Impairment, Disability, and Handicap

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.