The language of disability

One impediment to talking about disability is that people are unsure what are the “right” words to use. This is compounded by the fact that disability issues are often not in the public discourse. Media reports reinforce some usage that is counter to preferences in the disability community  (e.g., “traffic was snarled due to a disabled truck” or “despite her disability she was successful in school”). The purpose of this article is to give some guidance on current language in the disability community. But two caveats: 

• Language is fluid and changes as new ideas emerge.
• We hope readers will not get tongue-tied with fear of using “wrong” words.

Although these two are often viewed as separate and opposites, they are part of a whole. It is possible to be very healthy and still have a disability (e.g., ADHD) or to have a disability that affects health (e.g., Lupus). Significant health issues usually are associated with some impairment to function (e.g., COPD). The World Health Organization (WHO) focuses on health and functioning, i.e., being as healthy as possible and maintaining the highest possible level of functioning. Therefore knowing the cause of a condition is less valuable than understanding its effects on health and functioning. The WHO makes a key distinction among impairment, handicap, and disability.

This term is used by professionals to identify some disruption at the system level of an organ in the body, like the brain or the left leg, that leads to loss of use or some variation from a norm. Impairments are not defects, and they can be psychological, physiological or anatomical; some are permanent, others are temporary. Impairments can lead to disruptions in thinking, emotion, or behavior.

A handicap is an obstacle that affects people because, once present in their environment, it blocks them from completing some role. Thus, a disabled person can be handicapped—that is, disadvantaged—by a missing ramp, but the handicap does not reside within the person.

“Disability results from the interaction between individuals with a health condition such as cerebral palsy, down syndrome and depression as well as personal and environmental factors including negative attitudes, inaccessible transportation and public buildings, and limited social support.” (WHO). As such, disability is not a feature of the person but of the interaction of the person and the contextual variables (e.g., attitudes, built environments, economic policies).

“The transition from an individual, medical perspective to a structural, social perspective has been described as the shift from a medical model to a social model in which people are viewed as being disabled by society rather than by their bodies” (World Report on Disability, Chapter 1, p. 4). The two models are not binary, as disabled people experience medical conditions (e.g., pain, fatigue) as well as social disadvantage. Thus the biopsychosocial model encompasses a more wholistic perspective on disability.

Although “person-first” language was the preference for some time (e.g., people with disabilities, a person with schizophrenia, a person with spinal cord injury, a wheelchair user). More recently guidelines such as the APA Style Manual, 7th edition (2020) gives the option to use either person-first or identity-first language. With identity-first language, “the disability becomes the focus, which allows the individual to claim the disability and choose their identity rather than permitting others . . . to name it or to select terms with negative implications” (APA, 2020 p. 136). The APA Style Manual also has a section on bias-free language (pp. 131–149); one of its key points is to consider many different identities simultaneously, rather than solely on disability as a special case.

There are several language conventions that can promote derogatory stereotypes about disability. Burden is commonly associated with disabled persons’ effects on others, such as caregiver burden or the financial burden on parents of disabled children. People are often described as suffering from or afflicted by a disability. Equally problematic is describing individuals as accomplishing something despite the disability. Words and phrases that are considered derogatory include cripple, lame, deaf, and dumb.

With this basic understanding of the nuances of language for disability, we suggest some follow-up activities:

• Spend a week identifying the use of good and bad examples in media. Write them down, then compare notes with peers.
• Conduct an online search for disability and XX, then put in terms such as “burden,” an ethnicity, “social model,” or “attitudes.” 

What topics are current or trending? Compare with peers.

Rhoda Olkin, PhD, is a distinguished professor in the clinical PsyD program at the California School of Professional Psychology in San Francisco.

Dana S. Dunn, PhD, is professor and chair of psychology at Moravian University in Bethlehem, Pennsylvania.