree, but this is a separate issue and not one I was attempting to address.

    • Some businesses etc. do ignore the ADA when it comes to wheelchair access also, eg when a building is massively renovated then the newly implemented changes need to be accessible (eg, if you’re already ripping out an entire doorway, then the new one needs to be wide enough and so forth), but sometimes this regulation is ignored even when brought to the attention of the responsible parties–they don’t care. And the newly renovated section of the building goes up with accessibility barriers in place.

      The ADA protects my right to sign interpreters in many sorts of situations, but although this does happen in some situations this is completely ignored in many others even when I explain their legal responsibilities to them (e.g. I am told that it is not “their policy” to provide sign interpreters even after I explain to them that, um, actually, their policy therefore violates federal legislation)

      Businesses not only need to make buildings accessible but also the lay out of their store needs to be accessible as well–for instance, temporary store displays are not supposed to block wheelchair access. Yet there are many stores that completely ignore this policy. Then it gets brought to their attention, then maybe they fix it for a while, then revert right back to the way it was before until they are asked again to fix it, rinse and repeat ad nauseum. That or they eventually get fed up with being reminded and start to get hostile about it and stop trying to fix it. (Okay there are some businesses that are much nicer than this, but not all of them).

      Although there are SOME members of society who more or less accept that certain types of accommodations need to be made and think this should be a “given”, there are still many others who don’t.

      Although I do agree that people are more likely to recognize and accommodate the need for more FAMILIAR accessibility accommodations (like wheelchair access, or sign interpreters for deaf people), it still frustrates me when people seem to assume that our accessibility needs are now all magically met just because the law says it’s supposed to happen or just because these are more familiar than the accommodations needed by disability groups who are newer at advocating for their needs as an organized community (the autistic community being much younger than many of the other disability communities).

      Speaking as a deaf person who sometimes needs other people to change their behaviors too (for example to pick up a pen and paper when lip reading simply isn’t working and a sign interpreter isn’t available), I agree there are a lot of people who really only are comfortable with disability accommodations if someone else has already arranged for them to be in place and don’t want to have to change their own usual patterns of behaviors.

      • Thank you Andrea, this is exactly what I was trying to get at in my response.

        Also: Though I spend a lot of time on this blog talking about my brain disabilities (I’m Autistic, as well as having some discrete Learning “disorders” and Mental Health Conditions,) I personally also have disabilities that are physical and Chronic. I have Hypermobility to the extent that the biggest reason I lack an Ehler’s-Danlos Syndrome dx is I lack sufficient skin symptoms, joint damage from that going unaddressed for most of my life, Fibromaylgia, cataplexy, and assorted GI issues. Particularly but not exclusively when I use my cane, I have people– even people well versed in broader disability– assume less of my abilities, and do not offer the same opportunities for involvement. On days when I don’t have my cane because of lower pain (I’m in PT 2xs a week, and am supposed to go to the gym a minimum of 2xs a week, for my hypermobility and pain) people assume that I must not really need access to the supports I need to negotiate physically with or without my cane. If I have a cataplexic episode, those episodes are treated as clumsiness or deliberately dropping things or falling over.

  3. I believe that everyone has, or will have, at least one disability during their lifetime. That’s just the way life is. Some people start out in life with one, as I did, being born with Spina Bifida, others get them in childhood, adulthood, or in their senior years, I define myself as disabled, I always hated the word, ‘handicapped’! I was referred as that while growing up, and resented that word immensely! Right now, the main obstacle I face, is transportation, I mean, reliable, weekly transportation. Sadly, I cannot seem to find this in my area. I use a wheelchair, and need wheel-chair lift accessible van service. I can get to a doctor’s appointment, or hospital, but that is the extent of it. I am on Social Security, Maryland state Medicaid and Medicare. I have worked as a temporary office clerk off and on for years, but now I have no transportation to even go shopping. It’s disheartening, to put it mildly.

  4. Pingback: Disability and Society’s Role | Emma's Hope Book

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