Person-First Language Resource

When a child has chronic health needs, the disability or disease may become the focal point of your communication with the child and family. It is important that your language does not imply that the disability is the most important part of your relationship with the patient. If you put the disability before the patient, you will unintentionally create a barrier in the physician-patient relationship. You may make a parent or a child with special needs uncomfortable or even defensive, and may subtly imply that you have forgotten that this child is a whole person who is worthy of respect. Even when a disability impacts a child’s life in a substantial way, the disability does not define the child or the family, nor is it the sole focus of their existence. The language that you use when talking with or about the patient provides reinforcement to the child and family that they come first, rather than the disability.

Person-first language involves just that: It puts the person first and tells the child and family that you view the child as an individual. By rearranging sentence structure to emphasize the individual, you let the child know that you think of him or her as a person and not as a disease. This small change in language can greatly improve the mindset and outlook of the child and family. Consistently using person-first language in your communication with patients and families, with co-workers and supervisors, and in academic writing will also, over time, influence your own attitudes, reminding you that children with disabilities are children first.

Mention the person first, before the disability. For example:

  • "The patient with spina bifida…” as opposed to “the spina bifida patient”
  • "The speech of children who stutter” as opposed to “the stuttering children”
  • “The community of persons who are deaf” as opposed to “the deaf community”
  • “The adolescent with schizophrenia” as opposed to “the schizophrenic”

Use “to have” verbs rather than “to be“ verbs. This suggests that the patient has a disease rather than suggesting that the patient is the disease, and therefore stigmatizes less. For example:
  • “The child with a hearing loss” as opposed to “The child who is hearing impaired”
  • “He has ADHD” as opposed to “He’s ADHD”

Avoid mentioning the disability altogether unless it is pertinent to the discussion.  Use the patient’s name whenever possible, such as calling a young girl “Shana” as opposed to “the girl with spina bifida.” This reinforces the child’s sense of self worth and avoids unnecessary emphasis on the disability.

Avoid language that may project pain or suffering onto the patient’s condition.  Certain words and phrases are potentially insulting or demeaning because they suggest that the individual is less than normal because of the disability.

  • Victim (implies that the individual is in need of sympathy)
  • Invalid (archaic term)
  • Deaf and dumb; deaf mute (insulting)
  • Unfortunate, pitiful, poor (condescending when used in reference to a disability)
  • Deformed (implies ugliness)
  • Confined to a wheelchair, restricted to crutches ( an individual gains mobility through use of these implements; the individual is not confined by them )
  • Patient (implies that the individual is sick and needs help; it is acceptable to use ”patient“ if the individual is in hospital or clinic, but not when directly addressing the person)
  • Mentally ill, crazy, retarded, mentally deficient, feeble minded (archaic, insulting terms)
  • Spastic ( muscles may be spastic but the person is not)
  • Language challenged, hearing challenged (this is ‘disease-first’ not ‘person-first language and suggests that the individual needs to try harder)
  • Problem (the child does not have a problem, they have a need)
  • Handicapped (implies that an individual cannot live a ‘normal’ life )
  • Special (the need may be special, but the child is not necessarily “special,” even if the child is enrolled in special education.)

Avoid implying that other people who do not have a disability are more ’normal.’ By calling those without a disability “normal,” you suggest that your patient is abnormal. Try to use the following terminology instead of attributing ”normalcy“ to those who do not have a disability:
  • “The speech of individuals who do not have a speech, language, or hearing impairment” as opposed to “the speech of ’normal’ individuals”
  • “Children with typically developing speech and language” as opposed to ”children with ‘normal’ speech and language“
  • “Hearing sensitivity within typical limits” as opposed to ”hearing within ‘normal’ limits.

Make an effort to emphasize strengths, positive points, and resilience. Emphasizing a child’s skills and abilities and the ways that the family supports the child can help both you and them to refocus on the positive, use strengths to solve problems, and promote resilience for the child and the family.

Try to imagine how you would want people to talk to you if you were sick. You would not want to be “that cancerous man/woman,” but perhaps “my buddy who plays soccer, has three kids, and has leukemia.” A disability or disease does not define the person even though it is a part of his or her life. Language reflects our attitudes and beliefs.  By using person-first language, you can ensure that you show respect for all children and their families and accord them the dignity to which they are entitled.

See the following website for suggestions and explanations about person-first language:
American Speech-Language-Hearing Association.

 

  
 
URL for CLIPP URL for CLIPP