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According to many definitions, a disability is an impairment that may be cognitive, developmental, intellectual, mental, physical, sensory, or some combination of these. Other definitions describe disability as the societal disadvantage arising from such impairments. Disability substantially affects a person's life activities and may be present from birth or occur during a person's lifetime.
Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations. Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives.
Disability is a contested concept, with different meanings in different communities. It may be used to refer to physical or mental attributes that some institutions, particularly medicine, view as needing to be fixed (the medical model). It may refer to limitations imposed on people by the constraints of an ableist society (the social model). Or the term may serve to refer to the identity of disabled people. Physiological functional capacity (PFC) is a related term that describes an individual's performance level. It gauges one's ability to perform the physical tasks of daily life and the ease with which these tasks are performed. PFC declines with advancing age to result in frailty, cognitive disorders or physical disorders, all of which may lead to labeling individuals as disabled.
For the purposes of the Americans with Disabilities Act of 1990, the Equal Employment Opportunity Commission regulations provide a list of conditions that should easily be concluded to be disabilities: deafness, blindness, an intellectual disability (formerly termed mental retardation), partially or completely missing limbs or mobility impairments requiring the use of a wheelchair, autism, cancer, cerebral palsy, diabetes, epilepsy, HIV/AIDS, multiple sclerosis, muscular dystrophy, major depressive disorder, bipolar disorder, post-traumatic stress disorder, obsessive compulsive disorder, and schizophrenia.
Handicap has been disparaged as a result of false folk etymology that says it is a reference to begging. It is actually derived from an old game, Hand-i'-cap, in which two players trade possessions and a third, neutral person judges the difference of value between the possessions. The concept of a neutral person evening up the odds was extended to handicap racing in the mid-18th century. In handicap racing, horses carry different weights based on the umpire's estimation of what would make them run equally. The use of the term to describe a person with a disability – by extension from handicap racing, a person carrying a heavier burden than normal – appeared in the early 20th century.
In contexts where their differences are visible, persons with disabilities often face stigma. People frequently react to disabled presence with fear, pity, patronization, intrusive gazes, revulsion, or disregard. These reactions can, and often do, exclude persons with disabilities from accessing social spaces along with the benefits and resources these spaces provide. Disabled writer/researcher Jenny Morris describes how stigma functions to marginalize persons with disabilities:
“Going out in public so often takes courage. How many of us find that we can't dredge up the strength to do it day after day, week after week, year after year, a lifetime of rejection and revulsion? It is not only physical limitations that restrict us to our homes and those whom we know. It is the knowledge that each entry into the public world will be dominated by stares, by condescension, by pity and by hostility.”
Additionally, facing stigma can cause harm to psycho-emotional well-being of the person being stigmatized. One of the ways in which the psycho-emotional health of persons with disabilities is adversely affected is through the internalization of the oppression they experience, which can lead to feeling that they are weak, crazy, worthless, or any number of other negative attributes that may be associated with their conditions. Internalization of oppression damages the self-esteem of the person affected and shapes their behaviors in ways that are compliant with nondisabled dominance. Ableist ideas are frequently internalized when disabled people are pressured by the people and institutions around them to hide and downplay their disabled difference, or, "pass". According to writer Simi Linton, the act of passing takes a deep emotional toll by causing disabled individuals to experience loss of community, anxiety and self-doubt. The media play a significant role in creating and reinforcing stigma associated with disability. Media portrayals of disability usually cast disabled presence as necessarily marginal within society at large. These portrayals simultaneously reflect and influence the popular perception of disabled difference.
The International Symbol of Access (ISA), also known as the (International) Wheelchair Symbol, consists of a blue square overlaid in white with a stylized image of a person in a wheelchair. It is maintained as an international standard, ISO 7001 image of the International Commission on Technology and Accessibility (ICTA), a committee of Rehabilitation International (RI).
The ISA was designed by Danish design student Susanne Koefoed in 1968. It was first sketched at a radical design conference mounted by the Scandinavian Students Organization (SDO). The group organized a summer study session at Stockholm's art and design college, Konstfack, alternating time between workshop sessions and larger lectures. In these lectures, the tone was set by the American designer and educator Victor Papanek. In the writings that he formulated during this period, too, he imagined persons who were disabled –both physically challenged and mentally—as figures in need of renewed attention. Although there is no evidence that Papanek met Koefoed, his influence pervaded the seminar where the original ISA was drafted. Charged with creating a sign-symbol to mark barrier-free accommodations, Koefoed presented an early version of the symbol at the July 1968 exhibition held at the SDO seminar's end. Koefoed's symbol depicts an empty wheelchair. This icon was widely promoted around Sweden the following year.
Karl Mountain, director of Sweden's new Handicapped Institute, also promoted Koefoed's design to Rehabilitation International. Head of RI's International Commission of Technology and Accessibility (ICTA), Mountain was asked by RI to form a special committee that would find and deliver a symbol to the group's 1969 convention in Dublin. Mountain's group was asked to choose from six symbols. When Koefoed's symbol was presented, several members complained that it was too austere and illegible. As Mountain noted: "a slight inconvenience with the symbol is the equally thick lines, which may give an impression of a monogram of letters. With a 'head' on the symbol this inconvenience would disappear." Taking the original copy of the design, Mountain would add a circle to the top of the seat to give the impression of a seated figure.
Some disability activists are advocating for a modified access symbol. Sara Hendren and Brian Glenney co-founded the Accessible Icon project, designing the new icon to display an active, engaged image with focus on the person with disability. Some disability organizations such as Enabling Unit in India are promoting it, while other disability organizations like Second Thoughts Connecticut reject it as ableist. This version of the symbol is officially used in the U.S. states of New York and Connecticut. The Modified ISA is in the permanent collection of Museum of Modern Art. According to Emma Teitel of the Toronto Star, critics say that the modified image would still socially stigmatize to those who have a disability but do not use a wheelchair.
In May 2015, the Federal Highway Administration rejected the new design for use on road signs in the United States, citing the fact that it has not been adopted or endorsed by the U.S. Access Board, the agency responsible for developing the federal criteria for accessible design. The International Organization for Standardization, which established the regular use of the original symbol under ISO 7001, has also rejected the design.