Person First Language

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Guidelines for Nonhandicapping Language in APA Journals

Committee on Disability Issues in Psychology

The use of certain words or phrases can express gender, ethnic, or racial bias either intentionally or unintentionally. The same is true of language referring to persons with disabilities, which in many instances can express negative and disparaging attitudes.

It is recommended that the word disability be used to refer to an attribute of a person, and handicap to refer to the source of limitations. Sometimes a disability itself may handicap a person, as when a person with one arm is handicapped in playing the violin. However, when the limitation is environmental, as in the case of attitudinal, legal, and architectural barriers, the disability is not handicapping—the environmental factor is. This distinction is important because the environment is frequently overlooked as a major source of limitation, even when it is far more limiting than the disability. Thus, prejudice handicaps people by denying access to opportunities; inaccessible buildings surrounded by steps and curbs handicap people who require the use of a ramp.

Use of the terms nondisabled or persons without disabilities is preferable to the term normal when comparing persons with disabilities with others. Usage of normal makes the unconscious comparison of abnormal, thus stigmatizing those individuals with differences. For example, state "a nondisabled control group," not "a normal control group."

The guiding principle for nonhandicapping language is to maintain the integrity of individuals as whole human beings by avoiding language that

implies that a person as a whole is disabled (e.g., disabled person)
equates a person with his or her condition (e.g., epileptic)
has superfluous, negative overtones (e.g., stroke victim)
is regarded as a slur (e.g., cripple).

For decades, persons with disabilities have been identified by their disability first, and as persons, second. Often, persons with disabilities are viewed as being afflicted with, or being victims of, a disability. In focusing on the disability, an individual's strengths, abilities, skills, and resources are often ignored. In many instances, persons with disabilities are viewed neither as having the capacity or right to express their goals and preferences nor as being resourceful and contributing members of society. Many words and phrases commonly used when discussing persons with disabilities reflect these biases.

Listed below are examples of negative, stereotypical, and sometimes offensive words and expressions. Also listed are examples of preferred language, which describes without implying a negative judgment. Even though their connotations may change with time, the rationale behind use of these expressions provides a basis for language reevaluation.

The specific recommendations are not intended to be all-inclusive. The basic principles, however, apply in the formulation of all nonhandicapping language.

Put people first, not their disability.

Comment: Preferred expressions avoid the implication that the person as a whole is disabled or defective.

Problematic	Preferred
disabled person	person with (who has) a disability
defective child	child with a congenital disability; child with a birth impairment
mentally ill person	person with mental illness or psychiatric disability

Do not label people by their disability.

Comment: Because the person is not the disability, the two concepts should be separate.

Problematic	Preferred
schizophrenics	people who have schizophrenia
epileptics	individuals with epilepsy
amputee	person with an amputation
paraplegics	individuals with paraplegia
the disabled	people with disabilities
the retarded	children with mental retardation
the mentally ill	people with a mental illness or psychiatric disability
the CMI or SPMI	people with long-term or serious and persistent mental illness or psychiatric disabilities

Do not label persons with disabilities as patients or invalids.

Comment: These names imply that a person is sick or under a doctor's care. People with disabilities should not be referred to as patients or invalids unless the illness status (if any) is under discussion or unless they are currently residing in a hospital.

Do not overextend the severity of a disability.

Comment: Preferred expressions limit the scope of the disability. Even if a person has a particular physical disability, this does not mean that the person is unable to do all physical activities. Similarly, a child with a learning disability does not have difficulty in all areas of learning nor does mental retardation imply retardation in all aspects of development. Chronicity in physical illness often implies a permanent situation, but persons with psychiatric disabilities are able to recover.

Problematic	Preferred
the physically disabled	individuals with a physical disability
the learning disabled	children with specific learning disabilities
retarded adult	adult with mental retardation
chronic mental illness	long-term or persistent mental illness or psychiatric disability

Use emotionally neutral expressions.

Comment: Objectionable expressions have excessive, negative overtones and suggest continued helplessness.

Problematic	Preferred
stroke victim	individual who had a stroke
afflicted with cerebral palsy	person with cerebral palsy
suffering from multiple sclerosis	people who have multiple sclerosis

Emphasize abilities, not limitations.

Comment: The person is not confined to a wheelchair but uses it for mobility; a person is not homebound who is taught or who works at home.

Problematic	Preferred
confined to a wheelchair	uses a wheelchair
homebound	child who is taught at home

Avoid offensive expression.

Problematic	Preferred
cripple	person who has a limp
deformed	person with a shortened arm
mongoloid	child with Down Syndrome
crazy, paranoid	person with symptoms of mental illness

Focus on the right and capacity of people with disabilities to express their own goals and preferences and to exercise control over their own services and supports.

Comment: In many instances, persons with disabilities are not given opportunities to participate in decisions regarding the services or supports they will receive as part of a treatment or rehabilitation program. Instead, they are viewed as requiring "management" as patients or cases, rather than as individuals with goals and preferences that should be taken into account.

Problematic	Preferred
placement	discussion of suitable and preferred living arrangements
professional judgment	include a consideration of a person's goals and preferences
patient management, case management	care coordination, supportive services, resource coordination, assistance

Seeing people with disabilities as a resource and as contributing community members, not as a burden or problem.

Comment: Discussions regarding the service needs of persons with disabilities and their families often use terms that define the individual as a burden or a problem. Instead, terms that reflect the special needs of these persons are preferable, with a clear recognition of the responsibility of communities for inclusion and support of persons with disabilities.

Problematic	Preferred
family burden	family supports needs
problem of mental illness or of the mentally ill	challenges that people with psychiatric disabilities face
community support needs of individuals	responsibilities of communities for inclusion and support

[April 1992]

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