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Bimsybims 02-17-20 04:26 PM

Is it not a handicap?
 
I am listening to the book: "taking charge of adult ADHD" and just heard the author say that ADHD isn't a handicap.
He then went on to describe that we need help just as someone in a wheelchair need ramps to get into a building.


If it isn't a handicap- what should I call it?
An impairment?
A different way of functioning?


Is this just one of those things when a word has been loaded with too much negative meaning and is therefore switched out with a new, less loaded word?

Lunacie 02-17-20 04:51 PM

Re: Is it not a handicap?
 
For some people it may be considered a handicap, or a disability, but not usually.
To qualify as a disability in an adult, it must mean it prevents you from working.

namazu 02-17-20 05:17 PM

Re: Is it not a handicap?
 
Quote:

Originally Posted by Lunacie (Post 2023774)
For some people it may be considered a handicap, or a disability, but not usually.
To qualify as a disability in an adult, it must mean it prevents you from working.

For disability payments, perhaps.

But ADHD may still be considered a disability under the Americans with Disabilities Act (ADA), the Rehabilitation Act of 1974 (from which 504 plans come), and (sometimes) the Individuals with Disabilities Education Act (IDEA, from which IEPs come). To be considered a disability under these laws, the ADHD must impair major life activities (which is basically required for diagnosis).

Someone with ADHD may be able to work with or without accommodations and still be considered to have a disability under those laws.

Of course, to any given individual, regardless of any legal definition, they may consider their ADHD a disability, a gift, a fact of life, or whatever they choose.

I'm a little surprised that Russell Barkley would say that ADHD is not a disability, since he usually takes a rather negative (some would say "realistic") view of the condition, unlike some writers who like to put a much more positive spin on it. I'm having trouble finding the context when I search the book online. I wonder if he was just getting at the idea that with accommodations, many people with ADHD can be successful.

EDIT: Found the context:
Quote:

Originally Posted by Russell Barkley, Taking Charge of ADHD, p.96
You are not a victim. ADHD is not a handicap. The fact that you're reading this book says you are looking for answers, not excuses.

[...some stuff about not shying away from challenges, but finding strategies/accommodations to make success possible, including wheelchair ramp metaphor, and a bunch of stuff about accountability...]

So make (and accept) no excuses! Own your ADHD, own its consequences, and then seek to minimize those disastrous delays in life that are preventing you from being as effective, productive, and successful as people who don't have ADHD. Find your ramps or build them as necessary, but don't quit on your plans or goals.


Lunacie 02-17-20 05:36 PM

Re: Is it not a handicap?
 
Namazu. yeah, that's what I said. But thanks for the additional info.

It's not usually considered a handicap or a disability.

It may be, though, depending on how impaired the person is.

namazu 02-17-20 05:39 PM

Re: Is it not a handicap?
 
Quote:

Originally Posted by Lunacie (Post 2023779)
Namazu. yeah, that's what I said. But thanks for the additional info.

It's not usually considered a handicap or a disability.

Ah, but I disagree. I'm saying that ADHD *is* (or at least could be considered) a disability for most purposes (other than disability payments), because by definition it must cause impairment in at least 2 domains of life.

So, for example, an adult college student with ADHD may be eligible for accommodations on the basis of disability, and someone in the workplace may also be eligible for accommodations on the basis of a disability. These accommodations may make it possible for the person with ADHD to "be as effective, productive, and successful as people who don't have ADHD", or at least to keep their job or earn a degree.

It may be mostly semantics, but it makes a real difference. If you claim that ADHD usually isn't a disability, then people with ADHD usually wouldn't be eligible for accommodations in school or at work, which would make it harder for those of us with ADHD to arrange the "ramps" we need to be successful unless we can do it all informally.



There are also those who take a neurodiversity perspective and claim that ADHD is just a different way of thinking, and some people who hold this view might not consider it a disability (and instead contend that society and its strictures are the real disability). I don't take that view, personally, at least not all the way. (I mean, it would be lovely if society were better able to countenance and accommodate people with different strengths and weaknesses, but I find my ADHD impairing even in contexts that I largely control, like my own home.)

namazu 02-17-20 06:03 PM

Re: Is it not a handicap?
 
In the context of the book, though, I think Barkley's point is that ADHD isn't a reason to give up on life goals, nor a reason to fail to put forth effort, nor a reason to shirk responsibilities.

It is interesting to me that he doesn't use the word "disability" anywhere in the book, though. He generally seems to consider ADHD a nontrivial diagnosis; you can read the 2002 International Consensus Statement on ADHD to get a more concentrated dose of his "sobering" perspective.

sarahsweets 02-19-20 05:57 AM

Re: Is it not a handicap?
 
Quote:

Originally Posted by Bimsybims (Post 2023773)
I am listening to the book: "taking charge of adult ADHD" and just heard the author say that ADHD isn't a handicap.
He then went on to describe that we need help just as someone in a wheelchair need ramps to get into a building.


If it isn't a handicap- what should I call it?
An impairment?
A different way of functioning?


Is this just one of those things when a word has been loaded with too much negative meaning and is therefore switched out with a new, less loaded word?

That is hard for me to understand too. But I guess a ramp is an accommodation for someone's wheelchair and medicine or extra time on tests, lists and certain distraction-minimizing things are similar accommodations for us? I am definitely in the impairment camp of beliefs. And I think impairments can handicap people but not all impaired people are handicapped.

Bimsybims 02-19-20 06:35 AM

Re: Is it not a handicap?
 
Thanks for finding the context, Namazu!


I think about it a lot, not so much because of insurance but rather how I view myself and my life.
I guess a handicap means that there are things you will never be able to do, if I'm permanently in a wheelchair it means I'll never be able to run for example.


I have listened more to R.Barkley and heard him say that ADHD is the diabetes of psychiatry, it needs to be regulated daily in order for you to have a decent life.
That was quite an interesting way of looking at it.


I think of ADHD as having to drive a car even though you're not used to driving, so you mess up the timing and all the multiple things you need to do at once.
I used to have nightmares about that exakt thing as a child so it resonates with me but it's a pretty negative picture of it I suppose.

Lunacie 02-19-20 11:08 AM

Re: Is it not a handicap?
 
Quote:

Originally Posted by sarahsweets (Post 2023804)
That is hard for me to understand too. But I guess a ramp is an accommodation for someone's wheelchair and medicine or extra time on tests, lists and certain distraction-minimizing things are similar accommodations for us? I am definitely in the impairment camp of beliefs. And I think impairments can handicap people but not all impaired people are handicapped.

The bolded part is what I was trying to convey. Thank you sarah.

namazu 02-19-20 12:54 PM

Re: Is it not a handicap?
 
Quote:

Originally Posted by sarahsweets
I guess a ramp is an accommodation for someone's wheelchair and medicine or extra time on tests, lists and certain distraction-minimizing things are similar accommodations for us?

Yes, that's how I understood it.

Quote:

Originally Posted by sarahsweets
I am definitely in the impairment camp of beliefs. And I think impairments can handicap people but not all impaired people are handicapped.

OK, so how do all y'all define "handicapped"? If it weren't an outdated and offensive-to-some word, I would use it synonymously with "disabled".

To me, both of these terms connote having areas of poor functioning, having a disadvantage, or having to work harder due to an impairing condition. They don't mean a permanent inability to do anything ever; if they did, the ADA and related areas of employment and school law would be pointless.

(Much as a "handicap" in bowling or golf means that you need a boost/accommodation to level the playing field, which seems to be exactly what Barkley is suggesting we need while simultaneously saying it's not a handicap, which is confusing! Maybe he just means that we cannot always expect others to do the accommodating, and we need to work to find our own solutions?)

What kinds of biologically-based impairments in major life activities would not constitute handicaps/disabilities?

Is it if they are treatable?

If the person has found work-arounds?

Is it contextual?

I don't mean to be contrarian; it just seems that we are thinking of or using these terms differently and I'm trying to understand your perspective.

Lunacie 02-19-20 08:54 PM

Re: Is it not a handicap?
 
This info from NCBI explains better how I see the terms differently.
(edited into smaller paragraphs for easier readability)

Quote:

Impairment, disability and handicap

Just as various impairments may lead to the same disability, so a given
disability may produce a range of handicap which is dependent on the
individual carrying out their expected role or activity.

The partial loss of a finger (the impairment) will lead to some disability
in anyone so afflicted. The majority, however, will not find this a serious
handicap as it will not interfere with their usual work and leisure activities.

In contrast, the same impairment and disability in a professional pianist
will result in a profound handicap.

One of the most moving personal accounts that distinguishes between
disability and handicap was written by Stephen Hawking in his best seller
book, A Brief History of Time.

Motor neurone disease had confined Hawking to a wheelchair for over 20
years and the relentless progression of the disease had necessitated a
tracheostomy which removed his ability to speak and made it almost
impossible for him to communicate.

It is difficult to imagine anyone having a more profound disability. Yet he
goes on to say that he had led a fairly normal life having been fortunate
to choose theoretical physics as a career, which is all in the mind, so that
his disability was not a serious handicap.

namazu 02-19-20 10:09 PM

Re: Is it not a handicap?
 
Quote:

Originally Posted by Lunacie (Post 2023828)
This info from NCBI explains better how I see the terms differently.
(edited into smaller paragraphs for easier readability)

Thanks, Lunacie.

The author you quoted (Martin F. Robards, from his book called Running a Team for Disabled Children and Their Families, 1994) is basing his discussion on World Health Organization definitions from 1980. They use "handicap" to mean the "socialization of an impairment or disability, and as such it reflects the consequences for the individual...that stem from the presence of impairment and disability".

"Impairment" is used there in a way that seems to differ from the way it's used in the DSM when discussing ADHD, at least as I (mis-?)understand it. In the DSM, "impairment" seems to mean the adverse effects on someone's life that come from the symptoms resulting from the presumed biological differences (which seems closest to "disability" under the 1980 WHO guidelines). The biological differences (in the nervous system in the case of ADHD, or the missing finger in the example you quoted) would not themselves be considered impairments in that way of thinking. There was some discussion a while back about the lack of clarity in the DSM when it comes to differentiating "symptoms" from "impairments".

The ADA language seems to be somewhere in between that and the WHO language; "major life activities" which may be "impaired" include things like walking, standing, seeing, learning, etc., and these impairments may constitute a disability.

The author of the piece you quotes goes on to note that self-perception may be at odds with societal perception (i.e., society might view people as handicapped who do not consider themselves handicapped). He also notes that environment/circumstance is a big factor in handicap, beyond the inherent medical consequences of a particular condition. In the case of Stephen Hawking, were he not in the peculiarly suitable academic position he were in, and were he not able to secure the kinds of assistance (technological and personal) that he did, his condition very much could have ended his career prematurely and resulted in a much immediately worse outcome.

I guess my tendency to see "disability" and "handicap" as equivalent terms is non-standard, if the WHO guidelines are still widely used. (Clearly, it's not how several of you think of the terms!)

If Barkley has the the WHO guidelines in mind, then it makes sense to say that "ADHD is not a handicap" because no condition is inherently a handicap. But ADHD, like other conditions, could certainly result in handicap if a person is unable to fulfill their expected social roles due to their impairments/disability. Per the excerpt, "The key feature of the definition of handicap is that it is an outcome, not a cause." Which is, I guess, what you and Sarah have been saying. It does, however, sound like ADHD would almost always qualify as a disability, even under the WHO definition, because it must adversely affect 2 domains of life just to be diagnosed.

Thanks again for the excerpt, Lunacie, which does help clarify how others use these terms.

Lunacie 02-19-20 10:34 PM

Re: Is it not a handicap?
 
Quote:

Originally Posted by namazu (Post 2023829)

The author of the piece you quotes goes on to note that self-perception may be at odds with societal perception (i.e., society might view people as handicapped who do not consider themselves handicapped).

Thanks for finding the basis for that link, not having a good enough head day
here to take that effort. Must less try to explain my thinking, hence my looking
for a link that explains.

Sadly, societal perception seems to be at odds with self-perception when it
comes to impairment caused by adhd, among other disorders. I'm seeing
more educational info shared on things like autism and migraine disorders
lately, but there sure isn't much presented on adhd, is there?


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