Language and
disability.
Which words, and who gets to choose?
How to talk and write about disability respectfully in therapy: identity-first and person-first language, words to reconsider, clinical terms that carry assumptions, and how to ask a client what they prefer.
What this is: a practical guide to disability language for therapists and clients.
Why it matters: words in sessions, notes and letters can signal respect or carry old assumptions.
The sharpest reframe: the right word is usually the one the person uses for themselves.
One thing to take away: ask, then follow the client’s lead.
The short version
There is no single correct way to talk about disability. Some people prefer identity-first language (“disabled person”, “autistic person”), others person-first (“person with a disability”). Both are used respectfully, and communities disagree, sometimes strongly. A few terms are widely considered outdated or hurtful. In therapy, the most reliable approach is simple: ask how the person describes themselves, follow their lead, and notice how language in notes and letters can carry assumptions.
Identity-first and person-first
ConceptsIdentity-first
“Disabled person”, “autistic person”, “Deaf person”, “blind person”.
Often chosen to express that disability is part of identity, culture or community, not something to be separated from the person. In the UK, “disabled people” also reflects the social model: people are disabled by barriers in society.
Person-first
“Person with a disability”, “person with autism”, “person with a learning disability”.
Often chosen to put the person before the condition. Widely used in the US, in health services, and used by some self-advocacy groups, such as the People First movement of people with learning disabilities.
Where communities have expressed a preference:
- Autism: in a large UK survey, most autistic adults preferred “autistic person” or “autistic”, while most professionals preferred “person with autism”. All groups disliked “high-functioning” and “low-functioning”.
- Deafness: many people who are part of the Deaf community, and use sign language, use a capital D to signal a cultural and linguistic identity.
- Blindness: some organisations of blind people have explicitly rejected person-first language.
- Learning disability: the self-advocacy movement People First takes its name from person-first language, and “people with learning disabilities” is widely used in the UK.
These are tendencies, not rules. Individuals within every group differ.
Words to reconsider
PracticeTerms widely considered outdated, inaccurate or hurtful, with common alternatives. Based largely on UK government guidance, adapted for therapy.
Clinical language that carries assumptions
Therapist ReflectionSome therapy language turns access problems or disagreement into personal failings. Before writing these words, check what you actually observed.
See also the Clinical Ableism Checklist and Clinical Ableism.
Asking a client
Practice“How do you like to describe yourself, or your disability or condition? I’ll follow your lead, and you can tell me if that changes.”
- Follow their words. Use the terms the client uses for themselves, in sessions and, where possible, in letters.
- Don’t correct their self-description. If a client calls themselves “disabled” and you have been saying “person with a disability”, change yours, not theirs.
- Reclaimed words belong to their users. Some disabled people use words like “crip” about themselves or their community. That doesn’t invite a therapist to use them unless the client asks.
- Language can change. Someone recently diagnosed, or newly disabled, may move between words over time. That movement can be meaningful.
Language as material in therapy
How a client talks about their body or mind can say a great deal: “my bad leg”, “my broken brain”, “when I was normal”. Rather than correcting, a therapist can get curious: where did that phrase come from, what does it hold, does it still fit? Sometimes it is shorthand. Sometimes it carries grief, shame or someone else’s voice. See Internalised Ableism and Shame, Difference and Belonging.
How this site uses language
Our frameworkThis site mostly uses identity-first language (“disabled people”, “autistic people”), in line with UK social model usage and the stated preferences of many disabled people. Where we quote or describe someone, we use their own words. We know not every reader shares this choice, and we would rather you used the words that fit you.
Words you can use
For clientsQuestions worth carrying, as a therapist
Therapist Reflection- Have I asked this client how they describe themselves?
- Do I use the client’s words, or my profession’s?
- Would the client recognise themselves in my notes and letters?
- Do I correct, even gently, how clients describe themselves?
- Which clinical words do I use that turn a barrier into a personal failing?
Evidence & sources
Sources checked in October 2026, using targeted searches rather than a systematic review. “We have not located” means our searches did not find it.
In a UK online survey with the National Autistic Society, most autistic adults preferred “autistic” or “autistic person”, most professionals preferred “person with autism”, and all groups disliked “high-functioning” and “low-functioning”. The authors concluded there is no single consensus. Kenny, L., Hattersley, C., Molins, B., Buckley, C., Povey, C. & Pellicano, E. (2016; online 2015). Autism, 20(4), 442–462. doi:10.1177/1362361315588200
Person-first and identity-first language, and their use as part of psychologists’ cultural competence, are discussed in Dunn, D. S. & Andrews, E. E. (2015), “Person-first and identity-first language: Developing psychologists’ cultural competence using disability language”, American Psychologist, 70(3), 255–264.
UK government guidance recommends “disabled people” as the collective term and lists words to avoid, such as “wheelchair-bound”, “suffers from” and “able-bodied”. GOV.UK inclusive language guidance
The APA style guidelines treat both person-first and identity-first language as acceptable, advise using the terms people use for themselves, and recommend avoiding euphemisms such as “special needs”. APA Style: Disability
The clinical-language alternatives, the guidance on asking clients, and this site’s own language choice are this site’s synthesis. They are not a validated standard.
We have not located research on how therapists’ choice of disability language affects disabled clients’ experience of therapy or the therapeutic relationship.