Background on
Disability
Disability is complex, dynamic, multidimensional and
contested (World Health Organization, 2011). Understanding the nature of
disability and their circumstances is substantial for these can improve efforts
to remove disabling barriers and provide services to allow people with
disabilities to participate. For the context of the present study, the
succeeding discussion offers the manifold definitions of disability across
legal, medical and psycho-social standpoints. It presents categorical
definitions of specific disabilities and how are these characteristics be given
consideration in identifying persons with disabilities and their eligibility
for special education services.
Over the years, disability has been defined by various
sectors due to the increasing progress in disability movements, legislation and
research. In these definitions, two perspectives emerge as to what constitutes
disability. The first is the medical model of disability which assumes
disability as a biological fact, a condition which moves away from normal
physical, cognitive and/or psychological functioning, resulting in reduced
opportunities and quality of life. The second is the social model of
disability, which views disability as a social construct, that the challenge of
disability is not exclusively credited to a condition, but rather from the
social and environmental barriers which omit persons with disability from full
participation in society. However, the World Health Organization (2011)
stresses that disability should not be viewed as purely medical nor purely
social. Though society can contribute to handicapping conditions, persons with
disabilities also experience difficulty because of their physical/health
condition. For this reason, the World Health Organization adopted a “bio-psycho-social”
model”. This model defines functioning and disability as a dynamic interaction
between health (or physical) conditions and contextual factors, both personal
and environmental (International Classification of Functioning, UNESCO, 2001).
Hence, considering this bio-psycho-social model, a person
with physical impairment who depends on a wheelchair for mobility and who goes
to a school without ramps and/or accessible sanitation facilities clearly has a
disability as a result of the environmental barriers s/he faces. However a
child who is blind and has access to books and other learning materials in
Braille, educational support through itinerant resource teachers, and a school
that is welcoming, inclusive and accessible for all children has impairment,
does not necessarily has a disability because s/he faces no environmental and
attitudinal barriers (UNESCO, 2009).
Moreover, various legislations enacted for the past years
have provided definitions of disability. This is done to recognize individuals
eligible for special education and related services as well as to protect these
individual’s rights against discrimination.
In particular, the Americans with Disabilities Act defined
a person with disability as: (1) having a physical or mental impairment that
substantially limits him or her in some major life activity, and (2) having
experienced discrimination resulting from their physical and mental impairment
(Boyle and Scanlon, 2010).
Individuals with Disabilities Education Act on the other
hand defined the term "child with a disability" means a child:
"with mental retardation, hearing impairments (including deafness), speech
or language impairments, visual impairments (including blindness), serious
emotional disturbance, orthopedic impairments, autism, traumatic brain injury,
other health impairments, or specific learning disabilities; and who, by reason
thereof, needs special education and related services”. This definition
includes specific disability terms, which are also defined by IDEA and be later
defined in this chapter.
In the Philippines, persons with disabilities are defined
as follows (Japan International
Cooperation Agency, 2002):
As defined by Batas Pambansa No. 344:
“those suffering from restriction or lack of ability to
perform an activity in the manner or within the range considered normal for a
human being as a result of a mental, physical, or sensory impairment.”
As defined by the Economic Independence of Disabled Persons
Act:
“persons who cannot perform work in the usual and customary
way due to loss of limbs or any part of the body by injury or absence thereof
by birth.”
As defined by Republic Act 7277 (Magna Carta for Persons
with Disabilities):
“those persons suffering from restrictions from different
abilities as a result of a mental, physical, and sensory impairment, to perform
an activity in the manner or within the range considered normal for a human
being.”
The term “disability” is most often used interchangeably
with the terms “impairment” and “handicap”. To differentiate each of these
terms distinctively, the World Health Organization revised and currently
defines the words “impairment”, “disability”, and “handicap” as the following
(International Classification of Functioning, World Health Organization, 2001):
Impairment is a loss or abnormality in body structure or physiological
function (including mental functions). Abnormality here is used strictly to
refer to a significant variation from established statistical norms (i.e. as a
deviation from a population mean within measured standard norms) and should be
used only in this sense.
Disability is an umbrella term for impairments, activity limitations
and participation restrictions. It denotes the negative aspects of the interaction
between an individual’s health condition and contextual factors (environmental
and personal factors).
Handicap is the outdated term for what is now “participation restrictions”.
These are problems an individual may experience in involvement in life
situations. The presence of a participation restriction is determined by
comparing an individual's participation to that which is expected of an
individual without disability in that culture or society.
In grouping or thinking about disabilities, three major
schemes are used. These are (a) disability types, (b) severity of the
disability, and (c) in terms of incidence, or how often they occur (Bryant, et
al, 2008).
Disability Types. This classification utilizes categorical approach in
describing disabilities. This approach is the primary way persons with
disabilities are identified, are labeled and qualify especially for special
education services. The Individuals with Disabilities Act defines thirteen
specific disabilities. These are:
(1) Autism. A
developmental disability significantly affecting verbal and nonverbal
communication and social interaction, generally evident before age three, that
adversely affects a child's educational performance. Other characteristics
often associated with autism are engagement in repetitive activities and stereotyped
movements, resistance to environmental change or change in daily routines, and
unusual responses to sensory experiences.
(2) Deaf-blindness.
A concomitant hearing and visual impairments, the combination of which causes
such severe communication and other developmental and educational needs that
they cannot be accommodated in special education programs solely for children
with deafness or children with blindness.
(3) Deafness.
A hearing impairment that is so severe that the child is impaired in processing
linguistic information through hearing, with or without amplification that
adversely affects a child's educational performance.
(4) Emotional
Disturbance. A condition exhibiting one or more of the following
characteristics over a long period of time and to a marked degree that
adversely affects a child's educational performance: , characterized by
(a) an inability to learn that cannot be explained by intellectual,
sensory, or health factors; (b) an inability to build or maintain satisfactory
interpersonal relationships with peers and teachers; (c) inappropriate types of
behavior or feelings under normal circumstances; (d) general pervasive mood of
unhappiness or depression; and (e) tendency to develop physical symptoms or
fears associated with personal or school problems. This includes schizophrenia,
but does not apply to children who are socially maladjusted, unless it is
determined that they have an emotional disturbance.
(5) Hearing
Impairment. An impairment in hearing, whether permanent or fluctuating,
that adversely affects a child's educational performance but that is not
included under the definition of deafness in this section.
(6) Mental
Retardation. This means significantly subaverage general intellectual
functioning, existing concurrently with deficits in adaptive behavior and
manifested during the developmental period, that adversely affects a child's
educational performance.
(7) Multiple
Disabilities. Concomitant impairments (such as mental retardation-blindness
or mental retardation-orthopedic impairment), the combination of which causes
such severe educational needs that they cannot be accommodated in special
education programs solely for one of the impairments. Multiple disabilities
does not include deaf-blindness.
(8) Orthopedic Impairment.
This is a severe orthopedic impairment that adversely affects a child's
educational performance. The term includes impairments caused by a congenital
anomaly, impairments caused by disease (e.g., poliomyelitis, bone
tuberculosis), and impairments from other causes (e.g., cerebral palsy,
amputations, and fractures or burns that cause contractures).
(9) Other Health
Impairment. This means having limited strength, vitality, or alertness,
including a heightened alertness to environmental stimuli, that results in
limited alertness with respect to the educational environment, that (a) is
due to chronic or acute health problems such as asthma, attention deficit
disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a
heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic
fever, sickle cell anemia, and Tourette syndrome; and (b) adversely affects a
child's educational performance.
(10) Specific
Learning Disability. A disorder in one or more of the basic psychological
processes involved in understanding or in using language, spoken or written,
that may manifest itself in the imperfect ability to listen, think, speak,
read, write, spell, or to do mathematical calculations, including conditions
such as perceptual disabilities, brain injury, minimal brain dysfunction,
dyslexia, and developmental aphasia. This does not include learning problems
that are primarily the result of visual, hearing, or motor disabilities, of
mental retardation, of emotional disturbance, or of environmental, cultural, or
economic disadvantage.
(11) Speech or
Language Impairment. A communication disorder, such as stuttering, impaired
articulation, a language impairment, or a voice impairment, that adversely
affects a child's educational performance.
(12) Traumatic
Brain Injury. An acquired injury to the brain caused by an external
physical force, resulting in total or partial functional disability or
psychosocial impairment, or both, that adversely affects a child's educational
performance. Traumatic brain injury applies to open or closed head injuries
resulting in impairments in one or more areas, such as cognition; language;
memory; attention; reasoning; abstract thinking; judgment; problem-solving;
sensory, perceptual, and motor abilities; psychosocial behavior; physical
functions; information processing; and speech. Traumatic brain injury does not
apply to brain injuries that are congenital or degenerative, or to brain
injuries induced by birth trauma.
(13) Visual
Impairment including Blindness. This is impairment in vision that, even
with correction, adversely affects a child's educational performance. The term
includes both partial sight and blindness.
However, this categorical approach does more harm than good
according to some parents, educators and groups (Allen and Cowdery, 2005). They
argue that individuals, particularly the very young ones, may get locked into
categories or put into programs that compound the child’s delay. The danger of
the stigma, the label and the stereotype a certain category hold could also
greatly affect the person categorized in a particular disability. Labeling
students seems to imply that the student with disability is the cause of
educational problem rather than the education’s system limitations (Waldron,
1996). Nevertheless, categorizing helps, primarily educators, to understand and
effectively meet the person with disabilities’ needs. The more specific their
understanding is, the more specific their intervention can be (Wilmshurst and
Brue, 2010). It also paved the way to the development of specialized
teaching methods, assessment approaches, and behavioral interventions for each
of the specific disability.
Severity of the
Disability. This is a non-categorical
approach where persons with disabilities are grouped by the severity (mild,
moderate, severe) of their problems not by disability (Bryant et al, 2008).
This considers how the condition influences an individual’s performance. For
example, individuals with mild disabilities need some accommodation while those
with severe disabilities need thorough support and assistance for an extensive
period of time.
In grouping disabilities according to severity, it has to
be noted that no disability is more severe than the other. All disabilities are
serious and the effect on the person with disabilities including their families
should never be underestimated. Also, each disability grouping falls along a
continuum of severity from mild to severe. It is therefore improper to think
that all learning disabilities are mild (Bryant et al, 2008).
Incidence. A non-categorical approach in which disabilities are
grouped according to how often they occur: high-incidence or low-incidence
disabilities. High-incidence disabilities include learning disabilities, speech
language impairment, health impairments, mental retardation and
emotional/behavioral disorder. Low-incidence disabilities on the other hand
consist of autism, multiple-severe disabilities, developmental delays, deaf and
hard of hearing, visual disabilities, physical disabilities and traumatic brain
injury (Mastropieri and Scruggs, 2000; Bryant, et al, 2008).
This grouping scheme in grouping disabilities contends that
dealing with more common disabilities should be different from less frequent or
low-incidence disabilities. The less commonly occurring disabilities often
require specialized services from a multidisciplinary team of professionals. In
addition, this grouping is of use when the issue
at hand for students with disabilities centers on the provision of services,
the availability of qualified personnel and the technical assistance needed in
important resources (National Center on Accessible Instructional Materials,
2010).
Nowadays, both categorical and
non-categorical approaches in grouping disabilities are used. For instance,
individuals with disabilities qualify for special education by being determined
as having a specific disability. Schools then usually serve these individuals
in line with their needs and performance.
