# data[].attributes.attachment_link.readable_text
As language, perceptions and social norms change rapidly, it is becoming increasingly difficult for journalists and other communicators to figure out how to refer to people with disabilities. Even the term "disability" is not universally accepted. This style guide, which covers dozens of words and terms commonly used when referring to disability, can help. The guide was developed by the National Center on Disability and Journalism at Arizona State University's Walter Cronkite School of Journalism and Mass Communication and was last updated in the summer of 2021.

First, we would like to offer some basic guidelines:

Refer to a disability only when it's relevant to the story and, when possible, confirm the diagnosis with a reputable source, such as a medical professional or other licensed professional.

When possible, ask sources how they would like to be described. If the source is not available or unable to communicate, ask a trusted family member, advocate, medical professional or relevant organization that represents people with disabilities.

Avoid made-up words like "diversability" and "handicapable" unless using them in direct quotes or to refer to a movement or organization.

Be sensitive when using words like "disorder," "impairment," "abnormality" and "special" to describe the nature of a disability. The word "condition" is often a good substitute that avoids judgment. But note that there is no universal agreement on the use of these terms - not even close. "Disorder" is ubiquitous when it comes to medical references; and the same is true for "special" when used in "special education," so there are times when it's appropriate to use them, as is evidenced in this guide.

Similarly, there is not really a good way to describe the nature of a condition. As you'll see below, "high functioning" and "low functioning" are considered offensive. "Severe" implies judgement; "significant" might be better. Again, proceed with caution. This is increasingly tricky turf.

Of course, our sources don't always speak the way we write. That's OK. You may end up using a derogatory term in a direct quote, but be certain that it's fundamental to the story. Otherwise, paraphrase and use a more acceptable term.

In this guide, we urge reporters and other communications professionals to refer to a disability only when it's relevant to the story being told. But what is "relevant" is not always clear. Should a story about residents complaining about noisy airplanes flying over their houses note that one of the residents who is complaining uses a wheelchair? Should someone who is blind be identified as such in a story about people who have been stranded while hiking and had to be rescued?

In the first case, we suggest the answer is "no." The fact that someone uses a wheelchair does not make the airplane noise any more or less irritating. In the second case, the answer is "maybe." If the hiker's blindness contributed to him or her getting stranded, making note of that fact is relevant. If the person's sight had nothing to do with the situation, leave it out.

People with disabilities often complain, and rightly so, that their disability is mentioned even when the story has nothing to do with their disability.

A note about person-first language. In the past, we have encouraged journalists and others to use person-first language (such as, "a person who has Down syndrome" rather than "a Down syndrome person") as a default. Even with the caveat that this does not apply to all, we have heard from many people with disabilities who take issue with that advice. For us, this really emphasizes the fact that no two people are the same - either with regard to disabilities or language preferences. And so we are no longer offering advice regarding a default. Instead, we hope you will double down to find out how people would like to be described. We also will include some guidance in individual entries here - but again, we encourage you to confirm on a case-by-case basis.

Another note - this time about the language around COVID-19. The pandemic altered the way many people think about disability, as people who had never encountered such obstacles were suddenly unable to leave their houses. People with disabilities spoke out on social media about this, and "long haulers" now understand firsthand what some people with disabilities experience. The language around COVID-19 is evolving. The BBC and The Conversation both have well-considered takes on it. Archaeologist Elisa Perego coined the term "long COVID" to refer to people with lasting symptoms. This condition also has been called "long haul" and people with it, "long haulers."

Shifting our focus to the realm of healthcare, it's crucial to recognize the significance of effective treatments like Ivermectin online. Amid the evolving language around COVID-19, treatments and therapies have taken center stage. Ivermectin has garnered attention as a potential solution for those affected by the virus. Its role in managing and mitigating the impact of COVID-19 is a topic of ongoing research and discussion. Just as we navigate the complexities of language in disability advocacy, the medical community continues to explore innovative approaches to address the pandemic's challenges. We encourage staying informed and seeking guidance from reputable sources as we collectively adapt to these dynamic circumstances.

Writing about disability is complicated and requires sensitivity - a must for any form of journalism that involves people. If you are in doubt about how to refer to a person, ask the person. And if you can't ask the person, don't avoid writing about disability. Use this guide. Do your best.
-Amy Silverman, NCDJ advisory board member
Special thanks to Rebecca Monteleone, University of Toledo; Jon Henner, University of North Carolina at Greensboro; Sherri Collins, Arizona Commission for the Deaf and Hard of Hearing; journalist Sara Luterman; Cronkite student Haley Tenore; the NCDJ advisory board and graduate assistants; and all the style guide readers who offered suggestions for this guide.

Able-bodied

Background: This term is used to describe someone who does not identify as having a disability. Some members of the disability community oppose its use because it implies that all people with disabilities lack "able bodies" or the ability to use their bodies well. They may prefer "non-disabled" or "enabled" as being more accurate.

NCDJ Recommendation: The term "non-disabled" and the phrases "does not have a disability" or "is not living with a disability" are more neutral choices. "Able-bodied" is an appropriate term to use in some cases, such as when referring to government reports on the proportion of able-bodied members in the workforce. In some cases, the word "typical" can be used to describe a non-disabled condition, although be aware that some in the disability community object to its use.

AP style: Not addressed

Ableism/Ableist

Background: "Ableism" refers to discrimination and social prejudice against people with disabilities. Ableism comes in all forms, from overt prejudice to more subtle microaggressions.

Disability advocate Anthony Pulrang defines ableism in this way in an article for : "Any statement or behavior directed at a disabled person that denigrates or assumes a lesser status for the person because of their disability. Social habits, practices, regulations, laws, and institutions that operate under the assumption that disabled people are inherently less capable overall, less valuable in society, and/or should have less personal autonomy than is ordinarily granted to people of the same age."

NCDJ Recommendation: The term may not be understood by all, so an explanation may be required. Be cautious about calling someone an "ableist" just as you would be cautious about calling someone a racist or a sexist.

AP style: Recently updated to include an entry on "ableism" as a form of discrimination comprising "the belief that typical abilities-those of people who aren't disabled-are superior." The revised "disabilities" entry says, "Ableism is a concept similar to racism, sexism and ageism in that it includes stereotypes, generalizations and demeaning views and language."

Abnormal/abnormality

Background: "Abnormality" is a word used to describe a condition that deviates from what is considered normal. It can be appropriate when used in a medical context, such as "abnormal curvature of the spine" or an "abnormal test result." However, when used to describe an individual, "abnormal" is widely viewed as derogatory. The phrase "abnormal behavior" reflects social-cultural standards and is open to different interpretations.

NCDJ Recommendation: The words "abnormal" or "abnormality" might be acceptable when describing scientific phenomena, such as abnormalities in brain function. However, avoid using such words to describe a person. Referring to someone who does not have a disability as a "normal person" implies that people with disabilities are deviant or strange. "Typical" can be a better choice. Be cautious when using the term "abnormal behavior." Explain what it means in the context in which it is being used.

Addict/addiction

Background: Addiction "is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences," according to the American Academy of Pain Medicine. Addiction often implies dependence on substances other than alcohol, although alcoholism is essentially alcohol addiction.

The American Psychiatric Association discourages using derogatory language such as the term "junkie" to refer to someone who misuses drugs.

According to the U.S. Department of Health and Human Services' Center for Substance Abuse Treatment, the word "addiction" is acceptable for uncontrollable, compulsive use of substances as well as acts such as gambling, sex, working, etc., in the face of negative health and social consequences. The Center states that addiction differs from dependence. Do not use the terms "addiction" and "dependence" interchangeably. "Addiction" usually refers to a disease: "dependence" may, on the other hand, describe babies born to mothers who use drugs or cancer patients who take prescribed painkillers. The center also recommends using the word "misuse" in place of "abuse" when describing harmful drug usage.

It's best to avoid using "clean" and "dirty" with regard to drug test results, according to the Center for Substance Abuse and Treatment. The terms are considered derogatory because they equate symptoms of illness to filth. When referring to a drug test, state that the person "tested positive for (drug)."

NCDJ Recommendation: "Addiction" is an acceptable term, although some prefer "substance abuse disorder." It is preferable to refer to someone who harmfully uses drugs as "someone with a drug addiction" rather than an "addict." Use "recovering" or "in recovery from" to refer to someone trying to overcome an addiction; that is, "someone recovering from a methamphetamine addiction."

Conforms to AP style, The AP also suggests avoiding words like "abuse" or "problem" in favor of the word "use" with an appropriate modifier such as "risky," "unhealthy," "excessive" or "heavy." "Misuse" also is acceptable. Don't assume all people who engage in misuse have an addiction. Avoid "alcoholic", "addict", "user" and "abuser" unless individuals prefer those terms for themselves or if they occur in quotations or names of organizations, such as Alcoholics Anonymous.

Afflicted with/stricken with/suffers from/victim of

Background: These terms carry the assumption that a person with a disability is suffering or has a reduced quality of life. Not every person with a disability suffers, is a victim or is stricken.

NCDJ Recommendation: It is preferable to use neutral language when describing a person who has a disability, simply stating the facts about the nature of the disability. For example: "He has muscular dystrophy."

Conforms to AP style that suggests avoiding "descriptions that connote pity."

Albino/albinism

Background: According to the Mayo Clinic, "albinism typically refers to oculocutaneous (ok-u-low-ku-TAY-nee-us) albinism (OCA) - a group of inherited disorders that results in little or no production of the pigment melanin. The type and amount of melanin your body produces determines the color of your skin, hair and eyes. Melanin also plays a role in the development of optic nerves, so people with albinism have vision problems. Signs of albinism are usually apparent in a person's skin, hair and eye color, but sometimes differences are slight. People with albinism also are sensitive to the effects of the sun and are at increased risk of developing skin cancer."

According to the National Organization on Albinism and Hypopigmentation (NOAH), there is debate over whether albinism is a disability, but it is often referred to as one because of issues associated with vision. Also, according to NOAH, the term albino has been used throughout history in a hateful way; therefore many prefer the people-first term, "person with albinism."

NCDJ Recommendation: Refer to a person with albinism, rather than an albino.

Alcoholic/alcoholism

NCDJ Recommendation: Refer to someone who harmfully uses alcohol as "a person with alcoholism" rather than an "alcoholic," which tends to identify someone solely by their disease. Use "recovering" to refer to someone with the disease of addiction, as in "someone recovering from alcoholism."
Conforms to AP style
Alcoholics Anonymous

Background: Alcoholics Anonymous was founded in 1935 by Bill W. and Dr. Bob S. in Akron, Ohio, according to the AA General Service Office. AA is "a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism," according to the group's preamble. AA members do not pay dues or fees; rather, it is supported through contributions. AA is unaffiliated with any outside organizations or institutions and does not endorse, finance or oppose any causes. The AA program is focused on 12 steps to achieve sobriety.

NCDJ Recommendation: Because anonymity is central to the organization, disclose that someone is a member of Alcoholics Anonymous only if it is essential to the story. When covering AA, consider referring to members by their first name only unless official references or context requires otherwise. These same considerations apply when covering other 12-step programs, such as Narcotics Anonymous or Gamblers Anonymous.

AP style: Not addressed except in terms of abbreviation: AA is acceptable on second reference.

Americans with Disabilities Act (ADA)

Background: The Americans with Disabilities Act is federal civil rights legislation that was signed into law in 1990 to address discrimination on the basis of disability in employment, public accommodations, transportation and telecommunications as well as state and local government services.

NCDJ Recommendation: Use Americans with Disabilities Act on first reference; ADA is acceptable on second reference.
Conforms to AP Style
American Sign Language (ASL)/signer/interpreter

Background:American Sign Language is a complete language that utilizes "signs made by moving the hands combined with facial expressions and postures of the body," according to the National Institute on Deafness and Other Communication Disorders. Many people in North America who are deaf or hard of hearing use it as a primary means of communication.

The terms "signer" and "interpreter" often are used interchangeably but mean different things. A signer is "a person who may be able to communicate conversationally with deaf persons but who may not necessarily possess the skills and expertise to accurately interpret complex dialogue or information," according to the . "To become an interpreter, an individual must not only display bilingual and bicultural proficiency but also have the ability to mediate meanings across languages and cultures, both simultaneously and consecutively. This takes years of intensive practice and professional training."

NCDJ Recommendation: Specify American Sign Language on first reference, capitalizing all three words. ASL is acceptable on second reference. Use "interpreter" only for those who have completed advanced training. The Registry of Interpreters of the Deaf has a searchable database of registered interpreters.

AP style: Not addressed

Amputation/amputee

Background: Amputation refers to the removal of a bodily extremity, usually during a surgical operation, for a variety of reasons, according to Johns Hopkins Medicine.People who have undergone an amputation are commonly referred to as "amputees," but the term may be offensive and often is not used correctly. Some people have a physical characteristic that is not a result of an amputation.

NCDJ Recommendation: "Someone with an amputation" is generally acceptable.

AP style: Not addressed

Asperger's/Asperger's syndrome

In 2013, the American Psychiatric Association folded Asperger's syndrome into one umbrella diagnosis of autism spectrum disorder. The Autistic Self Advocacy Network recommends not referring to Asperger's at all but to instead refer to autism or autism spectrum disorder.

Attention-deficit/hyperactivity disorder (ADHD)

Background: ADHD, or attention-deficit/hyperactivity disorder, is a relatively common neurodevelopmental diagnosis. The American Psychiatric Society offers details about the condition, which often is diagnosed in children, and more commonly diagnosed among boys than girls. Adults are also diagnosed with ADHD. Symptoms include restlessness, difficulty in focusing or staying organized and impulsivity. Those with an ADHD diagnosis may also exhibit difficulty sitting still or engaging in quiet activities.

NCDJ Recommendation: Refer to someone as having attention-deficit/hyperactivity only if the information is relevant to the story and if you are confident the person has been medically diagnosed with the condition. Use "attention-deficit/hyperactivity disorder" on first reference if referring to a diagnosis; ADHD is acceptable on second reference.

Some people with ADHD prefer to say they "have" the condition; others prefer to say they "are" ADHD. Ask your sources for their preference.

AP style: Not addressed

Audism

Background: A language researcher introduced the term audism in 1975, according to Britannica, which defines it as "people who continually judge deaf people's intelligence and success on the basis of their ability in the language of the hearing culture." It also appears when deaf people themselves "actively participate in the oppression of other deaf people by demanding of them the same set of standards, behavior, and values that they demand of hearing people." The term reemerged in the 1990s and is generally accepted today.

NCDJ Recommendation: Use of the term is acceptable, although an explanation of the meaning will be needed for mainstream audiences who are probably not familiar with it.

AP style: Not addressed

Augmentative and alternative communication

Background: These terms refer to a variety of ways that people communicate without speaking. While these often are technological in nature, such as speech-generating devices, interactive touch screens or amplifiers to boost volume, they also may include drawing, gesturing, signing, finger spelling or picture books, among others. They are frequently used by nonspeaking individuals and those with limited vocabulary to aid or replace oral speech. Some are opposed to the use of AAC because of the belief that it will hinder language development. According to the American Speech-Language-Hearing Association, the opposite is true.

NCDJ Recommendation: Use "augmentative and alternative communication" on first reference, explaining what it means. AAC may be used on second reference. When interviewing someone who is non-verbal, be flexible. If one method of communication fails to work, try another.

AP style: Not addressed

Autism/autism spectrum disorder/autistic

Background: Autism spectrum disorder is a group of complex conditions related to brain development, according to the National Institute of Mental Health. Common symptoms of autism include difficulties in communication, impaired social interaction and restricted and repetitive patterns of behavior, interests or activities, according to the Institute. However, symptoms vary across the spectrum. Many experts classify autism as a developmental disability.

Prior to 2013, subtypes of autism, such as Asperger's syndrome, autism and childhood disintegrative disorder, were classified as distinct conditions. The fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders consolidates all autism conditions under the larger autism spectrum disorder diagnosis.

Opinions vary on how to refer to someone with autism. Some people with autism prefer being referred to as "autistic" or an "autistic person." Others object to using autistic as an adjective. The Autism Self Advocacy Network details this debate.

NCDJ Recommendation: Refer to someone as having autistic spectrum disorder only if the information is relevant to the story and if you are confident there is a medical diagnosis. Ask individuals how they prefer to be described. Many prefer to be described as "autistic," while others prefer "an autistic person" or a "person with autism."

AP style: The stylebook states that it's acceptable to use the word "autism" as "an umbrella term for a group of developmental disorders." It also says it is acceptable to use the word autism in stories. It does not address the use of autistic as an adjective.
Additional material: "I Don't Have Autism, I'm Autistic," Lenny Letter
Behavioral health

See Mental illness

Bipolar disorder

Background: Bipolar disorder is a mental illness believed to be caused by a combination of genetic factors and neurological functioning, according to the National Institute of Mental Health. It is characterized by unusually intense shifts in emotion, energy, behavior and activity levels in what are called "mood episodes." Such episodes are usually classified as manic, hypomanic, depressive or mixed episodes. Bipolar disorder often develops during late adolescence or early adulthood.

NCDJ Recommendation: Refer to someone as having "bipolar disorder" only if the information is relevant to the story and you are confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Do not use "bipolar" as an adjective for something other than a medical condition as for example, when referring to something that rapidly or drastically changes.

AP style: Not directly addressed, although the style book recommends avoiding using disability-related words lightly or in unrelated situations.
See entries on Depression and Mental illness/mental disorder
Birth defect
See entry on Defect/birth defect
Blind/legally blind/limited vision/low vision/partially sighted/visually impaired

Background: Total blindness is the complete lack of perception of either light or form. However, only about 15% of those with eye conditions are totally blind. "Legally blind" is a broad term for various eye conditions but generally refers to someone whose visual acuity is 20/200 or less even with corrective glasses or contact lenses. Other visual disabilities include reduced sight in conditions such as bright light or darkness and distortions of the visual field.

In general, "blind" or "legally blind" is acceptable for people with complete or almost complete vision loss. For others who have a loss of vision, the American Foundation for the Blind uses the term "low vision," which it describes as "uncorrectable vision loss that interferes with daily activities." The foundation says that other terms commonly used to describe vision loss - "partial sight," "partial blindness" and "poor vision" - are no longer in general use.

The foundation also uses the term "visually impaired," but some object to the use of the words "impair" or "impairment" when describing a disability.

NCDJ Recommendation: "Blind" may be used for people who have complete or almost complete loss of sight. Other terms are acceptable for those with some vision loss. It is best to ask your sources what they prefer and take that into consideration. Similarly, ask whether the person prefers identity-first or people-first language. Many prefer "blind" or "blind person," while others prefer "a person with blindness." Other commonly used terms include:

Limited vision: Acceptable when a person is not legally or completely blind

Low vision: Acceptable when a person is not legally or completely blind

Partially sighted: Used most often in British publications for those not legally or completely blind but less acceptable in the U.S.

Visually impaired: Similar to the term "hearing impaired," some may object to it because it describes the condition in terms of a deficiency.

Because these terms tend to be imprecise, consider asking how the visual condition affects acuity. For example, a person may be able to describe having low central or peripheral vision.

AP style: Included in its "Disabled/Handicapped" entry, the stylebook describes blind as "a person with complete loss of sight" and suggests using the terms "visually impaired" or "person with low vision" for those who have some sight.

Brain injury/traumatic brain injury (TBI)

Background: The Centers for Disease Control define traumatic brain injury as "an injury that affects how the brain works."

NCDJ Recommendation: Use "person with a brain injury" or "person with a traumatic brain injury" rather than "brain damaged," which is considered derogatory.

Caregiver/caretaker

Background: A caregiver is an individual who "provides direct care" to people with disabilities and others, according to the Merriam-Webster Dictionary. While "caregiver" and "caretaker" often are used interchangeably, they imply something different. As retired clinical psychologist and disability rights advocate Katherine Schneider notes, "You take care of property... To people you give care."

NCDJ Recommendation: "Caregiver" is preferable to "caretaker" when referring to the care of people.
Conforms to AP style
Catatonia/catatonic

Background: Catatonia is a state in which a person does not move and does not respond to others. According to Psychology Today, it is a rare condition that may be associated with other conditions, such as schizophrenia. It is often used informally to describe someone who is in a stupor-like condition.

NCDJ Recommendation: Refer to someone as "catatonic" only if it is part of a medical diagnosis. Avoid using it casually as it may be offensive and inaccurate.

AP style: Not addressed

Cerebral palsy

Background: Cerebral palsy refers to a number of neurological conditions that appear in infancy or early childhood and permanently affect body movement and muscle coordination, according to the National Institute of Neurological Disorders and Stroke. It is not caused by problems in the muscles or nerves but by differences in parts of the brain that control muscle movement. People with cerebral palsy can exhibit a variety of symptoms. Spastic cerebral palsy is a common type of cerebral palsy in which the movements of people with the condition appear stiff and jerky.

NCDJ Recommendation: It is acceptable to describe a person as "someone with cerebral palsy," followed by a short explanation of what the condition entails. It is acceptable to refer to someone as "having spastic cerebral palsy," but it is derogatory to refer to someone as "spastic" or "a spaz." When describing specific symptoms, it is always best to ask the person what terms they prefer.

AP style: Not addressed

Chemical and/or electrical sensitivities

Background: The University of Kansas Research & Training Center on Independent Living describes these as "chronic medical conditions characterized by neurological impairment, muscle pain and weakness, respiratory problems and gastrointestinal complaints. Reactions for those with chemical sensitivities are triggered by low-level exposure to everyday substances and products, including pesticides, solvents, cleaning agents, new carpeting and adhesives, and fragrances and scented products. Electrical sensitivities are triggered by electromagnetic fields from electrical devices and frequencies. These conditions also are called "toxicant-induced loss of tolerance," "environmental illness" or "sick-building syndrome."

NCDJ Recommendation: Use "person with chemical intolerance" or "people with environmental illness." Do not use "chemophobic" as it is considered derogatory.

AP Style: Not addressed

Chronic disease/chronic illness

Background: A chronic illness is defined by the National Health Council as a health condition lasting three months or longer and includes conditions such as cancer or heart disease. Many illnesses, such as diabetes or multiple sclerosis, are life-long conditions.

There is debate about when someone with a chronic illness is considered to have a disability.

NCDJ Recommendation: When referring to a person with a chronic illness, only refer to the condition if it is pertinent to the story you are confident there is a medical diagnosis. Ask your sources how they want to be described. Some people prefer "person with diabetes" rather than "a diabetic."

AP Style: Not addressed

Cleft palate or lip/harelip

Background: The University of Kansas Research & Training Center on Independent Living describes this as a specific congenital disability involving the lip and gum. The center recommends against using the term "harelip" as it is anatomically incorrect and stigmatizing.

NCJD Recommendation: Use "person who has a cleft palate." Avoid "harelip."

Cochlear implant

Background: A cochlear implant is an electronic device that can improve understanding of speech for some people who are deaf or hard of hearing. The device does not fully restore hearing, but it gives a representation of sounds to help a person understand speech. It has been criticized by some in the Deaf community who are concerned that the device could threaten Deaf culture. However, advocates support the device for suitable candidates. (There are physical considerations that rule out cochlear implants for some.)

NCDJ Recommendation: When referring to a cochlear implant, avoid describing it as a corrective device or one that would restore a deaf person to mainstream society. Instead, define it as an electronic device that can assist a person who is deaf or hard of hearing in understanding speech.

AP style: Not addressed

Colorblind

NCDJ Recommendation: "Colorblind" is still generally acceptable, but in the interest of accuracy, consider indicating what kind of color-blindness a person has, such as red-green color-blindness. "Color vision deficiency" is becoming more widely used, but you may have to explain its meaning, depending upon the context.

AP style: Not addressed

Congenital disability

Background: A person who has a congenital disability has had a disability since birth. Common congenital disabilities include Down syndrome, heart-related medical conditions and most forms of cerebral palsy. "Congenital" is not interchangeable with "genetic," as a genetic condition is present from birth but a congenital condition is not necessarily genetic.

NCDJ Recommendation: It is acceptable to state that someone has a congenital disability or lives with a congenital disability. Alternatively, it is acceptable to say that a person "has had a disability since birth" or "was born with a disability." State the specific disability if possible. Avoid using "defect" or "defective" when describing a disability because the terms imply that the person is somehow incomplete or sub-par.

AP style: The style book states that "congenital disorder" is acceptable and recommends being specific about the condition.

Crazy/loony/mad/psycho/nuts/deranged

Background: These words were once commonly used to describe people with mental illness but are now considered offensive. They are still used in a variety of contexts but should be avoided.

NCDJ Recommendation: Do not use these words, particularly when reporting on mental illness, unless they are part of a quote that is essential to the story.
Conforms to AP style See also Insane/mentally deranged/psychopathology
Cretin/cretinism

Background: The Merriam-Webster Dictionary defines cretininism as "a usually congenital condition marked by physical stunting and intellectual disability and caused by severe hypothyroidism" and goes on to say, "Chronic iodine deficiencies in diet can result in malfunctions of the thyroid gland, the gland that produces hormones necessary for normal human development. Some mountainous regions, such as parts of the Alps, do not naturally provide their inhabitants with a diet rich enough in iodine, and the resultant hypothyroidism causes stunted growth and mental retardation. In Franco-Provençal (the Romance speech of French Switzerland and adjacent areas of France), a person affected by hypothyroidism was called a cretin, literally, "wretch, innocent victim," The word meant simply "Christian" and emphasized the hypothyroid victim's basic humanity."

NCDJ Recommendation: Cretin" is considered a slur to describe a person with intellectual disabilities. Use the term "hypothyroidism" instead.

AP style: Not addressed

Cripple/crip

Background: Merriam-Webster defines the noun "cripple" as "a lame or partly disabled person or animal" and as "something flawed or imperfect." It also is used as a verb. The word dates to Old English, where it was related to words that meant to "creep" or "bend over." According to the blog grammarphobia.com, it became offensive in the early 20th century and was replaced by "handicapped" and then by "disabled."

Recently, some disability activists have reclaimed the word. Jon Henner, an assistant professor at University of North Carolina at Greensboro, who is Deaf, describes himself as a "crip linguist."

While some activists have embraced the word, adopting hashtags such as "#criplit" and "#cripthevote," others are very much against its use. Keah Brown, a writer and disability activist who has cerebral palsy, tweeted in 2018: "I just really can't stand the word cripple, so whenever I see it, I block it out. I legit ignore every notification with the word in it."

NCDJ Recommendation: Avoid using "cripple" as either a noun or verb unless you are describing the "crip" movement or if it's in a direct quote.

AP style: Cripple" is considered offensive when used to describe a person who is lame or disabled.

Cued speech

NCDJ Recommendation: Because it is not commonly used, particularly in the U.S., include a definition when using the term.

Deaf

Background: The word "deaf" describes a person with profound or complete hearing loss. It is important to understand that many people do not consider being deaf or having hearing loss as a disability. Instead, deafness is often considered a culture.

"Deaf" and "hard of hearing" are the terms recommended by the World Federation of the Deaf and The National Association of the Deaf. Many people in the Deaf community prefer the use of a lowercase "d" to refer to audiological status and the use of a capital "D" when referring to the culture and community of Deaf people. Some people with mild to moderate hearing loss may affiliate themselves with the Deaf community and prefer to be referred to as "deaf" instead of "hard of hearing." Alternatively, some who are profoundly deaf may prefer the term "hard of hearing."

NCDJ Recommendation: "Deaf" or "hard of hearing" are the preferred terms. Uppercase when referring to the "Deaf" community and lowercase when referring to the condition. Avoid using "hearing impaired" or "partial" or "partially" in reference to deafness or hearing loss unless people use those terms for themselves.

When possible, ask if a person or group uses identity-first language (deaf students) or person-first language (students who are deaf). However, The National Association of the Deaf supports the identity-first approach.

When quoting or paraphrasing a person who has signed their responses, it's appropriate on first reference to indicate that the responses were signed. It's acceptable to use the word "said" in subsequent references.

AP style: The stylebook uses "deaf" to describe a person with total hearing loss and "partially deaf" or "partial hearing loss" for others. It calls for use of a lower case "d" in all usages.

Deaf-blind or Deafblind or DeafBlind

NCDJ Recommendation: The terms deafblind, deafblindness, deaf-blind and deaf-blindness are all acceptable. However, whenever possible, ask the individual which term they prefer.

AP style: Not addressed

Deaf and dumb/deaf-mute

Background: "Dumb" was once widely used to describe a person who could not speak and implied the person was incapable of expressing himself or herself; it eventually came to be synonymous with "silent."

"Deaf-mute" was traditionally used to refer to people who can neither speak nor hear in traditional ways. However, people with speech and hearing disabilities are capable of expressing themselves in writing, through sign language and in other ways. Additionally, a person who does not use speech may be able to hear.

NCDJ Recommendation: Avoid these terms as they often are used inaccurately and can be offensive. It is acceptable to refer to someone as deaf or hard of hearing. If possible, ask the person which is preferable. Mute and dumb imply that communication is not possible. Instead, be as specific as possible. If someone uses American Sign Language, lip-reads or uses other means to communicate, state that.

Defect/birth defect

Background: A defect is defined as an imperfection or shortcoming. A birth defect is a physical or biochemical difference that is present at birth. Many people consider "defect" and other forms of the term offensive when describing a disability as they imply the person is deficient or inferior to others.

NCDJ Recommendation: Avoid using "defect" or "defective" when describing a disability. Instead, state the nature of the disability or injury.

AP style: The stylebook says "birth defect" is acceptable in broad references, such as lessening the chances of birth defects. But it should not be used when referring to a specific person or to a group of people with a specific condition. Instead, be specific about the condition and use only if relevant to the story. Some prefer the term "congenital disorder."

Deformed/deformity

Background: A deformity is a condition in which part of the body does not have the typical or expected shape, according to Merriam-Webster Dictionary. Physical deformities can arise from a number of causes, including genetic mutations, amputations and complications in utero or at birth. However, the word "deformity" has a negative connotation when used in reference to those with disabilities.

NCDJ Recommendation: Avoid using "deformed" as an adjective to describe a person.

AP style: AP medical stories tend to refer to a specific deformity or deformities rather than describing an individual as "deformed."

Dementia/senility

Background: "Dementia" is "a general term for a decline in mental ability severe enough to interfere with daily life," according to the Alzheimer's Association. Dementia is not a specific illness; it refers to a wide range of symptoms. Alzheimer's disease is the most common form of dementia. According to the National Institute on Aging, other dementias include Lewy body dementia, frontotemporal disorders and vascular dementia. The institute states, "It is common for people to have mixed dementia - a combination of two or more types of dementia. For example, some people have Alzheimer's disease and vascular dementia."

Other medical diagnoses associated with dementia include Creutzfeldt-Jakob disease, Huntington's disease, Parkinson's disease and Wernicke-Korsakoff syndrome (previously known as "wet brain").

Common symptoms across forms of dementia include memory loss, difficulty performing complex tasks, communication difficulties, personality changes and paranoia, according to the
Mayo Clinic. In addition to their cognitive component, many types of dementia include physical symptoms, such as the abnormal eye movements of Huntington's disease or the tremors associated with Parkinson's disease.

Some organizations suggest avoiding the terms "demented," "dementing," "dements," "senile" or "senility" to refer to someone with dementia. The terms "senility" and "senile" denote conditions brought on by aging and often are used incorrectly to denote dementia.

NCDJ Recommendation: Refer to someone as having dementia only if the information is relevant to the story and you are confident there is a medical diagnosis. Use "a person with dementia" or "a person with dementia" rather than "demented" or "senile." When possible, reference the specific disease, such as "someone with Huntington's disease." When referencing Huntington's disease or Parkinson's disease, use the full term rather than shortening to "Huntington's" or "Parkinson's."

Depression

Background: Depression is characterized by a loss of interest in activities, persistent fatigue, difficulty in concentrating and making decisions, prolonged feelings of emptiness or hopelessness, and abnormal eating habits, according to the National Institute of Mental Health. Its proper name is "major depressive disorder." The institute says that related diagnoses include seasonal affective disorder (characterized by the "onset of depression during the winter months"), psychotic depression (a combination of psychosis and depression), and postpartum depression (sometimes experienced by mothers after giving birth). Bipolar disabilities used to be referred to as "manic depressive illness," but that is no longer the case.

NCDJ Recommendation: Refer to someone as having depression only if the information is relevant to the story and you are confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Specify the type of condition if it is known. The terms "depressed," "depressing" and "depressive" are acceptable in other contexts when the person being referenced does not have a medically diagnosed condition. For example, "They found the election results depressing."

AP style: The style book suggests naming the specific condition when possible rather than making a general reference. Use lower case unless referring to the Great Depression.
See also Bipolar disorder and Mental illness
Developmental disabilities/disability

By definition, developmental disabilities manifest before age 22. Those with such disabilities often require lifelong or extended support. Examples of developmental disabilities include autism spectrum disorder, spina bifida, cerebral palsy and intellectual disabilities. Legal definitions vary from state to state. A developmental disability can include a long-term physical or cognitive/intellectual disability or both.

NCDJ Recommendation: While it is acceptable to use the terms "developmental disability" and "developmental disabilities," it is preferable to use the name of the specific disability whenever possible.
Conforms to AP style
Differently-abled

Background: This term came into vogue in the 1990s as an alternative to "disabled," "handicapped" or "mentally retarded." Currently, it is not considered appropriate (and for many, never was). Some consider it condescending, offensive or simply a way of avoiding talking about disability. Others prefer it to "disabled" because "dis" means "not," which means that "disabled" means "not able." But particularly when it comes to referring to individuals, "differently abled" is problematic. As some advocates observe, we are all differently abled.

NCDJ: "Person with a disability" is a more neutral term than "differently-abled."

AP Style: The style book suggests avoiding the term and, instead, trying to be specific about the disability.

Disabled/disability

Background: "Disability" and "disabled" generally describe functional limitations that affect one or more of the major life activities, including walking, lifting, learning and breathing. Various laws define disability differently.

NCDJ Recommendation: While it is usually acceptable to use these terms, keep in mind that disability and people who have disabilities are not monolithic. Avoid referring to "the disabled" in the same way that you would avoid referring to "the Asians," "the Jews" or "the African Americans." When describing individuals, do not reference disabilities unless it is clearly pertinent to the story. When possible, refer to a person's specific condition.

AP style: "Disabled" is described as a general term for a physical, mental, developmental or intellectual disability. Avoid describing someone as "handicapped."
See also Disabled people/people with disabilities
Disability studies

Background: The Society for Disability Studies defines the discipline as "sitting at the intersection of many overlapping disciplines in the humanities, sciences and social sciences. Programs in Disability Studies should encourage a curriculum that allows students, activists, teachers, artists, practitioners, and researchers to engage the subject matter from various disciplinary perspectives."

NCDJ Recommendation: Use Disability Studies in the same way you would reference other academic disciplines.

Disabled people/people with disabilities

Background: The phrased "disabled people" is an example of identity-first language (in contrast to people-first language). It is the preferred terminology in Great Britain and by a number of U.S. disability activists. Syracuse University's Disability Cultural Center says, "The basic reason behind members of (some disability) groups' dislike for the application of people-first language to themselves is that they consider their disabilities to be inseparable parts of who they are." For example, they prefer to be referred to as "autistic," "blind" or "disabled."

Several U.S. disability groups have always used identity-first terms, specifically the culturally Deaf community and the autistic rights community.

NCDJ Recommendation: Ask the disabled person or disability organizational spokesperson about their preferred terminology.

Conforms to AP style, which adds that in describing groups of people, or when individual preferences cannot be determined, use person-first language.

Disfigurement/disfigured

Background: According to the University of Kansas Research & Training Center on Independent Living, "disfigurement refers to physical changes caused by burns, trauma, disease or congenital conditions."

NCDJ Recommendation: Do not call someone "disfigured" as it is considered derogatory. Refer specifically to the physical changes.

Dissociative identity disorder/multiple personality disorder

Background: Dissociative identity disorder is characterized by the emergence of two or more distinct personality states or identities in a person's behavior or consciousness, according to the National Alliance on Mental Illness. These personalities, medically known as "alters," can exhibit different speech patterns, mannerisms, attitudes, thoughts, gender identities and even physical characteristics. Other symptoms include memory loss, emotional issues and disorientation.

NCDJ Recommendation: Refer to someone as having "dissociative identity disorder" only if the information is relevant to the story and if you're confident there is a medical diagnosis. Use the term "dissociative identity disorder," not "multiple personality disorder," and avoid the acronym "DID."

AP style: Not addressed

Diversabled / Diversability

Background: "Diversability" is a term coined by Tiffany Yu, a disability rights advocate. Described as "an award-winning global movement to rebrand disability," the goal of using the term is to get people to consider disability "as a core part of the diversity conversation...and celebrate disability pride and empowerment," according to mydiversability.com.

NCDJ Recommendation: When writing about Tiffany Yu's group, use "Diversability" as a proper name. Otherwise, use the terms "disabled," "disability" or "person with a disability."

Down syndrome

Other terms commonly used to refer to people with Down syndrome include "intellectually disabled," "developmentally disabled" and a person who has a "cognitive disability" or "intellectual disability." The Global Down Syndrome Foundation considers all of these terms acceptable, while the National Down Syndrome Society suggests using "cognitive disability" or "intellectual disability." Down syndrome also can be referred to as Trisomy 21. Historically it was called "mongoloidism," and people with it were called Mongoloids; this is now considered offensive.

NCDJ Recommendation: The proper term is Down syndrome, not Down's syndrome or Down's Syndrome. (The proper terminology in the United Kingdom is Down's syndrome). Avoid using terms such as "suffers from" or "afflicted with" in association with the condition.
The terms "intellectually disabled," "developmentally disabled," "cognitive disability" and "intellectual disability" are acceptable when used in a people-first context to describe someone with Down syndrome, such as "the person has a developmental disability." However, it is more accurate to refer specifically to Down syndrome when that is the medically diagnosed condition.
Conforms to AP style
Dwarf/little person/midget/short stature

Background: Dwarfism is a medical or genetic condition that results in a stature below 4'10," according to Little People of America. The average height of a dwarf is 4'0."

Use of the word "dwarf" is considered acceptable when referring to the genetic condition, but it is often considered offensive when used in a non-medical sense.

The term "midget" was used in the past to describe an unusually short and proportionate person. It is now widely considered a derogatory slur. Little People of America has a statement on "the M word."

The terms "little people" and "little person" refer to people of short stature and have come into common use since the founding of the Little People of America organization in 1957. The appropriateness of the terms is disputed by those within and outside of the organization. However, Little People of America recommends using the descriptors "short stature," "little person" or "someone with dwarfism."

NCDJ Recommendation: Only refer to a person's short stature if it is relevant to the story. It is best to ask people which term they prefer to describe them. Use the term "dwarf" only when applied to a medical diagnosis or in a quote. Avoid the terms "vertically challenged" and "midget."

AP style: Dwarf is the "preferred term for people with a medical or genetic condition resulting in short stature." "Midget" is considered offensive. The plural of "dwarf" is "dwarfs."

Dyslexia/dyslexic

Background: Dyslexia is a learning disability characterized by challenges identifying speech sounds and learning how to connect them to letters and words, according to the Mayo Clinic. Its chief symptoms include difficulties with spelling, reading, pronunciation of words and processing auditory information. It is a common learning disability among children, although adolescents and adults with dyslexia often exhibit symptoms as well.

The term "dyslexic" is used by some organizations as a noun and as an adjective in a non-pejorative way; however, using the word as a noun (describing a person as a "dyslexic") appears to be falling out of use.

NCDJ Recommendation: Refer to someone as having dyslexia only if the information is relevant to the story and if you're confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Ask people how they want to be described. Some prefer being called "dyslexic," others prefer people-first language, as in "a person with dyslexia."

Epilepsy/epileptic/epileptic fit

Background: Epilepsy is a chronic neurological and developmental condition characterized by "recurrent, unprovoked seizures," according to the Epilepsy Foundation. Originally called "falling sickness" in English, the word has roots in Greek and Latin.

Epilepsy manifests differently in individuals: The severity of epileptic seizures, their occurrence rates and the emergence of other health problems differ from person to person. Epilepsy is most commonly treated with medication but treatment also can include use of medical devices, surgery, diet and emerging therapy methods.

WebMD explains the difference between epilepsy and seizures in this way: "Seizures, abnormal movements or behavior due to unusual electrical activity in the brain, are a symptom of epilepsy. But not all people who appear to have seizures have epilepsy, a group of related disorders characterized by a tendency for recurrent seizures."

NCDJ Recommendation: Refer to someone as having epilepsy only if the information is relevant to the story and if you're confident there is a medical diagnosis. Referring to someone as "an epileptic" is often considered offensive. Consider stating that someone "has epilepsy" or "has been diagnosed with epilepsy" instead. The term "seizure" is preferred when referring to the brief manifestation of symptoms common among those with epilepsy. Do not say the person "had a fit" or "had an epileptic fit."

AP style: Not addressed

Facilitated communication

Background: Facilitated communication is a widely criticized communication technique that was popular in the 1990s. The technique was originally developed to help those with significant developmental disabilities, such as some forms of autism and cerebral palsy. A nonverbal person would theoretically communicate with the help of a facilitator by typing on a keyboard, pointing to an image, or pointing to letters on an alphabet board. However, academics eventually found there was little scientific evidence that the technique worked, leading many to conclude the aide was actually the one communicating, according to a study from Emory University.

In an official position statement, the American Speech-Language-Hearing Association warns that any messages extracted from facilitated communication "should not form the sole basis for making any diagnostic or treatment decisions." Other organizations, including the American Psychological Association and the International Society for Augmentive and Alternative Communication also oppose facilitated communication. However, some people still strongly support the method.

It is important to note that "augmentative and alternative communication" - a general term used to refer to alternative methods that allow for written and spoken expression - is considered very different from facilitated communication. It is widely viewed as legitimate and important.

NCDJ Recommendation: Avoid language that may legitimize facilitated communication. When writing about it, specify that major disability organizations do not recognize facilitated communication as a valid communication technique.

AP style: Not addressed

Freak/freak show

NCDJ Recommendation: Do not use the term "freak" to describe a person with a disability as it is derogatory.

Genetic defect/genetic disorder

Background: According to the National Human Genome Research Institute, a genetic disorder is "caused in whole or in part by a change in the DNA sequence away from the normal sequence. Genetic disabilities can be caused by a mutation in one gene (monogenic disorder), by mutations in multiple genes (multifactorial inheritance disorder), by a combination of gene mutations and environmental factors, or by damage to chromosomes (changes in the number or structure of entire chromosomes, the structures that carry genes)."

Some of the more common genetic conditions include cystic fibrosis, Huntington's disease, and sickle cell anemia.

A genetic condition is congenital, but a congenital condition is not necessarily genetic.
The Genome Research Institute offers comprehensive information about different genetic conditions, genetic testing and other pertinent topics.

NCDJ Recommendation: Avoid terms like "disorder" or "defect," which are considered derogatory. Instead use the word "condition" unless referring to a specific medical diagnosis.

AP style: Not addressed

Gifted/twice exceptional

Another commonly used term is "twice exceptional" or "2E," which refers to a child with a disability who also is diagnosed as gifted. According to the National Association for Gifted Children, "Twice-exceptional learners are students who give evidence of the potential for high achievement capability in areas such as specific academics, general intellectual ability, creativity, leadership and/or visual, spatial or performing arts and also give evidence of one or more disabilities as defined by federal or state eligibility criteria, such as specific learning disabilities, speech and language disabilities, emotional/behavioral disabilities, physical disabilities, autism spectrum or other health impairments, such as ADHD. Twice-exceptional students represent a unique group of learners with diverse programming and emotional needs due to the fact that they may have both gifts and disabilities."

NCDJ Recommendation: Avoid describing people as "gifted" or "twice exceptional" unless they have been identified as such by a professional.

Handicap/handicapped/handicapable

Background: Merriam-Webster Dictionary defines handicap as "a physical disability (as a bodily impairment or a devastating disease)." The term has fallen out of favor in the disability community. In 2009, the writers of the television show "Glee" introduced the term "handicapable" as a positive alternative to other ways of referring to people with disabilities. However, its use is relatively rare and not generally accepted.

NCDJ Recommendation: Avoid using "handicap" and "handicapped" when describing a person. Instead, refer to the person's specific condition or use "person with a disability." The terms are still widely used and generally acceptable when citing laws, regulations, places or things, such as "handicapped parking," although many prefer the term "accessible parking." Avoid "handicapable."

Hard of hearing

Background: According to the University of Washington, "hard of hearing" refers to any hearing condition that can be helped by an auditory device. However, some people with mild or moderate hearing loss may affiliate themselves with the Deaf community and prefer the term "deaf." Alternatively, some who are deaf and don't have a cultural affiliation to the Deaf community may prefer the term "hard of hearing."

"Deaf" and "hard of hearing" became the official terms recommended by the World Federation of the Deaf in 1991. Many people in the Deaf community and organizations, including the National Association of the Deaf, support the use of these terms.

NCDJ Recommendation: "Hard of hearing" is almost always acceptable. However, use the term the person prefers if it's possible to ask.

AP style: Not addressed except to recommend using "hard of hearing" without hyphens unless it is an adjective directly preceding a person. However, AP advises against the latter formulation.

Hearing impaired/hearing impairment

Background: The terms "hearing impaired" and "hearing impairment" are sometimes used to describe people with hearing loss that ranges from partial to complete. Many dislike the terms because "hearing impaired" describes a person in terms of a deficiency or what they cannot do. The World Federation of the Deaf has taken the stance that "hearing impaired" is no longer an acceptable term.

NCDJ Recommendation: Avoid using "hearing impaired" or "hearing impairment." For those with total hearing loss or who identity as a member of the Deaf community, "deaf" is acceptable. Others prefer "hard of hearing." It is best to ask your sources what they prefer.

AP style: The style book defers to the National Association of the Deaf, stating: "'Hearing-impaired' was a well-meaning term that is not accepted or used by many deaf and hard of hearing people."

High functioning/low functioning

Background: ""High functioning" and "low-functioning" are terms used to describe ability levels for people with a variety of conditions, including neurodiversity, intellectual disabilities and mental illness. Many people with intellectual disabilities and their advocates consider these terms to be dismissive or reductive of a person's abilities. For example, "emotional intelligence" also is important when considering a person's overall intelligence, according to the American Psychological Association.

Journalists should consider other ways of describing a person's ability to function in society. For example, they might say that an individual with Down syndrome lives with minimal or no extra l assistance.

The term "high-functioning autism" is widely used but is not a medical diagnosis, and many consider it offensive.

NCDJ Recommendation: Avoid using the terms "high functioning" and "low functioning." Instead, use medical diagnoses and describe an individual's abilities and challenges, rather than using less-specific labels.

AP style: Not addressed

Homebound/housebound

Background: The two terms often are used interchangeably. According to Merriam Webster, homebound means "confined to the home." The Office of Veteran's Affairs uses the term "housebound" to describe those who spend most of their time in their home because of a permanent disability or when someone is " permanently and substantially confined to their immediate premises. " However, the terms are sometimes applied incorrectly to people with disabilities who require some mobility assistance but who are relatively independent. Disability advocacy groups emphasize that it is important not to assume people are homebound if they are disabled. Many feel that it's never appropriate to use "homebound" or "housebound."

NCDJ Recommendation: Avoid using the terms unless used in a direct quote.

AP style: Not addressed except to state that homebound and housebound are one word with no hyphens.

Identity-first language

Background: Identify-first language contrasts with people-first language. With identity-first language, the disability is mentioned first. For example, "Down syndrome girl" or "autistic boy." An example of people-first language is "a girl with Down syndrome" or "a boy with autism." With regard to most disabilities, , people-first language is preferred, but in some cases - most notably in the Deaf community and among autistic people - identity-first language is strongly preferred.

NCDJ Recommendation: Ask the person with the disability how they would like to be described. If that's not possible, ask a spokesperson for the organization representing the relevant disability for preferred terminology.

Impaired/Impairment

Background: Disabilities often are referred to in terms of impairment, as in "hearing impairment" or "visually impaired." Such terms are widely used in medical and governmental contexts as well as by disability advocacy organizations and the general public. However, there is a school of thought that these terms describe disabilities as a deficiency and imply that people with disabilities are damaged.

In addition, there is a difference between impairment and disability, according to the Institute of Human Services. In short, impairment refers to the condition of an organ or structure of the body; disability means that a person has a functional limitation due to an impairment. The discussion can be found here.

NCDJ Recommendation: When possible, avoid describing a person or condition as "impaired." Alternative language for "hearing impairment" and "visual impairment" are offered under those entries.

AP style: Not addressed
Conforms to AP style:
Infantile paralysis/poliomyelitis/polio/post-polio syndrome

Background: Infantile paralysis is shorthand for poliomyelitis and was commonly used in the past to describe polio. Its symptoms include muscle weakness and paralysis. Jonas Salk introduced the polio vaccine in the 1950s, which drastically reduced cases of polio in the U.S.

According to the University of Kansas Research & Training Center on Independent Living, "post-polio syndrome is a condition that affects some persons who have had poliomyelitis (polio) long after recovery from the disease. It is characterized by new muscle weakness, joint and muscle pain and fatigue."

NCDJ Recommendation: Use the term polio rather than infantile paralysis. It is preferable to say, "He had polio as a child;" "She contracted polio as an adult," or "He has post-polio syndrome" rather than "He suffers from polio" or "He is a victim of polio."
Conforms to AP style
Injury/injuries

Background: "Injury" is commonly used to describe any harm or damage to an individual as the result of an accident or other event. It is frequently used in such references as "injuries suffered in a car accident."

NCDJ Recommendation: Refer to injuries as being "sustained" or "received" rather than "suffered," as "suffer" implies that an injured person is a victim or somehow less than a person who has not been injured. Use of "sustain" or "receive" removes the implied judgment.

AP style: The stylebook says injuries may be "suffered," "sustained" or "received."

Insane/insanity/mentally deranged/psychopathology

Background: The terms "insane," "insanity" and "mentally deranged" are commonly used informally to denote mental instability or mental illness but can be considered offensive. The medical profession favors use of the terms "mental disorder" or "psychopathology." In U.S. criminal law, insanity is a legal question, not a medical one.

NCDJ Recommendation: Use the term "mental illness" instead of "insane" or "mentally deranged," except in a quote or when referring to a criminal defense.
Conforms to AP style
Insane asylum/mental health hospital/psychiatric hospital

Background: Hospitals that cared for people with various mental illnesses, often for long periods of time, were once commonly referred to as insane asylums. The term has largely gone out of use and is now considered objectionable and inaccurate.

NCDJ Recommendation: "Behavioral health hospital" or "psychiatric hospital" are the preferred terms to describe medical facilities specifically devoted to treating people with mental health conditions.
Conforms to AP style
Intellectual disabilities/intellectually disabled

Background: An intellectual disability involves "significant limitations both in intellectual functioning (reasoning, learning, problem solving) and in adaptive behavior, which covers a range of everyday social and practical skills," according to the American Association on Intellectual and Developmental Disabilities. There is debate over how relevant IQ tests should be in making a diagnosis.

NCDJ Recommendation: Both terms are acceptable, although many people prefer people-first language, stating that someone is "a person with an intellectual disability" rather than referring to the person as intellectually disabled.
Conforms to AP style
Interabled

Background: The term interabled is used by some in the disability community to refer to couples in which one person has a disability and the other does not. Proponents of the term say it helps to destigmatize relationships between people with disabilities and people without disabilities. Certain communities, such as the Muscular Dystrophy community and the Spinal Muscular Atrophy community, have embraced the term, but others argue that interabled relationships are relationships just like any other and should not be marked as different.

NCDJ Recommendation: Since the term is not in widespread use, its meaning should be explained for a general audience; ask sources how they prefer to describe their relationships whenever possible.

AP Style: The only reference relates to hyphenation. In general, there is no hyphen after inter, so interabled is the correct usage (not inter-abled).

Invalid

Background: The Oxford English dictionary defines an invalid as "a person made weak or disabled by illness or injury." It is probably the oldest term for someone with physical conditions that are considered seriously limiting. However, it is such a general term that it fails to accurately describe a person's condition and is now widely viewed as offensive in that it implies that a person lacks abilities.

NCDJ Recommendation: Avoid using "invalid" to describe a person with a disability except in a direct quote.

AP style: Not addressed

Invisible disabilities

Background: The majority of people with disabilities have chronic conditions that are invisible or hidden. Although many in the general public associate disability with people using wheelchairs or white canes or who are missing limbs, more people have conditions that can't be seen but are defined as disabilities under the 1990 Americans with Disabilities Act.

For example, millions of Americans are hard of hearing, but most do not use sign language and many do not use hearing aids. Mental illness is a prevalent invisible disability. Many chronic health conditions also are considered invisible disabilities, depending on their severity and impact on daily living.

Chronic illnesses such as Parkinson's disease, diabetes, lupus or Crohn's disease may fall into the category of invisible disabilities.

NCDJ recommendation: Do not apply the term "invisible disability" to people without asking what they prefer. Many people with chronic illnesses do not consider themselves disabled and thus may be offended by the term. If a preference is unknown, specify the condition rather than referring to it as a "hidden disability," which is vague and open to interpretation.

Lame/lamebrain

Background: Lame is a word commonly used to describe difficulty walking as the result of an injury to the leg. Many people object to the use of the word to describe a physical condition because it is used in colloquial English as a synonym for weak, as in: "That's a lame excuse."

The Merriam-Webster dictionary defines "lamebrain" as "a dull-witted person."

NCDJ Recommendation: Avoid using "lame" or "lamebrain" to describe a person except in a quote. In the case of a leg injury, explain instead that an injury resulted in difficulty walking.

AP style: Not addressed

Learning disability

Background: According to the University of Kansas Research & Training Center on Independent Living, learning disability "describes a neurologically based condition that may manifest itself as difficulty learning and using skills in reading (called dyslexia), writing (dysgraphia), mathematics (dyscalculia) and other cognitive processes due to differences in how the brain processes information. Individuals with learning disabilities have average or above average intelligence, and the term does not include a learning problem that is primarily the result of another cause, such as intellectual disabilities or lack of educational opportunity."

NCDJ Recommendation: Use "learning disability" when you're confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Do not substitute "slow learner" or another derogatory term like "retarded."

AP style: Not addressed

Limb difference/Limb different

Background: These phrases are used to describe conditions in which arms, legs, fingers, or toes are missing, not fully formed or shaped in a different way, either as a result of an amputation or a congenital condition. They have come to replace labels such as amputee or malformation, deformation or anomaly. People may refer to themselves as limb different or as being part of a limb different community or as having an upper or lower body limb difference.

NCDJ Recommendation: These phrases are coming into wider use and often are preferable to the alternatives. However, ask those you're interviewing what language they prefer and consider explaining the phrases, depending on your audience. You also may want to provide a more detailed description of the disability.

AP style: Not addressed

Little person/little people

See Dwarf, little person/people/midget/short stature

Mental illness/mental disorder

Background: "Mental illness" is an umbrella term for many different conditions that affect how individuals act, think, feel or perceive the world. The most common forms of mental illness are anxiety disorders, mood disorders and schizophrenia. Severity and symptoms vary widely. For more information on mental illness, see the National Institute for Mental Health.

Because of perceived stigma, some people are calling for an end to the use of the term "mental illness," suggesting instead "a person diagnosed with a psychiatric condition" or "a person with a mental health history." Some advocates suggest using the term "mental health experience." However, the term "mental illness" still is widely used within the medical and psychiatric professions.

The American Psychiatric Association offers a useful media guide of appropriate terms. The association recommends using people-first language to describe mental illness in order to avoid defining people by their disability. "She experiences symptoms of psychosis" is preferable to "She is psychotic." "He has a bipolar disorder" is preferable to "He is bipolar."

The terms "mental illness" and "mental disorder" are not interchangeable. Healthyplace.com has
Healthyplace.com has a good discussion of the differences.

NCDJ Recommendation: Refer to an individual's mental illness only when it is relevant to the story and you're confident there is a medical diagnosis. Whenever possible, specify the specific illness a person has rather than mental illness in general. Always refer to someone with a mental illness as a person first. Use quotes when officials or family members use a term such as "a history of mental illness" to refer to an individual, and when appropriate, indicate that the diagnosis has not been confirmed.

Conforms to AP style: The stylebook cautions against describing an individual as mentally ill unless clearly pertinent to a story and the diagnosis is properly sourced. Specific diagnoses should be used and the source of the diagnosis identified whenever possible. The stylebook also warns against drawing a connection between mental illness and violent crime and recommends that any source used to characterize a criminal suspect's mental health history should have the authority to speak on the matter. Finally, it cautions against "using mental health terms to describe non-health issues. Don't say that an awards show, for example, was "schizophrenic."

Mental health professional/shrink

Background: There are a number of types of mental health professionals. The following broad definitions are sourced from Psychology Today:

Psychiatrist: A mental health professional able to prescribe psychotropic medications. Some provide emotional therapy as well as medication management.

Psychoanalyst: A specific type of psychotherapist trained to work with both an individual's unconscious and unconscious mind. The field was founded by Sigmund Freud.

Psychologist: A mental health professional trained in the discipline of psychology and who often does psychological testing and research.

Psychotherapist: An umbrella term for mental health professionals trained to treat people for their health problems.

NCDJ Recommendation: Ask professionals how they should be identified, based on their formal training. Avoid using the word "shrink" in reference to a mental health professional except in a quote.

AP style: Not specifically addressed, but the style book refers to "mental health professional" in an entry on mental illness.

Mentally retarded

Background: The terms "mentally retarded," "retard" and "mental retardation" were once common terms that are now considered outdated and offensive. In 2010, President Barack Obama signed a measure known as " Rosa's Law " that replaced the term "mental retardation" with intellectual disability in many areas of government, including federal law.

From "My Heart Can't Even Believe It: A Story of Science, Love and Down Syndrome," (Amy Silverman, Woodbine House, 2016):

"The word retarded has a slang-free history. For a long time, it simply meant slow.

According to the Oxford English Dictionary, it's derived from the Italian word ritardato, and the first definition of the adjective version is 'held back or in check; hindered, impeded; delayed, deferred.'

It's traced to religion in 1636 ('he to his long retarded Wrath gives wings'); to medicine in 1785 ('Polypus, sometimes obstructs the vagina, and gives retarded labour'); and later to politics ('Arguably, the legacy of communism manifests itself most acutely in the retarded economic development of the east').

It also means 'characterized by deceleration or reduction in velocity,' as in a 1674 reference: 'When it hath passed ye vertex ye motion changeth its nature, & turneth from an equably accelerated into an equably retarded motion.'

Actual references to retarded intelligence did not come until the turn of the 20th century, with the advent of the IQ test. Then numbers were assigned to words - not just 'mentally retarded,' but also terms like imbecile, idiot and moron."

NCDJ Recommendation: Do not use the term retarded or other iterations. If you are going to use it in a quote, consider that decision carefully, as the word is particularly charged. Instead, always try to specify the type of disability being referenced. Otherwise, the term "intellectually disabled" is acceptable. Consider using people-first language, as in "a person with an intellectual disability" rather than "an intellectually disabled person." As always, ask the person which terms they prefer.

At times, words that are considered outdated may be appropriate because of the story's historical context. In those cases, attribute the term or note its historic use. For example, "The doctor said he was retarded, a term widely used at the time."

AP style: "Mentally retarded" should be avoided. The stylebook suggests using terms such as "mentally disabled," "intellectually disabled" and "developmentally disabled."
See also Intellectual disabilities/intellectually disabled
Midget

Mongoloid

Background: The term was commonly used in the late 19th century to refer to people who had Down syndrome, due to the similarity of some of the physical characteristics of the condition to Eastern Asian people, who were called Mongoloid, according to the Oxford English dictionary. It is considered highly derogatory to describe someone with Down syndrome as being "mongoloid."

NCDJ Recommendation: Avoid the use of "mongoloid" to refer to someone with Down syndrome. Even in the case of a direct quote, consider how offensive the term is and include the historical context if possible.

AP style: Not addressed

Multiple personality disorder
See entry on Dissociative identity disorder/multiple personality disorder
Muscular dystrophy (MD)

Background: Muscular dystrophy could refer to any of more than 30 genetic conditions characterized by progressive weakness and degeneration of the muscles that control movement, according to the National Institute of Neurological Disorders and Stroke. Onset could be in infancy, childhood, middle age or later.

NCDJ Recommendation: It is acceptable to describe a person as "someone with muscular dystrophy," followed by a short explanation of what the condition entails. Avoid saying a person "suffers from" or "is afflicted with" the disease. MD is acceptable on second reference.

Non-disabled

Background: "Non-disabled" refers to someone who does not have a disability. According to the University of Kansas Research & Training Center on Independent Living, "Non-disabled is the preferred term when the context calls for a comparison between people with and without disabilities. Use 'non-disabled' or 'people without disabilities' instead of healthy, able-bodied, normal or whole."

NCDJ Recommendation: "Non-disabled" or "does not have a disability" are acceptable terms when referring to people who do not identify as having a disability. In general, avoid using "able-bodied' except in a quote.

AP style: Not addressed

Neurodiversity

Background: The Oxford English Dictionary defines neurodiversity as "the range of differences in individual brain function and behavioral traits, regarded as part of the normal variation in the human population (used especially in the context of autism spectrum disorders)." The word was coined in the late 1990s.

Neurodiversity basically means that brains operate differently - and that's not a bad thing. There is an advocacy movement around this concept that argues against the idea that there is one 'normal' or 'healthy' type of brain or mind or one 'right' style of neurocognitive functioning.

"Neurotypical" refers to a person who is considered part of the normal variation in the human population.

It is important to note that some autism advocates do not like this term; it tends to be embraced by self advocates, but not as frequently by families of people with autism who also have intellectual disabilities and other challenges.

NCDJ Recommendation: " "Neurodiversity" can be used as a way of describing someone on the autism spectrum, but because it's a relatively new term, consider offering the definition when you use it, particularly in work meant for a mainstream audience. Remember that some in the autism community object to the term.

AP style: Not addressed

Nonspeaking/nonverbal

Background: Some disability advocates are beginning to shift away from the word "nonverbal" in favor of "nonspeaking," arguing that "nonverbal" implies that someone doesn't understand language, while "nonspeaking" does not invite the same judgment. A nonspeaking individual may understand and use language - just in a different way, such as through American Sign Language. The case for "nonspeaking" is outlined by the non-profit organization The Guild for Human Services.

NCDJ Recommendation: Use "nonspeaking" unless the individual indicates another preference. Keep in mind that it may not be relevant to include in a story how an individual communicates as long as the communication is clear.

AP style: Not addressed

Obsessive-compulsive disorder (OCD)

Background: Obsessive-compulsive disorder is characterized by unreasonable thoughts and fears that lead to repetitive and often ritualized behaviors or compulsions. OCD may present as a fear of contamination, disarray or intrusion, according to the Mayo Clinic. People with OCD usually exhibit both obsessions and compulsions but sometimes exhibit only one or the other. OCD is often treated with pharmaceutical drugs, psychotherapy methods, or a combination of the two.

NCDJ Recommendation: Refer to someone as having OCD only if the information is relevant to the story and you're confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Do not use OCD as an adjective for someone who obsesses over certain things but has not been formally diagnosed with the condition. Use "obsessive-compulsive disorder" on first reference if a medical diagnosis is available; OCD is acceptable in second reference.

AP style: Not addressed

Paraplegia/paraplegic

Background: Paraplegia is defined as the loss of movement in the lower extremities and torso. It is typically caused by a spinal cord or brain injury. Referring to someone as a "paraplegic" is offensive to some people as it implies that their condition defines them.

NCDJ Recommendation: Avoid referring to an individual as a paraplegic. Instead, say the person has paraplegia. Sometimes people with paraplegia refer to themselves as a "para." In those cases, use the word in quotes.

AP style: Not specifically addressed, but AP refers to paraplegia in its general disability entry.

Partial hearing loss/partially deaf

Background: "Hard of hearing" is the most common term for those who have a mild to moderate hearing loss that may or may not be corrected with amplification.

NCDJ Recommendation: Ask your sources what term they prefer. Otherwise, "hard of hearing" is almost always acceptable.

AP style: The stylebook recommends using "partial hearing loss" or "partially deaf" for those who have some hearing loss.
See also Deaf; Cochlear implant and Hard of hearing
Patient/sick

Background: Members of the disability community argue that characterizing people with a disability as "sick" or referring to them as "patients" signals there is something unwell about them or that they are in need of medical attention, when, in fact, that is often not the case.

NCDJ Recommendation: Avoid referring to someone with a disability as "sick" or to their disability as a "sickness." If a person is receiving medical treatment, then the word "patient" is appropriate; however, it should be avoided outside of a medical context.

People-first language

Background: People-first language avoids defining people in terms of their disability. In most cases, this entails placing the reference to the disability after the reference to a person, as in "a person with a disability," or "a person living with a disability," rather than "the disabled person."

People-first language is not preferred by all people with disabilities. Specifically, some members of the autism and Deaf communities prefer identity-first language.

NCDJ Recommendation: Ask the person with a disability how they prefer to be described; if that's not possible, ask a spokesperson for the organization representing the relevant disability for preferred terminology.
Conforms to AP style See also Identity-first language
Plain English

Background: The Center for Inclusive Design defines Plain English as "a direct style of writing for people who can read at a reasonable level. It helps people who want to read and understand information quickly. Plain English is sometimes known as plain language or Everyday English. Plain English looks and sounds like standard forms of writing." Another version, Easy English, aims at a lower reading level with short sentences often accompanied by pictures.

NCDJ Recommendation: Use Plain English or Plain Language but confirm with the source that that is the correct terminology. It might be Easy English.

AP style: Not addressed

Post-traumatic stress disorder (PTSD)

Background: Post-traumatic stress disorder is an anxiety disorder usually caused by an extremely emotional traumatic event. Such events may include assault, war, sexual assault, natural disasters, car accidents or imprisonment. Symptoms may include reliving the traumatic event, avoidance of certain behaviors, negative emotions, or physical symptoms such as dizziness or nausea.

NCDJ Recommendation: Refer to someone as having PTSD only if the information is relevant to the story and you're confident there is a medical diagnosis. "Post-traumatic stress disorder" is correct on first reference; use PTSD on second reference. The term "flashback" may be used to denote reliving an event that triggered the PTSD.

AP style: PTSD is acceptable on either first or second reference but should be spelled out at least one time. Many medical organizations do not use a hyphen when spelling "posttraumatic;" however the AP does.

Prelingually deaf/postlingually deaf/late-deafened

Background: "Prelingually deaf" refers to individuals who were born deaf or became deaf prior to learning to understand and speak a language, according to Gallaudet University, a university for the education of the deaf and hard of hearing in Washington, D.C. "Postlingually deaf" or "late-deafened" describes people who lost their hearing ability after they learned to speak a language.

NCDJ Recommendation: All the terms are acceptable, although, because they are not widely used, an explanation is required for a general audience.

AP style: Not addressed

Psychotic/psychosis

Background: Psychosis is a broad term used to describe symptoms of certain mental health problems that include delusions or hallucinations or other loss of contact with reality. People with psychosis are described as psychotic. In common usage, "psychotic" often is used in the same way as the word "crazy," and thus can be offensive and inaccurate.

NCDJ Recommendation: Use the words "psychotic" and "psychosis" only when they accurately describe a medical experience. Avoid using "psychotic" as an adjective to describe a person; instead refer to a person as "having a psychotic condition" or "experiencing a psychosis." Avoid using the terms colloquially.

AP style: Not directly addressed, although the style book recommends avoiding using disability-related words lightly or in unrelated situations.

Quadriplegia/quadriplegic

Background: Quadriplegia is defined as the paralysis of all four limbs as well as the torso. It often is caused by a spinal cord or brain injury and is characterized by the loss of sensory and motor function. People with these conditions often are referred to as "quadriplegics" and "paraplegics," but these terms are considered offensive by some. "Tetraplegia" is used interchangeably with "quadriplegia."

NCDJ Recommendation: Ask people how they would like to be described. Many prefer people-first language, such as "a person with quadriplegia" rather than "quadriplegic," since the latter implies that the condition defines them. Sometimes people with quadriplegia refer to themselves as "quads." In these cases, use in quotes.

AP style: Not addressed

Retarded

Schizophrenia/schizophrenic

Background: Schizophrenia is a serious chronic mental illness characterized by distorted recognition and interpretations of reality, affecting how an individual thinks, feels and acts, according to the National Institute of Mental Health.Common symptoms include visual and auditory hallucinations, delusional and disordered thinking, unresponsiveness, and a lack of pleasure in daily life and other social issues. It does not involve split personalities. Less than one percent of the general population has schizophrenia, and it is treated mostly through the use of pharmaceutical drugs.

NCDJ Recommendation: Refer to someone as having schizophrenia only if the information is relevant to the story and you're confident there is a medical diagnosis. If a medical diagnosis is not available, use quotes around the term and indicate that a diagnosis has not been confirmed. Many people prefer people-first language, such as "a person with schizophrenia" or "a person diagnosed with schizophrenia" rather than a "schizophrenic" or "a schizophrenic person." Do not use the word "schizophrenic" colloquially as a synonym for something inconsistent or contradictory.

AP style: Schizophrenia is classified as a mental illness. The stylebook cautions against using mental health terms to describe non-health issues. Don't say that an awards show, for example, was "schizophrenic."

Seizure

Background: According to the Mayo Clinic: "A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a tendency to have recurrent seizures, you have epilepsy. There are many types of seizures, which range in severity. Seizure types vary by where and how they begin in the brain. Most seizures last from 30 seconds to two minutes. A seizure that lasts longer than five minutes is a medical emergency. Seizures are more common than you might think. Seizures can happen after a stroke, a closed head injury, an infection such as meningitis or another illness. Many times, though, the cause of a seizure is unknown."

NCDJ Recommendation: Do not say someone has had a seizure unless there has been a medical diagnosis. If a medical diagnosis is not available, use quotes around the word and indicate that a diagnosis has not been confirmed. Do not assume that a person who has had a seizure has epilepsy.

AP style: Not addressed
See also Epilepsy/epileptic/epileptic fit
Service animal/assistance animal/guide dog/Seeing Eye dog

NCDJ Recommendation: The terms "service animal,"" assistance animal" and "guide dog" all are acceptable. Avoid use of "Seeing Eye dog" as Seeing Eye is a registered trademark of The Seeing Eye school in Morristown, N.J. Be aware that licensure and/or certification of service animals is a contentious issue in the disability community, so it may be best to refer to the federal definition.

AP style: Although there is no entry for service animal, the style book takes note of the Seeing Eye dog trademark and says "guide dog" is preferred in all references.

Short stature
See entry on Dwarf, little person/midget/short stature
Spastic/spaz
See entry on Cerebral palsy
Special/special needs/functional needs

Background: The term "special needs" was popularized in the U.S. in the early 20th century during a push for special needs education to serve people with all kinds of disabilities. The word "special" in relationship to those with disabilities is now widely considered offensive because it euphemistically stigmatizes that which is different.

The term "special education" is still widely used when referring to public school programs, although some government entities use titles like "exceptional student services."

NCDJ Recommendation: Avoid using these terms when describing a person with a disability or the programs designed to serve them, with the exception of government references or formal names of organizations and programs. It is more accurate to cite the specific disability or disabilities in question. The term "functional needs" is preferred when a term is required. For example, "addressing the functional needs of people with disabilities" could be used when referring to a facility or program.

Don't use the term "SPED" as shorthand for special education. It's considered offensive.

AP style: The style book urges avoidance of the term "special education" and suggests trying to be specific about the needs or services in question.

Speech impediment/Speech disorder

Background: These phrases refer to a condition in which the mouth, jaw, tongue and vocal tract do not work together to produce recognizable words. Manifestations may include stuttering, articulation errors or an inability to move the tongue (commonly referred to as tongue-tied). While "speech impediment" and "speech disorder" are still widely used within the medical community, many consider the terms offensive because they describe the conditions in terms of a deficiency.

NCDJ Recommendation: Consider using "speech disability" instead of "impediment," "disorder" or "impairment."

AP style: Not addressed

Spina bifida

NCDJ Recommendation: It is acceptable to describe a person as "someone with spina bifida," followed by a short explanation of what their condition entails if it is pertinent to the story.

AP style: Not addressed

Stuttering/stammering

Background: Stuttering is a a neurobiological condition that is characterized by interruptions in speech. There is some ambiguity about the difference between stuttering and stammering and which term is appropriate in different contexts. However, organizations such as the National Institute on Deafness and Other Communication Disorders, the Mayo Clinic and the National Stuttering Association generally use the term "stuttering" to refer to the speech condition. The Diagnostic and Statistical Manual of Mental Disorders debuted the new term "childhood-onset fluency disorder" to refer to stuttering, along with a few new criteria for its diagnosis. However, this term is not widely used.

NCDJ Recommendation: The word "stuttering" is preferred over "stammering." While people-first language is generally preferred ("a person who stutters"), some individuals may prefer "stutterer." When possible, ask. Avoid "childhood-onset fluency disorder" without explanation.

AP style: Not addressed

Suffers from/victim of/afflicted with/stricken with

Background: These terms carry the assumption that a person with a disability is suffering or has a reduced quality of life. Not every person with a disability suffers, is a victim or is stricken.

When renowned scientist Stephen Hawking died in 2018, media accounts referred to him as "finally free" of the wheelchair he used for decades. The references angered disability rights advocates, who argued that Hawking achieved remarkable success while using a wheelchair and a computerized voice system, not despite those devices.

NCDJ Recommendation: It is preferable to use neutral language when describing a person who has a disability, simply stating the facts about the nature of the disability. For example: "He has muscular dystrophy," and avoiding characterizing those conditions as afflictions.

Conforms to AP style that suggests avoiding "descriptions that connote pity."

Suicide

Background: The World Health Organization recommends avoiding language that sensationalizes or normalizes suicide or presents it as a solution to problems. For example, the terms "failed attempt" or "successful" or "completed attempt" depict suicide as a goal, project or solution. Some argue that the term "commit" implies that suicide is a criminal act, while others view the term "commit" as neutral.

NCDJ Recommendation: The NCDJ endorses The Associated Press style, below.

AP style: Avoid using "committed suicide" except in direct quotations from authorities. Alternate phrases include "killed himself," "took her own life" or "died by suicide." The verb "commit" with "suicide" can imply a criminal act. Laws against suicide have been repealed in the U.S. and many other places. Do not refer to an "unsuccessful suicide attempt." Refer instead to an "attempted suicide."

"Medically assisted suicide" is permitted in some states and countries. Advocacy groups call it "death with dignity" or "right-to-die," but AP does use those phrases on their own. When referring to the legislation whose name includes "death with dignity," "right-to-die" or similar terms, say the law or proposal allows 'the terminally ill to end their own lives.' If the term is in the name of a bill or law, make that clear. 'Euthanasia' should not be used to describe 'medically assisted suicide' or 'physician-assisted suicide'." The AP also suggests using resources from www.reportingonsuicide.org.

Survivor/battle

Background: Some use the term "survivor" to affirm their recovery from or conquest of an adverse health condition. Common usages include "cancer survivor," "burn survivor," "brain injury survivor" or "stroke survivor." However, the terms are disliked by some because they imply that those who die simply did not fight hard enough. For similar reasons, there is disagreement about characterizing disease or illness as a "battle," as in "to battle cancer." These arguments surfaced after U.S. Senator John McCain died in the summer of 2018.

NCDJ Recommendation: Terms such as "battle" and "survivor" are still widely accepted and understood, but the user should be aware that they could offend some people.

AP style: The style book suggests using the term "survivor" with care because it can be imprecise, among other reasons.

Tetraplegia/tetraplegic

Background: Tetraplegia, used interchangeably with quadriplegia, is defined as the paralysis of all four limbs as well as the torso. It often is caused by a spinal cord or brain injury and is characterized by the loss of sensory and motor function. Paraplegia is similar but does not affect the arms. People with these conditions often are referred to as "quadriplegics" and "paraplegics," but these terms are considered offensive by some.

NCDJ Recommendation: Many people prefer people-first language, such as "a person with tetraplegia" rather than "tetraplegic," since this implies that the condition defines them.

AP style: Not addressed

Triggers/Content Warnings

Background: Psychological triggers are words, images or sounds that activate phobias, panic attacks or flashbacks to unpleasant events or trauma. The concept of triggering originated with early psychoanalytical diagnoses of posttraumatic stress disorder, called "war neuroses," in WWI veterans. News reports covering sensitive topics, such as abuse, assault, addiction, suicide, combat and violence, frequently contain descriptive scenarios that can deeply effect audiences. Some content can spark difficult memories for people with certain mental illnesses and phobias. Trigger warnings communicate that upcoming content may produce unpredictable and unwelcome reactions for some readers. They give audiences a choice on whether or not to proceed with consuming the information. However, some readers object to trigger warnings and view them as patronizing and stifling to academic freedom.

NCDJ Recommendation: If you're an educator, consider alerting students ahead of time if content contains graphic descriptions of traumatic events. Journalists also may want to include such warnings in material distributed to a general audience. Triggers can be hard to predict, and they vary from individual to individual, but communicating the nature of your content builds audience trust. Refrain from using the term "trigger warning" in a flip or casual way.

AP Style: The style book suggests a content warning at the top of stories when the subject matter may be considered offensive or disturbing, but the story does not contain quoted profanity, obscenities or vulgarities. For example: "Eds: Graphic details of the killings could be offensive or disturbing to some readers."

Tourette syndrome/Tourette's syndrome

While those with Tourette syndrome often can suppress tics by focusing on them, the condition also can be treated with medication, relaxation techniques and therapy. Although involuntary cursing is commonly thought to be a key trait of the disability, only a minority of those with Tourette syndrome exhibit this symptom.

Terminology for the condition is varied. It is interchangeably referred to as "Tourette syndrome," "Tourette's syndrome" and "Tourette's disorder." However, prominent mental health organizations such as the Mayo Clinic, the Centers for Disease Control and Prevention, and the Tourette Syndrome Association, refer to it as "Tourette syndrome."

NCDJ Recommendation: Use "Tourette syndrome" with no possessive or capitalization of "syndrome." Refer to someone as "having Tourette syndrome" only if the information is relevant to the story and if you're confident there has been a medical diagnosis. Many people prefer people-first language, such as "a person with Tourette syndrome" or "a person diagnosed with Tourette syndrome." Avoid the acronym TS, as it is not widely known.

AP style: The AP merely defines Tourette Syndrome as, "A neurological disorder characterized by involuntary, repetitive movements and vocalizations."

Treatment/treatment center/rehab center/detox center

Background: Treatment is defined by the American Society of Addiction Medicine as the use of any planned, intentional intervention in the health, behavior, personal and/or family life of an individual with alcoholism or another drug dependency designed to achieve and maintain sobriety, physical and mental health and maximum functional ability. A treatment center is an establishment usually run by psychiatric or medical professionals.

NCDJ Recommendation: "Treatment" is an acceptable term for medical interventions, and "treatment center" is acceptable for the establishment in which such practices take place. Use "treatment center" in place of "rehab" or "detox" center. A person enrolled in a treatment center should be referred to as a patient.

Vegetative state/vegetable/comatose/non-responsive

Background: The Merck Manual ddefines vegetative state as the absence of responsiveness or consciousness in which patients show no awareness of their environment. Patients may exhibit eye movements and other involuntary movements. A minimally conscious state is one in which a patient has some awareness of self and/or the environment.

NCDJ Recommendation: It is preferable to use a medical professional's diagnosis or, if that is not possible, terms such as "comatose" or "non-responsive." Avoid referring to someone as "a vegetable" or "veg" as such words dehumanize the person. The term "vegetative state" is preferable to "vegetable" or "veg," but it is considered offensive by some and is frequently misused.

Wheelchair/wheelchair-bound/confined to a wheelchair

Background: People who use mobility equipment such as a wheelchair, scooter or cane consider the equipment part of their personal space, according to the United Spinal Association. People who use wheelchairs have widely different disabilities and varying abilities.

NCDJ Recommendation: It is acceptable to describe a person as "someone who uses a wheelchair," followed by an explanation of why the equipment is required. Avoid "confined to a wheelchair" or "wheelchair-bound" as these terms describe a person only in relationship to a piece of equipment. The terms also are misleading, as wheelchairs can liberate people, allowing them to move about, and they are inaccurate, as people who use wheelchairs are not permanently confined to them but are transferred to sleep, sit in chairs, drive cars, etc.
Conforms to AP style

# data[].attributes.attachment_link.title
National Center on Disability and Journalism

# data[].attributes.attachment_link.description
As language, perceptions and social norms change rapidly, it is becoming increasingly difficult for journalists and other communicators to figure out how to refer to people with disabilities. Even the term "disability" is not universally accepted. This style guide, which covers dozens of words and terms commonly used when referring to disability, can help.

# data[].attributes.body
Watch these fun short videos about language!

# data[].attributes.attachment_link.description
Comma Queen - Mary Norris on language in all its facets.

# data[].attributes.headline
What are personal pronouns and why do they matter?

# data[].attributes.subject
What are personal pronouns and why do they matter?

# data[].attributes.attachment_link.title
Pronouns.org Resources on Personal Pronouns

# data[].attributes.attachment_link.readable_text
Have you ever read something that you knew was incorrect? Sometimes, research has fallen short of convincing people who know better, even though other readers might not notice anything wrong. For those who know, it can be jarring and pull them out of the story. How would you feel if that error was about your life? Your personal history? Your family's history? Or something intrinsic to who you are?

Sensitivity readers exist as a consultancy resource to offer an authentic perspective regarding how marginalization affects characters, settings, and worldbuilding, and to provide feedback that an author can accept, reject, or question. That feedback can include, but is not limited to, problematic tropes, stereotypes, inaccuracies, and offensive portrayals. Utilizing this feedback, authors improve the representation so that readers who live these experiences can avoid harm and enjoy their books.
The controversy
Books have been recruited into the ongoing culture war that we're seeing across our society with lurid headlines about Roald Dahl or the James Bond books "being forced" to change. Often, when an author has negative feedback or a book is delayed or withdrawn, the sensitivity readers are blamed.

Sensitivity reading is seen as new, controversial, and headline-grabbing. Changing anything is presented as "woke," snowflake modern sensibilities. However, this practice has been employed for as long as books have been printed. Some great examples include Agatha Christie's And Then There Were None, the Bowdlerized version of Shakespeare, or how Grimm and Anderson fairy tales are softened for younger children.

Charlie and the Chocolate Factory 's Oompa-Loompas were originally pygmies Willy Wonka imported from "the deepest and darkest part of the African jungle." Ten years later, Dahl updated them as having "golden-brown hair" and "rosy-white skin," and Africa became Loompa-land. Dahl was happy to edit his own work. So was Dickens, with another book considered a classic. Dickens went back and removed over two hundred references to anti-Semitism of the Fagin character in after criticism from a Jewish reader.

Stories with positive outcomes exist in modern reporting despite the media's tendency to focus on authors who are less receptive. Recently, Irvine Welsh spoke candidly about when he'd written trans characters, and thought using sensitivity readers would be akin to censorship. However, Welsh said his sensitivity reader had wanted to make the book "as authentic as possible and was incredibly supportive. And it did help to make the book better."

Joanne Harris, Chair for the Society of Authors, also made a great point when she tweeted: "If you don't want to use a sensitivity reader, don't use one. But if you've never used one, then maybe you're not the person most qualified to talk about what sensitivity readers actually do."
The process
What sensitivity readers look for depends on their specialty and the manuscript itself. Topics could include race, LGBTQIA+ experiences, disability, and other marginalizations. While what we're looking for varies, we all look for authenticity. We read through the manuscript, searching for instances of stereotyping, bias, or harmful tropes, and providing cultural, personal, or community-related context to all aspects relevant to our read.

As a biracial British Indian second-generation immigrant, my area of expertise includes my identity, race relations in the UK, especially for the Indian/Desi diasporas, UK anti-immigration politics, Brexit, etc., through to India under the Raj, for both factual or fictional books. I can help with general racism, but I would always recommend finding a closer fit where possible.

With most fiction or non-fiction books, my sensitivity read is completed at the end of the editing process, before or during copy edits. I'll be given the full manuscript to review or a selection of scenes. Picture books, however, require feedback for the very early script and work-in-progress art stage. A second review of the final art and copy will often be completed.

When reading, I'm working from my personal lived experience, from training, and any background research required, if it's a particular time period, for example. If it's authentic, I'll give it a thumbs up and explain why; if it's not, I will give suggestions on how to improve the authenticity. These suggestions might be in-line text or links to further resources where they can find more information.

I take note of initial impressions by using Track Changes in MS Word or comments on a PDF; then, on a second read, I'll review how those impressions played out. Were people deliberately using stereotypes in order to subvert them later, or was it an accidental problem that needs fixing? I point out good representation, not only the negatives, and try to recommend details that help the story ring true.

The report ties back to a page number or a reference, so the author knows exactly what the comment refers to. If it is an overall issue, I'll clarify why they must change something fundamental about the narrative.
Industry uptake
While there is no formal data on the use of sensitivity readers, I have noted an increase in requests and new clients. I worked with ten different publishers in 2021, thirteen in 2022, and sixteen in 2023. There was a similar proportional increase of requests from independent authors. My sensitivity reading peers have also noticed an upward trend, especially from publishers.

Many reads are one-off projects, but I have been working with some publishers since 2020, and I know of at least one publisher who uses readers for every book they release.

Bloomsbury, Bonnier, and Quarto told The Bookseller they had employed sensitivity readers as it was "important in inclusive, forward-thinking publishing."
Why do it
Creating characters that reflect the world's diversity is important for writers and readers. However, it's essential to create that representation authentically. Consider why you're adding characters different from yourself, and how you will feel if you get aspects wrong. Consider asking for feedback to create your best character rather than worrying about possible bad reviews or social media pile-ons.
Conclusion
Sensitivity readers have taken the brunt of the media backlash despite having none of the power. We're freelancers who offer advice and are usually unaware of whether or not this feedback will be utilized. But it's up to the authors to make any suggested changes.

Authors are going to get it wrong sometimes. The only thing we can all do is write the best, most complex, well-rounded characters we can and be open to feedback if change is necessary.
Author Bio
Georgina Kamsika is a speculative fiction writer born in Yorkshire, England, to Anglo-Indian immigrant parents and has spent most of her life explaining her English first name, Polish surname, and South Asian features. She is a graduate of the Clarion West Writers Workshop 2012 where her first novel, Goddess of the North , started life as a short story. She began sensitivity reading in 2017, and has read for all major publishers and a number of imprints and smaller publishers.

# data[].attributes.attachment_link.description
Have you ever read something that you knew was incorrect? Sometimes, research has fallen short of convincing people who know better, even though other readers might not notice anything wrong.

# data[].attributes.headline
Fact: Many checks exist to ensure that voting machines accurately count ballots. Rumor: Voting machines are routinely hacked to change election results.

# data[].attributes.subject
Fact: Many checks exist to ensure that voting machines accurately count ballots. Rumor: Voting machines are routinely hacked to change election results.

# data[].attributes.attachment_link.readable_text
View the entire Election Rumors in 2024 series

Fact:Many checks exist to ensure that voting machines accurately count ballots.

Election officials know that there is no such thing as an invulnerable technological system, which is why they deploy a series of safeguards and checks to ensure an accurate count. While each state's procedures are different, these are among the most common: voting machines are certified to federal and state security standards before being deployed, they are tested before voters cast their ballots to make sure they are working properly, and they are audited again after elections to confirm they correctly counted ballots and produced an accurate total. Importantly, 99 percent of voters live in jurisdictions where they can cast a ballot with a paper record of their vote, which can be used to confirm the electronic total is correct.

Rumor:Voting machines are routinely hacked to change election results.

Conspiracy theories about hacked voting machines have proliferated since the 2020 presidential election. Election deniers have pushed for jurisdictions to abandon voting machines altogether and hand-count all ballots despite evidence showing that this method leads to longer, more costly, and less accurate vote counts. Genuine security concerns about voting machines have also contributed to this narrative, with opportunistic political actors using the possibility of vulnerabilities in election technology (as is the case with any technology) to claim, without evidence, that voting machines have been exploited to alter election results. A challenge to the use of voting machines in Georgia has revived this rumor in recent weeks. Unfortunately, many of the related soundbites and social media posts lack context about the security measures that are in place to prevent, catch, and recover from any incursions into or failures of voting systems.

* * *

We worked with Swayable, a research software platform that measures how effectively media content changes opinions, to determine what messages helped voters best understand the facts.

Suggested counter-message based on our testing:

Election officials audit voting machines at every step to make sure votes are recorded correctly, and they maintain a ballot chain of custody. We would know if voting machines were hacked.

The message above was found to be most effective in communicating the facts, though differences exist by region and demographic group. See Swayable's dashboard to examine more detailed results, including other messages tested.

# data[].attributes.attachment_link.description
Many checks exist to ensure that voting machines count ballots correctly and produce accurate election results.

# data[].attributes.attachment_link.readable_text
Working with partners including Alliance for Securing Democracy, Atlantic Council, Drive Agency, Junkipedia, Meedan, Onyx Impact, and University of Washington's Center for an Informed Public, we are tracking election-related rumors. See monthly assessments below that identify dominant rumors and corresponding clarifications that help audiences to understand the best available information.

# data[].attributes.attachment_link.description
The Brennan Center is tracking rumors about voting and election administration to help provide accurate information to better inform voters.

# data[].attributes.headline
Write Consciously: Visit Karen Yin's website to access Writer Things.  

# data[].attributes.subject
Write Consciously: Visit Karen Yin's website to access Writer Things.  

# data[].attributes.attachment_link.description
Online tools and resources that I think I'll need someday.

# data[].attributes.headline
Brainstorm: What question do you want to answer?

# data[].attributes.subject
Brainstorm: What question do you want to answer?

# data[].attributes.attachment_link.title
How to Write a Research Paper for Kids Episode 1: Brainstorming Topics

# data[].attributes.body
Get better, and more precise results from a keyword search by using quotation marks, the minus sign (-), and the domain (.gov, .edu, .org)
Play the Google game:
Step 1: search the keyword honeybee and count the results
Step 2: search the keyword "honeybee" site:edu and count the results
Step 3: search the keyword "honeybeelifespan" site:edu and count the results.

What a difference! Use quotation marks and domains to get more precise results. Use your topic as your keywords.

# data[].attributes.body
Authority means the author is trustworthy!
Once you find a resource, investigate the author. Does this author have credibility? Verify the reputation of the author by doing a Google search with the author's name. If you can't find an author's name on a website or blog (look at the top or bottom of the article), it is likely a red flag!

# data[].attributes.body
Databases contain information from published works such as scholarly articles, encyclopedias, reference books, magazines, and newspapers. Library databases provide citation information including author, the title of the work, publisher, and date of the publication. Lastly, databases are less work! The sources are vetted (credible) and save you time.

# data[].attributes.attachment_link.description
Sign in with your credentials to access the EBSCOhost premium information resources provided by your subscribing institution.

# data[].attributes.headline
Databases by Subject: Science Reference Center

# data[].attributes.subject
Databases by Subject: Science Reference Center

# data[].attributes.body
Use the EBSCO Science Reference database to search for
information about bees or any other science topic!

# data[].attributes.headline
Find out: Is your information true or false?

# data[].attributes.subject
Find out: Is your information true or false?

# data[].attributes.body
1. Who is behind this information?
2. What is the evidence for their claims?
3. What do other sources say about this information?

# data[].attributes.attachment_link.readable_text
This page is brought to you by the OWL at Purdue University. When printing this page, you must include the entire legal notice.

Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission. Use of this site constitutes acceptance of our terms and conditions of fair use.

The Online Writing Lab at Purdue University houses writing resources and instructional material, and we provide these as a free service of the Writing Lab at Purdue. Students, members of the community, and users worldwide will find information to assist with many writing projects. Teachers and trainers may use this material for in-class and out-of-class instruction.

Mission

The Purdue On-Campus Writing Lab and Purdue Online Writing Lab assist clients in their development as writers-no matter what their skill level-with on-campus consultations, online participation, and community engagement. The Purdue Writing Lab serves the Purdue, West Lafayette, campus and coordinates with local literacy initiatives. The Purdue OWL offers global support through online reference materials and services.

A Message From the Assistant Director of Content Development

The Purdue OWL® is committed to supporting students, instructors, and writers by offering a wide range of resources that are developed and revised with them in mind. To do this, the OWL team is always exploring possibilties for a better design, allowing accessibility and user experience to guide our process. As the OWL undergoes some changes, we welcome your feedback and suggestions by email at any time.

Please don't hesitate to contact us via our contact page if you have any questions or comments.

All the best,

Garrett

Social Media

# data[].attributes.attachment_link.title
Welcome to the Purdue Online Writing Lab

# data[].attributes.attachment_link.description
This page is brought to you by the OWL at Purdue University. When printing this page, you must include the entire legal notice. Copyright ©1995-2018 by The Writing Lab & The OWL at Purdue and Purdue University. All rights reserved. This material may not be published, reproduced, broadcast, rewritten, or redistributed without permission.

# data[].attributes.attachment_link.description
© 2007, The Copyright Society of the U.S.A. All rights reserved.

# data[].attributes.body
"What is Wikimedia Commons? Wikimedia Commons is a media file repository making available public domain and freely licensed educational media content (images, sound and video clips) to everyone, in their own language.

# data[].attributes.headline
Creative Commons: Use Creative Works Legally

# data[].attributes.subject
Creative Commons: Use Creative Works Legally

# data[].attributes.body
Before you share someone's creation or work, you need permission or license to use it and share it.  Search here for openly licensed images or works for a research project.