People-First Language vs Identity-First Language for Occupational Therapy Practice

People First vs Identity First Language Occupational Therapy

Background

In 2006, the People First Respectful Language Modernization Act was enacted which “require the use of respectful language when referring to people with disabilities in all new and revised District laws, regulations, rules, and publications and all internet publications”.

The National Federation of the Blind (NFB) has elected to use identity-first language instead of people-first language as it may “imply shame instead of true equality”.

Definition

People-first language puts the person before the disability.

Identity-first language centers on the disability while still recognizing the person, e.g. “disabled person”

Examples

Examples of phrases with people-first language in mind include:

  • “child with autism” instead of “autistic child”
  • “man who has a disability” instead of “crippled man”
  • “people with disabilities” instead of “the disabled”
  • “adults with disabilities” instead of “disabled adults”
  • “people with mental health conditions” instead of “the insane person”
  • “he/she has a disability” instead of “suffering from a disability”
  • “person who uses a wheelchair” instead of “wheelchair user”, “wheelchair-bound”

Use

Should you be using person-first language, identity-first language, or something else in your conversations and writing? Many organizations, groups, and professions have adopted people-first language. People-first is prevalent in academic and professional psychology in the United States and is also mandated in some scholarly journals and academic programs.

Advocates for using a people-first language approach, say it allows individuals or groups to “claim” their disability or “reframe it” with pride and value. People-first language may promote autonomy and agency. On the other hand, this approach may imply something inherently negative about disability and the way disability is phrased. A study in 2004 of 100 people with visual impairments found that 37% had no preference for terminology. 76% preferred identity-first language over person-first language.

OT Practice

The nature of this study provides insight into several points.

  • Each individual or group is different and has their own preferences.
  • There is no one-size-fits all language for an individual, group, or population.
  • Some groups or communities may prefer one term over another, e.g. visually impaired, autism, deaf and hard-of-hearing.

Just ask what the person or group prefers in your occupational therapy sessions. This may be new territory for some individuals who have a new disability. Occupational therapists can educate their clients of the two choices, their meaning, and reasons for why one group may prefer one over the other. Some clients may have no preference at all.

If you are writing for academics, ask your professor what they prefer you use. It may not be general may depend on a group or those with a certain condition. If you are writing for a journal, ask what they prefer. It may be best to default to people-first language for larger audiences. When writing online, there is no right answer and it may depend on the context, e.g. a subreddit group may be offended by one term, while another subreddit may actually prefer it.

Thinking more broadly, these concepts may be applied to other groups and cultures such as ethnicities. Examples include recent LGBTQ, pronoun preference, Latinx movements. As an occupational therapy professional, I think it is important to keep up with emerging terms and language to be culturally sensitive. Language is an interesting thing as it continues to evolve and some terminology may become outdated, irrelevant, or even offensive. One way to become aware of this area is by reading the latest Occupational Therapy Practice Frameworks (OTPF) as they contain updates on terms and their definitions. I imagine this topic will be a hot topic for many years to come and I am looking forward to more research into what people prefer, why, and why not.

References

Dunn, D. S., & Andrews, E. E. (2015). Person-first and identity-first language: Developing psychologists’ cultural competence using disability language. American Psychologist70(3), 255.

https://odr.dc.gov/page/people-first-language

Jeff is a licensed occupational therapist and lead content creator for OT Dude. He covers all things occupational therapy as well as other topics including healthcare, wellness, mental health, technology, science, sociology, and philosophy. Buy me a Coffee on Venmo.