Understanding the Word "Disability"

The Disability Continuum

Although there is no universally accepted meaning for the word "disability". However, the Ontario Human Rights Code provides definitions of disability that form our guiding principles. Definitions of disability can be placed on a continuum. At one end, disability is explained in terms of medical conditions (medical model). At the opposite end, disability is explained in terms of the social and physical contexts in which it occurs (environmental model).

The medical model focuses on deficiencies, symptoms and treatments. The World Health Organization's (WHO) 1976 definition for disability, for example, is "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." Medical model definitions promote the idea that disability is a deviation from the norm. 

Many people with disabilities are troubled by definitions that regard disability as abnormal, preferring instead to portray disability as commonplace, natural, and in fact, inevitable. As people age, they experience gradual declines in visual acuity, auditory sensitivity, range of motion, bodily strength and mental powers. Significant functional limitations affect almost half of people between the ages of 55 and 79, and over 70% of people over 80 (World Health Organization (WHO) report titled "Ageing and health", 2015). Beyond middle age, disability is the norm.

The environmental model explains disability in relation to social and physical contexts. In this view, the environment, not an individual's medical condition, causes disability. For example, during an electrical blackout, a person who is completely blind can effortlessly navigate around the home, hammer nails, and, if a Braille user, read a novel.

A sighted person would be unable to perform these tasks easily, if at all. In this example, the environment disables the sighted person.

The environmental model emphasizes that people with disabilities are capable individuals, and it is the barriers in the built and human environments, not their medical conditions, that create disability. Disability occurs when the world is designed only for a certain way of living, without considering the natural variation among human beings. Barriers are created by humans, and modifying how we live, the tools we use, and our understanding of the proper way to do things can eliminate or minimize design problems that cause barriers. Systematic barriers can be eliminated by modifying policies, plans, and processes. Attitudes that cause barriers can be addressed through disability awareness, respect, and positive interactions with people with disabilities.

Types of Disability and Functional Limitations

A person's disability may make it physically or cognitively challenging to perform everyday tasks such as operating a keyboard, reading a sign, differentiating colours, distinguishing sounds, climbing stairs, grasping small items, remembering words, or doing arithmetic.

There are many kinds of disabilities, including physical, sensory, hearing, mental health, developmental and learning. Disabilities can be visible or invisible.

Visual Disabilities

Visual disabilities reduce one’s ability to see clearly. Very few people are totally blind. Some have limited vision such as tunnel vision, where a person has a loss of peripheral or side vision, or a lack of central vision, which means they cannot see straight ahead. Some can see the outline of objects while others can see the direction of light. Impaired vision can restrict a person’s ability to read signs, locate landmarks or see hazards. In some cases, it may be difficult to tell if a person has a visual disability. Others may use a guide dog or white cane.

Here are some suggestions to help you interact with people with visual disabilities:

• Identify yourself when you approach the person and speak directly to them.
• Speak normally and clearly.
• Avoid referring to the disability or using phrases like “handicapped”.
• Unless it is an emergency, only touch the person if you have been given permission.
• If you offer assistance, wait until your receive permission.
• Offer your arm (the elbow) to guide the person and walk slowly.
• Service animals are working and have to pay attention at all times. Refrainfrom engaging with the animal.
• If you’re giving directions or verbal information, be precise and clear. For example, if you’re approaching a door or an obstacle, say so. Don't just assume the individual can't see you.
• When entering a room, show the individual to a chair, or guide them to a comfortable location.
• Identify landmarks or other details to orient the person to the environment around them.
• Ensure you say good-bye prior to leaving the individual.
• Be patient. Things may take a little longer.

Hard of Hearing and Deafness

People who have hearing loss may be deaf or hard of hearing. Like other disabilities, hearing loss has a wide variety of degrees. People who are hard of hearing may require assistive devices when communicating. While some people may use sign language, notes or hearing aids when communicating, others may also use email, pagers, TTY telephone service or Bell Canada Relay Service.

Here are some suggestions to help you interact with people who are deaf or hard of hearing:

• Always ask how you can help. Don’t shout.
• Avoid referring to the disability or using phrases like “handicapped”.
• Attract the person’s attention before speaking. The best way is a gentle touch on the shoulder or gently waving your hand.
• Make sure you are in a well-lighted area where the person can see your face.
• Look at and speak directly to the person. Address the person, not their interpreter.
• If necessary, ask if another method of communicating would be easier, for example a pen and paper.
• Keep your face clearly visible when speaking.
• Be clear and precise when giving directions and repeat or rephrase if necessary. Make sure you have been understood.
• Service animals are working and have to pay attention at all times. Refrain from engaging with the animal.
• Any personal (e.g., financial) matters should be discussed in a private room to avoid other people overhearing
• Be patient. Communication for people who are deaf is different because their first language may not be English. It may be American Sign Language (ASL).
•  If the person uses a hearing aid, try to speak in an area with few competing sounds.

Physical Disabilities

There are many types and degrees of physical disabilities and not all require a wheelchair. For example, people who have arthritis, heart or lung conditions, or amputations may also have difficulty moving, standing or sitting. It may be difficult to identify a person with a physical disability.

Here are some suggestions to help you interact with people with physical disabilities:

• Speak normally and directly to the person rather than someone who is with them.
• People with physical disabilities often have their own ways of doing things. Ask before you help.
• Avoid referring to the disability or using phrases like “handicapped”.
• Be patient and be sure you understand their needs.
• Unless it is an emergency, refrain from touching any assistive devices, including wheelchairs.
• Provide the person with information about accessible features of theimmediate environment (automatic doors, accessible washrooms, etc.).

Intellectual Disabilities

People with intellectual or developmental disabilities may have difficulty doing many things most of us take for granted. These disabilities can mildly or profoundly limit one’s

ability to learn. You may not be able to know that someone has one of these disabilities unless you are told, or you notice the way people act, ask questions or body language.

Here are some suggestions to help you interact with people with intellectual disabilities:

As much as possible, treat the person with an intellectual disability like anyone else.They may understand more than you think, and they will appreciate you treating them with respect.

• Don’t assume what a person can or cannot do.
• Avoid referring to the disability or using phrases like “handicapped”.
• Use simple words and short sentences.
• Make sure the person understands what you’ve said.
• If you can’t understand what’s being said, ask again.
• Give one piece of information at a time.
• Be polite and patient.
• Speak directly to the person, not to someone who is with the person.

Learning or Cognitive Disabilities

Learning or cognitive disabilities can result in a host of different communications difficulties for people. They can be subtle, as in having difficulty reading, or more pronounced, but they can interfere with the person’s ability to receive, express or process information. You may not be able to know that someone has one of these disabilities unless you are told, or you notice the way people act, ask questions or body language.

Here are some suggestions to help you interact with people with learning disabilities or disabilities:

• Patience and a willingness to find a way to communicate are your best tools.
• Recognize that some people with communication difficulties use augmentative communication systems such as Signed English andPicture Exchange System.
• When you know that someone with a learning disability needs help, ask how you can best help.
• Speak normally and clearly, and directly to the person
• Take some time — people with some kinds of disabilities may take a little longer to understand and respond.
• Try to find ways to provide information in a way that works best for them.For example, have a paper and pen handy.
• If you’re dealing with a child, be patient, encouraging and supportive.
• Avoid referring to the disability or using phrases like “handicapped”.
• Be courteous and patient and the person will let you know how to best provide service in a way that works for them.

Mental Health Disabilities

People with mental health disabilities look like anyone else. You won’t know that the person has a mental health disability unless you’re informed of it. But if someone is experiencing difficulty in controlling their symptoms or is in a crisis, you may need to help out. Be calm and professional and let the person tell you how you can best help.

Here are some suggestions to help you interact with people with mental health disabilities:

• Treat people with a mental health disability with the same respect and consideration you have for everyone else.
• Be confident and reassuring and listen to persons with a mental health disability and their needs.
• If someone appears to be in a crisis, ask him or her to tell you the best way to help.
• Take the person with a mental health disability seriously, and work with them to meet their needs.

Speech and Language Disabilities

Some people have communication challenges. It could be the result of cerebral palsy, hearing loss, or another condition that makes it difficult to pronounce words, causesslurring or stuttering, or not being able to express oneself or understand written or spokenlanguage. Some people who have severe difficulties may use communication boards, sign language or other assistive devices.

Here are some suggestions to help you interact with people with speech and language disabilities:

• Just because a person has one disability doesn’t mean they have another. For example, if a person has difficulty speaking; make no assumption they have an intellectual disability as well.
• If you don’t understand, ask the person to repeat the information.
• Avoid referring to the disability or using phrases like “handicapped”.
• If you are able, ask questions that can be answered 'yes' or 'no'.
• Take some time. Be patient and polite and give the person whatever time they need to get their point across.
• Allow the individual to finish their sentences themselves without interruption.
• Patience, respect and a willingness to find a way to communicate are your best tools.

Deaf-Blind Disabilities

A person who is deafblind cannot see or hear to some extent. This results in greater difficulties in accessing information and managing daily activities. Most people who are deafblind will be accompanied by an intervener, a professional who helps with communicating. Interveners are trained in special sign language that involves touching the hands of the client in a two-hand, manual alphabet or finger spelling, and may guide and interpret for their client.

Here are some suggestions to help you interact with people who are deafblind:

• Make no assumptions about what a person can or cannot do. Some deaf-blind people have some sight or hearing, while others have neither.
• Avoid referring to the disability or using phrases like “handicapped”.
• A deaf-blind person is likely to explain to you how to communicate with them or give you an assistance card or a note explaining how to communicate with them.
• Speak directly to the person, as you normally would, not to the intervener.
• Identify yourself to the intervener when you approach the personwho is deaf-blind.
• Don’t touch service animals – they are working and have to pay attention at all times.
• Unless it’s an emergency, refrain from touching a deaf-blind person without permission.