Impairment, Disability, Handicap

This section deals with the concepts that are the essence of medical rehabilitation that define, compare and contrast the terms impairment, disability and handicap and deals with it as follows; Impairment, disability, handicap, proper values in working with disability, 10 rules for good behavior, mental retardation, down syndrome, autistic disorder/infantile autism.

Definition according to World Health Organization's International Classification of Impairment, Disabilities, and Handicap ( ICIDH)

Impairment- any loss or abnormality of psychological, physiological or anatomical. structure or function.

Disability- any restricting or lack resulting from an impairment of ability to perform an activity in the manner or within the range considered for normal human being,

Handicap- a disadvantage or given individual resulting from an impairment or a disability that limits or prevented the fulfillment of a role that is normal ( depending on the age, sex, social and cultural factors for the individual)

When you meant about impairment it means that the person have the problem i.e, the Anatomic and pathophysiologic diagnosis. Any tissue, organ, or system can respond in only finite number of ways to the sceningly unlimited number of combination and permutations of etiologic insults. these responses are impairment, sometimes called the clinical features of manifestations of disease or condition. The function referred as the function of body part not the whole person function.

When we talked about disability, the term is meaningless without the description of what it is happen to be the person is unable to do, one may be is disabled from the perspective of walking, or climbing stair but be able to play a piano.

Standard to compare disabled from non- disabled.

  • .The extend of disability may be expressed as the discrepancy between a person's current functional capacity (CFC) and normal functional capacity (NFC)- preferably the person's own capacity before the onset of the disabling condition's but if such information is not available, then that of his or her peers.
  • The only way true disability (TD) can be decreased is by increasing CFC and the NFC cannot be changed.
  • Significant disability (SD) is different, this term represents an important clinical distinction.
  • SD can be decreased either by increasing CFC (as for TD) or by decreasing required functional capacity (RFC), such as an in a lowering of expectations. see the diagram below.