Disability

When people hear the word disability, they often associate the expression only with blindness, deafness, or with those who might rely on a wheelchair. However, disability is much broader in scope and includes people who suffer from chronic illnesses, mental and sensory conditions, neurodiversity, as well as other physical impairments that substantially limit one or more major life activities. 

Consider the following statistics that are related to disability:

• 61 million adults in the US suffer from some type of disability at one point in their lives. (Center for Disease Control)
• 1.3 billion people worldwide live with some form of disability. (World Bank)
• People with disabilities generate $1.9 trillion in annual disposable income (Global Economics of Disability Report)
• 50% of people in the US experience a mental health condition in their lifetime, with depression as the leading cause of disability worldwide. (World Health Organization)

Disability can take many different forms. Physical disability is when one or more of your senses prohibits you from having an equitable experience as do people without the disability. Physical disability generally includes an impairment of visual, motor, or auditory functions. 

Visual impairment

Visual disabilities have a wide range of potential impact. Vision can be related to perception, color, light, and distance. According to the Center for Disease Control (CDC), approximately 12 million people who are 40 years and over in the United States have vision impairment. The following list describes some common types of visual impairment. 

Legal blindness 

You describe normal vision as 20/20 vision, which means that you can clearly see an object that is 20 feet away. A person is legally blind when their vision is 20/200 or less in one eye, which means that if an object is 200 feet away, they need to stand 20 feet from that object to clearly see it. Aside from being born blind, this impairment might also result from some conditions such as glaucoma, cataracts, diabetes, and macular degeneration.  According to Webmd.com, an estimated 1.1 million Americans are legally blind.

Low vision 

Low vision is the best-corrected visual acuity of less than 20/40 in the better-seeing eye, according to the National Institutes of Health (NIH). Glasses, contact lenses, or other standard treatments, such as medicine or surgery, cannot fix low vision. Common causes of low vision include age-related macular degeneration, cataracts, diabetic retinopathy, and glaucoma. Some of the common types of low vision include the following categories: 

• Central vision loss: inability to see things in the center of their vision
• Peripheral vision loss: inability to see things out of the corner of their eyes
• Night blindness: inability to see in low light
• Blurry or hazy vision

The estimates for 2010 indicated that approximately 2.9 million adults in between the ages of 40-80 in the U.S. suffer from low vision. according to the National Eye Institute.

Color blindness 

Color blindness, also known as color deficiency, is when someone cannot distinguish between certain colors. This condition usually affects distinguishing between greens and reds, and occasionally blues. Different degrees of color blindness exist. Some people with mild color deficiencies can see colors normally in good light but have difficulty in dim light. Others cannot distinguish certain colors in any light. 

Color blindness usually affects both eyes equally and remains stable throughout life. The three types include the following categories, according to the National Eye Institute (NEI):

• Red/green color blindness, which is inherited and impacts 5-8% of males. This condition makes reds and greens look similar (brown).
• Blue/yellow color blindness, which is less common.
• Complete color blindness, also called monochromacy, which is an inability to see any color at all. Monochromacy is a very rare condition.

Motor or mobility impairment  

Most motor or mobility challenges arise from damage to the brain or spinal cord. When such injuries occur, signals cannot travel to and from the lower regions of the body, and the body cannot send signals back up the spinal cord to the brain, which leads to paralysis. According to Medical News Today, over 68% of impairments are a result of accidents; however, some chronic conditions can impact mobility as well, such as multiple sclerosis, cerebral palsy, strokes, and tumors. Various degrees of paralysis exist depending on severity, location, or muscle tension. In most cases, individuals use a wheelchair or other devices to support mobility.

According to the NIH, nearly 5.4 million people in the United States live with paralysis.  

Hearing impairment  

According to the World Health Organization, deafness means complete loss of the ability to hear from one or both ears; this condition is profound hearing impairment, with 81 dB or greater hearing threshold. Hearing impairment means complete or partial loss of the ability to hear from one or both ears, with 26 dB or greater hearing threshold. Disabling hearing impairment means moderate or worse hearing impairment in the better ear. Consider the following data for hearing impairments: 

• 6% of the world population suffers from disabling hearing loss. (World Health Organization)
• One-third of people over 65 years in the U.S. have disabling hearing loss. (NIH)
• In the US, 15% of American adults (37.5 million) aged 18 and over report some trouble hearing. (NIH)

Emotional and behavioral disorders generally include conditions that are related to cognitive or intellectual disabilities, learning disabilities, and mental health disorders. Like other disabilities, these disorders exhibit a wide range of severity and symptoms that individuals can experience.

Cognitive or intellectual impairment

Cognitive or intellectual impairment occurs when a person has certain limitations in cognitive functioning and skills, including communication, social and self-care skills. According to the American Association of Intellectual and Developmental Disabilities, an individual has an intellectual disability if they meet the following criteria:

1. IQ is below 70-75.
2. They experience significant limitations in two or more adaptive areas of skills that they need to live, work, and play in the community, such as communication or self-care.
3. The condition manifests itself before the age of 18.

Some challenges these individuals may experience include the inability to:

• Focus on the current task
• Retain information for short periods of time 
• Store and recall information for later use 
• Reason, prioritize, and plan 
• Recognize letters and words and understand written or spoken language 
• Recognize numbers and symbols and to understand and calculate simple math 

According to the Special Olympics, 1-3% of the global population, or approximately 200 million people, has an intellectual disability. 

Learning disability 

Learning disabilities occur usually because of genetic or neurobiological factors that alter brain functioning in a manner that affects one or more cognitive processes of learning, specifically reading, writing, math, and oral language. Consider the following facts about learning disabilities:

• 2.3 million students in the U.S. have specific learning disabilities (SLD). (Learning Disabilities Association of America) 
• 60% of adults in the U.S. with severe literacy problems have undetected or untreated learning disabilities. (National Adult Literacy and Learning Disabilities Center)

Examples of learning disabilities include dyslexia, dyscalculia, dysgraphia, and attention-deficit / hyperactivity disorder (ADHD):

• Dyslexia: trouble making the connection between letters and sounds and with spelling and recognizing words 

• Dyscalculia: problems with understanding basic arithmetic concepts, such as fractions, number lines, and positive and negative numbers 

• Dysgraphia: very poor handwriting or trouble writing

• Attention-deficit / hyperactivity disorder (ADHD): difficulty focusing, paying attention, and following directions

Mental health disorders  

According to the National Library of Medicine and Mentalhealth.gov, mental health includes your emotional, psychological, and social well-being. Mental disorders are conditions that can affect your thinking, mood, and behavior. They may be occasional or long-lasting and affect how you handle stress, relate to others and function every day. 

Some common mental health disorders include the following conditions:

• Anxiety disorders
• Behavior disorders
• Eating disorders
• Substance abuse disorders
• Mood disorders
• Obsessive-compulsive disorders
• Personality disorders
• Psychotic disorders
• Trauma and stress-related disorders

The definition of disability can extend beyond those individuals with a permanent disability to include those people who might have a temporary or situational impairment. In each use case, the individual faces some type of challenge. For example, while one user might be permanently hearing impaired, another person might simply have an ear infection that is temporary but still has the same effect for a time period. Another individual might work in a location where they cannot hear because of the surrounding noise (bartender) or required silence (librarian). In this context, the number of people who experience some kind of disability greatly increases.

Microsoft provides a toolkit to understand how a solution can scale for this broader audience such that it addresses permanent, temporary and situational impairment. In the following figure we show an example of this from the perspective of mobility.

With the lens of permanent, temporary and situational perspective, you can imagine how the impact would be for those with hearing, visual or speech impairments.