Disability and Intergroup Communication
Summary and Keywords
Intergroup communication adds to the general knowledge about disability by summarizing key areas in research and commentary. Intergroup communication is discussed in terms of how stigma affects identification, perception, and communication. Scholarship examining efforts to measure attitudes these groups have about each other, and the effects of inter-group communication on attitudes, beliefs, and behaviors, is reviewed. Scholarly commentary plays a role in the complicated relationship between identity and disability, and how this relationship impacts intergroup interactions, as well as present a summary of studies examining intergroup communication and disability in interpersonal, group, mediated, and professional settings. Illustrations from social media are provided to show how mediated inter-group communication can impact perceptions and knowledge. Studies are presented from an international perspective, allowing for culturally based comparisons.
Keywords: disability, disability studies, disability advocacy, stigma, communication technology, communication disorders, communication education, assistive technology, nonverbal communication, intergroup communication, interpersonal communication, mass media, organizational communication, uncertainty reduction/uncertainty management
A person with a disability is defined by the Americans with Disabilities Act (ADA) as one who has “a physical or mental impairment that substantially limits one or more major life activities, a person who has a history or record of such an impairment, or a person who is perceived by others as having such an impairment.” The definition of major life activities was expanded and clarified in 2008 amendments to the Act and includes, but is not limited to “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.”
Three terms are widely used in further describing a person with a disability and assessing the disability’s impact: impairment, disability, and handicap. The 29th World Health Assembly of the World Health Organization defined impairment as “any loss or abnormality of psychological, physiological, or anatomical structure or function” (WHO, 1980, p. 27). Impairment may be mild or severe, ranging from, for example, a slight visual deficit such as myopia (easily corrected with glasses) or a mild learning disorder, to more extreme cases such as loss of a limb or paralysis, or mental illness. Impairments may be temporary or permanent. In contrast, the WHO defines disability as “any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being” (WHO, 1980, p. 28). In other words, labeling one as having a disability or disabled implies abnormality—outside the range of normal. Finally, the WHO defines handicap as “a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfillment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual” (WHO, 1980, p. 29).
Possible interactions and relationships among these three categorical definitions are illustrated in the following example. A severe visual impairment caused by a detached retina results in a disability related to sight that is likely to be handicapping to an airline pilot or truck driver (for whom visual acuity is necessary to perform tasks required for their employment) but not to a radio broadcaster (whose role can be performed with accommodations despite the visual disability). Pharoah (1990) notes that a disability such as blindness may be caused by a broad variety of physical impairments related to genetics, disease, or injury.
The distinction between disability and handicap is clarified if one recognizes that disability relates to the ability to perform a particular task in a particular way. A worker with a disability may be unable to perform the task in the conventional way, but with appropriate accommodation may perform it proficiently. Only when there are insufficient accommodations available to allow the individual to perform a “normal” role is a person with a disability considered to be handicapped by that disability.
Closely related to this distinction is the notion that technological advancements may reduce the handicapping effects of a given disability. For example, individuals with visual or developmental disabilities now have available to them technological innovations in the form of assistive devices and interactive digital technology that may serve to reduce handicaps in performing required tasks. Self-driving automobiles may soon be used by those with visual or limited cognitive impairments, allowing for increased independence and autonomy. The level of technological innovation in a society can also affect the extent to which a disability is, or is not, handicapping. For example, a neurological condition resulting in an inability to read may be handicapping in a modern technological society, but could produce no handicap in a traditional agrarian one (Pharoah, 1990).
Communication Implications of Disability
In her Preface and Introduction to the Handbook of Communication and People With Disabilities (Braithwaite & Thompson, 2000), Thompson noted how, to her knowledge, most if not all disability scholars began studying the topic due to personal experience with disability (Thompson, 2000a, 2000b). This scholar pointed directly (and wisely) to something those who study disability know well—personal experience, either directly through one’s own disability, or through personal connections—communicating, living, working, or learning directly through someone with a disability, and seeing how others communicate with a person with a disability, are tremendous influences in our lives, shaping not only our perspectives on research but on the world. She writes, “those kinds of experiences impress themselves on one’s heart—they influence the kind of person you become and the types of things you find worthy of study …. The power of those personal experiences is a reflection of the nature of the phenomenon that is our focus” (Thompson, 2000b, p. 3).
Ryan, Bajorek, Beaman, and Anas (2005) noted a number of implications of the effects of disability on communication between those with disabilities and those without. They write, “once disabled, one’s conversations with able-bodied people might now be interpreted as intergroup encounters in which the person with the disability is marginalized” (p. 118). In other words, “disabled” becomes the primary group association, and that primary association now becomes a generally negative or abnormal one.
As Ryan et al. (2005) continue, “intergroup communication can simultaneously affect the physically challenged person’s evolving social identity and their communication patterns with others. Adjustment to the changed social milieu can lead to a limited social identity, but more positive outcomes are possible through the use of empowering communication strategies” (p. 118). Indeed, research examining inter-group communication in this area has spanned a broad spectrum of positive and negative behaviors and effects, examining broad issues of culture and identity along with documenting patterns and effects of individual behaviors. Recurring themes of stigma, stereotypes, and perceptions of disability are found consistently across contexts and methods related to the study of intergroup communication and disability.
Disability Studies is the broad field associated generally with research on disability and its effects on people, places, organizations, and societies. Many disability scholars, perhaps due to the connection observed by Thompson (2000a), that most if not all of the individuals who study disability have some personal connection with disability, also engage in some form of disability advocacy. Indeed, drawing attention to disability in research could be seen as an act of advocacy itself, given the dearth of research in the area compared to research on communication between other, larger or more common groups. Disability studies is often approached from a social justice perspective, where persons with disabilities are treated as members of a minority or disenfranchised group. The Americans with Disabilities Act (ADA, 1990) has been widely credited with focusing attention on disability issues in the U.S., spurring research and activism and providing “a historical marker for the disability civil rights movement” by broadening the U.S. legal definition of disability and giving “people with disabilities a bigger role in negotiating their own reasonable accommodations” (Merrigan, 2000, p. 223).
Simpson (2009) wrote about the digital divide related to the unique needs and accessibility concerns that impact those with disabilities and analyzed U.S. policies affecting the accessibility and adoption of communication technologies for persons with disabilities. She identified a number of “digital divide disability fracture lines” aligned with various communication technologies. Her analysis emphasized the need for policymakers to learn the needs for persons with disabilities related to each form of communication and create government mandates and voluntary commitments to improve accessibility. Specifically, telecommunications relay services, mandating accessible phone devices and services, developing telephone standards for accessibility, captioning, video descriptions, and accessible interfaces are strategies recommended to reduce the digital divide and improve inter-group communication between people with disabilities and others.
A review of recent research on technology and disability reveals a general focus on technologies to enhance mobility rather than those that can help or hinder communication. However, some scholars have looked at ways technology can enhance, enable, or impede communication between the disabled and non-disabled. New technologies have expanded modalities for augmentative and alternative communication (AAC), a broad category that encompasses a variety of strategies for individuals with impairments in the production or comprehension of communication. For example, wrist wearable technologies now allow vital signs and measures of physical activity to be communicated directly to health professionals or family caregivers of persons with communicative disabilities (Ahanathapillai, Amor, & James, 2015).
Individuals with cognitive and communicative disabilities that affect reading and writing can now communicate through text messaging using pictures, symbols representing words or phrases, or via speech recognition (Buchholz, Müller, & Ferm, 2013). Research funded by the National Institute on Deafness and Other Communication Disorders (NIDCD) continues to support improved hearing devices and more natural speech synthesis, and explores how neural signals in the brain might be translated into communication for persons with conditions like ALS that severely impair both speech and movement.
Disability affects one’s identity or self-concept; this self-conceived identification in turn affects impression management, or how we use communication (verbal and non-verbal) to influence the images others hold of us (Merrigan, 2000). Conceptualizing disability according to the medical pathological model, for example, where disability is framed as a health-related disease or defect, is a source of cultural disempowerment and miscommunication for persons with disabilities, in stigmatizing people with disabilities as “defective or abnormal” (Merrigan, 2000, p. 225). Iwakuma and Nussbaum (2000) demonstrated, through their analysis of views of disability in Asia and Africa, that the meaning of “disability” can vary considerably from culture to culture, is context-dependent, and culture-bound. Therefore, the impact of disability on inter-group interactions is also likely to be highly culture-specific.
Stigma, Stereotypes, and Perceptions of Disability: Effects on Intergroup Interactions
The stigma of disability (Goffman, 1963) affects intergroup communication in primary, direct, and varying ways. Stigma contributes to both ignorance and fear of people with disabilities by others. Non-disabled individuals may view those with disabilities as inferior, frightening, or dangerous. Perceptions of difference versus similarity in general are related to inter-group communication and disability in that perceived differences may lead to stigma, stereotypes, and misperceptions of disability.
Research examining the stereotyping of people with disabilities as reflected in news media have identified the most common disability stereotypes appearing in U.S. and international news outlets, such as the “supercrip,” hero, victim, or survivor (Clogston, 1994; Haller, 1993, 1995; Haller, 2000; Jones & Reyna, 2010; Jones & Smith, 2007; Longmore, 1985). Ten disability stereotypes, identified by Norden (1994), include “the civilian superstar” (world-class performer); “the noble warrior” (disabled war veteran); “the comic misadventurer” (one whose disability causes self-directed or other-directed problems); “the elderly dupe” (an aged disabled character who is easily fooled); “the high-tech guru” (wheelchair-using male who proves unusually adept at managing technology); “the obsessive avenger” (typically male character who seeks vengeance on those responsible for his disability and/or violating moral code); “the saintly sage” (elderly disabled character with remarkable means of perception); “the sweet innocent” (typically a child or young woman, whose pure, Godly, humble presence is designed to bring out the protectiveness of able-bodied characters and who typically receives some kind of “miracle cure” or “healing” of the disability); “the techno marvel” (character whose prosthesis performs better than the physical part replaced); and “the tragic victim” (usually a poor social outcast whose character dies at some point in the film).
As Wolfson and Norden (2000) note, the images portrayed through these stereotypes “typically bear little resemblance to the actual experiences and lifestyles of people with disabilities” (p. 295); Klobas (1988) and Longmore (1985) attribute much of the stigma, misunderstanding, and fear about those with disabilities among the able-bodied to this “cultural chasm” between popular culture and reality.
Trait attributions and stereotyping have been documented in perceptions of non-disabled and wheelchair user students (Fichten & Amsel, 1986). Fraser, Kenyon, Lagace, and Southail (2016) identified stereotypes associated with age-related conditions and assistive device use in Canadian media, concluding media depictions may exacerbate stereotypes, resulting in more limited options and reductions in help seeking and assisted device use.
The concept of disability as a positive identity, where disability is communicated as a signal of group membership, has also been explored. Examples such as a mother of a child with Prader-Willi syndrome referring to herself as a “PWS Mom” (Jones & Adams, 2008) or a person with Tourette syndrome referring to himself and others with Tourette as “Touretters” (Jones & Reyna, 2010) illustrate intentional use of “disabling” language to rather intentionally communicate association with others who share a disability. Social media “badges” and other forms of communication further demonstrate positive associations in support of various forms of disability.
The notion that able-bodied people hold negative attitudes toward physically disabled persons was documented in the late 1970s and early 1980s (Jackman, 1983; Yuker & Block, 1979). Also during that time, research suggested that non-disabled people were likely to avoid contact with people with disabilities (Eberly, Eberly, & Wright, 1981), perhaps in part due to anxiety (Snyder, Kleck, Strenta, & Mentzer, 1979). These earlier attitudes and behaviors may be closely linked to the notion of negative spread. Spread refers to the human tendency to replace missing information about an individual with substituted information that is perceived to be consistent with a known attribute. For example, in the case of disability, observer’s perceptions of burden and severity of disability may be greater than the experience of the person with the disability (Olkin, 1999). In the case of negative spread, negative characteristics are associated with having the disability, in comparison to positive spread, otherwise known as the “halo effect,” a type of confirmation bias where positive thoughts and feelings about an individual in one area result in positive trait evaluations. Spread leads to stereotyping and perceptual distortion which in turn affect inter-group communication.
In one study that appears to document the negative spread phenomenon, Fichten and Bourdon (1986) found that, while interactions between disabled and non-disabled were generally socially appropriate, nondisabled students described wheelchair users as unassertive or passive; stated the belief that the behavior of wheelchair users reflected self-pity; and further, that wheelchair users perceived themselves as a burden to others. Wheelchair users, in contrast, reported that many nondisabled students avoided or prematurely terminated social interactions, while others were perceived as participating in do-gooder or “missionary” behavior that was perceived as overly solicitous or patronizing. Wheelchair users believed they were stereotyped by students who lacked understanding of the realities and challenges of wheelchair use. The authors conclude that neither group lacked an adequate understanding of appropriate social interaction, but that execution of known appropriate communication was inhibited by attitudes, uncertainties about how the other would respond, and a lack of self-confidence. More recent research has led scholars such as England-Kennedy (2008) to note that those with disabilities “have moved away from being primarily portrayed in unrealistic ways, such as villains, victims, and monsters (with a scattering of realistic portrayals) to being more often depicted as super-human, and just plain human” (p. 112).
Communication about disability and handicap may vary both between those who are part of disability culture and the non-disabled and across subcultures within the larger society. The definition of impairment is, as noted above, a question of biological deviation from normality and as such is subject to relatively little variation over time or across cultures, (except as medical opinion and diagnostic technologies change). Disability and handicap are, however, much more labile as they are subject to influence by changes in means of economic production, (e.g., shifts from agrarian, to industrial, to knowledge economies) cultural norms, and a variety of other societal factors. Perceived handicap and disability, and appropriate individual and cultural communication about these issues, therefore may undergo temporal changes and vary substantially across cultures, thus complicating intergroup communication.
As an example, changing perceptions of physical disability in Ireland, spurred by the rapidly changing nature of work in the nation’s economic and employment opportunities during the first decade after joining the EU, led to intracultural clashes over disability status. Lynch (2013) notes that this was exemplified in the reaction to inclusion of disability status in equality legislation passed in the late 1990s. Pushback against this legislation was quite substantial and, according to Lynch, illustrates the presence of two cultures and two sets of values in Ireland “the longstanding culture that defined access to public services as a form of charity given at the goodwill of the State and its agents, and a culture that defined public services as rights to which people had entitlements” (Lynch, 2013).
A similar, but more profound marginalization of people with intellectual disabilities has also been noted in Irish culture. Sheerin (2013) describes the system for dealing with intellectual disabilities marked by a “care/control” philosophy that led people with intellectual disabilities to accept that their reality was different from that of other human beings. As objects of charity, they were expected to extend their hands to receive the generosity of others. This marginalization moved the group out of societal consciousness to the point that they were “forgotten” by society. Recent economic slowdowns in Ireland appear to have reinforced some of the traditional views of persons with disabilities as objects of charity.
Wa Munyi’s review of historical attitudes toward disability across cultures notes a historical pattern of marginalization and separation from society and notes that in pre-scientific cultures “the desire to avoid whatever is associated with evil has affected people’s attitudes towards people with disabilities simply because disability is associated with evil.” (Wa Munyi, 2012). Wa Munyi notes that this attitude frequently persists in family communications about disability even when societal institutions approach it from a more neutral standpoint. Zheng and colleagues (2016) conducted a cross-sectional survey in Guangzhou, China to characterize attitudes toward disability among people with disabilities, family caregivers, and the general public. Caregivers had the least positive attitudes on the Attitudes Toward Disability scale, while persons with disabilities had the most positive scores. Lower scores among caregivers were associated with longer duration of caregiving. To the extent that disability culture exists, communication between a family caregiver and a person with disabilities is both intercultural in the sense of communication from non-disabled to disabled, and intra-cultural as it reflects family traditions and family socialization. The authors concluded that the negativity of caregivers may reflect caregiver burden associated with a lack of adequate societal support services for caregivers in China. The “shame” of having a disability and the “pollution” of disability on family members and others, and resulting impacts on inter-group communication, has been documented in Japanese culture (Iwakuma & Nussbaum, 2000).
Communication between people with disabilities and school personnel has been studied; for example, Malian and Nevin (2000) proposed strategies for intergroup communication from a psychodynamic perspective; Worley (2000) summarized interability communication on the college campus around three types of variables identified by Dunkin and Biddle (1974): preoperational or presage, context, and process. Frymier and Wanzer (2003) examined differences in perceptions of students’ communication with professors in a study comparing students with and without disabilities. Their results indicated students with disabilities perceived their interactions with their instructors somewhat differently than the students without disabilities. Interestingly, students with learning disabilities perceived their instructors as less effective communicators than those with physical disabilities, signaling professors may not be prepared enough to fully accommodate the communication needs of students with learning disabilities.
Kayama and Haight (2013) examined communication between teachers and parents of children with special needs, a group only recently identified in Japan. In Japan, cultural beliefs and practices related to stigma resulted in formal special education services for developmental disabilities not being introduced until the 2007–2008 school year (Kayama & Haight, 2013). Parents interviewed in this study expressed concern, support, fear of stigma, and sometimes difficult family conversations about their children’s learning disabilities. The concept of Henken, or discriminative views in society, including stigma, was discussed in relation to the child’s disability. Cooper (1994) also found the views of one immigrant family to be significantly impacted by lack of understanding about disability and concerns over community-based stigma. These qualitative reports are consistent with research examining newspaper coverage of disability, where international reports were more likely to use “disabling” language and negative frames compared to U.S. outlets in general (Jones & Reyna, 2010; Jones & Smith, 2007). Cultural variations in intergroup communication and disability, as demonstrated in interpersonal and mediated contexts, merit additional study and analysis.
Strategies for Interability Communication
Speech or behavior directed by able individuals toward people with apparent disabilities frequently differs from speech or behavior directed at those without such disabilities. This modified behavior or speech is not necessarily intended to be demeaning, but nevertheless may be interpreted by the person with disabilities or bystanders as patronizing communication. Patronizing speech or gestures represent over-accommodation to the appearance of disability (Ryan, Hummert, & Boich, 1995) and may also convey negative spread. A familiar image of the “helpful” clerk who speaks loudly and slowly to someone with a perceived disability, whether or not that disability is related to hearing, illustrates this phenomenon. Behavior perceived by others as patronizing is often merely intended to be helpful; nevertheless, the patronizing talk sets the disabled person apart from those without disabilities in ways that are unhelpful and dehumanizing for the target. Behavior intended to be helpful may be especially likely to be perceived as patronizing when it represents “overhelping,” when it is proffered without a request or implies incompetence or dependence on the part of the person with a disability (Braithwaite & Eckstein, 2003).
This paradox of defining the appropriateness of helpful behavior was illustrated by Morris (2007), who studied patronizing speech toward persons with intellectual disabilities and noted that respondents rated a cashier who used patronizing speech as warmer, more nurturing and more caring than a clerk who did not communicate in this manner, but also perceived this clerk’s communication as more dominant, less professional, less appropriate, and less respectful. Morris (2007) notes that this “illustrates the paradox that is associated with patronizing speech: it stems from a desire to help or be nice, but … can actually cause emotional, mental, and physical harm to its listener.” Similarly, Fox and Giles (1996) presented vignettes with and without patronizing of a person with disability and noted that recipients and observers felt less supported and less comfortable when speech was patronizing and that an individual engaging in patronizing communication was perceived as less competent, less sensitive, and less social.
Responses to patronizing communication may be passive or may involve active resistance to and correction of the patronizing behavior. Ryan et al. (2005) proposed “selective assertiveness” as a central construct in moderating the effects of stereotyping on inter-group communication between persons with disabilities and those without. The researchers proposed The Communication Predicament Model of Disability, a descriptive model that depicts the potential moderating effect of selective assertiveness in encounters between people with disabilities and others. The focus of the model is on communication behaviors designed to specifically address the effects of stereotyping, and draws on constructs from Communication Accommodation Theory (CAT, Giles, Coupland, & Coupland, 1991). In this model, the “predicament” represented is a negative feedback cycle characterized by four phases: stigmatization (phase one), modified communication (phase two), passive or aggressive reactions by the person with disability (PWD) (phase three), and negative consequences for social identity (phase four).
According to the model, “conversational options” may be introduced into the inter-group communication feedback loop to address the negative effects of stigmatization and stereotyping. Selective assertiveness is recommended specifically as an effective strategy at the individual level “to elicit respectful behavior on the part of the able-bodied” (Ryan et al., 2005, p. 126). “Selective” is used to indicate “goal-based, situational choices involved in when and how to be assertive” (p. 127). At the group level, recommended communication strategies for the disability group include “social creativity,” seeking new positive dimensions for inter-group comparisons, and “social competition,” striving politically to gain status and social resources.
Resource Theory (Foa & Foa, 1974) was posed by Soule and Rohloff (2000) as a framework to examine and explain inter-group communication between disabled and non-disabled persons in situations where able-bodied persons provide assistance to those with disabilities. The theory assumes communication as a form of social exchange, where individuals use “cognitive filters” to interpret the actions of others, and is used to explain reasons for negative outcomes in these types of interpersonal interactions. Soule and Rohloff (2000) recommend a number of communication strategies for persons with disabilities and able-bodied persons and recommend future research focus on three issues: determinants of appropriate assistance, means of providing nonthreatening assistance, and conflict management strategies for people with disabilities.
The independent living model developed in the United States in the 1980s as part of a broader disabled person’s movement is an example of social creativity, where PWDs were encouraged and enabled to make their own care decisions and goals. Adopting the term “independent” allowed PWDs to redefine and use the term in alignment with a general American philosophy of independent living. Social competition goals and strategies can be seen in disability rights activism related to the social discrimination of “ableism” and legislation providing equal rights for those with disabilities.
In research examining interpersonal communication in a retail setting, Ryan, Anas, and Gruneir (2006) explored participants’ ratings of overhelping, underhelping, and professional speech styles. Assertiveness options for managing needed or unwanted help in this setting could improve intergroup communication, perceptions of customer satisfaction, salesperson effectiveness, and perceived competence. In a study examining televised representations of deafness, Foss (2014) found support for a pathological model, in which deaf characters are framed as vulnerable or dehumanized, with the cochlear implant being promoted as a cure for deafness. Tolerance and acceptance were also found in reinforcing deafness as a cultural trait. Real-life tensions between the Deaf community and medical experts are believed by Foss (2014) to have been represented in television during the study period, 1987–2013.
Effects of Perception and Attribution of Disability on Inter-group Communication
Secondary gain has been defined as “gain achieved from the … symptoms, which enables the patient to avoid a particularly noxious activity or which enables the patient to get support from the environment (gain) not otherwise forthcoming” (Fishbain, 2007, p. 1095). The breadth of the conditions that can be defined as disability under the ADA make disability status vulnerable to manipulation for secondary gain and, conversely, put the person with a disability at risk of being perceived as malingering or illegitimately exploiting the system. According to Varul (2010), Parsons’ notion of the “sick role” reflected a reciprocity in which individuals defined as sick were excused from performing usual social roles in exchange for making a concerted effort to regain their health. These “secondary gains” were offset by the suffering associated with the illness and by an expectation that the effort to recover was substantial and equivalent to the efforts excused due to illness.
When a condition is defined as permanent and unalterable, and therefore not amenable to improvement, the expectation of effort to recover completely is modified. Further, in modern social welfare states, the person with a long-term or permanent disability is likely to receive economic and social benefits such as educational benefits. In some instances, there may be an expectation that social benefits received encourage a return to the workforce. Benefits may range from formalized medical assistance and service provision to informal supports, such as access to shortened lines at amusement parks or special hours at local retailers.
When a person with a disability receives social or economic benefits, particularly when that individual has an invisible or hidden disability, given research on stigma, stereotypes, and attribution of disability, non-disabled observers may be more likely to perceive individuals as exploiting the system. In cases where individuals are caught doing just that, media outlets may broadcast the “newsworthy” story widely. For example, a 2013 Time magazine article titled, “National Epidemic of Horrible People Pretending to be Disabled,” read, “around the country, an increasing number of ethically challenged human beings are faking disabilities in order to snag good parking spots, cut lines at theme parks, or just bring their dogs into restaurants” (Tuttle, 2013). The article also noted that the use of disabled parking permits by non-disabled persons in Seattle cost the city $1.4 million annually in lost parking revenues. Recent economic downturns among the working class may also be creating resentment related to perceived benefits received by adults not in the workforce, including those with disabilities.
Attribution theory suggests that individuals whose disabilities are perceived as resulting from their own behavioral choices may be viewed more negatively than those whose disabilities are seen as caused by factors beyond their control. Fichten and Amsel (1986) studied trait attributions about college students with a physical disability, finding that “the stereotypes attributed by able-bodied college students to their physically disabled peers can interfere with comfortable interaction between the two groups” (Fichten & Amsel, p. 423). Traits attributed to disabled students by non-disabled students were not only different but the opposite of those attributed to able-bodied students, and were also less socially desirable, with the disabled/able-bodied association “so strong that it overrode even the effects of sex role stereotypes” (p. 423).
Conversely, in research investigating controllability as an attribute of disability, Chan, McMahon, Cheing, Rosenthal, and Bezak (2005) examined data on over 35,000 allegations of workplace discrimination related to disability and found little support for the notion that discrimination was worse for those whose disabilities were attributed as resulting from controllable factors versus uncontrollable ones. As a result, the researchers concluded, “the origins of negative attitudes toward people with disabilities are complex and cannot be explained by attribution alone” (Chan et al., 2005, p. 86). They continue, “the specific impairment, social setting, type of discriminatory behavior, and other characteristics of both individuals and employers contribute to the formation and manifestation of attitudes in complex ways” (p. 86).
While many disabilities are observable or apparent, some are invisible or hidden to the average observer. Invisible disabilities may be intentionally or unintentionally hidden from others. The University of Hawaii’s Center on Disability Studies has identified several “common denominators” that characterize hidden disabilities. These include lack of outward signs such as canes, wheelchairs, use of sign language, etc.; permanence that requires daily coping behaviors; manageable but not curable; and causing physical or emotional pain.
Indeed, shame resulting from a stigmatizing condition, and typically triggered by an experience or “precipitating event” can impact one’s identity through self-assessments that trigger a “negative shame spiral” (Matthews, 1996; Matthews & Harrington, 2000) driven by anger and characterized by maladaptive responses by the person with the invisible disability. Implications for inter-group communication include the need for “health care providers, family members, and friends … to be aware of the potential for their messages to initiate a shame response” (Matthews & Harrington, 2000, p. 416) and for those with invisible disabilities “themselves to learn to respond differently to shame-eliciting situations” (p. 417).
McClure (2011) writes that attribution theory can be used to help explain public misconceptions about one example of a hidden disability, traumatic brain injury (TBI). According to McClure, misconceptions about TBI occur due to misattributions related to the actions of the person with the condition. The “absence of visual markers of the injury” and “the tendency to compare persons with TBI with their peers rather than their own preinjury performance” (p. 92). McClure concludes, “these two processes lead to the opposite pattern to the stigma that occurs with visible disabilities: specifically, a failure among members of the public to recognize that problematic behaviors may result from the injury” (p. 85).
Invisible disabilities, if kept hidden, can go undiagnosed, limiting the effectiveness of potential medical, educational, or workplace interventions designed to help individuals fairly manage the disability’s effects. De Cesarei (2015) studied psychological factors that foster or deter the disclosure of disability by university students, and found factors related to identity, stigma, self-worth, and self-awareness to be associated with decisions to disclose a disability. Specifically, previous positive experiences, high self-awareness, good metacognitive skills, and high self-worth were positively associated with early intervention and family support, metacognitive intervention and support during transition, early support, and psychological support. Conversely, previous negative experiences, social stigma, identity issues and denial were associated with early intervention, family support, legislative intervention, active engagement in defining the situation, and psychological support. In sum, De Cesarei (2015) concludes that self-awareness and good metacognitive skills are critical for the academic success of students with disabilities.
Uncertainty and Interability Communication
In addition to attribution, the construct of uncertainty is probably the other most central and recurring theme across theories applied to the study in inter-group communication between people with disabilities and the able-bodied. Communication behaviors that serve to reduce uncertainty should, in general, have a positive impact on inter-group perceptions, attitudes, and communication. For example, Uncertainty Reduction Theory (URT, Berger, 1979) was applied to an examination of communication strategies recommended during job interviews where the candidate has a disability (Herold, 2000); in evaluating dialectical tensions in communication in personal relationships involving disabled and non-disabled individuals (Braithwaite & Harter, 2000); during client-physician encounters related to genetic syndrome diagnosis (Jones, 2010); and during adjustment to disability resulting from spinal cord injury (Parrott, Stuart, & Cairns, 2000). In each of these studies, specific inter-group communication strategies to reduce uncertainty, such as information seeking and strategic use of self-disclosures, are explored.
In an effort to further refine our understanding of the role of uncertainty in combination with other factors affecting inter-group interactions, Fox and Giles (1996) used Dahnke’s (1983) model of URT, adapted to apply to interability communication, combined with Positive Outcome Value Theory (Sunnafrank, 1986), Social Identity Theory (SIT, Tajfel, 1978), Intergroup Contact Theory (IGCT, and Communication Accommodation Theory (CAT) to develop Interability Communication Theory (ICT, Fox & Giles, 1996), which was later refined by Fox, Giles, Orbe, and Bourhis (2000) by adding the Interactive Acculturation Model (IAM, Bourhis et al., 1997). In general, ICT adopts the perspective that, in interability situations, people with disabilities attempt to “immigrate” into the “host” community and examines interactions in terms of the relational outcomes of host (nondisabled) and immigrant (disabled) communities. In attempting “to explain interpersonal, intercultural, and intergroup motivations for the actions and communication occurring in interability situations” (Fox et al., 2000, p. 218), the ICT holds promise as a theoretical model that could serve to unify several relevant perspectives in the study of inter-group communication between the disabled and non-disabled.
For example, disability resulting from a psychiatric condition is often kept hidden due to the stigma and fear commonly associated with mental illness in many cultures. Similarly, persons may have disabilities related to physical or mental function that they seek to keep hidden. Those with hidden or invisible disabilities may be suspected of malingering, faking, imagining, or exaggerating their symptoms and associated degree of impairment, thus hindering effective inter-group communication between those with disabilities and those who perceive that they may not have a “genuine” impairment. For example, individuals with conditions such as chronic fatigue syndrome or Lyme disease are likely to experience limitations on the part of health care professionals in accurately diagnosing their conditions, and are likely to experience a great deal of uncertainty related to how much information to disclose to others about their illness. This uncertainty could in turn contribute negatively to interactions with others. This is just one example of a situation that would benefit from research applying the ICT.
Summary and Conclusions
Our review of scholarship and popular media coverage of inter-group communication related to disability has yielded more questions than answers. Our call to action, then, is similar to one made by Braithwaite and Thompson in the closing of their 2000 handbook on communication and people with disabilities: “There is still much work to be done” (p. 508) in the field of research that involves the study of communication between the disabled and non-disabled. In identifying areas in need of further scholarship, sadly, we also echo many of the recommendations made by Braithwaite and Thompson 17 years ago. For example, they note,
There has been little work regarding social support and people with disabilities. When such work has been done, the assumption has been that support is one-way, from ablebodied to disabled others. Researchers need to look at support as an exchange relationship between people with disabilities and others and maximize what people with disabilities bring to personal relationships. For example, people who are not working outside the home may have one commodity that many others do not have—time. They may have developed a level of empathy that many others do not have. These issues are relevant to social support.
(Braithwaite & Thompson, 2000, p. 508)
When reviewing the research conducted on interability communication since these words were first published, most of the scholarship conducted over the past two decades appears to have been done from an interpersonal communication perspective, and some inroads have been made in theory development coming from this area. However, many areas of inter-group communication and disability remain largely unexplored.
One possible explanation for the limited amount of research on inter-group communication between the disabled and non-disabled is likely a practical one. As Thompson (2000a, 2000b) and others have noted, people with disabilities and/or their family members are most often the ones who heed the call to study disability and communication, and managing disability on a day-to-day basis can be a resource-consuming affair. The lead author of this chapter, for example, has a teenage son with multiple disabilities and complex special needs. The research ideas and goals always—always—exceed available time and energy, which are depleted much more quickly in comparison to those required to care for a “typical,” independent 15-year-old who does not require around-the-clock care and attention. Those with physical disabilities such as cerebral palsy are likely to tire more easily and have physical conditions that limit one’s time on the computer. A faculty member with depression is likely to find, at times, that teaching a full course load and contributing required academic service is all that can be accomplished, leaving little to no time, energy, or motivation to conduct a study and submit the findings for publication. Scholars who are disabled themselves or who care for others who are disabled are also likely to be involved in advocacy or education initiatives, and these efforts may be seen as more immediate or primary in need at certain points of time or at certain stages of life. Others involved in the management of disability may even have had to leave professional (i.e., scholarly) work altogether to care for themselves or their disabled loved ones.
There are countless opportunities for scholars to look to the study of disability and its effects on communication. For example, researchers interested in documenting the impact of constructs such as mindfulness or resilience on inter-group communication could extend their scholarship to situations such as adjusting to disability; family communication scholars could examine communication between disabled and non-disabled family members to extend and refine theory and research in that important, broad area of scholarship; political communication scholars could study the impact of candidates’ portrayals and treatment of disabled individuals on voter perceptions and voting behavior; those interested in looking at communication from an intercultural perspective could test the social and cultural constructions of “disability,” with the acculturation and socialization of interest occurring between disabled and able-bodied individuals; those interested in media advocacy could examine media coverage and agenda-building efforts related to disability rights, individuals with disabilities, and legal rights of the disabled and their families and caregivers; nonverbal communication scholars could examine the fascinating processes involved in learning how to communicate nonverbally with developmentally delayed child with perception and sensory issues; organizational communication scholars could study the impact of disability in organizations from the perspectives of employers, employees, work teams, and the like.
Stigma continues to play a key role in influencing inter-group communication between those with disabilities and others. Attribution theory has been widely applied to the study of inter-group communication and disability, with mixed results. Differences in disability types have been explored in relation to variations in attribution, perceived similarity, and comfort levels, and the communication behaviors that may result. Media representations of disability have been studied to shed light on common stereotypes, cultural practices, communication norms, and social problems that influence perceptions and communication. A number of studies have examined effects of disability on communication in educational settings; other contexts such as the legal setting and service delivery settings merit further study. Uncertainty reduction and uncertainty management are primary constructs in the study of communication in this area and should continue to be explored.
Cooper (1994) identified themes that people with disabilities and their families face when “adjusting” to disability, and documented the anxiety related to perceived social stigma by family members. Supportive family communication could be a significant source of coping and stress relief for people with disabilities. Research on communication in families of persons with disabilities could shed important light on the study of inter-group communication in the context of disability. How do family members and caregivers consider themselves in terms of primary or secondary group memberships, and how do these perceptions influence communication with their disabled family members? How do individuals with disabilities perceive their own family/community group memberships in relation to their identity as a person with a disability/disabled person? What are the unique ways in which family members communicate with disabled relatives? How do persons with disabilities communicate directly with family members, caregivers, teachers, and others? What are their unique challenges, and what lessons can we learn uniquely from them?
Examining inter-group communication related to organizational challenges in the workplace is a clear area in need of further study. Negotiating realities such as negative spread with specific communication strategies, such as selective assertiveness, is a part of daily life for many with disabilities, and more research should be done to document, predict, and explain these behaviors. Ryan et al. (2005) documented reactions to communication perceived as under-helping, over-helping, and professional in a retail setting; this research could be extended to other similar professional settings to further our understanding of the effects of intergroup communication on people with disabilities and nondisabled “helpers” or supportive professionals or caregivers.
Health professionals are likely to interact with people with disabilities more frequently, since those with complex or unusual medical needs resulting from disability are more likely to see providers at disproportionately higher rates. Much more research should be done to document communication between persons with disabilities and their medical providers. For example, in the case of disabling conditions that leave an individual mentally or physically incapacitated, inter-group communication between the persons with disabilities, their family members or caregivers, and other care providers provide real-life settings to document a broad range of perceptions, motivations, and interactions related to communication practices and needs. Inter-group communication in this context provides an opportunity to examine procedural and supportive communication strategies, expectations, and goals. Research and training on communication in the clinical setting has the potential to improve inter-group communication between PWDs, their caregivers, and their medical providers. The potential effects of supportive communication gained through professional counseling is a related area that merits additional exploration, particularly when the onset of disability results in trauma for the individual and others.
Thanks in large part to social media and the advent of “instant news” via bystanders’ smartphone recordings that can now be posted live as well as shared through traditional media outlets to worldwide audiences, communication between law enforcement agents and people with disabilities has become a topic of growing concern in recent years. To add to media representations and personal stories documenting interactions between people with disabilities and those formally assigned to protect them, research can now include these individually documented experiences. Training programs designed to improve knowledge, perceptions and intergroup communication between people with disabilities and officials, spurred by social media activism, provides another related context to examine communication behaviors and their effects.
Mental illness and other invisible or hidden disabilities that also carry a significant burden of stigma will continue to provide meaningful situations to examine the effects of stigma and misperceptions related to observable functions. As technology continues to advance and medical treatments allow more persons with disabilities to appear “normal,” what impact will the efforts at normalization have on perceptions and inter-group communication?
Smart phones and social media networks allow users to instantly share and create news along with traditional mainstream outlets. As a result, we have seen footage of a man with a disability and his caregiver being called to and then shot by police, along with videos of parents and siblings playing happily with a developmentally and physically disabled family member. Comments can be shared, edited, and viewed by an extended social group. Social media may serve to decrease uncertainty and increase perceived similarity and appreciation more effectively than any other form of inter-group communication due to its unique nature. Media advocacy efforts can and should also be studied as a unique form of inter-group communication involving legal, ethical, political, organizational, and interpersonal contexts related to disability and its impact on societies.
Currently, a cultural phenomenon known as “inspirational porn” exists related to the patronizing effects of mass and social media-distributed images, stories, and headlines that in essence portray persons with disabilities as being “heroic” just for being alive. According to Rakowitz (2016), “these images are created in order to inspire and motivate people, all the while degrading the disabled community by telling the viewer that however bad their life is, it could be worse.” These portrayals are consistent with stereotypes and frames found in mass media in general.
The ability for individuals to interact in real time via social media could be an important area for future research investigating the effects of social media on communication between the disabled and non-disabled, particularly as technology continues to provide new enhancements in communication technologies and media. For example, an article published in the online publication, Parenting Special Needs Magazine, highlights the story of a 16-year-old girl, Natalie Hampton, who developed an app where users can connect with others at their school and privately arrange to sit together at lunch. The intended message of the app is that it is used for bringing people together of all different characteristics, which very well includes the special needs community. Natalie explains that in middle school, she ate lunch alone every day and understands what it’s like to feel disconnected from others, and is quoted in the story as saying, “I can only imagine that kids with special needs have an even greater fear to go up to strangers and ask if they can join the table” (McNamara, 2017). One organization, Special Books for Special Kids, has launched a social media campaign where a special education teacher interviews children and young adults with special needs, in a broadly disseminated representation of inter-group communication. The positive message is designed to promote understanding and reduce uncertainty, and thus is likely to be a successful strategy in improving perceptions and attitudes, leading to more effective inter-group communication. Such social media-driven illustrations provide a rich, timely, unique data set for additional scholarly research and practical skill-building.
Studies examining media coverage of people with disabilities have highlighted patterns and areas for opportunity. How can media advocacy strategies be used to improve public discourse about disability, in turn reducing stigma and raising awareness? Social media may provide the opinion leaders and change agency necessary to stimulate meaningful, lasting change to inter-group communication between people with disabilities and their family members, coworkers, peers, friends, community members, and publics. Grassroots campaigns and programs such as those developed by students who share a desire to improve intergroup communication between people with disabilities and others also have potential to re-shape the effects of stigma and isolation that once characterized the majority of interactions between those with disabilities and those without.
Those with disabilities are often seen or treated as less than a person, in being represented or described as “abnormal” or “subhuman.” There are far-reaching effects of such representations of personhood. For example, proposals that seek to curtail (intentionally or not) the rights and freedoms of those with disabilities, such as work requirements to obtain public benefits or proposed cuts to those benefits, such as food stamps, Medicaid, Social Security, or other forms of assistance, could reinforce underlying assumptions related to the social value of those who, due to disability, are unable to work. Communicating other forms of social value that people with disabilities contribute is one area of inter-group communication that deserves further attention. Communication between people with disabilities and policymakers is a critical area in particular where research could begin to document communication practices and provide a unique context for theory-testing and strategy development.
Finally, one challenge encountered during the development of this chapter was in conceptualizing people with disabilities as “the other” in terms of being a member of another group for the purpose of assessing interability communication from an inter-group perspective. While scholars have previously asserted that disability serves as the “primary” group membership, we propose that looking through lenses of other group affiliations/competing group affiliations and identities may yield important insights. For example, in a family where one of the children is severely disabled, how do the non-disabled siblings and parents see themselves in comparison to the disabled child, and vice versa, in terms of group identity and role perceptions? In other words, is one’s identity as a parent and family member more dominant, impactful, or meaningful, than an identity based on ability? Participation in sports teams, organizations, political events, and community affiliations could provide rich data to test these kinds of complex questions related to intergroup perspectives on disability communication.
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