What is a disability?
In the literature, in legal and other documents, different definitions and concepts are used for people with disabilities. For example, terms such as disabled person, person with a handicap, person with special needs, person with difficulties, physically and mentally impaired person, etc. are mentioned.
Back in 1980, the World Health Organization gave a classification of impairments (biotic), disabilities (functional) and handicaps (social) – (International Classification of Impairments, Disabilities and Handicaps – ICIDH) and defined the mentioned terms. According to this classification, impairment is any loss or deviation from normal psychological, physiological or anatomical structure or function.
A disability is any limitation or lack (resulting from an impairment) of the ability to perform an activity in a manner or to an extent considered normal for a human being.
Handicap is a deficiency, for a certain individual, which results from impairment or disability, and limits or prevents him from fulfilling his natural role in society (depending on age, gender and social and cultural factors).
Handicap actually means a difficulty, a hindrance that hinders an activity. Therefore, handicap can be understood very broadly, and in a narrower sense, as already stated, it refers to persons who, due to impairments or disabilities, have difficulties in social integration. However, difficulties in social integration more often than from a person’s impairment or disability arise precisely from his social environment, and sometimes exclusively from that environment. Thus, some authors define handicap as a total negative effect of an individual’s condition, which includes:
- DISORDERS arising from some characteristics or impairments belonging to the person himself;
- LIMITATIONS set by the company itself;
- NEGATIVE ATTITUDES of the social environment i
- SELF-PERCEPTION, i.e. the experience or perception of oneself.
In general, it can be said that handicaps occur as a result of impairments (characteristics of the person) and limitations (social attitudes).
The latest version of the classification of functioning, disability and health of the World Health Organization from 2001 (International Classification of Functioning, Disability and Health – ICF), looks at the functioning of the individual and disability as the results of the interaction of the physical or mental state of the person, and the social and physical environment . Disability is not a characteristic of a person, but a series of factors, many of which are created by the social environment. For this reason, active social action is needed, in order to bring about changes that would enable the full participation of people with disabilities in all aspects of society. The same includes providing equal opportunities to all individuals, increasing the participation of people with disabilities in social life, identifying possible activities of society with the aim of increasing the independence and choice of individuals, raising the level of living conditions and quality of life, and raising awareness and encouraging changes in social behavior.
This version of the classification actually provides a unified framework for the very classification of disease consequences. It is structured based on the following components:
- Body functioning (e.g. mental functioning, sensory functioning, cardiovascular…) and body structures (e.g. nervous system structure, movement structures, metabolic and endocrine system structures…)
- Activities (in relation to a person’s daily activities and self-activity in general) and participation (involvement in life situations) – (e.g. communication, mobility, self-care, social participation…) and
- Relevant information on the complexity of the impairment and environmental factors (attitudes, services, support system, policy, social relations, assistive technology…).
Functioning and disability are defined as a complex interaction between an individual’s health condition and contextual environmental factors, as well as personal factors. The picture that is obtained by combining these factors and dimensions is “a person in his or her world”. This classification treats the mentioned dimensions interactively and dynamically, not linearly and statically.
The classification does not address etiology and emphasizes functioning rather than condition or disease. It is very carefully designed, so that it is relevant for all world cultures, as well as age and gender groups, and is appropriate for a heterogeneous population.
In the Republic of Croatia, there is no single definition of persons with disabilities. Different systems also use different terms, which sometimes results in minor or major practical problems. Thus, for example, the social welfare system uses the term physically or mentally impaired person, while the education system uses the term children and youth with developmental disabilities, and the pension insurance and employment system uses the term disabled person. According to one of the newer definitions provided by the Act on Professional Rehabilitation and Employment of Persons with Disabilities from 2002, a person with a disability is any person who has a physical, sensory or mental impairment that results in a permanent or for at least 12 months reduced ability to meet personal needs a need in everyday life.
The pension insurance system distinguishes between disability and invalidity. It defines disability as a term specific to pension insurance only, and it is determined in relation to the state of health and work ability at the time of establishment of the insured’s status in pension insurance.
It is related exclusively to the ability or inability to perform work (professional and general incapacity for work are distinguished). It can exist even when no physical damage has occurred. Disability, on the other hand, according to this understanding, is a much broader term and is assessed according to abilities in the form of complex activities and behaviors, generally accepted as significant determinants of everyday life.
In the Republic of Croatia, the term “person with special needs” is increasingly used. This term is a consequence of the increasingly present inclusion (educational, but also wider social), which is based on basic human rights and implies equal participation in social life, i.e. exactly equal chances for everyone. This is a prerequisite (when it comes to people with disabilities, but also other vulnerable social groups), awareness and active engagement of the social community in creating conditions (“positive discrimination” measures) for meeting the daily needs of people with disabilities.
Persons with disabilities themselves point out, however, the inappropriateness of this term, because, as they point out, it is not about meeting special, but common human needs. Of course, when we talk about people with disabilities, we are actually talking about people with physical disabilities, people with chronic diseases, people with hearing impairments, people with visual impairments, people with mental retardation, people with autism and people with multiple disabilities. According to some authors, the same group also includes people with difficulties in voice-speech communication and people with mental and organic disorders.