In Adult Learning Disabilities and ADHD Robert L. Mapou provides scientific and practical guidance on assessing learning disabilities and ADHD in adults. In the excerpt below Mapou looks at the definition of “disability”.
To begin, it is important to understand the distinction between the neuropsychological concept of a learning disability, with which most clinicians are familiar, and the legal concept of a learning disability, which may be less familiar. Note that the same distinction can be made between ADHD as a neuropsychological disorder and ADHD as a disability from a legal perspective. As discussed further, this distinction is important to understand, because not all disorders that cause neuropsychological impairment are considered disabling from a legal perspective. In fact, Gordon, Lewondowski, Murphy, and Dempsey (2002) found that many clinicians were not clear about this distinction.
Regarding the concept of a learning disability, Brumback (2004) noted that the term was first used in a professional context at the 1963 Conference on the Exploration into the Problems of the Perceptually Handicapped Child. At that meeting, Samuel Kirk, who was a professor of special education at the University of Illinois, stated:
I have used the term “learning disabilities” to describe a group of children who have disorders in development in language, speech, reading, and associated communication skills needed for social interaction. In this group I do not include children who have sensory handicaps such as blindness or deafness, because we have methods of managing and training the deaf and the blind. I also exclude from this group children who have generalized mental retardation. (cited in Brumback, 2004)
Shortly after this conference, members of the audience organized the Association for Children with Learning Disabilities (now the Learning Disabilities Association of America), and a grassroots organization focused on learning disabilities began to grow. For many years the term “learning disability” was conceptual rather than legal. It came to refer to a disorder in one of the basic academic skills (i.e., reading, writing, math), as manifested by poor progress in school for children of presumed normal intelligence, but it did not include criteria for determining the degree of disability. Even the first legal definitions of a learning disability, used to identify learning disabled children in public education…did not specify the degree of impairment needed to establish disability.
These educational laws also did not apply to adults. However, the Rehabilitation Act of 1973, which mandated equal access to facilities that received federal financial assistance, established a broad functional definition of disability for both children and adults. For example, Section 504 of the Act is commonly used to provide accommodations for children in school who are disabled but do not require special education services. With the 1990 passing of ADA, the protections of Section 504 were expanded to mandate equal access for individuals with disabilities in public and private settings, including school and work. The definition of who is protected was taken directly from the Rehabilitation Act of 1973 and included in the ADA. According to the ADA:
A disability is “a physical or mental impairment that substantially limits one or more of the major life activities of [an] individual.”
A person is considered disabled if “the individual’s important life activities are restricted as to the conditions, manner, or duration under which they can be performed in comparison to most people.”
The ADA also protects individuals who have a history of a disability or who are perceived as having a disability, as it is intended to cover a broad array of individuals. However, from a diagnostic standpoint, clinicians who are doing evaluations of those with learning disabilities or ADHD focus on the first two criteria. As a result of the ADA’s far broader coverage compared with Section 504 of the Rehabilitation Act, there have been greater demands on the clinician to provide adequate documentation. In response to the ADA, personnel in postsecondary education settings concluded that it was necessary to document that the features of a diagnosed learning disability or ADHD fit with extant research and that the degree of impairment rose to the level of the legal definition of a disability. This, in turn, led to the establishment of guidelines for evaluation of adolescents and adults with learning disabilities and ADHD in the late 1990s (Association on Higher Education and Disability, 1997; Educational Testing Service, 1998a, 1998b).
However, these guidelines have sometimes left clinicians in the position of having evaluated individuals in their practice who clearly had problems in a specific academic skill or had ADHD, but whose impairment might not have met the legal definition of a disability. Think, for instance, of individuals labeled in the past as gifted and learning disabled or having ADHD. Many of these individuals—with superior or very superior intellectual skills, but only average reading or writing skills—could not read or write at the level of their intellect. Although they were impaired compared with peers of similar intelligence and may have received special education services and accommodations in primary and secondary schooling based on an aptitude-achievement discrepancy (Gordon, Lewandowski, & Keiser, 1999), this impairment was relative. Most would not be considered disabled in terms of how they perform life activities “in comparison with most people.”
It is very important to understand this concept…when evaluating adults for learning disabilities or ADHD. It implies that not all learning disorders that cause impairment rise to the level of a disability. That is, a person may be impaired on neuropsychological testing and have relative weaknesses in everyday functioning, but the impairment may not be disabling based on the legal definition. Consequently, from a clinical standpoint, not everyone with neuropsychological impairment qualifies for accommodations. Much research on learning disabilities and ADHD is based on the presence of a disorder or impairment, but typically does not address whether the subject is disabled from a legal perspective. Therefore, for the purpose of definition in this book, the term “learning disorder” is considered broader than the term “learning disability,” with the latter referring to a disorder that is disabling from a legal perspective. However, it is important to note that not everyone writing about learning disabilities uses these terms in the same way. The next three chapters on research and assessment use the term “disorder” interchangeably with “disability,” often based on which term was used in the cited study…