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This alphabetical list provides an explanation of terms that may require clarification. The definitions are taken from original surveys or cited publications as closely as possible, to convey the original authors' perspectives.
Activities of daily living (ADLs): The National Health Interview Survey (NHIS) asks questions to identify people who "need the help of other persons with personal care needs such as eating, bathing, dressing or getting around...(inside the) home." (Adams and Marano, 1995). These particular activities are termed activities of daily living.
The Survey of Income and Program Participation (SIPP) definition of ADL includes eating, bathing, dressing or getting around inside the home, but also specifies getting into and out of bed or a chair, and toileting. The SIPP asks about whether a person has difficulty with any of these ADLs (one of the criteria for disability) and whether a person needs assistance to do the activity (one of the criteria for severe disability).
(See also instrumental activities of daily living).
Activity limitation(s): On the National Health Interview Survey (NHIS), activity limitation refers to a long-term reduction in a person's capacity to perform the average kind or amount of activities associated with his or her age group. (See major activity for an explanation of the activities associated with each age group.) People are classified into one of four categories:
Advocacy services: Service provided to assist individuals with disabilities and their family members, guardians, advocates, and authorized representatives in accessing assistive technology devices and assistive technology services (AT Act of 1998).
Assistive Technology Act of 1998: The legislation that funds the State grant programs and other activities to maintain and strengthen programs of technology-related assistance for people with disabilities. The RESNA Technical Assistance Project provides on the Web a text, PDF and summary version of the AT Act of 1998.
Assistive technology service: Any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device. This includes:
(Adapted from the AT Act of 1998)
Assistive technology device: Any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. (AT Act of 1998)
Augmentative and Alternative Communications (AAC): A broad category of various techniques and devices that enhance expressive language and its comprehension when the routine use of spoken or written language is limited. AAC devices range from word boards to computer based devices. (NIDRR/UCP, 1998)
Blind: See Visually impaired/blind
Capacity building and advocacy activities: Efforts that empower people with disabilities to achieve greater independence, productivity, and inclusion in the community and workplace. These may be achieved through changes in laws, policies, and organizational structures or through facilitating and increasing access to, provision of, and funding for, assistive technology (AT Act of 1998).
Children with disabilities: The Individuals with Disabilities Education Act (IDEA) includes children with mental retardation, hearing impairments including deafness, speech or language impairments, visual impairments including blindness, serious emotional disturbance, orthopedic impairments, autism, traumatic brain injury, other health impairments, or specific learning disabilities. In order to qualify under IDEA, children must need special education and related services by reason of their disability.
Communication: This is the process of expressing one's own thoughts and feelings through spoken, written, and body language, and interpreting the language of others. Communication impairments may involve problems with listening, speech and writing. A person with a communication impairment may use devices such as communication boards, described in more detail under Augmentative and Alternative Communications (AAC). The SIPP includes a measure of communication impairment: whether a person has difficulty or is unable to have speech understood.
The Current Population Survey: (CPS) The CPS is a monthly survey conducted by the U.S. Census Bureau that collects labor force data on the non-institutionalized civilian population. The data presented in this publication are from the March Income Supplement, in which questions related to labor force participation and income are asked of all members of the household 16 years of age and older.
Survey design and sampling -- The sample of approximately 60,000 is selected to be representative of the entire population of the United States, and numbers are "weighted" or adjusted to independent population estimates based on the results of the decennial Census. These weights take into account age, gender, sex, race, Hispanic origin and state of residence.
Respondents -- About 60,000 households were eligible to participate in the survey, representing about 1 in every 1,600 households in the country.
Definitions -- Work disability is the only disability measured by the CPS. People are classified as having a work disability if they:
Deaf: See Hearing impaired/Deaf
Disabled worker: Under the Social Security definition, disabled workers are people under age 65 who receive benefits as part of the Old Age, Survivors and Disability Insurance (OASDI) program. They have been determined to be disabled under Social Security criteria (i.e., cannot engage in "substantial gainful activity.") They have also earned at least a certain minimum amount of wages in employment covered under Social Security in order to receive income from Social Security Disability Insurance (SSDI).
Disability: There is no one definition of disability; the meaning of the word depends on the context in which it is used. The surveys and other sources that we use on this Web site each define disability differently:
According to the AT Act of 1998, disability is defined as a condition of an individual that is considered to be a disability or handicap for the purposes of any Federal law or for the purposes of the law of the State in which the individual resides.
On the NHIS, disability refers to any long- or short-term reduction of a person's activity as a result of an acute or chronic condition.
On the SIPP, people age 15 and over were considered to have a disability if they met any the following criteria:
A person also was considered to have a disability if
Durable Medical Equipment (DME): As defined in the Medicare statute, DME is equipment that is expected to last for a substantial period of time, is subject to repeated use and not consumed by this use, is not needed by an individual in absence of a medical need, and is appropriate for use in the home (NIDRR/UCP, 1998).
Functional activity or activities: The SIPP asked respondents about their ability to perform the following specific sensory and physical activities:
Difficulty in performing any of these functional activities is classified as a functional limitation in the SIPP.
The NHIS-D asked respondents about their ability to perform the following activities:
Inability to perform any of these activities is classified as a functional limitation.
Functional limitation(s): See functional activities.
Hearing impaired/Deaf: A person is considered to be hearing impaired/Deaf if he or she lacks the ability to detect or discriminate sounds. A person with a hearing impairment or deafness may use sign language, or devices to improve face-to-face and telephone communication, such as a hearing aid or TTY/TDD. Systems or companion animals that alert a person to important sounds in the environment may also be useful. The SIPP includes functional measures of hearing impairment and deafness: whether a person has difficulty or is unable to hear normal conversation.
IADL: See Instrumental activities of daily living (IADLs).
IDEA: IDEA stands for the Individuals with Disabilities Education Act, Part B Program. IDEA is now the major federal program that provides states with financial assistance to educate children and youth with disabilities. Before 1995, special education was also funded under the Elementary and Secondary Education Act (ESEA), State Operated Programs, Chapter 1.
Instrumental activities of daily living (IADLs): The NHIS collects information on people's need for assistance from others in performing instrumental activities of daily living (IADLs). The IADLs include: "doing everyday household chores, necessary business, shopping or getting around for other purposes." People who need assistance in activities of daily living (ADLs) were not asked about IADL.
On the SIPP, instrumental activities of daily living include: going outside the home, keeping track of money or bills, preparing meals, doing light housework, and using the telephone.
(See also activities of daily living).
Major activity: In NHIS, people are classified in terms of the major activity usually associated with their particular age group. The major activities for the age groups are:
People ages 18-69 years who are classified as keeping house are also classified according to their ability to work at a job or business. (See activity limitation.)
Mobility: Mobility is movement that involves changing the position of oneself or an object. A person with a mobility impairment may have difficulty with walking, standing, lifting, climbing stairs, carrying, balancing, or having the stamina and endurance to do these kinds of activities. A person with a mobility impairment may use devices such as a wheelchair, crutches, cane, walker, scooter, or standing aid. People with mobility limitations may also need modified transportation (such as an adapted van) or home accessibility features (such as ramps, modified kitchen or bathroom).
The SIPP asks a number of questions related to mobility, including three specific functional activities: walk three blocks, climb stairs without resting, and lift or carry 10 lbs. The SIPP also provides data on the use of wheelchairs, canes and other mobility devices.
The National Health Interview Survey: (NHIS) The NHIS is a principal source of information on the health of the civilian non-institutionalized population of the United States. It has been conducted annually by the National Center for Health Statistics (NCHS) since 1957. Each year, the survey consists of a basic set of questions on health, socioeconomic and demographic items as well as one or more special questionnaires to obtain more detailed information on major current health issues. A special questionnaire on mental health was conducted in 1989 and a special questionnaire on disability, the NHIS-D, was conducted in 1994-95. The NHIS also provides information about activity limitations and chronic conditions.
Survey design and sampling -- The NHIS is conducted according to a multistage probability design, permitting continuous sampling of the civilian non-institutionalized population living in the United States. Each weekly sample is representative of the target population and is additive with other weekly samples. Sampling is done throughout the year, preventing seasonal bias. Information is obtained about health and other characteristics of each member of the household. The usual sample size is approximately 48,000 households or about 122,000 individuals each year.
Respondents -- The interviewed sample for 1994 was 116,179 individuals (45,705 households) and for 1995 was 102,467 individuals (39,239 households). Response rates were 94.1 percent in 1994, and 93.8% in 1995.
Definitions -- The NHIS defines chronic condition as one that has lasted for three months or more, or one that is on the NCHS list of chronic conditions regardless of onset. Disability refers to the state of being limited, due to a chronic mental or physical health condition, in the type or amount of activities. The NHIS has three measures of disability: (1) activity limitation in major activity, (2) work limitation, and (3) need for personal assistance with activities of daily living (ADLs).
National Health Interview Survey on Disability (NHIS-D): In 1994-95, a special questionnaire on disability, the NHIS-D, was included as a topical module on the National Health Interview Survey. The survey was conducted in two phases. Phase I of the NHIS-D was designed to identify a wide range of children and adults with chronic conditions, impairments, disabilities and elevated service needs. Information was collected on 107,469 individuals, of whom 30,032 were children. The response rate for the NHIS-D, Phase I, was 87%. Phase II of the NHIS-D was designed as a follow-up questionnaire with individuals who were identified in Phase I. See functional activity for definitions of this term as used in the NHIS-D.
Non-institutionalized: Many estimates from federal surveys are based only on people who are not in institutions at the time of the survey, that is, the non-institutionalized people in the population. Institutions include correctional institutions, mental (psychiatric) hospitals, residential treatment centers, tuberculosis hospitals, chronic disease hospitals, homes for the aged, homes and schools for the mentally handicapped, homes and schools for the physically handicapped, homes for unwed mothers, homes for dependent and neglected children, training schools for juvenile delinquents, and detention homes for juveniles.
Non-severe disability: In the SIPP, people are classified as having a non-severe disability if they meet the criteria for disability, but do not meet the criteria for severe disability. For example, a person who has difficulties with activities of daily living (one of the criteria for disability) but who does not need personal assistance with activities of daily living, would be classified as having a non-severe disability (unless that person met other criteria for severe disability).
Old Age, Survivors and Disability Insurance (OASDI): This federally-administered program provides monthly benefits to retired and disabled workers and their dependents and survivors. Benefits are earned in employment covered under Social Security. The part of OASDI that provides benefits to workers on the basis on disability is called Social Security Disability Income (SSDI).
Personal assistance: In the NHIS core questionnaire, respondents are asked if they "need the help of other people" with personal care needs (activities of daily living) or handling other routine needs (instrumental activities of daily living). Those who answer affirmatively are categorized as needing personal assistance.
On the SIPP, respondents are first asked whether they have difficulty with any activities of daily living or instrumental activities of daily living. If they report difficulties, they are then asked a follow-up question about whether they need the help of another person to perform the activity, that is, the need for personal assistance.
Prevalence: Prevalence is the number of cases of a disease, number of infected people, or number of people with a given attribute present during a particular interval of time. It is often expressed as a rate or percentage (for example, the prevalence of arthritis per 100 people during a year).
Protection and advocacy services: There are services that are federally mandated to protect the rights of people with disabilities, and assist overcoming barriers to obtaining assistive technology devices and assistive technology services.
Section 508: First adopted in 1986 and amended in 1998, Section 508 of the Federal Rehabilitation Act requires governmental agencies to ensure accessibility by persons with disabilities of a range of communications equipment and other electronic devices purchased for agency use, or purchased with Federal funds for use by the public or other entities (NIDRR/UCP, 1998).
Severe disability: Severe disability is defined by the SIPP as follows: People 15 years and over were identified as having a severe disability if they
Severe work disability: The Current Population Survey (CPS) classified people as having a severe work disability if they:
(See also work disability.)
Special education: Special education refers to free and appropriate public education and related services provided for children and youth with disabilities from birth through age 21. Funding is provided via federal legislation under IDEA.
Social Security benefits: Social security benefits for individuals with disabilities include: (1) Social Security Disability Insurance (SSDI) which is a part of the Old Age, Survivors and Disability Insurance (OASDI) and (2) Supplemental Security Income (SSI). Individuals may receive benefits from either or both programs, depending on their work history, age, and financial resources. See individual listings under these terms for more information about each program.
Social Security Disability Insurance (SSDI): A federal program in the Social Security Administration providing monthly benefits to disabled workers and their dependents. A person builds protection through employment covered under Social Security (compulsory tax on earnings). The disability definition is an inability to engage in substantial gainful activity because of any medically determinable permanent physical or mental impairment. Later amendments required that a person have a disability for at least five months in order to be eligible for SSDI.
Supplemental Security Income (SSI): The federally-administered Supplemental Security Income program provides income support to people 65 and over, as well as blind or disabled adults and children who have little or no income or other financial resources. In order to be considered disabled for SSI, an adult must be unable to engage in any substantial gainful activity by reason of a medically determinable physical or mental impairment that is expected to result in death or last for a continuous period of at least 12 months. Blindness is defined as 20/200 or less vision in the better eye with the use of correcting lenses, or with tunnel vision of 20 degrees or less. Children who have a physical or mental impairment which results in marked or severe functional limitations are eligible for SSI.
The Survey of Income and Program Participation (SIPP) is a multipanel, longitudinal survey conducted by the U. S. Census Bureau.
The SIPP covers the non-institutionalized population of residents living in the United States, and collects data on source and amount of income, labor force information, program participation and eligibility data, and general demographic characteristics. The SIPP also includes disability supplements that ask questions to determine individuals' disability status. Historical background and more detailed information on the SIPP can be found on the Internet at http://www.sipp.census.gov/sipp.
Survey design and sampling. The survey design is a continuous series of national panels in which the same households are interviewed every four months for periods ranging from 2 1/2 to 4 years. A cycle of four interviews covering the entire sample and using the same questionnaire is called a wave. Interviews are conducted by personal visit and by follow-up telephone calls. All household members 15 years old and older are interviewed if possible, and proxy response is permitted when individuals are not available for interviewing.
Respondents. Sample size generally ranges from 34,000 to 40,000. A rough estimate of the number of individuals interviewed would be 85,000 to 100,000, based on an estimated average of 2.5 individuals per household.
Definitions. The questions that have been asked in the disability supplements of the SIPP were designed to be consistent with the definition of disability set forth in the Americans with Disabilities Act (ADA). People 15 years of age and older were considered to have a disability if they met the following criteria:
Functional limitations are defined from the questions asked about the difficulty in performing basic activities such as seeing, hearing, having one's speech understood, walking, carrying or lifting 10 pounds or walking up a flight of stairs. Activities of Daily Living (ADLs) covered in the survey include getting around inside the home, getting in and out of bed or a chair, bathing, dressing, eating and toileting. Instrumental Activities of Daily Living (IADLs) covered in the survey include going outside the home, keeping track of money or bills, preparing meals, doing light housework and using the telephone.
Targeted individuals: Under the AT Act of 1998, targeted individuals include:
Underrepresented population: In the AT Act of 1998, an underrepresented population is defined as a population that is typically underrepresented in service provision, and includes populations such as persons who have low-incidence disabilities, persons who are minorities, poor persons, persons with limited-English proficiency, older individuals, or persons from rural areas.
Universal design: Universal design includes products or designs developed with built-in flexibility enabling use by all people, regardless of age and ability at no additional cost (Mace, Hardie, & Place, 1996). Under the AT Act of 1998, "universal design" means a concept or philosophy for designing and delivering products and services that are usable by people with the widest possible range of functional capabilities. Examples of universal design are curb cuts and captioning of television and movies.
Visually impaired/blind: One is considered to be visually impaired/blind if one lacks the ability to use the eyes to detect and discriminate. Visual impairments may involve difficulties with light sensitivity, depth perception, color recognition, and how things are seen under different circumstances, such as low vs. bright light. A person with a visual impairment may use a white cane, guide dog, Braille, large print, audiotapes, and devices such as writing aids, computer screenreaders and magnifiers. The SIPP includes measures of visual impairment and blindness: whether a person has difficulty or is unable to see words and letters.
Vocational Rehabilitation: This term refers to programs conducted by state Vocational Rehabilitation agencies operating under the Rehabilitation Act of 1973. Vocational Rehabilitation programs provide or arrange for a wide array of training, educational, medical, and other services to meet the needs of people with disabilities. The services are intended to help people with disabilities to acquire, reacquire, and maintain gainful employment. Most of the funding is provided by the federal government.
With employment outcome: This phrase is used to indicate the successful placement of a Vocational Rehabilitation client into competitive, sheltered, or self-employment for a minimum of 60 days after the completion of all necessary rehabilitation services. This category, "with employment outcome," was formerly called "rehabilitated."
Work disability: People were classified as having a work disability by the Current Population Survey (CPS) if they met any of the following criteria:
(See also Severe work disability.)
On the NHIS-D, work disability is defined as a limitation in or inability to work as a result of a physical, mental or emotional health condition.
Work limitation: In the NHIS, this category includes respondents with a chronic health condition that prevents the performance of work at all, allows only certain types of work to be performed or prevents regular working.
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