Attempting to Distinguish Impairment from Disability in the Bioarchaeological Record: An Example from DeArmond Mound (40RE12) in East Tennessee

  • Jonathan D. BethardEmail author
  • Elizabeth A. DiGangi
  • Lynne P. Sullivan
Part of the Bioarchaeology and Social Theory book series (BST)


In bioarchaeological contexts involving interpretations of impairment and disability, scholars can benefit by engaging with the literature from other fields, particularly Disability Studies (DS), to better understand the complexities and nuances of these terms. In this chapter, definitions of impairment and disability are introduced from a number of perspectives, including academic scholarship, as well the World Health Organization (WHO) and the Americans with Disabilities Act of 1990 (ADA). While impairment has typically been identified by bioarchaeologists as paleopathological in nature, some frameworks from DS expand this definition to include social components. The nuances of these terms are applied to an archaeological case study from a Mississippian site in East Tennessee and describe the remains of a woman who presented a lifelong musculoskeletal impairment of her upper and lower limbs. This impairment would have restricted her ability to move around the landscape in the same way as her peers. Despite these physical differences, her mortuary treatment was not markedly different from other members in her community and does not appear to fit a recent definition of deviant burial practices proposed by Tsaliki (2008). While mortuary data are vital to better understand impairment and disability in the past, bioarchaeologists must be careful to not over interpret the subtle, and simultaneously, marked differences between these two concepts.


Disability Impairment Mississippian period Enchondromatosis Osgood–Schlatter’s disease Cartilaginous dysplasia DeArmond mound Works Progress Administration (WPA)/Tennessee Valley Authority (TVA) excavations 



We would like to thank the editors of this volume for extending the invitation for this contribution and their thoughtful critiques and patience during the review process. We also would like to thank the anonymous reviewers who provided useful feedback on a draft of this chapter. We thank the University of Alabama Museums for granting permission to reprint the mortuary image of the individual from Moundville. We acknowledge the McClung Museum of Natural History and Culture and its employees for providing access to the TVA collection. Drs. Benjamin Auerbach, Jane Buikstra, Mercie DiGangi, Linda Klepinger, Donna McCarthy, Megan Moore, Timothy Pauketat, and Maria Smith gave valuable advice and feedback during the initial stages of the skeletal analysis, as did the late Dr. Don Ortner. We thank Shannon D. Koerner for kind permission to utilize the map presented in Fig. 13.1. JDB would like to thank Aviva Cormier for her helpful insight and comments related to this topic while this chapter was being written.


  1. Anderson, D. G. (1996). Fluctuations between simple and complex chiefdoms: Cycling in the Late Prehistoric Southeast. In J. F. Scarry (Ed.), Political structure and change in the Prehistoric Southeastern United States (pp. 231–252). Gainesville, FL: University Press of Florida.Google Scholar
  2. Aufderheide, A. C., & Rodríguez-Martín, C. (1998). The Cambridge encyclopedia of human paleopathology. Cambridge: Cambridge University Press.Google Scholar
  3. Battles, H. (2011). Towards engagement: Exploring the prospects for an integrated anthropology of disability. vis-à-vis: Explorations in Anthropology, 11(1), 107–124.Google Scholar
  4. Buikstra, J. E. (2010). Paleopathology: A contemporary perspective. In C. S. Larsen (Ed.), A companion to biological anthropology (pp. 395–411). Malden, MA: Wiley-Blackwell.CrossRefGoogle Scholar
  5. Buikstra, J. E., & Scott, R. E. (2009). Key concepts in identity studies. In K. J. Knudson & C. M. Stojanowski (Eds.), Bioarchaeology and identity in the Americas (pp. 24–55). Gainesville, FL: University Press of Florida.Google Scholar
  6. Bloom, O. J., & Mackler, L. (2004). What is the best treatment for osgood-schlatter disease? Clinical Inquiries, 2004 (MU).Google Scholar
  7. Byrnes‚ J. F.‚ & Muller‚ J. (2017). Mind the gap: Bridging disability studies and bioarchaeology—An introduction. In J. F. Byrnes‚ & J. Muller (Eds.)‚ Bioarchaeology of impairment and disability: Theoretical‚ ethnohistorical, and methodological perspectives. New York: Springer.Google Scholar
  8. Çakmak, S., Tekin, L., & Akarsu, S. (2014). Long term outcome of osgood schlatter disease: Not always favorable. Rheumatology International, 34, 135–136.Google Scholar
  9. Charmaz, K. (1995). The body, identity, and self: Adapting to impairment. The Sociological Quarterly, 36(4), 657–680.CrossRefGoogle Scholar
  10. Cobb, C. R. (2003). Mississippian chiefdoms: How complex. Annual Review of Anthropology, 32, 63–84.CrossRefGoogle Scholar
  11. Cormier‚ A., & Buikstra, J. (2017). Impairment‚ disability‚ and identity in the middle Woodland period: Life at the juncture of achondroplasia, pregnancy‚ and osteomyelitis. In J. F. Byrnes‚ & J. Muller (Eds.)‚ Bioarchaeology of impairment and disability: Theoretical‚ ethnohistorical‚ and methodological Perspectives. New York: Springer.Google Scholar
  12. Cross, M. (1999). Accessing the inaccessible: Disability in archaeology. Archaeological Review from Cambridge: Archaeology and Disability, 15, 7–30.Google Scholar
  13. Cross, M. (2007). Accessing the inaccessible: Disability and archaeology. In T. Insoll (Ed.), The archaeology of identities: A reader (pp. 179–194). London: Routledge.Google Scholar
  14. D’Angelo, L., Massimi, L., Narducci, A., & Di Rocco, C. (2009). Ollier Disease. Child’s System, 25(6), 647–653.Google Scholar
  15. Dettwyler, K. A. (1991). Can paleopathology provide evidence for “compassion”? American Journal of Physical Anthropology, 84(4), 375–384.CrossRefGoogle Scholar
  16. DiGangi, E. A., Bethard, J. D., & Sullivan, L. P. (2010). Differential diagnosis of cartilaginous dysplasia and probable Osgood-Schlatter’s Disease in a Mississippian individual from East Tennessee. International Journal of Osteoarchaeology, 20(4), 424–442.Google Scholar
  17. Dunn, J. F. (1990). Osgood-Schlatter disease. American Family Physician, 41(1), 173–176.Google Scholar
  18. Dye‚ D. H. (Ed.). (2016). New deal archaeology in Tennessee: Intellectual‚ methodological and theoretical contributions. Tuscaloosa: The University of Alabama Press.Google Scholar
  19. El-Husseini, T. F., & Abdelgawad, A. A. (2010). Results of surgical treatment of unresolved Osgood-Schlatter disease in adults. The Journal of Knee Surgery, 23(2), 103–107.CrossRefGoogle Scholar
  20. Finlay, N. (1999). Disability and archaeology. Archaeological Review from Cambridge, 15(2), 1–6.Google Scholar
  21. Forber-Pratt, A. J., & Aragon, S. R. (2013). A model of social and psychosocial identity development for postsecondary students with physical disabilities. In M. Wappett & K. Arndt (Eds.), Emerging perspectives on disability studies (pp. 1–22). New York: Palgrave Macmillan.Google Scholar
  22. Gadacz, R. R. (1994). Rethinking disability. Edmonton: The University of Alberta Press.Google Scholar
  23. Gholve, P. A., Scher, D. M., Khakharia, S., Widmann, R. F., & Green, D. W. (2007). Osgood Schlatter syndrome. Current Opinion in Pediatrics, 19(1), 44–50.CrossRefGoogle Scholar
  24. Hatch, J. W. (1976). Status in death: Principles of ranking in Dallas culture mortuary remains. Ph.D. dissertation, Ann Arbor: University Microforms International.Google Scholar
  25. Hughes, B., & Paterson, B. (1997). The social model of disability and the disappearing body: Towards a sociology of impairment. Disability & Society, 12, 325–340.CrossRefGoogle Scholar
  26. Insoll, T. (2007). Introduction: Configuring identities in archaeology. In T. Insoll (Ed.), The archaeology of identities: A reader (pp. 1–18). New York: Routledge.Google Scholar
  27. Jacobi, K. P. (2002). A time capsule of physical anthropology: Charles E. Snow’s WPA Letters, 1940–1941. Southeastern Archaeology, 89, 55–62.Google Scholar
  28. Jacobi, K. P. (2003). The malevolent “undead” cross-cultural perspectives. In C. D. Bryant (Ed.), Handbook of death and dying (pp. 96–109). Thousand Oaks, CA: Sage Publications Inc.CrossRefGoogle Scholar
  29. Kaibara, N., Mitsuyasu, M., Katsuiki, I., Hotokebuchi, T., & Takagishi, K. (1982). Generalized enchondromatosis with unusual complications of soft tissue calcifications and hemangiomas. Skeletal Radiology, 8, 43–46.CrossRefGoogle Scholar
  30. Kamnikar, K. R., Zuckerman, M. K., Herrmann, N. P., & Franklin, J. D. (2015). Interpreting physical impairment in the Mississippian Period: A case study from the Holliston Mills Site, TN. Paper Presented at the 84th Annual Meeting of the American Association of Physical Anthropologists, St. Louis, MO, March 25–28.Google Scholar
  31. Kasnitz, D., & Shuttleworth, R. P. (2001). Introduction: Anthropology in disability studies. Disability Studies Quarterly, 21(3), 2–17.Google Scholar
  32. Kerr, N. (1995). Severe facial injury nearly 4000 years ago. International Journal of Osteoarchaeology, 5, 196–197.CrossRefGoogle Scholar
  33. King, A., & Meyers, M. (2002). Frontiers, backwaters, and peripheries: exploring the edges of the Mississippian world. Southeastern Archaeology, 21, 113–116.Google Scholar
  34. Knudson, K. J., & Stojanowski, C. M. (2008). New directions in bioarchaeology: Recent contributions to the study of human social identities. Journal of Archaeological Research, 16(4), 397–432.CrossRefGoogle Scholar
  35. Knudson, K. J., & Stojanowski, C. M. (2009). The bioarchaeology of identity. In K. J. Knudson, & C. M. Stojanowski (Eds.), Bioarchaeology and identity in the Americas (pp. 1–23, Bioarchaeological Interpretations of the Human Past: Local, Regional, and Global Perspectives). Gainesville: University Press of Florida.Google Scholar
  36. Knüsel, C., Chundun, Z., & Cardwell, P. (1992). Slipped proximal femoral epiphysis in a priest from the Medieval period. International Journal of Osteoarchaeology, 2, 109–119.CrossRefGoogle Scholar
  37. Koerner, S. D. (2005). Deciphering DeArmond Mound (40RE12): The Ceramic Analysis of an East Tennessee Mississippian Center. Unpublished MA Thesis, Department of Anthropology, University of Tennessee, Knoxville, Tennessee.Google Scholar
  38. Koerner‚ S. D.‚ & Dalton-Carriger‚ J. (2016). Depression-era archaeology in the Watts Bar Reservoir‚ East Tennessee. In D. H. Dye (Ed.)‚ New deal archaeology in Tennessee: Intellectual‚ methodological and theoretical contributions (pp. 96–115). Tuscaloosa: The University of Alabama Press.Google Scholar
  39. Krause, B. L., Williams, J. P. R., & Catterall, A. (1990). Natural history of Osgood-Schlatter’s disease. Journal of Pediatric Orthopedics, 10, 65–68.Google Scholar
  40. Kumar, A., Jain, V. K., Bharadwaj, M., & Arya, R. K. (2015). Ollier disease: Pathogenesis, diagnosis, and management. Orthopedics, 38(6), e497–e506.Google Scholar
  41. Lewis, T. M. N., Lewis, M. K., & Sullivan, L. P. (1995). The prehistory of the Chickamauga basin in Tennessee (2 Vols.). Knoxville: The University of Tennessee Press.Google Scholar
  42. Martin, D. L., Harrod, R. P., & Perez, V. R. (2013). The mortuary component and human remains. Bioarchaeology: An integrated approach to working with human remains (pp. 117–150). New York: Springer.CrossRefGoogle Scholar
  43. Meskell, L. (2007). Archaeologies of identity. In T. Insoll (Ed.), The archaeology of identities: A reader (pp. 23–43). London: Routledge.Google Scholar
  44. Metzler, I. (2006). Thinking about physical impairment during the high middle ages, c.1100–1400. London: Routedge.Google Scholar
  45. Milner, G. R., & Jacobi, K. P. (2006). A new deal for human osteology. In J. E. Buikstra & L. A. Beck (Eds.), Bioarchaeology: The contextual analysis of human remains (pp. 113–129). Burlington, MA: Academic Press.Google Scholar
  46. Murphy, E. M. (2000). Developmental defects and disability: The evidence from the iron age semi-nomadic peoples of Aymyrlyg, South Siberia. In J. Hubert (Ed.), Madness, disability, and social exclusion: The archaeology and anthropology of ‘difference’ (pp. 61–80). London: Routledge.Google Scholar
  47. Ortner, D. J. (2003). Identification of pathological conditions in human skeletal remains. San Diego: Academic Press.Google Scholar
  48. Pannier, S., & Legeai-Mallet, L. (2008). Hereditary multiple exostoses and enchondromatosis. Best Practice & Research Clinical Rheumatology, 22(1), 45–54.CrossRefGoogle Scholar
  49. Parliament of the United Kingdom. (2010). Equality Act 2010.Google Scholar
  50. Pauketat, T. R., & Alt, S. M. (Eds.). (2015). Medieval Mississippians: The Cahokian World. Santa Fe: School for Advanced Research Press.Google Scholar
  51. Payne, C., & Scarry, J. (1998). Town structure at the edge of the Mississippian world. In R. Lewis & C. Stout (Eds.), Mississippian towns and sacred places (pp. 22–48). Tuscaloosa: University of Alabama Press.Google Scholar
  52. Peebles, C. S. (1974). Moundville: the organization of a prehistoric community and culture. Ph.D. dissertation, Ann Arbor: University Microforms International.Google Scholar
  53. Power, S. C. (2004). Early art of the Southeastern Indians: Feathered Serpents and Winged Beings. Athens, GA: University of Georgia Press.Google Scholar
  54. Raji, O., & Hollins, S. (2000). Exclusion from funeral rituals and mourning: Implications for social and individual identity. In J. Hubert (Ed.), Madness, disability, and social exclusion: The archaeology and anthropology of difference (pp. 208–216). London: Routledge.Google Scholar
  55. Riddle, C. A. (2013). The ontology of impairment: Rethinking how we define disability. In M. Wappett & K. Arndt (Eds.), Emerging perspectives on disability studies (pp. 23–39). New York: Palgrave Macmillan.CrossRefGoogle Scholar
  56. Roberts, C. A. (1999). Disability in the skeletal record: Assumptions, problems and some examples. Archaeological Review from Cambridge, 15, 79–97.Google Scholar
  57. Roberts, C. A. (2000). Did they take sugar? The use of skeletal evidence in the study of disability in past populations. In J. Hubert (Ed.), Madness, disability, and social exclusion: The archaeology and anthropology of “difference” (pp. 46–59). New York: Routledge.Google Scholar
  58. Roberts, C. A. (2011). The bioarchaeology of leprosy and tuberculosis: A comparative study of perceptions, stigma, diagnosis, and treatment. In S. C. Agarwal & B. A. Glencross (Eds.), Social bioarchaeology (pp. 252–281, Blackwell Studies in Global Archaeology). Malden, MA: Wiley-Blackwell.Google Scholar
  59. Rodning, C. B. (1999). Archaeological perspectives on gender and women in traditional Cherokee society. Journal of Cherokee Studies, 20, 3–27.Google Scholar
  60. Ross, M. D., & Villard, D. (2003). Disability levels of college-aged men with a history of Osgood-Schlatter disease. Journal of Strength and Conditioning Research, 17(4), 659–663.Google Scholar
  61. Schroedl, G. F., Boyd, C. C., & Davis, R. S. (1990). Explaining Mississippian origins in East Tennessee. In B. Smith (Ed.), Mississippian emergence (pp. 175–196). Washington, D.C.: Smithsonian Institution Press.Google Scholar
  62. Scotti, D. M., Sadhu, V. K., Heimberg, F., & O’Hara, A. E. (1979). Osgood-Schlatter’s disease. An emphasis on soft tissue changes in roentgen diagnosis. Skeletal Radiology, 4, 21–25.CrossRefGoogle Scholar
  63. Shakespeare, T. (2006). Disability Rights and Wrongs. London: Routledge.Google Scholar
  64. Silve, C., & Jüppner, H. (2006). Ollier disease. Orphanet Journal of Rare Diseases, 1, 1–37.CrossRefGoogle Scholar
  65. Smith, B. (1978). Variation in Mississippian settlement patterns. In B. Smith (Ed.), Mississippian settlement patterns (pp. 479–503). New York: Academic Press.Google Scholar
  66. Smith, B. (1986). The archaeology of the Southeastern United States: From Dalton to de Soto 10,500–500 B. P. In F. Wendorf & A. Close (Eds.), Advances in new world archaeolgoy (pp. 1–92). Orlando: Academic Press.Google Scholar
  67. Smith, M. O. (1990). Frank H. McClung Skeletal inventory. Knoxville, TN: University of Tennessee.Google Scholar
  68. Snow, C. (1943). Two prehistoric Indian dwarf skeletons from Moundville. In G. S. O. Alabama (Ed.), (Vol. Museum Paper 21): University of Alabama.Google Scholar
  69. Southwell-Wright, W. (2013). Past perspectives: What can archaeology offer disability studies. In M. Wappett & K. Arndt (Eds.), Emerging perspectives on disability studies (pp. 67–95). New York: Palgrave Macmillan.CrossRefGoogle Scholar
  70. Steponaitis, V. P. (1986). Prehistoric archaeology in the Southeastern United States, 1979–1985. Annual Review of Anthropology, 15, 363–404.CrossRefGoogle Scholar
  71. Steponaitis, V. P. (1978). Location theory and complex chiefdoms: A mississippian example. In B. Smith (Ed.), Mississippian settlement patterns (pp. 417–435). New York: Academic Press.Google Scholar
  72. Sullivan, L. P. (1986). The late Mississippian Village: Community and society of the mouse creek phase in Southeastern Tennessee. Ph.D. dissertation, Ann Arbor: University Microforms International.Google Scholar
  73. Sullivan, L. P. (2001). Those men in the mounds: Gender, politics, and mortuary practices in late prehistoric Eastern Tennessee. In J. Eastman & C. Rodning (Eds.), Archaeological studies of gender in the Southeastern United States (pp. 101–126). Gainesville, FL: University Press of Florida.Google Scholar
  74. Sullivan, L. P. (2006a). Gendered contexts of Mississippian leadership in Southern Appalachia. In P. Welch & B. Butler (Eds.), Leadership and polity in Mississippian Society (pp. 264–285). Carbondale, IL: Southern Illinois University Press.Google Scholar
  75. Sullivan, L. P. (2006b). Madeline D. Kneberg. In J. E. Buikstra, & L. A. Beck (Eds.), Bioarchaeology: The contextual analysis of human remains (pp. 148–154). Burlington, MA: Academic Press.Google Scholar
  76. Sullivan, L. P., & Rodning, C. (2001). Gender, tradition, and social negotiation in Southern Appalachian Chiefdoms. In T. R. Pauketat (Ed.), The archaeology of historical process: Agency and tradition before and after columbus (pp. 107–120). Gainesville, FL: University Press of Florida.Google Scholar
  77. Sullivan, L. P., & Rodning, C (2011). Residential burial, gender roles, and political development in late prehistoric and early Cherokee cultures of the Southern appalachians. In R. Adams & S. King (Eds.), Residential burial: A multi-regional exploration (pp. 79–97). AP3A Series, American Anthropological Association. Washington D.C.Google Scholar
  78. Sunny, G., Ravi Hoisala, V., Cicilet, S., & Sadashiva, S. (2016). Multiple enchondromatosis: Olliers disease—A case report. Journal of Clinical and Diagnostic Research 10(1): TD01-TD02. doi: 10.7860/JCDR/2016/14105.7010
  79. Thomas, C. (2004a). Developing the social relational in the social model of disability: A theoretical agenda. In C. Barnes & G. Mercer (Eds.), Implementing the social model of disability (pp. 32–47). Leeds: The Disability Press.Google Scholar
  80. Thomas, C. (2004b). Disability and impairment. In J. Swain, S. French, C. Barnes, & C. Thomas (Eds.), Disabiling barriers—Enabling environments (2nd ed., pp. 21–27). London: Sage Publications.Google Scholar
  81. Tiet, T. D., & Alman, B. A. (2003). Developmental pathways in musculoskeletal neoplasia: Involvement of the Indian Hedgehog-parathyroid hormone-related protein pathway. Pediatric Research, 53, 539–543.CrossRefGoogle Scholar
  82. Tilley, L. (2015). Theory and practice in the bioarchaeology of care (bioarchaeology and social theory). New York: Springer.CrossRefGoogle Scholar
  83. Tilley, L., & Cameron, T. (2014). Introducing the index of care: A web-based application supporting archaeological research into health-related care. International Journal of Paleopathology, 6, 5–9.CrossRefGoogle Scholar
  84. Tilley, L., & Oxenham, M. F. (2011). Survival against the odds: Modeling the social implications of care provision to seriously disabled individuals. International Journal of Paleopathology, 1(1), 35–42.CrossRefGoogle Scholar
  85. Trinkhaus, E., & Zimmerman, M. (1982). Trauma among the Neandertals. American Journal of Physical Anthropology, 57, 61–76.CrossRefGoogle Scholar
  86. Tsaliki, A. (2008). Unusual burials and necrophobia: An insight into the burial archaeology of fear. In E. M. Murphy (Ed.), Deviant Burial in the Archaeological Record (pp. 1–16). Oxford, UK: Oxbow Books.Google Scholar
  87. United States Congress. (1990). An act to establish a clear and comprehensive prohibition of discrimination on the basis of disability.Google Scholar
  88. Wakely, J. (1993). Bilateral congenital disolcation of the hip, spina bifida occulta and spondylolysis in a female skeleton from the medieval cemetery at Abingdon, England. Journal of Paleopathology, 5(1), 37–45.Google Scholar
  89. Wejjakul, W., Pruksakorn, D., Sirirungruangsarn, Y., Luevitoonvechkij, S., Khunsree, S., & Vaseenon, T. (2013). The literature review of Ollier disease. Chiang Mai Medical Journal, 52(3–4), 73–79.Google Scholar
  90. Wells, C. (1982). The human burials. In A. McWhirr, L. Viner, & C. Wells (Eds.), Romano-British cemeteries at cirencester. Cirencester Excavations Committee: Cirencester.Google Scholar
  91. WHO. (2001). International classification of functioning. Disability and health. Geneva: World Health Organization.Google Scholar
  92. Zakrzewski, S. (2014). Palaeopathology, disability, and bodily impairments. In R. Melcalfe, J. Cockitt, & R. David (Eds.), Palaeopathology in Egypt and Nubia: A century in review (Vol. 6, pp. 57–68, Archaeopress Egyptology). Oxford: ArchaeoPressGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Jonathan D. Bethard
    • 1
    Email author
  • Elizabeth A. DiGangi
    • 2
  • Lynne P. Sullivan
    • 3
  1. 1.Department of AnthropologyUniversity of South FloridaTampaUSA
  2. 2.Department of AnthropologyBinghamton UniversityBinghamtonUSA
  3. 3.McClung Museum of Natural History and CultureUniversity of TennesseeKnoxvilleUSA

Personalised recommendations