Ableist Language & Disability Professionals: Differences in Language Based on Professionals’ Demographics

Posted on September 6, 2023

By Carli Friedman, CQL Director of Research, and Zach Gordon, AAIDD Production Coordinator, Publications

In this two-part research series, we examine ableist language and disability professionals. In the first part of this series, we examined if disability professionals (people working in a disability field, who work with disabled people, or whose work is about disability) use ableist language, and if they recognize it as problematic. In this second part of the series, we explored sociodemographic differences in disability professionals’ language use. Skip to accessible summary.

Background

As mentioned in the first part of this series, linguistic ableism impacts disabled people immensely and can serve as one source of oppression. Yet, ableist language is often so deeply embedded in everyday language that speakers may not even realize it is problematic or that they are reinforcing ableist ideas through this language use (Carruthers, 2019; Kiesling, 2005). In fact, while some ableist language is overt and more obviously, ableist language can also be more subtle and euphemistic. For example, euphemistic terms such as ‘differently abled’ can be used to distance from disability, thereby implying there is something wrong with it and it should be avoided (Brown, 2013; Linton, 1998).

Disability professionals have long played a role in disability language and terminology by creating and reinforcing deficit-based understandings of disability, often without the input of disabled people themselves (Bottema-Beutel et al., 2021; Oliver, 1990). For example, despite many disabled people preferring identity-first language (i.e., ‘disabled people’), many disability professions still default to person-first language (i.e., ‘person with a disability’) as it was originally championed as the ‘correct’ approach (Andrews et al., 2019; Andrews et al., 2022); as a result, some disability professionals still believe identity-first language is wrong. Disability professions and industries have been critiqued for creating and reinforcing individualized, deficit-based understandings of disability – often pathologizing disability with the help of stigmatizing, objectifying terminology (Oliver, 1990).

Design of This Study

As a result of the harmful impact of ableist language, as well as the role disability professionals can play in disabled people’s health and quality of life, it is important to examine ableist language among disability professionals. For these reasons, the aim of this study was to examine demographic differences in how disability professionals use ableist language and if they recognize ableist language as problematic.

A total of 347 disability professionals participated in this study between October 2021 and March 2022 (participant demographics are available in Appendix Table 1). In the online survey, participants were asked to select from a list words/phrases they used in everyday language as well as those words they found problematic. The list included overtly ableist words, euphemistically ableist words, contextually ableist words, and disability words that are not inherently ableist. To examine demographic differences in the number of words people used and found problematic we ran linear regression models with participants’ demographics as the independent variables (IVs) and the number of words as the dependent variables (DVs) in each model. Next, to examine specific word use, we ran a series of binary logistic regression models with participants’ demographics as the IVs and use of each word as the DV in each model. In addition, to examine demographic differences in what language people found problematic, we ran a series of binary logistic regression models with participants’ demographics as the IVs and finding each problematic as the DV in each model.

Findings

There were many differences in language based on disability professionals’ sociodemographics (Appendix Tables 2-4) that may point to differences in how language may have evolved in different disability fields, people having different education and training, and/or people having different relationships to disability.

Relationships To and With Disability

For example, disabled disability professionals in this study were less likely to use words like ‘people affected by disability’ and more likely to find ‘people with abilities’ problematic. However, they did not significantly differ from nondisabled people in the number of overtly, or euphemistically ableist words used, and frequently did not differ in which words were used or found problematic. They were also less likely to find words like ‘maniac,’ ‘moron,’ and ‘wheelchair bound’ problematic. While more research is needed to determine why this was the case – perhaps working in a disability profession led these professionals to have different views, education, and experience than other disabled people – it is important to recognize that, due to compulsory ableism in society, many disabled people have internalized ableism, even if they generally have lower levels of ableism than nondisabled people (Friedman, 2016; Friedman & Awsumb, 2019; Kafer, 2013; Nosek et al., 2007; VanPuymbrouck et al., 2020). In addition, the hierarchy of disability, which favors certain disabilities over others, reinforces difference, stigma, and oppression, even within the disability community (Charlton, 1998; Deal, 2003). According to the hierarchy, people with psychiatric and intellectual disabilities, the very people who would have been previously labeled with terms like ‘maniac’ and ‘moron,’ are at the bottom of the hierarchy and are more likely to be stigmatized (Charlton, 1998).

Disability professionals with disabled family in particular were more likely to find ‘special needs’ problematic than disability professionals without disabled family. However, in general, disability professionals with disabled friends and/or disabled family did not significantly differ from those without these relationships in terms of the use of overtly, and euphemistically ableist words. While having a close disabled family member or friend often reduces ones’ ableism, many people with disabled family and/or friends still hold implicitly negative attitudes about disability, reflecting both to prevalence of ableism in society which people internalize, and the difference between lived experience with disability and arm’s length knowledge (Friedman, 2019a; VanPuymbrouck et al., 2020).

Professional Differences

There were also significant differences in use and perceptions of ableist language based on professional context. For example, clinicians were less likely to find ‘handicap’ and ‘handicapable’ problematic than disability professionals who were not clinicians. ‘Handicap’ is an outdated clinical term, which has become significantly less common due to disability advocacy and the Americans with Disabilities Act (ADA; Andrews et al., 2019; Haller et al., 2006), while ‘handicapable’ is an euphemistic derivative, which was not frequently used in our study, but believed to be less problematic by clinicians nonetheless. Why clinicians would look favorably on an outdated term is unknown but may be based on their original education and training when the term was still commonplace.

The people that worked most directly with disabled people, including support staff, frontline supervisors, support coordinators, and those who worked in residential and employment/day settings, were more likely to use many of the euphemistically ableist words and less likely to recognize them as problematic. These types of professionals may be more likely to use euphemistic terms than other professionals as a result of working more directly with people with disabilities. This may especially be the case as the disability service system generally operates under a paternalistic custodial model of care that makes assumptions about disabled people’s abilities and reinforces pity, both of which align with the purported aims of euphemistic language (Spagnuolo, 2016). As a result of working directly with disabled people, the use of euphemistically ableist language by this population very likely means disabled people are subjected to hearing these terms on a regular basis, likely negatively impacting disabled people’s self-images as well as possibly straining the relationships between the professional and the disabled person.

In contrast, those in leadership roles, including human service provider executive leadership, may work less directly with disabled people. However, they have more control over the direction and vision of their organizations, including top-down language policies for the daily communication of everyone who works directly and indirectly with disabled people at their organizations. Yet, these leaders fared no better than other disability professionals, and in fact were more likely to use ‘special needs’ than other professionals. Given human service provider executive leadership have more power and control, including to impact the language of other professionals, it is especially important they lead by example and rid themselves of ableism, including related to language.

Those professionals in quality management found more overtly ableist and euphemistically ableist words problematic than professionals in other roles. As people in quality management often oversee compliance and regulations, incident management, and/or operations, we believe it is promising that people in quality management observed more ableist words, including euphemistically ableist words which can be more difficult for disability professionals to recognize. Certainly, ableism conflicts with quality. However, it is also important to note that those in quality management were not less likely to use ableist words than other disability professionals, they were just more likely to recognize them as ableist.

Disability researchers and academics found fewer overtly ableist words problematic. Disability researchers and academics were also more likely to use ‘stupid’ and less likely to find words like ‘dumb,’ ‘idiot,’ and ‘stupid’ problematic. This may be due to disability researchers and academics valuing and prioritizing intelligence and hierarchies, as is commonly reinforced in academia. It is also important to note that like disability professionals in general, research and academic fields about disability are heterogenous, with different orientations toward and views of disability, and different levels of metalinguistic awareness. Also pertinent is that this group was comprised of only 13 participants; as such, the small sample size may have impacted results.

In addition to professional role, there were also a number of differences in language based on how long disability professionals worked in the disability field. For example, the longer disability professionals worked in the field, the more overtly ableist words they found problematic. This may be due to people working in the field longer receiving more or different education about disability. Research also suggests that the longer people work in disability fields, the more likely they are to understand disability as simply a general difference (without a negative affect), and the less likely they are to understand disability as something that slows or prevents actions or tasks (Friedman & Owen, 2017); this evolution may contribute to the difference in language found in this study. There may also be an interaction between length of time in the field, age, and profession that impacted this relationship.

Other Sociodemographic Differences

In fact, older disability professionals used fewer overtly ableist words than younger disability professionals in our study. It may be that older people are more sensitive to insults in general, regardless of their ableist origins, or that older people made different language choices based on generational or professional experience. We believe more research is needed to explore this phenomenon, especially as research suggests older people are more ableist than younger people, although no age group is prejudice-free (Friedman, 2019a; VanPuymbrouck et al., 2020).

Political orientation was correlated with language use and perceptions. Disability professionals that were more conservative found fewer euphemistic words problematic, including ‘differently abled’ and ‘special needs,’ and were more likely to use euphemistic words such as ‘people with abilities,’ ‘people affected by disability,’ and ‘special needs’ than more liberal disability professionals. While ableist sentiment is common among both conservatives and liberals, especially implicitly, conservative disability professionals may be less likely to view euphemistic words negatively as they are more likely express ableism through symbols, such as opposition to the ADA (Friedman, 2020; Friedman & Awsumb, 2019; Friedman & VanPuymbrouck, 2021).

Findings were inconsistent in terms of gender. While women disability professionals were more likely to use the euphemistic term ‘people struggling with mental illness’ than men disability professionals, they were less likely to use euphemistic term ‘consumer’ than men. In addition, they were less likely than men to find the euphemistic term ‘special needs’ problematic, but more likely to find the overt term ‘wheelchair bound’ problematic. While women are generally less ableist than men (Friedman, 2019a; Friedman & Awsumb, 2019; Hirschberger et al., 2005; VanPuymbrouck et al., 2020), given these findings reveal an inconsistent pattern, perhaps their ableism is expressed in different ways then men that requires further exploration to clearly delineate. Due to the gendered nature of care work, it may also be that the women participants worked in different areas of the disability field than the men participants, and this contributed to the differences in language we discovered (Campbell, 2017).

While the number of words used did not differ based on race, Black disability professionals were more likely to use ‘consumer’ and ‘people with abilities’ than White disability professionals, and were less likely to find ‘special needs’ problematic. In addition, people that fell into the ‘other’ race category were less likely find ‘wheelchair bound’ problematic than White people. More research is needed to determine why these differences exist as well as which factors contribute to these differences. For example, they may be due to cultural differences among communities; they may also be due to interactions with other variables which were not explored.

While there were fewer significant differences based on country, disability professionals outside of the United States were more likely to use ‘people struggling with mental illness’ and less likely to use ‘client’ than disability professionals in the United States. People from outside the United States were also more likely to find the terms ‘wheelchair bound’ and ‘handicapable’ problematic. These distinctions may be due to different dialects and cultural terms in those countries, disability rights/history trajectories in those countries, and/or political and education systems in those countries.

Implications

Use of ableist language by disability professionals has an even greater capacity for harming disabled people than commonplace use by the general public as these professionals are positioned as experts and authority figures, and are often tasked with making or executing important and powerful decisions, both indirectly and directly, about disabled people across many aspects of life. Not only are they making decisions that affect the lives of disabled people now, but they are setting the precedent for how the next generation of disability professionals speaks about disabled people and how disability is understood and framed more broadly.

While we found a number of differences in language based on disability professionals’ sociodemographics, most professionals in this study reported using at least some ableist language. Findings from both parts of this study indicate disability professionals need for more education about disability, language, and ableism. While doing so, the sociodemographic factors unearthed in this study can help guide targeted education and intervention efforts.  

Conclusions

Ableism is extremely prominent in society, and linguistic ableism is very harmful to disabled people (Brown, 2014; Campbell, 2009; Carruthers, 2019). In our study, overall, most disability professionals used at least some ableist language. While disability professionals used overtly ableist words less frequently, many of those that used overtly ableist terminology did so despite having an awareness regarding the problematic nature of such language. In contrast, many disability professionals did not recognize euphemistically ableist words as problematic, and, as a result, used many of these terms frequently. While often this type of language use may be unintentional and without awareness, pejorative language use is a strong indicator of how a speaker acts towards disabled people (Carruthers, 2019). This negatively impacts interactions and makes well-intended interactions between the disability professional and the disability community more fraught and tenuous, and often leaves disabled people feeling unvalued and uncared for. Even when such language is directed at nondisabled people, this language draw upon social norms that reassert disability as inferior and less than (Carruthers, 2019; Cousens, 2020). This is especially harmful when done by disability professionals who often have power over disabled people and are positioned as authority experts about disability.

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