Resource on Person-First Language
The Language Used to Describe Individuals With
Disabilities
John Folkins, ASHA Publications Board
December 1992
This statement of principles is intended as a resource for
editors and authors. It is advisory only; that is, none of the
principles given should be considered to be binding rules for
material published by ASHA.
Principle One: Person-First Language
Use person-first language. Disabilities are not persons and
they do not define persons, so do not replace person-nouns with
disability-nouns.
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Avoid:
- the aphasic
- the schizophrenic
- stutterers
- cleft palates
- the hearing impaired
Further, emphasize the person, not the disability, by putting
the person-noun first.
Use:
- people with cleft palate
- the lawyer who has dyslexia
- persons who stutter
- the speech of children with language impairment
- the speech of individuals who stutter
Avoid:
- cleft palate children
- the hearing impaired client
- the dyslexic lawyer
- the retarded adult
Is there a difference between
to be
and
to have? Between saying a person "with a hearing loss" and
saying a person "is hearing impaired"? Some have
suggested that
to have
may imply possession and
to be
may imply identity.
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Thus they argue that it is less stigmatizing to use
have
than
be.
"The deaf" and "the speech of the deaf"
also violate the person-first rule. However, the community of
persons who are deaf prefer to use deaf with a capital D to
denote the Deaf culture and the Deaf community, not the hearing
loss. As a general rule, we may wish to follow the preferences of
a disability group, even if it violates other principles. The
problems with following the desires of different groups occur
when one doesn't know what the members of a group want or
when the preferences of individuals in a group differ.
In my opinion, "stuttered speech" is okay.
"Stuttered" describes the speech. "Cleft palate
speech" is not okay, because the person (not the speech) has
the cleft. However, "deaf speech" violates this rule;
yet many people believe that "deaf speech" is
acceptable.
Person-first language makes sentences more complicated. The
consensus of the Publications Board on November 19, 1992, was
that deviations from person-first language should be allowed in
cases when the only alternative is awkward sentence structure.
When publishing research reports in ASHA journals, it is
important to describe individuals with sensitivity. There are no
absolute rules in regard to what language is sensitive and what
language is not sensitive. Clearly, the most appropriate
approaches may differ across different circumstances and
different types of publications.
The clarity of research papers may be affected if one is
required to use person-first language every time a group of
subjects from a specific population is mentioned. One approach
may be to describe populations with person-nouns first in the
initial description of the subjects. Then one can refer to these
descriptions throughout the rest of the paper. It is more
important to use person-first language when describing
individuals making up a group than when referring to the group.
That is, although it may be preferable to say "the group of
individuals who are dysarthric" than to say "the group
of dysarthrics," when stylistically necessary, it may be
appropriate to use "the dysarthric group."
The general rule is that person-first language is more
important than group-first language.
There are many examples in which we do categorize people and
omit the person-noun and the person-first position; for example,
the audiologist (as opposed to "the person who performs
audiological services"), the speech-language pathologist,
the professor, the professional, the teacher, the grandparent,
the leader, the pacifist, the hypocrite, et cetera. One could
make the case that we should not categorize the person by these
attributes. Yet, "the person who grandmothers" is
difficult to support as an alternative to
"grandmother."
When the categorizing is negative, person-first language might
be preferable. "The person with a criminal record" may
be better than "the criminal." However, we may need to
do the same thing for both positive and negative attributes. If
we use person-first language only for negative attributes, then
person-first language could take on a negative connotation. The
way out of this is to assert that it is proper for society to
categorize people without person-first language in many
instances, but that disabilities are not one of them.
Disabilities need not be defining characteristics in the way that
a profession or role in society is. There are many circumstances
in which it may be appropriate to use the terms
disability,
disorder, or
impairment. One needs to be sensitive to when it is, and when it is not,
appropriate to use terms with a negative connotation.
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Principle Two: Disability Versus Handicap
Disabilities, disorders, or impairments can be caused by birth
defects, illnesses, or injuries; but disability is a possible
result of, not a synonym for, the birth defect, illness, or
injury.
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The public may have negative connotations for sickness and
disease (e.g., diseases are sometimes contagious, disabilities
are not). Inability differs from disability in that inability
implies a total loss. The World Health Organization has explicit
definitions that distinguish among disabilities, disorders, and
impairments; however, for most purposes these terms are
synonymous. Further, people have disabilities, not handicaps.
Handicaps are social or environmental obstacles imposed by
society on those with disabilities.
To summarize:
- Disability, disorder, and impairment can be synonyms.
- Disability does not equal inability.
- Disability does not equal birth defect, illness, disease,
or injury.
- Disability does not equal handicap.
- People do not have handicaps; society imposes them.
- Handicap is a useful term in golf and horse racing.
Some writers don't like "birth defect" and
"congenital anomaly."
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Congenital disability can be substituted if appropriate. A
disabled computer, light switch, or bomb are objects that do not
work at all. Here disability really does imply inability.
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Principle Three: We All Like to Think of Ourselves as Normal
Individuals with disabilities are "normal" in many
ways. Referring to persons without disabilities as normal implies
that persons who have disabilities are abnormal.
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The term abnormal has a pejorative flavor. At the least,
normal
should be used only in regard to explicitly defined limits for
specific attributes.
Avoid:
- normals
- normal speakers
- the speech of individuals who are normal
Use:
- the speech of individuals with no history of speech,
language, or hearing impairment
- individuals who were judged to show no speech, language, or
hearing impairment
- children with normally developing speech and language
- normal-hearing
- hearing sensitivity within normal limits
- normal speech (can be used when speech sounds normal and it
can be produced in some instances by individuals with speech
impairments)
- normal-language group ("group-first" language is
not always necessary)
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Principle Four: Avoid Terms That Project an Unnecessary Negative
Connotation
It is desirable to avoid language that projects struggle,
pain, or suffering when it is not necessarily part of the
circumstances being described. When suffering is a part of the
message to be conveyed, it is appropriate to use the term for
example, "tinnitus sufferer." However, this may not
always be clear-cut. For example, some groups (e.g., the
Commission of Persons with Disabilities
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version 2 and presumably Self Help for Hard of Hearing People,
Inc.) prefer "hard-of-hearing" to either "hearing
impaired" or "hearing loss."
Some authors have suggested avoiding the term
dysfluency.
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They prefer to use "disfluency." They claim that
"dys" has more of a pathological flavor. The prefix
"dis" means apart from. The prefix "dys"
means "difficult, painful, bad, or disordered." This is
clearly a judgment call, and there is presently little
consistency among authors.
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In general, avoid the following:
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- patient ("Use client for most recipients of clinical
services because patient may denote sickness or medical
intervention. Patient is appropriate for individuals who are
patients in a hospital.)
- confined to a wheelchair, restricted to a wheelchair,
wheelchair bound (People receive mobility from wheelchairs, not
confinement.)
- victim (This implies a desire for sympathy.)
- cripple, crippled, the crippled, lame, the lame
- deformed (may imply ugly)
- deaf and dumb, deaf mute (needs no justification)
- afflicted with, stricken with, suffering from (say the
person has...)
- invalid (not valid)
- courageous, brave, inspirational (Not all people with
disabilities have these traits.)
- unfortunate, pitiful, poor (condescending when used in
reference to a disability)
- incapacitated (There are still capacities.)
- retardate, mongoloid, idiot, moron, mentally deficient,
mentally defective, imbecile, feeble minded (Use "persons
with mental retardation" or children with developmental
delay.")
- mentally deranged, mentally ill, mentally deviant, maniac,
crazy, lunatic, mad (Use "persons with a mental
disorder.")
- deafening silence, blind rage, blind faith, turned a deaf
ear, lame excuse (Avoid metaphors with pejorative
connotations.)
- fit (Use "seizure" when applicable;
"fit" may be an appropriate synonym for
tantrum.)
- spastic (Use only to describe muscular spasticity. Not all
types of cerebral palsy involve spasticity. Muscles are spastic
not people.)
- hare lip (Does not compliment people or rabbits. Use cleft
lip.)
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Principle Five: Don't Overdo It
Be careful with the term
special. In some respects, we are all special. From another perspective,
people with disabilities are not necessarily special even if they
are enrolled in "special education."
"Language challenged" or "hearing
challenged" may imply that people need to try harder than
they are trying at present.
Blatant euphemisms (differently hearing, physically different,
differently abled, speech inconvenienced, vertically challenged,
horizontally challenged, chronologically gifted) don't hide
disability, but they can produce confusion. It is not more
sensitive to refer to individuals who are physically within
normal limits as temporarily ablebodied (TABs) or momentarily
ablebodied (MABs).
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References
1. National Easter Seal Society. (undated).
Portraying people with disabilities in the media.
2. Language awareness. (1985, March).
National Rehabilitation Association Newsletter.
3. The language of disability: Problems of politics and practice.
(1988).
Journal of the Disability Advisory Council of Australia,
1(3), 13-21.
4. Monjar, S. (undated).
What do you say after you see they're disabled?
Rehabilitation Institute of Chicago.
5. National Easter Seal Society. (undated).
Awareness is the first step toward change: Tips for
disability awareness.
6. Commission of Persons with Disabilities, Iowa Department of
Human Rights. (undated).
Use words with dignity. (There are two different versions of this handout.)
7. Quesal, R. (1998). Inexact use of "disfluency" and
"dysfluency" in stuttering research."
Journal of Speech and Hearing Disorders, 53, 349-350.
8. Bernstein Ratner, N. (1988). Response to Quesal: Terminology
in stuttering research.
Journal of Speech and Hearing Disorders, 53, 350-351.
9. National Easter Seal Society. (undated).
Awareness is the first step toward change: Tips for
portraying people with disabilities in the media.
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