Patterns of impairment and disability related to social handicap in young people with cerebral palsy and spina bifida.

This paper explores the inter-relationships between impairment and disability in a sample of 119 teenagers in relation to their psychological adjustment and quality of social life. Poor psychological adjustment and extreme social isolation are associated not so much with individual functional limitations as with particular configurations of impairments and disabilities. It seems that social handicap is not a direct consequence of any impairment or disability but arises generally from severe functional loss and is shaped by dependency on others, restricted choices, physical barriers and adverse reactions of others.