Preferred language practice in professional rehabilitation journals.

This study examined the use of preferred language relative to persons with disabilities in three major rehabilitation journals: Journal of Rehabilitation, Journal of Applied Rehabilitation Counseling, and Rehabilitation Counseling Bulletin. The central preferred guideline identified from the literature on language is to stress person over the disability. Results show that preferred language is used about half the time over more conventional forms. Reasons for inconsistency in using preferred language forms are explored. Primary consideration is given to lack of explicit language directives in the relevant professional literature.

The relationship between language and attitudes and possible ambivalence of professionals' personal attitudes towards people with disabilities are also discussed.

For more than a decade the rehabilitation profession has been dealing actively with the issue of appropriate language usage in referring to people with disabilities. A general consensus has developed that language communicates attitudes and that inappropriate language encourages negative stereotypes (Boland, 1980; Handley & Brodwin, 1988; Kailes, 1985; Manus, 1975; Patterson, 1988; Wright, 1983). Consequently, there has been strong support for language that does not devalue the person or encourage stereotypic images.

The primary general language recommendation of the past decade is that "person " or people " should precede the disability (Hadley and Brodwin, 1988; Kailes, 1985; Manus, 1975). Moreover, disability descriptors should not be used as nouns because this tends to identify the person with, or in terms of, the disability. For example, "person who is blind" or "person with paraplegia involvement" is preferable to blind person," "the blind," or "paraplegic" (Boland, 1980; Hadley & Brodwin, 1988; Kailes, 1985; Manus, 1975).

Other more specific recommendations on preferable language use include the following:

(1) Emotional or sensationalist terms- such as "sufferer" or "victim"- should be avoided because of their negative connotations and tendency to evoke pity (Hadley & Brodwin, 1988; Kailes, 1985; Staff, 1985).

(2) The term "patient" and similar medical terminology implies that people with disabilities are sick," connotating "disease" and possible contagion- which is not the case (Hadley & Brodwin, 1988). Moreover, "patienthood," consistent with the medical model, implies a relatively passive role whereas rehabilitation philosophy and practice stress active cooperation in a joint venture of provider and client.

(3) The term "disabled" should be used in place of "handicapped" since not all disabilities are handicapping, and some are handicapping only part of the time (Kailes, 1985; Staff, 1985).

(4) The term "normal" implies that people with disabilities are abnormal" and so should be avoided (Kailes, 1985).

(5) The term "wheelchair user" is preferable to wheelchair bound" or "confined to a wheelchair" (Hadley & Brodwin, 1988; Kailes, 1985; Staff, 1985). Still, "wheelchair user" sounds like someone has made a career out of using a wheelchair; "person who uses a wheelchair" is preferred (Hadley & Brodwin, 1988).

Although there appears to be professional consensus on preferred language forms, ambiguity abounds in the advisory literature on language. For example, the brochures Guidelines for Reporting and Writing about People with Disabilities (1984) and What Makes Disabled People Disabled? (Catalog number 6-12) are designed to improve the public's attitudes and language. Consistent with the above guidelines, both recommend: 1) emphasizing the person over the disability- as in "persons with disabilities" rather than "the disabled," and 2) avoiding sensationalist terms which evoke inappropriate emotional responses. Yet both these brochures manage to mix preferred with non-preferred or conventional usage such as "disabled people," "mentally ill people," and "deaf persons;" that is, putting the disability descriptor first.

In 1985 the National Rehabilitation Association provided guidelines for preferred language usage with respect to people with disabilities (Staff, 1985). Though also generally consistent with the recommendations above, the NRA Newsletter recommended the terms "able-bodied" and normal"- contrary to the fourth guideline recommendation listed above. These examples indicate the literature on preferred language usage does not always follow the sense of its own advice.

Boland reported in 1980 that although appropriate or preferred language guidelines had been encouraged during the preceding five years, 40% of the rehabilitation journal manuscript titles examined in her study, covering the years 1978-1979, continued to use non-preferred or what she referred to as "disabling" language. In a subsequent study covering the years 1984-1985 Patterson (1988) found that 73% of manuscript titles used non-preferred language versus 27% preferred, which shows a reduction in the use of preferred language in manuscript titles.

Patterson (1988) discussed this lack of consistency in implementing preferred language standards and noted that journals do not provide explicit guidelines on appropriate language use. To date the only journal to offer explicit advice on language, implementing the central guideline recommendation as noted above, is the final 1988 issue of the Journal of Rehabilitation:

Author(s) should be especially sensitive to their use of language related to disabilities. Maintain the integrity of all people with disabilities by avoiding language that equates people with the conditions they have (such as "the mentally ill "). Use instead the phrase people with mental illness " (p. 78).

Boland (1980) has called on rehabilitation professionals to lead the way by using preferred language wherever possible in both written and oral communication -- journals, books, promotional materials, presentations, and in the classroom. She suggested that professional journals -- particularly rehabilitation journals-- review manuscripts for disabling language. Finally, Boland encouraged active advocacy by suggesting that rehabilitation professionals write to publishers and editors to advance the cause of preferred language over disabling language. It was the purpose of this study to determine the degree of consistent preferred language usage by rehabilitation professionals as indicated in professional writing.

Methodology

This study examined all full-length articles published during 1988 in three major rehabilitation journals: Journal of Rehabilitation, Journal of applied Rehabilitation Counseling, and Rehabilitation Counseling Bulletin. All articles were read completely to identify relevant language usage as either "preferred" or "non-preferred"- consistent with the central language guideline recommendation reviewed in the preceding section.

Language relating to recognizable disability which put the person or people first and disability second was scored as preferred. For example: "person with a spinal cord injury" or people who are deaf' was counted as preferred vis a vis their non-preferred counterparts of "visually-impaired person" or "the mentally retarded."

Quoted materials were not included in the count since, obviously, authors are not in control of the language of their sources. Results were tabulated in terms of an overall percentage of preferred versus non-preferred usage for each journal.

Results

Overall, preferred language is used a little better than half the time: The three journals showed similar preferred language usage rates averaging 55% (see Table 1). (TABULAR DATA OMITTED)

While Patterson (1988) reports a 27% preferred usage rate in manuscript titles, the present study reflects a 71% preferred language usage rate in manuscript titles for all three journals (see Table 2). (TABULAR DATA OMITTED)

Finally, of those articles with preferred language titles (the 71% noted in Table 2) 85% continued to employ non-preferred language within the article text itself (see Table 3). (TABULAR DATA OMITTED)

Discussion

While rehabilitation professionals have been called on to lead the way, they have not, apparently, been in front of the general public in adapting to language trends (Boland, 1980; Patterson, 1988). Despite general agreement among rehabilitation professionals on emphasizing the person over disability, few articles examined in this study consistently reflected preferred language practice. The high percentage of articles with preferred language titles which nevertheless employ non-preferred text usage suggests good intentions without strong follow-through commitment; or, it may reflect awareness of published research on preferred manuscript title usage (Boland, 1980, Patterson, 1988).

The articles reviewed began well, but then lapsed into more conventional modes, as if it became too awkward or inconvenient to use the preferred phrase throughout. For example, authors frequently used "the mentally retarded" for "people with mental retardation." One author may have found a resolution to the problem of language consistency and possible inconvenience or awkwardness by shortening "blacks who are disabled" to "BWD" for the remainder of the article.

Some uncertainty may be expected while language usage regarding people with disabilities is undergoing change. Patterson observes that ambiguities reflected in the professional literature on preferred usage, such as discussed above, helps explain the lack of language consistency. Clearly, the rehabilitation discipline needs to develop and implement explicit guidelines, as noted above, relevant to preferred language practices to adapt effectively to ongoing language change. Such advice would encourage authors to use preferred forms by providing reviewers and editors, who are in a unique position to influence authors, with more objective evaluative language standards.

In view of the apparently significant evidence of disabling language among rehabilitation professionals, perhaps we should also reconsider the relationship between language and attitudes toward people with disabilities. We may want to ask ourselves whether we are putting emphasis on language per se without the necessary corresponding emphasis on supportive attitudes--putting the cart before the horse so to speak (Kelly, 1954). Ironically, the exclusive concern for putting the person first and disability second- apart from a reasonable rationale- may appear to reinforce the notion that it is "bad" to have a disability, which in and of itself may not be, and need not be, necessarily or inherently negative. Perhaps those of us in the rehabilitation profession may need to confront our own possibly limiting attitudes before we are enabled to lead the public in consistently employing language signifying positive regard for all humankind-including those with disabilities.

A final note: As researchers we are, presumably, committed to dispassionate analysis of empirical issues, not letting our values dictate outcome. We do not yet, apparently, have sufficient evidence to prove that disabling language encourages negative attitudes toward those with disabilities, or to suggest that changing language alone produces better attitudes (Patterson & Witten, 1987). We do not even have data to support the claim, and belief, that those who are disabled themselves prefer what is now called non-disabling language (Kailes, 1985). Still, all this may be beside the point.

Some issues are not resolved- perhaps cannot be resolved--empirically, and the language issue may be just such a case. The rehabilitation profession is committed to positive language change because, presumably, of the tie-in to human rights which are assumed rather than proven - as part of a broader sociopolitical movement of the past two decades to recognize minority rights- Blacks, Women, Native Americans, and now people with disabilities (Henderson & Bryan, 1984). Once the language changes reflecting these new value commitments are firmly in place, it may be easier to demonstrate the relationship between disabling language and negative attitudes (Patterson, 1988).

References

Boland, J.(1980).1975-1980: Five long years or five short years? Journal of Rehabilitation, 46(4), 40-41.

Editor. (1988). Contributor's guidelines, Instructions. Journal of Rehabilitation, 54(4), 78.

Guidelines for Reporting and Writing about People with Disabilities. (1984). "Appropriate terms for special disabilities; Portrayal Issues." The Research and Training Center on Independent Living, funded in part by National Institute of Handicapped Research.

Hadley, Robert G. & Brodwin, Martin G. (1988). Language about people with disabilities. Journal of Counseling and Development, 67(3), 147-149.

Henderson, G. & Bryan, W. (1984). Psychosocial Aspects of Disability, Springfield: Charles C. Thomas.

Kailes, J. (1985). Watch your language, please! Journal of Rehabilitation, 51(1), 68-69.

Kelly, G. A. (1954). The Psychology of Personal Constructs (Vol. 1). New York: Norton.

Manus, G. (1975). Is your language disabling? Journal of Rehabilitation, 41(5), 35.

Patterson, J. (1988). Disabling language: Fact or fiction? The Journal of Applied Rehabilitation Counseling, 19(l), 30-32.

Staff. (March, 1985). NRA initiates campaign for language awareness. NRA Newsletter, p. 1, 3-4.

What Makes Disabled People Disabled? (n.d.). Ohio Governor's Council on Disabled Persons, Catalog Number G-12.

Wright, B. A. (1983). Physical disability: A psychosocial approach.

New York: Harper & Row.

Received:   June 1989
Revised:    November 1989
Accepted:   December 1989