Affirmation and Impairment

Dora Raymaker recently wrote a thoughtful post on the Change.org autism blog contrasting the social model of disability with the medical model and discussing a proposed new model of disability, which is called the affirmation model. She explains that although the social model views disability as arising from barriers in society rather than from medical conditions, it may not go far enough toward affirming that disability need not be a tragedy or a misfortune.

The affirmation model speaks of people with impairments, rather than people with disabilities, and seeks to promote personal acceptance of impairment. Under the affirmation model, Dora writes, "we are fine with who we are as we are: our impairments are an important part of ourselves and our lives."

I certainly agree that all people should feel empowered to accept themselves as they are; however, it seems to me that the word "impairment" is not useful for advancing this goal because of its inherently negative connotations. The dictionary on my bookshelf lacks a separate listing for impairment, but it defines "impaired" as follows:


adj: being in a less than perfect or whole condition: as a: handicapped or functionally defective…


Granted, my dictionary is a few years out of date; it's a 2001 Webster's Collegiate that I haven't gotten around to replacing. However, I expect that this definition, or something quite similar, is still the first thought that comes into most people's minds when someone mentions impairment.

Under the commonly referenced definition put forth by the World Health Organization, impairment is a "loss or abnormality of psychological, physiological, or anatomical structure or function." While this language isn't as bad as Webster's, it still frames the concept in negative terms.

It should also be noted that neither of these definitions—nor any other definition of which I am aware—provides an objective way to determine whether or not particular characteristics are impairments. Instead, that determination is made by reference to whether a characteristic is seen as normal or abnormal, which is always a subjective concept and often changes as society's values shift.

Thus, using the word "impairment" to describe a personal trait implicitly acknowledges as legitimate—and further perpetuates—the practice of classifying certain kinds of human characteristics as abnormal on the basis of society's prevailing prejudices. It is not conducive to critical discussion of whether such a distinction should exist in the first place.

We are never going to reach the point where disability is seen as a normal part of life if we continue to define the underlying personal characteristics as the opposite of normal.