Invisible disability

Invisible disabilities, also known as Hidden Disabilities or Non-visible Disabilities (NVD), are disabilities that are not immediately apparent, are typically chronic illnesses and conditions that significantly impair normal activities of daily living.

A woman holding a sign that says "LD = Less equally intelligent / Strike out stigma" poses for a photo in Times Square with a man holding a sign that says "Take a picture with a proud dyslexic". The event was held by Project Eye-To-Eye to raise awareness of Learning Disabilities Month.

For instance, some people with visual or auditory disabilities who do not wear glasses or hearing aids, or who use discreet hearing aids, may not be obviously disabled. Some people who have vision loss may wear contact lenses. A sitting disability is another category of invisible impairments; sitting problems are usually caused by chronic back pain. Those with joint problems or chronic pain may not use mobility aids on some days, or at all. Most people with RSI move in a typical and inconspicuous way, and are even encouraged by the medical community to be as active as possible, including playing sports; yet those people can have dramatic limitations in how much they can type, write or how long they can hold a phone or other objects in their hands.

It is estimated that 1 in 10 people live with an invisible disability.

Impact

Invisible disabilities, also known as Hidden Disabilities or Non-visible Disabilities (NVD), can hinder a person's efforts to go to school, work, socialize, and more. Although the disability creates a challenge for the person who has it, the reality of the disability can be difficult for others to recognize or acknowledge. Others may not understand the cause of the problem, if they cannot see evidence of it in a visible way. Students with cognitive impairments find it difficult to organize and complete school work, but teachers who are unaware of the reason for a student's difficulties, can become impatient:[1]

I recently met Grace, a woman who had a traumatic brain injury when she was sixteen years old. She was in a car accident, an all too common occurrence. An accident occurs, the head hits a part of the car and internal damage to the brain results, ranging from mild to severe. Grace shows no outside cues of brain damage. There are no visible cues of her head injury. Grace's walking, vision and physical reflexes look "normal." [...] People look at Grace and assume she is fine and then react to her difficulty as if she is being lazy or choosing to be obstinate. Teachers' judgments of Grace have been based on assumptions made from Grace's physical appearance.

This lack of understanding can be detrimental to a person's social capital. People may see someone with an invisible disability as lazy, weak, or antisocial. A disability may cause someone to lose connections with friends or family due to this lack of understanding, potentially leading to a lower self-esteem.

A disability that may be visible in some situations may not be obvious in others, which can result in a serious problem. For example, a plane passenger who is deaf may be unable to hear verbal instructions given by a flight attendant. It is for this reason that travellers with a hidden disability are advised to inform the airline of their need for accommodations before their flight:[2][3]

Once, flying to Washington shortly after 9/11, I didn't hear the announcement that absolutely no one was to get out of their seat for the last 30 minutes of the flight. Normally, I get up to use the washroom 20 minutes before landing. If the nice stewardess had not remembered me and come over to my seat, crouched down to my eye level, and told me that if I had to use the washroom, I had better use it right now, who knows what might have happened. I later learned the air marshals on board would have thrown a blanket on me and wrestled me to the floor.

Some employees with an invisible disability choose not to disclose their diagnosis with their employer, due to social stigma directed at people with disabilities, either in the workplace or in society in general. This may occur when a psychiatric disability is involved, or a number of other medical conditions that are invisible. Researchers in the human resources field may need to take this non-disclosure into account when carrying out studies.[4] Many people who think of those with a disability generally consider them lower to middle class due to their medical costs, and also because many people with disabilities often lack reliable, full-time employment. According to one US survey, 74% of individuals with a disability do not use a wheelchair or other aids that may visually portray their disability.[5] A 2011 survey found that 88% of people with an invisible disability had negative views of disclosing their disability to employers.[5] Data from the Bureau of Labor Statistics in 2017 states that the unemployment rate for individuals with an invisible disability is higher than those without one.[6] The unemployment rate for people with a disability was 9.2%, while the rate of those without was less than half of this at only 4.2%. BBC states that people with HIV specifically have an unemployment rate three times higher than those without HIV.[5] Beyond the work force, Bureau of Labor Statistics data also showed that individuals with an invisible disability are also less likely to receive a bachelor's degree or higher education.[6]

Prevalence

United States

In the United States, 96% of people with chronic medical conditions show no outward signs of their illness, and 10% experience symptoms that are considered disabling.[7]

Nearly one in two Americans (165 million) has a chronic medical condition of one kind or another.[7][8] However, most of these people are not actually disabled, as their medical conditions do not impair normal activities.[8]

Ninety-six percent of people with chronic medical conditions live with a condition that is invisible. These people do not use a cane or any assistive device and act as if they did not have a medical condition.[9] About a quarter of them have some type of activity limitation, ranging from mild to severe; the remaining 75% are not disabled by their chronic conditions.[8]

Those with invisible disabilities are protected by national and local disability laws, such as the Americans with Disabilities Act in the US. The Rehabilitation Act of 1973 has been amended several times such that the definition of "handicapped" includes the statement, "any person who... (C) is regarded as having such an impairment".[10]

This particular defining point of "handicapped" puts the assessment of impairment in the hands of observers who may or may not regard others as having an impairment. For people with disabilities, invisible or not, this creates a space for discriminatory practices which stem from the observer's perception of who is disabled and who is not.

In the United Kingdom, the Equality Act 2010 (and the Disability Discrimination Act 1995 before it) require employers to make reasonable adjustments for employees with special needs, including disabilities both visible and invisible.[11]

Responses

A growing number of organizations, governments, and institutions are implementing policies and regulations to accommodate persons with invisible disabilities. Governments and school boards have implemented screening tests to identify students with learning disabilities, as well as other invisible disabilities, such as vision or hearing difficulties, or problems in cognitive ability, motor skills, or social or emotional development. If a hidden disability is identified, resources can be used to place a child in a special education program that will help them progress in school.[12]

One mitigation is to provide an easy way for people to self-designate as having an invisible disability, and for organisations to have processes in place to assist those so self-designating. An example of this is the Hidden Disability Sunflower,[13] initially launched in the UK in 2016 but now gaining some international recognition as well.

See also

References
  1. Shapiro, Alison Bonds, M.B.A. (12 August 2010). "Hidden Disabilities". Psychology Today. Retrieved 13 July 2012.
  2. "TSA: Hidden disabilities". Transportation Security Administration, United States Government. Archived from the original on 1 July 2012. Retrieved 13 July 2012.
  3. Biderman, Beverly (11 July 2012). "Being a deaf traveller has its perks". The Globe and Mail. Retrieved 13 July 2012.
  4. Anderson, Valerie (2004). Research Methods in Human Resource Management. CPID Publishing. p. 161. ISBN 9780852929827.
  5. Holland, Jessica. "The hidden challenges of invisible disabilities". Retrieved 27 November 2018.
  6. "Persons with a Disability: Labor Force Characteristics Summary" (Press release). Bureau of Labor Statistics. 26 February 2019. Retrieved 28 November 2018.
  7. "Invisible Disabilities Information: What are Invisible Disabilities?". Disabled World. Retrieved 13 July 2012.
  8. "Chronic Conditions: Making the Case for Ongoing Care". Chronic Care in America: A 21st Century Challenge, a study of the Robert Wood Johnson Foundation & Partnership for Solutions: Johns Hopkins University, Baltimore, MD for the Robert Wood Johnson Foundation (September 2004 Update).
  9. 2002 US Census Bureau
  10. Pelka, Fred. The ABC-CLIO Companion to The Disability Rights Movement. CA: ABC-CLIO, 1997. p. 264
  11. "Equality Act 2010". The National Archives. 8 April 2010. Retrieved 7 October 2018.
  12. Turkington, Carol; Joseph Harris (2006). The Encyclopedia of Learning Disabilities. Infobase Publishing. p. 202. ISBN 9780816069910.
  13. "Sunflower Lanyard Scheme". Retrieved 28 July 2020.

Further reading
  • Sveilich, C. (2004). Just Fine: Unmasking Concealed Chronic Illness and Pain. Avid Reader Press. ISBN 0-9700150-4-6.
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