Impairment, Disability, and Handicap
One of the email lists I'm on recently had an interesting discussion
of the terms "Impairment", "Disability", and
"Handicap" as they relate to hearing loss. As you might
imagine, people had a wide variety of views regarding these terms, how
they apply to hearing loss, and especially how they apply to
individuals.
I think part of the contention regarding this issue is due to
misunderstanding the terms. People tend to use terms like disability,
handicap, and impairment synonymously, but they really refer to quite
different concepts. Here are the definitions of these terms, according
to the World Health Organization:
Impairment: Any loss or abnormality of psychological, physiological,
or anatomical structure or function.
Disability: Any restriction or lack (resulting from an impairment) of
ability to perform an activity in the 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, depending on age, sex, social and cultural factors,
for that individual.
So, do these descriptions apply to people with hearing loss?
It looks like "impairment does". Hearing loss is certainly
a loss of function.
According to this definition, the term "disability" also
applies to hearing loss, because it is a lack of ability to hear within
the normal range.
"Handicap" isn't so black and white. Whether or not a
hearing loss is a handicap depends upon a person's circumstance. I think
this is the point Culturally Deaf people are trying to make when they
insist that deafness is not a handicap. If a person is in an environment
in which hearing is not important, then lack of hearing is not a
handicap. I question whether that environment exists in America today,
but people who exist pretty much exclusively within the Deaf World may
come pretty close.
But, for the vast majority of people with hearing loss (who, after
all, are "hearing people" who can't hear), I think hearing
loss is a handicap, as well as an impairment and a disability.
So what do you all think? I'd love to publish some of your responses.
Email your thoughts to lsivertson@juno.com.
Reader Responses
Last week we published an article that defined the words
'impairment', 'disability', and 'handicap'. We asked for your thoughts
on these terms and their relationship to hearing loss, and you guys came
through like gangbusters. (I knew you would <grin>). I'm thrilled
to share some of your comments with all our readers.
BTW, names and email addresses - or lack thereof - are at the
discretion of the individuals. If you would like to reply to a person
whose email address is not provided, please contact me, and I will
forward your message or email address to that person. As you might
imagine, I'm very concerned with maintaining confidentiality when
requested.
Dianne W. mentioned some of the difficulties that had resulted from
her hearing loss, then pointed out an important distinction between the
Culturally Deaf and people who lose their hearing later. A person who
was born deaf "accepted his handicap from birth and learned how to
deal with it. I rejected the idea that I was 'handicapped', but I
am."
Dianne went on to explain that, "People do not view me as
handicapped and have even laughed and said 'Oh, you hear what you want
to hear', etc. They just cannot believe I am handicapped."
Dianne is now learning sign language and feels extremely comfortable
with her Culturally Deaf friends. She observed, "I feel my Deaf
friends have been braver than I at handling a more profound disability
and I admire them greatly. I might also add I have found a new level of
comfort with them, and I have never with them been ashamed of or
embarrassed by my lack of hearing."
Diane Edge (another article about her appears elsewhere in this
issue) comments that hearing people are often interested in how much a
person with hearing loss hears, and that information "is often used
to discredit an individual's right to access goods and services."
She also believes that "there is an ongoing and silent
discrimination aimed at a deaf person that is so subtle and so demeaning
- that sets my blood to boil."
Diane further points out that it is important to respect how a person
refers to herself; but she is concerned that denying reality often
prevents people from getting available help. She sums it all up with,
"I don't see any clear cut answers, but what works for me is 'I am
deaf'".
Regular readers remember Curtis (hearmeco@infi.net) as our Assistive
Listening Device (ALD) guru. He also waxes philosophical from time to
time. Here are some of his thoughts.
"I agree with these definitions. I have an impairment (hearing
loss) that makes me disabled (can't hear normally). Therefore I am
handicapped (can't maintain the status quo in normal
communications)."
Curtis provides the following quote from Helen Keller: "Hearing
is the deepest, most humanizing philosophical sense man possesses."
He also points out that "the key word in the quote is
'humanizing'".
Jean Camberg (camberg@penn.com) provides the following food for
thought:
"All the definitions mention 'normal'. What is normal??? To me,
all the definitions are very limited. If a newly diagnosed hard of
hearing or deaf person is told, you are one of the following: disabled,
impaired, handicapped, how easy will it be for that person to think that
he/she can succeed with this problem?"
She adds that all sensory loss will require some adaptation, and that
"to be deaf in the mind is worse than deaf in the ear, and I know
hearing people who are VERY DEAF in their minds!"
Lucy points out that the word 'handicapped' has a variety of meanings
and severities, and that different people require different
accommodations in response to their individual needs. She suggests that
"young hearing people take courses in sign language so they are
able to communicate with people who use ASL". But, her primary
concern is that each person gets the accommodation they need to be able
to communicate.
Stuart Watson looked at these definitions in terms of how the person
adapts and what he can do. He stated, " I think which definition
fits best depends partly on the level of hearing loss. A profoundly deaf
person would be both handicapped and disabled but a person with a mild
hearing loss correctable with ITE aids say would be considered impaired
at most. Dependency on open/closed captioning would also help determine
which term fits best.
Stuart continues with the observation, "The adaptation [to the
loss] of the person with hearing loss ... would also be a factor. Those
not admitting to any hearing loss wouldn't call themselves even
impaired. An assertive person would probably admit to only being
impaired. Ability to find and keep meaningful employment should also be
considered."
Peggy contends that there is no need to limit ourselves to those
three definitions, and is concerned that they all have negative
connotations. She says, "I like sometimes to use 'differently abled'.
Sometimes we need to use pluses...and it can be a real eye opener for
non-differently abled people to hear! I agree there is a need to make
our situation known but I also feel that negative labels can be a real
downer and that's why people resist them so fiercely."
So there you have it - lots of insightful and thought-provoking
comments. It's obvious that our readers have diverse and interesting
opinions. Thanks to all of you who shared your thoughts. I'm sure our
other readers enjoyed hearing from you.
