Whether you’re wanting to learn more about the people we serve, you’ve recently been faced with a disability - personally, or within your family - or you’re just curious, we’re happy to help you learn more about disabilities and disabilities issues.

The term "disability" covers a lot of ground, and can be defined according to a variety of contexts, applications, and usages. All of the definitions, however, have the same central theme: a disability is something that makes it difficult or impossible to perform a major life function that most people can do easily.

One of the more important definitions of "disability" is the legal definition, as set forth by Congress in the Americans with Disabilities Act (ADA) in 1990. This definition defines a disability for an individual as "a physical or mental impairment that substantially limits one or more of the major life activities of such individual". The definition consists of several elements:

an impairment, the type of impairment (mental or physical), a limitation on a life activity, the degree to which the limitation applies (it must be a substantial impairment), and the nature of the activity or activities limited (they must be "major").

All of these conditions must be met for a person to qualify as having a "disability". As the courts have discovered, though, even this straightforward definition is inadequate to encompass all questions related to whether or not a condition qualifies as a “disability.” Does carpal tunnel syndrome qualify as a disability? Does a condition that can be corrected (poor vision, for instance, that can be corrected by glasses or contact lenses) qualify as a disability? What about the mere diagnosis of a disease, such as AIDS?

To be simplistic, the answer is "it depends". Other related regulations, administrative rules, and court decisions have added an additional element to the definition: the term applies only to those conditions that cannot be corrected. One who has a vision problem is not "disabled" if that problem can be corrected by glasses. Hearing loss is not a disability if a hearing aid permits a "normal" level of function. Bipolar disorder that is controlled through drugs does not meet this definition of a "disability".

Most definitions also include another element: the duration of the disability. Though it is perhaps implied, the ADA definition of a disability does not explicitly specify that the condition must be long-lasting. Most other definitions of a disability, however, specify that the condition must last for a very long time, possibly for the rest of the affected person’s life.

Disabilities are typically fit into one or both of the following two categories: physical disabilities and mental disabilities.

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Physical Disabilities

Physical disabilities are those disabilities that affect mobility, flexibility, and the ability to manipulate the environment. Physical disabilities can be caused by disease or injury at any point in a person's life (often referred to as acquired disabilities) or they can be present at birth. Paralysis, amputation, sight or hearing impairments, and severe arthritic or neurological conditions would fall into the category of physical disabilities.

Physical disabilities can be visible or hidden. Visible disabilities are ones that can easily be seen: someone who uses a wheelchair or cane or who is missing an arm would have a visible disability. A hidden disability might be something like brittle diabetes or fibromyalgia: medical conditions that can limit work abilities, require an accommodation, and impact an individual's ability to perform typical activities of daily living.

Some physical disabilities remain the same over time and some can change. For example, a person who has no usable sight in one eye may have no changes in vision for their entire life, but a person with rheumatoid arthritis may experience a progression of symptoms that require different accommodations at different times in their life.

Physical disabilities might be accommodated by lifestyle changes, medications, assistive technology, or a combination of any of these.

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Mental Disabilities

Mental disabilities are those that involve the ability to reason, learn, and make appropriate decisions. Conditions that would qualify as mental disabilities include mental retardation, autism, mental illnesses (such as schizophrenia), and learning disabilities.

Mental Illness

 A mental illness is an emotional or mental problem (or combination of emotional and mental problems) that significantly impacts an individual’s ability to function in the community. Mental illness may be emotional or organic (biological) in origin, or a combination of both. The results affect emotional, relational, and coping aspects of one’s life. People who experience mental illness have many strengths; with a combination of a strong support system, professional assistance, and connection to one’s community, people can live productive, fulfilling, and rewarding lives.

Mental Retardation

"Mental retardation" is a difficult term to define. The term is linked to the idea of "intelligence", and because of this carries the same uncertainties. Intelligence can apply to different aspects of thinking and learning. For instance, one can be a brilliant mathematician but be completely incapable of learning to speak French and play the piano. Similarly, one could find it difficult to process abstract concepts but be able to repair a complex mechanical device without previously working on similar devices. The problems caused by these distinctions and different types of intelligence carry over into terms that are reliant on "intelligence" as a concept.

The American Association on Mental Retardation (AAMR) defines mental retardation as "a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior as expressed in conceptual, social, and practical adaptive skills that originates before the age of 18". Until 2002, AAMR also included an intelligence quotient (IQ) of less than 70 as one of its criteria. AAMR no longer includes this element in its definition, but most other definitions of mental retardation still do.

It should be noted that AAMR also does not define mental retardation as a mental disability, despite its connection to cognition and learning. Rather, AAMR notes that "Mental retardation reflects the ‘fit’ between the capabilities of individuals and the structure and expectations of their environment". Nonetheless, mental retardation is considered by most to fall into the larger category of "mental disability".

Another important distinction to make is the difference between mental retardation and mental illness. Mental retardation is not a type of mental illness, and mental illness is not a type of mental retardation. Although one can be a person with mental retardation and simultaneously suffer from mental illness, the two conditions would not be part and parcel of each other. It is important to note, however, that the conditions that often result from mental retardation can be a significant factor in the development of chronic depression or related mental illnesses. In these cases, the mental retardation is certainly a contributing factor to the mental illness, but this does not make the mental retardation itself a mental illness.

The causes of mental retardation vary. Literally hundreds of known causes exist, ranging from genetic factors (causing up to 75% of cases of mental retardation) to conditions such as lead poisoning or traumatic injuries. In many cases, the cause cannot be determined.

Learning Disabilities

A learning disability is typically defined as "a disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations". A learning disability may be caused by minor brain damage, a perceptual disorder (such as dyslexia), or other causes.

A learning disability is not the same thing as mental retardation. In fact, most definitions (including the federal definition, which has a tremendous impact on educational assistance programs) specifically limit application of the term to disabilities that are not the result of visual, hearing, or motor disabilities; mental retardation; or environmental, cultural, or economic disadvantage.

A learning disability differs from mental retardation in several important ways:

First, a learning disability is very limited in scope. While mental retardation is a condition that encompasses an overall assessment of one’s abilities and level of function, a learning disability is limited to a very specific area of learning, such as language, mathematics reasoning, or organization. While the effect of the learning disability may be felt in other areas of one’s life, the disability itself is not directly related to those other life skills.

Second—and most importantly—a learning disability does not severely limit one’s ability to live independently. Since it affects only a specific aspect of one’s abilities, it does not result in the overall loss of independence associated with mental retardation. In other words, a person with a learning disability that causes difficulty in arithmetic will still have the ability to read, dress himself, and learn the rules of a sport. This contrasts sharply with mental retardation, in which all of those abilities would likely be deeply impacted.

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Other Classifications of Disabilities

"Mental" and "physical" are not the only ways in which disabilities are described. Classifications are often necessary for purposes of study, treatment, or funding. Legislatures often classify disabilities to specify legal protections, establish support agencies, and allocate resources. In addition to physical disabilities, the State of Michigan recognizes three kinds of disabilities in its Mental Health Code: mental illness, Serious Emotional Disturbance, and developmental disabilities.

Mental Illness

The Michigan State Mental Health Code defines mental illness as “a substantial disorder of thought or mood that significantly impairs judgment, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life.” Serious mental illness has a far more complex definition, but the outstanding characteristic of a serious mental illness is that it has resulted in functional impairment that substantially interferes with or limits one or more major life activities. Serious mental illness includes dementia with delusions, dementia with depressed mood, and dementia with behavioral disturbance. Under some circumstances, addictions or developmental disorders can also be considered mental illness.

Mental illness is typically the result of a biological disorder in the brain, and can affect anyone regardless of age, gender, race, education, or income. Mental illness is not necessarily disabling; many people with mental illnesses have been very accomplished. The list of those who battled mental illness but succeeding is quite long, but it includes such notables as Abraham Lincoln, Winston Churchill, Mike Wallace, William Styron, Patty Duke, Tipper Gore, Ted Turner, both Theodore and Eleanor Roosevelt, and Virginia Woolf. Joan of Arc is often speculated to have suffered from a type of schizophrenia.

People with mental illness are often stereotyped as dangerous, mentally retarded, or both. Both stereotypes are misleading.

As discussed earlier, mental illness is distinct from mental retardation. Although one can have mental retardation and mental illness, the two are not necessarily linked.

Most people who suffer from mental illness are not dangerous. Those few whose disorders do lead them to become dangerous are more likely to harm themselves than anyone else. In such a case, the laws of Michigan and most other states provide for involuntary commitment to a mental health facility for treatment.

Naturally, mental illnesses are best treated early. Early warning signs of mental illness include:

• Marked personality changes
• Confused thinking
• Prolonged severe depression
• Excessive anxiety or fear
• Withdrawal from others
• Denial of obvious problems
• Marked changes in eating or sleeping patterns
• Anger or hostility out of proportion to the situation
• Growing inability to cope with problems and daily activities
• Thinking or talking about suicide

Alone, these signs are probably not an indication of possible mental illness. If several of these warning signs are present for long periods, however, it may be advisable to seek the advice of a mental health professional.

Serious Emotional Disturbance (SED)

Under the Michigan Mental Health Code, a Serious Emotional Disturbance (SED) is "a diagnosable mental, behavioral, or emotional disorder affecting a minor that exists or has existed during the past year" for a significant period of time, and that "substantially interferes with or limits the minor’s role or functioning in family, school, or community activities". The conditions that meet these criteria are hotly debated; biophysical, psychoanalytical, behavioral, sociological, and ecological factors are all offered as potential causes of SED, and psychologists disagree on what patterns of behavior are properly used to diagnose the condition. The legal definition, however, recognizes SED by its effects, leaving the debate over causes and exact characteristics to the mental health professionals.

The number of children affected by SED is, not surprisingly, a subject of some debate. Teachers typically report that up to 20% of their students have emotional or behavioral problems, but most mental health professionals put the number of children affected by severe emotional problems closer to 2%. Even at this low figure, the raw number of children affected by SED is very high, numbering in the hundreds of thousands. The exact number of children affected depends, of course, on the definition one adopts. Some mental health professionals include hyperactivity, attention deficit disorder, childhood schizophrenia, and autism under the definition of SED, while others do not. The federal definition of SED demonstrates such a twist: it includes schizophrenia but specifically excludes autism. This disagreement is one of the major problems in determining the exact number of children affected with SED.

SED differs from the other conditions described in Michigan’s mental health code largely because it only affects children; by definition, it is not a life-long disability. This does not, however, mean that the effects are not lasting. SED can impair a child’s education and socialization, impacting her adult life in immeasurable ways.

Developmental Disabilities

In this "discussion", we are concerned primarily with the category of disabilities known as "developmental disabilities". Developmental disabilities are a specific subset of disabilities that occur before the age of 22. The Michigan Mental Health Code—the state law that protects people who receive assistance through Michigan’s mental health system—defines a developmental disability as:

A severe, long-lasting condition which:

• is caused by a mental or physical problem, or both;
• becomes a problem before the person reaches 22 years of age;
• is likely to continue for a very long time;
• results in major limitations in the ability to
• talk or express one’s self and understand and follow simple directions,
• take care of one’s self in daily living activities (such as dressing and going to the toilet),
• learn to recognize colors, shapes, letters, words, and foods,
• move in a normal manner that includes walking, running, and sitting,
• make decisions or do what is needed to take care of one’s self, live independently, or earn money and partially support one’s self;
• and requires special treatment for a long time, often continuing over one’s lifetime.

The federal definition of a developmental disability differs slightly, defining a developmental disability as a severe, chronic disability in an individual five years of age or older that:

• is attributable to a mental or physical impairment or a combination of mental and physical impairments;
• is manifested before the person attains age 22;
• is likely to continue indefinitely;
• results in substantial functional limitations in three or more of the following areas of major life activity:
• self-care,
• receptive and expressive language,
• learning,
• mobility,
• self-direction,
• capacity for independent living,
• economic self-sufficiency;
• and reflects the individual’s need for a combination and sequence of special, interdisciplinary, or generic services, individualized supports, or other forms of assistance that are of lifelong or extended duration and are individually planned and coordinated.

While the two definitions are slightly different, the thrust of the two definitions is the same: a developmental disability emerges early in life, is very long in duration, and causes the individual affected to rely on the assistance of others. This covers a broad spectrum of disabilities, including mental illness, mental retardation, autism, Down Syndrome, Fragile X Syndrome, cerebral palsy, and other disabilities that cause severe limitations in independence.

It is important to note that by definition, the mere presence of one of these disabilities does not necessarily mean that the person affected has a developmental disability. For the condition to be a developmental disability, it must have the required impact on independence. Two people could have the same disability—cerebral palsy, for instance—but if only one of them is severely limited in her ability to live independently, then that individual would be considered to have a developmental disability, while her companion would not. Thus, whether or not a person has a developmental disability depends upon the effect of a condition on an individual, not the condition itself.

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