The many definitions of "disability", and the effects on support and public benefit systems

 When you hear the word "disability", what is the first thing comes to mind? Many might answer, "a wheelchair". Others might answer "blindness" or "deafness". These are conditions that are widely recognized as preventing people from living the way that most others do. When we see someone in a wheelchair, walking with a cane, or flapping their hands, we think "that person is disabled", but not many able-bodied people think about what a disability is, including many people in charge of agencies that provide support or funding. The truth is that the word "disability" has been defined in different ways by different organizations, and has undergone many shifts in meaning over the decades. The combination of public ignorance and these conflicting definitions has made the process of obtaining the very supports that we disabled people need unnecessarily daunting and confusing.

According to the Americans with Disabilities Act, a person with a disability is "a person who has a physical or mental impairment that substantially limits one or more major life activity." The Social Security Administration defines a disability as "the inability to do any substantial gainful activity by reason of any medically determinable physical or mental impairment" (emphasis added). Because these two definitions are different, a person can be simultaneously "disabled" according to the ADA and "not disabled" according to the SSA. Such people are not few; anyone who requires workplace accommodations but can work and earn a substantial income as long as those accommodations are made falls into this trap. This includes autistic people who need extra breaks, or visually impaired people who need to have instructions and policies read to them. This conflict creates problems when they need to communicate with people like employers or public agencies who may not necessarily understand the situation.

For example, an autistic person works as a data entry clerk but needs extra breaks, so he requests this from his employer as a reasonable accommodation under the ADA. The employer grants this request. However, his father is retired, and so he also tries to apply for Social Security benefits. He is denied because his job pays above the level of income that is considered to be "substantial gainful activity". The letter that he receives states that he is "not disabled". His employer hears about this, becomes suspicious of malingering, and removes the accommodation of extra breaks. In order to continue working, the autistic person is then forced to engage in a long, heated argument with his supervisor or leave and seek other employment.

This sort of hassle results entirely from two different legal definitions created for different political purposes. It would be very nice if there was a universally agreed-upon, legal definition of the word "disabled". That way, situations like this would not arise.

The difference between "intellectual disability" and "developmental disability"

By now, many of you know that "intellectual disability" (ID) is the new term for a low IQ—what we used to call "mental retardation". In recent times, many people use "intellectual disability" as an umbrella term for any deficit in a person's thought processes. However, this term is actually a diagnostic label for a certain type of developmental disability that slows down learning and logical thought processes. We need another label for those who excel intellectually but struggle with other skills such as social interaction.

The abbreviation "I/DD" is widely understood to stand for "intellectual and developmental disabilities". However, on websites and discussion forums a common example of a "developmental disability" that is not an "intellectual disability" is a physical disability such as being paraplegic. This contributes to a popular perception that autism is a form of intellectual disability. In fact, autism is another diagnostic label for a different set of mental deficits from the ones seen in intellectual disability. An "intellectually disabled" person's limitations stem primarily from deficits in the ability to learn concepts, such as reading, writing, arithmetic, and reasoning, whereas an autistic person's limitations are primarily due to problems recognizing social cues or processing language.

Many people have a perception that autism is a form of intellectual disability. This may be because, in practice, what limits the ability of people with ID to function in daily life are struggles with forms of communication or social activities that require problem-solving abilities that the rest of us take for granted; they often are unable to speak in full sentences or understand more complex social rules. Many autistic people are limited in similar ways, and so daily interactions between neurotypical people, autistic people, and those with ID have many of the same challenges. Statistically, a majority of autistic people do, indeed, have a below-average IQ, though it often is not low enough for them to be considered "intellectually disabled". However, many autistic individuals have an average, or even (as in my case) an above-average IQ. These individuals think quite logically and learn skills such as artistic or even mathematical abilities very quickly, but are delayed in developing language (even to the point of being completely nonverbal) or understanding social cues because the parts of the brain that are involved in those specific areas of functioning develop more slowly than typical. To truly understand the disabilities of people like me requires understanding the difference between the ability to learn concepts and the ability to communicate.

So, the "I/DD" community is not just a mix of intellectually disabled people with people in wheelchairs. It includes people who are quite intelligent and able-bodied but have deficits in other areas of adaptive functioning, such as communication and focus. If society wants to include people with I/DD, it needs to learn not just about the needs and limitations that can be seen at first glance, but the specific areas of help that people need to put the gifts that they have to practical use in solving humanity's problems.