People-first language

Short description: Putting the person before the diagnosis

Not to be confused with first-person language.

Autism described using identity-first language and person-first language Disability

Theory and models

* Disability theory
* Ableism / Disablism
* Medical model
* Social model

Education

* Mainstreaming
* Individualized Education Program (IEP)

* Special needs
* Special school
* Special education
* Learning disability

Therapy

* Physical
* Occupational
* Speech

Societal implications

* Disability rights movement
* Inclusion
* Normalization
* People-first language
* Pejorative terms

Personal assistance

* Unlicensed assistive personnel (ADLs)

* Orthotics and braces
* Prosthetics
* Assistive technology
* Assisted living
* Mobility aid
* Physical accessibility
* Universal design
* Web accessibility

Socioeconomic assistance

* Social Security Disability Insurance
* Supplemental Security Income
* Ticket to Work
* Disability Living Allowance
* Disabled students allowance
* Disabled Persons Railcard
* Freedom Pass
* Assured Income for
the Severely Handicapped

* Groups
* Organizations

* National Telecommuting Institute
* Society for Disability Studies
* Disabled Peoples' International (DPI)
* Visitability

Disabled sports

* Special Olympics
* Paralympic Games
* Deaflympics
* Invictus Games

Culture

* Disability in the arts
* Disability art
* Disability in the media

*     * Disability
* Lists

* v
* t
* e

People-first language or person-first language is the practice of distancing a person from a trait or condition they have by preferring phrases such as "a person with diabetes", "people experiencing homelessness", and "people with substance use disorders" as opposed to identity-first language like "diabetic people", "homeless people", and "substance abusers".

As a form of disability etiquette, the practice is intended to avoid unconsciously stigmatizing or dehumanizing people with chronic illnesses or disabilities, by treating them as a secondary characteristics to their personhood rather than an essential or subsuming component of their identity.

Some organizations have adopted style guidelines preferring or requiring person-first language when writing about disability, though some communities including Deaf people, blind people, and some autism advocates have rejected its usage. APA style recommends using either identity-first or person-first language as appropriate for the community or individual being discussed.[1] Phrases like "disabled person", "Deaf person", and "blind person" are generally accepted and often preferred.

## Contents

* 1 Definition
* 2 History
* 3 Rationale
* 4 Usage guidelines
* 4.1 United States
* 4.2 United Kingdom
* 5 Criticism
* 6 See also
* 7 References
* 8 Further reading

## Definition

People-first language is a type of linguistic prescription. It aims to avoid perceived and subconscious dehumanization when discussing people with disabilities and is sometimes referred to (for example, by NHS England's style guide) as a type of disability etiquette. People-first language can also be applied to any group that is defined by a condition rather than as a people: for example, "those that are homeless" rather than "the homeless."

Rather than using labels to define individuals with a health issue, people-first language uses terminology that describes individuals as being diagnosed with an illness or disorder. People-first language puts the person before the diagnosis and describes what the person has, not what the person is.[2]

The basic idea is to use a sentence structure that names the person first and the condition second, for example, "people with disabilities" rather than "disabled people" or "disabled," to emphasize that they are people first. Because it is a common practice in English to place an adjective before a noun, the adjective might be replaced with a relative clause, e.g., from "an asthmatic person" to "a person who has asthma."

By using such a sentence structure, the speaker articulates the idea of a disability as a secondary attribute, not a characteristic of a person's identity. (See also: Distancing (psychology).)

## History

Recommendations and explanations to use person-first language date back as early as around 1960. In her classic textbook,[3] Beatrice Wright began her rationale for avoiding the dangers of terminological short cuts like "disabled person" by citing studies from the field of semantics that "show that language is not merely an instrument for voicing ideas but that it also plays a role in shaping ideas" (p. 7). She concludes her arguments thus: "Since physique does stimulate value judgments, it is particularly important to use expressions insofar as feasible that separate physical attributes from the total person" (p. 8). Another influential rehabilitation psychologist, Carolyn Vash, who also spoke from the perspective of her experience living with quadriplegia from polio, advanced similar arguments for person-first language in an unpublished address in 1959.[4]

The term people-first language first appeared in 1988 as recommended by advocacy groups in the United States.[4] The usage has been widely adopted by speech-language pathologists and researchers, with "person who stutters" (PWS) replacing "stutterer".[5] It has been used in AIDS activism, appearing in the Denver Principles (1983), which stated in part, "We condemn attempts to label us as 'victims', a term which implies defeat, and we are only occasionally 'patients', a term which implies passivity, helplessness, and dependence upon the care of others. We are 'People With AIDS'."

Use has been recommended in other increasingly common chronic conditions, such as asthma and diabetes. Non-profit organizations, such as the Obesity Action Coalition have expanded advocacy for People-First Language to obesity. As of 2017[update], 5 U.S. medical societies had pledged for it, and use it in their communications: the American Society for Metabolic and Bariatric Surgery, The Obesity Society, American Society of Bariatric Physicians, Academy of Nutrition and Dietetics, and the American Academy of Orthopaedic Surgeons.[6]

Some advocacy groups and organizations such as Autism Speaks,[7] The Arc[8] and Disability Is Natural[9] support using people-first language.

## Rationale

Main articles: Social:Linguistic prescriptivism and Language and thought

In people-first language, preconceptions judged to be negative are thought to arise from placing the name of the condition before the term "person" or "people", such as "white person" or "Jewish people". Proponents of people-first language argue that this places an undue focus on the condition, which distracts from the humanity of the members of the community of people with the condition.

A 2008 experiment researched teenagers' perception of epilepsy with respect to people-first language. Teenagers from a summer camp were divided into two groups. One group was asked questions using the term "people with epilepsy", and the other group was asked using the term "epileptics", with questions including "Do you think that people with epilepsy/epileptics have more difficulties at school?" and "Do you have prejudice toward people with epilepsy/epileptics?" The study showed that the teenagers had higher "stigma perception" on the Stigma Scale of Epilepsy when hearing the phrase "epileptics" as opposed to "people with epilepsy".[10]

## Usage guidelines

### United States

Some U.S. organizations like the United Spinal Association have published disability etiquette guides, which prescribe people-first language.[11][12] The 2007 For Dummies guide to etiquette prescribed people-first language.[13]

As of 2017[update], the rules of people-first language have become normative in US governmental institutions on the federal (e.g. CDC)[14] and on state levels in the health departments' Developmental Disabilities Councils e.g. Michigan[15] West Virginia[16] Idaho,[17] Missouri[18] Georgia,[19] or Texas.[20]

As of 2007, it has been a requirement in AMA Manual of Style for academic journals.[21][22] APA style says that both people-first and identity-first language are acceptable, but stresses using the preferred style of the group or individuals involved (if they have one).[1]

### United Kingdom

NHS England's style guide calls for identity-first language in one instance (using "disabled people" rather than "people with a disability"), but remains ambivalent between people-first and identity-first languages in other examples (such as recommending "People with a learning disability or autistic people".[23] The UK government recommends people-first terminology such as "people with health conditions or impairments", but consents to the terms "disabled people", "deaf", and "blind" to reflect general acceptance by the relevant communities.[24] NHS Highland encourages "the use of 'people first' language; language that focuses first on the person, not the behaviour"[25] when communicating about drug and alcohol use.

## Criticism

The most common alternative to person-first language is usually called identity-first language. For example, while someone who advocates for person-first language might refer to a client as a "person with autism", that same client may prefer identity-first language, and ask to be called an "autistic person". Others have proposed "person-centered language", which, instead of being a replacement linguistic rule, promotes prioritizing the preferences of those who are being referred to and argues for greater nuance in the language used to describe people and groups of people.[26]

Autism activist Jim Sinclair rejects person-first language, on the grounds that "person with autism" suggests autism can be separated from the person.[27] Identity-first language is preferred by many autistic people and organizations run by them.[28][29][30] Lydia Brown of the Autistic Self Advocacy Network says:[31]

> In the autism community, many self-advocates and their allies prefer terminology such as "Autistic," "Autistic person," or "Autistic individual" because we understand autism as an inherent part of an individual's identity. ... It is impossible to affirm the value and worth of an Autistic person without recognizing his or her identity as an Autistic person. Referring to me as "a person with autism," or "an individual with ASD" demeans who I am because it denies who I am. ... When we say "person with autism," we say that it is unfortunate and an accident that a person is Autistic ... that the person would be better off if not Autistic, and that it would have been better if he or she had been born typical.

In 1993, the National Federation of the Blind in the US adopted a resolution condemning people-first language. The resolution dismissed the notion that "the word 'person' must invariably precede the word 'blind' to emphasize the fact that a blind person is first and foremost a person" as "totally unacceptable and pernicious" and resulting in the exact opposite of its purported aim, since "it is overly defensive, implies shame instead of true equality, and portrays the blind as touchy and belligerent".[32]

In Deaf culture, person-first language has long been rejected. Instead, Deaf culture uses Deaf-first language since being culturally Deaf is a source of positive identity and pride.[33] Correct terms to use for this group would be "Deaf person" or "hard of hearing person".[34] The phrase "hearing impaired" is not acceptable to most deaf or hard of hearing people because it emphasizes what they cannot do.[35]

Critics have objected that people-first language is awkward, repetitive and makes for tiresome writing and reading. C. Edwin Vaughan, a sociologist and longtime activist for the blind, argues that since "in common usage positive pronouns usually precede nouns", "the awkwardness of the preferred language focuses on the disability in a new and potentially negative way". According to Vaughan, it only serves to "focus on disability in an ungainly new way" and "calls attention to a person as having some type of 'marred identity'" in terms of Erving Goffman's theory of identity.[36] In the social model of disability, a person "is" disabled by societal and environmental factors. However, most people with visual impairment are not blind. Likewise, most people with hearing impairment are not profoundly deaf.

## See also

* Head-directionality parameter, regarding the placement of adjectives before or after nouns
* Political correctness
* Psychological distancing
* Slavery Terminology

## References

1. ↑ 1.0 1.1 "Disability". American Psychological Association. https://apastyle.apa.org/style-grammar-guidelines/bias-free-language/disability.
2. ↑ Lynn, V. A. (2017). Language and HIV communication. HIV/AIDS (Auckland, NZ), 9, 183."
3. ↑ Wright, B. A. (1960). Physical disability: A psychological approach.. New York: Harper & Row.
4. ↑ 4.0 4.1 "Letter to the editor". BusinessWeek (3059–3062). 1988. https://books.google.com/books?id=tGA1AAAAMAAJ&q="people-first+language". Retrieved 2022-08-05. "Supportive housing needs of elderly and disabled persons: hearing before the Subcommittee on Housing and Urban Affairs of the Committee on Banking, Housing, and Urban Affairs, United States Senate, One Hundred First Congress, first session on S. 566 ... the National Affordable Housing Act, June 2, 1989, Volumes 22–23: "All references to 'handicapped individuals' in the Act must be changed to 'people with disabilities'" – We join with many of our fellow advocacy organizations in emphasizing the importance of using 'people first' language throughout the Act.".
5. ↑ Folkins, John (December 1992). "Resource on Person-First Language". American Speech-Language-Hearing Association. http://www.asha.org/publications/journals/submissions/person_first.htm.
6. ↑ "Weight Bias - People-First Language". April 2013. http://www.obesityaction.org/weight-bias-and-stigma/people-first-language-for-obesity.
7. ↑ "AFYO about Autism". https://www.autismspeaks.org/sites/default/files/afyo_about_autism.pdf.
8. ↑ "What is People First Language?". http://www.thearc.org/who-we-are/media-center/people-first-language.
9. ↑ "Disability is Natural". https://www.disabilityisnatural.com/.
10. ↑ Fernandes, Paula T.; De Barros, Nelson F.; Li, Li M. (2009-05-01). "Stop saying epileptic" (in en). Epilepsia 50 (5): 1280–1283. doi:10.1111/j.1528-1167.2008.01899.x. ISSN 1528-1167. PMID 19054411.
11. ↑ "Disability Etiquette". United Spinal Association. 2011. http://www.unitedspinal.org/pdf/DisabilityEtiquette.pdf.
12. ↑ "Tools for Reporters: Disability Etiquette". United Cerebral Palsy. http://www.ucp.org/media/tools-for-reporters.
13. ↑ Fox, Sue (2007). "Being Sensitive about Disabilities and Illnesses". Etiquette for Dummies. John Wiley & Sons. ISBN 9781118051375.
14. ↑ Communicating With and About People with Disabilities CDC n.d., retrieved 13 Dec 2017
15. ↑ People First Language In Proposals for Michigan Developmental Disabilities Council Grants. Michigan Developmental Disabilities Council, October 12, 2016 7pp, retrieved 13 Dec 2017
16. ↑ Policy on People First Language, Approved 10/10/95 West Virginia, retrieved 13 Dec 2017
17. ↑ "2pp retrieved 13 December 2017". http://icdd.idaho.gov/pdf/Brochures/People First Language English.pdf.
18. ↑ "Missouri Department of mental health, 1p, retrieved 13 December 2017". https://dmh.mo.gov/docs/dd/self-determinationtippeoplefirstlanguage.pdf.
19. ↑ People First Language Georgia Developmental Disabilities Council, retrieved 13 Dec 2017
20. ↑ "People First Language". https://tcdd.texas.gov/resources/people-first-language/.
21. ↑ Iverson C, Christiansen S, Flanagin A, et al. AMA Manual of Style. 10th ed. New York, NY: Oxford University Press; 2007:416–417.
22. ↑ "Shaping attitudes through person-first language". Life Span Institute, University of Kansas. http://www.lsi.ku.edu/~lsi/aboutus/guidelines.shtml.
23. ↑ "Making information and the words we use accessible". https://www.england.nhs.uk/learning-disabilities/about/get-involved/involving-people/making-information-and-the-words-we-use-accessible.
24. ↑ "Inclusive language: words to use and avoid when writing about disability". 15 March 2021. https://www.gov.uk/government/publications/inclusive-communication/inclusive-language-words-to-use-and-avoid-when-writing-about-disability.
25. ↑ "Language Matters: communicating about people, alcohol, and drugs". https://www.highlandsubstanceawareness.scot.nhs.uk/wp-content/uploads/2021/09/Language-Matters.pdf.
26. ↑ Kapitan, Alex (2017). "On "Person-First Language": It's Time to Actually Put the Person First". Radical Copyeditor.com. https://radicalcopyeditor.com/2017/07/03/person-centered-language.
27. ↑ Sinclair, Jim. "Why I dislike person-first language". Autism Mythbusters. Retrieved January 7, 2016.
28. ↑ Kenny, L; Hattersley, C; Mollins, B; Buckley, C; Povey, C; Pellicano, E (2016). "Which terms should be used to describe autism? Perspectives from the UK autism community". Autism 20 (4): 442–462. doi:10.1177/1362361315588200. PMID 26134030.
29. ↑ Keating, Connor Tom; Hickman, Lydia; Leung, Joan; Monk, Ruth; Montgomery, Alicia; Heath, Hannah; Sowden, Sophie (2022-12-06). "Autism-related language preferences of English -speaking individuals across the globe: A mixed methods investigation" (in en). Autism Research 16 (2): 406–428. doi:10.1002/aur.2864. ISSN 1939-3792. PMID 36474364.
30. ↑ Emily Ladau (2015-07-20). "Why Person-First Language Doesn't Always Put the Person First". https://www.thinkinclusive.us/why-person-first-language-doesnt-always-put-the-person-first/.
31. ↑ Brown, Lydia (2012-03-02). "Identity First Language". http://autisticadvocacy.org/about-asan/identity-first-language/.
32. ↑ Jernigan, Kenneth (March 2009). "The Pitfalls of Treating people with respect: Euphemisms Excoriated". Braille Monitor 52 (3). "Be it resolved by the National Federation of the Blind in Convention assembled in the city of Dallas, Texas, this 9th day of July, 1993, that the following statement of policy be adopted: We believe that it is respectable to be blind, and although we have no particular pride in the fact of our blindness, neither do we have any shame in it. To the extent that euphemisms are used to convey any other concept or image, we deplore such use. We can make our own way in the world on equal terms with others, and we intend to do it."
33. ↑ Lum, Doman (2010). Culturally Competent Practice: A Framework for Understanding. Cengage Learning. p. 441. ISBN 9780840034434. https://books.google.com/books?id=aMqGhHCxXUYC&pg=PA441.
34. ↑ "Terminology Describing Deaf Individuals". Gallaudet University. http://www.gallaudet.edu/clerc_center/information_and_resources/info_to_go/educate_children_(3_to_21)/resources_for_mainstream_programs/terminology.html.
35. ↑ "Community and Culture – Frequently Asked Questions". National Association of the Deaf. http://www.nad.org/issues/american-sign-language/community-and-culture-faq.
36. ↑ Vaughan, C. Edwin (1997). "People-First Language: An Unholy Crusade". National Federation of the Blind.

## Further reading

* La Forge, Jan. "Preferred language practice in professional rehabilitation journals". The Journal of Rehabilitation 57 (1): 49–51.
* Lynn, V. A. (2017). Language and HIV communication. HIV/AIDS (Auckland, NZ), 9, 183.

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