3.2 Explain what is meant by the ‘triad’ and ‘dyad’ of impairment

This guide will help you answer 3.2 Explain what is meant by the ‘triad’ and ‘dyad’ of impairment.

The concepts of the ‘triad’ and ‘dyad’ of impairment are used in the field of health and social care to describe how people may experience barriers in life due to different kinds of impairment. These words are sometimes used in theory and practice to help professionals understand how an individual’s difficulties affect their life and daily routines.

Both the triad and dyad frameworks are important for identifying needs and planning support for people using health and social care services. By understanding these models, workers can provide more effective, thoughtful, and personalised care.

What Is Impairment?

Impairment means any loss or abnormality of physical, mental, or sensory function. This can include problems with movement, thinking, or perception. Impairment can result from birth, illness, accident, or age.

Some common types of impairment are:

• Physical (e.g., paralysis, limb loss)
• Sensory (e.g., sight or hearing loss)
• Intellectual (e.g., learning disabilities)
• Cognitive (e.g., dementia, brain injury)
• Mental health (e.g., depression, schizophrenia)

It is important to remember that impairment is not the same as disability. Impairment refers to the actual condition or difference with the person’s body or mind. Disability is the disadvantage or restriction caused by society not meeting the needs of people with impairments.

The Social and Medical Models

Before looking at the triad and dyad, it helps to understand the social and medical models of disability.

• The medical model sees disability as a problem within the person, caused directly by their impairment.
• The social model sees disability as a result of barriers in society. These can include attitudes, inaccessible places, or lack of support.

This difference is important. The triad and dyad help show how impairment and society interact.

The Triad of Impairment

The ‘triad’ of impairment refers to three main areas where a person might experience barriers or difficulties because of their impairment. These three areas are:

• Impairment itself
• Disability (social barriers and exclusion)
• Handicap (restrictions in everyday life)

Let’s break these down.

1. Impairment

This means the actual condition or change in body, mind, or function—such as limb loss, blindness, deafness, or learning disability.

Impairment is about the clinical facts or diagnosis. For example:

• A person born without sight has a visual impairment.
• Someone with cerebral palsy has a physical and neurological impairment.

2. Disability

Disability refers to the disadvantages that result when society does not accommodate people with impairments. This could occur when buildings do not have ramps, or written information is not available in braille.

Disability is not caused by the impairment itself but by the way society is organised.

Examples include:

• A wheelchair user being unable to access a public building because there is no lift.
• A deaf client being unable to participate fully in activities due to lack of a sign language interpreter.

3. Handicap

Handicap is the disadvantage a person experiences in daily life due to both their impairment and disability barriers in society. It reflects the practical results, such as loss of job opportunities or social roles.

The World Health Organization originally used ‘handicap’ to describe decreased participation in daily roles. The word is less common now and many prefer terms like ‘social participation’ or ‘activity limitation’.

For example:

• A person with mobility impairment (impairment) who cannot get on a bus with steps (disability) is unable to attend social events (handicap).
• A person who is unable to hear (impairment), who faces a lack of information in accessible formats (disability), may be excluded from community life (handicap).

The Triad and Professional Practice

Using the triad helps workers see that a person’s experience is shaped by both personal and external factors.

The three parts encourage workers to:

• Identify the type and level of impairment
• Recognise barriers in the environment or attitudes
• Consider how these together affect the person’s participation in daily life

This holistic approach supports good assessment and planning.

The Dyad of Impairment

The ‘dyad’ of impairment describes two main elements: the physical/mental condition (impairment) and its resulting social consequences (disability).

The dyad is a simplified model. Some frameworks group the triad into just two factors, arguing that ‘handicap’ and ‘disability’ overlap. Usually, the dyad covers:

• Impairment: The direct loss or difference in functioning
• Disability: The resulting restrictions caused by lack of inclusion or support in society

Sometimes, the dyad is used for simplicity or in settings where the distinction between ‘disability’ and ‘handicap’ is less important. It still reminds workers to think about both the person’s condition and how society responds.

Example of the Dyad

A child with dyslexia has an impairment affecting how they process written words. If classroom materials are not adapted, that child faces difficulties in learning—this is the disability created by the environment.

If the learning materials are made accessible (for example, with coloured overlays or audio), the ‘disability’ is reduced or removed even though the child’s impairment remains.

Differences Between the Triad and Dyad

The triad model includes a third stage: the effect on social participation (handicap). The dyad stops at considering impairment and disability.

Some key points:

• The triad is more detailed. It is helpful when exploring complex situations.
• The dyad makes things simpler. It is sometimes used in settings where service planning does not separate disability and handicap.
• Both models help workers identify barriers and provide informed support.

Origins and Use in Assessment

Both words come from older theories and classifications in health and social care.

• The ‘triad’ comes from the World Health Organization’s early work (International Classification of Impairments, Disabilities, and Handicaps, 1980).
• The ‘dyad’ is used in some policy and academic work.

More recent terms are ‘impairment’, ‘activity limitation’, and ‘participation restriction’. These come from the International Classification of Functioning, Disability and Health (ICF, 2001). While terms change, the idea is the same. Workers need to consider both clinical conditions and the role of society in either including or excluding someone.

In practice, the models guide workers to assess:

• What is the person’s impairment?
• Are there societal barriers making this worse?
• What is the impact on day-to-day life?

Examples from Health and Social Care

Example 1: Physical Impairment

A man has lost part of his leg (impairment). He struggles to enter public buildings with stairs and no ramps (disability). He then misses out on joining local groups and activities (handicap/participation restriction).

Support in practice would include:

• Arranging physiotherapy and prosthesis support for the impairment
• Advocating for adapted transport or building access for disability
• Supporting participation in the community using peer groups or digital links if physical attendance is limited

Example 2: Learning Disability

A woman with a moderate learning disability finds it hard to understand official letters (impairment). If services do not provide information in easy-read formats (disability), she cannot access benefits or appointments (handicap).

Workers could:

• Offer information in formats she finds easier
• Speak to partner agencies about better communication
• Provide one-to-one support in meetings

Example 3: Mental Health Difficulty

A young person with severe anxiety (impairment) may be unable to take part in education if no adjustments are made (disability). They can lose confidence and become isolated (handicap).

Support could involve:

• Access to therapeutic support for anxiety
• Flexible education plans or remote learning options
• Group work to rebuild self-esteem and engagement

Impact of the Models on Care Planning

Using the triad or dyad makes it easier to create personal, meaningful care plans. Workers can:

• Stop focusing only on medical issues
• Include environmental factors and attitudes
• Listen to the person’s own goals and wishes

This approach supports independence and inclusion.

Barriers Highlighted by the Models

Barriers can be:

• Physical: lack of lifts or accessible transport
• Attitudinal: discrimination or misunderstanding
• Organisational: inflexible rules about service eligibility
• Communication-based: information not available in accessible forms

Spotting these barriers is a key part of the worker’s role.

How to Apply the Triad and Dyad in Practice

Workers can:

• Use the triad or dyad in initial needs assessment
• Map out each factor—impairment, disability, and, if using the triad, handicap
• Talk openly with the person about their experiences, preferences, and barriers faced
• Write care and support plans that address each area
• Work with other agencies or the community to remove barriers
• Check back to review if improvements have been made and outcomes achieved

Strengths and Limitations

Both the triad and dyad have strengths and weaknesses.

Strengths:

• Help workers see the full picture, not just the diagnosis
• Help link personal experience with wider social issues
• Guide practical actions for support

Limitations:

• Some language (like ‘handicap’) is now outdated or can feel negative
• Not everyone fits neatly into the categories
• Must be used flexibly and with the person’s input

Older terms should be explained carefully and chosen with respect for people’s own preferences.

Plain English Definitions

Clear language helps everyone understand these models:

• Triad: Three elements—impairment (condition), disability (barriers and exclusion), handicap (impact on life).
• Dyad: Two elements—impairment (condition) and disability (barriers).

Tips for Workers

• Always use respectful and person-centred language
• Remember that the person’s own view is very important
• Focus on removing barriers, not just treating impairment
• Work with families, carers, and other professionals
• Regularly update your knowledge, as terms and best practice evolve

Final Thoughts

The triad and dyad of impairment offer clear frameworks for thinking about how health conditions, social barriers, and life impact connect. Using these models means you do not look at someone’s diagnosis alone, but you see the whole person and the world they live in.

Health and social care workers who apply these models are better placed to make real changes. You can help people live more independently, enjoy fuller lives, and be part of their community by recognising and helping to remove barriers.

Respect for each person’s experience and choices is central to good care. These models are tools to support your work—but the most important thing is to listen, learn, and act in partnership with the people you support. That is how you make a real and lasting difference in health and social care.