Importance of Time of Onset and Time of Diagnosis


A recent visit to a children’s home where some of them have different forms and degrees of disability aroused our curiosity into understanding the real facts that surrounded the situation. Some of the children seemed happy while others were really disturbed all that time the visitors were in the vicinity.

Key observations were later correlated to various aspects in life. Despite the varying perspectives between individuals with disability and the society in general, it is important to understand the distinction between the time of onset and time of diagnosis.

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The children’s home was inhabited by both the disabled and handicapped. It is important that the distinction between the two is elaborated for further understanding. Disability can be defined as a situation that restricts the performance of an activity in the normal human range (Smart, 2009).

It is usually beyond medical curative powers. Handicap, on the other hand, is a situation that hinders the accomplishment of a role. Human agency plays a role in addressing handicap issues. Disability can manifest itself during birth or sometimes later in life.

Congenital disability refers to that observed during birth while acquired disability comes at later stages of life. A further analysis into why some children seemed contented with their physical states while others were not is that whereas the former were associated with congenital disability the latter were associated with acquired disability.

Persons who experience later-onset acquired disability are usually faced with a problem of low self-actualization and relating with able persons is difficult. According to Smart (2009), they usually undergo psychogenic pain and stress as they come to terms with the reality.

The time of onset refers to the duration of symptoms. Symptoms for the disabled vary depending on whether the disability is physical or psychological. Parents are faced with a daunting task of observing these symptoms once a child is born and applying adaptive measures in time. The time of diagnosis refers to the moment when it is clear beyond any reasonable doubt that indeed a disability is present. Differential diagnosis refers to that process that separates one form of disability from similar ones.

Early diagnosis is useful in helping family members recognize the trends in emotional and psychological behavior among the disabled. Age, gender, culture and ethnicity may have serious effects on disability. Therefore, research should be enhanced in order to probe into how these variables affect or are affected by disability. Several psychological measures are important in ensuring that cases of disability are diagnosed early enough.

Medical experts can diagnose cases of disability by use of a set of self-report inventories and projective tests .A study conducted showed that people suffering from congenital blindness had a faster perception of touch. According to Eisenberg and Glueckauf, early onset blindness was viewed to enhance the quality of life with regards to non-visual senses (1991).

The adaptation of the disabled differs among those that have congenital disability and those that have acquired disability. As discussed earlier, acquired disability is characterized by a sudden change of social and relational status. Congenital disability is characterized by a gradual change in self actualization (Smart, 2009).

Adaptation is usually regarded as a subjective process because individuals depict an array of variations. The objectivity of the adaptation process is based on the nature of response offered by the disabled person in coming to terms with the condition.

The Quality Of Life (QOL) approach has been used to understand the effects that disabilities have on life aspects. QOL is achieved when these conditions are in place: psychological well-being, physical well-being, social and interpersonal well-being, financial well-being, productivity and functional ability (Eisenberg & Glueckauf, 1991).

The onset of acquired disability is detrimental to QOL. Satisfaction in some domains is usually reduced by disability thereby reducing the QOL. Possible responses by disabled persons may be adaptation, controlled change or no change at all.

Adaptation ensures that individuals come to terms with the reduced QOL by openly understanding and accepting their states. Controlled change is characterized by a change in QOL through increasing satisfaction levels. A no-change scenario may arise when individuals depict negative response to satisfaction levels and the overall QOL (Marinelli & Dell, 1999).

It is important to note that the time of onset and the time of diagnosis are really important to counselors in terms of the rehabilitation process. The QOL approach depends on this information in order to clearly understand varying individual variations as far as disability responses are concerned.

Marinelli and Dell (1999) are of the opinion that positive and negative experiences can be clearly distinguished with a comprehensive QOL approach. The Disability Centrality Approach (DCA) examines the level of impact that disabilities have on aspects of life. It is therefore important to understand the individuals’ experience with regard to social relations, physical and mental health. Priority then should be given to the life aspect that positively affects the life of the disabled as a way of rehabilitation.


It is important that the onset time and diagnosis time are clearly separated and understood if clear adaptation and rehabilitation policies are to be put in place. The perception of the society towards disability should serve to enhance the common good.


Eisenberg, M. & Glueckauf, R. (Eds.) (1991). Disability: Empirical approaches to the psychosocial aspects. New York: Springer.

Julie, S. (2009). Disability, society, and the individual (2nd ed). Aspen Publishers, Inc.

Marinelli, R. P. & Dell, O. A. (1999). The Psychological and Social Impact of Disability (4th ed). New York: Springer.


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