Introduction
Many of the barriers which people with disabilities face are reinforced by small details of language and behavior. These details may seem insignificant, but they often reaffirm inaccurate assumptions and cause offense. By changing how you portray and communicate with people with disabilities, and by modifying a few features of your environment, you, as human service providers, educators, and the media, are in a unique position to shape public attitudes about people with disabilities in a helpful way.
This publication illustrates appropriate ways to reflect the increased participation of people with disabilities in our society. Although opinions may differ on some terms, the following suggestions represent the current consensus among disability organizations.
For more information or to receive this publication in an alternative format, please contact the Disability Issues in Psychology Office at 202-336-6038 (voice), 202-336-5662 (TTY), or via the internet at publicinterest@apa.org.
Portrayal Issues
Language influences perceptions and behavior. Words in popular use mirror prevailing attitudes in society. Oftentimes, societal attitudes create barriers for people with disabilities. Through language usage, we can conjure up images of people actively engaged in life, and we can avoid stereotypical phrases that suggest helplessness or tragedy.
Person First Language
When you refer to a "disabled woman," your listener or reader has already begun to form some kind of image of "disabled" before she/he hears the word "woman." The subject of the sentence then hasn't a chance to be thought of as a regular person. She will be considered mainly disabled and secondarily a woman until or unless your subsequent language jars this image loose.
On the other hand, if you refer to her as a "woman with a disability" the reverse tends to occur. Your audience first starts forming an image of an ordinary woman, and then modifies it. The focus becomes on the individual, not the particular functional limitation.
Once you've identified her as having a disability, and the most adaptive image you can conjure up for her is pretty much set in your reader or listener's mind, there is no reason not to use the briefer expression "disabled woman" from time to time if you feel the need for literary variety.
Sensationalizing
One common way of sensationalizing disability is to describe highly successful people with disabilities as "superhuman." Such individuals are shown as being "incredible" or "extraordinary" because they strive to overcome their limitations and serve as role models or yardsticks for measuring personal achievement. While people with disabilities have had to overcome obstacles dealing with their disability, they generally have the same range of talents and dispositions as non-disabled individuals. Portraying persons with disabilities as "superstars" creates unfair expectations.
Another common way of sensationalizing is to use the language of tragedy or catastrophe. Words and phrases like "afflicted with," "struck by," "a victim of," or "crippled with" disability generate sentimental feelings of pity, which can be socially damaging to the person described. It also leaves the reader or listener with the nebulous impression that individuals with disabilities face serious problems with which they cannot cope.
Focus
If you get stuck on a person's disability, your listener or reader will get stuck there too. Usually, other aspects of the person are more interesting or relevant to the issue at hand. This is equally true regarding race, ethnicity, sex, and sexual orientation. If such demographics seem worth mentioning, then mention them. This can be done without making them the focus of the described individual's being.
Being, Having, Doing
It is generally useful to avoid verbs that imply that disability encapsulates all there is to say about a person. Also, it is useful to avoid verbs that suggest images of passivity. For example, the phrase "so-and-so is in a wheelchair" conjures a passive image, someone just sitting there doing nothing. By contrast, the phrase "so-and-so uses a wheelchair" tends to elicit an action image, someone wheeling a chair or operating a control device. The first person seems helpless and detached; the second, participatory and involved.
Most people who have been hospitalized even briefly understand how disconcerting it is to be known temporarily as "the heart in room 18" or "the liver in room 24." It doesn't take much imagination to understand how annoying it would be to hear yourself referred to as a "spinal cord injury" or a "manic depressive" for the rest of your life. It's no harder to say, "Charlie has a spinal cord injury" or "manic-depressive illness" than it is to say, "Charlie is a spinal cord injury" or "manic depressive." The first suggests that disability is just one trait among many. The second implies that it summarizes the essence of all that Charlie is.
In summary, in the most wholesome, socially appealing image, the person is doing something. In the second best, one is seen as a person who has a disability. In the least helpful social image, one's very being is identified by disability--other facets of personality disappear, leaving only embodied disablement.
Disability-Disease Distinction
Some disabilities are progressive results of chronic conditions, but many, probably most, are not. The illness/injury that caused the disability is an event of the past. A person with a substantial disability may be healthier than you are. This distinction can be very important in such situations as a job search, acquiring health insurance, and getting a date. A person with a severe disability doesn't need the unwarranted obstacle of being seen as also having an active disease.
Injury-caused disabilities are easy to distinguish from disease-caused disabilities once you know they result from injuries. Disease-caused disabilities pose more problems because most people don't know which diagnostic labels reflect acute illnesses that are long past and which designate continuing illnesses. To err on the safe side, assume "stable disability, no disease" unless the person corrects you.
Euphemisms
Euphemisms claimed as politically correct by various splinter groups (e.g., "impaired," "physically challenged," and "differently abled") have generated endless jokes and parodies, which may not be what their promoters wanted. Suffice it to say, these are fad phrases that have not gained general acceptance among people with disabilities.
Of the main non-euphemistic terms, "disability" has come to be preferred over "handicap" as the more general descriptor. This is owing to the latter's narrower meaning as well as its historical association with fundraising pathos. The word "disability" refers to the functional limitation a person experiences as a result of an impairment. The word "handicap" refers to the social consequences of the disability. For example, stairs, narrow doorways, and curbs are handicaps to people with disabilities who use wheelchairs.
Communication Issues
Many people feel uncomfortable around individuals with disabilities. Much of this discomfort stems from lack of personal contact with people with disabilities and a sense of awkwardness and uncertainty as to how to speak and act in their presence.
The following section offers suggestions for increasing effective communication and reducing anxiety when interacting with people with specific disabilities.
Hearing Impairments
Do not make assumptions about a person's ability to communicate or the way in which they do it. Always ascertain which communication medium the deaf or partially hearing person intends to use.
When interacting with people who prefer lip reading, use a well-lit, glare-free area.
Face the person directly and continue speaking at a normal volume and rate.
Rephrase sentences rather than repeat them.
Do not cover your mouth or look away from the person, such as to take notes, while you are talking.
Communicate in writing, if necessary.
When a sign language interpreter is present, it is best to face the person and speak normally.
Omit phrases such as "please tell him/her that..." and address the person directly while the interpreter signs.
Visual Impairments
Ask if any particular assistance is needed.
Orient the person to the area, explaining where major furniture is located. If the person has been there before, you should inform him/her of any changes or new obstacles.
Keep doors fully open or closed to prevent accidents.
Offer to read written information for a person with a visual impairment, when appropriate.
If you are guiding someone, let him/her take your arm just above the elbow, and guide rather than lead or propel the person. Give him/her clear instructions such as 'this is a step up' as opposed to 'this is a step.'
When giving directions, use specific words such as "straight ahead" or "forward." Refer to positions in terms of clock hands: "The chair is at your 2:00." Avoid vague terms such as "over there."
Don't assume the person will recognize you by your voice even though you have met before. Identify yourself by name, maintain normal voice volume, speak directly to the person, and maintain eye contact.
Speech Impairments
Listen patiently and avoid completing sentences for the person unless she/he looks to you for help.
Don't pretend to understand what a person with a speech disability says just to be
polite. Ask the person to write down a word if you're not sure what she/he is saying.
Mobility Impairments
Ask if assistance is required.
Do not remove a person's mobility aid, for example crutches, without the person's consent.
When talking to someone who is in a wheelchair and the conversation continues for more than a few minutes, sit down or kneel to be eye level. This avoids neck strain and is much more positive. his/her
Don't lean on a person's wheelchair unless you have his/her permission--it's his/her personal space.
Information contained in the Communication Issues section was obtained from:
United Cerebral Palsy
155 N. Wacker Drive, Suite 315
Chicago, IL 60605
(312) 368-0380 voice, (312) 368-0179 TTY
Compliance Issues
As service providers and advocates, psychologists and other mental health providers need to ensure that their services adequately meet legal and ethical obligations.
To improve compliance with the Americans With Disabilities Act and to better meet the needs of individuals with disabilities:
Do not deny your services to a client with a disability. You may refer him/her if that individual requires treatment outside of your area of specialization.
Do not separate out or give unequal service to clients with disabilities unless you must do so to provide a service that is as effective as that provided to those without disabilities.
Watch for criteria that screen out clients with disabilities. For instance, do not require a driver's license for payment by check. Use policies, practices, and procedures in your office that can be modified for those with disabilities, such as making sure service animals are permitted in your office.
Provide auxiliary aids and services, such as readers, sign-language interpreters, Braille materials, large-print materials, videotapes and audiotapes, and computers when necessary to effectively communicate with your clients with disabilities. You may use alternative forms of communication, such as notepads and pencils, when these forms are as effective.
Evaluate your office for structural and architectural barriers that prevent individuals with disabilities from getting the services they need from you. Change these barriers when they can be readily changed (without much difficulty or expense).
Look at ramps, parking spaces, curb cuts, shelving, elevator control buttons, width of doorways, levered door handles, width of toilet partitions, height of toilet seats, high-pile carpeting, and ensure that rooms are large enough to maneuver a walker or wheelchair.
When building new offices or remodeling, hire an architect or contractor familiar with ADA requirements.
Information contained in the Compliance Issues section was obtained from the following sources:
Americans With Disabilities Act, 42 U.S.C. §§ 12101-12213 (1995).
Americans With Disabilities Act, 42 U.S.C. § 12181(7)(F) (1995).
Americans With Disabilities Act, 42 U.S.C. § 12182(b)(2)(A)(iii) (1995).
Americans With Disabilities Act, 42 U.S.C. § 12182(b)(2)(A)(iv) (1995).
Americans With Disabilities Act, 42 U.S.C. § 12182(b)(2)(A)(v) (1995).
Americans With Disabilities Act, 42 U.S.C. §§ 12181-12189 (1995).
Golden, M. (1995). Americans With Disabilities Act of 1990: Implications for the medical field. Journal of Legal Medicine, 18, 2-13.
Mahoney, R. E., & Gibofsky A. (1992). Changes in existing protection and impact on the private health services provider. Journal of Legal Medicine, 13, 51-74.
Miltko, S. M. (1995). The need for professional discretion: Health professionals under the Americans With Disabilities Act. Northwestern University Law Review, 89, 1731-1767.
