Impairment: any loss or abnormality of psychological, physiological or anatomical structure or
function.
Disability: any restriction or lack (resulting from an impairment) of ability to perform an activity in the
manner or within the range considered normal for a human being.
Handicap: a disadvantage for a given individual that limits or prevents the fulfillment of a role that is
normal
As traditionally used, impairment refers to a problem with a structure or organ of the body; disability is
a functional limitation with regard to a particular activity; and handicap refers to a disadvantage in
filling a role in life relative to a peer group.
. Behaviour
A learning disorder characterized by specific behavior problems over such a period of time, and to such
a marked degree and of such a nature, as to adversely affect educational performance, and that may be
accompanied by one or more of the following:
• an inability to build or to maintain interpersonal relationships;
• excessive fears or anxieties;
• a tendency to compulsive reaction;
• an inability to learn that cannot be traced to intellectual, sensory, or other health
factors;
• or any combination thereof.
2. Communication
Autism: A severe learning disorder that is characterized by disturbances in:
• rate of educational development;
• ability to relate to the environment;
• mobility;
• perception, speech, and language; and
• lack of the representational symbolic behaviour that precedes language.
Deaf and hard-of-hearing: An impairment characterized by deficits in language and
speech development because of a diminished or non-existent auditory response to sound.
Language impairment: A learning disorder characterized by impairment in comprehension and/or
the use of verbal communication or the written or other symbol system of communication, which
may be associated with neurological, psychological, physical or sensory factors, and which may:
• involve one or more of the form, content and function of language in
communication; and
include one or more of:
• language delay;
• dysfluency; and
• voice and articulation development, which may or may not be organically or
functionally based.
Learning disability
A learning disorder evident in both academic and social situations that involves one or more
of the processes necessary for the proper use of spoken language or the symbols of
communication, and that is characterized by a condition that:
Is not primarily the result of:
• impairment of vision;
• impairment of hearing;
• physical disability;
• developmental disability;
• primary emotional disturbance; or
• cultural difference.
Results in a significant discrepancy between academic achievement and
assessed intellectual ability, with deficits in one or more of the following:
• receptive language (listening, reading);
• language processing (thinking, conceptualizing, integrating);
• expressive language (talking, spelling, writing); or
• mathematical computations.
And may be associated with one or more conditions diagnosed as:
• a perceptual handicap;
• a brain injury;
• minimal brain dysfunction;
• dyslexia; or
• developmental aphasia.
3. Intellectual
Giftedness
An unusually advanced degree of general intellectual ability that requires differentiated
learning experiences of a depth and breadth beyond those normally provided in the regular
school program to satisfy the level of educational potential indicated.
Mild intellectual disability
A learning disorder characterized by:
• an ability to profit educationally within a regular class with the aid of considerable
curriculum modification and supportive service;
• an inability to profit educationally within a regular class because of slow intellectual
development; or
• a potential for academic learning, independent social adjustment, and economic self-
support.
Developmental disability
A severe learning disorder characterized by:
• an inability to profit from a special education program for students with mild
intellectual disabilities because of slow intellectual development;
• an ability to profit from a special education program that is designed to
accommodate slow intellectual development; or
• a limited potential for academic learning, independent social adjustment, and
economic self-support.
4. Physical
Physical disability
A condition of such severe physical limitation or deficiency as to require special assistance
in learning situations to provide the opportunity for educational achievement equivalent to
that of pupils without exceptionalities who are of the same age or development level.
Blind and low vision
A condition of partial or total impairment of sight or vision that even with correction affects
educational performance adversely.
5. Multiple
Multiple exceptionalities
A combination of learning or other disorders, impairments or physical disabilities that is of such a
nature as to require, for educational achievement, the services of one or more teachers holding
qualifications in special education and the provision of support services appropriate for such disorders,
impairments or disabilities.
Resource on Person-First Language
The Language Used to Describe Individuals With Disabilities
John Folkins, ASHA Publications Board
December 1992
This statement of principles is intended as a resource for editors and authors. It is advisory only; that is,
none of the principles given should be considered to be binding rules for material published by ASHA.
• Principle One: Person-First Language
• Principle Two: Disability Versus Handicap
• Principle Three: We All Like to Think of Ourselves as Normal
• Principle Four: Avoid Terms That Project an Unnecessary Negative Connotation
• Principle Five: Don't Overdo It
• References
Principle One: Person-First Language
Use person-first language. Disabilities are not persons and they do not define persons, so do not replace
person-nouns with disability-nouns. [ 1][ 2]
Avoid:
• the aphasic
• the schizophrenic
• stutterers
• cleft palates
• the hearing impaired
Further, emphasize the person, not the disability, by putting the person-noun first.
Use:
• people with cleft palate
• the lawyer who has dyslexia
• persons who stutter
• the speech of children with language impairment
• the speech of individuals who stutter
Avoid:
• cleft palate children
• the hearing impaired client
• the dyslexic lawyer
• the retarded adult
Is there a difference between to be and to have? Between saying a person "with a hearing loss" and
saying a person "is hearing impaired"? Some have suggested that to have may imply possession and to
be may imply identity. [ 3] Thus they argue that it is less stigmatizing to use have than be.
"The deaf" and "the speech of the deaf" also violate the person-first rule. However, the community of
persons who are deaf prefer to use deaf with a capital D to denote the Deaf culture and the Deaf
community, not the hearing loss. As a general rule, we may wish to follow the preferences of a
disability group, even if it violates other principles. The problems with following the desires of
different groups occur when one doesn't know what the members of a group want or when the
preferences of individuals in a group differ.
In my opinion, "stuttered speech" is okay. "Stuttered" describes the speech. "Cleft palate speech" is not
okay, because the person (not the speech) has the cleft. However, "deaf speech" violates this rule; yet
many people believe that "deaf speech" is acceptable.
Person-first language makes sentences more complicated. The consensus of the Publications Board on
November 19, 1992, was that deviations from person-first language should be allowed in cases when
the only alternative is awkward sentence structure. When publishing research reports in ASHA
journals, it is important to describe individuals with sensitivity. There are no absolute rules in regard to
what language is sensitive and what language is not sensitive. Clearly, the most appropriate approaches
may differ across different circumstances and different types of publications.
The clarity of research papers may be affected if one is required to use person-first language every time
a group of subjects from a specific population is mentioned. One approach may be to describe
populations with person-nouns first in the initial description of the subjects. Then one can refer to these
descriptions throughout the rest of the paper. It is more important to use person-first language when
describing individuals making up a group than when referring to the group. That is, although it may be
preferable to say "the group of individuals who are dysarthric" than to say "the group of dysarthrics,"
when stylistically necessary, it may be appropriate to use "the dysarthric group." The general rule is
that person-first language is more important than group-first language.
There are many examples in which we do categorize people and omit the person-noun and the person-
first position; for example, the audiologist (as opposed to "the person who performs audiological
services"), the speech-language pathologist, the professor, the professional, the teacher, the
grandparent, the leader, the pacifist, the hypocrite, et cetera. One could make the case that we should
not categorize the person by these attributes. Yet, "the person who grandmothers" is difficult to support
as an alternative to "grandmother."
When the categorizing is negative, person-first language might be preferable. "The person with a
criminal record" may be better than "the criminal." However, we may need to do the same thing for
both positive and negative attributes. If we use person-first language only for negative attributes, then
person-first language could take on a negative connotation. The way out of this is to assert that it is
proper for society to categorize people without person-first language in many instances, but that
disabilities are not one of them. Disabilities need not be defining characteristics in the way that a
profession or role in society is. There are many circumstances in which it may be appropriate to use the
terms disability, disorder, or impairment. One needs to be sensitive to when it is, and when it is not,
appropriate to use terms with a negative connotation.
Return to Top
Principle Two: Disability Versus Handicap
Disabilities, disorders, or impairments can be caused by birth defects, illnesses, or injuries; but
disability is a possible result of, not a synonym for, the birth defect, illness, or injury. [ 4][ 5] The
public may have negative connotations for sickness and disease (e.g., diseases are sometimes
contagious, disabilities are not). Inability differs from disability in that inability implies a total loss. The
World Health Organization has explicit definitions that distinguish among disabilities, disorders, and
impairments; however, for most purposes these terms are synonymous. Further, people have
disabilities, not handicaps. Handicaps are social or environmental obstacles imposed by society on
those with disabilities.
To summarize:
• Disability, disorder, and impairment can be synonyms.
• Disability does not equal inability.
• Disability does not equal birth defect, illness, disease, or injury.
• Disability does not equal handicap.
• People do not have handicaps; society imposes them.
• Handicap is a useful term in golf and horse racing.
Some writers don't like "birth defect" and "congenital anomaly." [ 6] Congenital disability can be
substituted if appropriate. A disabled computer, light switch, or bomb are objects that do not work at
all. Here disability really does imply inability.
Return to Top
Principle Three: We All Like to Think of Ourselves as Normal
Individuals with disabilities are "normal" in many ways. Referring to persons without disabilities as
normal implies that persons who have disabilities are abnormal. [ 3] The term abnormal has a
pejorative flavor. At the least, normal should be used only in regard to explicitly defined limits for
specific attributes.
Avoid:
• normals
• normal speakers
• the speech of individuals who are normal
Use:
• the speech of individuals with no history of speech, language, or hearing impairment
• individuals who were judged to show no speech, language, or hearing impairment
• children with normally developing speech and language
• normal-hearing
• hearing sensitivity within normal limits
• normal speech (can be used when speech sounds normal and it can be produced in some
instances by individuals with speech impairments)
• normal-language group ("group-first" language is not always necessary)
Return to Top
Principle Four: Avoid Terms That Project an Unnecessary Negative Connotation
It is desirable to avoid language that projects struggle, pain, or suffering when it is not necessarily part
of the circumstances being described. When suffering is a part of the message to be conveyed, it is
appropriate to use the term for example, "tinnitus sufferer." However, this may not always be clear-cut.
For example, some groups (e.g., the Commission of Persons with Disabilities [ 6] version 2 and
presumably Self Help for Hard of Hearing People, Inc.) prefer "hard-of-hearing" to either "hearing
impaired" or "hearing loss."
Some authors have suggested avoiding the term dysfluency. [ 7] They prefer to use "disfluency." They
claim that "dys" has more of a pathological flavor. The prefix "dis" means apart from. The prefix "dys"
means "difficult, painful, bad, or disordered." This is clearly a judgment call, and there is presently
little consistency among authors. [ 7][ 8]
In general, avoid the following: [ 1][ 2][ 4][ 6][ 9]
• patient ("Use client for most recipients of clinical services because patient may denote sickness
or medical intervention. Patient is appropriate for individuals who are patients in a hospital.)
• confined to a wheelchair, restricted to a wheelchair, wheelchair bound (People receive mobility
from wheelchairs, not confinement.)
• victim (This implies a desire for sympathy.)
• cripple, crippled, the crippled, lame, the lame
• deformed (may imply ugly)
• deaf and dumb, deaf mute (needs no justification)
• afflicted with, stricken with, suffering from (say the person has...)
• invalid (not valid)
• courageous, brave, inspirational (Not all people with disabilities have these traits.)
• unfortunate, pitiful, poor (condescending when used in reference to a disability)
• incapacitated (There are still capacities.)
• retardate, mongoloid, idiot, moron, mentally deficient, mentally defective, imbecile, feeble
minded (Use "persons with mental retardation" or children with developmental delay.")
• mentally deranged, mentally ill, mentally deviant, maniac, crazy, lunatic, mad (Use "persons
with a mental disorder.")
• deafening silence, blind rage, blind faith, turned a deaf ear, lame excuse (Avoid metaphors with
pejorative connotations.)
• fit (Use "seizure" when applicable; "fit" may be an appropriate synonym for tantrum.)
• spastic (Use only to describe muscular spasticity. Not all types of cerebral palsy involve
spasticity. Muscles are spastic not people.)
• hare lip (Does not compliment people or rabbits. Use cleft lip.)
Return to Top
Principle Five: Don't Overdo It
Be careful with the term special. In some respects, we are all special. From another perspective, people
with disabilities are not necessarily special even if they are enrolled in "special education."
"Language challenged" or "hearing challenged" may imply that people need to try harder than they are
trying at present.
Blatant euphemisms (differently hearing, physically different, differently abled, speech
inconvenienced, vertically challenged, horizontally challenged, chronologically gifted) don't hide
disability, but they can produce confusion. It is not more sensitive to refer to individuals who are
physically within normal limits as temporarily ablebodied (TABs) or momentarily ablebodied (MABs).
[ 3]
Return to Top
References
1. National Easter Seal Society. (undated). Portraying people with disabilities in the media.
2. Language awareness. (1985, March). National Rehabilitation Association Newsletter.
3. The language of disability: Problems of politics and practice. (1988). Journal of the Disability
Advisory Council of Australia, 1(3), 13-21.
4. Monjar, S. (undated). What do you say after you see they're disabled? Rehabilitation Institute of
Chicago.
5. National Easter Seal Society. (undated). Awareness is the first step toward change: Tips for disability
awareness.
6. Commission of Persons with Disabilities, Iowa Department of Human Rights. (undated). Use words
with dignity. (There are two different versions of this handout.)
7. Quesal, R. (1998). Inexact use of "disfluency" and "dysfluency" in stuttering research." Journal of
Speech and Hearing Disorders, 53, 349-350.
8. Bernstein Ratner, N. (1988). Response to Quesal: Terminology in stuttering research. Journal of
Speech and Hearing Disorders, 53, 350-351.
9. National Easter Seal Society. (undated). Awareness is the first step toward change: Tips for
portraying people with disabilities in the media.
